Source: National Health Interview Survey, 2015
Source: National Health Interview Survey, 2015
Questions for Tina Norris, Ph.D., Health Statistician and Lead Author of “Early Release of Selected Estimates Based on Data From the January – March 2017 National Health Interview Survey.”
Q: Were there any findings that surprised you in this early release report?
TN: It is hard to say with quarter 1 findings that anything is truly “surprising” because estimates are based on a smaller sample sizes and could fluctuate a bit before settling down by the time we have a full year’s worth of data to analyze.
Q: Are there any trends in this report that Americans should be concerned about?
TN: Obesity is an epidemic that has seen a steady increase since 1997 and now affects just under one third (32.0%) of U.S. adults.
Q: Can you define what the health measure “usual place to go for medical care” means?
TN: Having a “usual place to go for medical care” is based on the question, “Is there a place that you usually go to when you are sick or need advice about your health?” If there was at least one such place, then a follow-up question was asked: “What kind of place [is it/do you go to most often]—a clinic, doctor’s office, emergency room, or some other place?” Adults who indicated that the emergency room was their usual place for care were considered not to have a usual place for health care.
Q: What do the findings in this report tell us about access to healthcare?
TN: Since 2010, the percentage of uninsured persons has decreased by almost 50% (16.0% vs 8.8%), and the percentage of persons who had a usual place to go for medical care increased from 85.4% in 2010, to 88.8% in January–March 2017. These two indicators demonstrate increased access to healthcare from 2010 through the first quarter of 2017.
Q: How do you collect your data for these surveys?
TN: The data is collected by household interview surveys that are fielded continuously throughout the year by the National Center for Health Statistics (NCHS). Interviews are conducted in respondents’ homes. Health and socio-demographic information is collected on each member of all families residing within a sampled household. Within each family, additional information is collected from one randomly selected adult (the “sample adult”) aged 18 years or older and one randomly selected child (the “sample child”) aged 17 years or younger. NHIS data is collected at one point in time so we cannot determine causation. Data presented in this report are quarterly data and are preliminary.
Questions for Anjel Vahratian, Ph.D., Author of “Sleep Duration and Quality Among Women Aged 40-59, by Menopausal Status”
Q: What made you decide to conduct this study on sleep duration and sleep quality for this group of women?
AV: My research focuses on the health of women as they age and transition from the childbearing period. During this time, women may be at increased risk for chronic health conditions such as diabetes and cardiovascular disease. As insufficient sleep is a modifiable behavior that is associated with these chronic health conditions, I wanted to examine how sleep duration and quality varies by menopausal status.
Q: Was there a finding in your new study that surprised you, and if so, why?
AV: I was surprised to learn that nearly one in two women aged 40-59 did not wake up feeling well rested four times or more in the past week and that postmenopausal women aged 40-59 were more likely to experience disruptions in sleep quality compared with premenopausal women in the same age group.
Q: How did the women from your survey track their sleep behavior; for example, did they use a wearable sleep tracker?
AV: In this report, information on sleep duration and quality are based on self-report. Trained interviewers asked survey participants on average, how many hours of sleep did they get in a 24-hour period. In addition, they asked participants to recall how many times they had problems falling asleep and staying asleep and how many days they woke up not feeling well rested in the past week.
Q: In addition to menopausal status, do you have any other lifestyle information that could impact women’s sleep quality for this age group; for example, shift work employment or having infants or very young children in the home?
AV: While this report did not specifically look at other lifestyle factors that could affect women’s sleep duration and quality – other than age and menopausal status — my colleagues released a report in January 2016 on sleep duration and quality by sex and family type. This report looked at the presence of young children in the household. In addition, we have produced estimates of sleep duration and quality across several sociodemographic characteristics such as race and ethnicity, education, poverty status, marital status, and region.
Q: This report seems to offer just a single year of data – 2015; do you have any trend data to compare these findings to previous years, or any newer data?
AV: Unfortunately, we do not have any long-term trend data on sleep duration and quality among women aged 40-59 by menopausal status. The National Health Interview Survey, or NHIS, has included questions on sleep duration and quality since 2013, while the questions on menopausal status were a part of the 2015 NHIS cancer control supplement.
Q: What is the take-home message from this report?
AV: I think the real take-home message of this report is that sleep is critical for optimal health and wellbeing, and it is a modifiable risk factor for diabetes and cardiovascular disease. As sleep duration and quality vary by menopausal status, it is an area for targeted health promotion for women at midlife.
Questions for Robin Cohen, Ph.D., Health Statistician and Lead Author on “Health Insurance Coverage: Estimates from the National Health Interview Survey, January-March 2017”
Q: What do you think is the most interesting demographic finding among your new study’s short-term trends – age, poverty status, or race and ethnicity?
