PODCAST: The Toll of COVID-19 on Physician Practices

September 30, 2022

https://www.cdc.gov/nchs/pressroom/podcasts/2022/20220930/20220930.htm

HOST:  The COVID-19 pandemic took a major toll on the U.S. health care system.  In a new report released on September 28, data from the National Ambulatory Medical Care Survey were used to examine how COVID-19 impacted physician practices around the country.

Joining us to discuss that new study is Zach Peters, a health statistician with the NCHS Division of Health Care Statistics.

HOST:  What did you hope to achieve with this study?

ZACK PETERS:  This study was intended to produce nationally representative estimates of experiences at physician offices.  So it’s a physician level study and we really wanted to highlight some of the important experiences physicians had due to the pandemic, such as shortages of personal protective equipment.  And it highlights whether testing was common in physician, whether physicians were testing positive or people in their office were testing positive for COVID-19 given that they were on the front lines of helping to treat patients.  So we really wanted to touch on a broad set of experiences faced by physicians.  This certainly isn’t the first study to assess experiences and challenges faced by health care providers during the pandemic but often times those other studies are limited to specific facilities or locations or cohorts and can’t be generalized more broadly.  So a big benefit of a lot of the NCHS surveys is that we can produce nationally representative estimates and this study is an example of that.

HOST:  And what kind of impact has the pandemic had on physicians and their practices?

ZACH PETERS:  In having done quite a bit of literature review for this project it became pretty clear – and I think just listening to the news you sort of understood a lot of the impact.  A lot of research has shown that that health care providers experienced a lot of burnout or fatigue.  There was a lot of exposure and what not to COVID-19.  Long hours… So there’s a lot out there in in the literature that sort of cites some of the challenges.  What we really, what this study highlighted was it was the level of shortages of personal protective equipment that were faced.  About one in three physicians said that they had they had experienced personal protective equipment shortages due specifically to the pandemic .  The study highlighted that a large portion of physicians had to turn away patients who were either COVID confirmed or suspected COVID-19 patients.  And I think the last thing this really helped to show was the shift in the use of telemedicine due to the pandemic.  So prior to March of 2020 there were less than half of physicians at physician offices who were using telemedicine for patient care and that number, that percentage jumped to nearly 90% of office based physicians using telemedicine after March of 2020.  So this is sort of adding to the broader literature with some nationally representative estimates of experiences that providers had due to and during the pandemic.

HOST:  So what sort of personal protective equipment was most affected during this study?

ZACH PETERS:  It’s a good question.  The way in which we asked the questions about shortages of “PPE” – I’ll call it I guess – don’t allow us from really untangling that question.  We asked about face mask shortages, N-95 respirator shortages specifically, but then the second question we asked sort of grouped isolation gowns, gloves, and eye protection into one question.  So physicians didn’t really have the chance to check off specifically what they had shortages of other than face masks.  So it’s somewhat hard to untangle that but these results show that about one in five physicians faced N-95 respirator, face mask shortages due to the pandemic and a slightly higher – though we didn’t test significance in this in this report – a slightly higher percentage, about 25% of physicians, had shortages of isolation gowns,  gloves, or eye protection or some combination of those three. 

HOST:  And you say that nearly four in 10 physicians had to turn away COVID patients.  Now, was this due to a high volume of patients or a lack of staff?

ZACH PETERS:  Again that’s another great question. I think unfortunately we weren’t able to ask a lot of these really interesting follow-ups to some of these experiences. We didn’t get to pry physicians on some of the reasons why they had these experiences, including why they had to turn away patients.  So unfortunately we’re not able to answer some of the “why” questions that we would like with these data.

HOST:  And do you have any data on where these patients were referred to, the ones that were turned away?  Do you have any information on that?

ZACH PETERS:  Again unfortunately this specific question wasn’t something that we asked in the set of new COVID questions introduced in the 2020 NAMCS we did ask a question about whether physicians who had to turn away patients had a location where they could refer COVID-19 patients.  So there are a few reasons – we haven’t assessed that measure in this work so far, but it’s certainly an area we can dig into more especially as we have additional data from the 2021 NAMCS and can try to combine over time.

HOST:  Does it look like the shift to telemedicine visits is here to stay?

ZACH PETERS:  The broader literature sort of highlights that these changes are broad and likely indicate that physician offices and different health care settings have built up the infrastructure to allow for telemedicine use in the future.  And so it’ll be interesting to see if, as waves of COVID or other infections ebb and flow, if we see that the use of telemedicine kind of ebbs and flows along with that.  But I think the option for telemedicine is something that health care settings won’t get rid of now that they have them. 

