New NCHS report presents changes in state-specific birth rates for teenagers between 2017 and 2018 by race and Hispanic origin of mother.
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: Birth Rates for Teens Aged 15–19 Years, by State — National Vital Statistics System, United States, 2018November 8, 2019
In 2018, the U.S. birth rate for teens aged 15–19 years was 17.4 births per 1,000 females, with rates generally lower in the Northeast and higher across the southern states.
Teen birth rates ranged from 7.2 in Massachusetts, 8.0 in New Hampshire, 8.3 in Connecticut, and 8.8 in Vermont to rates of 30.4 in Arkansas, 27.8 in Mississippi, 27.5 in Louisiana, 27.3 in Kentucky, and 27.2 in Oklahoma.
Source: National Vital Statistics System. Birth data, 2018. https://www.cdc.gov/nchs/nvss/births.htm.
QuickStats: Birth Rates for Teens Aged 15–19 Years, by Age Group — National Vital Statistics System, United States, 1991–2018October 11, 2019
The birth rate for teens aged 15–19 years declined from a peak of 61.8 per 1,000 females in 1991 to a record low of 17.4 in 2018.
The rate has declined more rapidly since 2007. From 2007 to 2018, the rate declined from 21.7 to 7.2 for teens aged 15–17 years and from 71.7 to 32.3 for teens aged 18–19 years.
Source: NCHS, National Vital Statistics System. Birth Data, 1991–2018. https://www.cdc.gov/nchs/nvss/births.htm.
Questions for Brady E. Hamilton, Ph.D., Demographer, Statistician, and Lead Author of “Births: Provisional Data for 2018.”
Q: How does the provisional 2018 birth data compare to previous years?
BH: The number of births, the general fertility rate, the total fertility rate, birth rates for women aged 15-34, the cesarean delivery rate and the low-risk cesarean delivery rate declined from 2017 to 2018, whereas the birth rates for women aged 35-44 and the preterm birth rate rose.
Q: When do you expect the final 2018 birth report to come out?
BH: The 2018 final birth report is scheduled for release in the fall of 2019.
Q: How did the data vary by age and race?
BH: Birth measures shown in the report varied widely by age and race and Hispanic origin groups. Birth rates ranged from 0.2 births per 1,000 females aged 10-14 to 99.6 births per 1,000 women aged 30-34. By race and Hispanic origin, the cesarean delivery rate ranged from 28.7% of births for non-Hispanic American Indian or Alaska Native women to 36.1% for non-Hispanic black women and the preterm birth rate ranged from 8.56% for non-Hispanic Asian women to 14.12% for non-Hispanic black women.
Q: Was there a specific finding in the provisional data that surprised you?
BH: The report includes a number of interesting findings. The record lows reached for the general fertility rate, the total fertility rate and birth rates for females aged 15-19, 15-17, 18-19, and 20-24 are noteworthy. In addition, the magnitude of the continued decline in the birth rate for teens aged 15-19, down 7% from 2017 to 2018, is also historic.
Q: What is the take home message for this report?
BH: The number of births for the United States was down 2% from 2017 to 2018, as were the general fertility rate and the total fertility rate, with both at record lows in 2018. Birth rates declined for nearly all age groups of women under 35, but rose for women in their late 30s and early 40s. The birth rate for teenagers aged 15–19 was down 7% from 2017 to 2018. The cesarean delivery rate and low-risk cesarean delivery rate were down in 2018. The preterm birth rate rose for the fourth year in a row in 2018.
Q: Do you anticipate this drop will continue?
BH: The factors associated with family formation and childbearing are numerous and complex. The data on which the report are based come from all birth certificates registered in the U.S. While the scope of these data is wide, with detailed demographic and health information on rare events, small areas, or small population groups, the data do not provide information on the attitudes and behavior of the parents regarding family formation and childbearing. Accordingly, these data do not answer the question of why the number of births dropped in 2018 or if the decline will continue.
Questions for Brady E. Hamilton, Ph.D., Demographer, Statistician, and Lead Author of “Births: Provisional Data for 2017”
Q: What did you think was the most interesting finding in your new analysis?
BH: The report includes a number of very interesting findings. The general fertility rate, 60.2 births per 1,000 women aged 15–44, declining 3% in 2017 and reaching a record low is certainly noteworthy. In addition, the continued decline in the birth rate for teens, down 7% from 2016 to in 2017, and reaching another record low, is very significant. The increase in the cesarean delivery rate following several years of decline is noteworthy as are the recent increase in rates of preterm and low birthweight births.
Q: Why does fertility keep going down in the U.S.?
BH: In general, there are a number of factors associated with fertility. The data on which the report is based comes from the birth certificates registered for births in the U.S. While the scope of this data is essentially all births in the country, and provides detailed information about rare events, small areas, or small population groups, the data does not provide information about the parent’s decision to have (or not have) a child. And so, accordingly, we cannot examine the “why” of the changes and trends in births.
Q: Does the decline in the Total Fertility Rate essentially mean fertility is down below “replacement” levels? Could you explain this in general terms?
BH: “Replacement” refers to a minimum rate of reproduction necessary for generation to exactly replace itself, that is, enough children born to replace a group of 1,000 women and their partners. For the total fertility rate, this rate is generally considered to be 2,100 births per 1,000 women. In 2017, the total fertility rate, 1,764.5 births per 1,000 women, was below replacement.
Q: Do the increases among women over 40 suggest a “new norm” in people waiting till much later to have children?
BH: Birth rates for women aged 40-44 and 45-49 years have increased generally over the last 3 decades. Given this, it reasonable to expect this trend to continue.
Q: Are the annual declines in teen pregnancy something that we are in danger of taking for granted?
