Untitled
Untitled
Untitled
Suggested citation
National Center for Health Statistics.
Health, United States, 2014 is the 38th report on the health Trend Tables
status of the nation and is submitted by the Secretary of the
Department of Health and Human Services to the President The Chartbook is followed by 123 detailed Trend Tables that
and the Congress of the United States in compliance with highlight major trends in health statistics. Comparability
Section 308 of the Public Health Service Act. This report across editions of Health, United States is fostered by
was compiled by the Centers for Disease Control and including similar Trend Tables in each volume, and
Prevention's (CDC) National Center for Health Statistics timeliness is maintained by improving the content of tables
(NCHS). to reflect key topics in public health. An important criterion
The Health, United States series presents an annual overview used in selecting these tables is the availability of
of national trends in health statistics. The report contains a comparable national data over a period of several years.
Chartbook that assesses the nation's health by presenting
trends and current information on selected measures of Appendixes
morbidity, mortality, health care utilization and access,
health risk factors, prevention, health insurance, and Appendix I. Data Sources describes each data source used in
personal health care expenditures. This year's Chartbook Health, United States and provides references for further
includes a Special Feature on the health of adults aged information about the sources. Data sources are listed
55–64. The report also contains 123 Trend Tables organized alphabetically within two broad categories: Government
around four major subject areas: health status and Sources, and Private and Global Sources.
determinants, health care utilization, health care resources,
Appendix II. Definitions and Methods is an alphabetical
and health care expenditures. A companion report—Health,
listing of selected terms used in Health, United States. It also
United States: In Brief—features information extracted from
contains information on the statistical methodologies used
the full report. The complete report, In Brief, and related data
in the report.
products are available on the Health, United States website
at: http://www.cdc.gov/nchs/hus.htm.
Index
The 2014 Edition The Index to the Trend Tables and Chartbook figures is a
useful tool for locating data by topic. Tables and figures are
Health, United States, 2014 contains a summary At a Glance cross-referenced by such topics as child and adolescent
table that displays selected indicators of health and their health; older population aged 65 and over; women's health;
determinants, cross-referenced to charts and tables in the men's health; state data; American Indian and Alaska Native,
report. This is followed by a Highlights section, a Chartbook, Asian, black or African American, and Hispanic-origin
detailed Trend Tables, two Appendixes, and an Index. The populations; education; injury; disability; and metropolitan
major sections of the 2014 report are described below. and nonmetropolitan data. Many of the Index topics are also
available as conveniently grouped chart packages on the
Chartbook Health, United States website at: http://www.cdc.gov/nchs/
hus.htm.
The 2014 Chartbook contains 29 figures, including 10 figures
on this year's Special Feature on the health of adults aged
55–64 (Figures 20–29). The Special Feature figures provide
Data Considerations
an overview of the health and well-being of the current
55–64 group as they approach retirement age and
Racial and Ethnic Data
enrollment in the Medicare program, noting similarities and Many tables in Health, United States present data according
differences with 55- to 64-year-olds a decade ago, who are to race and Hispanic origin, consistent with a department-
now enrolled in Medicare. Data are presented on leading wide emphasis on expanding racial and ethnic detail when
causes of death, prevalence of chronic physical and mental presenting health data. Trend data on race and ethnicity are
health conditions, health behavior patterns, health presented in the greatest detail possible after taking into
insurance coverage, and health care utilization and access in account the quality of the data, the amount of missing data,
this year’s Special Feature. and the number of observations. These issues significantly
affect the availability of reportable data for certain
populations, such as the Native Hawaiian and Other Pacific
Questions?
If you have questions about Health, United States or related
data products, please contact:
Office of Information Services
Information Dissemination Staff
National Center for Health Statistics
Centers for Disease Control and Prevention
3311 Toledo Road, Room 5419
Hyattsville, MD 20782–2064
Phone: 1–800–CDC–INFO (1–800–232–4636)
TTY: 1–888–232–6348
Internet: http://www.cdc.gov/nchs
Online request form: http://www.cdc.gov/cdc-info/
requestform.html
For e-mail updates on NCHS publication releases,
subscribe online at: http://www.cdc.gov/nchs/
govdelivery.htm.
References
1. Altman B, Bernstein A. Disability and health in the United
States, 2001–2005. Hyattsville, MD: NCHS; 2008. Available from:
http://www.cdc.gov/nchs/data/misc/disability2001-2005.pdf.
2. CDC. Youth Risk Behavior Surveillance System (YRBSS).
Interpretation of YRBS trend data. Atlanta, GA; 2014. Available
from: http://www.cdc.gov/HealthyYouth/yrbs/pdf/
YRBS_trend_interpretation.pdf.
3. SUDAAN, release 11.0.0 [computer software]. Research Triangle
Park, NC: RTI International; 2012.
with Ji-Eun Kim. Data and analysis for specific charts were
CDC/OD/OADC.
Beth Han, Kevin Hennessey, Sharon Larson, Neil Russell, and
Barbara J. Wassell.
Contents
Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . iii
Health Risk Factors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Acknowledgments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vi
Current Cigarette Smoking . . . . . . . . . . . . . . . . . . . . . 13
Prevention . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
At a Glance Table . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Vaccination Coverage Among Children
Highlights . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Aged 19–35 Months. . . . . . . . . . . . . . . . . . . . . . . . . . 16
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
Mortality. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Infant Mortality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Suicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Natality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Technical Notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46
Teenage Childbearing . . . . . . . . . . . . . . . . . . . . . . . . . 12
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
Morbidity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Diabetes Prevalence. . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Disability Measures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Limitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Population . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
Mortality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76
Personnel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 291
Facilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 297
Appendixes
Appendix Contents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 353
Index
Index. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 449
Population age 75, by sex, race, and Hispanic origin: United States,
1950–2013 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
origin, state, and territory: United States and U.S.
years 1970–2013 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
1980 and 2013 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97
years 1970–2013 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64
Table 23. Death rates for all causes, by sex, race,
Table 7. Low birthweight live births, by race and Hispanic Hispanic origin, and age: United States, selected years
origin of mother, state, and territory: United States and 1950–2013 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106
2011–2013 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65
Hispanic origin, and age: United States, selected years
1982–2013 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
years 1950–2013 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 116
2005–2007 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75
1983–2012 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76
Table 33. Death rates for suicide, by sex, race, Hispanic Table 49. Hearing limitations among adults aged 18 and
origin, and age: United States, selected years over, by selected characteristics: United States, selected
1950–2013 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 138 years 2007–2013 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 176
Table 34. Death rates for firearm-related injuries, by sex, Table 50. Respondent-assessed fair-poor health status,
race, Hispanic origin, and age: United States, selected by selected characteristics: United States, selected
years 1970–2013 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 141 years 1991–2013 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 178
Table 35. Deaths from selected occupational diseases Table 51. Serious psychological distress in the past
among persons aged 15 and over: United States, 30 days among adults aged 18 and over, by selected
selected years 1980–2013 . . . . . . . . . . . . . . . . . . . . . . . . 144 characteristics: United States, average annual, selected
Table 36. Occupational fatal injuries, by industry, sex, age, years 1997–1998 through 2012–2013 . . . . . . . . . . . . . . 180
race, and Hispanic origin: United States, selected years Table 52. Current cigarette smoking among adults
2003–2012 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 145 aged 18 and over, by sex, race, and age: United States,
selected years 1965–2013 . . . . . . . . . . . . . . . . . . . . . . . . 182
Determinants and Measures of Health Table 53. Age-adjusted prevalence of current cigarette
Table 37. Selected notifiable disease rates and number of smoking among adults aged 25 and over, by sex, race,
new cases: United States, selected years 1950–2012. . . 147 and education level: United States, selected years
1974–2013 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 184
Table 38. Human immunodeficiency virus (HIV) diagnoses,
by year of diagnosis and selected characteristics: Table 54. Current cigarette smoking among adults
United States, 2008–2012 . . . . . . . . . . . . . . . . . . . . . . . . 149 aged 18 and over, by sex, race, Hispanic origin, age, and
education level: United States, average annual, selected
Table 39. Health conditions among children under age 18, years 1990–1992 through 2011–2013 . . . . . . . . . . . . . . 185
by selected characteristics: United States, average annual,
selected years 1997–1999 through 2011–2013 . . . . . . . 151 Table 55. Use of selected substances in the past month
among persons aged 12 and over, by age, sex, race,
Table 40. Age-adjusted cancer incidence rates for and Hispanic origin: United States, selected years
selected cancer sites, by sex, race, and Hispanic origin: 2002–2013 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 188
United States, selected geographic areas, selected years
1990–2011 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 156 Table 56. Use of selected substances in the past 30 days
among 12th graders, 10th graders, and 8th graders,
Table 41. Five-year relative cancer survival rates for by sex and race: United States, selected years
selected cancer sites, by race and sex: United States, 1980–2013 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 190
selected geographic areas, selected years 1975–1977
through 2004–2010 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 160 Table 57. Health risk behaviors among students in
grades 9–12, by sex, grade level, race, and Hispanic
Table 42. Respondent-reported prevalence of heart disease, origin: United States, selected years 1991–2013 . . . . . . 193
cancer, and stroke among adults aged 18 and over, by
selected characteristics: United States, average annual, Table 58. Heavier drinking and drinking five or more
selected years 1997–1998 through 2012–2013 . . . . . . . 161 drinks in a day among adults aged 18 and over, by
selected characteristics: United States, selected years
Table 43. Number of respondent-reported chronic 1997–2013 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 196
conditions from 10 selected conditions among adults aged
18 and over, by selected characteristics: United States, Table 59. Selected health conditions and risk factors,
selected years 2002–2013 . . . . . . . . . . . . . . . . . . . . . . . . 163 by age: United States, selected years 1988–1994
through 2011–2012 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 199
Table 44. Diabetes prevalence and glycemic control
among adults aged 20 and over, by sex, age, and race and Table 60. Hypertension among adults aged 20 and over,
Hispanic origin: United States, selected years 1988–1994 by selected characteristics: United States, selected
through 2009–2012 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 165 years 1988–1994 through 2009–2012 . . . . . . . . . . . . . . 201
Table 45. End-stage renal disease patients, by selected Table 61. Cholesterol among adults aged 20 and over, by
characteristics: United States, selected years selected characteristics: United States, selected years
2000–2012 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 167 1988–1994 through 2009–2012 . . . . . . . . . . . . . . . . . . . 203
Table 46. Severe headache or migraine, low back pain, Table 62. Mean macronutrient intake among adults
and neck pain among adults aged 18 and over, by aged 20 and over, by sex and age: United States,
selected characteristics: United States, selected years selected years 1988–1994 through 2009–2012 . . . . . . . 207
1997–2013 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 169 Table 63. Participation in leisure-time aerobic and
Table 47. Disability measures among adults aged 18 and muscle-strengthening activities that meet the federal
over, by selected characteristics: United States, selected 2008 Physical Activity Guidelines for Americans among
years 1997–2013 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 172 adults aged 18 and over, by selected characteristics:
United States, selected years 1998–2013 . . . . . . . . . . . . 209
Table 48. Vision limitations among adults aged 18 and
over, by selected characteristics: United States, selected
years 1997–2013 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 174
antihypertensive medication.
2
Includes physician-diagnosed and undiagnosed diabetes (fasting plasma glucose of at least 126 mg/dL or a hemoglobin A1c of at least 6.5%).
3
Having high serum total cholesterol of 240 mg/dL or greater and/or respondent report of taking cholesterol-lowering medication.
4
Obesity is a body mass index (BMI) greater than or equal to 30 for adults. Height and weight are measured rather than self-reported.
5
Federal guidelines recommend at least 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity aerobic physical activity a week and muscle-
6
Copyright 2014. Used with permission of the American Medical Association.
7
Copyright 2014. Used with permission of Health Forum LLC, an affiliate of the American Hospital Association.
NOTES: Estimates in this table are taken from the PDF, printed, or spreadsheet versions of the cited tables. For more information and the spreadsheet versions of the
tables, see the complete report, Health, United States, 2014, available from: http://www.cdc.gov/nchs/hus.htm.
This section presents selected data from this year's Special population; by 2013, the difference had narrowed to 3.6
Feature on the health of the population aged 55–64 and years (Table 16).
from the four major areas included in the report: health
Between 2003 and 2013, the infant mortality rate decreased
status and determinants, utilization of health resources,
13%, from 6.85 to 5.96 deaths per 1,000 live births. In 2003,
health care resources, and health care expenditures and
the infant mortality rate for white mothers was 5.72,
payers. The section focuses on topics of public health
compared with 14.01 for black mothers; by 2013, the infant
importance and illustrates the breadth of material included
mortality rate declined to 5.07 among white mothers and
in Health, United States. Each highlight includes a reference
11.22 among black mothers (Table 12).
to the detailed trend table, spreadsheet file, or figure where
more information can be obtained. In 2013, the 10 leading causes of death were heart disease,
cancer, chronic lower respiratory diseases, unintentional
injuries, stroke, Alzheimer’s disease, diabetes, influenza and
Special Feature on Adults Aged 55–64 pneumonia, nephritis, and suicide. These 10 causes of death
accounted for 74% of the 2.6 million deaths in 2013
All-cause death rates in 2013 for those aged 55–64 were 6% (Table 20).
lower for men and 11% lower for women than in 2003,
driven by decreases in death rates for cancer and heart Between 2003 and 2013, the age-adjusted heart disease
disease (Figure 20). death rate decreased 28%, from 236.3 to 169.8 deaths per
100,000 population. In 2013, 24% of all deaths in the United
In 2012–2013, 18.1% of noninstitutionalized adults aged States were from heart disease (Tables 20 and 24).
55–64 were current cigarette smokers, 8% lower than the
percentage in 2002–2003 (19.7%) (Figure 23). Between 2003 and 2013, the age-adjusted cancer death rate
decreased 15%, from 190.9 to 163.2 deaths per 100,000
For adults aged 55–64, the percentage with private health population. In 2013, 23% of all deaths in the United States
insurance was lower for all family income groups in 2012– were from cancer (Tables 20 and 26).
2013 compared with 2002–2003, with the largest loss of
private coverage occurring for those with family income Between 2003 and 2013, the age-adjusted suicide death rate
below 200% of the poverty level (Figure 25). increased 17%, from 10.8 to 12.6 deaths per 100,000
population. In 2013, 17% of deaths among those aged
In 2009–2012, the percentage of adults aged 55–64 who 15–24 and 11% of deaths among those aged 25–44 were
took no, 1–4, or 5 or more prescription drugs in the past from suicide (Tables 21 and 33).
30 days was similar to levels in 1999–2002; use of
prescription cholesterol-lowering drugs was 54% higher Between 2003 and 2013, the age-adjusted drug poisoning
among 55- to 64-year-olds in 2009–2012 (31.8%) compared death rate involving opioid analgesics increased from 2.9 to
with 1999–2002 (20.6%) (Figure 28). 5.1 deaths per 100,000 population. In 2013, the drug
poisoning death rate involving opioid analgesics was
highest among those aged 45–54 (10.6), followed by those
Health Status and Determinants aged 35–44 (8.6), 25–34 (7.5), and 55–64 (7.5) (Table 30).
In 2011, children under age 21 accounted for 47.2% of In 2013, Massachusetts (4.4%), the District of Columbia
Medicaid recipients but only 19.6% of Medicaid (7.1%), Puerto Rico (7.7%), Vermont (8.1%), and Hawaii
expenditures. The aged and blind and persons with (8.3%) had the lowest percentages of persons uninsured
disabilities accounted for 20.3% of Medicaid recipients and (i.e., without public or private coverage) among those under
60.6% of Medicaid expenditures (Table 118). 65, while Nevada (23.4%), Florida (24.2%), and Texas (24.5%)
had the highest percentages (Table 123, a new table in the
In 2013, the Medicare program had 52.3 million enrollees 2014 edition).
and expenditures of $582.9 billion, up from 50.9 million
enrollees and $574.2 billion expenditures the previous year.
Expenditures for the Medicare drug program (Part D) were
$69.7 billion in 2013 (Table 116).
Mortality
Life Expectancy at Birth
Figure 1. Life expectancy at birth, by selected characteristics: United States, Between 2003 and 2013, life expectancy at birth
1980–2013 increased for white females (1.2 years), white
males (1.6 years), black females (2.7 years), and
100
2013 black males (3.4 years).
Black, not Hispanic Life expectancy is a measure often used to
White, not Hispanic gauge the overall health of a population (1).
Between 1980 and 2013, life expectancy at birth
Life expectancy at birth, in years
starting in 2006.
Excel and PowerPoint: http://www.cdc.gov/nchs/hus/contents2014.htm#fig01 Data from the National Vital Statistics System (NVSS).
Mortality
Infant Mortality
Infant, neonatal, and postneonatal mortality rates
declined 13% between 2003 and 2013. Figure 2. Infant, neonatal, and postneonatal mortality rates: United States,
The infant mortality rate is the risk of death 2003–2013
during the first year of life (1). The 2013 infant 10
mortality rate of 5.96 per 1,000 live births—a
historical low—was 13% lower than in 2003.
During the same period, the neonatal mortality
rate (death rate among infants under 28 days, a 8
subset of infant mortality) decreased 13% to
Deaths per 1,000 live births
Infant
4.04 per 1,000 live births, and the postneonatal
mortality rate (death rate among infants 28
days through 11 months, a subset of infant 6
mortality) declined 13% to 1.93 per 1,000 live
births. Neonatal
0
2003 2013
Figure 3. Age-adjusted death rates for selected causes of death for all ages, Between 2003 and 2013, the all-cause age-
by sex: United States, 2003–2013 adjusted death rate decreased 15% among males
and 13% among females.
10,000
Male Female During this 10-year period, age-adjusted death
rates among males declined 34% for stroke, 27%
Deaths per 100,000 population (log scale)
Excel and PowerPoint: http://www.cdc.gov/nchs/hus/contents2014.htm#fig03 SOURCE: CDC/NCHS, Health, United States, 2014, Table 18.
Mortality
Suicide
In 2013, suicide rates were highest for males aged
45–64 (29.0) and 65 and over (30.9); rates were Figure 4. Suicide death rates, by sex and age: United States, 2003–2013
substantially lower for females aged 45–64 (9.4)
and 25–44 (6.8).
40
Suicide was the 10th leading cause of death in the
U.S., with more than 40,000 deaths in 2013
(Table 20). Suicide deaths take a large emotional
toll on family and friends (2,3). Biological, social, Male
65 years and over
Deaths per 100,000 population
not Hispanic
Between 2003 and 2013, birth rates declined
100 45% for teenagers aged 15–17 and 32% for
those aged 18–19 (Table 3). Birth rates were
higher among Hispanic and non-Hispanic black
American Indian teenagers than among other racial and ethnic
or Alaska Native groups. Since 2003, birth rates have decreased
Black,not American
Hispanic Hispanic Indian 54% for Hispanic teenagers aged 15–17 and
50 51% for non-Hispanic black teenagers in the
or Alaska
White, not Hispanic same age group. Also during this period, birth
Native
rates for those aged 18–19 decreased 43% for
White, not Hispanic Hispanic teenagers and 35% for non-Hispanic
Asian or Pacific Islander black teenagers.
Morbidity
Diabetes Prevalence
In 2009–2012, 26.8% of those aged 65 and over
had diabetes (diagnosed or undiagnosed), Figure 6. Diagnosed and undiagnosed diabetes prevalence among adults aged
compared with 16.2% of those aged 45–64 and 20 and over, by age: United States 1988–1994 and 2009–2012
3.7% of those aged 20–44.
Diabetes is a complex chronic condition 20–44 years
requiring ongoing medical care and active Undiagnosed Physician-
1988–1994 *2.1 diabetes diagnosed
patient self-management (5,6). Long-term
diabetes
complications of diabetes include heart disease 1.6 2.1
and renal, nerve, and retinal damage. In 2013, 2009–2012 3.7
diabetes was the 7th leading cause of death in
the U.S. (Table 20). Between 1988–1994 and
2009–2012, diabetes prevalence among adults 45–64 years
aged 20 and over increased from 8.8% to 11.7% 1988–1994 6.0 7.9 14.0
(age-adjusted; Table 44). The increase occurred
only for those aged 20–44 and 65 and over. 2009–2012 4.8 11.4 16.2
In 2009–2012, the prevalence of diabetes
increased with age among adults from 3.7% of 65 years and over
those 20–44 to 16.2% of those 45–64, and 1988–1994 6.7 12.7 19.4 * Components not
shown because
26.8% of those 65 and over. Although diabetes total is unreliable
prevalence is lowest among adults aged 20–44, 2009–2012 5.5 21.2 26.8 (relative standard
the undiagnosed share is larger than in other error 20%–30%).
age groups.
0 10 20 30 40 50
NOTE: The components of diabetes may not sum to the total
due to rounding.
Percent
SOURCE: CDC/NCHS, Health, United States, 2014, Table 44.
Survey (NHANES).
Excel and PowerPoint: http://www.cdc.gov/nchs/hus/contents2014.htm#fig06
Figure 7. Basic actions difficulty and complex activity limitation among adults The prevalence of basic actions difficulty is higher
aged 18 and over, by sex and age: United States, 2003–2013 among those aged 65 and over than those aged
18–64; the prevalence of complex activity
100 limitation also is higher among those aged 65 and
At least one basic actions At least one complex activity over compared with those aged 18–64.
difficulty limitation
Basic actions difficulty and complex activity
80 limitation are two constructs to measure
disability (7). Basic actions difficulty captures at
65 years and over
Women least one limitation in movement, emotional,
sensory, or cognitive functioning associated with
60
a health problem. Complex activity limitation is a
Percent
women aged 18–44 and aged 45–64, while High school seniors
remaining stable for men and women aged 65
18–44 years
and over. In 2013, 20.5% of adult men aged 18 20 45–64 years
and over and 15.3% of adult women were High school seniors 45–64 years
current cigarette smokers (Table 52).
0
2003 2013 2003 2013
20–44 years declined for all age groups for men and women.
45–64 years
However, nearly one-half (47.4%) of adults aged
40 20 and over with hypertension had
65–74 years 45–64 years uncontrolled high blood pressure in 2009–2012
(Table 60).
20
SOURCE: CDC/NCHS, Health, United States, 2014, Table 60.
Data from the National Health and Nutrition Examination
Survey (NHANES).
0
1988– 1999– 2003– 2009– 1988– 1999– 2003– 2009–
1994 2002 2006 2012 1994 2002 2006 2012
Figure 11. Overweight and obesity among adults aged 20 and over, by Between 1988–1994 and 2009–2012, the
sex: United States, 1988–1994 through 2009–2012 prevalence of men and women with Grades 1, 2,
and 3 obesity increased while the prevalence of
100
Men Women men and women aged 20 and over who were
overweight but not obese was stable.
Reducing the prevalence of obesity is a public
80
health priority because obesity is correlated
Grade 3 obesity
Prevention
Influenza and Pneumococcal Vaccination
During 2003–2013, influenza vaccination in the
past 12 months increased among adults under Figure 12. Influenza and pneumococcal vaccination among noninstitutionalized
age 75, while remaining stable among those aged adults aged 18 and over, by type of vaccination and age: United States,
Prevention
Colorectal Tests and Procedures
Between 2003 and 2013, colorectal cancer tests and
procedures increased 48% among noninsti Figure 14. Colorectal tests and procedures among adults aged 50–75, by
tutionalized adults aged 50–75, to 57.8% in 2013. race and ethnicity: United States, 2003 and 2013
Among men and women, colorectal cancer is the
third leading cause of cancer deaths responsible
for more than 50,000 deaths a year (1,23). The U.S. 39.1
Preventive Services Task Force recommends Total
57.8
colorectal cancer screening for those aged 50–75
(24). A variety of colorectal tests are
41.0
recommended (Table 78). Increased screening can White, not Hispanic
reduce colorectal cancer incidence because the 60.4
tests can find precancerous growths that can be
removed before they progress to cancer. 35.3
Black, not Hispanic
Screening also increases the likelihood that 58.2
colorectal cancer will be detected at an earlier and
thus, more treatable stage (23).
26.7
Between 2003 and 2013, the percentage of adults Asian
49.8
aged 50–75 who reported having colorectal tests
and procedures increased from 39.1% to 57.8%,
and increased among all racial and ethnic groups. 27.2 2003
Hispanic
In 2013, Hispanic and Asian adults were less likely 41.5 2013
than non-Hispanic white and non-Hispanic black
adults to have had colorectal tests and procedures.
0 10 20 30 40 50 60 70
SOURCE: CDC/NCHS, Health, United States, 2014,Table 78. Data Percent
from the National Health Interview Survey (NHIS).
Health Insurance
Coverage Among Adults Aged 19–25
Between 2010 and 2013, the percentage of
uninsured adults aged 19–25 decreased from Figure 16. Health insurance coverage among adults aged 19–25, by type
33.8% to 26.7%. of coverage: United States, 2003–2013
Adults aged 19–25 have had high levels of
uninsurance (Table 114). The percentage with 100
private coverage declined from 57.8% in 2003 to
51.8% in 2010 and then rose to 58.9% in 2013
(Table 111). Between 2003 and 2010, the
80
percentage uninsured was stable at 31%–34%, and
then decreased to 26.7% in 2013. The ACA allows
most young adults to remain on their parent’s
coverage until age 26 (fully effective in 2011) Private
60
(28–30). The percentage with Medicaid increased
Percent
22 Chartbook: Special Feature on Adults Aged 55–64 Health, United States, 2014
This Special Feature explores recent trends in important
health issues for the 55–64 age group. The charts that follow
provide detailed comparisons on key measures of mortality,
health status, health care access, and utilization between
those aged 55–64 in 2002–2003 and the current 55- to
64-year group. Differences by gender, socioeconomic status,
and racial and ethnic group within this age group are also
presented. Featured charts include leading causes of death;
prevalence of chronic physical and mental health conditions;
health behavior patterns (specifically, current cigarette
smoking and participation in leisure-time physical activity);
health insurance coverage; utilization of various sectors of
the health care system, prescription drugs, and prevention-
related services; and finally, an examination of problems
accessing the health care system due to financial
considerations. Together, the special feature charts provide
an overview of the health and well-being of the current 55–
64 group as they approach retirement age and enrollment in
the Medicare program, noting similarities and differences
with 55- to 64-year-olds a decade ago, who are now enrolled
in Medicare.
Health, United States, 2014 Chartbook: Special Feature on Adults Aged 55–64 23
Health, United States, 2014: Profile of the 55–64 age group
2002–2003 2012–2013
Percent Percent
Characteristic distribution SE distribution SE
Sex
Race/ethnicity1
Education2
Marital Status
SE is standard error.
1
Does not sum to 100% because all racial and ethnic groups are not presented.
2
GED is General Educational Development high school equivalency diploma. See Appendix II, Education.
3
Percent of poverty level is based on family income and family size and composition, using U.S. Census Bureau poverty thresholds. Missing family
4
Employment status was assessed by asking respondents what they were doing last week. If they responded they had a job but were not working
or not working and not looking for work, a followup question was asked that probed the main reason they were not working last week. Other
includes adults who were looking for work, or those who were not working and not looking for work (excluding those who responded they were not
NOTES: The detailed Trend Tables contained in Health, United States, 2014 provide additional data for the 55–64 age group: population numbers
(Table 1), death rates (Tables 23–34), morbidity measures (Tables 42, 43, 46, 48–50, 51, 52, 58, 60, 61, 63, and 64), health care access and
utilization of health care (Tables 68, 69, 71, 77, 80, 82, 83, 87, and 88), and health insurance coverage (Tables 111–114).
SOURCE: CDC/NCHS, National Health Interview Survey, family core questionnaire. See Appendix I, National Health Interview Survey (NHIS).
24 Chartbook: Special Feature on Adults Aged 55–64 Health, United States, 2014
Leading Causes of Death
In 2013, all-cause death rates for adults aged 55–64 were lower lower. In contrast, unintentional injury death rates were 31%
for both men and women compared with 2003, driven by higher in 2013, driven by a more than threefold increase in
decreases in death rates for the top two leading causes of death drug poisoning death rates (39); chronic liver disease death
for this group—cancer and heart disease. rates were 33% higher than in 2003. Compared with 2003,
death rates among men aged 55–64 in 2013 were lower for
Death rates are one summary measure of population health
chronic lower respiratory diseases (CLRD) (6%) and
and well-being. Variation in death rates between groups is
diabetes (7%).
associated with underlying distributions of health
determinants and risk factors, access to and use of health For women aged 55–64, the death rate for cancer—the
services, and public health efforts aimed at health leading cause of death in both periods—was 18% lower in
promotion and disease prevention (50). 2013 than in 2003, heart disease death rates were 24%
lower, and CLRD death rates were 6% lower. Unintentional
All-cause death rates in 2013 for those aged 55–64 were 6%
injury death rates were 35% higher, driven by a more than
lower for men and 11% lower for women than in 2003. In
threefold increase in drug poisoning death rates (39). Both
both time periods, all-cause death rates were higher for men
diabetes and stroke death rates were lower in 2013 than in
aged 55–64 than for women (68% higher in 2013).
2003 (22% and 25% lower, respectively).
For men aged 55–64, the death rate for cancer—the leading
cause of death in both periods—was 14% lower in 2013
than in 2003, and the death rate for heart disease was 19%
Figure 20. Death rates for leading causes of death among adults aged 55–64, by sex: United States, 2003–2013
10,000
Men Women
Deaths per 100,000 population (log scale)
All causes
1,000
All causes
Cancer
Cancer
Heart disease
Heart disease
100
Unintentional injuries CLRD
CLRD
Diabetes Diabetes
Chronic liver disease Stroke
and cirrhosis
Unintentional injuries
10
2003 2013 2003 2013
NOTES: CLRD is chronic lower respiratory diseases. Diabetes coding rules SOURCE: CDC/NCHS, National Vital Statistics System. See Appendix I, National
changed starting in 2011 resulting in an increased number of deaths coded to Vital Statistics System (NVSS).
Health, United States, 2014 Chartbook: Special Feature on Adults Aged 55–64 25
Selected Chronic Conditions
For adults aged 55–64, the percentage with hyper the levels in 1999–2002. In 2009–2012, one-half (50.1%) of
cholesterolemia was higher in 2009–2012 (50.1%) than in those aged 55–64 had hypercholesterolemiac (defined as
1999–2002 (39.1%), while the prevalence of other selected taking cholesterol-lowering medication or having a
chronic conditions was similar in both time periods. measured serum total cholesterol level of at least
240 mg/dL), up from 39.1% in 1999–2002. The percentage
Chronic conditions are common among those aged 55–64
with measured high cholesterol was stable, but the
and necessitate periodic contact with the health care system
percentage taking cholesterol-lowering drugs increased
for monitoring, treatment, and control to promote optimum
(Table 61) (56). Additionally, one-half (51.4%) of those aged
health and wellness. Obesity increases the risk of heart
55–64 in 2009–2012 had hypertensiond, similar to the level
disease, stroke, diabetes, certain cancers, kidney disease, and
in 1999–2002.
osteoarthritis (51). Diabetes increases the risk of heart
disease, stroke, kidney disease, blindness, and peripheral Increases in the prevalence of chronic conditions may be
nerve disease (52,53). High serum cholesterol levels increase related to a variety of factors, including higher incidence
the risk of heart disease and stroke (54). High blood pressure (new cases), longer duration with the condition, and
also increases the risk of heart disease and stroke (55). increased diagnosis.
In 2009–2012, about 2 in 10 (18.9%) of those aged 55–64
had diabetesa, and 4 in 10 were obeseb (40.6%), similar to
Figure 21. Selected chronic conditions among adults aged 55–64: United States, 1999–2002 and 2009–2012
1999–2002
16.7
Diabetesa 2009–2012
18.9
38.9
Obesityb
40.6
39.1
Hypercholesterolemiac
50.1
49.5
Hypertensiond
51.4
0 10 20 30 40 50 60 70
Percent
a d
Defined as respondent report of physician-diagnosed diabetes, or
Defined as reporting taking antihypertensive medication or having a
b
Defined as body mass index greater than or equal to 30.
NOTE: See data table for Figure 21.
c
Defined as reporting taking cholesterol-lowering medication or having
SOURCE: CDC/NCHS, National Health and Nutrition Examination Survey. See
26 Chartbook: Special Feature on Adults Aged 55–64 Health, United States, 2014
Psychological Distress: Serious or Mild-moderate
The prevalence of serious psychological distress for those aged experienced SPD varied by gender, racial and ethnic group,
55–64 was 22% higher in 2012–2013 (4.4%) than in 2002–2003 and family income for those aged 55–64. In 2012–2013,
(3.6%), while the prevalence of mild-moderate psychological SPD prevalence was higher for women (5.0%) than for
distress for those aged 55–64 was similar in both periods men (3.7%) and was higher for Hispanic adults (5.7%) than
(7.1% and 6.4%, respectively). non-Hispanic black adults (3.6%). The prevalence of SPD was
more than nine times as high for those living below poverty
Mental health is a key component of overall health and
(14.5%) as for those at 400% or more of poverty (1.5%).
well-being (57). Mental illnesses and conditions are serious,
disabling, and costly (2,58–62). Two measures of In 2012–2013, 7.1% of adults aged 55–64 experienced
psychological distress (serious and mild-moderate) are mild-moderate psychological distress (MMPD) in the past
explored based on respondents' responses to a series of six 30 days, similar to the percentage for the 55–64 group in
questions—the K6 scale—that asks how frequently they 2002–2003 (6.4%). As with SPD, MMPD varied by gender,
experienced symptoms of general psychological distress racial and ethnic group, and family income. In 2012–2013,
within the past 30 days (see data table for Figure 22) (63–66). prevalence of MMPD was higher for women (7.8%) than men
(6.3%) and for Hispanic adults (9.9%) than non-Hispanic
For adults aged 55–64, 4.4% had serious psychological
white (6.7%) adults. The prevalence of MMPD was more than
distress (SPD) in the past 30 days in 2012–2013, 22% higher
five times as high for those living below poverty (17.1%) as
than in 2002–2003 (3.6%). The percentage with SPD was
for those at 400% or more of poverty (3.1%) in 2012–2013.
higher in 2012–2013 than in 2002–2003 for men and for
non-Hispanic white persons. The percentage who
Figure 22. Serious or mild-moderate psychological distress in the past 30 days among adults aged 55–64, by selected
2002–2003 2012–2013
0 10 20 30 40 50 0 10 20 30 40 50
Percent Percent
NOTE: See data table for Figure 22. SOURCE: CDC/NCHS, National Health Interview Survey. See Appendix I,
National Health Interview Survey (NHIS).
Health, United States, 2014 Chartbook: Special Feature on Adults Aged 55–64 27
Current Cigarette Smoking
In 2012–2013, 18.1% of adults aged 55–64 were current of adults aged 55–64 who were current smokers in 2012–
cigarette smokers, 8% lower than the percentage in 2002–2003 2013 was lower than in 2002–2003 for women, Hispanic
(19.7%); cigarette smoking prevalence varied by persons, and those living at 400% or more of poverty.
sociodemographic group.
Cigarette smoking varies by gender, racial and ethnic group,
Tobacco use remains the leading preventable cause of death and family income for those aged 55–64. In 2012–2013, men
in the United States, resulting in about 480,000 deaths (20.7%) were more likely than women (15.7%), and non-
across all ages for each year during 2005–2009 (67). Tobacco Hispanic white (18.8%) and non-Hispanic black (21.5%)
use is associated with death from many types of cancer, adults were more likely than Hispanic (10.1%) adults to be
heart disease, diabetes, stroke, and chronic obstructive current smokers. Those living below poverty (32.4%) were
pulmonary disease (67–69)—all of which are major causes of nearly three times as likely to be current smokers as those at
death for those 55–64 (Figure 20). Quitting smoking has 400% or more of poverty (11.2%) in 2012–2013.
immediate health benefits, and in the long-term, the risks of
smoking-related diseases decrease (67,70–72).
In 2012–2013, 18.1% of adults aged 55–64 were current
cigarette smokers, which was 8% lower than the percentage
for 55- to 64-year-olds in 2002–2003 (19.7%). The percentage
Figure 23. Current cigarette smoking among adults aged 55–64, by selected characteristics: United States, average annual
2002–2003 and 2012–2013
2002–2003 2012–2013
0 10 20 30 40 50 0 10 20 30 40 50
Percent Percent
NOTE: See data table for Figure 23. SOURCE: CDC/NCHS, National Health Interview Survey. See Appendix I,
National Health Interview Survey (NHIS).
28 Chartbook: Special Feature on Adults Aged 55–64 Health, United States, 2014
Leisure-time Physical Activity
In 2012–2013, the percentage of adults aged 55–64 who moderate or high intensity and involve all major muscle
engaged in leisure-time aerobic and muscle-strengthening groups on 2 or more days a week.
activities at levels sufficient to meet federal guidelines was 23%
In 2012–2013, 15.7% of adults aged 55–64 met both the
higher than in 2002–2003; participation in leisure-time aerobic
aerobic activity and muscle-strengthening (AAMS) guidelines,
and muscle-strengthening activities varied by
23% higher than in 2002–2003 when 12.8% met the guidelines.
sociodemographic group.
For adults aged 55–64, the percentage who met AAMS
Physical activity has many positive health benefits, including guidelines was higher in 2012–2013 compared with 2002–2003
assisting with weight control, reducing the risk for many for all sociodemographic groups examined, except among
chronic conditions including heart disease and some Hispanic persons and those living at 100%–199% of poverty,
cancers, strengthening bones and musculature, improving where percentages were similar to the earlier period.
mental health, and decreasing the risk of premature death
Participation in AAMS varies by gender, racial and ethnic group,
(16,73–77). The 2008 Physical Activity Guidelines for Americans
and family income for adults aged 55–64. In 2012–2013, men
recommend adults perform at least 150 minutes a week of
(17.2%) were more likely than women (14.2%), and non-
moderate-intensity, or 75 minutes a week of vigorous-
Hispanic white (17.0%) adults were more likely than non-
intensity aerobic physical activity, or an equivalent
Hispanic black (12.3%) and Hispanic (10.2%) adults to have met
combination of moderate- and vigorous-intensity aerobic
AAMS guidelines. In 2012–2013, adults aged 55–64 living
activity (77). Aerobic activity should be performed in
below 200% of the poverty level were less likely to have met
episodes of at least 10 minutes. In addition, adults should
both AAMS guidelines than those with higher family income.
perform muscle-strengthening activities that are of
Figure 24. Participation in recommended levels of leisure-time aerobic and muscle-strengthening activities among adults aged
55–64, by selected characteristics: United States, average annual 2002–2003 and 2012–2013
2002–2003 2012–2013
0 10 20 30 0 10 20 30
Percent Percent
aerobic activity and muscle strengthening. See data table for Figure 24.
Health, United States, 2014 Chartbook: Special Feature on Adults Aged 55–64 29
Health Insurance Coverage
For adults aged 55–64, the percentage with private health insurance was nearly 50% lower than in 2002–2003 (20.5%). For those living
was lower for all family income groups in 2012–2013 compared with below 100% of the poverty level, the percentage with only public
2002–2003, with the largest loss of private coverage occurring for coverage was 17% higher and the percentage uninsured was
those with family income below 200% of the poverty level. 14% higher in 2012–2013 (32.0%) than in 2002–2003 (28.0%).
Similarly, for those at 100%–199% and 200%–399% of the
Health insurance coverage is a major determinant for access
poverty level, the percentage with private coverage and
to the health care system and influences both health care
workplace coverage was lower in 2012–2013 than in the earlier
utilization patterns and health outcomes (78).
period, and the percentage with only public coverage and the
Across all income groups, the percentage of adults aged 55–64 percentage uninsured was higher. For those in the highest family
with any private coverage—and private workplace income group, the percentage with private coverage was 2%
coverage—was lower in 2012–2013 than in 2002–2003, while lower in 2012–2013 (90.8%) than in 2002–2003 (92.5%), the
the percentage with only public coverage was higher in percentage with only public coverage was 53% higher (5.5%
2012–2013 than in the earlier period. The percentage of adults compared with 3.6%), and the percentage uninsured was similar
aged 55–64 who were uninsured was higher in 2012–2013 than (about 4%).
in 2002–2003 for all income groups below 400% of poverty.
In 2012–2013, a strong gradient persisted between family
For adults aged 55–64 living below 100% of the poverty level, the income and type of health insurance coverage. As family
percentage with private coverage in 2012–2013 (15.5%) was 43% income decreased, the share with private coverage and
lower than in 2002–2003 (27.3%), and the percentage with private workplace coverage decreased, and the share with
private coverage through the workplace (10.4% in 2012–2013) only public coverage, and the uninsured increased.
Figure 25. Health insurance coverage among adults aged 55–64, by percent of poverty level and type of coverage: United States,
average annual 2002–2003 and 2012–2013
2002–2003 2012–2013
Below 100%
Any private, including workplace 27.3 15.5
Private through workplace only 20.5 10.4
Public only 44.7 52.5
Uninsured 28.0 32.0
100%–199%
Any private, including workplace 51.1 37.3
Private through workplace only 42.0 29.7
Public only 25.2 34.8
Uninsured 23.7 27.8
200%–399%
Any private, including workplace 77.7 70.5
Private through workplace only 69.0 61.5
Public only 9.8 14.0
Uninsured 12.5 15.5
400% or more 92.5 90.8
Any private, including workplace
Private through workplace only 86.8 83.4
Public only 3.6 5.5
Uninsured 3.8 3.7
0 20 40 60 80 100 0 20 40 60 80 100
Percent Percent
NOTES: Any private coverage includes those with coverage through the other government programs. Persons not covered by private or public
workplace or other sources and includes a small percentage of adults with coverage were considered uninsured. See data table for Figure 25.
both private and public coverage (3.2% in 2012–2013). Public only includes SOURCE: CDC/NCHS, National Health Interview Survey. See Appendix I,
Medicaid, Children's Health Insurance Program (CHIP), Medicare, military National Health Interview Survey (NHIS).
health care (TRICARE/VA/CHAMP–VA), state-sponsored health plans, and
30 Chartbook: Special Feature on Adults Aged 55–64 Health, United States, 2014
Health Care Utilization
For those aged 55–64, there were few changes in health care who had 1–3 doctor visits in the past 12 months was 10%
utilization in 2012–2013 compared with 2002–2003; utilization higher in 2012–2013 (43.3%) than in 2002–2003 (39.5%),
of the health care system varied by type of care. while the percentage with 4 or more doctor visits in the past
12 months was 10% lower in 2012–2013 (43.4%) when
Over the past few years, the United States has grappled with
compared with visits in 2002–2003 (48.4%).
the issues of health reform and insurance coverage
including how to ensure access and provide high-quality, In 2012–2013, about one in five (18.1%) of those aged 55–64
safe, affordable, and appropriate care and how to pay for had at least one emergency department visit in the past 12
that care (42,44,48,79,80). The final charts in this Special months, similar to the percentage in 2002–2003. In 2012–
Feature focus on the intertwined issues of health care access 2013, 10.1% of those aged 55–64 had at least one hospital
and utilization. Better understanding of recent utilization stay in the past 12 months, 14% lower than in 2002–2003
patterns is key for future planning because the aging of the (11.7%). In 2012–2013, 12.6% of those aged 55–64 did not
historically large Baby Boom generation threatens to impact have any doctor visits, emergency department visits, or
the capacity of the health care system and the sufficiency of hospitalizations in the past 12 months, which was 13%
the supply of health care workers (33,81,82). higher than in 2002–2003 (11.2%). Less than 1% of those
aged 55–64 had an emergency department visit or a
In 2012–2013, 86.7% of adults aged 55–64 had at least one
hospitalization, but no doctor visits, in 2012–2013 (data
doctor visit in the past 12 months, 1% lower than in
table for Figure 26).
2002–2003 (87.9%). The percentage of those aged 55–64
Figure 26. Health care utilization in the past 12 months among adults aged 55–64, by type of visit: United States, average
annual 2002–2003 and 2012–2013
87.9
Any doctor visit
86.7
39.5
1–3 doctor visits
43.3
48.4 2002–2003
4 or more doctor visits 2012–2013
43.4
11.7
Any hospital stay
10.1
11.2
No visit
12.6
0 20 40 60 80 100
Percent
NOTES: No visit is no doctor visit, emergency department visit, or hospital stay, SOURCE: CDC/NCHS, National Health Interview Survey. See Appendix I,
in the past 12 months. See data table for Figure 26. National Health Interview Survey (NHIS).
Health, United States, 2014 Chartbook: Special Feature on Adults Aged 55–64 31
Use of Preventive Services and Screening
For adults aged 55–64, utilization of annual influenza In 2013, 49.9% of adults aged 55–64 had an influenza
vaccination and colorectal procedures was higher in 2013 than vaccination in the past 12 months, 24% higher than in 2003
in 2003, while use of pneumococcal vaccination for high-risk (40.4%). The percentage of adults aged 55–64 in high-risk
groups was at similar levels, and use of mammograms and Pap groups who had ever received a pneumococcal vaccination
smears was lower than in the earlier period. was similar in the two periods (35.2% and 32.5%,
respectively).
In addition to utilizing the health care system to diagnose,
manage, and control acute and chronic conditions and treat Utilization of colorectal, breast, and cervical cancer
injuries, adults aged 55–64 require access to address procedures can occur for routine screening or for diagnostic
prevention and screening recommendations (24,83,84). reasons. In 2013, 58.3% of adults aged 55–64 had a
CDC recommends annual influenza vaccination for all adults colorectal test or procedure, 46% higher than 2003 (40.0%)
and pneumococcal vaccination for adults under age 65 in (see data table for Figure 27 for definition of colorectal test
high-risk categories (83). The U.S. Preventive Services Task or procedure). In 2013, 71.3% of women aged 55–64 had a
Force recommends periodic colorectal screening for those mammogram in the past 2 years, 7% lower than 2003
aged 50–75, breast cancer screening for women aged 50–74, (76.9%). In 2013, 75.9% of women aged 55–64, who had not
and cervical cancer screening for women aged 21–65 (24). had a hysterectomy, had a Pap smear in the past 3 years,
However, screening guidelines and frequencies differ for 11% lower than in 2000, when 85.5% of women aged 55–64
those in high-risk categories, have changed over time, and had a Pap smear.
vary by recommending organization (85,86).
Figure 27. Use of preventive services and screening among noninstitutionalized adults aged 55–64: United States, 2003
and 2013
2003
Influenza vaccination
40.4
2013
in past 12 months
49.9
40.0
Colorectal test
or procedure
58.3
Mammogram
76.9
in past 2 years
71.3
Pap smear in
85.5
past 3 years
75.9
0 20 40 60 80 100
Percent
NOTES: The pneumococcal high-risk group includes persons who reported Data shown for Pap smear were for 2000 and 2013 and were for women who
diabetes; cancer; heart, lung, liver, or kidney disease; or cigarette smoking. have not had a hysterectomy. See data table for Figure 27.
Colorectal test or procedure is fecal occult blood test (FOBT) in the past year, SOURCE: CDC/NCHS, National Health Interview Survey. See Appendix I,
sigmoidoscopy in the past 5 years with FOBT in the past 3 years, or National Health Interview Survey (NHIS).
32 Chartbook: Special Feature on Adults Aged 55–64 Health, United States, 2014
Prescription Drug Use
In 2009–2012, the percentage of adults aged 55–64 who took the past 30 days was 54% higher for cholesterol-lowering
no, 1–4, or 5 or more prescription drugs in the past 30 days was drugs, 78% higher for gastric reflux drugs, 40% higher for
similar to levels in 1999–2002; use of prescription cholesterol- antidepressant drugs, and 29% higher for antidiabetic drugs.
lowering drugs was 54% higher among 55- to 64-year-olds in In contrast, the percentage of adults aged 55–64 who took
2009–2012 compared with 1999–2002. prescription cardiovascular agents (which include heart,
blood pressure, and kidney drugs) and the percentage who
Prescription drugs play an important role in preventing,
took prescription analgesics were similar to the levels in
treating, ameliorating, and curing health conditions and
1999–2002.
disease for those aged 55–64 (87). Major technological
advances resulting in more drugs coming to market In 2009–2012, nearly one-half (45.0%) of adults aged 55–64
combined with increases in clinical recommendations for took a prescription cardiovascular drug in the past 30 days,
tighter control of chronic conditions, which often affect nearly one-third (31.8%) took a prescription cholesterol-
those aged 55–64 (Figure 21), have contributed to the use of lowering drug, and 16.0% used prescription gastric reflux
prescription drugs (88,89). medications (for anti-acid reflux and stomach ulcers). Fifteen
percent of those aged 55–64 used prescription analgesics
In 2009–2012, 24.2% of adults aged 55–64 did not use any
(narcotics, nonsteroidal anti-inflammatory drugs, and
prescription drugs in the past 30 days, 55.6% used 1–4
aspirin), and 14.4% used prescription antidepressants in the
prescription drugs, and 20.3% used 5 or more prescription
past 30 days. Antidepressant drugs can be prescribed for a
drugs in the past 30 days, which was similar to levels in
wide variety of clinical reasons (90,91). In 2009–2012, 12.9%
1999–2002.
of those aged 55–64 used prescription antidiabetic agents in
In 2009–2012 compared with 1999–2002, the percentage of the past 30 days.
adults aged 55–64 who took selected prescription drugs in
Figure 28. Prescription drug use in the past 30 days among adults aged 55–64, by number of drugs and selected drug class:
1999–2002 41.3
2009–2012 Cardiovascular
45.0
9.0
Gastric reflux
16.0
10.3
Antidepressant
14.4
5 or more
17.7
prescription drugs
20.3
10.0
Antidiabetic
12.9
0 10 20 30 40 50 60 70 0 10 20 30 40 50 60 70
Percent Percent
NOTE: See data table for Figure 28 for indications and conditions for which SOURCE: CDC/NCHS, National Health and Nutrition Examination Survey. See
drug classes are commonly prescribed. Appendix I, National Health and Nutrition Examination Survey (NHANES).
Health, United States, 2014 Chartbook: Special Feature on Adults Aged 55–64 33
Delay or Nonreceipt of Medical Care or Nonreceipt of Prescription Drugs Due to Cost
For adults aged 55–64, the percentage who delayed or did not delayed or did not receive needed medical care due to cost
receive needed medical care due to cost in the past 12 months, was 14% higher in 2012–2013 (44.2%) compared with
or who did not receive needed prescription drugs due to cost in 2002–2003 (38.7%).
the past 12 months, was higher in 2012–2013 than in 2002–
In 2012–2013, 8.8% of adults aged 55–64 did not receive
2003 and varied by insurance coverage.
needed prescription drugs in the past 12 months due to
Forgoing or delaying needed health care can have serious cost, 26% higher than in 2002–2003 (7.0%). For adults who
health effects (92). Access to care is a complex process that were insured for the entire past year, the percentage who
addresses the extent to which a population can connect did not receive needed prescription drugs due to cost was
with health care and reflects the affordability, availability, 25% higher in 2012–2013 (5.5%) than in 2002–2003 (4.4%).
and acceptability of health services (93). Health insurance For those who were uninsured for all or part of the year,
facilitates access to health care by connecting individuals to 26.7% did not receive needed prescription drugs due to cost
health care providers and by covering a portion of the cost in 2012–2013, similar to the level in 2002–2003.
of care (94).
An association exists between not receiving needed medical
In 2012–2013, 13.2% of adults aged 55–64 delayed or did care and prescription drugs due to cost and insurance
not receive needed medical care in the past 12 months due status. In 2012–2013, for adults aged 55–64, those who were
to cost, 39% higher than in 2002–2003 (9.5%). For adults uninsured for some or all of the past year were 5.7 times as
aged 55–64 who were insured for the entire past year, the likely to delay or not receive needed medical care due to
percentage who delayed or did not receive needed medical cost and 4.9 times as likely to not receive needed
care due to cost was 32% higher in 2012–2013 (7.8%) than in prescription drugs due to cost as those who were
2002–2003 (5.9%). The percentage of adults aged 55–64 continuously insured in the past year.
who were uninsured for all or some of the past year and who
Figure 29. Adults aged 55–64 who delayed or did not receive needed medical care or needed prescription drugs
due to cost in the past 12 months, by insurance status: United States, average annual 2002–2003 and 2012–2013
9.5
Total 2002–2003
13.2 2012–2013
5.9
Insured all year
7.8
4.4
Insured all year
5.5
0 10 20 30 40 50
Percent
NOTE: See data table for Figure 29. SOURCE: CDC/NCHS, National Health Interview Survey. See Appendix I,
National Health Interview Survey (NHIS).
34 Chartbook: Special Feature on Adults Aged 55–64 Health, United States, 2014
Data Tables for Special Feature: Figures 20–29
Data table for Figure 20. Death rates for leading causes of death among adults aged 55–64, by sex: United States,
2003–2013
Excel and Powerpoint: http://www.cdc.gov/nchs/hus/contents2014.htm#fig20
Rank
Sex and underlying cause of death1 2013 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
Malignant neoplasms (Cancer). . . . . . . . . . . 1 341.6 330.8 323.9 317.7 311.4 304.7 301.7 300.1 295.8 293.2 288.2
Diseases of heart . . . . . . . . . . . . . . . . . . . . 2 232.3 217.1 212.8 205.1 197.8 195.3 190.0 186.6 183.2 184.6 184.6
Unintentional injuries. . . . . . . . . . . . . . . . . . 3 32.7 32.9 35.4 35.8 36.8 37.4 36.5 38.4 39.8 41.0 43.4
Chronic lower respiratory diseases (CLRD) . . . 4 43.1 40.1 41.6 38.8 38.6 41.1 40.0 39.0 39.5 39.4 40.5
Diabetes2 . . . . . . . . . . . . . . . . . . . . . . . . . . 5 38.3 36.8 36.9 35.8 34.1 33.3 32.1 32.0 33.3 32.5 33.2
Chronic liver disease and cirrhosis . . . . . . . . . 6 22.9 22.4 23.3 22.6 24.2 25.0 25.9 26.8 28.2 29.1 30.4
Cerebrovascular diseases (Stroke) . . . . . . . . . 7 35.5 34.0 32.7 32.9 31.7 30.6 29.7 29.3 29.4 28.7 28.9
Suicide . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 13.7 13.7 13.7 14.4 15.3 16.0 16.4 17.5 17.1 18.0 18.1
Septicemia . . . . . . . . . . . . . . . . . . . . . . . . . 9 13.0 12.8 12.8 12.6 12.8 13.3 13.1 12.6 13.0 12.9 13.6
Nephritis, nephrotic syndrome and
nephrosis2 . . . . . . . . . . . . . . . . . . . . . . .. 10 13.6 13.5 13.5 13.7 13.4 14.1 13.5 13.9 12.5 12.3 12.6
Men
All causes . . . . . . . . . . . . . . . . . . . . . . . . . ... 1,159.9 1,119.2 1,119.8 1,097.5 1,086.5 1,089.8 1,078.4 1,075.5 1,071.1 1,080.2 1,088.4
Malignant neoplasms (Cancer) . . . . . . . . . . . 1 384.9 373.5 365.8 359.4 353.9 349.3 345.9 344.9 340.4 336.9 331.3
Diseases of heart . . . . . . . . . . . . . . . . . . . . 2 330.0 310.1 303.9 293.4 285.1 280.8 274.1 269.5 263.6 266.4 267.3
Unintentional injuries . . . . . . . . . . . . . . . . . . 3 46.9 46.5 50.8 51.0 52.3 54.0 52.5 54.6 56.9 58.1 61.5
Chronic liver disease and cirrhosis . . . . . . . . . 4 33.6 32.5 34.5 33.1 35.9 37.1 37.9 39.5 41.3 42.7 44.8
Chronic lower respiratory diseases (CLRD) . . . 5 46.3 42.7 44.6 41.4 42.1 44.7 43.1 42.2 43.0 42.4 43.7
Diabetes2 . . . . . . . . . . . . . . . . . . . . . . . . . . 6 44.8 43.6 44.5 43.3 41.6 40.6 40.0 40.5 41.5 41.0 41.8
Cerebrovascular diseases (Stroke) . . . . . . . . . 7 40.6 39.1 38.2 38.3 37.5 35.5 35.0 34.7 34.9 34.5 35.1
Suicide . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 22.1 21.9 22.0 22.5 23.9 25.8 26.1 27.7 27.3 28.7 28.3
Septicemia . . . . . . . . . . . . . . . . . . . . . . . . . 9 14.0 13.7 14.0 13.9 13.8 14.7 14.3 13.9 14.4 14.5 15.3
Nephritis, nephrotic syndrome and
nephrosis2 . . . . . . . . . . . . . . . . . . . . . . .. 10 15.3 15.0 15.9 15.9 15.5 16.2 15.9 16.4 14.7 14.5 14.8
Women
All causes . . . . . . . . . . . . . . . . . . . . . . . . . ... 730.5 702.4 692.4 680.0 661.8 659.6 650.1 643.5 642.9 643.8 647.4
Malignant neoplasms (Cancer) . . . . . . . . . . . 1 301.4 291.2 284.8 278.9 271.8 263.3 260.6 258.5 254.1 252.5 248.1
Diseases of heart . . . . . . . . . . . . . . . . . . . . 2 141.5 130.6 128.0 122.8 116.4 115.6 111.6 109.3 108.4 108.4 107.5
Chronic lower respiratory diseases (CLRD) . . . 3 40.2 37.7 38.8 36.3 35.2 37.8 37.1 36.1 36.3 36.7 37.6
Unintentional injuries . . . . . . . . . . . . . . . . . . 4 19.6 20.3 21.1 21.8 22.4 22.0 21.7 23.4 23.9 25.1 26.5
Diabetes2 . . . . . . . . . . . . . . . . . . . . . . . . . . 5 32.3 30.5 29.8 28.8 27.2 26.5 24.7 24.1 25.7 24.6 25.2
Cerebrovascular diseases (Stroke) . . . . . . . . . 6 30.8 29.3 27.7 28.0 26.3 26.1 24.8 24.3 24.4 23.3 23.1
Chronic liver disease and cirrhosis . . . . . . . . . 7 13.0 13.1 12.8 12.8 13.2 13.7 14.6 14.9 16.0 16.5 17.0
Septicemia . . . . . . . . . . . . . . . . . . . . . . . . . 8 12.1 11.9 11.6 11.4 11.8 12.1 11.9 11.4 11.7 11.4 12.0
Nephritis, nephrotic syndrome and
nephrosis2 . . . . . . . . . . . . . . . . . . . . . . .. 9 12.0 12.1 11.3 11.7 11.4 12.0 11.4 11.6 10.4 10.3 10.5
Influenza and pneumonia . . . . . . . . . . . . . .. 10 9.4 8.8 9.0 7.7 7.4 8.8 9.9 8.0 8.9 8.1 10.0
Health, United States, 2014 Chartbook: Special Feature on Adults Aged 55–64 35
Data table for Figure 20. Death rates for leading causes of death among adults aged 55–64, by sex: United States,
2003–2013—Con.
Excel and Powerpoint: http://www.cdc.gov/nchs/hus/contents2014.htm#fig20
Rank
Sex and underlying cause of death1 2013 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
Men
All causes . . . . . . . . . . . . . . . . . . . . . . . . . ... 2.93 2.82 2.75 2.67 2.61 2.57 2.51 2.47 2.42 2.41 2.40
Malignant neoplasms (Cancer) . . . . . . . . . . . ... 1.69 1.63 1.57 1.53 1.49 1.46 1.42 1.40 1.36 1.35 1.32
Diseases of heart . . . . . . . . . . . . . . . . . . . . ... 1.56 1.48 1.43 1.38 1.34 1.31 1.27 1.24 1.20 1.20 1.19
Unintentional injuries . . . . . . . . . . . . . . . . . . ... 0.59 0.57 0.59 0.58 0.57 0.57 0.55 0.56 0.56 0.56 0.57
Chronic liver disease and cirrhosis . . . . . . . . . ... 0.50 0.48 0.48 0.46 0.47 0.47 0.47 0.47 0.47 0.48 0.49
Chronic lower respiratory diseases (CLRD) . . . ... 0.59 0.55 0.55 0.52 0.51 0.52 0.50 0.49 0.48 0.48 0.48
Diabetes2 . . . . . . . . . . . . . . . . . . . . . . . . . . ... 0.58 0.56 0.55 0.53 0.51 0.50 0.48 0.48 0.48 0.47 0.47
Cerebrovascular diseases (Stroke) . . . . . . . . . ... 0.55 0.53 0.51 0.50 0.48 0.46 0.45 0.44 0.44 0.43 0.43
Suicide . . . . . . . . . . . . . . . . . . . . . . . . . . . ... 0.41 0.39 0.39 0.38 0.39 0.40 0.39 0.40 0.39 0.39 0.39
Septicemia . . . . . . . . . . . . . . . . . . . . . . . . . ... 0.32 0.31 0.31 0.30 0.29 0.30 0.29 0.28 0.28 0.28 0.28
Nephritis, nephrotic syndrome and
nephrosis2 . . . . . . . . . . . . . . . . . . . . . . .. ... 0.34 0.33 0.33 0.32 0.31 0.31 0.30 0.31 0.28 0.28 0.28
Women
All causes . . . . . . . . . . . . . . . . . . . . . . . . . ... 2.24 2.15 2.09 2.03 1.96 1.93 1.88 1.85 1.81 1.79 1.78
Malignant neoplasms (Cancer) . . . . . . . . . . . ... 1.44 1.38 1.34 1.30 1.26 1.22 1.19 1.17 1.14 1.12 1.10
Diseases of heart . . . . . . . . . . . . . . . . . . . . ... 0.99 0.93 0.90 0.86 0.82 0.81 0.78 0.76 0.74 0.74 0.73
Chronic lower respiratory diseases (CLRD) . . . ... 0.53 0.50 0.49 0.47 0.45 0.46 0.45 0.44 0.43 0.43 0.43
Unintentional injuries . . . . . . . . . . . . . . . . . . ... 0.37 0.37 0.36 0.36 0.36 0.35 0.34 0.35 0.35 0.35 0.36
Diabetes2 . . . . . . . . . . . . . . . . . . . . . . . . . . ... 0.47 0.45 0.43 0.42 0.40 0.39 0.37 0.36 0.36 0.35 0.35
Cerebrovascular diseases (Stroke) . . . . . . . . . ... 0.46 0.44 0.42 0.41 0.39 0.38 0.37 0.36 0.35 0.34 0.34
Chronic liver disease and cirrhosis . . . . . . . . . ... 0.30 0.29 0.28 0.28 0.28 0.28 0.28 0.28 0.29 0.29 0.29
Septicemia . . . . . . . . . . . . . . . . . . . . . . . . . ... 0.29 0.28 0.27 0.26 0.26 0.26 0.25 0.25 0.24 0.24 0.24
Nephritis, nephrotic syndrome and
nephrosis2 . . . . . . . . . . . . . . . . . . . . . . .. ... 0.29 0.28 0.27 0.27 0.26 0.26 0.25 0.25 0.23 0.23 0.23
Influenza and pneumonia . . . . . . . . . . . . . .. ... 0.25 0.24 0.24 0.22 0.21 0.22 0.23 0.21 0.21 0.20 0.22
36 Chartbook: Special Feature on Adults Aged 55–64 Health, United States, 2014
Data table for Figure 21. Selected chronic conditions among adults aged 55–64: United States, 1999–2002 and
2009–2012
Excel and Powerpoint: http://www.cdc.gov/nchs/hus/contents2014.htm#fig21
1999–2002 2009–2012
SE is standard error.
1
Defined as respondent report of physician-diagnosed diabetes, or undiagnosed diabetes (measured fasting plasma glucose of at least 126 mg/dL
2
Defined as body mass index greater than or equal to 30. See Appendix II, Body mass index.
3
Defined as reporting taking cholesterol-lowering medication or having a measured serum total cholesterol level of at least 240 mg/dL. See
Health, United States, 2014 Chartbook: Special Feature on Adults Aged 55–64 37
Data table for Figure 22. Serious or mild-moderate psychological distress in the past 30 days among adults aged 55–64, by
selected characteristics: United States, average annual 2002–2003 and 2012–2013
Excel and Powerpoint: http://www.cdc.gov/nchs/hus/contents2014.htm#fig22
Serious Mild-moderate
Total age 55–64 . . . . . . . . . . . . . . . . . . . . . . 3.6 0.2 4.4 0.2 6.4 0.3 7.1 0.3
Sex
Men. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.6 0.3 3.7 0.3 5.3 0.4 6.3 0.4
Women . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.5 0.3 5.0 0.3 7.4 0.5 7.8 0.4
SE is standard error.
* Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error (RSE) of 20%–30%. Data not shown have an
RSE greater than 30%.
1
Two measures of psychological distress are presented for those aged 55–64 in the noninstitutionalized population: serious and mild-moderate
psychological distress. These measures are based on respondent’s responses to a series of six questions—the K6 scale—that asks how
frequently they experienced symptoms of nonspecific psychological distress within the past 30 days. See Appendix II, Serious psychological
distress. Scores on the K6 scale range from 0 to 24 with scores of 13 to 24 classified as probable serious mental illness and scores of 8 to
12 as probable mild–moderate mental illness based on K6 validation studies. See: Kessler RC, Galea S, Gruber MJ, Sampson NA,
Ursano RJ, Wessely S. Trends in mental illness and suicidality after Hurricane Katrina. Molecular Psychiatry 2008;13:374–84. Available from:
http://www.nature.com/mp/journal/v13/n4/full/4002119a.html. Serious psychological distress as measured by the K6 indicates a high probability of
serious mental illness with serious impairment in functioning. Mild-moderate psychological distress also indicates a high probability of a mental
illness diagnosable according to the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM–IV), but accompanying
difficulties in functioning are less severe. Scores on the K6 do not provide specific psychiatric diagnoses.
2
The race group, Asian only, includes persons of Hispanic and non-Hispanic origin. Persons of Hispanic origin may be of any race. Race-specific
estimates are tabulated according to the 1997 Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity and are not
strictly comparable with estimates for earlier years. The single-race categories shown in the table conform to the 1997 Standards and are for
persons who reported only one racial group. Starting with 2003 data, race responses of other race and unspecified multiple race were treated as
missing, and then race was imputed if these were the only race responses. Almost all persons with a race response of other race were of Hispanic
origin. See Appendix II, Hispanic origin; Race.
3
Based on family income and family size and composition using U.S. Census Bureau poverty thresholds. Missing family income data were
imputed. See Appendix II, Family income; Poverty; Table VI.
SOURCE: CDC/NCHS, National Health Interview Survey. Family core and sample adult questionnaires. See Appendix I, National Health Interview
Survey (NHIS).
38 Chartbook: Special Feature on Adults Aged 55–64 Health, United States, 2014
Data table for Figure 23. Current cigarette smoking among adults aged 55–64, by selected characteristics: United States,
average annual 2002–2003 and 2012–2013
Excel and Powerpoint: http://www.cdc.gov/nchs/hus/contents2014.htm#fig23
Current cigarette smoker1
2002–2003 2012–2013
Sex
Men . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21.0 0.7 20.7 0.7
Women. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18.5 0.7 15.7 0.6
SE is standard error.
* Estimate is considered unreliable. Data preceded by an asterisk have a relative standard error of 20%–30%.
1
Current cigarette smokers smoked 100 cigarettes in their lifetime and smoke now every day or some days. See Appendix II, Cigarette smoking.
2
The race group, Asian only, includes persons of Hispanic and non-Hispanic origin. Persons of Hispanic origin may be of any race. Race-specific
estimates are tabulated according to the 1997 Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity and are not
strictly comparable with estimates for earlier years. The single-race categories shown in the table conform to the 1997 Standards and are for
persons who reported only one racial group. Starting with 2003 data, race responses of other race and unspecified multiple race were treated as
missing, and then race was imputed if these were the only race responses. Almost all persons with a race response of other race were of Hispanic
origin. See Appendix II, Hispanic origin; Race.
3
Based on family income and family size and composition using U.S. Census Bureau poverty thresholds. Missing family income data were
imputed. See Appendix II, Family income; Poverty; Table VI.
SOURCE: CDC/NCHS, National Health Interview Survey. Family core and sample adult questionnaires. See Appendix I, National Health Interview
Survey (NHIS).
Health, United States, 2014 Chartbook: Special Feature on Adults Aged 55–64 39
Data table for Figure 24. Participation in recommended levels of leisure-time aerobic and muscle-strengthening activities
among adults aged 55–64, by selected characteristics: United States, average annual 2002–2003 and 2012–2013
Excel and Powerpoint: http://www.cdc.gov/nchs/hus/contents2014.htm#fig24
Met both aerobic activity and muscle-strengthening guidelines1
2002–2003 2012–2013
Sex
Men . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13.5 0.7 17.2 0.7
SE is standard error.
* Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error of 20%–30%.
1
The federal 2008 Physical Activity Guidelines for Americans recommend that for substantial health benefits adults perform at least 150 minutes a
week of moderate-intensity, or 75 minutes a week of vigorous-intensity aerobic physical activity, or an equivalent combination of moderate- and
vigorous-intensity aerobic activity. In addition, adults should perform muscle-strengthening activities that are moderate or high intensity and involve
all major muscle groups on 2 or more days a week. See Appendix II, Physical activity, leisure-time.
2
The race group, Asian only, includes persons of Hispanic and non-Hispanic origin. Persons of Hispanic origin may be of any race. Race-specific
estimates are tabulated according to the 1997 Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity and are not
strictly comparable with estimates for earlier years. The single-race categories shown in the table conform to the 1997 Standards and are for
persons who reported only one racial group. Starting with 2003 data, race responses of other race and unspecified multiple race were treated as
missing, and then race was imputed if these were the only race responses. Almost all persons with a race response of other race were of Hispanic
3
Based on family income and family size and composition using U.S. Census Bureau poverty thresholds. Missing family income data were
NOTE: Data reported are for leisure-time physical activity and do not include physical activity performed for work, transportation, or other non-
leisure-time activities.
SOURCE: CDC/NCHS, National Health Interview Survey. Family core and sample adult questionnaires. See Appendix I, National Health Interview
Survey (NHIS).
40 Chartbook: Special Feature on Adults Aged 55–64 Health, United States, 2014
Data table for Figure 25. Health insurance coverage among adults aged 55–64, by percent of poverty level and type of
coverage: United States, average annual 2002–2003 and 2012–2013
Excel and Powerpoint: http://www.cdc.gov/nchs/hus/contents2014.htm#fig25
2002–2003 2012–2013
1,2
Percent of poverty level and type of coverage Percent SE Percent SE
Below 100%
Any private, including workplace . . . . . . . . . . . . . . . . . . . . . . . . . 27.3 1.6 15.5 1.0
Private through workplace only . . . . . . . . . . . . . . . . . . . . . . . . 20.5 1.5 10.4 0.9
Public only . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44.7 1.7 52.5 1.2
Uninsured . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28.0 1.2 32.0 1.2
100%–199%
Any private, including workplace . . . . . . . . . . . . . . . . . . . . . . . . . 51.1 1.3 37.3 1.0
Private through workplace only . . . . . . . . . . . . . . . . . . . . . . . . 42.0 1.3 29.7 1.0
Public only . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25.2 1.2 34.8 1.0
Uninsured . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23.7 1.1 27.8 1.0
200%–399%
Any private, including workplace . . . . . . . . . . . . . . . . . . . . . . . . . 77.7 0.8 70.5 0.7
Private through workplace only . . . . . . . . . . . . . . . . . . . . . . . . 69.0 0.9 61.5 0.7
Public only . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.8 0.6 14.0 0.6
Uninsured . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.5 0.7 15.5 0.6
400% or more
Any private, including workplace . . . . . . . . . . . . . . . . . . . . . . . . . 92.5 0.4 90.8 0.4
Private through workplace only . . . . . . . . . . . . . . . . . . . . . . . . 86.8 0.5 83.4 0.5
Public only . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.6 0.3 5.5 0.3
Uninsured . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.8 0.3 3.7 0.3
SE is standard error.
1
Percent of poverty level is based on family income and family size and composition using U.S. Census Bureau poverty thresholds. Missing family
income data were imputed. See Appendix II, Family income; Poverty; Table VI.