RC: There are many interesting short-term trends presented in this report, though I would like to highlight the three that I find most interesting. Among poor adults aged 18 to 64, the percentage who were uninsured decreased from 42.2% in 2010 to 22.6% in the first 3 months of 2017. A similar decrease in the percentage of uninsured was seen for near poor adults aged 18 to 64, from 43.0% in 2010 to 23.0% in the first 3 months of 2017. Hispanic adults aged 18 to 64 had the greatest percentage point decrease in the uninsured rate from 2013 (40.6%) through the first 3 months of 2017 (24.1%).
Q: What is the most compelling long-term trend in your new health insurance report?
RC: It is quite striking and encouraging to see long-term improvements in health insurance coverage for children in the United States. The percentage of children who were uninsured generally decreased from 13.9% in 1997 to 5.3% in the first 3 months of 2017. The observed increase in the percentage of uninsured children from 4.5% in 2015 to 5.3% in the first 3 months of 2017 was not statistically significant. From 1997 to 2012, the percentage of children with private coverage has generally decreased, and the percentage of children with public coverage has generally increased. However, more recently, the percentage of children with public or private coverage has leveled off.
Q: Why aren’t state estimates presented?
RC: State level estimates of insurance coverage are not presented in the Early Release report based on the first 3 months of data from the National Health Interview Survey due to considerations of sample size and precision. However, state level estimates are included in the Health Insurance Early Release report three times a year, with the report based on 6 months of data, 9 months of data and a full year of data.
Q: It looks as though coverage through high-deductible private health insurance plans continues to rise in 2017; what patterns do your estimates show this year compared to previous years?
RC: In the first 3 months of 2017, 42.3% of persons under age 65 with private health insurance coverage were enrolled in a high-deductible health plan (HDHP), an increase from 39.4% in 2016. The percentage of persons enrolled in an HDHP increased 17 percentage points from 25.3% in 2010 to 42.3% in the first 3 months of 2017.
Q: What is the take home message from this report?
RC: I think the real take-home message from this report is the long-term trend of remarkable improvement in the number of uninsured Americans. In the first 3 months of 2017, 28.1 (8.8%) million persons of all ages were uninsured at the time of interview —20.5 million fewer persons than in 2010 (16.0%). However, there was no significant change from the 2016 uninsured rate of 9.0% (28.6 million).
Questions for Carla Zelaya, Survey Statistician and Lead Author on “Health Care Access and Utilization among Native Hawaiians and Pacific Islanders Persons in the United States, 2014”
Q: What did your report find on health care access for the Native Hawaiian and Pacific Islander (NHPI) population?
CZ: Some of the main highlights of the report were NHPI adults were more likely to be insured, have public health coverage, have a usual place of care and a flu vaccination in the past 12 months compared with all U.S. adults. However, NHPI adults were also less likely to have private insurance, and those aged 65 and over were less likely to have ever received a pneumococcal vaccination compared with all U.S. adults.
Q: Is this the first published health data on NHPI population?
CZ: The Native Hawaiian and Pacific Islander National Health Interview Survey (NHPI NHIS), is the first federal survey designed exclusively to measure the health of the civilian non-institutionalized NHPI population of the United States. It was conducted by NCHS, and this is the third report published from the survey.
The first two reports are:
Citation #1: Galinsky AM, Zelaya CE, Simile C, Barnes PM. Health conditions and behaviors of Native Hawaiian and Pacific Islander persons in the United States, 2014. National Center for Health Statistics. Vital Health Stat 3(40). 2017.
Citation #2: Galinsky AM, Zelaya CE, Barnes PM, Simile C. Selected health conditions among Native Hawaiian and Pacific Islander adults: United States, 2014. NCHS data brief, no 277. Hyattsville, MD: National Center for Health Statistics. 2017.
Q: How do you collect data on the NHPI population?
CZ: To conduct the 2014 NHPI NHIS, NHIS field interviewers visited houses previously identified in the American Community Survey (ACS) to have at least one resident of any age with an NHPI racial identity (either alone or in combination with one or more other racial identities).
Q: Is there anything in the data that surprised you?
CZ: Within the NHPI population it was especially interesting that Native Hawaiians and Pacific Islanders adults differed in prevalence of uninsurance and private coverage (but not public coverage).
Q: What is the take home message from this report?
CZ: The prevalence of many indicators of access and utilization of health care among NHPI people differ from the total U.S. population and more specifically from Asians in the U.S. There was also diversity in access and utilization of health care within the NHPI population.