Racial and Ethnic Differences in Mortality Rate of Infants Born to Teen Mothers: United States, 2017–2018

July 31, 2020

Questions for Ashley Woodall, Health Statistician and Lead Author of “Racial and Ethnic Differences in Mortality Rate of Infants Born to Teen Mothers: United States, 2017–2018.”

Q: Why did you decide to focus on teenagers for this report?

AW: There has not been much research on infant mortality using national data that focuses on specific maternal age groups. Teenagers are an age group of particular interest because infants born to teenagers have higher infant mortality rates compared with infants born to women in older age groups. Consequently, we wanted to explore the recent patterns in infant mortality for teenagers in the United States.


Q: Can you summarize some of the findings?

AW: In 2017–2018, infants born to teenagers aged 15–19 had the highest rate of mortality (8.77 deaths per 1,000 live births) compared with infants born to women aged 20 and over. Among teenagers, infants of non-Hispanic black females had the highest infant mortality rate (12.54) compared with non-Hispanic white (8.43) and Hispanic (6.47) females. Among the five leading causes of infant death, the largest racial and ethnic difference in mortality rates was found for preterm- and low-birthweight-related causes, where rates were two to three times higher for infants of non-Hispanic black teenagers (284.31 per 100,000 live births) than infants of non-Hispanic white (119.18) and Hispanic (94.44) teenagers.


Q: Was there a specific finding in the data that surprised you from this report?

AW: We were surprised by the large racial and ethnic disparity in deaths for preterm- and low-birthweight-related causes. This finding suggests that preterm birth and low birthweight are significant contributing factors for death among infants born to non-Hispanic black teenagers.


Q: Can you explain the difference between total infant, neonatal, and postneonatal mortality rates?

AW: Infant mortality is the death of a baby before his or her first birthday. It is calculated by dividing the number of infant deaths during a calendar year by the number of live births reported in the same year. It is expressed as the number of infant deaths per 1,000 live births. Neonatal mortality rate is the death of a baby during the first 27 days after birth, per 1,000 live births. Postneonatal mortality rate is the death of a baby between 28 days to under 1 year after birth, per 1,000 live births.


Q: What is the take home message for this report?

AW: The different mortality patterns seen among infants born to teenage mothers illustrate the racial and ethnic disparities in infant mortality and suggest that preterm birth and low birthweight are major public health concerns for infants born to non-Hispanic black teenagers.


QuickStats: Percentage of Adults Who Volunteered or Worked in a Hospital, Medical Clinic, Doctor’s Office, Dentist’s Office, Nursing Home, or Some Other Health Care Facility by Sex, Race, and Hispanic Origin — National Health Interview Survey, United States, 2016–2018

July 17, 2020

During 2016–2018, women aged 18 years or older were more likely to volunteer or work in a hospital, medical clinic, doctor’s office, dentist’s office, nursing home, or some other health care facility (health care settings) than were men (12.3% compared with 5.2%).

Non-Hispanic black (15.8%), Asian (12.8%), and white women (12.3%) were more likely to volunteer or work in health care settings than were Hispanic women (9.6%).

Non-Hispanic Asian men (7.6%) were more likely to volunteer or work in health care settings than were black (6.0%), white (5.3%), and Hispanic men (3.8%).

Source: National Health Interview Survey, 2016–2018 data. https://www.cdc.gov/nchs/nhis.htm.

https://www.cdc.gov/mmwr/volumes/69/wr/mm6928a7.htm

 


Infant Mortality in the United States, 2018: Data From the Period Linked Birth/Infant Death File

July 16, 2020

Questions for Danielle Ely, Health Statistician and Lead Author of “Infant Mortality in the United States, 2018: Data From the Period Linked Birth/Infant Death File.”

Q: Why does NCHS conduct studies on infant mortality?

DE: NCHS collects data from U.S. jurisdictions on infant deaths to provide national statistics on infant mortality. Infant mortality is considered a key public health indicator for a country.


Q: Can you explain what the Linked Birth/Infant Death File is?