2
Information on health insurance coverage is collected at the time of interview. The categories any private, public only, and uninsured are mutually
exclusive, but may not sum to 100% due to rounding. Any private coverage includes those with coverage through the workplace, or other sources
of private coverage, and includes a small percentage of adults aged 55–64 with both private and public coverage (3.2% in 2012–2013). Any
private workplace coverage includes coverage obtained through a present or former employer, union, self-employment, or a professional
association and is a subset of the any private category. Public only includes Medicaid, Children’s Health Insurance Program (CHIP), Medicare,
military health care (TRICARE/VA/CHAMP–VA), state-sponsored health plans, and other government programs. Adults aged 55–64 in the public
only category may have more than one source of public coverage, but they do not have any private coverage. Persons not covered by private or
public coverage were considered to be uninsured. See Appendix II, Health insurance coverage.
SOURCE: CDC/NCHS, National Health Interview Survey. Family core and sample adult questionnaires. See Appendix I, National Health Interview
Survey (NHIS).
Health, United States, 2014 Chartbook: Special Feature on Adults Aged 55–64 41
Data table for Figure 26. Health care utilization in the past 12 months among adults aged 55–64, by type of visit:
United States, average annual 2002–2003 and 2012–2013
Excel and Powerpoint: http://www.cdc.gov/nchs/hus/contents2014.htm#fig26
2002–2003 2012–2013
1
Visits in the past 12 months Percent SE Percent SE
SE is standard error.
1
Respondents were asked a series of questions about their health care contacts in the past 12 months: ‘‘Have you seen a doctor or other health
care professional about your own health at a doctor’s office, a clinic, or some other place? Do not include times you were hospitalized overnight,
visits to hospital emergency departments, home visits, or telephone calls’’; ‘‘During the past 12 months how many times have you gone to a
hospital emergency room about your own health?’’ (This includes emergency room visits that resulted in a hospital admission.) In 2002–2003,
respondents were asked ‘‘During the past 12 months were you a patient in a hospital overnight?’’; in 2012–2013, respondents were asked ‘‘During
the past 12 months were you a patient in a hospital overnight?’’ (Do not include an overnight stay in the emergency room.) Less than 1% of those
aged 55–64 had an emergency department visit or a hospitalization, but no doctor visits, in 2012–2013. No visit is no doctor visit, emergency
department visit, or hospital stay, in the past 12 months.
SOURCE: CDC/NCHS, National Health Interview Survey. Family core and sample adult questionnaires. See Appendix I, National Health Interview
Survey (NHIS).
42 Chartbook: Special Feature on Adults Aged 55–64 Health, United States, 2014
Data table for Figure 27. Use of preventive services and screening among noninstitutionalized adults aged 55–64:
United States, 2003 and 2013
Excel and Powerpoint: http://www.cdc.gov/nchs/hus/contents2014.htm#fig27
2003 2013
SE is standard error.
1
Respondents were asked about influenza vaccination in the past 12 months. See Appendix II, Vaccination.
2
Respondents were asked, ‘‘Have you ever had a pneumonia shot? This shot is usually given only once or twice in a person’s lifetime and is
different from the flu shot. It is also called the pneumococcal vaccine.’’ High-risk group membership is based on recommendations of CDC’s
Advisory Committee on Immunization Practices (ACIP). The high-risk group includes persons who reported diabetes; cancer; heart, lung, liver,
or kidney disease. Starting in 2009, this definition was expanded to include persons who reported asthma or cigarette smoking, to be consistent
with the revised ACIP recommendation. Starting with data year 2012, the survey questionnaire was changed to ask respondents a new question
on chronic obstructive pulmonary disease (COPD), and this information was added to the list of lung diseases used to construct the high-risk
category. For more information on high-risk groups, see the 2009 ACIP recommendation available from: http://www.cdc.gov/mmwr/pdf/wk/
mm5934.pdf.
3
Colorectal test or procedure is defined as fecal occult blood test (FOBT) in the past year, sigmoidoscopy in the past 5 years with FOBT in the
past 3 years, or colonoscopy in the past 10 years. See Appendix II, Colorectal tests or procedures.
4
Questions concerning use of mammography differed slightly on the National Health Interview Survey across the years for which data are shown.
5
Estimates are for women who have not had a hysterectomy. Questions concerning use of Pap smears and hysterectomy status differed slightly
on the National Health Interview Survey across the years for which data are shown. Hysterectomy status was not assessed in 2003; therefore,
data shown for Pap smear were for 2000 and 2013 when hysterectomy status was available. See Appendix II, Pap smear.
NOTE: Utilization of colorectal, cervical, and breast cancer procedures can occur for routine screening or for diagnostic reasons.
SOURCE: CDC/NCHS, National Health Interview Survey. Family core and sample adult questionnaires. See Appendix I, National Health Interview
Survey (NHIS).
Health, United States, 2014 Chartbook: Special Feature on Adults Aged 55–64 43
Data table for Figure 28. Prescription drug use in the past 30 days among adults aged 55–64, by number of drugs and
selected drug class: United States, 1999–2002 and 2009–2012
Excel and Powerpoint: http://www.cdc.gov/nchs/hus/contents2014.htm#fig28
1999–2002 2009–2012
SE is standard error.
1
Respondents were asked if they had taken a prescription drug in the past 30 days. Those who answered ‘‘yes’’ were asked to show the
interviewer the medication containers for all prescriptions. If no container was available, the respondent was asked to verbally report the name of
the medication. Each drug’s complete name was recorded and classified.
2
The December 2012 Multum Lexicon Plus database was used for processing and editing the National Health and Nutrition Examination Survey
prescription drug data. Lexicon Plus, a proprietary database of Cerner Multum, Inc. (Denver, CO), is used to assist with collection, editing, and
release of drug data. Lexicon Plus is a comprehensive database of all prescription and some nonprescription drug products available in the U.S.
drug market. See: http://www.multum.com/. Lexicon Plus provides a three-level nested category system that assigns a therapeutic classification to
each drug reported. Not all drugs have three classification levels; some may only have two classification levels, and others only have one
classification level. For more information, see: http://wwwn.cdc.gov/nchs/nhanes/1999-2000/RXQ_DRUG.htm. Up to four different therapeutic
classes can be assigned to each drug. Drugs classified into more than one class were counted in each therapeutic class. Respondents taking
more than one drug in a specific drug class were counted once; respondents taking drugs in different drug classes were counted in both classes.
The therapeutic drug class identifies the therapeutic effect(s) of the drug as a whole and for multi-ingredient drugs differs from a classification
scheme based on drug ingredients. In this analysis, cardiovascular drugs (including ACE inhibitors, beta blockers, calcium channel blockers, and
diuretics) are level 1, class 40; cholesterol-lowering drugs are level 2, class 19; antidepressant drugs are level 2, class 249; analgesic drugs are
level 2, class 58; gastric reflux drugs (including proton pump inhibitors) are level 2, class 272, and H2 antagonists are level 2, class 94; and
antidiabetic drugs are level 2, class 99. The therapeutic drug classes proton pump inhibitors (272) and H2 antagonists (94) were combined
because of their similar indications for use. See Appendix II, Drug; Multum Lexicon Plus therapeutic drug class.
SOURCE: CDC/NCHS, National Health and Nutrition Examination Survey. See Appendix I, National Health and Nutrition Examination Survey
(NHANES).
44 Chartbook: Special Feature on Adults Aged 55–64 Health, United States, 2014
Data table for Figure 29. Adults aged 55–64 who delayed or did not receive needed medical care or needed prescription
drugs due to cost in the past 12 months, by insurance status: United States, average annual 2002–2003 and 2012–2013
Excel and Powerpoint: http://www.cdc.gov/nchs/hus/contents2014.htm#fig29
2002–2003 2012–2013
SE is standard error.
1
This table presents health insurance coverage over the past year. Insured respondents had coverage continuously for the year prior to interview,
while those categorized as uninsured for all or part of the past year had some period of time without insurance during the year prior to interview.
NOTE: The percentage who delayed or did not receive medical care and the percentage who did not receive prescription drugs were determined
SOURCE: CDC/NCHS, National Health Interview Survey. Family core and sample adult questionnaires. See Appendix I, National Health Interview
Survey (NHIS).
Health, United States, 2014 Chartbook: Special Feature on Adults Aged 55–64 45
Technical Notes
Data Sources and Comparability were assessed for statistical significance at the 0.05 level
using two-sided significance tests (z-tests) without
Data for the Health, United States, 2014 Chartbook come correction for multiple comparisons. Data tables include
from many surveys and data systems and cover a broad point estimates and standard errors for users who would like
range of years. Detailed descriptions of the data sources to perform additional statistical tests.
included in the Chartbook are provided in Appendix I. Data Terms such as ‘‘similar,’’‘‘stable,’’ and ‘‘no difference’’ used in
Sources. Additional information clarifying and qualifying the the text indicate that the statistics being compared were not
data are included in the table notes and in Appendix II. significantly different. Lack of comment regarding the
Definitions and Methods. difference between statistics does not necessarily suggest
that the difference was tested and found to be not
Data Presentation significant. Because statistically significant differences or
trends are partly a function of sample size (the larger the
Many measures in the Chartbook are shown for people in sample, the smaller the change that can be detected), they
specific age groups because of the strong effect of age on do not necessarily have public health significance (95).
most health outcomes. Age-adjusted estimates use the age Testing and comparisons use the estimates and standard
distribution of the 2000 standard population; where this has errors in the trend and data tables.
been done, it is noted in the data tables that accompany the
Overall estimates generally have relatively small sampling
charts. Age-adjusted rates are computed to eliminate
errors, but estimates for certain population subgroups may
differences in observed rates that result from age differences
be based on small numbers and have relatively large
in population composition (see Appendix II, Age
sampling errors. Numbers of deaths obtained from the
adjustment). For some charts, data years are combined to
National Vital Statistics System represent complete counts
increase sample size and the reliability of the estimates.
and therefore are not subject to sampling error. They are,
Some charts present time trends, and others focus on
however, subject to random variation, which means that the
differences in estimates among population subgroups for
number of events that actually occur in a given year may be
the most recent time point available. Trends are generally
considered as one of a large series of possible results that
shown on a linear scale to emphasize absolute differences
could have arisen under the same circumstances. When the
over time. The time trends for the overall mortality measures
number of events is small and the probability of such an
are shown on a logarithmic (log) scale to emphasize the rate
event is small, considerable caution must be observed in
of change and to enable measures with large differences in
interpreting the conditions described by the charts.
magnitude to be shown on the same chart. Point estimates
Estimates that are unreliable because of large sampling
and standard errors for Figures 1–19 are available in the
errors or small numbers of events have been noted with an
Trend Table and Excel spreadsheet specified in the note
asterisk. The criteria used to designate or suppress unreliable
below the chart. Data tables with point estimates and
estimates are indicated in the notes to the applicable tables
standard errors accompany Figures 20–29. Some data tables
or charts.
contain additional data that were not graphed because of
space considerations. For NCHS surveys, point estimates and their corresponding
variances were calculated using the SUDAAN software
Statistical Testing package, which takes into consideration the complex survey
design (96). Standard errors for other surveys or data sets
Data trends can be described in many ways. For trend were computed using the methodology recommended by
analyses presented in the Chartbook, increases or the programs providing the data, or were provided directly
decreases in the estimates during the entire time period by those programs.
shown are measured by the annual percent change using
the weighted least squares regression method.
Statistically significant changes in the trend are assessed
at the 0.05 level using the National Cancer Institute's
Joinpoint software, and permitting up to one joinpoint
(change in inflection). For more information on Joinpoint,
see: http://srab.cancer.gov/joinpoint. For analyses that
show two time periods, differences between the two periods
1. Xu JQ, Murphy SL, Kochanek KD, et al. Deaths: Final data 14. National Heart, Lung, and Blood Institute; National Institute of
for 2013. National vital statistics reports; vol 64 no 2. Diabetes and Digestive and Kidney Diseases. Clinical guidelines
Hyattsville, MD: NCHS. Forthcoming. Portions available from: on the identification, evaluation, and treatment of overweight
http://www.cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_02.pdf. and obesity in adults: The evidence report. NIH pub no
2. HHS; National Action Alliance for Suicide Prevention. 98–4083. Bethesda, MD: National Institutes of Health; 1998.
2012 National strategy for suicide prevention: Goals and Available from: http://www.nhlbi.nih.gov/guidelines/obesity/
objectives for action: A report of the U.S. Surgeon General ob_gdlns.pdf.
and the National Action Alliance for Suicide Prevention. 15. Jensen MD, Ryan DH, Apovian CM, Ard JD, Comuzzie AG,
Washington, DC: HHS; 2012. Available from: Donato KA, et al. 2013 AHA/ACC/TOS guideline for the
http://www.surgeongeneral.gov/library/reports/national management of overweight and obesity in adults: A report of
strategy-suicide-prevention/full_report-rev.pdf. the American College of Cardiology/American Heart
3. Institute of Medicine. Reducing suicide: A national imperative. Association Task Force on Practice Guidelines and the Obesity
Washington, DC: National Academies Press; 2002. Available Society. Circulation 2014;129(25 suppl 2):S102–40. Available
from: http://www.iom.edu/Reports/2002/Reducing-Suicide-A from: http://circ.ahajournals.org/content/early/2013/11/11/
National-Imperative.aspx. 01.cir.0000437739.71477.ee.citation.
4. Ventura SJ, Hamilton BE, Mathews TJ. National and state 16. HHS. The Surgeon General’s vision for a healthy and fit nation.
patterns of teen births in the United States, 1940–2013. Rockville, MD: HHS, Office of the Surgeon General; 2010.
National vital statistics reports; vol 63 no 4. Hyattsville, MD: Available from: http://www.surgeongeneral.gov/initiatives/
NCHS; 2014. Available from: http://www.cdc.gov/nchs/data/ healthy-fit-nation/obesityvision2010.pdf.
nvsr/nvsr63/NVSR63_04.pdf. 17. Flegal KM, Graubard BI, Williamson DF, Gail MH. Excess deaths
5. American Diabetes Association. Standards of medical care in associated with underweight, overweight, and obesity.
diabetes—2014. Diabetes Care 2014;37(suppl 1):S14–80. JAMA 2005;293(15):1861–7.
6. Porter RS, Kaplan JL, Homeier BP (eds). The Merck manual 18. CDC. Recommendations of the Advisory Committee on
home health handbook. 3rd ed. Whitehouse Station, NJ: Merck; Immunization Practices (ACIP): General recommendations on
2009. Available from: http://www.merckmanuals.com/home/ immunization. MMWR 2011;60(RR02):1–60. Available from:
index.html. http://www.cdc.gov/mmwr/preview/mmwrhtml/
7. Altman B, Bernstein A. Disability and health in the United rr6002a1.htm?s_cid=rr6002a1_e.
States, 2001–2005. Hyattsville, MD: NCHS; 2008. Available from: 19. CDC. Experiences with obtaining influenza vaccination among
http://www.cdc.gov/nchs/data/misc/disability2001-2005.pdf. persons in priority groups during a vaccine shortage—United
8. HHS. How tobacco smoke causes disease: The biology and States, October–November, 2004. MMWR 2004;53(49):1153–5.
behavioral basis for smoking-attributable disease. A report of Available from: http://www.cdc.gov/mmwr/preview/
the Surgeon General. Atlanta, GA: CDC, National Center for mmwrhtml/mm5349a2.htm.
Chronic Disease Prevention and Health Promotion, Office 20. CDC. Ten great public health achievements—United States,
on Smoking and Health; 2010. Available from: 1900–1999. MMWR 1999;48(12);241–3. Available from:
http://www.ncbi.nlm.nih.gov/books/NBK53017/. http://www.cdc.gov/mmwr/preview/mmwrhtml/
9. National High Blood Pressure Education Program. Seventh 00056796.htm.
report of the Joint National Committee on Prevention, 21. Zhou F, Shefer A, Wenger J, Messonnier M, Wang LY, Lopez A, et
Detection, Evaluation, and Treatment of High Blood Pressure: al. Economic evaluation of the routine childhood immunization
Complete report. NIH pub no 04–5230. Bethesda, MD: National program in the U.S., 2009. Pediatrics 2014;133(4):577–85.
Institutes of Health, National Heart, Lung, and Blood Institute; 22. CDC. National, state, and selected local area vaccination
2004. Available from: http://www.nhlbi.nih.gov/guidelines/ coverage among children aged 19–35 months—United States,
hypertension/jnc7full.htm. 2013. MMWR 2014;63(34):741–8. Available from: http://
10. Freedman DS, Mei Z, Srinivasan SR, Berenson GS, Dietz WH. www.cdc.gov/mmwr/preview/mmwrhtml/mm6334a1.htm.
Cardiovascular risk factors and excess adiposity among 23. Weinberg DS, Schoen RE. Screening for colorectal cancer. Ann
overweight children and adolescents: The Bogalusa Heart Intern Med 2014;160(9):ITC5–1–14.
Study. J Pediatr 2007;150(1):12–7. 24. Agency for Healthcare Research and Quality, U.S. Preventive
11. Engeland A, Bjørge T, Tverdal A, Søgaard AJ. Obesity in Services Task Force. The guide to clinical preventive services
adolescence and adulthood and the risk of adult mortality. 2014. Rockville, MD: HHS, AHRQ; 2014. Available from:
Epidemiology 2004;15(1):79–85. http://www.ahrq.gov/professionals/clinicians-providers/
12. Kuczmarski RJ, Ogden CL, Guo SS, et al. 2000 CDC growth guidelines-recommendations/guide/cpsguide.pdf.
charts for the United States: Methods and development. 25. Kaiser Commission on Medicaid and the Uninsured.
National Center for Health Statistics. Vital Health Stat 11(246); The uninsured and the difference health insurance
2002. Available from: http://www.cdc.gov/growthcharts/ makes. Kaiser Family Foundation; 2012. Available from:
2000growthchart-us.pdf. http://www.kff.org/uninsured/upload/1420-14.pdf.
13. Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of
childhood and adult obesity in the United States, 2011–2012.
JAMA 2014;311(8):806–14.
Table 1 (page 1 of 3). Resident population, by age, sex, race, and Hispanic origin: United States, selected years 1950–2013
Updated data when available, Excel, PDF, and more data years: http://www.cdc.gov/nchs/hus/contents2014.htm#001.
[Data are based on the decennial census updated with data from multiple sources]
Age
Total
Sex, race, Hispanic resident Under 1–4 5–14 15–24 25–34 35–44 45–54 55–64 65–74 75–84 85 years
origin, and year population 1 year years years years years years years years years years and over
Male
1950 . . . . . . . . . . . . . . . . . . 74,833 1,602 6,634 12,375 10,918 11,597 10,588 8,655 6,697 4,024 1,507 237
1960 . . . . . . . . . . . . . . . . . . 88,331 2,090 8,240 18,029 11,906 11,179 11,755 10,093 7,537 5,116 2,025 362
1970 . . . . . . . . . . . . . . . . . . 98,912 1,778 6,968 20,759 17,551 12,217 11,231 11,199 8,793 5,437 2,436 542
1980 . . . . . . . . . . . . . . . . . . 110,053 1,806 6,556 17,855 21,419 18,382 12,570 11,009 10,152 6,757 2,867 682
1990 . . . . . . . . . . . . . . . . . . 121,239 2,018 7,581 17,971 18,915 21,564 18,510 12,232 9,955 7,907 3,745 841
2000 . . . . . . . . . . . . . . . . . . 138,054 1,949 7,862 21,043 20,079 20,121 22,448 18,497 11,645 8,303 4,879 1,227
2010 . . . . . . . . . . . . . . . . . . 151,781 2,014 8,305 20,970 22,318 20,632 20,436 22,142 17,601 10,097 5,477 1,790
2011 . . . . . . . . . . . . . . . . . . 153,291 2,044 8,256 20,971 22,432 21,044 20,223 22,019 18,358 10,476 5,573 1,894
2012 . . . . . . . . . . . . . . . . . . 154,492 2,017 8,199 21,026 22,512 21,339 20,174 21,807 18,603 11,203 5,648 1,964
2013 . . . . . . . . . . . . . . . . . . 155,652 2,017 8,136 21,061 22,525 21,641 20,145 21,569 18,957 11,798 5,761 2,042
Female
1950 . . . . . . . . . . . . . . . . . . 75,864 1,545 6,383 11,944 11,181 12,162 10,863 8,688 6,672 4,316 1,771 340
1960 . . . . . . . . . . . . . . . . . . 90,992 2,022 7,969 17,437 12,114 11,639 12,326 10,393 8,036 5,881 2,609 567
1970 . . . . . . . . . . . . . . . . . . 104,300 1,707 6,701 19,986 17,890 12,690 11,857 12,021 9,797 6,998 3,683 969
1980 . . . . . . . . . . . . . . . . . . 116,493 1,727 6,259 17,087 21,068 18,700 13,065 11,791 11,551 8,824 4,862 1,559
1990 . . . . . . . . . . . . . . . . . . 127,471 1,928 7,231 17,124 18,098 21,596 18,925 12,824 11,158 10,139 6,267 2,180
2000 . . . . . . . . . . . . . . . . . . 143,368 1,857 7,508 20,034 19,105 19,771 22,701 19,181 12,629 10,088 7,482 3,013
2010 . . . . . . . . . . . . . . . . . . 156,964 1,930 7,952 20,056 21,309 20,432 20,635 22,864 18,882 11,617 7,584 3,704
2011 . . . . . . . . . . . . . . . . . . 158,301 1,953 7,910 20,068 21,366 20,746 20,404 22,699 19,704 12,005 7,602 3,843
2012 . . . . . . . . . . . . . . . . . . 159,422 1,926 7,857 20,118 21,432 20,971 20,343 22,462 19,983 12,783 7,624 3,923
2013 . . . . . . . . . . . . . . . . . . 160,477 1,925 7,791 20,160 21,429 21,203 20,307 22,198 20,360 13,419 7,686 3,999
White male
1950 . . . . . . . . . . . . . . . . . . 67,129 1,400 5,845 10,860 9,689 10,430 9,529 7,836 6,180 3,736 1,406 218
1960 . . . . . . . . . . . . . . . . . . 78,367 1,784 7,065 15,659 10,483 9,940 10,564 9,114 6,850 4,702 1,875 331
1970 . . . . . . . . . . . . . . . . . . 86,721 1,501 5,873 17,667 15,232 10,775 9,979 10,090 7,958 4,916 2,243 487
1980 . . . . . . . . . . . . . . . . . . 94,976 1,487 5,402 14,773 18,123 15,940 11,010 9,774 9,151 6,096 2,600 621
1990 . . . . . . . . . . . . . . . . . . 102,143 1,604 6,071 14,467 15,389 18,071 15,819 10,624 8,813 7,127 3,397 760
2000 . . . . . . . . . . . . . . . . . . 113,445 1,524 6,143 16,428 15,942 16,232 18,568 15,670 10,067 7,343 4,419 1,109
2010 . . . . . . . . . . . . . . . . . . 121,403 1,518 6,281 16,043 17,069 16,139 16,208 18,096 14,840 8,726 4,866 1,617
2011 . . . . . . . . . . . . . . . . . . 122,321 1,531 6,218 16,015 17,117 16,433 15,985 17,931 15,423 9,033 4,926 1,710
2012 . . . . . . . . . . . . . . . . . . 122,937 1,513 6,159 16,013 17,118 16,594 15,882 17,701 15,549 9,667 4,977 1,766
2013 . . . . . . . . . . . . . . . . . . 123,559 1,509 6,101 16,000 17,093 16,764 15,813 17,447 15,787 10,160 5,056 1,830
White female
1950 . . . . . . . . . . . . . . . . . . 67,813 1,341 5,599 10,431 9,821 10,851 9,719 7,868 6,168 4,031 1,669 314
1960 . . . . . . . . . . . . . . . . . . 80,465 1,714 6,795 15,068 10,596 10,204 11,000 9,364 7,327 5,428 2,441 527
1970 . . . . . . . . . . . . . . . . . . 91,028 1,434 5,615 16,912 15,420 11,004 10,349 10,756 8,853 6,366 3,429 890
1980 . . . . . . . . . . . . . . . . . . 99,835 1,412 5,127 14,057 17,653 15,896 11,232 10,285 10,325 7,951 4,457 1,440
1990 . . . . . . . . . . . . . . . . . . 106,561 1,524 5,762 13,706 14,599 17,757 15,834 10,946 9,698 9,048 5,687 2,001
2000 . . . . . . . . . . . . . . . . . . 116,641 1,447 5,839 15,576 14,966 15,574 18,386 15,921 10,731 8,757 6,715 2,729
2010 . . . . . . . . . . . . . . . . . . 124,020 1,451 5,993 15,270 16,153 15,552 15,941 18,311 15,586 9,846 6,601 3,314
2011 . . . . . . . . . . . . . . . . . . 124,773 1,464 5,940 15,253 16,174 15,778 15,696 18,109 16,201 10,149 6,580 3,430
2012 . . . . . . . . . . . . . . . . . . 125,287 1,444 5,885 15,254 16,176 15,893 15,573 17,853 16,340 10,809 6,576 3,485
2013 . . . . . . . . . . . . . . . . . . 125,785 1,440 5,826 15,247 16,146 16,021 15,489 17,569 16,588 11,319 6,603 3,537
Age
Total
Sex, race, Hispanic resident Under 1–4 5–14 15–24 25–34 35–44 45–54 55–64 65–74 75–84 85 years
origin, and year population 1 year years years years years years years years years years and over
Black or
African American male Number, in thousands
1 2
1950 . . . . . . . . . . . . . . . . . . 7,300 -- 944 1,442 1,162 1,105 1,003 772 459 299 113 --
1960 . . . . . . . . . . . . . . . . . . 9,114 281 1,082 2,185 1,305 1,120 1,086 891 617 382 137 29
1970 . . . . . . . . . . . . . . . . . . 10,748 245 975 2,784 2,041 1,226 1,084 979 739 461 169 46
1980 . . . . . . . . . . . . . . . . . . 12,585 269 967 2,614 2,807 1,967 1,235 1,024 854 567 228 53
1990 . . . . . . . . . . . . . . . . . . 14,420 322 1,164 2,700 2,669 2,592 1,962 1,175 878 614 277 66
2000 . . . . . . . . . . . . . . . . . . 17,407 313 1,271 3,454 2,932 2,586 2,705 1,957 1,090 683 330 87
2010 . . . . . . . . . . . . . . . . . . 20,101 341 1,388 3,408 3,591 2,801 2,639 2,708 1,832 886 396 110
2011 . . . . . . . . . . . . . . . . . . 20,418 353 1,396 3,411 3,652 2,876 2,612 2,717 1,946 924 415 115
2012 . . . . . . . . . . . . . . . . . . 20,686 346 1,391 3,432 3,698 2,944 2,620 2,707 2,021 979 424 123
2013 . . . . . . . . . . . . . . . . . . 20,935 346 1,381 3,447 3,720 3,019 2,629 2,693 2,092 1,038 439 129
Black or
African American female
1 2
1950 . . . . . . . . . . . . . . . . . . 7,745 -- 941 1,446 1,300 1,260 1,112 796 443 322 125 --
1960 . . . . . . . . . . . . . . . . . . 9,758 283 1,085 2,191 1,404 1,300 1,229 974 663 430 160 38
1970 . . . . . . . . . . . . . . . . . . 11,832 243 970 2,773 2,196 1,456 1,309 1,134 868 582 230 71
1980 . . . . . . . . . . . . . . . . . . 14,046 266 951 2,578 2,937 2,267 1,488 1,258 1,059 776 360 106
1990 . . . . . . . . . . . . . . . . . . 16,063 316 1,137 2,641 2,700 2,905 2,279 1,416 1,135 884 495 156
2000 . . . . . . . . . . . . . . . . . . 19,187 302 1,228 3,348 2,971 2,866 3,055 2,274 1,353 971 587 233
2010 . . . . . . . . . . . . . . . . . . 21,965 330 1,343 3,292 3,568 3,066 2,962 3,056 2,197 1,192 675 282
2011 . . . . . . . . . . . . . . . . . . 22,261 335 1,349 3,296 3,598 3,123 2,935 3,067 2,331 1,238 696 293
2012 . . . . . . . . . . . . . . . . . . 22,517 331 1,344 3,314 3,622 3,171 2,941 3,056 2,420 1,305 706 307
2013 . . . . . . . . . . . . . . . . . . 22,762 331 1,333 3,333 3,630 3,224 2,950 3,043 2,499 1,378 723 318
American Indian or
Alaska Native male
1980 . . . . . . . . . . . . . . . . . . 702 17 59 153 161 114 75 53 37 22 9 2
1990 . . . . . . . . . . . . . . . . . . 1,024 24 88 206 192 183 140 86 55 32 13 3
2000 . . . . . . . . . . . . . . . . . . 1,488 28 109 301 271 229 229 165 88 45 18 5
2010 . . . . . . . . . . . . . . . . . . 2,143 39 160 381 392 336 290 264 167 76 29 7
2011 . . . . . . . . . . . . . . . . . . 2,186 41 160 383 395 345 293 269 179 82 32 8
2012 . . . . . . . . . . . . . . . . . . 2,210 39 158 386 396 350 296 270 186 89 33 9
2013 . . . . . . . . . . . . . . . . . . 2,240 40 157 388 396 356 299 272 194 95 35 9
American Indian or
Alaska Native female
1980 . . . . . . . . . . . . . . . . . . 718 16 57 149 158 118 79 57 41 27 12 4
1990 . . . . . . . . . . . . . . . . . . 1,041 24 85 200 178 186 148 92 61 41 21 6
2000 . . . . . . . . . . . . . . . . . . 1,496 26 106 293 254 219 236 174 95 54 28 10
2010 . . . . . . . . . . . . . . . . . . 2,121 38 156 370 364 316 282 273 179 87 41 14
2011 . . . . . . . . . . . . . . . . . . 2,161 39 155 373 368 321 283 276 192 93 44 15
2012 . . . . . . . . . . . . . . . . . . 2,188 38 154 375 371 325 285 277 200 100 45 16
2013 . . . . . . . . . . . . . . . . . . 2,217 39 153 378 374 329 288 277 209 107 48 18
Asian or
Pacific Islander male
1980 . . . . . . . . . . . . . . . . . . 1,814 35 130 321 334 366 252 159 110 72 30 6
1990 . . . . . . . . . . . . . . . . . . 3,652 68 258 598 665 718 588 347 208 133 57 12
2000 . . . . . . . . . . . . . . . . . . 5,713 84 339 861 934 1,073 947 705 399 231 112 27
2010 . . . . . . . . . . . . . . . . . . 8,134 116 476 1,138 1,266 1,356 1,299 1,075 761 409 186 55
2011 . . . . . . . . . . . . . . . . . . 8,366 119 482 1,162 1,269 1,390 1,334 1,102 810 437 201 61
2012 . . . . . . . . . . . . . . . . . . 8,658 119 492 1,195 1,301 1,451 1,376 1,128 847 469 214 66
2013 . . . . . . . . . . . . . . . . . . 8,917 121 497 1,226 1,316 1,503 1,405 1,158 884 504 230 73
Age
Total
Sex, race, Hispanic resident Under 1–4 5–14 15–24 25–34 35–44 45–54 55–64 65–74 75–84 85 years
origin, and year population 1 year years years years years years years years years years and over
Asian or
1990 . . . . . . . . . . . . . . . . . . 3,805 65 247 578 621 749 664 371 264 166 65 17
2000 . . . . . . . . . . . . . . . . . . 6,044 81 336 817 914 1,112 1,024 812 451 305 152 41
2010 . . . . . . . . . . . . . . . . . . 8,859 110 460 1,124 1,223 1,498 1,450 1,223 920 491 267 93
2011 . . . . . . . . . . . . . . . . . . 9,106 114 465 1,146 1,226 1,524 1,491 1,247 979 525 282 105
2012 . . . . . . . . . . . . . . . . . . 9,430 113 474 1,175 1,262 1,582 1,543 1,276 1,023 569 298 115
2013 . . . . . . . . . . . . . . . . . . 9,713 116 479 1,202 1,279 1,628 1,580 1,309 1,064 615 313 127
1990 . . . . . . . . . . . . . . . . . . 11,388 279 980 2,128 2,376 2,310 1,471 818 551 312 131 32
2000 . . . . . . . . . . . . . . . . . . 18,162 395 1,506 3,469 3,564 3,494 2,653 1,551 804 474 203 50
2010 . . . . . . . . . . . . . . . . . . 25,619 515 2,094 4,755 4,648 4,419 3,734 2,736 1,535 735 352 95
2011 . . . . . . . . . . . . . . . . . . 26,443 537 2,114 4,868 4,745 4,535 3,846 2,874 1,658 786 374 107
2012 . . . . . . . . . . . . . . . . . . 26,930 523 2,105 4,959 4,784 4,579 3,919 2,967 1,747 840 389 116
2013 . . . . . . . . . . . . . . . . . . 27,461 518 2,091 5,049 4,826 4,638 3,996 3,070 1,840 898 407 127
1990 . . . . . . . . . . . . . . . . . . 10,966 268 939 2,039 2,028 2,073 1,448 868 632 403 209 59
2000 . . . . . . . . . . . . . . . . . . 17,144 376 1,441 3,318 3,017 3,016 2,476 1,585 907 603 303 101
2010 . . . . . . . . . . . . . . . . . . 24,859 497 2,008 4,561 4,206 4,016 3,564 2,728 1,679 914 510 176
2011 . . . . . . . . . . . . . . . . . . 25,602 513 2,029 4,670 4,314 4,070 3,662 2,842 1,800 969 536 197
2012 . . . . . . . . . . . . . . . . . . 26,098 502 2,025 4,760 4,382 4,092 3,730 2,922 1,888 1,029 557 213
2013 . . . . . . . . . . . . . . . . . . 26,610 496 2,013 4,844 4,449 4,124 3,794 3,011 1,979 1,089 580 230
Latino male
1980 . . . . . . . . . . . . . . . . . . 88,035 1,308 4,772 13,317 16,554 14,739 10,284 9,229 8,803 5,906 2,519 603
1990 . . . . . . . . . . . . . . . . . . 91,743 1,351 5,181 12,525 13,219 15,967 14,481 9,875 8,303 6,837 3,275 729
2000 . . . . . . . . . . . . . . . . . . 96,551 1,163 4,761 13,238 12,628 12,958 16,088 14,223 9,312 6,894 4,225 1,062
2010 . . . . . . . . . . . . . . . . . . 98,386 1,067 4,438 11,817 12,930 12,171 12,813 15,606 13,434 8,045 4,536 1,528
2011 . . . . . . . . . . . . . . . . . . 98,580 1,062 4,362 11,693 12,888 12,365 12,492 15,316 13,908 8,307 4,577 1,610
2012 . . . . . . . . . . . . . . . . . . 98,773 1,054 4,312 11,616 12,857 12,491 12,327 15,001 13,954 8,891 4,613 1,656
2013 . . . . . . . . . . . . . . . . . . 98,937 1,058 4,270 11,529 12,794 12,612 12,193 14,654 14,108 9,332 4,677 1,711
Latina female
1980 . . . . . . . . . . . . . . . . . . 92,872 1,240 4,522 12,647 16,185 14,711 10,468 9,700 9,935 7,707 4,345 1,411
1990 . . . . . . . . . . . . . . . . . . 96,557 1,280 4,909 11,846 12,749 15,872 14,520 10,153 9,116 8,674 5,491 1,945
2000 . . . . . . . . . . . . . . . . . . 100,774 1,102 4,517 12,529 12,183 12,778 16,089 14,446 9,879 8,188 6,429 2,633
2010 . . . . . . . . . . . . . . . . . . 101,741 1,016 4,225 11,219 12,426 11,972 12,718 15,839 14,049 9,000 6,125 3,150
2011 . . . . . . . . . . . . . . . . . . 101,843 1,016 4,158 11,108 12,346 12,154 12,389 15,535 14,557 9,253 6,081 3,247
2012 . . . . . . . . . . . . . . . . . . 101,926 1,005 4,108 11,035 12,286 12,254 12,210 15,208 14,618 9,859 6,057 3,286
2013 . . . . . . . . . . . . . . . . . . 101,982 1,007 4,063 10,958 12,194 12,358 12,073 14,844 14,785 10,314 6,064 3,321
1
Population for age group under 5 years.
2
Population for age group 75 years and over.
NOTES: The race groups, white, black, American Indian or Alaska Native, and Asian or Pacific Islander, include persons of Hispanic and non-Hispanic origin. Persons
of Hispanic origin may be of any race. Starting with Health, United States, 2003, population estimates for 1991–1999 are intercensal estimates based on the 1990 and
2000 censuses. Starting with Health, United States, 2012, population estimates for 2001–2009 are intercensal estimates based on the 2000 and 2010 censuses.