HOST:  Sticking with the topic of telemedicine – did physicians list any benefits to telemedicine visits other than limiting exposure to COVID-19?

ZACH PETERS:  The set of questions that we asked physicians were limited in scope and we didn’t really have that level of follow-up.  There are some additional questions about telemedicine use that we asked and hope to be able to dig into further.  We asked physicians what percentage of their visits they had used telemedicine and some other questions about just kind of the scope of use, but not necessarily the benefits that they felt they received due to using telemedicine.

HOST:  Is it possible that you might be getting some data on these questions in the future?

ZACH PETERS:  These questions were introduced part way through the 2020 survey year, so we were only able to ask half of our physician sample about these experiences in the 2020 survey.  But we kept the exact same set of COVID related questions in the 2021 NAMCS survey year and so we’re working to finalize the 2021 data and hope to be able to look into some of the more nuanced aspects of this that we might be interested in, such as trends over time if we combine years.  So we might be able to assess differences in experiences based on the characteristics of physicians.  So yeah, we asked these specific questions in the 2021 survey year so hope to have some additional information to put out for folks.

HOST:  You were talking a little bit about the fact that you made changes to the National Ambulatory Medical Care Survey, which this study is based on, which allowed you to collect more complete data during this period. Could you again sort of go over what sort of changes you made?

ZACH PETERS:  Yes the NAMCS team with the Division of Health Care Statistics, we made changes to a few of our surveys partway through the 2020 survey year.  Partly out of necessity and partly out of just interest in an unfolding public health crisis.  So for NAMCS two big changes were made. The first was that we had to cancel visit record abstraction at physician offices.  So historically we have collected a sample of visit records or encounter records from physicians to be able to publish estimates on health care utilization at physician offices due to sort of wanting to keep our participants safe, our data collectors safe, and patients safe.  We cancelled abstraction partly into the 2020 survey year so that was an important change in that we won’t be able to produce visit estimates from the survey year.  But the other change that we made – I think I alluded to it earlier – was that partway through the survey year we introduced a series of COVID-19 related questions, which is what this report summarizes.  And the reason it came partway through the survey year is simply due to the fact that adding a series of new questions to a national survey takes a lot of planning and a lot of levels of review and approval.  So this is partly why we were only able to ask these questions of half of our survey sample.

HOST:  Are there any other changes forthcoming in the NAMCS or for that matter any of your other health care surveys?

ZACH PETERS:  Historically there have been a few different types of providers that have been excluded from our sample frame.  We didn’t include anesthesiologists working in office-based settings, radiologists working in office-based settings.  So we had a few different types of promoting specialties that we couldn’t speak to in terms of their office characteristics and their care that they provided.  In future years we are hoping to expand to include other provider types that we haven’t in the past so I think that’s the big change going forward for the traditional NAMCS.  We also have a kind of a second half of NAMCS that looks at health centers in the U.S., and the big change for that survey in the 2021 survey years that we are in is instead of abstracting a sample of visit records, are we are starting to collect electronic health record data from health centers.  So that’s another a different portion of NAMCS but those are a couple of the big changes at high level that are implementing in NAMCS. 

HOST:  What would you say is the main take-home message you’d like people to know about this study?

ZACH PETERS:  I think the main strength of using data from NCHS in general is that many of our surveys allow for nationally representative estimates and NAMCS is the same in that regard.  We sampled physicians in a way that allows us to produce nationally representative estimates.  And so I think this study highlights how we’re able to leverage our surveys in a way that other studies that you might see in the literature can’t in that they’re more cohort-based.  So I think another important aspect of this is just that it highlights an example of some of the adaptations that DHCS end and NCHS more broadly, some of the adaptations that we made during the pandemic to better collect data and disseminate data.  And so outside of the topic being hopefully important to understand how physicians nationally experienced various things related to the pandemic, this highlights some of the ways in which NCHS was able to remain nimble during a public health crisis.

MUSIC

HOST:  On September 1, NCHS released a new report looking at emergency department visits for chronic conditions associated with severe COVID illness.  The data, collected through the National Hospital Ambulatory Medical Care Survey, were collected during the pre-pandemic period of 2017-2019 and serve as a useful baseline, since it is well established that chronic conditions increase the risk of hospitalization among COVID patients.  The report showed that during this pre-pandemic period, hypertension was present in one-third of all emergency department visits by adults, and diabetes and hypertension were also present together in one-third of these visits.

On the 7th of September, NCHS released a study focusing on mental health treatment among adults during both the pre-pandemic and pandemic period, 2019 to 2021.  It has been documented by the Household Pulse Survey and other studies that anxiety and depression increased during 2020 and the beginning of 2021, and this new study focuses on the use of counseling or therapy, and/or the use of medication for mental health during this period.   The study found there was a small increase in the use of mental health treatment among adults from 2019 to 2021, with slightly larger increases among non-Hispanic white and Asian people.

