Source: National Health and Nutrition Examination Survey
Source: National Health and Nutrition Examination Survey
Questions for Anjel Vahratian, Supervisory Statistician (Health) and Lead Author on “Utilization of Clinical Preventive Services for Cancer and Heart Disease Among Insured Adults: United States, 2015”
Q: Why did you decide to look at clinical preventive services for cancer and heart disease among insured adults?
AV: Heart disease and cancer are the top two leading causes of death in the United States. The clinical preventive services discussed in this report are recommended for the prevention or early detection of heart disease and cancer. We limited our analysis to insured adults because most insurance plans were required to cover these clinical preventive services without co-payment from the insured adult in 2015.
Q: What did your report find out about cancer screenings among insured adults?
AV: In 2015, two-thirds of insured adults aged 50-75 were screened for colorectal cancer within the recommended intervals, and screening was significantly associated with age for both men and women. Insured women aged 50-59 were more likely to be screened for colorectal cancer compared with men of the same age. Among insured women, more than 8 out of 10 of those aged 21-65 had been screened for cervical cancer, and nearly 3 out of 4 of those aged 50-74 had been screened for breast cancer within the recommended intervals.
Q: What did your report find out about heart disease screenings among insured adults?
AV: In 2015, more than 8 in 10 insured adults aged 18 and over had their blood pressure checked by a doctor or other health professional, and about 2 in 3 overweight and obese insured adults aged 40-70 had a fasting blood test for high blood sugar or diabetes in the past 12 months. Receipt of these services increased with advancing age and varied by sex. Insured women aged 18-39 and 40-64 were more likely than their male peers to have their blood pressure checked in the past 12 months, and insured overweight and obese women aged 40-49 were more likely than men of the same age and BMI to have a fasting blood test or diabetes in the past 12 months.
Q: Was there a specific finding that you found surprising?
AV: It was surprising that only 49.5% of overweight and obese insured men aged 40-49 had a fasting blood test for diabetes in the past 12 months. Diabetic adults are at increased risk of developing cardiovascular disease, and overweight and obesity and abnormal blood glucose are modifiable cardiovascular risk factors.
Q: What is the take home message of this report?
AV: Utilization of clinical preventive services aimed at the early detection of cancer and cardiovascular disease varied by sex and age among insured adults. Insured adults in their 40s and 50s were less likely than those in their 60s to be screened for colorectal cancer, high blood pressure, and diabetes. Limited knowledge about the recommendations for clinical preventive services may prevent eligible adults from seeking out timely preventive care.
Questions for Tainya C. Clarke, Ph.D., M.P.H., Health Statistician and Lead Author on the “Early Release of Selected Estimates Based on Data From the January–September 2016 National Health Interview Survey.”
Q: What health measures does this report look at?
TC: The measures covered in this report are lack of health insurance coverage and type of coverage, having a usual place to go for medical care, obtaining needed medical care, receipt of influenza vaccination, receipt of pneumococcal vaccination, obesity, leisure–time physical activity, current cigarette smoking, alcohol consumption, human immunodeficiency virus (HIV) testing, general health status, personal care needs, serious psychological distress, diagnosed diabetes, and asthma episodes and current asthma. Three of these measures (lack of health insurance coverage, leisure-time physical activity, and current cigarette smoking) are directly related to Healthy People 2020 Leading Health Indicators.
Q: How do you collect your data for these surveys?
TC: 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.
Q: What are some of the findings that you would highlight in this early release report?
TC: Here are some findings from the early release report:
• The percentage of persons of all ages who had a usual place to go for medical care decreased, from 87.9% in 2003 to 85.4% in 2010, and then increased to 88.3% in January–September 2016.
• The percentage of persons who failed to obtain needed medical care due to cost increased, from 4.3% in 1999 to 6.9% in 2009 and 2010, and then decreased to 4.4% in January–September 2016.
• The percentage of adults aged 65 and over who had ever received a pneumococcal vaccination increased from 63.5% in 2015 to 67.3% in January–September 2016.
• The prevalence of obesity among U.S. adults aged 20 and over increased, from 19.4% in 1997 to 30.6% in January–September 2016.
• In the third quarter of 2016, 52.8% of U.S. adults aged 18 and over met the 2008 federal physical activity guidelines for aerobic activity (based on leisure-time activity). This was higher than the third quarter of 2015 estimate of 49.5%.
• The prevalence of current cigarette smoking among U.S. adults declined, from 24.7% in 1997 to 15.3% in 2015 and remained low through the third quarter of 2016 (15.9%).
• During January–September 2016, men were more likely to have had at least 1 heavy alcohol drinking day (31.6%) in the past year compared with women (18.6%).
• The prevalence of diagnosed diabetes among adults aged 18 and over increased, from 5.1% in 1997 to 9.2% in 2010, and has since remained stable through January–September 2016.
Q: What do the findings in this report tell us about the health of the country overall?
TC: Since 2010, the percentage of uninsured persons has decreased by almost 50% (16.0% vs 8.8%) and the percentage of persons who failed to obtain needed medical care due to cost has also shown a significant decline during the same time period (6.9% to 4.4%). These two indicators demonstrate increased access to healthcare from 2010 to September 2016.
Q: Are there any trends in this report that Americans should be concerned about?
TC: Although in the 3rd quarter of 2016, 52.8% of U.S. adults met the 2008 federal physical activity guidelines for aerobic activity; obesity is an epidemic that has seen a steady increase since 1997 and now affects just under one third (30.6%) of U.S. adults.
Asthma is a common chronic airway disorder characterized by periods of airflow obstruction known as asthma attacks. Symptom frequency can range from intermittent to constant, and attack severity can vary from mild to life threatening.
Several studies have shown that among adults, obesity is associated with an increased risk of asthma diagnosis, more frequent asthma-related health care use, and greater symptom or severity burden.
In a new NCHS report, current asthma prevalence is examined by weight status among U.S. adults aged 20 and over.
Obesity, a complex and costly condition, affects more than one-third of adults in the United States. It raises the risk of morbidity from chronic diseases and is a major cause of preventable death.
A new NCHS report examines health care visits for obesity by adults aged 20 and over in 2012. A visit for obesity is one where the provider listed obesity as one of the diagnoses for the visit. National estimates on the assessment of risk factors and the provision of health-education services at these visits are presented.
The main implication of these findings relates to the provision of weight-related health-education services at visits for obesity. While this type of education was offered relatively more often at visits for obesity, it was offered at less than one-half of those visits.
This finding can inform efforts in health care settings related to providing diet and nutrition, exercise, and weight-reduction health- education services, especially when obesity is a listed diagnosis.
No significant changes were seen in either adult or childhood obesity prevalence in the United States between 2003–2004 and 2011–2012.
An NCHS report provides the most recent national data on obesity prevalence by sex, age, and race and Hispanic origin, using data for 2011–2014. Overall prevalence estimates from 1999–2000 through 2013–2014 are also presented.
About one-quarter of Canadian adults and more than one-third of adults in the United States are obese. Obese children are at risk of becoming obese adults and can experience immediate health consequences such as psychosocial stress, elevated blood pressure and cholesterol, and abnormal glucose tolerance. Monitoring trends in childhood obesity is important in order to assess interventions aimed at reducing the burden of obesity.
A new NCHS report looks at the prevalence of obesity among children and adolescents in the United States and Canada.
Key Findings from the Report: