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 Lead Author Sally Curtin, Health Statistician, of “Mortality Among Adults Aged 25 and Over by Marital Status: United States, 2010–2017.”
Q: This study seems to confirm what other research has concluded, that married people tend to live longer. Would that be a correct assumption?
SC: Yes, many studies have found that married people have better health and live longer than unmarried people. In this report, we are presenting age-adjusted death rates which clearly show that the rates are lower for married than never-married, divorced or widowed adults. In addition, the age-adjusted death rate for married adults declined 7% over the period, the largest decline of any group.
Q: There are a lot of jokes and other narratives in pop culture that married life is far from ideal, and yet these results seem to at least suggest that there is one major positive outcome related to the institution. Do you know why that is?
SC: There has been much research over the years on the pathways through which marriage might work to result in better health outcomes. In particular, researchers have explored the question of whether marriage is selective for good health or whether the institution itself is protective of health. By selective, I mean that people who are healthier, or who have correlates of better health (e.g. more education, higher income), are more likely to marry. This is true for the most part. However, there has also been research that has shown that marriage is protective of health, particularly for men, because married people are more likely to have health insurance, and a spouse may encourage better lifestyle and health habits as well as assist in healthcare related activities (scheduling doctor’s appointments, etc…). For example, a 2014 NCHS report found that among men with health insurance, those who were married were more likely than their unmarried counterparts (including those who were cohabiting) to seek preventive health services.
Q: Was this the first time you studied this topic?
SC: NCHS publishes age-adjusted death rates by marital status every year in their final death report. However, this is the first specialized report on this topic in almost 50 years.
Q: Was there anything in the findings that were surprising?
SC: I think it was the fact that even though age-adjusted death rates are much lower for married adults, these rates declined 7% between 2010 and 2017. This was the greatest decline of all groups–rates for never married persons declined by 2%, rates for divorced persons remained stable, and rates for widowed persons actually increased, by 6%.
Q: The patterns seem pretty consistent among men and women. Was there anything that you found between the genders that was inconsistent?
SC: Both men and women had 7% declines in the age-adjusted death rate for married persons. However, for men, the other groups remained relatively stable from 2010 to 2017. For women, those who were divorced had stable death rates but never-married women had a decline of 3% while widowed women had a 6% increase.
Q: Anything else you’d like to add?
SC: Just that the next step is to look at these findings by selected causes of death to determine whether the lower death rates for married adults are broad across most of the leading causes or contained to a few specific causes.
Fact or Fiction: Are death rates for married people in the U.S. lower than the rates for unmarried people?October 10, 2019
Breast Cancer Screening Among Women by Nativity, Birthplace, and Length of Time in the United StatesOctober 9, 2019
Questions for Lead Author Tainya Clarke, Health Statistician, of “Breast Cancer Screening Among Women by Nativity, Birthplace, and Length of Time in the United States.”
Q: Why did you decide to do a report on mammography screening among women by nativity?
TC: There is currently limited published research on how nativity, birthplace and/or lifetime in the US of ethnically diverse foreign-born women affect the likelihood of having a mammogram.
Q: How did the data vary by nativity, birthplace and lifetimes in the United States?
TC: Foreign-born women were less likely than US-born women to have ever had a mammogram. If evaluated on equal standing for selected sociodemographic factors e.g. income, education, marital status; foreign-born women residing in the United States for less than 25% of their lifetime were as likely as US-born women to have met the U.S. Preventive Services Task Force (USPSTF) recommendations, while those residing in the United States for 25% or more of their lifetime were more likely to do so than US-born women.
Q: Was there a specific finding in your report that surprised you?
TC: Yes, we found that after controlling for the sociodemographic factors examined in this research, foreign-born women from some countries such as Mexico, and Central America were more likely to have received mammogram compared with US-born women.
Q: How did you obtain this data for this report?
TC: The data was obtained from the National Center for Health Statistics NCHS and most of the information used are publicly available. Information such as country of birth and year of immigration may be obtained through the CDC’s Research Data Center (RDC) by submitting a proposal stating the reason for use.
Q: What is the take home message for this report?
TC: Length of lifetime in the US among foreign-born women have some positive affect on the likelihood of having a mammogram among foreign-born women. However, analyses indicate that the absence of some sociodemographic factors such as health insurance coverage, usual place for medical care, and poor standing in some factors such as educational attainment, seeing a doctor in the past year and income, also play a role in the likelihood of getting a mammogram among foreign-born women.
Reported Importance and Access to Health Care Providers Who Understand or Share Cultural Characteristics With Their Patients Among Adults, by Race and EthnicityOctober 8, 2019
Questions for Emily P. Terlizzi, M.P.H., Lead Author on “Reported Importance and Access to Health Care Providers Who Understand or Share Cultural Characteristics With Their Patients Among Adults, by Race and Ethnicity”
Q: Why did you choose to look at this topic?
ET: As we mention in the report, the National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care, or the CLAS standards, were released from OMH in order to provide guidance to health care organizations in order to practice more culturally competent care. Previously though, there weren’t a lot of sources of nationally representative data to measure progress towards these standards. So to address this, there were several questions added to the NHIS in 2017 about patients’ perceptions of cultural competence of their health care providers. This report takes a look at two of these questions, and is one of few which provides nationally representative data on perceptions of cultural competence in the health care setting.
Q: How do you measure how well a provider “understands” their patient’s culture?
ET: The questions asked on the NHIS that are analyzed in this report are asking about patient’s perceptions of their providers. The question asks “Some people think it is important for their providers to understand or share their race or ethnicity or gender or religion or beliefs or native language. How important is it to you that your health care providers understand or are similar to you in any of these ways? Would you say… very important, somewhat important, slightly important, or not important at all”? We don’t know specifically what the respondents were thinking of when they answered these questions, just what they were asked and how they answered.
Q: What were some of the more interesting findings you uncovered?
ET: Among adults who had seen a health care professional in the past 12 months, the percentage of non-Hispanic white adults who thought it was very important to have a health care provider who shared or understood their culture was significantly lower than that among all other race and Hispanic-ethnicity groups. Among those who thought it was at least slightly important to have a health care provider who shared or understood their culture, minority groups were generally more likely to report never being able to see a culturally similar health care provider compared with non-Hispanic white adults, and this pattern persisted regardless of sex, age group, or urbanicity.
Q: So would you say that the “lack of understanding” or sharing of culture is a problem in the U.S.?
ET: I can’t speak to the implications of these findings, but what I can say is that per our 2017 data, there are racial and ethnic differences in reported importance and access to health care providers who share or understand their culture.
Q: What will this information do to improve health care quality in the U.S.?
ET: This study examined racial and ethnic differences in patients’ perceptions of the importance and frequency of seeing providers who share or understand their cultural characteristics. Our study isn’t looking at the effects on health care quality, but is just the start of measuring progress towards the CLAS standards.
Q: Any other things about this study that you’d like people to be aware of?
A: I think the take home message of the report is that racial and ethnic minorities were more likely to find it important that their provider share or understand their culture, but were less likely to be able to see a provider who met these criteria.
QuickStats: Percentage of Adults Aged 18–24 Years Who Currently Smoke Cigarettes or Who Currently Use Electronic Cigarettes, by Year — National Health Interview Survey, United States, 2014–2018October 4, 2019
From 2014 to 2018, the percentage of adults aged 18–24 years who currently smoked cigarettes decreased from 16.7% to 7.8%. The percentage of adults in this age group who currently used electronic cigarettes increased from 5.1% to 7.6%.
Source: National Health Interview Survey, 2014–2018 data. https://www.cdc.gov/nchs/nhis.htm.