Also this month, NCHS updated two of its interactive web dashboards, featuring data from the revamped National Hospital Care Survey.  On September 12, the dashboard on COVID-19 data from selected hospitals in the United States was updated, and two days later the dashboard featuring data on hospital encounters associated with drug use was updated. 

On the same day, September 14, NCHS released the latest monthly estimates of deaths from drug overdoses in the country, through April of this year, showing 108,174 people died from overdoses in the one-year period ending in April.  This death total was a 7% increase from the year before.  Over two-thirds of these overdose deaths were from fentanyl or other synthetic opioids. 

On September 29, the latest infant mortality data for the U.S. was released, based on the 2020 linked birth and infant death file, which is based on birth and death certificates registered in all 50 states and DC. 

Finally, September is Suicide Prevention Month, and on the final day of the month, NCHS released its first full-year 2021 data on suicides in the country.  For the first time in three years, suicide in the United States increased.  A total of 47,646 suicides took place in 2021, according to the provisional data used in the report.  The rate of suicide was 14 suicides per 100,000 people.

MUSIC FADES

Leave a Comment » | COVID-19, Division of Health Care Statistics, Drug Overdose Deaths, infant mortality, National Ambulatory Medical Care Survey, podcasts, suicide | Permalink
Posted by briantsai

QuickStats: Age-Adjusted Suicide Rates, by Urbanization Level and Sex — National Vital Statistics System, 2020

September 9, 2022

In 2020, age-adjusted suicide rates among females increased as the level of urbanization declined, from 4.6 per 100,000 population in large central metropolitan areas to 7.1 in small metropolitan areas, but were similar for small metropolitan, micropolitan, and noncore areas.

Rates among males were lowest in large central areas (16.9) and increased as the level of urbanization declined to 33.7 in noncore areas. Males had higher death rates than females for each corresponding urbanization level.

Source: National Vital Statistics System, Mortality Data, 2020. https://www.cdc.gov/nchs/nvss/deaths.htm

https://www.cdc.gov/mmwr/volumes/71/wr/mm7136a4.htm

Leave a Comment » | MMWR, National Vital Statistics System, QuickStats, rural, suicide, urban, Vital Statistics System | Permalink
Posted by briantsai

QuickStats: Percentage of Suicides and Homicides Involving a Firearm Among Persons Aged ≥10 Years, by Age Group — National Vital Statistics System, United States, 2020

May 13, 2022

In 2020, among persons aged ≥10 years, the percentage of suicide deaths that involved a firearm was lowest among those aged 25–44 years (45.1%) and highest among those aged ≥65 years (70.8%).

The percentage of homicide deaths that involved a firearm decreased with age, from 91.6% among those aged 10–24 years to 46.0% among those aged ≥65 years.

Persons aged ≥65 years had the highest percentage of suicide deaths that involved a firearm but the lowest percentage of homicide deaths that involved a firearm.

Source: National Vital Statistics System, Mortality Data, 2020. https://www.cdc.gov/nchs/nvss/deaths.htm

https://www.cdc.gov/mmwr/volumes/71/wr/mm7119a5.htm

Leave a Comment » | Deaths, firearm, Homicide, mortality, National Vital Statistics System, QuickStats, suicide, Vital Statistics System | Permalink
Posted by briantsai

PODCAST: Alcohol Deaths on the Rise and Suicide Declines

March 18, 2022

https://www.cdc.gov/nchs/pressroom/podcasts/2022/20220318/20220318.htm

HOST:  The month of March is often associated with St. Patrick’s Day, which for some is also an occasion of heavy alcohol use.  NCHS has historically collected data on various health behaviors, including alcohol use, and since the arrival of the pandemic, vital statistics show that there has been a surge in alcohol-induced deaths, an increase from slightly over 39,000 deaths in 2019 to just over 49,000 deaths in 2020 – an increase of more than 25 percent.  Provisional data from 2021 show the number of alcohol-induced deaths have continued to increase, to more than 52,000, up 34 percent from pre-pandemic levels.

Chronic liver disease and cirrhosis is another, long-term adverse consequence of alcohol abuse, and those deaths have increased during the pandemic as well, from over 44,000 deaths in 2019 to over 56,000 deaths in 2021 – an increase of more than 26 percent.  Chronic liver disease and cirrhosis became the 9th leading cause of death of all Americans in 2021, up from 11th prior to the pandemic.