BH: The birth rate for females aged 15-19 has decreased 8% per year from 2007 through 2017. For comparison, the decline in the birth rates for women aged 20-24 and 25-29 was 4% and 2% from 2007 through 2017. The decline in teen births is very noteworthy.
Q: Can you explain how the increases in preterm births and low birthweight are connected?
BH: Infants born preterm are also often, but not exclusively, born low birthweight and vice-versa. The causes of the recent upward shift in these rates are not well understood.
Questions for T.J. Mathews, M.S., Demographer, Statistician, and Lead Author of “Declines in Births to Females Aged 10–14 in the United States, 2000–2016”
Q: Why did you decide to examine trends in births to females aged 10-14 in the U.S.?
TM: We have published data on births to females aged 10-14 for decades but only once before have we published data specific to this group. We decided this significant decline was noteworthy and needed publishing.
Q: How have U.S. birth rates to females ages 10-14 changed since 2000?
TM: The birth rate to females aged 10-14 in the U.S. has declined 78% from 0.9 per 1,000 in 2000 to 0.2 in 2016.
Q: What differences or similarities did you see among race and Hispanic origins in this analysis?
TM: From 2000 to 2016, all groups observed declines in the birth rate for this age group. The largest decline was seen for non-Hispanic black females, a decline of 79%. This group had the highest rate in both time periods.
Q: Is there any comparable trend data on U.S. births to females aged 10-14 older than 2000?
TM: While we didn’t study trends in birth rates to 15-19 year olds in this publication we have been reporting significant declines for this age group over this time period.
Q: Were there any surprises in the findings from this report?
TM: First is the wide range of birth rates for this age by state. Using 2014 to 2016 combined the highest rate was seen in Mississippi, 0.7 per 1,000 while a handful of states had rates as low as 0.1. A second interesting observation is that the majority, 81%, of births to 10-14 years old occurred to those 14 years old.
Q: What is the take home message in this report?
TM: Birth and birth rates to females aged 10-14 in the U.S. have declined significantly since 2000. Disparities by race and Hispanic origin and by state persist.
A new Health, United States Spotlight Infographic from the National Center for Health Statistics is now available online. This infographic features data on teenage childbearing, tobacco use, suicide deaths and obesity.
Health, United States Spotlights are infographics of selected health data available in Health, United States, the annual report on the health of the nation sub
mitted by the Secretary of the Department of Health and Human Services to the President and Congress.
Content includes selected indicators on important public health issues from the report’s four subject areas: health status and determinants, utilization of health resources, health care resources, and health care expenditures and payers. Like the report, the Spotlights display the most current data available and, where possible, trends over a ten-year period.
For some indicators, a different set of data years or combined years of data may be shown, depending on survey cycles and design changes. Data sources are identified for each health indicator to enable further exploration and include data systems from both the National Center for Health Statistics and partnering government and private agencies. Changes over time and differences among groups are presented using standard statistical techniques used in Health, United States.
Each Spotlight displays approximately four health indicators allowing users to visualize and interpret complex information from different data systems and Health, United States subject areas. Multiple infographics will be released throughout the year to spotlight important and relevant health data from Health, United States.
For more information on past and present infographics, please visit: https://www.cdc.gov/nchs/hus/hus_infographic.htm.
Questions for Brady E. Hamilton, Ph.D., Demographer, Statistician, and Lead Author on “Births: Provisional Data for 2016”
Q: Why did you decide to change the name of the report from preliminary to provisional?
BH: report is part of the National Vital Statistics System, Vital Statistics Rapid Release provisional data series which replaces the preliminary report series to provide a consistent set of quarterly and annual data releases. Except for small changes in record weights, the same processing procedure was used for provisional as was used for the preliminary data and the data are comparable.
Q: How does provisional 2016 data on U.S. births overall compare to previous years?
BH: The provisional number of births for the United States was down 1% in 2016 from the final number of birth in 2015. The general fertility rate was down too from 2015, 1%, to 62.0 births per 1,000 women aged 15–44, a record low for the county.
Birth rates declined for women in all age groups under 30 years between 2015 and 2016, to record lows for all groups, whereas the rates for women in their 30s and 40s rose.
The nonmarital birth rate declined 3% in 2016. In 2016, slightly more than 3 out of 4 women began prenatal care in the first trimester, down 3% from 2015. The cesarean delivery rate declined in 2016 for the fourth year in a row (to 31.9%). However, the preterm birth rate rose for the second year in a row in 2016 (to 9.84%) and the low birthweight rate was also up for the second straight year in 2016 (to 8.16%).
Q: How has the birth rate changed for U.S. teenagers in provisional 2016 data?
BH: The birth rate for teenagers aged 15–19 declined 9% in 2016 to 20.3 births per 1,000 women, with rates declining 11% for both younger (aged 15–17) and 8% for older (aged 18–19) teenagers. The 9% decline for teenaged 15-19 from 2015 to 2016 is atop of a continuous average decline of 8% from 2007 through 2014.
(The rates for younger and older teens declined on average by 11% and 8% from 2007 through 2014.)
Q: Was there anything in the 2016 provisional birth data that surprised you?
BH: Apart from the continued, unprecedented decline in teen birth, it is worth noting that women aged 30-34 have the highest birth rate (102.6 births per 1,000 women) in 2016 than any other age group. Since 1983, the rate for women in their late thirties was the highest.
In addition, it is also worth noting the rise in the preterm birth rate which was up again in 2016 (by 2%), after falling 8% from 2007 to 2014.
Q: What is the take home message from this report?
BH: The number of births and general fertility rate were down in 2016, as were the rates for women under 30 years of age. The percentage of births beginning prenatal care in the first trimester and the cesarean delivery rate were also down in 2016, whereas preterm birth and low birthweight rates rose.