Mortality in the United States, 2017

November 29, 2018

Questions and Answers from the authors of the recently released 2017 mortality data.  The data can be found in the following reports, “Mortality in the United States, 2017, ” “Drug Overdose Deaths in the United States, 1999–2017, ” and “Suicide Mortality in the United States, 1999–2017.”

Q: Why did life expectancy decline in 2017?

A: Mortality rates increased for 7 out of the 10 leading causes of death in the U.S., including a 5.9% increase in the flu/pneumonia death rate, a 4.2% increase in the accidental/unintentional injury death rate, and 3.7% in the suicide rate. Many of the accidental/unintentional deaths were from drug overdoses, which continued to increase in 2017.


Q: Isn’t this the third straight year that life expectancy declined?

A: Estimated life expectancy at birth in 2017 was 0.3 years lower than in 2014 and 0.1 years lower than in 2016. The 2016 life expectancy estimate was revised to 78.7 years, up from an estimated 78.6 years, which was reported a year ago. This means that the 2016 life expectancy estimate is the same as the 2015 estimate, which also was revised to 78.7 years, down from an estimated 78.8 years, originally reported two years ago. As a routine matter, for the highest degree of accuracy, NCHS blends Medicare data for people ages 66 and over with our vital statistics data to estimate life expectancy. However, the two data sets are released on different schedules. When Medicare data for a year aren’t available at the time we release our final mortality statistics, we use the most recent Medicare data available at the time. We later revise life expectancy estimates when updated Medicare data become available.


Q: How many deaths in 2017 were attributed to opioids?

A: In 2017, 47,600 drug overdose deaths mentioned involvement of any type of opioid, including heroin and illicit opioids, representing over two-thirds of all overdose deaths (68%).


Q: Why is the 70,237 number of overdose deaths smaller than what CDC has previously reported for 2017?

A: The 70,237 number is a final, official number of overdose deaths among U.S. residents for 2017 whereas the previously reported (and slightly higher) numbers were provisional estimates. In August of 2017, CDC began calculating monthly provisional data on counts of drug overdose deaths as a rapid response to this public health crisis, in order to provide a more accurate, closer to “real-time” look at what is happening both nationally and at the state level. These monthly totals are provisional counts, and they include all deaths occurring in the U.S. – which include deaths among non-residents (i.e., visitors here on business or leisure, students from abroad, etc). These counts also do not include deaths that are still under investigation. As a result, the monthly numbers are provisional or very preliminary, and the final 2017 number of 70,237 deaths is an official number that only include deaths among U.S. residents and account for any previously unresolved deaths that were under investigation.


Q: Does this mean that the 70,237 total does not include deaths to undocumented immigrants here in the U.S.?

A: We don’t get immigration status off the death certificates, so we wouldn’t know how many of the deaths were to undocumented immigrants.


Q: In comparing the 2017 numbers with 2016 and past years, is the crisis of drug overdose deaths growing or about the same?

A: From 2016 to 2017, the number of drug overdose deaths increased from 63,632 deaths to 70,237, a 10% increase, which is a smaller increase compared to the 21% increase from 2015 to 2016, when the number of drug overdose deaths increased from 52,404 deaths to 63,632 deaths. Over a longer period of time, from 1999 through 2017, the age-adjusted rate of drug overdose deaths increased on average by 10% per year from 1999 to 2006, by 3% per year from 2006 to 2014, and by 16% per year from 2014 to 2017. So the trend is continuing, although the increase in 2017 was not as large as in previous years.


Q: Are there any other trends of significance when looking at the types of drugs attributed to overdose deaths?

A: The rate of drug overdose deaths involving synthetic opioids other than methadone, which include drugs such as fentanyl, fentanyl analogs, and tramadol, increased 45% in one year, from 6.2 per 100,000 in 2016 to 9.0 per 100,000 in 2017. In 2017, 40%(?) of all drug overdose deaths mentioned involvement of a synthetic opioid other than methadone.


Q: Has fentanyl overtaken heroin as the major cause of overdose death?

A: The data brief on drug overdose deaths does not specifically address fentanyl. However the rate of drug overdose deaths involving synthetic opioids other than methadone, which includes fentanyl, increased 45% 2016 and 2017 whereas the overdose death rate from heroin did not change (4.9 deaths per 100,000).


Q: There is a lot of stark news in these three reports. Are there any positives to report?

A: The cancer mortality rate declined between 2016 and 2017, and although estimated life expectancy declined in 2017, life expectancy for people at age 65 actually increased. Also, regarding drug overdose deaths, the rate of increase in drug overdose deaths slowed between 2016 and 2017, although the increases that occurred were still very significant.

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Infant Mortality by Age at Death in the United States, 2016

November 16, 2018

Questions for Danielle Ely, Ph.D., Health Statistician and Author of “Infant Mortality by Age at Death in the United States, 2016

Q:  What made you decide to focus on the age when infants die in this new analysis of infant mortality in the United States?

DE:  We focused this study on the age when infants die for a number for reasons. Age at death is an important factor in the risk of infant mortality. One important statistic is that infants are more likely to die before 28 days of age (neonatal deaths) than infants who live to 28 days and older (postneonatal deaths.) By presenting infant mortality rates by age at death, we show the differences in the likelihood of death between these two infant groups — information that can help inform the U.S. Public Health Community, families, and physicians on this critical age factor in infant lives and deaths.


Q:  What sort of trend data do you have for the demographics and the cause of death data in your new study on infant mortality at the age of death?

DE:  We have interesting trend data here in this report, as well as other public-use resources that are available for further research and data. Our new report looks at the overall trends in infant, neonatal and postneonatal mortality rates from 2007 (the most recent peak in infant mortality) through 2016. For 2016, we looked at infant mortality rates by mother’s race and Hispanic origin and age and cause of death.


Q:  Was there a result in your study’s analysis of infant mortality at the age of death that you hadn’t expected and that really surprised you?

DE:  An important finding in this study is the lack of improvements to infant mortality. Since infant mortality had been on the decline in the United States for much of the last two decades, it was surprising that the infant mortality rate did not show significant declines from 2011-2016. Another recent report also showed a similar lack of improvement in fetal/perinatal mortality rates from 2014 through 2016.


Q:  What differences, if any, did you see in infant mortality among race and ethnic groups, or any other demographics?

DE:  The sometimes substantial differences among race and Hispanic origin groups in this report on infant mortality are noteworthy. We found that infants of non-Hispanic black mothers continue to have total, neonatal, and postneonatal mortality rates that were more than two times as high as infants of non-Hispanic white, Asian or Pacific Islander, or Hispanic mothers. Infants of American Indian or Alaska Native mothers had the next highest rates and had postneonatal mortality rates that were similar to infants of non-Hispanic black mothers.


Q:  What would you say is the take-home message of this report?

DE:  The most important message from this data brief is the lack of improvement in total infant mortality rates since 2011. Neonatal infants of all race and Hispanic origin groups we examined have higher mortality rates than postneonatal infants. Further, infants of non-Hispanic black women continue to have a higher risk of mortality than infants of non-Hispanic white, Asian or Pacific Islander, American Indian or Alaska Native, or Hispanic mothers. This information can further our understanding of current infant mortality trends and provide information on where improvements can be made.


Health Insurance Coverage: Early Release of Estimates From the National Health Interview Survey, January–June 2018

November 15, 2018

A new report from NCHS presents selected estimates of health insurance coverage for the civilian noninstitutionalized U.S. population based on data from the 2018 National Health Interview Survey, along with comparable estimates from previous calendar years. Estimates for the first 6 months of 2018 are based on data for 39,112 persons.

Key Findings:

  • In the first 6 months of 2018, 28.5 million persons of all ages (8.8%) were uninsured at the time of interview—not significantly different from 2017, but 20.1 million fewer persons than in 2010.
  • In the first 6 months of 2018, among adults aged 18–64, 12.5% were uninsured at the time of interview, 20.0% had public coverage, and 69.2% had private health insurance coverage.
  • In the first 6 months of 2018, among children aged 0–17 years, 4.4% were uninsured, 43.4% had public coverage, and 53.6% had private health insurance coverage.
  • Among adults aged 18–64, 69.2% (137.1 million) were covered by private health insurance plans at the time of interview in the first 6 months of 2018. This includes 4% (7.9 million) covered by private health insurance plans obtained through the Health Insurance Marketplace or state-based exchanges.
  • The percentage of persons under age 65 with private health insurance enrolled in a high-deductible health plan increased, from 43.7% in 2017 to 46.0% in the first 6 months of 2018.

Fact or Fiction: Is yoga is the fastest-growing complementary health approach among children and adults in the United States?

November 8, 2018

 


Use Of Yoga and Meditation Becoming More Popular in U.S.

November 8, 2018

The use of yoga and meditation has increased in the U.S., according to two new reports released by the CDC’s National Center for Health Statistics (NCHS).

The first report “Use of Yoga, Meditation, and Chiropractors Among U.S. Adults Aged 18 and Older” examines changes from 2012 to 2017 in the percentage of U.S. adults that used yoga, meditation and chiropractors in the past 12 months. Of the three complementary health approached presented, yoga was the most commonly among U.S. adults in 2012 (9.5%) and 2017 (14.3%). The use of meditation increased more than threefold from 4.1% in 2012 to 14.2% in 2017.

The second report released today, “Use of Yoga, Meditation and Chiropractors Among U.S. Children Aged 4–17 Years,” reveals that U.S. children aged 4-17 years who used yoga in the past 12 months increased significantly from 3.1% in 2012 to 8.4% in 2017. Further examination of 2017 data showed that girls were more likely than boys to have used yoga in the past 12 months (11.3% vs. 5.6%).

Other findings documented in the reports:

  • In 2017, the use of yoga among U.S. adults aged 18-44 (17.9%) was more than twice that of adults 65 years and older (6.7%).
  • In 2017, non-Hispanic white adults were more likely to use yoga (17.1%) and see a chiropractor (12.7%) in the past 12 months compared with Hispanic (8% and 6.6%, respectively) and non-Hispanic black (9.3% and 5.5%, respectively) adults.
  • The use of yoga, meditation and chiropractors saw a significant increase from 2012 to 2017, among U.S. adults.
  • Use of meditation increased significantly for U.S. children from 0.6% in 2012 to 5.4% in 2017.
  • Older U.S. children aged 12-17 were more likely to have used meditation (6.5%) and a chiropractor (5.1%) than younger children aged 4-11 (4.7% and 2.1% respectively) in 2017.
  • There was no significant difference in the use of a chiropractor for children from 2012 to 2017.

The two reports, “Use of Yoga, Meditation, and Chiropractors Among U.S. Adults Aged 18 and Older” and “Use of Yoga, Meditation and Chiropractors Among U.S. Children Aged 4–17 Years” are available on the NCHS web site at www.cdc.gov/nchs.


“Births: Final Data for 2017” Released

November 7, 2018

The comprehensive report on final births data for the United States was released on November 7, 2018, documenting a total of 3,855,500 births registered in the United States, down 2% from 2016. Compared with rates in 2016, the general fertility rate declined to 60.3 births per 1,000 women aged 15–44. The birth rate for females aged 15–19 fell 7% in 2017. Birth rates declined for women in their 20s and 30s but increased for women in their early 40s. The total fertility rate declined to 1,765.5 births per 1,000 women in 2017. Birth rates for both married and unmarried women declined from 2016 to 2017, and the percentage of babies born to unmarried women (39.8) did not change between 2016 and 2017.  Many of these findings were documented in a May 2018 provisional release of 2017 data.

The final data are contained in the new publication “Births: Final Data for 2017.”

Some new data for 2017 are included for the first time in the new report:

  • The percentage of women who began prenatal care in the first trimester of pregnancy rose to 77.3% in 2017.
  • The percentage of all women who smoked during pregnancy declined to 6.9%. Percentages dropped for all race/ethnic groups from 2016 to 2017 except for Hispanic mothers (no change) and Native Hawaiian or Other Pacific Islander mothers (a 0.1 percentage point increase).
  • Medicaid was the source of payment for 43.0% of all births in 2017, up 1% from 2016.
  • Twin and triplet and higher-order multiple birth rates were essentially stable in 2017.
  • The average age of U.S. mothers at first birth in 2017 was 26.8 years, an increase from 26.6 years in 2016 – and a new all-time high.

QuickStats: Percentage of Residential Care Communities by U.S. Census Region — National Study of Long-Term Care Providers, 2012–2016

November 2, 2018

During 2012–2016, the percentage of residential care communities located in the West increased from 36.4% to 40.8%.

Throughout the period, a higher percentage of residential care communities were located in the West compared with other regions.

The percentage of residential care communities declined from 30.6% in 2012 to 28% in 2016 in the South and from 10.1% to 8.6% in the Northeast. In the Midwest, the percentage was 22.9% in 2012 and 22.6% in 2016.

Source: National Study of Long-Term Care Providers, 2012–2016 data. https://www.cdc.gov/nchs/nsltcp/index.htm.

https://www.cdc.gov/mmwr/volumes/67/wr/mm6743a7.htm