Drug abuse of course is a well-documented scourge in the country, and in March, NCHS released the latest monthly provisional tally of overdose deaths in the U.S., for the one-year period ending in October 2021.  105,752 people died of drug overdoses during this stretch.  Synthetic opioids, primarily fentanyl, accounted for the largest proportion of overdose deaths.

On March 17, NCHS released its latest estimates on emergency department visits in the United States from the National Hospital Ambulatory Medical Care Survey, documenting that more than 151 million ER visits occurred in the U.S. during 2019.

Earlier in the month, NCHS released a new studypdf icon looking at births during the pandemic.  The new report shows that the decline in births appears to have slowed during the first half of 2021, compared to the second half of 2020.  The decline in births during the first half of 2021 would have been even smaller except for a large drop during the month of January.

Finally, NCHS released the latest official trend report on suicide in America.  The latest trends were presented in November in a separate report, and we talked with the author of that report, Sally Curtin, about the latest numbers:

HOST: Despite other causes of death such as drug overdoses and homicides spiking during the pandemic, your data show suicide actually declined, correct?

SALLY CURTIN: Yes that is correct. The number, just under 46,000 in 2020, was 3% lower than in 2019 and also the rate of suicide per 100,000 population was 3% lower as well.  Now, this is actually building on a decline which actually had started before COVID.  There was the first decline in almost 20 years from 2018 to 2019 in suicide – of about 2% – and that’s after an almost steady increase in suicide between about the year 2000 and 2018… it had increased by 35% during that time

HOST: Was it a surprise that suicide dropped in 2020, particularly given the historic increases in homicide and drug overdose deaths?

SALLY CURTIN: That’s a good question because we do know – there’s documented evidence – that some risk factors for suicide definitely increased during 2020.  And some of those risk factors are mental health issues such as depression, anxiety… Also, substance abuse increased during 2020 as well as job and financial stress.  And those are known risk factors for suicide.  So, people were concerned that the actual suicide deaths would increase.  But in the very first sentence of our report we say that suicide is complex and it’s a multi-faceted public health issue.  So it’s not as easy to say, “OK, these risk factors went up for this cause of death; therefore, you know, the deaths are going to go up.”  Suicide is much more complex than that.  There are, as well as risk factors there are elements of, obviously, prevention as well as intervention.  So some of those factors – prevention and intervention – were definitely going on during 2020, and so therefore it’s hard to say and I think in general suicide is just harder to predict than a lot of other causes of death.

HOST: So then would you say that (with) the fact that suicide declined two years in a row, is this officially a new trend?

SALLY CURTIN: It’s hard to say.  I mean, certainly it’s positive in that it’s not continuing to trend upward as it had been for so many years.  But also let me point out it still is historically high – the number is historically high as well as the rate.  They’re both high over the last 20 years.  They’re just a little bit lower than the peak in 2018.  But certainly having two years of declines gives you some hope that it might continue.

HOST: Your new study looked at suicide during 2020 on a monthly basis – what were some things that stood out in your analysis?

SALLY CURTIN: For the most part, in early 2020 – in January and February – the numbers were higher than in 2019.  But starting in March they went lower, and pretty much suicide numbers in 2020 were lower than in 2019 for the rest of the year, except in the month of November where they were just slightly higher.  Now what really stood out is the month of April, where the suicide number in 2020 was 14% lower than in 2019, and that was the greatest percentage difference of any month. And we typically don’t see that big of a change year over year in monthly numbers, so that stood out.  And also it changed sort of the yearly pattern of suicides in general – the month that has the lowest number tends to be in the winter or maybe late Fall but in 2020, April was the month with the lowest number

HOST: That is interesting – would you say that it’s counter-intuitive given that everyone was in lockdown and a lot of people weren’t working etc?

SALLY CURTIN: You would think so and we definitely heard that calls to suicide hotlines just, they just blew up and one study said they went up 800%.  So we do know that people were stressed, but we also know that they were reaching out a lot and so… yeah it is (a surprise) – I think most people will be surprised there was that large drop in April.  And I’ll leave it to others to really sort of explain what was going on – you know, whether everyone was just sort of in shock or if the stigma of maybe reaching out wasn’t quite what it normally is during regular times.

HOST: It looks like the data suggest that the declines were pretty much across the board.  Is that correct?

SALLY CURTIN: Well, for females that’s pretty much correct.  And I mean by race and ethnicity groups – all of the groups for females were lower in 2020 than 2019.  And the greatest percent decline was for Non-Hispanic white females.  There was actually a drop of 10%, and that decline reached statistical significance.  But even for females the declines really started at age 35 and over. For the younger females ages 10 to 34, rates were either the same or actually increased a bit.  For males, there was a mixed picture.  Non-Hispanic white males, as well as Non-Hispanic Asian males, had a decline but groups of minority males had increases.  Non-Hispanic black men had an increase in their rates… Hispanic men… as well as Non-Hispanic American Indian men… And once again, for men, the groups for which there was a decline tended to be in middle-age or older ages, starting with age 35.  It was not apparent in the young people ages 10 to 34.