Population estimates for 2011–2013 are 2010-based postcensal estimates. Population figures are census counts as of April 1 for 1950, 1960, 1970, 1980, and 1990.
For 2000 and 2010, population estimates are bridged-race April 1 census counts. Estimates for other years are as of July 1. See Appendix I, Population Census and
Population Estimates. Populations for age groups may not sum to the total due to rounding. Unrounded population figures are available in the spreadsheet version of
this table. Available from: http://www.cdc.gov/nchs/hus.htm. Data for additional years are available. See the Excel spreadsheet on the Health, United States website at:
http://www.cdc.gov/nchs/hus.htm.
SOURCE: U.S. Census Bureau: 1950 Nonwhite Population by Race. Special Report P-E, No. 3B. Washington, DC: U.S. Government Printing Office, 1951; U.S.
Census of Population: 1960, Number of Inhabitants, PC(1)-A1, United States Summary, 1964; 1970, Number of Inhabitants, Final Report PC(1)-A1, United States
Summary, 1971; U.S. population estimates, by age, sex, race, and Hispanic origin: 1980 to 1991. Current population reports, series P–25, no 1095. Washington, DC:
U.S. Government Printing Office, Feb. 1993; NCHS. Estimates of the July 1, 1991–July 1, 1999; April 1, 2000; July 1, 2001–July 1, 2009; April 1, 2010; July 1,
2011–July 1, 2013 United States resident population by age, sex, race, and Hispanic origin, prepared under a collaborative arrangement with the U.S. Census Bureau,
Population Estimates Program. Available from: http://www.cdc.gov/nchs/nvss/bridged_race.htm. See Appendix I, Population Census and Population Estimates.
Selected characteristic,
race, and Hispanic origin 1 1973 1980 1990 2000 2 2005 2010 4 2011 2012 2013 5
Selected characteristic,
race, and Hispanic origin 1 1973 1980 1990 2000 2 2005 2010 4 2011 2012 2013 5
1
The race groups, white, black, and Asian, include persons of Hispanic and non-Hispanic origin. Persons of Hispanic origin may be of any race. Starting with 2002 data,
race-specific estimates are tabulated according to the 1997 Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity and are not strictly
comparable with estimates for earlier years. The three single-race categories shown in the table conform to the 1997 Standards. For 2002 and subsequent years,
race-specific estimates are for persons who reported only one racial group. Estimates for single-race categories prior to 2002 are based on answers to the Current
Population Survey question which asked respondents to choose only a single race. Prior to data year 2002, data were tabulated according to the 1977 Standards in
which the Asian only category included Native Hawaiian and Other Pacific Islander. See Appendix II, Hispanic origin; Race.
2
Estimates are consistent with 2001 data through implementation of the 2000 census-based population controls and a 28,000-household sample expansion.
3
Data for 2004 (shown in spreadsheet version) reflect a correction to the weights in the 2005 Annual Social and Economic Supplements of the Current Population
4
Data for 2010 reflect Census 2010-based population controls.
5
For 2013 data, the CPS ASEC used a split panel to test a new set of income questions. Data for 2013 presented here are consistent with 2012 and do not include the
NOTES: Estimates of poverty for 1991–1998 are based on 1990 postcensal population estimates. Estimates for 1999–2009 were based on Census 2000 population
controls. Estimates for 2010 and beyond were based on Census 2010 population controls. Poverty level is based on family income and family size using U.S. Census
Bureau poverty thresholds. See Appendix II, Poverty. Poverty estimates based on a supplemental poverty measure are available from the U.S. Census Bureau. The
Current Population Survey is not large enough to produce reliable annual estimates for American Indian or Alaska Native persons, or for Native Hawaiian and Other
Pacific Islander persons. In 2011–2013, an estimated 30.1% of American Indian or Alaska Native only persons (1,005,000 persons) were living below the poverty level.
In 2011–2013, an estimated 15.9% of Native Hawaiian and Other Pacific Islander persons (176,000 persons) were living below the poverty level. Data for additional
years are available. See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: U.S. Census Bureau, Current Population Survey, Annual Social and Economic Supplements; DeNavas-Walt C, Proctor BD. Income and poverty in the United
States: 2013. Current Population Reports, P60–249. Washington, DC: U.S. Government Printing Office. 2014. Available from:
Age of mother
15–19 years
Race, Crude
Hispanic origin, birth Fertility 10–14 15–17 18–19 20–24 25–29 30–34 35–39 40–44 45–54
and year rate 1 rate 2 years Total years years years years years years years years 3
1950 . . . . . . . . . . . . . . . . . . 24.1 106.2 1.0 81.6 40.7 132.7 196.6 166.1 103.7 52.9 15.1 1.2
1960 . . . . . . . . . . . . . . . . . . 23.7 118.0 0.8 89.1 43.9 166.7 258.1 197.4 112.7 56.2 15.5 0.9
1970 . . . . . . . . . . . . . . . . . . 18.4 87.9 1.2 68.3 38.8 114.7 167.8 145.1 73.3 31.7 8.1 0.5
1980 . . . . . . . . . . . . . . . . . . 15.9 68.4 1.1 53.0 32.5 82.1 115.1 112.9 61.9 19.8 3.9 0.2
1985 . . . . . . . . . . . . . . . . . . 15.8 66.3 1.2 51.0 31.0 79.6 108.3 111.0 69.1 24.0 4.0 0.2
1990 . . . . . . . . . . . . . . . . . . 16.7 70.9 1.4 59.9 37.5 88.6 116.5 120.2 80.8 31.7 5.5 0.2
1995 . . . . . . . . . . . . . . . . . . 14.6 64.6 1.3 56.0 35.5 87.7 107.5 108.8 81.1 34.0 6.6 0.3
2000 . . . . . . . . . . . . . . . . . . 14.4 65.9 0.9 47.7 26.9 78.1 109.7 113.5 91.2 39.7 8.0 0.5
2005 . . . . . . . . . . . . . . . . . . 14.0 66.7 0.6 39.7 21.1 68.4 101.8 116.5 96.7 46.4 9.1 0.6
2010 . . . . . . . . . . . . . . . . . . 13.0 64.1 0.4 34.2 17.3 58.2 90.0 108.3 96.5 45.9 10.2 0.7
2011 . . . . . . . . . . . . . . . . . . 12.7 63.2 0.4 31.3 15.4 54.1 85.3 107.2 96.5 47.2 10.3 0.7
2012 . . . . . . . . . . . . . . . . . . 12.6 63.0 0.4 29.4 14.1 51.4 83.1 106.5 97.3 48.3 10.4 0.7
2013 . . . . . . . . . . . . . . . . . . 12.4 62.5 0.3 26.5 12.3 47.1 80.7 105.5 98.0 49.3 10.4 0.8
Race of child: 4 White
1950 . . . . . . . . . . . . . . . . . . 23.0 102.3 0.4 70.0 31.3 120.5 190.4 165.1 102.6 51.4 14.5 1.0
1960 . . . . . . . . . . . . . . . . . . 22.7 113.2 0.4 79.4 35.5 154.6 252.8 194.9 109.6 54.0 14.7 0.8
1970 . . . . . . . . . . . . . . . . . . 17.4 84.1 0.5 57.4 29.2 101.5 163.4 145.9 71.9 30.0 7.5 0.4
1980 . . . . . . . . . . . . . . . . . . 14.9 64.7 0.6 44.7 25.2 72.1 109.5 112.4 60.4 18.5 3.4 0.2
Race of mother: 5 White
1980 . . . . . . . . . . . . . . . . . . 15.1 65.6 0.6 45.4 25.5 73.2 111.1 113.8 61.2 18.8 3.5 0.2
1985 . . . . . . . . . . . . . . . . . . 15.0 64.1 0.6 43.3 24.4 70.4 104.1 112.3 69.9 23.3 3.7 0.2
1990 . . . . . . . . . . . . . . . . . . 15.8 68.3 0.7 50.8 29.5 78.0 109.8 120.7 81.7 31.5 5.2 0.2
1995 . . . . . . . . . . . . . . . . . . 14.1 63.6 0.8 49.5 29.6 80.2 104.7 111.7 83.3 34.2 6.4 0.3
2000 . . . . . . . . . . . . . . . . . . 13.9 65.3 0.6 43.2 23.3 72.3 106.6 116.7 94.6 40.2 7.9 0.4
2005 . . . . . . . . . . . . . . . . . . 13.6 66.8 0.5 36.7 18.8 64.0 99.9 120.7 100.7 47.6 9.0 0.6
2010 . . . . . . . . . . . . . . . . . . 12.5 64.4 0.3 31.9 15.8 54.8 87.9 111.9 100.5 46.4 10.0 0.6
2011 . . . . . . . . . . . . . . . . . . 12.2 63.4 0.3 29.1 14.1 50.8 83.0 110.2 100.1 47.6 10.1 0.6
2012 . . . . . . . . . . . . . . . . . . 12.1 63.0 0.3 27.4 13.0 48.3 80.8 109.2 100.2 48.5 10.0 0.7
2013 . . . . . . . . . . . . . . . . . . 12.0 62.7 0.2 24.9 11.3 44.7 78.5 108.3 101.3 49.6 10.1 0.7
Race of child: 4 Black
or African American
1960 . . . . . . . . . . . . . . . . . . 31.9 153.5 4.3 156.1 -- -- 295.4 218.6 137.1 73.9 21.9 1.1
1970 . . . . . . . . . . . . . . . . . . 25.3 115.4 5.2 140.7 101.4 204.9 202.7 136.3 79.6 41.9 12.5 1.0
1980 . . . . . . . . . . . . . . . . . . 22.1 88.1 4.3 100.0 73.6 138.8 146.3 109.1 62.9 24.5 5.8 0.3
Race of mother: 5 Black
or African American
1980 . . . . . . . . . . . . . . . . . . 21.3 84.7 4.3 97.8 72.5 135.1 140.0 103.9 59.9 23.5 5.6 0.3
1985 . . . . . . . . . . . . . . . . . . 20.4 78.8 4.5 95.4 69.3 132.4 135.0 100.2 57.9 23.9 4.6 0.3
1990 . . . . . . . . . . . . . . . . . . 22.4 86.8 4.9 112.8 82.3 152.9 160.2 115.5 68.7 28.1 5.5 0.3
1995 . . . . . . . . . . . . . . . . . . 17.8 71.0 4.1 94.4 68.5 135.0 133.7 95.6 63.0 28.4 6.0 0.3
2000 . . . . . . . . . . . . . . . . . . 17.0 70.0 2.3 77.4 49.0 118.8 141.3 100.3 65.4 31.5 7.2 0.4
2005 . . . . . . . . . . . . . . . . . . 16.1 68.5 1.6 60.1 34.5 101.2 129.5 107.0 70.2 35.1 8.4 0.5
2010 . . . . . . . . . . . . . . . . . . 15.1 66.3 1.0 51.1 27.3 84.8 118.1 101.8 73.0 36.4 9.3 0.7
2011 . . . . . . . . . . . . . . . . . . 14.8 65.5 0.9 47.3 24.7 78.8 111.9 101.7 74.1 38.0 9.4 0.7
2012 . . . . . . . . . . . . . . . . . . 14.7 65.1 0.8 44.0 22.0 74.4 108.7 101.7 75.1 39.2 9.7 0.7
2013 . . . . . . . . . . . . . . . . . . 14.5 64.7 0.7 39.1 19.0 67.3 105.5 102.6 77.3 40.5 10.0 0.8
American Indian or
Alaska Native mother 5
1980 . . . . . . . . . . . . . . . . . . 20.7 82.7 1.9 82.2 51.5 129.5 143.7 106.6 61.8 28.1 8.2 *
1985 . . . . . . . . . . . . . . . . . . 19.8 78.6 1.7 79.2 47.7 124.1 139.1 109.6 62.6 27.4 6.0 *
1990 . . . . . . . . . . . . . . . . . . 18.9 76.2 1.6 81.1 48.5 129.3 148.7 110.3 61.5 27.5 5.9 *
1995 . . . . . . . . . . . . . . . . . . 15.3 63.0 1.6 72.9 44.6 122.2 123.1 91.6 56.5 24.3 5.5 *
2000 . . . . . . . . . . . . . . . . . . 14.0 58.7 1.1 58.3 34.1 97.1 117.2 91.8 55.5 24.6 5.7 0.3
2005 . . . . . . . . . . . . . . . . . . 12.6 53.6 0.8 46.0 26.3 78.0 102.9 86.3 51.8 23.3 5.4 0.3
2010 . . . . . . . . . . . . . . . . . . 11.0 48.6 0.5 38.7 20.1 66.1 91.0 74.4 48.4 22.3 5.2 0.3
2011 . . . . . . . . . . . . . . . . . . 10.7 47.7 0.5 36.1 18.2 61.6 86.6 75.4 47.3 23.1 5.5 0.2
2012 . . . . . . . . . . . . . . . . . . 10.5 47.0 0.5 34.9 17.0 60.5 81.7 73.9 49.7 23.3 5.5 0.5
2013 . . . . . . . . . . . . . . . . . . 10.3 46.4 0.4 31.1 15.9 53.3 78.9 75.6 50.4 24.7 5.5 0.3
Age of mother
15–19 years
Race, Crude
Hispanic origin, birth Fertility 10–14 15–17 18–19 20–24 25–29 30–34 35–39 40–44 45–54
and year rate 1 rate 2 years Total years years years years years years years years 3
Asian or
Pacific Islander mother 5 Live births per 1,000 women
1980 . . . . . . . . . . . . . . . . . . 19.9 73.2 0.3 26.2 12.0 46.2 93.3 127.4 96.0 38.3 8.5 0.7
1985 . . . . . . . . . . . . . . . . . . 18.7 68.4 0.4 23.8 12.5 40.8 83.6 123.0 93.6 42.7 8.7 1.2
1990 . . . . . . . . . . . . . . . . . . 19.0 69.6 0.7 26.4 16.0 40.2 79.2 126.3 106.5 49.6 10.7 1.1
1995 . . . . . . . . . . . . . . . . . . 16.7 62.6 0.7 25.5 15.6 40.1 64.2 103.7 102.3 50.1 11.8 0.8
2000 . . . . . . . . . . . . . . . . . . 17.1 65.8 0.3 20.5 11.6 32.6 60.3 108.4 116.5 59.0 12.6 0.8
2005 . . . . . . . . . . . . . . . . . . 15.9 63.0 0.2 15.4 7.7 26.4 52.9 96.6 115.3 61.8 13.7 1.0
2010 . . . . . . . . . . . . . . . . . . 14.5 59.2 0.1 10.9 5.1 18.7 42.6 91.5 113.6 62.8 15.1 1.2
2011 . . . . . . . . . . . . . . . . . . 14.5 59.9 0.1 10.2 4.6 18.1 41.9 93.7 114.9 64.1 15.2 1.2
2012 . . . . . . . . . . . . . . . . . . 15.1 62.2 0.1 9.7 4.1 17.7 41.4 95.8 121.3 68.1 16.1 1.4
2013 . . . . . . . . . . . . . . . . . . 14.3 59.2 0.1 8.7 3.7 16.1 39.1 89.5 114.6 66.6 16.1 1.5
Hispanic or Latina
mother 5,6
1980 . . . . . . . . . . . . . . . . . . 23.5 95.4 1.7 82.2 52.1 126.9 156.4 132.1 83.2 39.9 10.6 0.7
1990 . . . . . . . . . . . . . . . . . . 26.7 107.7 2.4 100.3 65.9 147.7 181.0 153.0 98.3 45.3 10.9 0.7
1995 . . . . . . . . . . . . . . . . . . 24.1 98.8 2.6 99.3 68.3 145.4 171.9 140.4 90.5 43.7 10.7 0.6
2000 . . . . . . . . . . . . . . . . . . 23.1 95.9 1.7 87.3 55.5 132.6 161.3 139.9 97.1 46.6 11.5 0.6
2005 . . . . . . . . . . . . . . . . . . 22.9 96.4 1.3 76.5 45.8 124.4 161.1 147.0 105.6 53.3 12.8 0.8
2010 . . . . . . . . . . . . . . . . . . 18.7 80.2 0.8 55.7 32.3 90.7 126.1 125.3 96.6 51.7 13.0 0.8
2011 . . . . . . . . . . . . . . . . . . 17.6 76.2 0.7 49.6 28.0 81.5 116.0 121.3 95.2 51.3 13.1 0.8
2012 . . . . . . . . . . . . . . . . . . 17.1 74.4 0.6 46.3 25.5 77.2 111.5 119.6 94.3 51.6 13.2 0.8
2013 . . . . . . . . . . . . . . . . . . 16.7 72.9 0.5 41.7 22.0 70.8 107.2 119.1 94.8 52.4 13.3 0.8
1
Live births per 1,000 population.
2
Total number of live births regardless of age of mother per 1,000 women aged 15–44.
3
Prior to 1997, data are for live births to mothers aged 45–49 per 1,000 women aged 45–49. In subsequent years, rates were computed by dividing the number of
births to women aged 45 and over by the population of women aged 45–49. See Appendix II, Age.
4
Live births are tabulated by race of child. See Appendix II, Race.
5
Live births are tabulated by race and/or Hispanic origin of mother. See Appendix II, Race.
6
Prior to 1993, data from states that did not report Hispanic origin on the birth certificate were excluded. See Appendix II, Hispanic origin. Rates in 1985 were not
calculated because estimates for the Hispanic and non-Hispanic populations were not available.
NOTES: Data are based on births adjusted for underregistration for 1950 and on registered births for all other years. Starting with 1970 data, births to persons who
were not residents of the 50 states and the District of Columbia are excluded. Starting with Health, United States, 2003, rates for 1991–1999 were revised using
intercensal population estimates based on the 1990 and 2000 censuses. Rates for 2000 were based on bridged-race April 1, 2000 census counts. Starting with Health,
United States, 2012, rates for 2001–2009 were revised using intercensal population estimates based on the 2000 and 2010 censuses. Rates for 2010 were based on
bridged-race April 1, 2010 census counts. Rates for 2011 and beyond were computed using 2010-based postcensal estimates. See Appendix I, Population Census and
Population Estimates. The race groups, white, black, American Indian or Alaska Native, and Asian or Pacific Islander, include persons of Hispanic and non-Hispanic
origin. Persons of Hispanic origin may be of any race. Starting with 2003 data, some states reported multiple-race data. The multiple-race data for these states were
bridged to the single-race categories of the 1977 Office of Management and Budget standards, for comparability with other states. See Appendix II, Race. Interpretation
of trend data for Hispanic women should take into consideration expansion of reporting areas. Data for additional years are available. See the Excel spreadsheet on the
Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC/NCHS, National Vital Statistics System, public-use Birth File. Martin JA, Hamilton BE, Osterman MJK, et al. Births: Final data for 2013. National vital
statistics reports; vol 64 no 1. Hyattsville, MD: NCHS. 2015; Available from: http://www.cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_01.pdf. Ventura SJ. Births of Hispanic
parentage, 1980 and 1985. Monthly vital statistics report; vol 32 no 6 and vol 36 no 11, suppl. Public Health Service. Hyattsville, MD. 1983 and 1988; Available from:
http://www.cdc.gov/nchs/data/mvsr/supp/mv32_06sacc.pdf and http://www.cdc.gov/nchs/data/mvsr/supp/mv36_11s.pdf. Internet release of: Vital statistics of the United
States, 2003, vol 1, Natality, Tables 1–1 and 1–7; available from: http://www.cdc.gov/nchs/products/vsus.htm#electronic. See Appendix I, National Vital Statistics System
(NVSS).
1
Estimates are not available for Asian or Pacific Islander subgroups because not all states have adopted the 2003 revision of the U.S. Standard Certificate of Live Birth.
See Appendix II, Race.
2
Prior to 1993, data from states that did not report Hispanic origin on the birth certificate were excluded. See Appendix II, Hispanic origin. Data for non-Hispanic white
and non-Hispanic black women for years prior to 1989 are not nationally representative and are provided solely for comparison with Hispanic data.
NOTES: The race groups, white, black, American Indian or Alaska Native, and Asian or Pacific Islander, include persons of Hispanic and non-Hispanic origin. Persons
of Hispanic origin may be of any race. Starting with 2003 data, some states reported multiple-race data. The multiple-race data for these states were bridged to the
single-race categories of the 1977 Office of Management and Budget standards, for comparability with other states. See Appendix II, Race. Interpretation of trend data
for Hispanic births should take into consideration expansion of reporting areas. Data for additional years are available. See the Excel spreadsheet on the Health, United
SOURCE: CDC/NCHS, National Vital Statistics System, public-use Birth File. Martin JA, Hamilton BE, Osterman MJK, et al. Births: Final data for 2013. National vital
statistics reports; vol 64 no 1. Hyattsville, MD: NCHS. 2015; Available from: http://www.cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_01.pdf. See Appendix I, National Vital
Maternal race,
Hispanic origin, and age 1970 1980 1985 1990 1995 2000 2005 2010 2012 2013
1
Rates computed by dividing births to unmarried mothers, regardless of age of mother, by the population of unmarried women aged 15–44. Population data for
unmarried American Indian or Alaska Native women are not available for rate calculations. Prior to 2000, population data for unmarried Asian or Pacific Islander women
2
For 1970 and 1975, birth rates are by race of child.
3
Prior to 1993, data from states that did not report Hispanic origin on the birth certificate were excluded. See Appendix II, Hispanic origin. Data for non-Hispanic white
and non-Hispanic black women for years prior to 1989 are not nationally representative and are provided solely for comparison with Hispanic data.
4
Estimates are not available for Asian or Pacific Islander subgroups because not all states have adopted the 2003 revision of the U.S. Standard Certificate of Live Birth.
See Appendix II, Race.
NOTES: National estimates for 1970 and 1975 for unmarried mothers are based on births occurring in states reporting marital status of mother. Changes in reporting
procedures for marital status occurred in some states during the 1990s. Data for states in which marital status was not reported have been inferred and included with
data from the remaining states. See Appendix II, Marital status. Interpretation of trend data for Hispanic births should take into consideration expansion of reporting
areas. The race groups, white, black, American Indian or Alaska Native, and Asian or Pacific Islander, include persons of Hispanic and non-Hispanic origin. Persons of
Hispanic origin may be of any race. Starting with 2003 data, some states reported multiple-race data. The multiple-race data for these states were bridged to the
single-race categories of the 1977 Office of Management and Budget standards, for comparability with other states. See Appendix II, Race. Starting with Health, United
States, 2003, rates for 1991–1999 were revised using intercensal population estimates based on the 1990 and 2000 censuses. Rates for 2000 were based on
bridged-race April 1, 2000 census counts. Starting with Health, United States, 2012, rates for 2001–2009 were revised using intercensal population estimates based on
the 2000 and 2010 censuses. Rates for 2010 were based on 2010 census counts. Rates for 2011 and beyond were computed using 2010-based postcensal estimates.
Data for additional years are available. See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC/NCHS, National Vital Statistics System, public-use Birth File. Martin JA, Hamilton BE, Osterman MJK, et al. Births: Final data for 2013. National vital
statistics reports; vol 64 no 1. Hyattsville, MD: NCHS. 2015; Available from: http://www.cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_01.pdf. Hamilton BE, Sutton PD, Ventura
SJ. Revised birth and fertility rates for the 1990s and new rates for Hispanic populations, 2000 and 2001: United States. National vital statistics reports; vol 51 no 12.
Hyattsville, MD: NCHS. 2003; Available from: http://www.cdc.gov/nchs/data/nvsr/nvsr51/nvsr51_12.pdf. Births: Final data for each data year 1997–2007. National vital
statistics reports. Hyattsville, MD; Final natality statistics for each data year 1993–1996. Monthly vital statistics report. Hyattsville, MD; Ventura SJ. Births to unmarried
mothers: United States, 1980–1992. Vital Health Stat 21(53). 1995. See Appendix I, National Vital Statistics System (NVSS).
Low birthweight
(less than 2,500 grams) Percent of live births 1
All races . . . . . . . . . . . . . . . . . . . . . . . . . 7.93 6.84 6.75 6.97 7.32 7.57 8.19 8.15 7.99 8.02
White . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.85 5.72 5.65 5.70 6.22 6.55 7.16 7.08 6.96 7.00
Black or African American . . . . . . . . . . . . . 13.90 12.69 12.65 13.25 13.13 12.99 13.59 13.21 12.84 12.76
American Indian or Alaska Native . . . . . . . 7.97 6.44 5.86 6.11 6.61 6.76 7.36 7.61 7.61 7.48
Asian or Pacific Islander 2 . . . . . . . . . . . . . -- 6.68 6.16 6.45 6.90 7.31 7.98 8.49 8.21 8.34
Hispanic or Latina 3 . . . . . . . . . . . . . . . . . -- 6.12 6.16 6.06 6.29 6.41 6.88 6.97 6.97 7.09
Mexican . . . . . . . . . . . . . . . . . . . . . . . . -- 5.62 5.77 5.55 5.81 6.01 6.49 6.49 6.48 6.62
Puerto Rican . . . . . . . . . . . . . . . . . . . . -- 8.95 8.69 8.99 9.41 9.30 9.92 9.55 9.40 9.38
Cuban . . . . . . . . . . . . . . . . . . . . . . . . . -- 5.62 6.02 5.67 6.50 6.49 7.64 7.30 7.43 7.35
Central and South American . . . . . . . . . -- 5.76 5.68 5.84 6.20 6.34 6.78 6.55 6.64 6.85
Other and unknown Hispanic or Latina . . -- 6.96 6.83 6.87 7.55 7.84 8.27 8.38 8.00 7.99
Not Hispanic or Latina: 3
White. . . . . . . . . . . . . . . . . . . . . . . . .. -- 5.69 5.61 5.61 6.20 6.60 7.29 7.14 6.97 6.98
Black or African American . . . . . . . . . .. -- 12.71 12.62 13.32 13.21 13.13 14.02 13.53 13.18 13.08
1
Excludes live births with unknown birthweight. Percentage based on live births with known birthweight. See Appendix II, Birthweight.
2
Estimates are not available for Asian or Pacific Islander subgroups because not all states have adopted the 2003 revision of the U.S. Standard Certificate of Live Birth.
See Appendix II, Race.
3
Prior to 1993, data from states that did not report Hispanic origin on the birth certificate were excluded. See Appendix II, Hispanic origin. Data for non-Hispanic white
and non-Hispanic black women for years prior to 1989 are not nationally representative and are provided solely for comparison with Hispanic data.
NOTES: The race groups, white, black, American Indian or Alaska Native, and Asian or Pacific Islander, include persons of Hispanic and non-Hispanic origin. Persons
of Hispanic origin may be of any race. Starting with 2003 data, some states reported multiple-race data. The multiple-race data for these states were bridged to the
single-race categories of the 1977 Office of Management and Budget standards, for comparability with other states. See Appendix II, Race. Interpretation of trend data
for Hispanic births should take into consideration expansion of reporting areas. Data for additional years are available. See the Excel spreadsheet on the Health, United
SOURCE: CDC/NCHS, National Vital Statistics System, public-use Birth File. Martin JA, Hamilton BE, Osterman MJK, et al. Births: Final data for 2013. National vital
statistics reports; vol 64 no 1. Hyattsville, MD: NCHS. 2015; Available from: http://www.cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_01.pdf. See Appendix I, National Vital
Black or
All races White African American
State and territory 2000–2002 2003–2005 2011–2013 2000–2002 2003–2005 2011–2013 2000–2002 2003–2005 2011–2013
American Indian or
Hispanic or Latina 4 Alaska Native 5 Asian or Pacific Islander 5
State and territory 2000–2002 2003–2005 2011–2013 2000–2002 2003–2005 2011–2013 2000–2002 2003–2005 2011–2013
* Percentages preceded by an asterisk are based on fewer than 50 births. Percentages not shown are based on fewer than 20 births.
– Quantity zero.
1
Excludes live births with unknown birthweight.
2
Excludes data for American Samoa, Guam, Northern Marianas, Puerto Rico, and Virgin Islands.
3
Comparable data were not available for all time periods and racial and ethnicity groups. Therefore, only selected low birthweight percentages are presented for the
territories.
4
Persons of Hispanic origin may be of any race. See Appendix II, Hispanic origin.
5
Includes persons of Hispanic and non-Hispanic origin.
NOTES: For information on very low birthweight live births by state, see Table I–10 in Martin JA, Hamilton BE, Osterman MJK, et al. Births: Final data for 2013.
National vital statistics reports; vol 64 no 1. Hyattsville, MD: NCHS. 2015; Available from: http://www.cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_01.pdf. Starting with 2003
data, some states and territories reported multiple-race data. The multiple-race data for these areas were bridged to the single-race categories of the 1977 Office of
Management and Budget standards, for comparability with other areas. See Appendix II, Race. Data for the territories are shown by race and ethnicity only if
race-specific data are available for all years in the 3-year period. Data for additional years are available. See the Excel spreadsheet on the Health, United States
website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC/NCHS, National Vital Statistics System, public-use and nonpublic-use Birth File. Martin JA, Hamilton BE, Osterman MJK, et al. Births: Final data for
2013. National vital statistics reports; vol 64 no 1. Hyattsville, MD: NCHS. 2015; Available from: http://www.cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_01.pdf. See Appendix
I, National Vital Statistics System (NVSS).
Data provider 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
NOTES: Each year, CDC requests abortion data from the central health agencies of 52 reporting areas (the 50 states, the District of Columbia, and New York City).
This information is provided voluntarily to CDC. See the annual Abortion Surveillance reports for more information on the characteristic-specific list of reporting areas.
Available from: http://www.cdc.gov/reproductivehealth/Data_Stats/Abortion.htm. For methodological differences between CDC and the Guttmacher Institute Abortion
Provider Census, see Appendix I, Abortion Surveillance System; Guttmacher Institute Abortion Provider Census. Some data were revised and differ from previous
editions of Health, United States.
SOURCE: CDC, National Center for Chronic Disease Prevention and Health Promotion. CDC. Abortion surveillance—United States, 2011. MMWR 2014;63(SS11);1–41.
Available from: http://www.cdc.gov/mmwr/preview/mmwrhtml/ss6311a1.htm?s_cid=ss6311a1_e. Guttmacher Institute Abortion Provider Survey. Perspect Sex Reprod
Health 2014;46(1):3–14. See Appendix I, Abortion Surveillance System; Guttmacher Institute Abortion Provider Census.
Age, in years
1
Race and Hispanic origin and year 15–44 15–19 20–24 25–34 35–44
Hispanic or Latina: 3
1982 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4,393 886 811 1,677 1,018
1995 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6,702 1,150 1,163 2,450 1,940
2002 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9,107 1,521 1,632 3,249 2,705
2006–2010 . . . . . . . . . . . . . . . . . . . . . . . . 10,474 1,904 1,734 3,611 3,225
2011–2013 . . . . . . . . . . . . . . . . . . . . . . . . 12,024 2,144 2,105 4,062 3,713
All women: 2
1982 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55.7 24.2 55.8 66.7 61.6
1995 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64.2 29.8 63.5 71.1 72.3
2002 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61.9 31.5 60.7 68.6 69.9
2006–2010 . . . . . . . . . . . . . . . . . . . . . . . . 62.2 30.5 58.3 67.3 74.9
2011–2013 . . . . . . . . . . . . . . . . . . . . . . . . 61.7 33.3 60.4 67.4 70.0
Hispanic or Latina: 3
1982 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50.6 * *36.8 67.2 59.0
1995 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59.0 26.1 50.6 69.2 70.8
2002 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59.0 20.4 57.4 66.2 72.9
2006–2010 . . . . . . . . . . . . . . . . . . . . . . . . 59.7 22.3 54.0 66.0 77.7
2011–2013 . . . . . . . . . . . . . . . . . . . . . . . . 57.3 26.3 52.7 67.8 66.5
Age, in years
1
Race and Hispanic origin and year 15–44 15–19 20–24 25–34 35–44
Hispanic or Latina: 3
1982 . . . . . . . . . . . . . . . . . . . . . . . . . . . . -- -- -- -- --
1995 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4,330 409 685 1,794 1,442
2002 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6,075 405 1,070 2,462 2,138
2006–2010 . . . . . . . . . . . . . . . . . . . . . . . . 6,978 563 1,076 2,656 2,683
2011–2013 . . . . . . . . . . . . . . . . . . . . . . . . 7,853 723 1,335 3,076 2,720
Hispanic or Latina: 3
1982 . . . . . . . . . . . . . . . . . . . . . . . . . . . . -- -- -- -- --
1995 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91.4 75.5 82.5 95.4 95.2
2002 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88.4 76.4 87.5 87.4 92.3
2006–2010 . . . . . . . . . . . . . . . . . . . . . . . . 89.6 75.5 87.0 89.7 93.4
2011–2013 . . . . . . . . . . . . . . . . . . . . . . . . 87.8 78.0 83.1 89.5 90.8
Age, in years
Male sterilization
1982 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.9 * *3.6 10.1 19.9
1995 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.9 – * 7.8 19.5
2002 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.2 – * 7.2 18.2
2006–2010. . . . . . . . . . . . . . . . . . . . . . . . . . 10.8 * * 7.1 19.8
2011–2013 . . . . . . . . . . . . . . . . . . . . . . . . . . 9.0 – * 4.2 19.6
Injectable 6
1982 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... ... ... ... ...
1995 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.0 9.7 6.1 2.9 *0.8
2002 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.5 14.2 10.6 5.5 *1.9
2006–2010. . . . . . . . . . . . . . . . . . . . . . . . . . 3.9 11.4 5.9 4.2 *1.3
2011–2013 . . . . . . . . . . . . . . . . . . . . . . . . . . 4.6 11.4 7.1 4.8 *
Intrauterine device
1982 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.1 * *4.2 9.7 6.9
1995 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.8 – * *0.8 1.1
2002 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.1 * 1.8 3.7 *1.3
2006–2010. . . . . . . . . . . . . . . . . . . . . . . . . . 5.6 * 5.6 7.2 4.9
2011–2013 . . . . . . . . . . . . . . . . . . . . . . . . . . 10.7 * 10.2 15.1 8.4
Age, in years
Condom
1982 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.0 20.8 10.7 11.4 11.3
1995 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23.4 45.8 33.7 23.7 15.3
2002 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23.8 44.6 36.0 23.1 15.6
2006–2010. . . . . . . . . . . . . . . . . . . . . . . . . . 23.1 34.7 39.6 25.2 12.8
2011–2013 . . . . . . . . . . . . . . . . . . . . . . . . . . 22.8 34.1 38.5 23.8 12.4
Withdrawal
1982 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.0 2.9 3.0 1.8 1.3
1995 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.1 13.2 7.1 6.0 4.5
2002 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.8 15.0 11.9 10.7 4.7
2006–2010. . . . . . . . . . . . . . . . . . . . . . . . . . 10.1 14.5 15.1 10.2 7.3
2011–2013 . . . . . . . . . . . . . . . . . . . . . . . . . . 12.6 17.9 16.8 15.3 6.9
Other methods 8
1982 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.9 2.6 5.4 4.8 5.3
1995 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.2 * 3.2 3.1 3.4
2002 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.7 * *0.9 *1.5 *1.8
2006–2010. . . . . . . . . . . . . . . . . . . . . . . . . . 0.6 * * *0.8 *
2011–2013 . . . . . . . . . . . . . . . . . . . . . . . . . . * * * * *
Black or Hispanic or
Method of contraception and year White only African American only Latina 3
Male sterilization
1982 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13.0 *1.5 *
1995 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13.7 *1.8 *4.0
2002 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.9 * 4.7
2006–2010. . . . . . . . . . . . . . . . . . . . . . . . . . 14.2 * 5.8
2011–2013 . . . . . . . . . . . . . . . . . . . . . . . . . . 12.9 *1.9 4.0
Injectable 6
1982 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... ... ...