DE: The linked file consists of infant death information linked with the birth certificate information for infants under 1 year of age. Individual birth and death records are selected from their respective files and linked into a single statistical record, thereby establishing a national linked record file. The linked birth/infant death data set is the preferred source for examining infant mortality by race and Hispanic origin. Infant mortality rates by race and Hispanic origin are more accurately measured from the birth certificate compared with the death certificate.


Q: Can you summarize how the infant mortality data varied?

DE: The U.S. infant mortality rate was 5.67 infant deaths per 1,000 live births, lower than the rate of 5.79 in 2017 and an historic low. The mortality rate declined in 2018 for infants of Hispanic women compared with the 2017 rate; changes in rates for other race and Hispanic-origin groups were not statistically significant. The 2018 infant mortality rate for infants of non-Hispanic black women (10.75) was more than twice as high as that for infants of non-Hispanic white (4.63), non-Hispanic Asian (3.63), and Hispanic women (4.86). Infants born very preterm (less than 28 weeks of gestation) had the highest mortality rate (382.20), 186 times as high as that for infants born at term (37–41 weeks of gestation) (2.05). Infant mortality rates by state for 2018 ranged from a low of 3.50 in New Hampshire to a high of 8.41 in Mississippi.


Q: What is the take home message for this report?

DE: Although the infant mortality rate continues to slowly decline, some groups have consistently higher rates than others (for example, by maternal race and Hispanic origin, infants of non-Hispanic black, American Indian or Alaska Native, and Native Hawaiian and Other Pacific Islander women have higher rates than infants of non-Hispanic white, non-Hispanic Asian, and Hispanic women). This information can further our understanding of current infant mortality trends and provide information on where improvements can be made.


Q: Any predictions for 2019 infant mortality data?

DE: We do not predict what will happen for the infant mortality rate in future years. Provisional estimates for each quarter can be found in the Vital Statistics Rapid Release Quarterly Provisional Estimates at https://www.cdc.gov/nchs/nvss/vsrr/infant-mortality-dashboard.htm. These data show a slight increase in the 2019 quarter 2 estimates to 5.69 infant deaths per 1,000 live births.  Note that this estimate may be revised when the 2018 quarter 3 estimate becomes available.


Racial and Ethnic Differences in the Prevalence of Attention-deficit/Hyperactivity Disorder and Learning Disabilities Among U.S. Children Aged 3–17 Years

March 4, 2020

Attention-deficit/hyperactivity disorder (ADHD) and learning disabilities are the most commonly diagnosed neurodevelopmental disorders in children and often coexist.

Previous research has suggested that the prevalence of these conditions may differ by race and Hispanic origin.

Using timely, nationally representative data, this report examines the reported prevalence of ADHD and learning disabilities by race and ethnicity and select demographic characteristics that are associated with the diagnosis of these conditions.

Findings: 

  • In 2016–2018, nearly 14% of children aged 3–17 years were reported as ever having been diagnosed with either attention-deficit/hyperactivity disorder (ADHD) or a learning disability; non-Hispanic black children were the most likely to be diagnosed (16.9%).
  • Among children aged 3–10 years, non-Hispanic black children were more likely to have ever been diagnosed with ADHD or a learning disability compared with non-Hispanic white or Hispanic children.
  • Diagnosis of ADHD or a learning disability differed by federal poverty level for children in all racial and ethnic groups.
  • Diagnosis of ADHD or a learning disability differed by parental education among non-Hispanic white children only.

QuickStats: Percentage of Adults Aged 18–64 Years with a Usual Place for Health Care by Race/Ethnicity

February 7, 2020

Although the percentage of Hispanic adults aged 18–64 years who had a usual place to go for medical care was higher in 2018 (74.1%) than in 2008 (67.3%), Hispanic adults remained the least likely to have a usual place to go for medical care.

Non-Hispanic white adults were the most likely to have a usual place for medical care in both 2008 (85.0%) and 2018 (85.5%).

In 2008, 78.7% of non-Hispanic black adults had a usual place for health care compared with 80.4% in 2018.