HOST: The increases among Non-Hispanic black and Hispanic and any other minority group – had these increases been happening prior to 2020 as well?

SALLY CURTIN: Yes, pretty much all of these groups that saw those increases from 2019 and 2020 had been trending upward.  The difference is for white and Asian, they had also been trending upward but now they’ve turned.  So yes, it was just a continuation of a generally upward trend.

HOST: Do you have any indications that the decline in suicide is continuing in 2021?

SALLY CURTIN: So far we do not have any provisional data for 2021 and something that is brought out in the report is that we don’t typically do suicide reports with provisional data because unlike other causes of death it can take longer to get an accurate cause of death saying that it’s suicide.  An example is in the context of a drug overdose.  Often, they have to do toxicology analysis to figure out if the intent was actually suicidal or if it was just accidental.  So for that reason suicide figures tend to lag behind other causes of death and unfortunately right now we don’t have any numbers at all for 2021.

HOST: OK, well any other points to add?

SALLY CURTIN: I think just you know that the overall decline – it’s probably unexpected or for a lot of people because there were known increases in risk factors.  But to just point out once again that although there was an overall decline, this was a lot driven by what happened with the majority group, with Non-Hispanic whites who have among the highest rates and the numbers of suicide.  So the fact that Non- Hispanic white women were down 10%, Non-Hispanic white men were down 3% , it sort of drove the overall decline.  And there were some groups that just did not experience declines – in fact, they experienced increases.  In particular, Hispanic men had an increase of 5% and that did reach statistical significance, but there were also increases for Non-Hispanic black men and Non-Hispanic American Indian men.  So it is encouraging that the overall rate declined, but we certainly need to continue to be vigilant and to realize that this decline was not experienced by everyone.

HOST: Alright, thank you Sally for joining us.

SALLY CURTIN: Oh sure.  Thank you.

Leave a Comment » | Alcohol, Drug Overdose Deaths, emergency department, National Vital Statistics System, podcasts, suicide, Vital Statistics System | Permalink
Posted by briantsai

Suicide Mortality in the United States, 2000–2020

March 3, 2022

New NCHS report presents final suicide rates from 2000 through 2020, in total and by sex, age group, and means of suicide, using mortality data from the National Vital Statistics System. This report updates a provisional 2020 report and a previous report with final data through 2019.

Key Findings:

  • Suicide rate in the United States increased 30% between 2000 and 2020.
  • Suicide rates increased from 10.4 per 100,000 in 2000 to a peak of 14.2 in 2018, followed by a 5% decline between 2018 and 2020 to 13.5.
  • Suicide rates for females in all age groups over age 25 showed recent declines, while rates for those aged 10–14 and 15–24 have generally increased.
  • Between 2018 and 2020, suicide rates decreased in males aged 45–64 and 65–74.
  • For females in 2020, the rate of firearm-related suicide (1.8) was higher than rates of suicide by poisoning (1.5) and suffocation (1.7).
  • For males in 2020, the leading means of suicide was firearm (12.5), at a rate twice that of suffocation (6.1), the second leading means.

Leave a Comment » | Data Briefs, National Vital Statistics System, suicide, Vital Statistics System | Permalink
Posted by briantsai

QuickStats: Age-Adjusted Suicide Rates for Males and Females, by Race and Ethnicity — National Vital Statistics System, United States, 2000–2020

February 25, 2022

After increasing from 2000 to 2018, age-adjusted suicide rates for non-Hispanic White males and females declined from 2018 to 2020, from 28.6 per 100,000 to 27.2 for males and from 8.0 to 6.9 for females.

Rates for non-Hispanic Black males and Hispanic males were lower than that for non-Hispanic White males over the entire period and increased more recently to 13.1 and 12.3, respectively, in 2020.

Rates for non-Hispanic Black females and Hispanic females, also lower than rates for non-Hispanic White females over the entire period, generally increased throughout most of the period and then leveled off to 2.9 and 2.8, respectively, in 2020.

Rates for all races and ethnic groups were higher for males than for females throughout the period.