1995 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.4 5.4 4.7
2002 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.3 9.4 7.8
2006–2010. . . . . . . . . . . . . . . . . . . . . . . . . . 2.5 8.9 6.0
2011–2013 . . . . . . . . . . . . . . . . . . . . . . . . . . *3.1 10.1 *4.7
Intrauterine device
1982 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.8 9.3 19.2
1995 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.7 * *
2002 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.7 * 5.3
2006–2010. . . . . . . . . . . . . . . . . . . . . . . . . . 5.6 5.0 6.8
2011–2013 . . . . . . . . . . . . . . . . . . . . . . . . . . 11.0 6.5 13.5
Diaphragm
1982 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.2 *3.2 *
1995 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.3 * *
2002 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . * * –
2006–2010. . . . . . . . . . . . . . . . . . . . . . . . . . * * *
2011–2013 . . . . . . . . . . . . . . . . . . . . . . . . . . – – –
Condom
1982 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13.1 6.3 *6.9
1995 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22.5 24.9 21.2
2002 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21.7 29.6 24.1
2006–2010. . . . . . . . . . . . . . . . . . . . . . . . . . 20.8 29.9 22.2
2011–2013 . . . . . . . . . . . . . . . . . . . . . . . . . . 21.5 25.9 21.0
Black or Hispanic or
Method of contraception and year White only African American only Latina 3
2006–2010 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . * * *
2011–2013. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . * – *
Withdrawal
1982 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.1 1.3 2.6
1995 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.4 3.3 5.7
2002 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.5 4.8 6.3
2006–2010 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.3 7.1 10.4
Other methods 8
1982 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.6 7.3 5.0
1995 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.3 3.8 *2.2
2006–2010 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.6 * *
2011–2013. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . * * *
* Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error (RSE) of 20%–30%. Data not shown have an RSE greater than 30%
– Quantity zero.
1
Starting with 1995 data, race-specific estimates are tabulated according to 1997 Revisions to the Standards for the Classification of Federal Data on Race and
Ethnicity and are not strictly comparable with estimates for earlier years. Starting with 1995 data, race-specific estimates are for persons who reported only one racial
group. Prior to data year 1995, data were tabulated according to the 1977 Standards. Estimates for single-race categories prior to 1995 included persons who reported
one race or, if they reported more than one race, identified one race as best representing their race. See Appendix II, Race.
2
Includes women of other or multiple race not shown separately.
3
Persons of Hispanic origin may be of any race. See Appendix II, Hispanic origin.
4
Had sexual (vaginal) intercourse in the past 3 months.
5
Data collected starting with the 1995 survey. Includes data about the contraceptive patch, with data collection starting in the 2002 survey, and the contraceptive ring,
6
Data collected starting with the 1995 survey.
7
In 2011–2013, includes the oral contraceptive pill only. In previous surveys includes the oral contraceptive pill and emergency contraception/morning-after pill.
8
In 2011–2013, includes emergency contraception, female condom/vaginal pouch, foam, cervical cap, Today sponge, suppository or insert, jelly or cream (without
diaphragm), and other methods. See Appendix II, Contraception, for the list of other methods reported in previous surveys.
NOTES: Survey collects up to four methods of contraception used in the month of interview. Percents may not add to the total because more than one method could
have been used in the month of interview. These data replace estimates of most effective method used and may differ from previous editions of Health, United States.
Standard errors for selected years are available in the spreadsheet version of this table. Available from: http://www.cdc.gov/nchs/hus.htm. Data for additional years are
available. See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC/NCHS, National Survey of Family Growth. See Appendix I, National Survey of Family Growth (NSFG).
Geographic region 3
Northeast . . . . . . . . . . . . . . . . . . . . . . 51.3 53.5 56.5 61.6 66.9 73.0 72.4
Midwest . . . . . . . . . . . . . . . . . . . . . . . 52.3 49.6 51.7 61.7 61.9 66.0 66.2
South . . . . . . . . . . . . . . . . . . . . . . . . . 44.6 43.6 48.6 58.1 60.9 62.2 62.6
West . . . . . . . . . . . . . . . . . . . . . . . . . 71.4 69.5 77.3 78.1 78.9 83.3 79.0
Education 2
No high school diploma or GED . . . . . . 21.8 17.6 25.2 33.9 37.0 39.9 41.3
High school diploma or GED . . . . . . . . 28.2 28.0 27.4 36.9 43.1 41.9 36.8
Some college, no bachelor’s degree . . . 38.7 33.1 38.7 49.6 52.8 43.2 48.7
Bachelor’s degree or higher . . . . . . . . . 55.0 56.1 59.3 64.5 64.1 75.9 65.8
Geographic region 3
Northeast . . . . . . . . . . . . . . . . . . . . . . 29.9 37.2 36.4 48.2 48.8 59.9 51.5
Midwest . . . . . . . . . . . . . . . . . . . . . . . 30.3 31.5 30.1 42.0 42.8 46.8 41.6
South . . . . . . . . . . . . . . . . . . . . . . . . . 27.7 20.1 26.2 38.9 44.4 42.7 40.5
West . . . . . . . . . . . . . . . . . . . . . . . . . 52.4 42.9 45.3 58.2 59.2 62.6 57.8
* Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error of 20%–30%.
1
Starting with 1995 data, race-specific estimates are tabulated according to 1997 Revisions to the Standards for the Classification of Federal Data on Race and
Ethnicity and are not strictly comparable with estimates for earlier years. Starting with 1995 data, race-specific estimates are for persons who reported only one racial
group. Prior to data year 1995, data were tabulated according to the 1977 Standards. Estimates for single-race categories prior to 1995 included persons who reported
one race or, if they reported more than one race, identified one race as best representing their race. See Appendix II, Race.
2
Educational attainment is presented only for women aged 22–44. Education is as of year of interview. GED is General Educational Development high school
3
See Appendix II, Geographic region.
NOTES: Data are based on single births to mothers aged 15–44 at interview, including those births that occurred when the mothers were younger than age 15. Data on
breastfeeding during 1986–1994 are based on responses to questions in the National Survey of Family Growth (NSFG) Cycle 5, conducted in 1995. Data for
1995–2001 are based on NSFG Cycle 6, conducted in 2002. Data for 2002–2007 are based on NSFG Cycle 7, conducted in 2006–2010. See Appendix I, National
Survey of Family Growth (NSFG). Standard errors are available in the spreadsheet version of this table. Available from: http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC/NCHS, National Survey of Family Growth, 1995, 2002, and 2006–2010. See Appendix I, National Survey of Family Growth (NSFG).
Late fetal 9 deaths per 1,000 live births plus late fetal deaths
All mothers . . . . . . . . . . . . ........... -- -- -- 3.6 3.3 3.0 3.0 3.0 3.0
Hispanic or Latina 5 . . . . . . ........... -- -- -- -- 3.1 2.8 2.6 2.7 2.6
Not Hispanic or Latina:
White. . . . . . . . . . . . . . . ........... -- -- -- -- 2.8 2.4 2.5 2.6 2.6
Black or African American ........... -- -- -- -- 5.2 4.8 4.7 4.6 4.7
Perinatal10 deaths per 1,000 live births plus late fetal deaths
All mothers . . . . . . . . . . . . ........... -- -- -- 7.6 7.0 6.6 6.2 6.3 6.2
Hispanic or Latina 5 . . . . . . ........... -- -- -- -- 6.1 5.9 5.5 5.6 5.6
Not Hispanic or Latina:
White. . . . . . . . . . . . . . . ........... -- -- -- -- 5.7 5.4 5.1 5.2 5.2
Black or African American ........... -- -- -- -- 12.6 12.2 10.6 10.8 10.8
* Estimates are considered unreliable. Rates preceded by an asterisk are based on fewer than 50 deaths in the numerator. Rates not shown are based on fewer than
1
Rates based on unweighted birth cohort data.
2
Rates based on a period file using weighted data. See Appendix I, National Vital Statistics System (NVSS), Linked Birth/Infant Death Data Set.
3
Infant (under 1 year of age), neonatal (under 28 days), and postneonatal (28 days–11 months).
4
Estimates are not available for Asian or Pacific Islander subgroups because not all states have adopted the 2003 revision of the U.S. Standard Certificate of Live Birth.
See Appendix II, Race.
5
Persons of Hispanic origin may be of any race.
6
Prior to 1995, data are shown only for states with an Hispanic-origin item on their birth certificates. See Appendix II, Hispanic origin.
7
Rates for 1999–2004 (shown in spreadsheet version) exclude data from Oklahoma, which did not report Hispanic origin on the fetal death report in those years.
8
Number of fetal deaths of 20 weeks or more gestation per 1,000 live births plus fetal deaths.
9
Number of fetal deaths of 28 weeks or more gestation (late fetal deaths) per 1,000 live births plus late fetal deaths.
10
Number of late fetal deaths plus infant deaths within 7 days of birth per 1,000 live births plus late fetal deaths.
NOTES: The race groups, white, black, American Indian or Alaska Native, and Asian or Pacific Islander include persons of Hispanic and non-Hispanic origin. Starting
with 2003 data, some states reported multiple-race data. The multiple-race data for these states were bridged to the single-race categories of the 1977 Office of
Management and Budget standards, for comparability with other states. See Appendix II, Race. National linked files do not exist for 1992–1994. Data for additional
years are available. See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC/NCHS, National Vital Statistics System, public-use Linked Birth/Infant Death Data Set, public-use Fetal Death File, public-use Birth File. National Center
for Health Statistics. User guide to the 2012 period linked birth/infant death public use file. Hyattsville, MD: NCHS; 2014. Available from:
ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/Dataset_Documentation/DVS/periodlinked/LinkPE12Guide.pdf. See Appendix I, National Vital Statistics System (NVSS).
Neonatal 1
Under Under
Race and year Infant 1 28 days 7 days Postneonatal 1
2
Includes births and deaths of persons who were not residents of the 50 states and the District of Columbia.
3
Infant deaths and live births are tabulated by race of child. See Appendix II, Race.
4
Infant deaths are tabulated by race of decedent; live births are tabulated by race of mother. See Appendix II, Race.
NOTES: Infant mortality rates in this table are based on infant deaths from the mortality file (numerator) and live births from the natality file (denominator).
Inconsistencies in reporting race for the same infant between the birth and death certificate can result in underestimated infant mortality rates for races other than white
or black. Infant mortality rates for additional population groups are available from the Linked Birth/Infant Death Data Set and are presented in Table 11. Data for
additional years are available. See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC/NCHS, National Vital Statistics System, public-use Mortality File, public-use Birth File; Xu JQ, Murphy SL, Kochanek KD, et al. Deaths: Final data for
2013. National vital statistics reports; vol 64 no 2. Hyattsville, MD: NCHS; 2015. Available from: http://www.cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_02.pdf. See Appendix I,
Black or
All races White African American
State and territory 1989–19911 2003–2005 2 2010–2012 2 1989–19911 2003–2005 2 2010–2012 2 1989–19911 2003–2005 2 2010–2012 2
Alabama . . . . . . . . . . . . . 11.4 9.0 8.6 8.6 6.8 6.8 16.8 13.6 13.3
Arizona . . . . . . . . . . . . . . 8.8 6.7 5.9 8.2 6.0 4.9 17.3 11.2 10.4
Arkansas . . . . . . . . . . . . . 9.8 8.3 7.2 8.1 7.2 6.5 15.2 13.6 10.5
California . . . . . . . . . . . . . 7.6 5.2 4.7 6.9 4.6 3.9 15.4 11.4 9.1
Colorado . . . . . . . . . . . . . 8.7 6.3 5.3 8.0 5.2 4.6 16.7 16.3 11.2
Connecticut . . . . . . . . . . . 7.9 5.5 5.2 5.9 3.9 3.7 17.0 12.7 10.6
Delaware . . . . . . . . . . . . . 11.2 9.0 8.0 8.2 6.5 6.4 20.1 16.8 12.2
District of Columbia . . . . . 20.3 12.2 7.6 *8.2 *3.4 *3.0 23.9 17.2 11.2
Florida. . . . . . . . . . . . . . . 9.4 7.2 6.4 7.2 5.8 5.0 16.2 12.9 11.1
Georgia . . . . . . . . . . . . . . 11.9 8.4 6.5 8.4 6.1 5.0 17.9 13.3 9.7
Illinois . . . . . . . . . . . . . . . 10.7 7.5 6.6 7.6 5.9 5.0 20.5 15.3 13.2
Indiana . . . . . . . . . . . . . . 9.4 7.9 7.3 8.4 7.1 6.6 17.3 15.1 12.7
Iowa . . . . . . . . . . . . . . . . 8.2 5.4 5.0 7.8 5.1 4.7 15.8 *11.0 11.4
Kansas . . . . . . . . . . . . . . 8.5 7.1 6.2 7.8 6.7 5.5 15.4 14.3 12.9
Kentucky . . . . . . . . . . . . . 8.7 6.8 6.8 8.1 6.4 6.5 14.4 10.9 10.0
Louisiana 5 . . . . . . . . . . . . 10.2 9.8 8.0 7.5 7.1 5.9 14.3 13.9 11.5
Maryland . . . . . . . . . . . . . 9.1 8.0 6.7 6.3 5.2 3.9 15.0 13.7 11.5
Massachusetts . . . . . . . . . 7.0 4.9 4.3 5.9 4.0 3.5 14.2 10.0 6.4
Michigan . . . . . . . . . . . . . 10.5 8.0 6.9 7.7 6.2 5.2 20.7 16.4 13.6
Minnesota . . . . . . . . . . . . 7.3 4.8 4.8 6.4 4.3 4.2 18.5 8.9 8.1
Mississippi . . . . . . . . . . . . 11.5 10.7 9.3 7.9 7.0 6.4 15.2 15.6 13.0
Missouri. . . . . . . . . . . . . . 9.7 7.6 6.5 8.0 6.6 5.5 18.0 13.8 12.1
Nebraska. . . . . . . . . . . . . 8.1 5.9 5.2 7.2 5.1 4.4 18.3 14.0 11.4
Nevada . . . . . . . . . . . . . . 8.6 5.9 5.4 7.8 5.6 5.1 16.9 12.2 9.0
New Jersey . . . . . . . . . . . 8.4 5.4 4.8 6.1 3.7 3.2 17.8 11.9 10.5
New York. . . . . . . . . . . . . 9.5 6.0 5.1 6.3 4.6 3.9 18.4 11.8 9.3
North Carolina . . . . . . . . . 10.7 8.6 7.2 8.0 6.3 5.4 16.9 15.8 12.7
Ohio . . . . . . . . . . . . . . . . 9.0 7.8 7.7 7.7 6.4 6.5 16.2 15.6 13.9
Oklahoma 5 . . . . . . . . . . . 8.0 7.9 7.4 7.3 7.5 6.9 12.7 13.0 10.9
Oregon . . . . . . . . . . . . . . 8.0 5.7 5.0 7.4 5.5 4.6 21.3 *8.6 *8.7
Pennsylvania . . . . . . . . . . 9.2 7.3 6.9 7.2 5.8 5.4 19.1 13.6 12.7
Rhode Island . . . . . . . . . . 8.7 6.2 6.7 7.5 4.5 5.5 *13.6 *10.8 *11.9
South Carolina . . . . . . . . . 11.8 9.0 7.4 8.4 6.4 5.2 17.2 14.2 12.1
Tennessee . . . . . . . . . . . . 10.2 8.9 7.5 7.8 7.0 6.4 18.2 16.3 12.3
Texas . . . . . . . . . . . . . . . 7.9 6.5 5.9 6.9 5.9 5.2 14.1 12.4 10.7
Virginia . . . . . . . . . . . . . . 9.9 7.5 6.7 7.4 6.0 4.9 18.0 13.7 12.6
Washington . . . . . . . . . . . 8.0 5.4 4.8 7.4 5.0 4.4 15.1 9.0 8.0
West Virginia . . . . . . . . . . 9.1 7.7 7.0 8.8 7.5 7.1 *15.7 *12.0 *9.8
Wisconsin . . . . . . . . . . . . 8.4 6.3 5.9 7.4 5.1 5.0 17.0 16.4 13.4
American Samoa 6 . . . . . . --- --- --- --- --- --- --- --- --
Guam 6 . . . . . . . . . . . . . . --- 11.1 12.8 --- * * --- * *
Northern Marianas 6 . . . . . --- --- --- --- --- --- --- --- ---
Puerto Rico 6 . . . . . . . . . . --- 8.9 8.3 --- --- --- --- --- ---
Virgin Islands 6 . . . . . . . . . --- 7.5 8.7 --- * * --- * 8.3
State and territory 1989–19911 2003–2005 2 2010–2012 2 1989–19911 2003–2005 2 2010–2012 2 1989–19911 2003–2005 2 2010–2012 2
Arizona . . . . . . . . . . . . . . 8.0 6.7 6.0 11.4 8.3 8.8 *8.5 6.7 6.0
California . . . . . . . . . . . . . 7.0 5.0 4.6 11.0 6.2 6.9 6.4 4.2 3.8
Maine . . . . . . . . . . . . . . . * * * * * * * * *
Minnesota . . . . . . . . . . . . *8.4 4.3 5.1 17.3 *8.6 *10.8 *5.1 3.8 3.8
Mississippi . . . . . . . . . . . . * * * * * * * * *
New York. . . . . . . . . . . . . 9.4 5.5 5.1 *15.2 * *10.2 6.4 3.9 3.5
North Carolina . . . . . . . . . *7.5 6.6 5.5 12.2 10.2 11.2 *6.3 5.9 4.4
Oregon . . . . . . . . . . . . . . 8.5 5.5 5.0 *15.7 *11.0 *9.5 *8.4 *5.8 *5.3
Vermont . . . . . . . . . . . . . * * * * * * * * *
Washington . . . . . . . . . . . 7.6 4.9 4.3 19.6 9.5 8.8 6.2 4.8 4.2
West Virginia . . . . . . . . . . * * * * * * * * *
Wisconsin . . . . . . . . . . . . *7.3 6.1 5.1 *11.9 *8.2 *8.4 *6.7 *6.6 *5.2
Wyoming . . . . . . . . . . . . . * * * * * * * * *
American Samoa 6 . . . . . . --- --- --- --- --- --- --- --- --
Guam 6 . . . . . . . . . . . . . . --- * * --- * * --- 11.5 13.2
Northern Marianas 6 . . . . . --- --- --- --- --- --- --- --- ---
Puerto Rico 6 . . . . . . . . . . --- --- --- --- --- --- --- --- ---
Virgin Islands 6 . . . . . . . . . --- * * --- * * --- * *
* Estimates are considered unreliable. Rates preceded by an asterisk are based on fewer than 50 deaths in the numerator. Rates not shown are based on fewer than
1
Rates based on unweighted birth cohort data.
2
Rates based on period file using weighted data. See Appendix I, National Vital Statistics System (NVSS), Linked Birth/Infant Death Data Set.
3
Under 1 year of age.
4
Excludes data for American Samoa, Guam, Northern Marianas, Puerto Rico, and Virgin Islands.
5
Rates for white and black are substituted for non-Hispanic white and non-Hispanic black for Louisiana for 1989, Oklahoma for 1989–1990, and New Hampshire for
1989–1991.
6
Comparable data were not available for all time periods and for all racial and ethnicity groups. Therefore, only selected rates are presented for the territories. Linked
birth/infant death data are not available for American Samoa and Northern Marianas.
7
Persons of Hispanic origin may be of any race. See Appendix II, Hispanic origin.
8
Includes persons of Hispanic origin.
9
Rates for Hispanic origin exclude data from states not reporting Hispanic origin on the birth certificate for 1 or more years in a 3-year period.
NOTES: Starting with 2003 data, some states reported multiple-race data. The multiple-race data for these states were bridged to the single-race categories of the
1977 Office of Management and Budget standards, for comparability with other states. See Appendix II, Race. National linked files do not exist for 1992–1994.
SOURCE: CDC/NCHS, National Vital Statistics System, public-use and nonpublic-use Linked Birth/Infant Death Data Set. National Center for Health Statistics. User
guide to the 2012 period linked birth/infant death public use file. Hyattsville, MD: NCHS; 2014. Available from:
ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/Dataset_Documentation/DVS/periodlinked/LinkPE12Guide.pdf. See Appendix I, National Vital Statistics System (NVSS).
International rankings 1
Country 2 1960 1970 1980 1990 2000 2009 2010 2011 1960 2011
1
Rankings are from lowest to highest infant mortality rates (IMR). Countries with the same IMR receive the same rank. The country with the next highest IMR is
assigned the rank it would have received had the lower-ranked countries not been tied, i.e., skip a rank. The latest year’s international rankings are based on 2011 data
because that is the most current data year for which most countries have reported their final data to OECD. Countries without an estimate in the OECD database are
omitted from this table. Relative rankings for individual countries may be affected if not all countries have reported data to OECD.
2
Refers to countries, territories, cities, or geographic areas with at least 2.5 million population in 2000 (United Nations Department of Economic and Social
Affairs/Population Division 172 World Population Prospects: The 2012 Revision, Volume 1: Comprehensive Tables. Available from:
http://esa.un.org/wpp/Documentation/pdf/WPP2012_Volume-I_Comprehensive-Tables.pdf) and with complete counts of live births and infant deaths according to the
3
Under 1 year of age.
4
In 1993, Czechoslovakia was divided into two nations, the Czech Republic and Slovakia. Data for years prior to 1993 are from the Czech and Slovak regions of
Czechoslovakia.
5
Until 1990, estimates refer to the Federal Republic of Germany; from 1990 onward data refer to Germany after reunification.
6
Statistical data for Israel are supplied by, and under the responsibility of, the relevant Israeli authorities. The use of such data by the OECD is without prejudice to the
status of the Golan Heights, East Jerusalem, and Israeli settlements in the West Bank under the terms of international law.
7
Data are from Table 13.
NOTE: Some rates for selected countries and selected years were revised and differ from previous editions of Health, United States.
SOURCE: Organisation for Economic Co-operation and Development (OECD) Health Data 2014, incorporating revisions to the annual update. Available from:
http://www.oecd.org/.
Male Female
Country 1980 1990 2000 2011 2012 1980 1990 2000 2011 2012
Male Female
Country 1980 1990 2000 2011 2012 1980 1990 2000 2011 2012
1
In 1993, Czechoslovakia was divided into two nations, the Czech Republic and Slovakia. Data for years prior to 1993 are from the Czech and Slovak regions of
Czechoslovakia.
2
Until 1990, estimates refer to the Federal Republic of Germany; from 1995 onward data refer to Germany after reunification.
3
Statistical data for Israel are supplied by, and under the responsibility of, the relevant Israeli authorities. The use of such data by OECD is without prejudice to the
status of the Golan Heights, East Jerusalem, and Israeli settlements in the West Bank under the terms of international law.
4
Data are from Table 18.
NOTES: Because calculation of life expectancy estimates varies among countries, ranks are not presented. Therefore, comparisons among countries and their
interpretation should be made with caution. See Appendix II, Life expectancy. Some estimates for selected countries and selected years were revised and differ from
previous editions of Health, United States.
SOURCE: Organisation for Economic Co-operation and Development (OECD) Health Data 2014, OECD. StatExtracts, available from: http://www.oecd.org/; CDC/NCHS.
Vital statistics of the United States (selected years). Public Health Service. Washington, DC. See Appendix I, Organisation for Economic Co-operation and Development
(OECD) Health Data.
At 65 years
1950 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13.9 12.8 15.0 14.1 12.8 15.1 13.9 12.9 14.9
1960 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14.3 12.8 15.8 14.4 12.9 15.9 13.9 12.7 15.1
1970 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15.2 13.1 17.0 15.2 13.1 17.1 14.2 12.5 15.7
1980 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.4 14.1 18.3 16.5 14.2 18.4 15.1 13.0 16.8
1990 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17.2 15.1 18.9 17.3 15.2 19.1 15.4 13.2 17.2
1995 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17.4 15.6 18.9 17.6 15.7 19.1 15.6 13.6 17.1
2000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17.6 16.0 19.0 17.7 16.1 19.1 16.1 14.1 17.5
2001 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17.9 16.2 19.2 18.0 16.3 19.3 16.2 14.2 17.7
2002 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17.9 16.3 19.2 18.0 16.4 19.3 16.3 14.4 17.8
2005 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18.4 16.9 19.6 18.5 17.0 19.7 16.9 15.0 18.3
2006 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18.7 17.2 19.9 18.7 17.3 19.9 17.2 15.2 18.6
2007 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18.8 17.4 20.0 18.9 17.4 20.1 17.3 15.4 18.8
2008 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18.8 17.4 20.0 18.9 17.5 20.0 17.5 15.5 18.9
2009 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19.1 17.7 20.3 19.2 17.7 20.3 17.8 15.9 19.2
2010 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19.1 17.7 20.3 19.2 17.8 20.3 17.8 15.9 19.3
2011. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19.2 17.8 20.3 19.2 17.8 20.4 18.0 16.2 19.4
2012 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19.3 17.9 20.5 19.3 18.0 20.4 18.1 16.2 19.5
2013 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19.3 17.9 20.5 19.3 18.0 20.5 18.1 16.3 19.5
At 75 years
1980 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.4 8.8 11.5 10.4 8.8 11.5 9.7 8.3 10.7
1990 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.9 9.4 12.0 11.0 9.4 12.0 10.2 8.6 11.2
1995 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.0 9.7 11.9 11.1 9.7 12.0 10.2 8.8 11.1
2000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.0 9.8 11.8 11.0 9.8 11.9 10.4 9.0 11.3
2001 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.2 9.9 12.0 11.2 10.0 12.1 10.5 9.0 11.5
2002 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.2 10.0 12.0 11.2 10.0 12.1 10.5 9.1 11.5
2005 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.5 10.4 12.3 11.5 10.4 12.3 10.9 9.4 11.2
2006 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.7 10.6 12.5 11.1 10.6 12.5 11.1 9.1 12.0
2007 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.9 10.7 12.6 11.9 10.8 12.6 11.2 9.8 12.1
2008 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.8 10.7 12.6 11.8 10.7 12.6 11.3 9.8 12.2
2009 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.1 11.0 12.9 12.1 10.4 12.9 11.6 10.2 12.5
2010 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.1 11.0 12.9 12.1 11.0 12.8 11.6 10.2 12.5
2011. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.1 11.1 12.9 12.1 11.0 12.8 11.7 10.4 12.5
2012 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.2 11.2 12.9 12.1 11.1 12.9 11.8 10.4 12.7
2013 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.2 11.2 12.9 12.1 11.1 12.9 11.8 10.4 12.7
At 65 years
2006 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18.7 17.2 19.9 17.1 15.1 18.5 20.2 18.5 21.5
2007 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18.8 17.4 20.0 17.2 15.3 18.7 20.5 18.7 21.7
2008 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18.8 17.4 20.0 17.4 15.4 18.8 20.4 18.7 21.6
2009 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19.1 17.7 19.5 17.7 15.8 19.1 20.7 19.0 21.9
2010 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19.1 17.7 20.3 17.7 15.8 19.1 20.6 18.8 22.0
2011. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19.1 17.8 20.3 17.9 16.1 19.2 20.7 19.1 21.8
2012 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19.3 17.9 20.4 18.0 16.1 19.4 21.0 19.5 22.1
2013 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19.3 17.9 20.4 18.0 16.1 19.4 20.9 19.3 22.0
At 75 years
2006 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.7 10.6 12.5 11.1 9.6 12.0 13.0 11.7 13.7
2007 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.8 10.7 12.6 11.2 9.7 12.1 13.1 11.8 13.8
2008 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.8 10.7 12.6 11.3 9.8 12.2 13.0 11.7 13.8
2009 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.0 11.0 12.9 11.6 10.1 12.4 13.3 12.0 13.8
2010 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.0 11.0 12.8 11.6 10.1 12.5 13.2 11.7 14.1
2011. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.0 11.0 12.8 11.7 10.4 12.5 13.2 12.0 13.9
2012 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.1 11.1 12.9 11.7 10.4 12.6 13.5 12.3 14.2
2013 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.1 11.1 12.9 11.7 10.4 12.6 13.4 12.3 14.1
1
Data shown for 1900–1960 are for the nonwhite population.
2
Death registration area only. The death registration area increased from 10 states and the District of Columbia (D.C.) in 1900 to the coterminous United States in
1933. See Appendix II, Registration area.
3
Includes deaths of persons who were not residents of the 50 states and D.C.
4
Hispanic origin was added to the U.S. standard death certificate in 1989 and was adopted by every state in 1997. To estimate life expectancy, age-specific death rates
were corrected to address racial and ethnic misclassification, which underestimates deaths in the Hispanic population. Life expectancies for the Hispanic population are
adjusted for underreporting on the death certificate of Hispanic ethnicity, but are not adjusted to account for the potential effects of return migration. To address the
effects of age misstatement at the oldest ages, the probability of death for Hispanic persons older than 80 years is estimated as a function of non-Hispanic white
mortality with the use of the Brass relational logit model. See Appendix II, Hispanic origin. See Appendix II, Race, for a discussion of sources of bias in death rates by
race and Hispanic origin.
NOTES: Populations for computing life expectancy for 1991–1999 are 1990-based postcensal estimates of the U.S. resident population. Starting with Health, United
States, 2012, populations for computing life expectancy for 2001–2009 were based on intercensal population estimates of the U.S. resident population. Populations for
computing life expectancy for 2010 were based on 2010 census counts. Life expectancy for 2011 and beyond was computed using 2010-based postcensal estimates.
See Appendix I, Population Census and Population Estimates. In 1997, life table methodology was revised to construct complete life tables by single years of age that
extend to age 100. (Anderson RN. Method for constructing complete annual U.S. life tables. NCHS. Vital Health Stat 2(129). 1999.) Previously, abridged life tables were
constructed for 5-year age groups ending with 85 years and over. In 2000, the life table methodology was revised. The revised methodology is similar to that developed
for the 1999–2001 decennial life tables. In 2008, the life table methodology was further refined. See Appendix II, Life expectancy. Starting with 2003 data, some states
allowed the reporting of more than one race on the death certificate. The multiple-race data for these states were bridged to the single-race categories of the 1977
Office of Management and Budget standards, for comparability with other states. The race groups, white and black include persons of Hispanic and non-Hispanic origin.
Persons of Hispanic origin may be of any race. See Appendix II, Race. Data for additional years are available. See the Excel spreadsheet on the Health, United States
website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC/NCHS, National Vital Statistics System, public-use Mortality Files; Grove RD, Hetzel AM. Vital statistics rates in the United States, 1940–1960.
Washington, DC: U.S. Government Printing Office, 1968; Arias E. United States life tables by Hispanic origin. Vital health statistics; vol 2 no 152. Hyattsville, MD:
NCHS. 2010. Murphy SL, Kochanek KD, Xu JQ, et al. Deaths: Final data for 2012. National vital statistics reports; vol 63 no 9. Hyattsville, MD: NCHS; 2014. Available
from: http://www.cdc.gov/nchs/data/nvsr/nvsr63/nvsr63_09.pdf. Xu JQ, Murphy SL, Kochanek KD, et al. Deaths: Final data for 2013. National vital statistics reports; vol
64 no 2. Hyattsville, MD: NCHS; 2015. Available from: http://www.cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_02.pdf. See Appendix I, National Vital Statistics System
(NVSS).
American
Black or Indian or Asian or White,
African Alaska Pacific Hispanic not Hispanic
All persons White American Native 1 Islander 1 or Latino 1 or Latino 1
State and territory 1979–1981 1989–1991 2011–2013 2011–2013 2011–2013 2011–2013 2011–2013 2011–2013 2011–2013
NOTES: The race groups, white, black, American Indian or Alaska Native, and Asian or Pacific Islander, include persons of Hispanic and non-Hispanic origin. Persons
of Hispanic origin may be of any race. United States, state, and territory rates for 2011–2013 were calculated using 2010-based postcensal population estimates.
Starting with 2003 data, some states allowed the reporting of more than one race on the death certificate. The multiple-race data for these states were bridged to the
single-race categories of the 1977 Office of Management and Budget standards, for comparability with other states. See Appendix II, Race. Rates are rounded at the
end of the calculation process. They may differ from rates based on the same data presented elsewhere if rounding is done earlier in the calculation process.
Data for additional years are available. See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC/NCHS, National Vital Statistics System; numerator data from annual public-use and nonpublic-use Mortality Files; denominator data from state
population estimates prepared by the U.S. Census Bureau 1980 from April 1, 1980 MARS Census File; 1990 from April 1, 1990 MARS Census File; 2011 and beyond
from 2010-based postcensal bridged-race files. Available from: http://www.cdc.gov/nchs/nvss/bridged_race.htm. For the territories (except for Puerto Rico) populations
are from the U.S. Census Bureau. International data base. 2010. Available from: http://www.census.gov/population/international/. For Puerto Rico, populations are from
U.S. Census Bureau. Puerto Rico Commonwealth characteristics. Available from: http://www.census.gov/popest/data/puerto_rico/asrh/2013/index.html. See Appendix I,
National Vital Statistics System (NVSS).
