Health Insurance Coverage: Early Release of Estimates From the National Health Interview Survey, January-September 2016

February 14, 2017
Michael Martinez, M.P.H., M.H.S.A., Epidemiologist and Health Statistician

Michael Martinez, M.P.H., M.H.S.A., Epidemiologist and Health Statistician

Questions for Michael Martinez, M.P.H., M.H.S.A., Epidemiologist, Health Statistician and Lead Author on “Health Insurance Coverage: Early Release of Estimates From the National Health Interview Survey, January-September 2016

Q: What do you think is the most significant finding in your new study?

MM: I think the most significant finding in this study is the snapshot view of varied health insurance types. While from January through September 2016, among adults aged 18 to 64, 12.3% were uninsured at the time of interview, 20.3% had public coverage, and 69.0% had private health insurance coverage. Among the 136.0 million adults in this age group with private coverage, 9.3 million–or 4.7%–were covered by private health insurance plans obtained through the Health Insurance Marketplace or state-based exchanges during the first 9 months of 2016.


Q: How did health insurance coverage in the United States compare in the first 9 months of 2016 to 2015 and 2010?

MM: We’ve observed a number of changes in health insurance coverage between 2010 and 2015 compared to the first 9 months of 2016. Between 2010 and the first 9 months of 2016, 20.4 million persons of all ages gained coverage. In the first 9 months of 2016, 28.2 million (8.8%) persons of all ages were uninsured at the time of interview, compared with 48.6 million (16.0%) persons in 2010 and 28.6 million (9.1%) persons in 2015. The difference in uninsured estimates between 2015 and the first 9 months of 2016 was not significant.


Q: Where do high-deductible plans through private health insurance fit into 2016 estimates compared to earlier years?

MM: Among private health insurance plans, enrollment in high-deductible health plans has been increasing in recent years. 39.1% of persons under age 65 with private health insurance were enrolled in high-deductible health plans in the first 9 months of 2016. This percentage has increased significantly, from 25.3% in 2010 and from 36.7% in 2015.


Q: What are the trends among race and ethnicity groups in health insurance coverage this year and compared over time?

MM: There’s been quite a bit of change in health insurance coverage among race and ethnicity groups over the years. For example, in the first 9 months of 2016, 24.7% of Hispanic, 15.1% of non-Hispanic black, 8.5% of non-Hispanic white, and 7.8% of non-Hispanic Asian adults aged 18–64 lacked health insurance coverage at the time of interview. Significant decreases in the percentage of uninsured adults were observed between 2013 and the first 9 months of 2016 for Hispanic, non-Hispanic black, non-Hispanic white, and non-Hispanic Asian adults. Hispanic adults had the greatest percentage point decrease in the uninsured rate between 2013 (40.6%) and the first 9 months of 2016 (24.7%).


Q: How is health insurance coverage looking this year for our youngest population – children under 18 years of age?

MM: From January through September 2016, among children under 18 years of age, 5.0% were uninsured at the time of interview, 43.4% had public coverage, and 53.5% had private health insurance coverage. Among the 39.3 million children under 18 years of age with private coverage, 1.7 million or 2.3% were covered by private health insurance plans obtained through the Health Insurance Marketplace or state-based exchanges during the first 9 months of 2016.


The Association of Marital Status and Offers of Employer-based Health Insurance for Employed Women Aged 27–64: United States, 2014–2015

January 12, 2017

Questions for Robin Cohen, Ph.D., Health Statistician and Lead Author on “The Association of Marital Status and Offers of Employer-based Health Insurance for Employed Women Aged 27–64: United States, 2014–2015

Q: Why did you decide to do a report comparing the marital status and offers of employer-based health insurance for employed women?

RC: A recent study found that women were less likely than men to have been insured through own employer and more likely to have been covered as a dependent. This report describes the association of marital status and the presence of employment-based insurance offers among employed women in the United States. It is important to note, that the presence of an offer does not necessarily indicated take-up.


Q: Is this the first time the National Health Interview Survey (NHIS) has released a report on this topic? If not, where is trend data available?

RC: This is the first time that NHIS has released a report on the association of marital status and of offers of employer-based private health insurance coverage for employed women.


Q: In general, how do offers of employer-based health insurance for employed women vary by marital status?

RC: Marital status is an important predictor of having an offer of health insurance through employment for employed women aged 27-64. Married women may gain an additional opportunity for an offer of health insurance coverage through their spouse’s employer. Therefore, taking all offers of health insurance into account, employed married women aged 27-64 were more likely than employed unmarried women to have an employer offer of health insurance.


Q: How do offers of employer-based health insurance vary by marital status for employed women within categories of educational attainment?

RC: Regardless of educational attainment, employed married women aged 27-64 were more likely than employed unmarried women to have been offered health insurance by their employer or their spouse’s employer. For both married and unmarried women, total health insurance offers increased as levels of educational attainment increased.


Q: Do offers of employer-based health insurance vary by marital status for employed women aged within categories of race and ethnicity?

RC: Employed non-Hispanic white and non-Hispanic Asian unmarried women were more likely than their married counterparts to have an offer of coverage from their own employer. However unmarried Hispanic and non-Hispanic black women were about as likely to have an offer of coverage from their own employer.


QuickStats: Percentage of Adults Who Are Very Worried about Medical Costs, by Home Ownership and Age Group

January 4, 2017

In 2015, 15.6% of adults who lived in rental houses/apartments were very worried about paying for medical costs, compared with 8.7% of adults who lived in family-owned homes.

Adults aged 18–39 years who lived in rental homes were more likely than those in family-owned homes to be very worried about paying medical costs (12.9% versus 8.0%).

Among adults aged 40–64 years and 65 years or older, renters were twice as likely as home owners to be very worried about medical costs (22.3% versus 11.4%, and 8.6% versus 4.0%, respectively).

Source: https://www.cdc.gov/mmwr/volumes/65/wr/mm655051a7.htm


Vaccination Coverage Among Adults With Diagnosed Diabetes: United States, 2015

December 6, 2016
Maria A. Villarroel, Ph.D., Health Statistician

Maria A. Villarroel, Ph.D., Health Statistician

Questions for Maria A. Villarroel, Ph.D., Health Statistician and Lead Author on “Vaccination Coverage Among Adults With Diagnosed Diabetes: United States, 2015.”

Q: Why did you decide to look at vaccination coverage with diagnosed diabetes?

MV: Persons with diabetes are at an increased risk for complications from vaccine-preventable infections, and a number of these of vaccines are recommended for adults living with diabetes. We wanted to examine the vaccine coverage among different segments of adults with diagnosed diabetes. This report describes the receipt of select vaccinations among adults with diagnosed diabetes by sex, age, race and ethnicity, and poverty status.


Q: Overall, which vaccinations were more prevalent for adults with diagnosed diabetes?

MV: We examined vaccination coverage for influenza, pneumococcal, hepatitis B and shingles among adults with diagnosed diabetes. Among adults aged 18 and over with diagnosed diabetes, influenza vaccination (61.6%) was more prevalent than pneumococcal (52.6%) and hepatitis B (17.1%) vaccination. The shingles vaccine is indicated for those aged 60 and older and we found that fewer than 3 in 10 (27.2%) adults aged 60 and over with diagnosed diabetes had been vaccinated for shingles.


Q: How did the vaccination rates for adults with diagnosed diabetes vary by age?

MV: We compared vaccination coverage for influenza, pneumococcal and hepatitis B among adults diagnosed with diabetes who were aged 18-44, 45-59, 60-74 and 75 and over. Vaccination coverage was not the same across age groups. Vaccination for influenza and pneumococcal disease increased with age. In contrast, vaccination for Hepatitis B decreased with age. We also examined vaccination coverage for shingles among adults aged 60 and over, and those who were aged 75 and over were likely to have been vaccinated than those aged 60-74.


Q: How did the vaccination rates for adults with diagnosed diabetes vary by race and ethnicity?

MV: We compared vaccination coverage among adults with diagnosed diabetes who were Hispanic, Non-Hispanic white, non-Hispanic black and Non-Hispanic Asian. Non-Hispanic white adults were more likely than non-Hispanic black and Hispanic adults to have been vaccinated for influenza in the past year and to have ever been vaccinated for pneumococcal disease and shingles at some point in the past. Non-Hispanic Asian adults were more likely than non-Hispanic black and Hispanic adults to have been vaccinated for influenza, but these groups did not differ from one another on pneumococcal and shingles vaccination.


Q: Were there any findings that surprised you?

MV: It was surprising to see the difference in the vaccination coverage for vaccines that are recommended for all adults with diabetes. In addition to differences by age and race and ethnicity, we observed wide differences in vaccination coverage by income status. Adults with diagnosed diabetes who were not living in poverty were consistently the most likely group to have been vaccinated for influenza, pneumococcal disease, hepatitis B, and shingles. From other reports, diagnosed diabetes is more common among poor and near poor adults, yet this report showed that these group are the least likely to get vaccinated.