Source: National Vital Statistics System, Mortality Data. http://www.cdc.gov/nchs/nvss/deaths.htm

https://www.cdc.gov/mmwr/volumes/71/wr/mm7108a7.htm

Leave a Comment » | National Vital Statistics System, QuickStats, race/ethnicity, suicide, Vital Statistics System | Permalink
Posted by briantsai

Suicide in America Declined During the Pandemic

November 3, 2021

Suicide in the United States has been on the rise for several years, becoming one of the top public health crises in the country and one that impacts Americans of all ages.  From 1999 to 2018, the number and rate of suicide increased 35%.  Suicide has frequently been among the ten leading causes of death in the country, ranking 10th as recently as 2019. 

Some of the trends in suicide may seem surprising.  For example, there has long been a belief that suicides peak during the holiday season.  But the data show that is not the case.  Over nearly two decades, December regularly has been the month with the second fewest number of suicides.  February, a shorter month, is the only month with fewer suicides.  Generally, it is the summer months in which the number of suicides peak each year.

When the pandemic struck in 2020, there was a record increase in the homicide rate and a continued spike in the number of drug overdose deaths in the country (as well as nearly 400,000 COVID-related deaths in the United States).  Many assumed suicide would also increase, particularly after the number of suicides had risen every year between 2004 and 2019.

But after a 2% decline in suicide from 2018 to 2019, there was another decline in the pandemic year of 2020.  Provisional data show the number of suicides declined 3% from 47,511 suicides in 2019 to 45,855 in 2020.  The suicide rate in the United States also declined 3% from 13.9 suicides per 100,000 in 2019 to 13.5 per 100,000 in 2020.  With COVID-19 now entrenched as the third leading cause of death in the country, suicide fell out of the top ten in 2020, dropping to 11th among leading killers. 

While the 2020 decline was surprising to some in public health, it is worth noting that the 2020 number and rate of suicide are still higher than any year in history, except for the period 2017-2019. 

These data are featured in a new report, “Provisional Numbers and Rates of Suicide by Month and Demographic Characteristics: United States: 2020,” released on November 3.  The new report documents that:

  • The monthly number of suicides was lower in 2020 than in 2019 in March through October and also in December.
  • The number of suicides were higher in January and February of 2020 than the previous year.  This period was just before the pandemic led to widespread lockdowns and business closures in March of 2020.
  • The largest percentage difference between monthly numbers for 2019 and 2020 occurred in April.  The provisional number in April 2020 (3,468) was 14% lower than in April 2019 (4,029).
  • Yet, April 2020 was also the month of the first spike in COVID-19 deaths in the country.

 Other findings in the new report:

  • The suicide rate was 2% lower in 2020 than in 2019 for males and 8% lower for females.
  • Suicide rates declined for females in all race and Hispanic-origin groups between 2019 and 2020, although only the 10% decline for non-Hispanic white females was significant.
  • Rates declined for non-Hispanic white and non-Hispanic Asian males but increased for non-Hispanic black, non-Hispanic American Indian or Alaska Native, and Hispanic males.
  • The 3% decline for non-Hispanic white males and the 5% increase for Hispanic males was significant. 

Final suicide data for 2020 are expected to be available in December of this year, along with other final 2020 data for causes of death in the country.

Leave a Comment » | National Vital Statistics System, suicide, Vital Statistics System | Permalink
Posted by briantsai

QuickStats: Age-Adjusted Rates of Firearm-Related Suicide, by Race, Hispanic Origin, and Sex — National Vital Statistics System, United States, 2019

October 15, 2021

mm7041a5-f

In 2019, among males, non-Hispanic White males had the highest age-adjusted rate of firearm-related suicide at 15.8 per 100,000 population, followed by non-Hispanic American Indian or Alaskan Native males (11.2), non-Hispanic Black males (6.9), Hispanic males (4.6), and non-Hispanic Asian or Pacific Islander males (3.2).

Among females, non-Hispanic White and non-Hispanic American Indian or Alaskan Native females had the highest rates (2.6 and 2.2, respectively), followed by non-Hispanic Black females (0.8), Hispanic females (0.6), and non-Hispanic Asian or Pacific Islander females (0.4).

Males had higher rates than females across all race and Hispanic origin groups.

Source: National Vital Statistics System, Mortality Data, 2019. https://www.cdc.gov/nchs/nvss/deaths.htm

https://www.cdc.gov/mmwr/volumes/70/wr/mm7041a5.htm

Leave a Comment » | Deaths, firearm, mortality, National Vital Statistics System, QuickStats, suicide, Vital Statistics System | Permalink
Posted by briantsai

NCHS UPDATES”STATS OF THE STATES” PAGE WITH LATEST FINAL DATA

March 26, 2021

SOS_Nav_Page

The CDC National Center for Health Statistics web page “Stats of the States” has been updated to include the latest state-based final data on selected vital statistics topics, including:

  • General fertility rates
  • Teen birth rates
  • Selected other maternal and infant health measures
  • Marriage & divorce rates
  • Leading causes of death
  • Other high profile causes of death.