Sex, race, Hispanic origin, and cause of death 1 1950 2,3 1960 2,3 1970 3 1980 3 1990 3 2000 4 2005 4 2010 4 2012 4 2013 4
Male
All causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,674.2 1,609.0 1,542.1 1,348.1 1,202.8 1,053.8 971.9 887.1 865.1 863.6
Diseases of heart . . . . . . . . . . . . . . . . . . . . . . . 699.0 687.6 634.0 538.9 412.4 320.0 268.2 225.1 214.7 214.5
Ischemic heart disease . . . . . . . . . . . . . . . . . . -- -- -- 459.7 328.2 241.4 192.3 151.3 141.1 138.2
Cerebrovascular diseases . . . . . . . . . . . . . . . . . 186.4 186.1 157.4 102.2 68.5 62.4 48.4 39.3 37.1 36.7
Malignant neoplasms . . . . . . . . . . . . . . . . . . . . . 208.1 225.1 247.6 271.2 280.4 248.9 227.2 209.9 200.3 196.0
Trachea, bronchus, and lung . . . . . . . . . . . . . . 24.6 43.6 67.5 85.2 91.1 76.7 69.1 60.3 56.1 53.7
Colon, rectum, and anus . . . . . . . . . . . . . . . . . -- 31.8 32.3 32.8 30.4 25.1 21.2 19.0 17.7 17.4
Prostate . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28.6 28.7 28.8 32.8 38.4 30.4 25.3 21.9 19.5 19.2
Chronic lower respiratory diseases . . . . . . . . . . . -- -- -- 49.9 55.4 55.8 52.2 48.7 47.2 47.5
Influenza and pneumonia . . . . . . . . . . . . . . . . . . 55.0 65.8 54.0 42.1 47.8 28.9 24.9 18.2 17.3 18.6
Chronic liver disease and cirrhosis . . . . . . . . . . . 15.0 18.5 24.8 21.3 15.9 13.4 12.4 12.9 13.4 13.8
Diabetes mellitus 6 . . . . . . . . . . . . . . . . . . . . . . . 18.8 19.9 23.0 18.1 21.7 27.8 28.8 24.9 25.5 25.6
† †
Alzheimer’s disease . . . . . . . . . . . . . . . . . . . . . . -- -- -- 15.2 19.5 21.0 19.8 19.3
Human immunodeficiency virus (HIV) disease . . . ... ... ... ... 18.5 7.9 6.3 3.8 3.2 3.1
Unintentional injuries . . . . . . . . . . . . . . . . . . . . . 101.8 85.5 87.4 69.0 52.9 49.3 55.0 51.5 52.6 53.1
Motor vehicle-related injuries . . . . . . . . . . . . . . 38.5 35.4 41.5 33.6 26.5 21.7 21.9 16.2 16.5 15.9
Poisoning . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.3 2.3 3.9 2.7 3.5 6.6 10.8 13.8 15.0 16.0
Nephritis, nephrotic syndrome and nephrosis 6 . . . -- -- -- 12.2 12.1 16.9 18.1 18.7 16.0 16.1
Suicide 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21.2 20.0 19.8 19.9 21.5 17.7 18.1 19.8 20.4 20.3
Homicide 7. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.9 7.5 14.3 16.6 14.8 9.0 9.7 8.4 8.5 8.2
Female
All causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,236.0 1,105.3 971.4 817.9 750.9 731.4 692.3 634.9 624.7 623.5
Diseases of heart . . . . . . . . . . . . . . . . . . . . . . . 486.6 447.0 381.6 320.8 257.0 210.9 177.5 143.3 135.5 134.3
Ischemic heart disease . . . . . . . . . . . . . . . . . . -- -- -- 263.1 193.9 146.5 115.0 84.9 77.8 74.9
Cerebrovascular diseases . . . . . . . . . . . . . . . . . 175.8 170.7 140.0 91.7 62.6 59.1 47.0 38.3 36.1 35.2
Malignant neoplasms . . . . . . . . . . . . . . . . . . . . . 182.3 168.7 163.2 166.7 175.7 167.6 156.7 146.7 142.1 139.5
Trachea, bronchus, and lung . . . . . . . . . . . . . . 5.8 7.5 13.1 24.4 37.1 41.3 40.6 38.1 36.4 35.5
Colon, rectum, and anus . . . . . . . . . . . . . . . . . -- 29.1 26.5 23.8 20.6 17.7 15.0 13.3 12.6 12.3
Breast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31.9 31.7 32.1 31.9 33.3 26.8 24.2 22.1 21.3 20.8
Chronic lower respiratory diseases . . . . . . . . . . . -- -- -- 14.9 26.6 37.4 38.7 38.0 37.8 38.5
Influenza and pneumonia . . . . . . . . . . . . . . . . . . 41.9 43.8 32.7 25.1 30.5 20.7 18.6 13.1 12.5 14.0
Chronic liver disease and cirrhosis . . . . . . . . . . . 7.8 8.7 11.9 9.9 7.1 6.2 5.8 6.2 6.7 6.8
Diabetes mellitus 6 . . . . . . . . . . . . . . . . . . . . . . . 27.0 24.7 25.1 18.0 19.9 23.0 21.9 17.6 17.7 17.6
† †
Alzheimer’s disease . . . . . . . . . . . . . . . . . . . . . . -- -- -- 19.3 26.2 27.3 26.1 25.9
Human immunodeficiency virus (HIV) disease . . . ... ... ... ... 2.2 2.5 2.3 1.4 1.2 1.1
Unintentional injuries . . . . . . . . . . . . . . . . . . . . . 54.0 40.0 35.1 26.1 21.5 22.0 25.3 25.6 26.4 26.6
Motor vehicle-related injuries . . . . . . . . . . . . . . 11.5 11.7 14.9 11.8 11.0 9.5 8.9 6.5 6.5 6.2
Poisoning . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.7 1.1 1.8 1.3 1.2 2.5 5.1 7.5 8.1 8.5
Nephritis, nephrotic syndrome and nephrosis 6 . . . -- -- -- 7.3 7.7 11.5 12.6 13.0 11.1 11.3
Suicide 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.6 5.6 7.4 5.7 4.8 4.0 4.4 5.0 5.4 5.5
Homicide 7. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.4 2.6 3.7 4.4 4.0 2.8 2.5 2.3 2.2 2.1
Sex, race, Hispanic origin, and cause of death 1 1950 2,3 1960 2,3 1970 3 1980 3 1990 3 2000 4 2005 4 2010 4 2012 4 2013 4
American Indian or
Alaska Native 8
All causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . -- -- -- 867.0 716.3 709.3 701.1 628.3 595.3 591.7
Diseases of heart . . . . . . . . . . . . . . . . . . . . . . . -- -- -- 240.6 200.6 178.2 156.6 128.6 119.6 120.6
Ischemic heart disease . . . . . . . . . . . . . . . . . . -- -- -- 173.6 139.1 129.1 106.1 84.9 79.2 78.2
Cerebrovascular diseases . . . . . . . . . . . . . . . . . -- -- -- 57.8 40.7 45.0 38.8 28.1 25.2 24.6
Malignant neoplasms . . . . . . . . . . . . . . . . . . . . . -- -- -- 113.7 121.8 127.8 128.8 122.4 111.4 110.2
Trachea, bronchus, and lung . . . . . . . . . . . . . . -- -- -- 20.7 30.9 32.3 35.3 33.1 30.1 27.7
Colon, rectum, and anus . . . . . . . . . . . . . . . . . -- -- -- 9.5 12.0 13.4 12.6 11.7 11.1 12.6
Chronic lower respiratory diseases . . . . . . . . . . . -- -- -- 14.2 25.4 32.8 31.6 33.8 29.8 30.8
Influenza and pneumonia . . . . . . . . . . . . . . . . . . -- -- -- 44.4 36.1 22.3 23.6 15.9 13.1 15.0
Chronic liver disease and cirrhosis . . . . . . . . . . . -- -- -- 45.3 24.1 24.3 21.6 22.8 25.3 24.8
Diabetes mellitus 6 . . . . . . . . . . . . . . . . . . . . . . . -- -- -- 29.6 34.1 41.5 44.1 36.4 36.9 34.1
† †
Alzheimer’s disease . . . . . . . . . . . . . . . . . . . . . . -- -- -- 9.1 15.0 17.2 12.3 12.7
Human immunodeficiency virus (HIV) disease . . . ... ... ... ... 1.8 2.2 2.5 1.6 1.0 1.3
Unintentional injuries . . . . . . . . . . . . . . . . . . . . . -- -- -- 99.0 62.6 51.3 51.3 46.9 49.5 47.1
Motor vehicle-related injuries . . . . . . . . . . . . . . -- -- -- 54.5 32.5 27.3 22.6 15.7 16.3 15.4
Poisoning . . . . . . . . . . . . . . . . . . . . . . . . . . . -- -- -- 2.3 3.2 4.7 8.6 13.0 15.1 14.2
Nephritis, nephrotic syndrome and nephrosis 6 . . . -- -- -- 12.2 11.6 15.0 15.6 16.4 12.6 11.4
Suicide 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . -- -- -- 11.9 11.7 9.8 10.7 10.8 10.8 11.7
Homicide 7. . . . . . . . . . . . . . . . . . . . . . . . . . . . . -- -- -- 15.5 10.4 6.8 6.8 5.7 5.8 5.3
Sex, race, Hispanic origin, and cause of death 1 1950 2,3 1960 2,3 1970 3 1980 3 1990 3 2000 4 2005 4 2010 4 2012 4 2013 4
causes of death between ICD–9 and ICD–10. See Appendix II, Cause of death; Comparability ratio; Table IV; Table V.
1
Underlying cause of death code numbers are based on the applicable revision of the International Classification of Diseases (ICD) for data years shown. See Appendix
2
Includes deaths of persons who were not residents of the 50 states and the District of Columbia (D.C.).
3
Underlying cause of death was coded according to the 6th Revision of the ICD in 1950, 7th Revision in 1960, 8th Revision in 1970, and 9th Revision in 1980–1998.
4
Starting with 1999 data, cause of death is coded according to ICD–10. See Appendix II, Cause of death; Comparability ratio; Table IV; Table V.
5
Age-adjusted rates are calculated using the year 2000 standard population. Prior to 2001, age-adjusted rates were calculated using standard million proportions based
on rounded population numbers. Starting with 2001 data, unrounded population numbers are used to calculate age-adjusted rates. See Appendix II, Age adjustment.
6
Starting with 2011 data, the rules for selecting Renal failure as the underlying cause of death were changed, affecting the number of deaths in the Nephritis, nephrotic
syndrome and nephrosis and Diabetes categories. These changes directly affect deaths with mention of Renal failure and other associated conditions, such as
Diabetes mellitus with renal complications. The result is a decrease in the number of deaths for Nephritis, nephrotic syndrome and nephrosis and an increase in the
number of deaths for Diabetes mellitus. Therefore, trend data for these two causes of death should be interpreted with caution. For more information, see Technical
7
Figures for 2001 (in Excel spreadsheet on the Web) include September 11-related deaths for which death certificates were filed as of October 24, 2002. See Appendix
8
The race groups, white, black, Asian or Pacific Islander, and American Indian or Alaska Native, include persons of Hispanic and non-Hispanic origin. Persons of
Hispanic origin may be of any race. Death rates for Hispanic, American Indian or Alaska Native, and Asian or Pacific Islander persons should be interpreted with
caution because of inconsistencies in reporting Hispanic origin or race on the death certificate (death rate numerators) compared with population figures (death rate
denominators). The net effect of misclassification is an underestimation of deaths and death rates for races other than white and black. See Appendix II, Race, for a
detailed discussion of sources of bias in death rates by race and Hispanic origin.
9
Prior to 1997, data from states that did not report Hispanic origin on the death certificate were excluded. See Appendix II, Hispanic origin.
NOTES: Starting with Health, United States, 2003, rates for 1991–1999 were revised using intercensal population estimates based on the 1990 and 2000 censuses.
For 2000, population estimates are bridged-race April 1 census counts. Starting with Health, United States, 2012, rates for 2001–2009 were revised using intercensal
population estimates based on the 2000 and 2010 censuses. For 2010, population estimates are bridged-race April 1 census counts. Rates for 2011 and beyond were
computed using 2010-based postcensal estimates. See Appendix I, Population Census and Population Estimates. Starting with 2003 data, some states allowed the
reporting of more than one race on the death certificate. The multiple-race data for these states were bridged to the single-race categories of the 1977 Office of
Management and Budget standards, for comparability with other states. See Appendix II, Race. Data for additional years are available. See the Excel spreadsheet on
the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC/NCHS, National Vital Statistics System; Grove RD, Hetzel AM. Vital statistics rates in the United States, 1940–1960. Washington, DC: U.S. Government
Printing Office. 1968; numerator data from National Vital Statistics System, annual public-use Mortality Files; denominator data from national population estimates for
race groups from Table 1 and unpublished Hispanic population estimates for 1985–1996 prepared by the Housing and Household Economic Statistics Division, U.S.
Census Bureau; Xu JQ, Murphy SL, Kochanek KD, et al. Deaths: Final data for 2013. National vital statistics reports; vol 64 no 2. Hyattsville, MD: NCHS; 2015.
Available from: http://www.cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_02.pdf. See Appendix I, National Vital Statistics System (NVSS).
Crude Age-adjusted 1
Sex, race, Hispanic origin,
and cause of death 2 2013 3 1980 2 1990 2 2000 3 2010 3 2012 3 2013 3
All persons Years lost before age 75 per 100,000 population under age 75
All causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7,002.7 10,448.4 9,085.5 7,578.1 6,642.9 6,588.0 6,593.1
Diseases of heart . . . . . . . . . . . . . . . . . . . . . . . 1,070.9 2,238.7 1,617.7 1,253.0 972.4 951.9 952.3
Ischemic heart disease . . . . . . . . . . . . . . . . . . 630.4 1,729.3 1,153.6 841.8 577.3 558.4 546.1
Cerebrovascular diseases . . . . . . . . . . . . . . . . . 177.2 357.5 259.6 223.3 169.3 161.6 158.1
Malignant neoplasms . . . . . . . . . . . . . . . . . . . . . 1,527.1 2,108.8 2,003.8 1,674.1 1,395.8 1,356.2 1,328.6
Trachea, bronchus, and lung . . . . . . . . . . . . . . 362.1 548.5 561.4 443.1 331.3 309.9 298.2
Colorectal . . . . . . . . . . . . . . . . . . . . . . . . . . . 139.2 190.0 164.7 141.9 125.0 123.0 123.5
Prostate 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57.6 84.9 96.8 63.6 52.2 48.1 47.5
Breast 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 278.5 463.2 451.6 332.6 262.4 256.0 250.0
Chronic lower respiratory diseases . . . . . . . . . . . 211.1 169.1 187.4 188.1 172.4 171.6 176.6
Influenza and pneumonia . . . . . . . . . . . . . . . . . . 88.8 160.2 141.5 87.1 71.4 67.4 82.3
Chronic liver disease and cirrhosis . . . . . . . . . . . 192.0 300.3 196.9 164.1 163.9 173.3 176.9
Diabetes mellitus 6 . . . . . . . . . . . . . . . . . . . . . . . 189.3 134.4 155.9 178.4 158.2 164.3 168.3
† †
Alzheimer’s disease . . . . . . . . . . . . . . . . . . . . . . 14.0 10.9 11.7 11.0 11.1
Human immunodeficiency virus (HIV) disease . . . 57.7 ... 383.8 174.6 76.6 61.8 58.1
Unintentional injuries . . . . . . . . . . . . . . . . . . . . . 1,027.8 1,543.5 1,162.1 1,026.5 1,025.2 1,046.1 1,051.2
Motor vehicle-related injuries . . . . . . . . . . . . . . 378.6 912.9 716.4 574.3 400.6 402.4 386.6
Poisoning . . . . . . . . . . . . . . . . . . . . . . . . . . . 417.1 68.0 81.2 163.6 379.7 408.8 430.9
Nephritis, nephrotic syndrome and nephrosis 6 . . . 74.4 -- 50.4 70.7 73.1 65.2 65.7
Suicide 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 394.4 392.0 393.1 334.5 385.2 402.1 401.6
Homicide 7. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 222.1 425.5 417.4 266.5 239.0 240.9 229.8
Male
All causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8,678.3 13,777.2 11,973.5 9,572.2 8,329.5 8,249.1 8,249.5
Diseases of heart . . . . . . . . . . . . . . . . . . . . . . . 1,473.5 3,352.1 2,356.0 1,766.0 1,370.8 1,336.6 1,338.2
Ischemic heart disease . . . . . . . . . . . . . . . . . . 917.1 2,715.1 1,766.3 1,255.4 864.8 831.8 816.2
Cerebrovascular diseases . . . . . . . . . . . . . . . . . 200.3 396.7 286.6 244.6 190.7 183.7 182.1
Malignant neoplasms . . . . . . . . . . . . . . . . . . . . . 1,609.9 2,360.8 2,214.6 1,810.8 1,500.8 1,450.9 1,415.9
Trachea, bronchus, and lung . . . . . . . . . . . . . . 408.5 821.1 764.8 554.9 390.5 361.1 345.1
Colorectal . . . . . . . . . . . . . . . . . . . . . . . . . . . 162.4 214.9 194.3 167.3 148.0 144.4 146.8
Prostate . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57.6 84.9 96.8 63.6 52.2 48.1 47.5
Chronic lower respiratory diseases . . . . . . . . . . . 215.0 235.1 224.8 206.0 182.8 179.7 185.2
Influenza and pneumonia . . . . . . . . . . . . . . . . . . 100.5 202.5 180.0 102.8 82.6 77.5 94.1
Chronic liver disease and cirrhosis . . . . . . . . . . . 260.0 415.0 283.9 236.9 226.9 237.2 242.1
Diabetes mellitus 6 . . . . . . . . . . . . . . . . . . . . . . . 229.4 140.4 170.4 203.8 194.8 203.5 208.6
† †
Alzheimer’s disease . . . . . . . . . . . . . . . . . . . . . . 12.1 10.6 10.7 10.2 10.2
Human immunodeficiency virus (HIV) disease . . . 83.8 ... 686.2 258.9 109.5 87.0 84.3
Unintentional injuries . . . . . . . . . . . . . . . . . . . . . 1,441.8 2,342.7 1,715.1 1,475.6 1,432.1 1,459.7 1,463.5
Motor vehicle-related injuries . . . . . . . . . . . . . . 546.7 1,359.7 1,018.4 796.4 569.2 574.3 552.2
Poisoning . . . . . . . . . . . . . . . . . . . . . . . . . . . 557.4 96.4 123.6 242.1 503.8 541.5 573.1
Nephritis, nephrotic syndrome and nephrosis 6 . . . 83.3 -- 58.9 81.1 82.3 75.3 75.3
Suicide 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 612.0 605.6 634.8 539.1 607.0 625.9 619.8
Homicide 7. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 359.7 675.0 658.0 410.5 380.3 383.6 365.9
Female
All causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5,337.8 7,350.3 6,333.1 5,644.6 4,994.0 4,959.6 4,967.9
Diseases of heart . . . . . . . . . . . . . . . . . . . . . . . 670.8 1,246.0 948.5 774.6 593.6 585.4 584.5
Ischemic heart disease . . . . . . . . . . . . . . . . . . 345.4 852.1 600.3 457.6 305.2 299.3 290.0
Cerebrovascular diseases . . . . . . . . . . . . . . . . . 154.2 324.0 235.9 203.9 149.1 140.7 135.4
Malignant neoplasms . . . . . . . . . . . . . . . . . . . . . 1,444.9 1,896.8 1,826.6 1,555.3 1,301.0 1,271.0 1,250.3
Trachea, bronchus, and lung . . . . . . . . . . . . . . 315.9 310.4 382.2 342.1 276.9 262.8 255.1
Colorectal . . . . . . . . . . . . . . . . . . . . . . . . . . . 116.2 168.7 138.7 118.7 103.4 102.8 101.5
Breast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 278.5 463.2 451.6 332.6 262.4 256.0 250.0
Chronic lower respiratory diseases . . . . . . . . . . . 207.2 114.0 155.9 172.3 162.8 164.1 168.7
Influenza and pneumonia . . . . . . . . . . . . . . . . . . 77.1 122.0 106.2 72.3 60.7 57.8 70.9
Chronic liver disease and cirrhosis . . . . . . . . . . . 124.3 194.5 115.1 94.5 103.5 111.9 114.4
Diabetes mellitus 6 . . . . . . . . . . . . . . . . . . . . . . . 149.5 128.5 142.3 154.4 123.5 127.0 129.8
† †
Alzheimer’s disease . . . . . . . . . . . . . . . . . . . . . . 15.8 11.1 12.6 11.8 12.0
Human immunodeficiency virus (HIV) disease . . . 31.8 ... 87.8 92.0 44.4 37.2 32.5
Unintentional injuries . . . . . . . . . . . . . . . . . . . . . 616.4 755.3 607.4 573.2 616.4 629.6 635.7
Motor vehicle-related injuries . . . . . . . . . . . . . . 211.5 470.4 411.6 348.5 230.5 228.7 219.0
Poisoning . . . . . . . . . . . . . . . . . . . . . . . . . . . 277.7 40.2 39.1 85.0 255.1 275.1 287.7
Nephritis, nephrotic syndrome and nephrosis 6 . . . 65.5 -- 42.4 60.8 64.6 55.6 56.6
Suicide 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 178.3 184.2 153.3 129.1 163.7 177.6 182.5
Homicide 7. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85.4 181.3 174.3 118.9 94.9 94.9 90.4
Crude Age-adjusted 1
Sex, race, Hispanic origin,
and cause of death 2 2013 3 1980 2 1990 2 2000 3 2010 3 2012 3 2013 3
White 8 Years lost before age 75 per 100,000 population under age 75
All causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6,864.3 9,554.1 8,159.5 6,949.5 6,342.8 6,321.6 6,338.2
Diseases of heart . . . . . . . . . . . . . . . . . . . . . . . 1,032.2 2,100.8 1,490.3 1,149.4 900.9 882.5 881.8
Ischemic heart disease . . . . . . . . . . . . . . . . . . 640.1 1,682.7 1,113.4 805.3 563.7 544.8 532.0
Cerebrovascular diseases . . . . . . . . . . . . . . . . . 157.7 300.7 213.1 187.1 142.7 138.7 135.1
Malignant neoplasms . . . . . . . . . . . . . . . . . . . . . 1,572.4 2,035.9 1,929.3 1,627.8 1,375.8 1,340.7 1,317.7
Trachea, bronchus, and lung . . . . . . . . . . . . . . 383.0 529.9 544.2 436.3 332.8 311.4 300.4
Colorectal . . . . . . . . . . . . . . . . . . . . . . . . . . . 138.5 186.8 157.8 134.1 118.4 117.9 118.6
Prostate 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53.9 74.8 86.6 54.3 45.3 42.1 41.9
Breast 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 272.0 460.2 441.7 315.6 245.0 239.3 236.0
Chronic lower respiratory diseases . . . . . . . . . . . 228.7 165.4 182.3 185.3 176.1 175.3 180.1
Influenza and pneumonia . . . . . . . . . . . . . . . . . . 86.7 130.8 116.9 77.7 66.7 63.2 78.4
Chronic liver disease and cirrhosis . . . . . . . . . . . 210.6 257.3 175.8 162.7 173.5 185.9 189.3
Diabetes mellitus 6 . . . . . . . . . . . . . . . . . . . . . . . 174.3 115.7 133.7 155.6 139.0 145.4 149.2
† †
Alzheimer’s disease . . . . . . . . . . . . . . . . . . . . . . 15.8 11.4 12.4 11.7 11.8
Human immunodeficiency virus (HIV) disease . . . 31.6 ... 309.0 94.7 39.9 32.8 31.5
Unintentional injuries . . . . . . . . . . . . . . . . . . . . . 1,089.1 1,520.4 1,139.7 1,031.8 1,098.6 1,119.7 1,125.2
Motor vehicle-related injuries . . . . . . . . . . . . . . 387.4 939.9 726.7 586.1 419.0 420.1 401.2
Poisoning . . . . . . . . . . . . . . . . . . . . . . . . . . . 472.2 64.9 74.4 167.2 435.4 467.6 493.0
Nephritis, nephrotic syndrome and nephrosis 6 . . . 62.1 -- 37.0 52.5 57.4 51.1 52.7
Suicide 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 440.3 414.5 417.7 362.0 430.8 450.8 451.2
Homicide 7. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 120.6 271.7 234.9 156.6 138.7 135.9 127.7
Black or African American 8
All causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9,508.1 17,873.4 16,593.0 12,897.1 9,832.5 9,555.7 9,528.5
Diseases of heart . . . . . . . . . . . . . . . . . . . . . . . 1,597.4 3,619.9 2,891.8 2,275.2 1,691.1 1,645.0 1,647.0
Ischemic heart disease . . . . . . . . . . . . . . . . . . 757.2 2,305.1 1,676.1 1,300.1 818.8 792.0 776.7
Cerebrovascular diseases . . . . . . . . . . . . . . . . . 309.9 883.2 656.4 507.0 358.1 326.5 319.2
Malignant neoplasms . . . . . . . . . . . . . . . . . . . . . 1,645.8 2,946.1 2,894.8 2,294.7 1,796.7 1,724.1 1,666.7
Trachea, bronchus, and lung . . . . . . . . . . . . . . 363.6 776.0 811.3 593.0 405.6 377.5 362.4
Colorectal . . . . . . . . . . . . . . . . . . . . . . . . . . . 169.2 232.3 241.8 222.4 188.6 177.0 174.2
Prostate 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.7 200.3 223.5 171.0 127.3 113.6 109.9
Breast 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 384.2 524.2 592.9 500.0 420.8 406.2 389.8
Chronic lower respiratory diseases . . . . . . . . . . . 198.2 203.7 240.6 232.7 187.7 192.8 200.1
Influenza and pneumonia . . . . . . . . . . . . . . . . . . 121.4 384.9 330.8 161.2 109.8 106.2 122.9
Chronic liver disease and cirrhosis . . . . . . . . . . . 120.5 644.0 371.8 185.6 120.2 116.2 122.4
Diabetes mellitus 6 . . . . . . . . . . . . . . . . . . . . . . . 314.4 305.3 361.5 383.4 316.4 316.6 323.8
† †
Alzheimer’s disease . . . . . . . . . . . . . . . . . . . . . . 8.9 8.3 10.0 9.3 9.8
Human immunodeficiency virus (HIV) disease . . . 224.4 ... 1,014.7 763.3 329.5 259.0 238.4
Unintentional injuries . . . . . . . . . . . . . . . . . . . . . 955.2 1,751.5 1,392.7 1,152.8 896.7 925.8 953.0
Motor vehicle-related injuries . . . . . . . . . . . . . . 408.4 750.2 699.5 580.8 393.4 404.0 402.6
Poisoning . . . . . . . . . . . . . . . . . . . . . . . . . . . 253.2 99.4 144.3 196.6 218.9 242.1 265.6
Nephritis, nephrotic syndrome and nephrosis 6 . . . 161.1 -- 160.9 216.9 193.2 172.4 165.7
Suicide 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 208.7 238.0 261.4 208.7 196.4 210.4 207.0
Homicide 7. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 847.5 1,580.8 1,612.9 941.6 821.2 842.9 813.5
American Indian or
Alaska Native 8
All causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6,359.5 13,390.9 9,506.2 7,758.2 6,771.3 6,842.6 6,698.8
Diseases of heart . . . . . . . . . . . . . . . . . . . . . . . 708.1 1,819.9 1,391.0 1,030.1 820.6 797.4 807.4
Ischemic heart disease . . . . . . . . . . . . . . . . . . 419.3 1,208.2 901.8 709.3 487.6 486.4 484.4
Cerebrovascular diseases . . . . . . . . . . . . . . . . . 107.6 269.3 223.3 198.1 129.7 121.5 124.1
Malignant neoplasms . . . . . . . . . . . . . . . . . . . . . 755.5 1,101.3 1,141.1 995.7 929.5 856.9 852.4
Trachea, bronchus, and lung . . . . . . . . . . . . . . 141.6 181.1 268.1 227.8 211.0 188.5 166.0
Colorectal . . . . . . . . . . . . . . . . . . . . . . . . . . . 91.4 78.8 82.4 93.8 95.8 90.0 103.3
Prostate 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26.3 66.7 42.0 44.5 36.8 36.7 32.6
Breast 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97.7 205.5 213.4 174.1 145.0 120.0 108.5
Chronic lower respiratory diseases . . . . . . . . . . . 116.0 89.3 129.0 151.8 154.5 133.2 135.6
Influenza and pneumonia . . . . . . . . . . . . . . . . . . 99.6 307.9 206.3 124.0 99.3 80.8 109.0
Chronic liver disease and cirrhosis . . . . . . . . . . . 497.9 1,190.3 535.1 519.4 510.8 553.3 562.2
Diabetes mellitus 6 . . . . . . . . . . . . . . . . . . . . . . . 248.2 305.5 292.3 305.6 267.6 286.4 281.7
† †
Alzheimer’s disease . . . . . . . . . . . . . . . . . . . . . . 4.5 * 8.8 6.2 5.7
Human immunodeficiency virus (HIV) disease . . . 30.2 ... 70.1 68.4 46.1 32.1 33.8
Unintentional injuries . . . . . . . . . . . . . . . . . . . . . 1,389.5 3,541.0 2,183.9 1,700.1 1,377.7 1,505.2 1,388.2
Motor vehicle-related injuries . . . . . . . . . . . . . . 603.5 2,102.4 1,301.5 1,032.2 570.6 637.0 575.7
Poisoning . . . . . . . . . . . . . . . . . . . . . . . . . . . 464.0 92.9 119.5 180.1 449.6 514.1 487.3
Nephritis, nephrotic syndrome and nephrosis 6 . . . 65.3 -- 88.5 102.0 81.7 67.5 73.7
Suicide 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 480.9 515.0 495.9 403.1 437.9 437.6 463.0
Homicide 7. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 234.9 628.9 434.2 278.5 256.4 244.5 227.8
Crude Age-adjusted 1
Sex, race, Hispanic origin,
and cause of death 2 2013 3 1980 2 1990 2 2000 3 2010 3 2012 3 2013 3
Asian or Pacific Islander 8 Years lost before age 75 per 100,000 population under age 75
All causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,061.9 5,378.4 4,705.2 3,811.1 3,061.2 3,049.4 3,050.9
Ischemic heart disease . . . . . . . . . . . . . . . . . . 256.3 697.7 486.6 381.1 250.6 248.3 250.4
Trachea, bronchus, and lung . . . . . . . . . . . . . . 139.8 238.2 204.7 185.8 148.2 145.2 136.7
Chronic lower respiratory diseases . . . . . . . . . . . 35.1 56.4 72.8 56.5 33.2 30.6 35.0
Influenza and pneumonia . . . . . . . . . . . . . . . . . . 36.6 79.3 74.0 48.6 38.4 33.5 36.4
Chronic liver disease and cirrhosis . . . . . . . . . . . 44.1 85.6 72.4 44.8 41.7 37.8 42.9
† †
Alzheimer’s disease . . . . . . . . . . . . . . . . . . . . . . 3.4 3.5 3.2 3.8 3.6
Human immunodeficiency virus (HIV) disease . . . 11.6 ... 77.0 19.9 10.7 9.9 11.2
Motor vehicle-related injuries . . . . . . . . . . . . . . 139.5 472.6 445.5 263.4 147.9 135.9 136.5
Ischemic heart disease . . . . . . . . . . . . . . . . . . 254.3 --- 756.6 564.6 366.6 341.7 340.0
Trachea, bronchus, and lung . . . . . . . . . . . . . . 74.6 --- 193.7 152.1 115.0 107.3 102.9
Chronic lower respiratory diseases . . . . . . . . . . . 43.7 --- 78.8 68.5 59.6 53.2 56.2
Influenza and pneumonia . . . . . . . . . . . . . . . . . . 55.3 --- 130.1 76.0 57.5 53.1 64.3
Chronic liver disease and cirrhosis . . . . . . . . . . . 165.1 --- 329.1 252.1 201.6 209.5 206.1
†
Alzheimer’s disease . . . . . . . . . . . . . . . . . . . . . . 5.2 --- 6.9 8.4 7.7 8.5
Human immunodeficiency virus (HIV) disease . . . 45.7 ... 600.1 209.4 74.9 55.2 52.5
Motor vehicle-related injuries . . . . . . . . . . . . . . 365.5 --- 740.8 540.2 340.3 346.0 344.8
Ischemic heart disease . . . . . . . . . . . . . . . . . . 729.0 --- 1,127.2 824.7 590.8 574.7 560.9
Trachea, bronchus, and lung . . . . . . . . . . . . . . 458.9 --- 566.8 460.3 359.1 337.7 327.2
Chronic lower respiratory diseases . . . . . . . . . . . 274.0 --- 188.1 193.8 189.1 190.0 195.9
Influenza and pneumonia . . . . . . . . . . . . . . . . . . 93.0 --- 112.3 76.4 67.8 64.5 80.5
Chronic liver disease and cirrhosis . . . . . . . . . . . 217.1 --- 162.4 150.9 166.9 179.6 183.9
†
Alzheimer’s disease . . . . . . . . . . . . . . . . . . . . . . 18.4 --- 11.7 12.7 12.1 12.1
Human immunodeficiency virus (HIV) disease . . . 26.8 ... 271.2 76.0 31.3 26.9 25.7
Motor vehicle-related injuries . . . . . . . . . . . . . . 383.9 --- 715.7 588.8 430.6 431.0 407.4
NOTES: Starting with Health, United States, 2003, rates for 1991–1999 were revised using intercensal population estimates based on the 1990 and 2000 censuses.
For 2000, population estimates are bridged-race April 1 census counts. Starting with Health, United States, 2012, rates for 2001–2009 were revised using intercensal
population estimates based on the 2000 and 2010 censuses. For 2010, population estimates are bridged-race April 1 census counts. Rates for 2011 and beyond were
computed using 2010-based postcensal estimates. See Appendix I, Population Census and Population Estimates. See Appendix II, Years of potential life lost (YPLL) for
definition and method of calculation. Starting with 2003 data, some states allowed the reporting of more than one race on the death certificate. The multiple-race data
for these states were bridged to the single-race categories of the 1977 Office of Management and Budget standards, for comparability with other states. See Appendix
II, Race. Rates are rounded at the end of the calculation process. They may differ from rates based on the same data presented elsewhere if rounding is done earlier
in the calculation process. Data for additional years are available. See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC/NCHS, National vital statistics system; numerator data from annual public-use Mortality Files; denominator data from national population estimates for
race groups from Table 1 and unpublished Hispanic population estimates for 1990–1996 prepared by the Housing and Household Economic Statistics Division, U.S.
Census Bureau. See Appendix I, National Vital Statistics System (NVSS).