QuickStats: Percentage of Adults Who Cannot or Find It Very Difficult to Stand or Be on Their Feet for About 2 Hours Without Using Special Equipment

December 2, 2016

A reported 10.2% of adults aged 18 years or older cannot, or find it very difficult to, stand or be on their feet for about 2 hours without using special equipment.

The percentage of adults who reported this difficulty increased with age: 2.9% of those aged 18–44 years, 11.8% of those aged 45–64 years, 19.1% of those 65–74 years, and 33.2% of those aged 75 years or older.

Overall, women were more likely (11.9%) than men (8.3%) to report this difficulty, and higher percentages were noted for women within each age group.

https://www.cdc.gov/mmwr/volumes/65/wr/mm6547a6.htm


Problems Paying Medical Bills Among Persons Under Age 65: Early Release of Estimates From the National Health Interview Survey, 2011-June 2016

November 30, 2016

Questions for Robin Cohen, Ph.D., Health Statistician and Lead Author on “Problems Paying Medical Bills Among Persons Under Age 65: Early Release of Estimates From the National Health Interview Survey, 2011-June 2016

Q: What do you think is the most significant finding in your new study?

RC: I think the key finding in this report is that between 2015 and the first 6 months of 2016, there was little change in the percentage of persons under age 65 who were in families having problems paying medical bills.


Q: How have trends for families having problems paying medical bills in the United States changed in 2016 since you began examining this issue?

RC: We’ve noticed a continuing drop in those experiencing difficulties making their medical bill payments. The number of persons under age 65 who were in families having problems paying medical bills has decreased from 56.5 million in 2011 to 43.8 million in the first 6 months of 2016.


Q: Is paying for health insurance premiums considered a medical bill in your study?

RC: Premiums are not considered a medical bill in our study. Medical bills include bills for doctors, dentists, hospitals, therapists, medication, equipment, nursing home, or home care.


Q: What are the trends among race and ethnicity groups who are having problems paying medical bills this year and compared over time?

RC: We’ve observed a number of trends among different groups over time. All race and ethnicity groups studied in the report saw decreases in the percentage of persons under age 65 who were in families having problems paying medical bills between 2011 and the first 6 months of 2016. Within each year from 2011 through 2016, non-Hispanic Asian persons were the least likely to be in families having problems paying medical bills.


Q: What is the take-home message of your report?

RC: I think the take-home message from this research is the story the data offers about American families–that among persons under age 65, one in six persons is in a family having problems paying medical bills.


Sports and Recreation Related Injury Episodes in the United States, 2011-2014

November 18, 2016
Yahtyng Sheu, Senior Service Fellow

Yahtyng Sheu, Senior Service Fellow

Questions for Yahtyng Sheu, Senior Service Fellow and Lead Author on “Sports and Recreation Related Injury Episodes in the United States, 2011-2014

Q: How many sports and recreation related injuries are being reported annually?

YS: According to our analysis, approximately 8.6 million of sports- and recreation- related injury episodes were reported annually among persons aged 5 and over using data from the 2011-2014 National Health Interview Survey. These injury episodes were medically-attended, for which a health care professional was contacted, either in person or by telephone, for advice or treatment. Therefore, these injury episodes were not limited to those resulted in emergency department visit or hospitalization.


Q: Did the sports and recreation related injuries differ by sex and age group? If so how?

YS: Yes. The distribution of sports- and recreation-related injuries differed by both sex and age. Approximately 60% of all the sports- and recreation-related injuries were sustained by men. Children and young adults between age 5 and 24 years old also accounted for 65% of the total sport- and recreation-related injuries.


Q: What types of sports and recreation activities are causing these injuries?

YS: Our data shows that general exercise, which includes aerobics, exercising, weight training, running, jogging, and school related activity, was the most frequently mentioned activity associated with sports-and recreation-related injuries. However, it does not mean that general exercise is more likely to “cause” injuries. We are unable to study what activities are more likely to cause injuries because the National Health Interview Survey do not collect data on activity participation. This prevents us from evaluating the risk of injury for individual activity.


Q: What parts of the body were more frequently injured while engaging in sports and recreation?

YS: Lower (42%) and upper (30%) extremities were the most frequently mentioned parts of body injured while engaging in the sports and recreation activity.


Q: Why did you decide to look at sports and recreation related injuries?

YS: Many epidemiological studies of sports- and recreation-related injuries have focused on specific populations, sport activities, or outcomes. Limited number of studies have provided national estimates on overall sports- and recreation-related injuries among all population. The latest national estimates on these type of injuries (that are not limited to emergency department visits data) were derived from 1997-1999 data. As more people engage in sports and recreation activity, we feel there is a need to address the patterns of sports- and recreation- related injuries using more recent data.