The site’s map pages allow users to rank states from highest to lowest or vice versa.  This latest version of “Stats of the States” also includes two new topics:  Life expectancy by state and COVID-19 death rates by state (provisional data on a quarterly basis, through Q3 of 2020).  All death rates are adjusted for age.  Rates are featured in the maps because they best illustrate the impact of a specific measure on a particular state.

The main “Stats of the States” page can be accessed at:  https://www.cdc.gov/nchs/pressroom/stats_of_the_states.htm

Leave a Comment » | Births, Cancer, cesarean, children, Deaths, divorce rate, Drug Overdose Deaths, elderly, first birth, heart attack, heroin, infant mortality, Influenza, kidney disease, leading causes of death, life expectancy, Marriage and Divorce, marriage rate, National Vital Statistics System, overdose, Preterm Births, State data, Stats of the States, stroke, suicide, Teen Births, unmarried childbearing, Vital Statistics System | Permalink
Posted by briantsai

PODCAST: Suicide Trends in the U.S. and Weekly NCHS Updates

February 26, 2021

STATCAST, FEBRUARY 2021: DISCUSSION WITH HOLLY HEDEGAARD, A STATISTICIAN, ABOUT SUICIDE TRENDS IN THE UNITED STATES.

https://www.cdc.gov/nchs/pressroom/podcasts/2021/20210226/20210226.htm

HOST:  Last week NCHS released the latest trend report on suicide rates in the nation.  Joining us today is Holly Hedegaard, the lead author of this new report.

Holly, so what do the latest final numbers tell us?

HOLLY HEDEGAARD:  Well the report that was just released from the National Center for Health Statistics looked at suicide rates over the last 20 years and what we saw was that from 1999 through 2018 there’s been a steady increase in the suicide rate – it increased about 35% over that time period. But what’s interesting is that in 2019 the rate is lower than it was in 2018 and that’s the first significant drop in suicide rates we’ve seen in the past 20 years.  While that’s an encouraging sign, I think it’s important to remember that a single year drop doesn’t necessarily say that’s a meaningful change in the overall trend is just that within a single year we saw a decrease in the suicide rates in 2019 compared to 2018

HOST:  Youth suicide in particular is a major concern.  What do the trends show among young people?

HOLLY HEDEGAARD:  So for young people suicide rates are actually lower than for other age groups – so that’s a good thing that the rates are lower – but what’s concerning is that these are the age groups where we’ve seen quite a bit of an increase in the suicide rates in recent years.  And so for example for girls who are age 10 to 14, their rates have increased about four-fold in the past 20 years, but their rates are still among the lowest of all the age and sex groups.  Rates have also increased for boys and for young men but not to the same extent as for girls.  And so again, for both boys and girls and for age 10 to 14 and ages 15 to 24, the rates are low but they are increasing – and I think that’s the reason of concern about suicide rates in young people.

HOST:  What groups have the highest suicide rates in the country?

HOLLY HEDEGAARD:  This report focuses on rates by sex and by age group, so the report looks at those particular characteristics, and the suicide rates are highest for men age 75 and older and that’s been true for a long period of time so the highest rates among men aged 75 and older.  For females the highest rates are for women ages 45 to 64 so it’s more of the middle-aged female when you look for high suicide rates among females.

HOST:  There aren’t full-year data available yet for 2020, but mental health professionals worry that the stress and isolation from the pandemic will result in a spike in suicide rates.  Do you have any insight at all about 2020 at this point?

HOLLY HEDEGAARD:  As you mentioned, we don’t have any of the final data for 2020 yet so we can’t give a definitive answer but NCHS has been generating from provisional estimates to try to get a sense of what has been happening during 2020.  And NCHS has posted some provisional estimates for the first quarter of 2020 – which it goes through March of 2020 – and as of the beginning of last year the rate, the suicide rate, was slightly higher than the rate during the comparable time period in 2019.  So a slight increase in the first quarter.  NCHS has been developing some additional modeling techniques to look at the trends in a variety of different types of deaths including drug overdose, suicide, and transportation related deaths during the early months of 2020, and based on that modeling technique the predicted weekly numbers of suicide deaths early 2020 were similar to historic levels, and then declined a little bit between March and June, and then again was pretty much no different than historic levels from July through October.  So based on these model estimates, that suggested there hasn’t really been a spike in suicide mortality, at least in the first half of 2020.  But it’s important to recognize that these are modeled estimates – these are not final numbers, they aren’t the final rates – and we’ll continue to be refining and confirming these estimates as NCHS receives more data for the deaths that occurred in 2020.  So as of now, we don’t have anything that looks like there’s been a huge increase in suicide during 2020 but that’s again based on modeled estimates.