All persons
Rank All causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,989,841 All causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,596,993
1. . . . . . ....... Diseases of heart . . . . . . . . . . . . . . . . . . . . . . . 761,085 Diseases of heart . . . . . . . . . . . . . . . . . . . . . . . 611,105
2. . . . . . ....... Malignant neoplasms . . . . . . . . . . . . . . . . . . . . . 416,509 Malignant neoplasms . . . . . . . . . . . . . . . . . . . . . 584,881
3. . . . . . ....... Cerebrovascular diseases . . . . . . . . . . . . . . . . . 170,225 Chronic lower respiratory diseases . . . . . . . . . . . 149,205
4. . . . . . ....... Unintentional injuries . . . . . . . . . . . . . . . . . . . . . 105,718 Unintentional injuries . . . . . . . . . . . . . . . . . . . . . 130,557
5. . . . . . ....... Chronic obstructive pulmonary diseases . . . . . . . 56,050 Cerebrovascular diseases . . . . . . . . . . . . . . . . . 128,978
6. . . . . . ....... Pneumonia and influenza . . . . . . . . . . . . . . . . . . 54,619 Alzheimer’s disease . . . . . . . . . . . . . . . . . . . . . . 84,767
7. . . . . . ....... Diabetes mellitus . . . . . . . . . . . . . . . . . . . . . . . . 34,851 Diabetes mellitus 1 . . . . . . . . . . . . . . . . . . . . . . . 75,578
8. . . . . . ....... Chronic liver disease and cirrhosis . . . . . . . . . . . 30,583 Influenza and pneumonia . . . . . . . . . . . . . . . . . . 56,979
9. . . . . . ....... Atherosclerosis . . . . . . . . . . . . . . . . . . . . . . . . . 29,449 Nephritis, nephrotic syndrome and nephrosis 1 . . . 47,112
10 . . . . . . ....... Suicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26,869 Suicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41,149
Male
Rank All causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,075,078 All causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,306,034
1. . . . . . ....... Diseases of heart . . . . . . . . . . . . . . . . . . . . . . . 405,661 Diseases of heart . . . . . . . . . . . . . . . . . . . . . . . 321,347
2. . . . . . ....... Malignant neoplasms . . . . . . . . . . . . . . . . . . . . . 225,948 Malignant neoplasms . . . . . . . . . . . . . . . . . . . . . 307,559
3. . . . . . ....... Unintentional injuries . . . . . . . . . . . . . . . . . . . . . 74,180 Unintentional injuries . . . . . . . . . . . . . . . . . . . . . 81,916
4. . . . . . ....... Cerebrovascular diseases . . . . . . . . . . . . . . . . . 69,973 Chronic lower respiratory diseases . . . . . . . . . . . 70,317
5. . . . . . ....... Chronic obstructive pulmonary diseases . . . . . . . 38,625 Cerebrovascular diseases . . . . . . . . . . . . . . . . . 53,691
6. . . . . . ....... Pneumonia and influenza . . . . . . . . . . . . . . . . . . 27,574 Diabetes mellitus 1 . . . . . . . . . . . . . . . . . . . . . . . 39,841
7. . . . . . ....... Suicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20,505 Suicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32,055
8. . . . . . ....... Chronic liver disease and cirrhosis . . . . . . . . . . . 19,768 Influenza and pneumonia . . . . . . . . . . . . . . . . . . 26,804
9. . . . . . ....... Homicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18,779 Alzheimer’s disease . . . . . . . . . . . . . . . . . . . . . . 25,836
10 . . . . . . ....... Diabetes mellitus . . . . . . . . . . . . . . . . . . . . . . . . 14,325 Chronic liver disease and cirrhosis . . . . . . . . . . . 23,709
Female
Rank All causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 914,763 All causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,290,959
1. . . .......... Diseases of heart . . . . . . . . . . . . . . . . . . . . . . . 355,424 Diseases of heart . . . . . . . . . . . . . . . . . . . . . . . 289,758
2. . . .......... Malignant neoplasms . . . . . . . . . . . . . . . . . . . . . 190,561 Malignant neoplasms . . . . . . . . . . . . . . . . . . . . . 277,322
3. . . .......... Cerebrovascular diseases . . . . . . . . . . . . . . . . . 100,252 Chronic lower respiratory diseases . . . . . . . . . . . 78,888
4. . . .......... Unintentional injuries . . . . . . . . . . . . . . . . . . . . . 31,538 Cerebrovascular diseases . . . . . . . . . . . . . . . . . 75,287
5. . . .......... Pneumonia and influenza . . . . . . . . . . . . . . . . . . 27,045 Alzheimer’s disease . . . . . . . . . . . . . . . . . . . . . . 58,931
6. . . .......... Diabetes mellitus . . . . . . . . . . . . . . . . . . . . . . . . 20,526 Unintentional injuries . . . . . . . . . . . . . . . . . . . . . 48,641
7. . . .......... Atherosclerosis . . . . . . . . . . . . . . . . . . . . . . . . . 17,848 Diabetes mellitus 1 . . . . . . . . . . . . . . . . . . . . . . . 35,737
8. . . .......... Chronic obstructive pulmonary diseases . . . . . . . 17,425 Influenza and pneumonia . . . . . . . . . . . . . . . . . . 30,175
9. . . .......... Chronic liver disease and cirrhosis . . . . . . . . . . . 10,815 Nephritis, nephrotic syndrome and nephrosis 1 . . . 23,619
10 . . . .......... Certain conditions originating in the perinatal period. . 9,815 Septicemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20,162
White
Rank All causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,738,607 All causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,217,103
1. . . . . . ....... Diseases of heart . . . . . . . . . . . . . . . . . . . . . . . 683,347 Diseases of heart . . . . . . . . . . . . . . . . . . . . . . . 522,645
2. . . . . . ....... Malignant neoplasms . . . . . . . . . . . . . . . . . . . . . 368,162 Malignant neoplasms . . . . . . . . . . . . . . . . . . . . . 498,116
3. . . . . . ....... Cerebrovascular diseases . . . . . . . . . . . . . . . . . 148,734 Chronic lower respiratory diseases . . . . . . . . . . . 136,682
4. . . . . . ....... Unintentional injuries . . . . . . . . . . . . . . . . . . . . . 90,122 Unintentional injuries . . . . . . . . . . . . . . . . . . . . . 112,803
5. . . . . . ....... Chronic obstructive pulmonary diseases . . . . . . . 52,375 Cerebrovascular diseases . . . . . . . . . . . . . . . . . 107,909
6. . . . . . ....... Pneumonia and influenza . . . . . . . . . . . . . . . . . . 48,369 Alzheimer’s disease . . . . . . . . . . . . . . . . . . . . . . 77,387
7. . . . . . ....... Diabetes mellitus . . . . . . . . . . . . . . . . . . . . . . . . 28,868 Diabetes mellitus 1 . . . . . . . . . . . . . . . . . . . . . . . 58,925
8. . . . . . ....... Atherosclerosis . . . . . . . . . . . . . . . . . . . . . . . . . 27,069 Influenza and pneumonia . . . . . . . . . . . . . . . . . . 49,013
9. . . . . . ....... Chronic liver disease and cirrhosis . . . . . . . . . . . 25,240 Nephritis, nephrotic syndrome and nephrosis 1 . . . 37,270
10 . . . . . . ....... Suicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24,829 Suicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37,154
Black or
African American
Rank All causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 233,135 All causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 302,969
1. . . . . . . ...... Diseases of heart . . . . . . . . . . . . . . . . . . . . . . . 72,956 Diseases of heart . . . . . . . . . . . . . . . . . . . . . . . 72,010
2. . . . . . . ...... Malignant neoplasms . . . . . . . . . . . . . . . . . . . . . 45,037 Malignant neoplasms . . . . . . . . . . . . . . . . . . . . . 67,953
3. . . . . . . ...... Cerebrovascular diseases . . . . . . . . . . . . . . . . . 20,135 Cerebrovascular diseases . . . . . . . . . . . . . . . . . 16,269
4. . . . . . . ...... Unintentional injuries . . . . . . . . . . . . . . . . . . . . . 13,480 Unintentional injuries . . . . . . . . . . . . . . . . . . . . . 13,413
5. . . . . . . ...... Homicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10,172 Diabetes mellitus 1 . . . . . . . . . . . . . . . . . . . . . . . 13,385
6. . . . . . . ...... Certain conditions originating in the perinatal period. . 6,961 Chronic lower respiratory diseases . . . . . . . . . . . . . 9,918
7. . . . . . . ...... Pneumonia and influenza . . . . . . . . . . . . . . . . . . . 5,648 Nephritis, nephrotic syndrome and nephrosis 1 . . . . . 8,393
8. . . . . . . ...... Diabetes mellitus. . . . . . . . . . . . . . . . . . . . . . . . . 5,544 Homicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8,059
9. . . . . . . ...... Chronic liver disease and cirrhosis . . . . . . . . . . . . . 4,790 Septicemia. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6,250
10 . . . . . . . ...... Nephritis, nephrotic syndrome and nephrosis . . . . . . 3,416 Alzheimer’s disease. . . . . . . . . . . . . . . . . . . . . . . 5,714
American Indian
or Alaska Native
Rank All causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6,923 All causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17,052
1. . . . . . . . . . . . . Diseases of heart . . . . . . . . . . . . . . . . . . . . . . . 1,494 Diseases of heart . . . . . . . . . . . . . . . . . . . . . . . 3,139
2. . . . . . . . . . . . . Unintentional injuries . . . . . . . . . . . . . . . . . . . . . 1,290 Malignant neoplasms . . . . . . . . . . . . . . . . . . . . . 3,109
3. . . . . . . . . . . . . Malignant neoplasms . . . . . . . . . . . . . . . . . . . . . 770 Unintentional injuries . . . . . . . . . . . . . . . . . . . . . 1,833
4. . . . . . . . . . . . . Chronic liver disease and cirrhosis . . . . . . . . . . . 410 Diabetes mellitus 1 . . . . . . . . . . . . . . . . . . . . . . . 959
5. . . . . . . . . . . . . Cerebrovascular diseases . . . . . . . . . . . . . . . . . 322 Chronic liver disease and cirrhosis . . . . . . . . . . . 944
6. . . . . . . . . . . . . Pneumonia and influenza . . . . . . . . . . . . . . . . . . 257 Chronic lower respiratory diseases . . . . . . . . . . . 757
7. . . . . . . . . . . . . Homicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 217 Cerebrovascular diseases . . . . . . . . . . . . . . . . . 595
8. . . . . . . . . . . . . Diabetes mellitus . . . . . . . . . . . . . . . . . . . . . . . . 210 Suicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 521
9. . . . . . . . . . . . . Certain conditions originating in the perinatal period. . 199 Influenza and pneumonia . . . . . . . . . . . . . . . . . . . 375
10 . . . . . . . . . . . . . Suicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 181 Nephritis, nephrotic syndrome and nephrosis 1 . . . . . 302
Asian or Pacific
Islander
Rank All causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11,071 All causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59,869
1. . . . . . . . . . . . . Diseases of heart . . . . . . . . . . . . . . . . . . . . . . . . 3,265 Malignant neoplasms . . . . . . . . . . . . . . . . . . . . . . 15,703
2. . . . . . . . . . . . . Malignant neoplasms . . . . . . . . . . . . . . . . . . . . . . 2,522 Diseases of heart . . . . . . . . . . . . . . . . . . . . . . . . 13,311
3. . . . . . . . . . . . . Cerebrovascular diseases. . . . . . . . . . . . . . . . . . . 1,028 Cerebrovascular diseases. . . . . . . . . . . . . . . . . . . 4,205
4. . . . . . . . . . . . . Unintentional injuries . . . . . . . . . . . . . . . . . . . . . . 810 Unintentional injuries . . . . . . . . . . . . . . . . . . . . . . 2,508
5. . . . . . . . . . . . . Pneumonia and influenza . . . . . . . . . . . . . . . . . . . 342 Diabetes mellitus 1 . . . . . . . . . . . . . . . . . . . . . . . . 2,309
6. . . . . . . . . . . . . Suicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 249 Influenza and pneumonia . . . . . . . . . . . . . . . . . . . 2,024
7. . . . . . . . . . . . . Certain conditions originating in the perinatal period. . 246 Chronic lower respiratory diseases . . . . . . . . . . . . . 1,848
8. . . . . . . . . . . . . Diabetes mellitus. . . . . . . . . . . . . . . . . . . . . . . . . 227 Alzheimer’s disease. . . . . . . . . . . . . . . . . . . . . . . 1,428
9. . . . . . . . . . . . . Homicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 211 Nephritis, nephrotic syndrome and nephrosis 1 . . . . . 1,147
10 . . . . . . . . . . . . . Chronic obstructive pulmonary diseases . . . . . . . . . 207 Suicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,121
Hispanic or Latino
Rank --- --- All causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 163,241
1. . . . . . . . . . . . . --- --- Malignant neoplasms . . . . . . . . . . . . . . . . . . . . . . 35,147
2. . . . . . . . . . . . . --- --- Diseases of heart . . . . . . . . . . . . . . . . . . . . . . . . 33,243
3. . . . . . . . . . . . . --- --- Unintentional injuries . . . . . . . . . . . . . . . . . . . . . . 12,015
4. . . . . . . . . . . . . --- --- Cerebrovascular diseases. . . . . . . . . . . . . . . . . . . 8,127
5. . . . . . . . . . . . . --- --- Diabetes mellitus 1 . . . . . . . . . . . . . . . . . . . . . . . . 7,632
6. . . . . . . . . . . . . --- --- Chronic liver disease and cirrhosis . . . . . . . . . . . . . 5,141
7. . . . . . . . . . . . . --- --- Chronic lower respiratory diseases . . . . . . . . . . . . . 4,827
8. . . . . . . . . . . . . --- --- Alzheimer’s disease. . . . . . . . . . . . . . . . . . . . . . . 4,127
9. . . . . . . . . . . . . --- --- Influenza and pneumonia . . . . . . . . . . . . . . . . . . . 3,592
10 . . . . . . . . . . . . . --- --- Nephritis, nephrotic syndrome and nephrosis 1 . . . . . 3,083
White male
Rank All causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 933,878 All causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,110,956
1. . . . . . . . . . . . . Diseases of heart . . . . . . . . . . . . . . . . . . . . . . . . 364,679 Diseases of heart . . . . . . . . . . . . . . . . . . . . . . . . 275,101
2. . . . . . . . . . . . . Malignant neoplasms . . . . . . . . . . . . . . . . . . . . . . 198,188 Malignant neoplasms . . . . . . . . . . . . . . . . . . . . . . 263,167
3. . . . . . . . . . . . . Unintentional injuries . . . . . . . . . . . . . . . . . . . . . . 62,963 Unintentional injuries . . . . . . . . . . . . . . . . . . . . . . 70,161
4. . . . . . . . . . . . . Cerebrovascular diseases. . . . . . . . . . . . . . . . . . . 60,095 Chronic lower respiratory diseases . . . . . . . . . . . . . 63,757
5. . . . . . . . . . . . . Chronic obstructive pulmonary diseases . . . . . . . . . 35,977 Cerebrovascular diseases. . . . . . . . . . . . . . . . . . . 44,203
6. . . . . . . . . . . . . Pneumonia and influenza . . . . . . . . . . . . . . . . . . . 23,810 Diabetes mellitus 1 . . . . . . . . . . . . . . . . . . . . . . . . 31,745
7. . . . . . . . . . . . . Suicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18,901 Suicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28,943
8. . . . . . . . . . . . . Chronic liver disease and cirrhosis . . . . . . . . . . . . . 16,407 Alzheimer’s disease. . . . . . . . . . . . . . . . . . . . . . . 23,648
9. . . . . . . . . . . . . Diabetes mellitus. . . . . . . . . . . . . . . . . . . . . . . . . 12,125 Influenza and pneumonia . . . . . . . . . . . . . . . . . . . 22,907
10 . . . . . . . . . . . . . Atherosclerosis . . . . . . . . . . . . . . . . . . . . . . . . . . 10,543 Chronic liver disease and cirrhosis . . . . . . . . . . . . . 20,884
Black or African
American male
Rank All causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 130,138 All causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 154,767
1. . . . . . . . . . . . . Diseases of heart . . . . . . . . . . . . . . . . . . . . . . . . 37,877 Diseases of heart . . . . . . . . . . . . . . . . . . . . . . . . 37,096
2. . . . . . . . . . . . . Malignant neoplasms . . . . . . . . . . . . . . . . . . . . . . 25,861 Malignant neoplasms . . . . . . . . . . . . . . . . . . . . . . 34,671
3. . . . . . . . . . . . . Unintentional injuries . . . . . . . . . . . . . . . . . . . . . . 9,701 Unintentional injuries . . . . . . . . . . . . . . . . . . . . . . 9,017
4. . . . . . . . . . . . . Cerebrovascular diseases. . . . . . . . . . . . . . . . . . . 9,194 Cerebrovascular diseases. . . . . . . . . . . . . . . . . . . 7,338
5. . . . . . . . . . . . . Homicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8,274 Homicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6,937
6. . . . . . . . . . . . . Certain conditions originating in the perinatal period. . 3,869 Diabetes mellitus 1 . . . . . . . . . . . . . . . . . . . . . . . . 6,378
7. . . . . . . . . . . . . Pneumonia and influenza . . . . . . . . . . . . . . . . . . . 3,386 Chronic lower respiratory diseases . . . . . . . . . . . . . 5,073
8. . . . . . . . . . . . . Chronic liver disease and cirrhosis . . . . . . . . . . . . . 3,020 Nephritis, nephrotic syndrome and nephrosis 1 . . . . . 3,976
9. . . . . . . . . . . . . Chronic obstructive pulmonary diseases . . . . . . . . . 2,429 Septicemia. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,882
10 . . . . . . . . . . . . . Diabetes mellitus. . . . . . . . . . . . . . . . . . . . . . . . . 2,010 Influenza and pneumonia . . . . . . . . . . . . . . . . . . . 2,696
American Indian
or Alaska Native
male
Rank All causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4,193 All causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9,331
1. . . . . . . . . . . . . Unintentional injuries . . . . . . . . . . . . . . . . . . . . . 946 Diseases of heart . . . . . . . . . . . . . . . . . . . . . . . 1,843
2. . . . . . . . . . . . . Diseases of heart . . . . . . . . . . . . . . . . . . . . . . . 917 Malignant neoplasms . . . . . . . . . . . . . . . . . . . . . 1,650
3. . . . . . . . . . . . . Malignant neoplasms . . . . . . . . . . . . . . . . . . . . . 408 Unintentional injuries . . . . . . . . . . . . . . . . . . . . . 1,177
4. . . . . . . . . . . . . Chronic liver disease and cirrhosis . . . . . . . . . . . 239 Chronic liver disease and cirrhosis . . . . . . . . . . . 511
5. . . . . . . . . . . . . Cerebrovascular diseases . . . . . . . . . . . . . . . . . 163 Diabetes mellitus 1 . . . . . . . . . . . . . . . . . . . . . . . 490
6. . . . . . . . . . . . . Homicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 162 Suicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 401
7. . . . . . . . . . . . . Pneumonia and influenza . . . . . . . . . . . . . . . . . . 148 Chronic lower respiratory diseases . . . . . . . . . . . 370
8. . . . . . . . . . . . . Suicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 147 Cerebrovascular diseases . . . . . . . . . . . . . . . . . 253
9. . . . . . . . . . . . . Certain conditions originating in the perinatal period. . 107 Influenza and pneumonia . . . . . . . . . . . . . . . . . . . 190
10 . . . . . . . . . . . . . Diabetes mellitus. . . . . . . . . . . . . . . . . . . . . . . . . 86 Homicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 187
Asian or Pacific
Islander male
Rank All causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6,809 All causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30,980
1. . . . . . . . . . . . . Diseases of heart . . . . . . . . . . . . . . . . . . . . . . . . 2,174 Malignant neoplasms . . . . . . . . . . . . . . . . . . . . . . 8,071
2. . . . . . . . . . . . . Malignant neoplasms . . . . . . . . . . . . . . . . . . . . . . 1,485 Diseases of heart . . . . . . . . . . . . . . . . . . . . . . . . 7,307
3. . . . . . . . . . . . . Unintentional injuries . . . . . . . . . . . . . . . . . . . . . . 556 Cerebrovascular diseases. . . . . . . . . . . . . . . . . . . 1,897
4. . . . . . . . . . . . . Cerebrovascular diseases. . . . . . . . . . . . . . . . . . . 521 Unintentional injuries . . . . . . . . . . . . . . . . . . . . . . 1,561
5. . . . . . . . . . . . . Pneumonia and influenza . . . . . . . . . . . . . . . . . . . 227 Diabetes mellitus 1 . . . . . . . . . . . . . . . . . . . . . . . . 1,228
6. . . . . . . . . . . . . Suicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 159 Chronic lower respiratory diseases . . . . . . . . . . . . . 1,117
7. . . . . . . . . . . . . Chronic obstructive pulmonary diseases . . . . . . . . . 158 Influenza and pneumonia . . . . . . . . . . . . . . . . . . . 1,011
8. . . . . . . . . . . . . Homicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 151 Suicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 820
9. . . . . . . . . . . . . Certain conditions originating in the perinatal period. . 128 Nephritis, nephrotic syndrome and nephrosis 1 . . . . . 574
10 . . . . . . . . . . . . . Diabetes mellitus. . . . . . . . . . . . . . . . . . . . . . . . . 103 Alzheimer’s disease. . . . . . . . . . . . . . . . . . . . . . . 447
Hispanic or
Latino male
Rank --- --- All causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88,880
1. . . . . . . . . . . . . --- --- Diseases of heart . . . . . . . . . . . . . . . . . . . . . . . . 18,377
2. . . . . . . . . . . . . --- --- Malignant neoplasms . . . . . . . . . . . . . . . . . . . . . . 18,371
3. . . . . . . . . . . . . --- --- Unintentional injuries . . . . . . . . . . . . . . . . . . . . . . 8,760
4. . . . . . . . . . . . . --- --- Diabetes mellitus 1 . . . . . . . . . . . . . . . . . . . . . . . . 3,934
5. . . . . . . . . . . . . --- --- Cerebrovascular diseases. . . . . . . . . . . . . . . . . . . 3,841
6. . . . . . . . . . . . . --- --- Chronic liver disease and cirrhosis . . . . . . . . . . . . . 3,552
7. . . . . . . . . . . . . --- --- Chronic lower respiratory diseases . . . . . . . . . . . . . 2,536
8. . . . . . . . . . . . . --- --- Suicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,279
9. . . . . . . . . . . . . --- --- Homicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,132
10 . . . . . . . . . . . . . --- --- Influenza and pneumonia . . . . . . . . . . . . . . . . . . . 1,816
White female
Rank All causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 804,729 All causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,106,147
1. . . . . . . . . . . . . Diseases of heart . . . . . . . . . . . . . . . . . . . . . . . . 318,668 Diseases of heart . . . . . . . . . . . . . . . . . . . . . . . . 247,544
2. . . . . . . . . . . . . Malignant neoplasms . . . . . . . . . . . . . . . . . . . . . . 169,974 Malignant neoplasms . . . . . . . . . . . . . . . . . . . . . . 234,949
3. . . . . . . . . . . . . Cerebrovascular diseases. . . . . . . . . . . . . . . . . . . 88,639 Chronic lower respiratory diseases . . . . . . . . . . . . . 72,925
4. . . . . . . . . . . . . Unintentional injuries . . . . . . . . . . . . . . . . . . . . . . 27,159 Cerebrovascular diseases. . . . . . . . . . . . . . . . . . . 63,706
5. . . . . . . . . . . . . Pneumonia and influenza . . . . . . . . . . . . . . . . . . . 24,559 Alzheimer’s disease. . . . . . . . . . . . . . . . . . . . . . . 53,739
6. . . . . . . . . . . . . Diabetes mellitus. . . . . . . . . . . . . . . . . . . . . . . . . 16,743 Unintentional injuries . . . . . . . . . . . . . . . . . . . . . . 42,642
7. . . . . . . . . . . . . Atherosclerosis . . . . . . . . . . . . . . . . . . . . . . . . . . 16,526 Diabetes mellitus 1 . . . . . . . . . . . . . . . . . . . . . . . . 27,180
8. . . . . . . . . . . . . Chronic obstructive pulmonary diseases . . . . . . . . . 16,398 Influenza and pneumonia . . . . . . . . . . . . . . . . . . . 26,106
9. . . . . . . . . . . . . Chronic liver disease and cirrhosis . . . . . . . . . . . . . 8,833 Nephritis, nephrotic syndrome and nephrosis 1 . . . . . 18,470
10 . . . . . . . . . . . . . Certain conditions originating in the perinatal period. . 6,512 Septicemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16,287
Black or African
American female
Rank All causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 102,997 All causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 148,202
1. . . . . . . . . . . . . Diseases of heart . . . . . . . . . . . . . . . . . . . . . . . 35,079 Diseases of heart . . . . . . . . . . . . . . . . . . . . . . . 34,914
2. . . . . . . . . . . . . Malignant neoplasms . . . . . . . . . . . . . . . . . . . . . 19,176 Malignant neoplasms . . . . . . . . . . . . . . . . . . . . . 33,282
3. . . . . . . . . . . . . Cerebrovascular diseases . . . . . . . . . . . . . . . . . 10,941 Cerebrovascular diseases . . . . . . . . . . . . . . . . . 8,931
4. . . . . . . . . . . . . Unintentional injuries . . . . . . . . . . . . . . . . . . . . . 3,779 Diabetes mellitus 1 . . . . . . . . . . . . . . . . . . . . . . . 7,007
5. . . . . . . . . . . . . Diabetes mellitus . . . . . . . . . . . . . . . . . . . . . . . . 3,534 Chronic lower respiratory diseases . . . . . . . . . . . 4,845
6. . . . . . . . . . . . . Certain conditions originating in the perinatal period. . 3,092 Nephritis, nephrotic syndrome and nephrosis 1 . . . . . 4,417
7. . . . . . . . . . . . . Pneumonia and influenza . . . . . . . . . . . . . . . . . . . 2,262 Unintentional injuries . . . . . . . . . . . . . . . . . . . . . . 4,396
8. . . . . . . . . . . . . Homicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,898 Alzheimer’s disease. . . . . . . . . . . . . . . . . . . . . . . 4,050
9. . . . . . . . . . . . . Chronic liver disease and cirrhosis . . . . . . . . . . . . . 1,770 Septicemia. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,368
10 . . . . . . . . . . . . . Nephritis, nephrotic syndrome and nephrosis . . . . . . 1,722 Essential hypertension and hypertensive renal
disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,959
American Indian
or Alaska
Native female
Rank All causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,730 All causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7,721
1. . . . . . . . . . . . . Diseases of heart . . . . . . . . . . . . . . . . . . . . . . . 577 Malignant neoplasms . . . . . . . . . . . . . . . . . . . . . 1,459
2. . . . . . . . . . . . . Malignant neoplasms . . . . . . . . . . . . . . . . . . . . . 362 Diseases of heart . . . . . . . . . . . . . . . . . . . . . . . 1,296
3. . . . . . . . . . . . . Unintentional injuries . . . . . . . . . . . . . . . . . . . . . 344 Unintentional injuries . . . . . . . . . . . . . . . . . . . . . 656
4. . . . . . . . . . . . . Chronic liver disease and cirrhosis . . . . . . . . . . . 171 Diabetes mellitus 1 . . . . . . . . . . . . . . . . . . . . . . . 469
5. . . . . . . . . . . . . Cerebrovascular diseases . . . . . . . . . . . . . . . . . 159 Chronic liver disease and cirrhosis . . . . . . . . . . . 433
6. . . . . . . . . . . . . Diabetes mellitus . . . . . . . . . . . . . . . . . . . . . . . . 124 Chronic lower respiratory diseases . . . . . . . . . . . 387
7. . . . . . . . . . . . . Pneumonia and influenza . . . . . . . . . . . . . . . . . . 109 Cerebrovascular diseases . . . . . . . . . . . . . . . . . 342
8. . . . . . . . . . . . . Certain conditions originating in the perinatal period. . 92 Influenza and pneumonia . . . . . . . . . . . . . . . . . . . 185
9. . . . . . . . . . . . . Nephritis, nephrotic syndrome and nephrosis . . . . . . 56 Alzheimer’s disease. . . . . . . . . . . . . . . . . . . . . . . 161
10 . . . . . . . . . . . . . Homicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55 Nephritis, nephrotic syndrome and nephrosis 1 . . . . . 159
Asian or Pacific
Islander female
Rank All causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4,262 All causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28,889
1. . . . . . . . . . . . . Diseases of heart . . . . . . . . . . . . . . . . . . . . . . . . 1,091 Malignant neoplasms . . . . . . . . . . . . . . . . . . . . . . 7,632
2. . . . . . . . . . . . . Malignant neoplasms . . . . . . . . . . . . . . . . . . . . . . 1,037 Diseases of heart . . . . . . . . . . . . . . . . . . . . . . . . 6,004
3. . . . . . . . . . . . . Cerebrovascular diseases. . . . . . . . . . . . . . . . . . . 507 Cerebrovascular diseases. . . . . . . . . . . . . . . . . . . 2,308
4. . . . . . . . . . . . . Unintentional injuries . . . . . . . . . . . . . . . . . . . . . . 254 Diabetes mellitus 1 . . . . . . . . . . . . . . . . . . . . . . . . 1,081
5. . . . . . . . . . . . . Diabetes mellitus. . . . . . . . . . . . . . . . . . . . . . . . . 124 Influenza and pneumonia . . . . . . . . . . . . . . . . . . . 1,013
6. . . . . . . . . . . . . Certain conditions originating in the perinatal period. . 118 Alzheimer’s disease. . . . . . . . . . . . . . . . . . . . . . . 981
7. . . . . . . . . . . . . Pneumonia and influenza . . . . . . . . . . . . . . . . . . . 115 Unintentional injuries . . . . . . . . . . . . . . . . . . . . . . 947
8. . . . . . . . . . . . . Congenital anomalies. . . . . . . . . . . . . . . . . . . . . . 104 Chronic lower respiratory diseases . . . . . . . . . . . . . 731
9. . . . . . . . . . . . . Suicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90 Nephritis, nephrotic syndrome and nephrosis 1 . . . . . 573
10 . . . . . . . . . . . . . Homicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60 Essential hypertension and hypertensive renal
disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 550
Hispanic or
Latina female
Rank --- --- All causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74,361
1. . . . . . . . . . . . . --- --- Malignant neoplasms . . . . . . . . . . . . . . . . . . . . . . 16,776
2. . . . . . . . . . . . . --- --- Diseases of heart . . . . . . . . . . . . . . . . . . . . . . . . 14,866
3. . . . . . . . . . . . . --- --- Cerebrovascular diseases. . . . . . . . . . . . . . . . . . . 4,286
4. . . . . . . . . . . . . --- --- Diabetes mellitus 1 . . . . . . . . . . . . . . . . . . . . . . . . 3,698
5. . . . . . . . . . . . . --- --- Unintentional injuries . . . . . . . . . . . . . . . . . . . . . . 3,255
6. . . . . . . . . . . . . --- --- Alzheimer’s disease. . . . . . . . . . . . . . . . . . . . . . . 2,829
7. . . . . . . . . . . . . --- --- Chronic lower respiratory diseases . . . . . . . . . . . . . 2,291
8. . . . . . . . . . . . . --- --- Influenza and pneumonia . . . . . . . . . . . . . . . . . . . 1,776
9. . . . . . . . . . . . . --- --- Chronic liver disease and cirrhosis . . . . . . . . . . . . . 1,589
10 . . . . . . . . . . . . . --- --- Nephritis, nephrotic syndrome and nephrosis 1 . . . . . 1,500
- - - Data not available. Complete coverage of all states for the Hispanic origin variable began in 1997.
1
Starting with 2011 data, the rules for selecting Renal failure as the underlying cause of death were changed, affecting the number of deaths in the Nephritis, nephrotic
syndrome and nephrosis and Diabetes categories. These changes directly affect deaths with mention of Renal failure and other associated conditions, such as
Diabetes mellitus with renal complications. The result is a decrease in the number of deaths for Nephritis, nephrotic syndrome and nephrosis and an increase in the
number of deaths for Diabetes mellitus. Therefore, trend data for these two causes of death should be interpreted with caution. For more information, see Technical
Notes in Deaths: Preliminary data for 2011, available from: http://www.cdc.gov/nchs/data/nvsr/nvsr61/nvsr61_06.pdf.
NOTES: For cause of death codes based on the International Classification of Diseases, 9th Revision (ICD–9) in 1980 and ICD–10 in 2013, see Appendix II, Cause of
death; Table III; Table IV. Starting with 2003 data, some states allowed the reporting of more than one race on the death certificate. The multiple-race data for these
states were bridged to the single-race categories of the 1977 Office of Management and Budget standards, for comparability with other states. The race groups, white,
black, Asian or Pacific Islander, and American Indian or Alaska Native, include persons of Hispanic and non-Hispanic origin. Persons of Hispanic origin may be of any
race. See Appendix II, Race; Hispanic origin.
SOURCE: CDC/NCHS, National Vital Statistics System: Vital statistics of the United States, vol II, mortality, part A, 1980. Washington, DC: Public Health Service. 1985.
Public-use 2013 Mortality File. Leading causes of death, Tables LCWK3 and LCWK4. 2013. Available from: http://www.cdc.gov/nchs/nvss/mortality_tables.htm#lcod. See
Appendix I, National Vital Statistics System (NVSS).
1980 2013 1
Age and
rank order Cause of death Deaths Cause of death Deaths
Under 1 year
Rank All causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45,526 All causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23,440
1. . . . . . . . . . . . . Congenital anomalies. . . . . . . . . . . . . . . . . . . . . 9,220 Congenital malformations, deformations and
chromosomal abnormalities. . . . . . . . . . . . . . . . 4,758
2. . . . . . . . . . . . . Sudden infant death syndrome . . . . . . . . . . . . . . 5,510 Disorders related to short gestation and low
birthweight, not elsewhere classified . . . . . . . . . 4,202
3. . . . . . . . . . . . . Respiratory distress syndrome . . . . . . . . . . . . . . 4,989 Newborn affected by maternal complications
of pregnancy . . . . . . . . . . . . . . . . . . . . . . . . . . 1,595
4. . . . . . . . . . . . . Disorders relating to short gestation and
unspecified low birthweight . . . . . . . . . . . . . . . . 3,648 Sudden infant death syndrome . . . . . . . . . . . . . . 1,563
5. . . . . . . . . . . . . Newborn affected by maternal complications
of pregnancy . . . . . . . . . . . . . . . . . . . . . . . . . . 1,572 Unintentional injuries . . . . . . . . . . . . . . . . . . . .. 1,156
6. . . . . . . . . . . . . Intrauterine hypoxia and birth asphyxia . . . . . . . . 1,497 Newborn affected by complications of placenta,
cord and membranes . . . . . . . . . . . . . . . . . . .. 953
7. . . . . . . . . . . . . Unintentional injuries . . . . . . . . . . . . . . . . . . . . . 1,166 Bacterial sepsis of newborn . . . . . . . . . . . . . . .. 578
8. . . . . . . . . . . . . Birth trauma . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,058 Respiratory distress of newborn . . . . . . . . . . . .. 522
9. . . . . . . . . . . . . Pneumonia and influenza . . . . . . . . . . . . . . . . . . 1,012 Diseases of circulatory system . . . . . . . . . . . . .. 458
10 . . . . . . . . . . . . . Newborn affected by complications of placenta,
cord, and membranes . . . . . . . . . . . . . . . . . . . 985 Neonatal hemorrhage. . . . . . . . . . . . . . . . . . . . . 389
1–4 years
Rank All causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8,187 All causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4,068
1. . . . . . . . . . . . . Unintentional injuries . . . . . . . . . . . . . . . . . . . . . 3,313 Unintentional injuries . . . . . . . . . . . . . . . . . . . . . 1,316
2. . . . . . . . . . . . . Congenital anomalies. . . . . . . . . . . . . . . . . . . . . 1,026 Congenital malformations, deformations and
chromosomal abnormalities . . . . . . . . . . . . . . . . 476
3. . . . . . . . . . . . . Malignant neoplasms . . . . . . . . . . . . . . . . . . . . . 573 Homicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 337
4. . . . . . . . . . . . . Diseases of heart . . . . . . . . . . . . . . . . . . . . . . . 338 Malignant neoplasms . . . . . . . . . . . . . . . . . . . . . 328
5. . . . . . . . . . . . . Homicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 319 Diseases of heart . . . . . . . . . . . . . . . . . . . . . . . 169
6. . . . . . . . . . . . . Pneumonia and influenza . . . . . . . . . . . . . . . . . . 267 Influenza and pneumonia . . . . . . . . . . . . . . . . . . 102
7. . . . . . . . . . . . . Meningitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 223 Chronic lower respiratory diseases . . . . . . . . . . . 64
8. . . . . . . . . . . . . Meningococcal infection . . . . . . . . . . . . . . . . . . . 110 Septicemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
9. . . . . . . . . . . . . Certain conditions originating in the perinatal period. . 84 In situ neoplasms, benign neoplasms and
neoplasms of uncertain or unknown behavior . . . . . 47
10 . . . . . . . . . . . . . Septicemia. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71 Certain conditions originating in the perinatal period. . 45
5–14 years
Rank All causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10,689 All causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5,340
1. . . . . . . . . . . . . Unintentional injuries . . . . . . . . . . . . . . . . . . . . . 5,224 Unintentional injuries . . . . . . . . . . . . . . . . . . . . . 1,521
2. . . . . . . . . . . . . Malignant neoplasms . . . . . . . . . . . . . . . . . . . . . 1,497 Malignant neoplasms . . . . . . . . . . . . . . . . . . . . . 895
3. . . . . . . . . . . . . Congenital anomalies. . . . . . . . . . . . . . . . . . . . . 561 Suicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 395
4. . . . . . . . . . . . . Homicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 415 Congenital malformations, deformations and
chromosomal abnormalities. . . . . . . . . . . . . . . . 340
5. . . . . . . . . . . . . Diseases of heart . . . . . . . . . . . . . . . . . . . . . . . 330 Homicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 277
6. . . . . . . . . . . . . Pneumonia and influenza . . . . . . . . . . . . . . . . . . 194 Diseases of heart . . . . . . . . . . . . . . . . . . . . . . . 173
7. . . . . . . . . . . . . Suicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 142 Chronic lower respiratory diseases . . . . . . . . . . . 155
8. . . . . . . . . . . . . Benign neoplasms . . . . . . . . . . . . . . . . . . . . . . . 104 Influenza and pneumonia . . . . . . . . . . . . . . . . . . 128
9. . . . . . . . . . . . . Cerebrovascular diseases . . . . . . . . . . . . . . . . . 95 Cerebrovascular diseases . . . . . . . . . . . . . . . . . 89
In situ neoplasms, benign neoplasms and
10 . . . . . . . . . . . . . Chronic obstructive pulmonary diseases . . . . . . . 85 neoplasms of uncertain or unknown behavior . . . 65
15–24 years
Rank All causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49,027 All causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28,486
1. . . . . . . . . . . . . Unintentional injuries . . . . . . . . . . . . . . . . . . . . . 26,206 Unintentional injuries . . . . . . . . . . . . . . . . . . . . . 11,619
2. . . . . . . . . . . . . Homicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6,537 Suicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4,878
3. . . . . . . . . . . . . Suicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5,239 Homicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4,329
4. . . . . . . . . . . . . Malignant neoplasms . . . . . . . . . . . . . . . . . . . . . 2,683 Malignant neoplasms . . . . . . . . . . . . . . . . . . . . . 1,496
5. . . . . . . . . . . . . Diseases of heart . . . . . . . . . . . . . . . . . . . . . . . 1,223 Diseases of heart . . . . . . . . . . . . . . . . . . . . . . . 941
6. . . . . . . . . . . . . Congenital anomalies. . . . . . . . . . . . . . . . . . . . . 600 Congenital malformations, deformations and
chromosomal abnormalities. . . . . . . . . . . . . . . . 362
7. . . . . . . . . . . . . Cerebrovascular diseases . . . . . . . . . . . . . . . . . 418 Influenza and pneumonia . . . . . . . . . . . . . . . . . . 197
8. . . . . . . . . . . . . Pneumonia and influenza . . . . . . . . . . . . . . . . . . 348 Diabetes mellitus 1 . . . . . . . . . . . . . . . . . . . . . . . 193
9. . . . . . . . . . . . . Chronic obstructive pulmonary diseases . . . . . . . 141 Pregnancy, childbirth, and the puerperium . . . . . . 178
10 . . . . . . . . . . . . . Anemias . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133 Chronic lower respiratory diseases . . . . . . . . . . . 155
1980 2013 1
Age and
rank order Cause of death Deaths Cause of death Deaths
25–44 years
Rank All causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 108,658 All causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115,036
1. . . . . . . . . . . .. Unintentional injuries . . . . . . . . . . . . . . . . . . . . . 26,722 Unintentional injuries . . . . . . . . . . . . . . . . . . . . . 31,563
2. . . . . . . . . . . .. Malignant neoplasms . . . . . . . . . . . . . . . . . . . . . 17,551 Malignant neoplasms . . . . . . . . . . . . . . . . . . . . . 15,022
3. . . . . . . . . . . .. Diseases of heart . . . . . . . . . . . . . . . . . . . . . . . 14,513 Diseases of heart . . . . . . . . . . . . . . . . . . . . . . . 13,599
4. . . . . . . . . . . .. Homicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10,983 Suicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12,899
5. . . . . . . . . . . .. Suicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9,855 Homicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6,817
6. . . . . . . . . . . .. Chronic liver disease and cirrhosis . . . . . . . . . . . 4,782 Chronic liver disease and cirrhosis . . . . . . . . . . . 3,167
7. . . . . . . . . . . .. Cerebrovascular diseases . . . . . . . . . . . . . . . . . 3,154 Diabetes mellitus 1 . . . . . . . . . . . . . . . . . . . . . . . 2,636
8. . . . . . . . . . . .. Diabetes mellitus . . . . . . . . . . . . . . . . . . . . . . . . 1,472 Cerebrovascular diseases . . . . . . . . . . . . . . . . . 2,195
9. . . . . . . . . . . .. Pneumonia and influenza . . . . . . . . . . . . . . . . . . 1,467 Human immunodeficiency virus (HIV) disease . . . 1,877
10 . . . . . . . . . . . .. Congenital anomalies. . . . . . . . . . . . . . . . . . . . . 817 Influenza and pneumonia . . . . . . . . . . . . . . . . . . 1,330
45–64 years
Rank All causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 425,338 All causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 515,851
1. . . . ......... Diseases of heart . . . . . . . . . . . . . . . . . . . . . . . 148,322 Malignant neoplasms . . . . . . . . . . . . . . . . . . . . . 159,509
2. . . . ......... Malignant neoplasms . . . . . . . . . . . . . . . . . . . . . 135,675 Diseases of heart . . . . . . . . . . . . . . . . . . . . . . . 107,735
3. . . . ......... Cerebrovascular diseases . . . . . . . . . . . . . . . . . 19,909 Unintentional injuries . . . . . . . . . . . . . . . . . . . . . 37,414
4. . . . ......... Unintentional injuries . . . . . . . . . . . . . . . . . . . . . 18,140 Chronic liver disease and cirrhosis . . . . . . . . . . . 20,736
5. . . . ......... Chronic liver disease and cirrhosis . . . . . . . . . . . 16,089 Chronic lower respiratory diseases . . . . . . . . . . . 20,561
6. . . . ......... Chronic obstructive pulmonary diseases . . . . . . . 11,514 Diabetes mellitus 1 . . . . . . . . . . . . . . . . . . . . . . . 18,960
7. . . . ......... Diabetes mellitus . . . . . . . . . . . . . . . . . . . . . . . . 7,977 Cerebrovascular diseases . . . . . . . . . . . . . . . . . 16,789
8. . . . ......... Suicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7,079 Suicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15,756
9. . . . ......... Pneumonia and influenza . . . . . . . . . . . . . . . . . . 5,804 Septicemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7,790
10 . . . . ......... Homicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4,019 Influenza and pneumonia . . . . . . . . . . . . . . . . . . 7,012
65 years
and over
Rank All causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,341,848 All causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,904,640
1. . . . . ........ Diseases of heart . . . . . . . . . . . . . . . . . . . . . . . 595,406 Diseases of heart . . . . . . . . . . . . . . . . . . . . . . . 488,156
2. . . . . ........ Malignant neoplasms . . . . . . . . . . . . . . . . . . . . . 258,389 Malignant neoplasms . . . . . . . . . . . . . . . . . . . . . 407,558
3. . . . . ........ Cerebrovascular diseases . . . . . . . . . . . . . . . . . 146,417 Chronic lower respiratory diseases . . . . . . . . . . . 127,194
4. . . . . ........ Pneumonia and influenza . . . . . . . . . . . . . . . . . . 45,512 Cerebrovascular diseases . . . . . . . . . . . . . . . . . 109,602
5. . . . . ........ Chronic obstructive pulmonary diseases . . . . . . . 43,587 Alzheimer’s disease . . . . . . . . . . . . . . . . . . . . . . 83,786
6. . . . . ........ Atherosclerosis . . . . . . . . . . . . . . . . . . . . . . . . . 28,081 Diabetes mellitus 1 . . . . . . . . . . . . . . . . . . . . . . . 53,751
7. . . . . ........ Diabetes mellitus . . . . . . . . . . . . . . . . . . . . . . . . 25,216 Influenza and pneumonia . . . . . . . . . . . . . . . . . . 48,031
8. . . . . ........ Unintentional injuries . . . . . . . . . . . . . . . . . . . . . 24,844 Unintentional injuries . . . . . . . . . . . . . . . . . . . . . 45,942
9. . . . . ........ Nephritis, nephrotic syndrome, and nephrosis. . . . 12,968 Nephritis, nephrotic syndrome and nephrosis 1 . . . 39,080
10 . . . . . ........ Chronic liver disease and cirrhosis . . . . . . . . . . . 9,519 Septicemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28,815
1
Starting with 2011 data, the rules for selecting Renal failure as the underlying cause of death were changed, affecting the number of deaths in the Nephritis, nephrotic
syndrome and nephrosis and Diabetes categories. These changes directly affect deaths with mention of Renal failure and other associated conditions, such as
Diabetes mellitus with renal complications. The result is a decrease in the number of deaths for Nephritis, nephrotic syndrome and nephrosis and an increase in the
number of deaths for Diabetes mellitus. Therefore, trend data for these two causes of death should be interpreted with caution. For more information, see Technical
Notes in Deaths: Preliminary data for 2011, available from: http://www.cdc.gov/nchs/data/nvsr/nvsr61/nvsr61_06.pdf.