Source: National Health Interview Survey, 2008 and 2018 data. https://www.cdc.gov/nchs/nhis.htm.

https://www.cdc.gov/mmwr/volumes/69/wr/mm6905a6.htm


QuickStats: Percentage of Adults Aged 18–64 Years Who Had Seen or Talked to a Health Care Professional in the Past 12 Months by Race/Ethnicity — National Health Interview Survey, 2012–2013 and 2017–2018

December 6, 2019

The percentage of adults aged 18–64 years who had seen or talked to a health care professional in the past 12 months increased from 79.3% in 2012–2013 to 82.1% in 2017–2018.

There was an increase in the percentage of Hispanic (67.0% to 73.6%), non-Hispanic white (82.8% to 84.9%), non-Hispanic black (80.0% to 83.2%), and non-Hispanic Asian (75.8% to 78.8%) adults who had seen or talked to a health care professional in the past 12 months between those two periods.

During 2012–2013 as well as 2017–2018, non-Hispanic white adults were the most likely and Hispanic adults were the least likely to have seen or talked to a health care professional in the past 12 months.

Source: National Health Interview Survey, 2012, 2013, 2017, and 2018 data. https://www.cdc.gov/nchs/nhis.htm.

https://www.cdc.gov/mmwr/volumes/68/wr/mm6848a3.htm


Births: Final Data for 2018

November 27, 2019

Questions for Joyce Martin, Health Statistician and Lead Author of “Births: Final Data for 2018

Q: What is new in this report from the 2018 provisional birth report?

JM: In addition to providing final numbers and rates for numerous birth characteristics such as fertility rates, teen childbearing, cesarean delivery and preterm and low birthweight, this report presents final information on  teen childbearing by race and Hispanic origin and by state, births to unmarried women, tobacco use during pregnancy, source of payment for the delivery and twin and triplet childbearing.


Q: Was there a specific finding in the 2018 final birth data that surprised you?

JM: The continued decline in birth rates to unmarried women (down 2% for 2017-2018 to 40.1 births per 1,000 unmarried women), the fairly steep decline in tobacco smoking among pregnant women (down 6% to 6.5% of all women) and the continued declines in twin (down 2%) and triplet (down 8%) birth rates.  Also of note is the decline in the percentage of births covered by Medicaid between 2017 and 2018 (down 2% to 42.3%) and the small rise in the percentage covered by private insurance (49.6% in 2018).


Q: How did you obtain this data for this report?

JM: These data are based on information for all birth certificates registered in the United States for 2018.


Q: What is the take home message for this report?

JM: Birth certificate data provide a wealth of important current and trend information on demographic and maternal and infant health characteristics for the United States.


Q: Why do you think the birth has dropped in the U.S.?

JM: The factors associated with family formation and childbearing are numerous and complex, involving psychological, cultural, demographic, and socio-economic influences. The data on which the report is based come from all birth certificates registered in the U.S. While the data provide a wealth of information on topics such as the number of births occurring in small areas, to small population groups, and for rare health outcomes, the data do not provide information on the attitudes and behavior of the parents regarding family formation and childbearing. Accordingly, the data in and of itself cannot answer the question of why births have dropped in the U.S.


QuickStats: Age-Adjusted Percentages of Adults Aged 18–64 Years Who Never Felt Rested in the Past Week by Sex, Race, and Hispanic Origin — National Health Interview Survey, 2017–2018

October 25, 2019

During 2017–2018, among persons aged 18–64 years, women were more likely than men to report they never felt rested in the past week overall (21.1% versus 14.3%) and in each race and Hispanic origin group.

Non-Hispanic white men (16.0%) were more likely to report they never felt rested than were Hispanic men (11.1%), non-Hispanic black men (12.0%), and non-Hispanic Asian men (9.7%).

Non-Hispanic white women (23.0%) were more likely to report they never felt rested than were Hispanic women (19.0%), non-Hispanic black women (18.9%), and non-Hispanic Asian women (13.7%).