HOST:  Your report looks at the different mechanisms used in suicides in the U.S.  What do those numbers tell us?

HOLLY HEDEGAARD:  The means of suicide varies by males compared to females, and for males about little over half of the suicides involve use of a firearm and about 28% involve hanging or suffocation… A much smaller proportion involved poisoning or other means. We’ve seen a slight increase in the rates for firearm-related suicides among men over the past 20 years but where there’s been a rather large increase has been in the rate for suicide by hanging or suffocation.  That rate among men has doubled over the last 20 years.  The picture for women is a little bit different.  From about 2001 through 2015, poisoning was the leading means of suicide among women.  But Interestingly in the last few years, since about 2016, we’ve actually seen a decline in the rate of suicide by poisoning among women and an increase in the rate of suicides that involve firearms or suffocation.  And so in the most recent years, the rates of suicide by firearm and by suffocation are slightly higher than the rate of suicide by poisoning.  The rate of suicide by suffocation among females has actually tripled in the past 20 years.

HOST:  Now by poisoning are you referring to drug overdoses?

HOLLY HEDEGAARD:  No, poisoning is actually a broader terminology that includes drug poisoning, but it also includes other types of poisons like carbon monoxide or chemicals or a variety of other things that sometimes people ingest or take. But they aren’t drugs there are used for other purposes.

HOST:  So your data then show that drug overdoses are really not a significant method used in suicides?

HOLLY HEDEGAARD:  It’s different – again, as I mentioned – for men or for women.  For men, only about 5% of suicide actually involve a drug overdose.  For women, it’s about 27% of their suicides involve a drug overdose.  So they’re not the, drug overdoses are not the leading means of suicide for either men or women.  For both men and women, rates of firearm-related suicide or suicide by hanging and suffocation are higher than the rates of suicide by drug overdose.

HOST:  This report doesn’t look at geographical differences but what areas of the country are having a tougher time with this problem?

HOLLY HEDEGAARD:  So the higher suicide rates are found in the Rocky Mountain states such as Wyoming, Montana, New Mexico, Colorado, Utah, as well as Alaska.  So these are states that have historically been high and they continue to remain high.  In the most current years or recent years, we’ve seen increase in the rates in some of the other states in the Midwest and in the New England states, up in Maine and Vermont and New Hampshire.  They aren’t the highest rates but they are increasing, so it’s important to sort of recognize that there are states in addition to the Rocky Mountain stage that also are seeing higher suicide rates.

HOST:   The National Health Interview Survey issued two new reports, on Tuesday and Wednesday of this week.  On Tuesday, NCHS teamed with the VA on a report that examined multiple chronic conditions among veterans and non-veterans.  Based on data from the 2015-2018 NHIS, the study authors found that about one-half of male veterans and over one-third of female veterans had two or more chronic conditions, compared with less than one-fourth of male nonveterans and less than one-fifth of female nonveterans.  Hypertension and arthritis were the most prevalent chronic conditions among all veterans age 25 and over.  Diabetes was also prevalent among male veterans ages 25 to 64 and asthma was also prevalent among female veterans in this age group.  Cancer was also prevalent among all veterans age 65 and older.

On Wednesday, NCHS released another study looking at health care utilization among those afflicted with inflammatory bowel disease, or IBD.  The study used NHIS data and found that adults with IBD were more likely than those without IBD to have visited any doctor or mental health provider in the past year, and were also more likely to have been prescribed medication or to have received acute care services such as ER visits, overnight hospital stays, or surgeries.

On Thursday, NCHS released a third study – on dietary supplement use among American adults age 20 and over.  The report used data from the 2017-2018 National Health and Nutrition Examination Survey, and found that over half of adults used a dietary supplement in the past month – nearly two-thirds /3 of women and just over half of men.  Eight out of ten women age 60 and over used dietary supplements, and older Americans are more likely to use more than one dietary supplement.   The most common dietary supplement used was multivitamin-mineral supplements.  Vitamin D and omega-3 fatty acid supplements were also commonly used.

Finally, today NCHS is releasing the latest quarterly provisional data on birth rates in the United States, through the third quarter of 2020, showing that fertility rates in the country continued to drop compared to the same point in 2019.  Teen birth rates and pre-term rates also declined in Quarter 3 of 2020 compared with Quarter 3 of 2019, while cesarean delivery rates increased over this period.

 

Leave a Comment » | National Vital Statistics System, podcasts, suicide, Vital Statistics System | Permalink
Posted by briantsai

« Previous Entries