Source: National Center for Health Statistics, National Health Interview Survey, 2017–2018. https://www.cdc.gov/nchs/nhis.htm.

https://www.cdc.gov/mmwr/volumes/68/wr/mm6842a4.htm 


Mortality trends by race and ethnicity among adults aged 25 and over: United States, 2000–2017

July 23, 2019

Questions for Lead Author Sally Curtin, Health Statistician, of “Mortality trends by race and ethnicity among adults aged 25 and over: United States, 2000–2017.”

Q: What is different in this report from what you released in the 2017 final deaths report?

SC: The 2017 final death report shows death rates by race and ethnicity for 5- and 10-year age groups.  The difference is that we are using broad age groups to categorize adults and examining mortality trends:

  • Young adults 25-44
  • Middle-aged 45-64
  • Elderly 65+

Q: Why did you decide to focus on death rates by race and ethnicity for this report?

SC: Compared with death rates for non-Hispanic white (NHW) adults, traditionally rates for non-Hispanic black (NHB) have been the higher while rates for Hispanic have been lower.  We wanted to see if these differences were narrowing or widening.  We also wanted to examine whether trends were similar among the race/ethnicity groups for the three age groups of adults.


Q: How did the data vary by age groups?

SC: Trends differed by age group.  For NHW, NHB and Hispanic, all groups experienced increases over the period for young adults 25-44, NHW and NHB experienced increases for middle-aged adults 45-64, and all groups experienced declines in death rates for the elderly.


Q: Was there a specific finding in your report that surprised you?

SC: A couple of very interesting findings. First, all race/ethnicity groups are seeing increases in death rates for young adults aged 25-44, by 21% since 2012 for NHW and NHB.  Also, death rates for elderly adults ages 65+ are now higher for NHW than NHB.


Q: Why did the death rate decline for U.S. Hispanic adults?

SC: Some of the causes of death which have caused the rates to stop declining, or even to increase, among NHW and NHB have not affected Hispanic adults similarly.  For example, a recent report showed that heart disease death rates have been increasing among middle-aged NHW and NHB adults, but not for Hispanic adults.

 

 


Dental Care Among Adults Aged 65 Years and Over, 2017

May 29, 2019

Questions for Lead Author Ellen Kramarow, Health Statistician, of “Dental Care Among Adults Aged 65 Years and Over, 2017.”

Q: Why focus on dental care among adults aged 65 years or older in the United States?

EK: Dental care is often overlooked as people age, but it is an important component of overall health care. Chronic diseases such as diabetes and osteoporosis, which are common among older persons, can affect oral health; in addition, having poor oral health may contribute to some chronic conditions and impact nutrition. Routine dental care is not covered under fee-for-service Medicare, so older adults may have trouble accessing appropriate dental care.


Q: What are the main findings on dental insurance, dental visits, and unmet dental care due to cost?

EK: In 2017, among adults aged 65 and over, 29.2% had dental insurance; 65.6% had a dental visit in the past 12 months; and 7.7% had an unmet need for dental care due to cost.

No statistically significant differences by sex were observed in any of these dental care indicators. Adults aged 65–74 were more likely to have dental insurance, to have visited the dentist in the past 12 months, and to have unmet need for dental care due to cost compared with adults over age 75.

Poor older adults were less likely to have dental insurance and to have visited the dentist, and more likely to have an unmet need for dental care due to cost compared with not-poor older adults.


Q: Are there any reasons why more U.S. adults aged 65 years or older don’t have dental insurance?

EK: Most older adults have access to health insurance through Medicare, which does not cover routine dental care.  Older adults who do have dental insurance may have obtained it through purchase of a separate dental plan, through retiree health benefits, through a Medicare Advantage plan, or through Medicaid.


Q: Was there a specific finding in your report that surprised you?

EK: Only 30.3% of older adults who were edentate (had no natural teeth) had a dental visit in the past 12 months, compared with 73.6% who had at least some natural teeth.  Even edentate adults need dental care to help maintain good oral health.


Q: What is the take home message for this report?

EK: Many older adults do not receive dental care, and access to dental care varies by age, poverty status, and race and Hispanic origin.