NOTE: For cause of death codes based on the International Classification of Diseases, 9th Revision (ICD–9) in 1980 and ICD–10 in 2013, see Appendix II, Cause of
death; Table III; Table IV.
SOURCE: CDC/NCHS, National Vital Statistics System: Vital statistics of the United States, vol II, mortality, part A, 1980. Washington, DC: Public Health Service. 1985.
Public-use 2013 Mortality File. Xu JQ, Murphy SL, Kochanek KD, et al. Deaths: Final data for 2013. National vital statistics reports; vol 64 no 2. Hyattsville, MD: NCHS;
2015. Available from: http://www.cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_02.pdf. Leading causes of death, Table LCWK2. 2013. Available from:
http://www.cdc.gov/nchs/nvss/mortality_tables.htm#lcod. See Appendix I, National Vital Statistics System (NVSS).
Small . . . . . . . . . . . . . . . . . . . 887.8 887.9 782.2 866.5 868.8 773.2 1,173.1 1,164.3 938.0
Nonmetropolitan counties:
Micropolitan. . . . . . . . . ...... 913.0 907.1 819.1 892.1 890.0 810.5 1,208.2 1,174.9 979.1
Nonmicropolitan . . . . . . ...... 933.0 923.2 843.1 909.6 902.8 830.4 1,191.6 1,162.8 961.9
Northeast:
Metropolitan counties:
Large:
Central. . . . . . . . . . . . . . . . . 909.6 861.7 681.9 881.4 838.6 691.7 1,052.4 1,001.1 748.0
Fringe . . . . . . . . . . . . . . . . . 827.8 814.0 664.0 823.3 810.8 673.5 1,000.0 986.6 720.6
Medium. . . . . . . . . . . . . . . . . . 851.9 836.2 709.5 842.2 828.6 711.0 1,076.6 1,040.8 778.0
Small . . . . . . . . . . . . . . . . . . . 852.0 849.5 736.3 847.8 846.5 737.1 1,106.9 1,072.4 836.2
Nonmetropolitan counties:
Micropolitan. . . . . . . . . ...... 878.4 854.4 755.8 877.9 855.7 759.7 * * *
Nonmicropolitan . . . . . . ...... 893.6 877.4 765.1 892.0 876.3 768.4 * * *
Midwest:
Metropolitan counties:
Large:
Central. . . . . . . . . . . . . . . . . 951.7 939.6 781.6 880.7 868.9 735.8 1,213.7 1,205.9 960.4
Fringe . . . . . . . . . . . . . . . . . 856.4 856.1 720.4 845.9 846.3 718.0 1,121.2 1,123.1 873.4
Medium. . . . . . . . . . . . . . . . . . 876.1 873.5 768.0 857.0 856.1 755.8 1,168.9 1,151.6 963.3
Small . . . . . . . . . . . . . . . . . . . 860.8 861.5 760.2 847.4 850.8 752.7 1,178.9 1,146.9 952.5
Nonmetropolitan counties:
Micropolitan. . . . . . . . . ...... 868.8 865.2 786.8 863.9 863.0 786.9 1,222.0 1,103.5 842.4
Nonmicropolitan . . . . . . ...... 867.6 852.7 779.3 858.2 845.9 773.0 1,388.1 1,058.9 699.6
South:
Metropolitan counties:
Large:
Central. . . . . . . . . . . . . . . . . 938.1 926.8 746.4 864.9 859.1 710.5 1,241.9 1,212.8 922.3
Fringe . . . . . . . . . . . . . . . . . 845.3 845.6 697.1 821.9 826.2 701.3 1,071.4 1,048.4 755.8
Medium. . . . . . . . . . . . . . . . . . 891.8 892.4 769.9 852.1 855.8 752.6 1,172.6 1,164.4 913.7
Small . . . . . . . . . . . . . . . . . . . 943.6 950.5 842.4 907.5 917.9 829.8 1,183.2 1,180.0 951.7
Nonmetropolitan counties:
Micropolitan. . . . . . . . . ...... 974.1 973.3 885.5 933.5 939.3 868.3 1,218.9 1,194.3 1,012.4
Nonmicropolitan . . . . . . ...... 1,005.3 1,003.0 925.8 975.9 978.5 919.2 1,188.4 1,171.2 983.7
West:
Metropolitan counties:
Large:
Central. . . . . . . . . . . . . . . . . 819.2 792.4 629.6 829.4 804.1 656.1 1,107.9 1,077.7 827.5
Fringe . . . . . . . . . . . . . . . . . 818.6 803.6 652.0 823.2 810.1 667.9 1,060.8 1,006.2 786.2
Medium. . . . . . . . . . . . . . . . . . 814.7 800.5 686.3 826.9 815.8 705.9 1,045.4 996.3 790.1
Small . . . . . . . . . . . . . . . . . . . 827.6 815.7 714.9 826.6 815.7 719.0 973.5 990.7 698.2
Nonmetropolitan counties:
Micropolitan. . . . . . . . . ...... 861.0 851.8 752.3 860.4 854.7 760.4 * * *
Nonmicropolitan . . . . . . ...... 867.1 847.4 749.2 845.9 828.6 724.7 * * *
Small . . . . . . . . . . . . . . . . . . . 1,104.6 1,079.2 919.9 1,077.4 1,056.1 908.7 1,497.6 1,449.1 1,124.3
Nonmetropolitan counties:
Micropolitan. . . . . . . . . ...... 1,139.9 1,108.6 962.5 1,113.5 1,087.5 951.0 1,547.8 1,475.9 1,184.5
Nonmicropolitan . . . . . . ...... 1,172.3 1,132.9 985.9 1,143.3 1,108.3 970.6 1,529.0 1,457.3 1,159.1
Northeast:
Metropolitan counties:
Large:
Central. . . . . . . . . . . . . . . . . 1,142.0 1,065.3 826.3 1,102.8 1,034.5 834.8 1,374.4 1,280.7 933.1
Fringe . . . . . . . . . . . . . . . . . 1,018.1 985.3 788.0 1,012.6 982.3 800.6 1,263.0 1,219.0 868.0
Medium. . . . . . . . . . . . . . . . . . 1,061.6 1,018.1 843.2 1,049.9 1,009.7 845.7 1,351.2 1,262.4 923.4
Small . . . . . . . . . . . . . . . . . . . 1,062.7 1,034.1 870.3 1,057.9 1,032.3 873.6 1,376.8 1,280.7 939.0
Nonmetropolitan counties:
Micropolitan. . . . . . . . . ...... 1,093.5 1,042.5 890.8 1,093.7 1,045.6 897.7 * * *
Nonmicropolitan . . . . . . ...... 1,096.9 1,056.9 893.3 1,096.1 1,056.6 899.3 * * *
Midwest:
Metropolitan counties:
Large:
Central. . . . . . . . . . . . . . . . . 1,192.6 1,155.5 938.9 1,101.0 1,064.6 876.7 1,559.8 1,525.5 1,201.6
Fringe . . . . . . . . . . . . . . . . . 1,051.7 1,030.0 839.8 1,038.7 1,018.7 836.0 1,399.4 1,372.7 1,054.0
Medium. . . . . . . . . . . . . . . . . . 1,089.0 1,063.2 902.6 1,065.3 1,043.8 887.6 1,470.0 1,394.4 1,158.6
Small . . . . . . . . . . . . . . . . . . . 1,076.0 1,057.3 896.2 1,059.7 1,045.0 888.3 1,463.9 1,401.9 1,117.0
Nonmetropolitan counties:
Micropolitan. . . . . . . . . ...... 1,092.0 1,063.4 928.1 1,086.0 1,062.0 929.6 1,551.8 1,315.8 960.9
Nonmicropolitan . . . . . . ...... 1,094.7 1,050.5 919.6 1,083.0 1,043.3 913.6 1,788.2 1,225.3 807.0
South:
Metropolitan counties:
Large:
Central. . . . . . . . . . . . . . . . . 1,172.0 1,130.9 892.0 1,074.6 1,042.9 845.6 1,616.0 1,542.6 1,139.3
Fringe . . . . . . . . . . . . . . . . . 1,030.8 1,009.7 816.3 1,000.5 984.8 817.8 1,351.1 1,297.8 921.0
Medium. . . . . . . . . . . . . . . . . . 1,106.6 1,081.2 907.0 1,053.0 1,033.8 882.5 1,517.1 1,466.2 1,121.7
Small . . . . . . . . . . . . . . . . . . . 1,185.9 1,160.8 993.9 1,138.6 1,118.6 975.9 1,526.9 1,487.0 1,156.6
Nonmetropolitan counties:
Micropolitan. . . . . . . . . ...... 1,228.0 1,198.9 1,042.1 1,175.1 1,154.7 1,016.4 1,577.6 1,519.8 1,247.0
Nonmicropolitan . . . . . . ...... 1,275.7 1,240.6 1,082.3 1,239.3 1,210.2 1,070.4 1,530.4 1,478.0 1,196.8
West:
Metropolitan counties:
Large:
Central. . . . . . . . . . . . . . . . . 996.3 949.8 742.6 1,006.7 962.4 770.3 1,383.8 1,323.2 982.3
Fringe . . . . . . . . . . . . . . . . . 981.1 947.0 764.9 988.0 954.5 781.3 1,228.8 1,171.2 919.7
Medium. . . . . . . . . . . . . . . . . . 987.4 952.8 804.4 1,003.1 969.3 820.7 1,230.6 1,165.1 912.9
Small . . . . . . . . . . . . . . . . . . . 1,003.7 970.5 833.2 1,001.7 971.6 837.4 1,178.9 1,088.1 798.2
Nonmetropolitan counties:
Micropolitan. . . . . . . . . ...... 1,037.8 1,012.6 877.2 1,036.0 1,013.6 882.9 * * *
Nonmicropolitan . . . . . . ...... 1,048.7 1,010.9 863.3 1,023.0 986.8 834.1 * * *
Small . . . . . . . . . . . . . . . . . . . 731.2 745.7 668.1 713.7 729.1 660.0 951.9 966.5 795.7
Nonmetropolitan counties:
Micropolitan. . . . . . . . . . . . . . . 745.9 754.8 696.7 728.8 740.2 689.8 975.6 968.3 822.0
Nonmicropolitan . . . . . . . . . . . . 750.6 759.5 716.9 731.4 741.9 705.7 951.5 953.0 813.7
Northeast:
Metropolitan counties:
Large:
Central. . . . . . . . . . . . . . . . . 748.4 719.6 574.4 725.6 699.1 580.9 848.3 823.6 625.7
Fringe . . . . . . . . . . . . . . . . . 696.3 692.6 568.1 692.4 689.3 574.5 827.2 828.1 616.9
Medium. . . . . . . . . . . . . . . . . . 709.1 707.5 604.2 701.4 700.9 604.7 883.4 877.0 664.6
Small . . . . . . . . . . . . . . . . . . . 706.7 717.3 627.5 703.2 713.8 626.9 919.9 930.0 741.1
Nonmetropolitan counties:
Micropolitan. . . . . . . . . . . . . . . 725.0 717.5 642.6 724.3 718.1 644.5 * * *
Nonmicropolitan . . . . . . . . . . . . 741.8 738.5 652.4 740.1 737.4 654.0 * * *
Midwest:
Metropolitan counties:
Large:
Central. . . . . . . . . . . . . . . . . 784.1 786.2 660.4 729.7 730.9 625.2 974.4 984.5 789.1
Fringe . . . . . . . . . . . . . . . . . 722.9 733.8 625.2 714.5 725.1 623.3 924.6 948.2 742.6
Medium. . . . . . . . . . . . . . . . . . 728.9 739.6 660.4 713.6 724.3 650.1 955.1 972.7 813.9
Small . . . . . . . . . . . . . . . . . . . 710.8 721.4 650.9 700.0 712.2 643.9 963.1 952.5 819.2
Nonmetropolitan counties:
Micropolitan. . . . . . . . . . . . . . . 711.2 721.2 670.5 707.3 718.6 669.7 998.7 948.8 745.9
Nonmicropolitan . . . . . . . . . . . . 696.1 700.0 657.8 688.9 693.9 651.5 1,123.8 955.4 627.6
South:
Metropolitan counties:
Large:
Central. . . . . . . . . . . . . . . . . 768.6 776.3 632.0 712.1 721.7 601.4 988.2 989.8 769.7
Fringe . . . . . . . . . . . . . . . . . 705.7 719.6 599.8 686.1 702.4 603.4 882.4 881.0 641.1
Medium. . . . . . . . . . . . . . . . . . 731.2 746.6 654.9 700.1 716.0 641.2 938.9 958.2 761.5
Small . . . . . . . . . . . . . . . . . . . 771.0 795.0 717.8 740.9 767.1 707.1 956.5 974.2 801.9
Nonmetropolitan counties:
Micropolitan. . . . . . . . . . . . . . . 788.4 803.8 752.0 754.8 774.5 739.4 977.3 975.7 839.4
Nonmicropolitan . . . . . . . . . . . . 803.4 821.3 789.3 778.3 799.5 784.4 946.7 955.0 825.4
West:
Metropolitan counties:
Large:
Central. . . . . . . . . . . . . . . . . 682.6 670.1 535.8 691.8 679.9 559.2 906.0 899.3 703.2
Fringe . . . . . . . . . . . . . . . . . 696.3 693.8 559.9 699.2 699.1 574.2 920.1 876.5 674.4
Medium. . . . . . . . . . . . . . . . . . 680.5 681.3 586.5 691.6 696.1 607.0 890.3 855.7 678.9
Small . . . . . . . . . . . . . . . . . . . 687.3 691.3 610.7 687.2 690.7 614.5 789.8 886.6 584.9
Nonmetropolitan counties:
Micropolitan. . . . . . . . . . . . . . . 712.6 715.1 638.1 713.8 720.0 647.5 * * *
Nonmicropolitan . . . . . . . . . . . . 710.4 704.0 637.3 694.2 690.7 617.4 * * *
* Estimates of death rates for the black population in nonmetropolitan counties in the Northeast and West may be unreliable, possibly due to anomalies in population
estimates for the black population in nonmetropolitan counties in these regions.
1
Urbanization levels are for county of residence of decedent. The levels were developed by NCHS using information from the Office of Management and Budget,
Department of Agriculture, and Census Bureau. More information on this six-level 2006 Urban-Rural Classification Scheme for Counties is available from:
http://www.cdc.gov/nchs/data_access/urban_rural.htm. See Appendix II, Urbanization. NCHS has updated the 2006 Urban-Rural classification scheme using the Office
of Management and Budget’s (OMB) February 2013 delineation of metropolitan statistical areas and micropolitan statistical areas. To maintain the consistency of trends
shown in this table, all counties are classified according to the 2006 scheme. Comparison of the 2013 and 2006 NCHS urban-rural classification scheme showed that
9% of counties had different category assignments in the two schemes, with most of the counties moving to a more urban category. For more information on the 2013
scheme, see: Ingram DD, Franco SJ. 2013 NCHS urban-rural classification scheme for counties. National Center for Health Statistics. Vital Health Stat 2(166). 2014.
Available from: http://www.cdc.gov/nchs/data/series/sr_02/sr02_166.pdf.
2
Age-adjusted rates are calculated using the year 2000 standard population. Prior to 2009, age-adjusted rates were calculated using standard million proportions based
on rounded population numbers. Starting with 2009 data (shown in spreadsheet version), unrounded population numbers are used to calculate age-adjusted rates. See
Appendix II, Age adjustment. Prior to 2009–2011, denominators for rates are resident population estimates for the middle year of each 3-year period, multiplied by 3. Starting
with 2009–2011 (shown in spreadsheet version), denominators for rates are the 3-year average population. See Appendix I, Population Census and Population Estimates.
NOTES: The race groups, white and black, include persons of Hispanic and non-Hispanic origin. Starting with 2003 data, some states allowed the reporting of more
than one race on the death certificate. The multiple-race data for these states were bridged to the single-race categories of the 1977 Office of Management and Budget
standards, for comparability with other states. See Appendix II, Hispanic origin; Race. Rates for 1999–2001 were calculated using intercensal 1999 population
estimates, 2000 bridged-race April 1 census counts, and postcensal population estimates for 2001. Rates for 2009 and beyond were calculated using intercensal
population estimates for 2009, 2010 bridged-race April 1 census counts, and 2010-based postcensal population estimates for 2011 and beyond. Rates are rounded at
the end of the calculation process. They may differ from rates based on the same data presented elsewhere if rounding is done earlier in the calculation process.
SOURCE: CDC/NCHS, National Vital Statistics System, Compressed Mortality File. See Appendix I, National Vital Statistics System (NVSS).
Female
All ages, age-adjusted 2 . . . . . . . 1,236.0 1,105.3 971.4 817.9 750.9 731.4 624.7 623.5
All ages, crude . . . . . . . . . . . . . 823.5 809.2 807.8 785.3 812.0 855.0 796.4 804.4
Under 1 year. . . . . . . . . . . . . . . 2,854.6 2,321.3 1,863.7 1,141.7 855.7 663.4 544.6 536.1
1–4 years . . . . . . . . . . . . . . . . . 126.7 98.4 75.4 54.7 41.0 28.7 23.2 22.4
5–14 years . . . . . . . . . . . . . . . . 48.9 37.3 31.8 24.2 19.3 15.0 10.8 11.2
15–24 years . . . . . . . . . . . . . . . 89.1 61.3 68.1 57.5 49.0 43.1 36.0 35.6
25–34 years . . . . . . . . . . . . . . . 142.7 106.6 101.6 75.9 74.2 63.5 65.8 66.0
35–44 years . . . . . . . . . . . . . . . 290.3 229.4 231.1 159.3 137.9 143.2 129.0 130.5
45–54 years . . . . . . . . . . . . . . . 641.5 526.7 517.2 412.9 342.7 312.5 312.7 314.1
55–64 years . . . . . . . . . . . . . . . 1,404.8 1,196.4 1,098.9 934.3 878.8 772.2 643.8 647.4
65–74 years . . . . . . . . . . . . . . . 3,333.2 2,871.8 2,579.7 2,144.7 1,991.2 1,921.2 1,466.1 1,464.6
75–84 years . . . . . . . . . . . . . . . 8,399.6 7,633.1 6,677.6 5,440.1 4,883.1 4,814.7 4,062.5 4,029.1
85 years and over . . . . . . . . . . . 19,194.7 19,008.4 15,518.0 14,746.9 14,274.3 14,719.2 13,030.0 13,021.6
White male 3
All ages, age-adjusted 2 . . . . . . . 1,642.5 1,586.0 1,513.7 1,317.6 1,165.9 1,029.4 860.0 859.2
All ages, crude . . . . . . . . . . . . . 1,089.5 1,098.5 1,086.7 983.3 930.9 887.8 882.8 899.1
Under 1 year. . . . . . . . . . . . . . . 3,400.5 2,694.1 2,113.2 1,230.3 896.1 667.6 558.5 566.4
1–4 years . . . . . . . . . . . . . . . . . 135.5 104.9 83.6 66.1 45.9 32.6 27.3 26.2
5–14 years . . . . . . . . . . . . . . . . 67.2 52.7 48.0 35.0 26.4 19.8 13.3 13.9
15–24 years . . . . . . . . . . . . . . . 152.4 143.7 170.8 167.0 131.3 105.8 89.7 87.1
25–34 years . . . . . . . . . . . . . . . 185.3 163.2 176.6 171.3 176.1 124.1 139.3 139.8
35–44 years . . . . . . . . . . . . . . . 380.9 332.6 343.5 257.4 268.2 233.6 207.2 208.0
45–54 years . . . . . . . . . . . . . . . 984.5 932.2 882.9 698.9 548.7 496.9 489.0 491.7
55–64 years . . . . . . . . . . . . . . . 2,304.4 2,225.2 2,202.6 1,728.5 1,467.2 1,163.3 1,043.5 1,050.7
65–74 years . . . . . . . . . . . . . . . 4,864.9 4,848.4 4,810.1 4,035.7 3,397.7 2,905.7 2,150.5 2,152.0
75–84 years . . . . . . . . . . . . . . . 10,526.3 10,299.6 10,098.8 8,829.8 7,844.9 6,933.1 5,529.5 5,507.2
85 years and over . . . . . . . . . . . 22,116.3 21,750.0 18,551.7 19,097.3 18,268.3 17,716.4 15,271.5 15,220.4
Black or
African American male 3 Deaths per 100,000 resident population
All ages, age-adjusted 2 . . . . . . . 1,909.1 1,811.1 1,873.9 1,697.8 1,644.5 1,403.5 1,058.6 1,052.8
All ages, crude . . . . . . . . . . . . . 1,257.7 1,181.7 1,186.6 1,034.1 1,008.0 834.1 728.0 739.3
Under 1 year. . . . . . . . . . . . . . . -- 5,306.8 4,298.9 2,586.7 2,112.4 1,567.6 1,147.3 1,120.1
1–4 years 4 . . . . . . . . . . . . . . . . 1,412.6 208.5 150.5 110.5 85.8 54.5 41.6 40.6
5–14 years . . . . . . . . . . . . . . . . 95.1 75.1 67.1 47.4 41.2 28.2 21.3 19.6
15–24 years . . . . . . . . . . . . . . . 289.7 212.0 320.6 209.1 252.2 181.4 138.7 135.5
25–34 years . . . . . . . . . . . . . . . 503.5 402.5 559.5 407.3 430.8 261.0 212.8 218.6
35–44 years . . . . . . . . . . . . . . . 878.1 762.0 956.6 689.8 699.6 453.0 306.1 312.4
45–54 years . . . . . . . . . . . . . . . 1,905.0 1,624.8 1,777.5 1,479.9 1,261.0 1,017.7 696.3 678.8
55–64 years . . . . . . . . . . . . . . . 3,773.2 3,316.4 3,256.9 2,873.0 2,618.4 2,080.1 1,615.8 1,628.0
65–74 years . . . . . . . . . . . . . . . 5,310.3 5,798.7 5,803.2 5,131.1 4,946.1 4,253.5 3,077.9 3,064.4
75–84 years 5 . . . . . . . . . . . . . . 10,101.9 8,605.1 9,454.9 9,231.6 9,129.5 8,486.0 6,416.8 6,362.4
85 years and over . . . . . . . . . . . -- 14,844.8 12,222.3 16,098.8 16,954.9 16,791.0 13,775.7 13,657.1
American Indian or
Alaska Native male 3
All ages, age-adjusted 2 . . . . . . . -- -- -- 1,111.5 916.2 841.5 690.5 689.2
All ages, crude . . . . . . . . . . . . . -- -- -- 597.1 476.4 415.6 410.2 416.5
Under 1 year. . . . . . . . . . . . . . . -- -- -- 1,598.1 1,056.6 700.2 528.4 493.4
1–4 years . . . . . . . . . . . . . . . . . -- -- -- 82.7 77.4 44.9 34.2 41.5
5–14 years . . . . . . . . . . . . . . . . -- -- -- 43.7 33.4 20.2 16.8 12.1
15–24 years . . . . . . . . . . . . . . . -- -- -- 311.1 219.8 136.2 107.9 98.0
25–34 years . . . . . . . . . . . . . . . -- -- -- 360.6 256.1 179.1 175.3 172.7
35–44 years . . . . . . . . . . . . . . . -- -- -- 556.8 365.4 295.2 248.6 244.4
45–54 years . . . . . . . . . . . . . . . -- -- -- 871.3 619.9 520.0 500.8 506.4
55–64 years . . . . . . . . . . . . . . . -- -- -- 1,547.5 1,211.3 1,090.4 939.2 937.8
65–74 years . . . . . . . . . . . . . . . -- -- -- 2,968.4 2,461.7 2,478.3 1,948.9 1,845.9
75–84 years . . . . . . . . . . . . . . . -- -- -- 5,607.0 5,389.2 5,351.2 4,190.2 4,224.5
85 years and over . . . . . . . . . . . -- -- -- 12,635.2 11,243.9 10,725.8 8,618.1 9,034.3
Asian or
Pacific Islander male 3
All ages, age-adjusted 2 . . . . . . . -- -- -- 786.5 716.4 624.2 484.1 487.8
All ages, crude . . . . . . . . . . . . . -- -- -- 375.3 334.3 332.9 332.8 347.4
Under 1 year. . . . . . . . . . . . . . . -- -- -- 816.5 605.3 529.4 430.9 408.9
1–4 years . . . . . . . . . . . . . . . . . -- -- -- 50.9 45.0 23.3 16.3 19.3
5–14 years . . . . . . . . . . . . . . . . -- -- -- 23.4 20.7 12.9 9.0 11.1
15–24 years . . . . . . . . . . . . . . . -- -- -- 80.8 76.0 55.2 41.5 42.2
25–34 years . . . . . . . . . . . . . . . -- -- -- 83.5 79.6 55.0 54.9 54.2
35–44 years . . . . . . . . . . . . . . . -- -- -- 128.3 130.8 104.9 92.0 88.5
45–54 years . . . . . . . . . . . . . . . -- -- -- 342.3 287.1 249.7 216.5 220.4
55–64 years . . . . . . . . . . . . . . . -- -- -- 881.1 789.1 642.4 505.9 517.6
65–74 years . . . . . . . . . . . . . . . -- -- -- 2,236.1 2,041.4 1,661.0 1,109.2 1,126.4
75–84 years . . . . . . . . . . . . . . . -- -- -- 5,389.5 5,008.6 4,328.2 3,218.0 3,239.9
85 years and over . . . . . . . . . . . -- -- -- 13,753.6 12,446.3 12,125.3 10,116.5 10,142.8
Hispanic or Latino male 3,6
All ages, age-adjusted 2 . . . . . . . -- -- -- -- 886.4 818.1 643.9 639.8
All ages, crude . . . . . . . . . . . . . -- -- -- -- 411.6 331.3 316.5 323.7
Under 1 year. . . . . . . . . . . . . . . -- -- -- -- 921.8 637.1 509.1 501.1
1–4 years . . . . . . . . . . . . . . . . . -- -- -- -- 53.8 31.5 23.5 23.1
5–14 years . . . . . . . . . . . . . . . . -- -- -- -- 26.0 17.9 12.3 11.7
15–24 years . . . . . . . . . . . . . . . -- -- -- -- 159.3 107.7 76.4 72.9
25–34 years . . . . . . . . . . . . . . . -- -- -- -- 234.0 120.2 100.0 99.9
35–44 years . . . . . . . . . . . . . . . -- -- -- -- 341.8 211.0 142.7 143.3
45–54 years . . . . . . . . . . . . . . . -- -- -- -- 533.9 439.0 342.7 348.0
55–64 years . . . . . . . . . . . . . . . -- -- -- -- 1,123.7 965.7 816.3 797.4
65–74 years . . . . . . . . . . . . . . . -- -- -- -- 2,368.2 2,287.9 1,679.1 1,710.4
75–84 years . . . . . . . . . . . . . . . -- -- -- -- 5,369.1 5,395.3 4,250.9 4,218.1
85 years and over . . . . . . . . . . . -- -- -- -- 12,272.1 13,086.2 10,799.6 10,596.0
Black or
African American female 3
All ages, age-adjusted 2 . . . . . . . 1,545.5 1,369.7 1,228.7 1,033.3 975.1 927.6 723.9 720.6
All ages, crude . . . . . . . . . . . . . 1,002.0 905.0 829.2 733.3 747.9 733.0 642.3 651.1
Under 1 year. . . . . . . . . . . . . . . -- 4,162.2 3,368.8 2,123.7 1,735.5 1,279.8 944.4 980.7
1–4 years 4 . . . . . . . . . . . . . . . . 1,139.3 173.3 129.4 84.4 67.6 45.3 33.0 33.4
5–14 years . . . . . . . . . . . . . . . . 72.8 53.8 43.8 30.5 27.5 20.0 14.0 14.8
15–24 years . . . . . . . . . . . . . . . 213.1 107.5 111.9 70.5 68.7 58.3 43.6 41.2
25–34 years . . . . . . . . . . . . . . . 393.3 273.2 231.0 150.0 159.5 121.8 89.5 91.0
35–44 years . . . . . . . . . . . . . . . 758.1 568.5 533.0 323.9 298.6 271.9 192.9 187.9
45–54 years . . . . . . . . . . . . . . . 1,576.4 1,177.0 1,043.9 768.2 639.4 588.3 461.5 454.4
55–64 years . . . . . . . . . . . . . . . 3,089.4 2,510.9 1,986.2 1,561.0 1,452.6 1,227.2 950.4 962.2
65–74 years . . . . . . . . . . . . . . . 4,000.2 4,064.2 3,860.9 3,057.4 2,865.7 2,689.6 1,918.7 1,909.2
75–84 years 5 . . . . . . . . . . . . . . 8,347.0 6,730.0 6,691.5 6,212.1 5,688.3 5,696.5 4,396.0 4,418.0
85 years and over . . . . . . . . . . . -- 13,052.6 10,706.6 12,367.2 13,309.5 13,941.3 12,149.6 11,929.2
American Indian or
Alaska Native female 3
All ages, age-adjusted 2 . . . . . . . -- -- -- 662.4 561.8 604.5 512.3 508.3
All ages, crude . . . . . . . . . . . . . -- -- -- 380.1 330.4 346.1 340.9 348.2
Under 1 year. . . . . . . . . . . . . . . -- -- -- 1,352.6 688.7 492.2 425.9 305.9
1–4 years . . . . . . . . . . . . . . . . . -- -- -- 87.5 37.8 39.8 22.7 25.5
5–14 years . . . . . . . . . . . . . . . . -- -- -- 33.5 25.5 17.7 9.6 10.9
15–24 years . . . . . . . . . . . . . . . -- -- -- 90.3 69.0 58.9 47.7 42.8
25–34 years . . . . . . . . . . . . . . . -- -- -- 178.5 102.3 84.8 98.8 93.5
35–44 years . . . . . . . . . . . . . . . -- -- -- 286.0 156.4 171.9 162.2 172.4
45–54 years . . . . . . . . . . . . . . . -- -- -- 491.4 380.9 284.9 329.6 334.5
55–64 years . . . . . . . . . . . . . . . -- -- -- 837.1 805.9 772.1 587.2 616.6
65–74 years . . . . . . . . . . . . . . . -- -- -- 1,765.5 1,679.4 1,899.8 1,390.3 1,314.7
75–84 years . . . . . . . . . . . . . . . -- -- -- 3,612.9 3,073.2 3,850.0 3,256.9 3,221.9
85 years and over . . . . . . . . . . . -- -- -- 8,567.4 8,201.1 9,118.2 7,987.3 8,008.4
Asian or
Pacific Islander female 3 Deaths per 100,000 resident population
All ages, age-adjusted 2 . . . . . . . -- -- -- 425.9 469.3 416.8 348.8 343.0
All ages, crude . . . . . . . . . . . . . -- -- -- 222.5 234.3 262.3 292.0 297.4
Under 1 year. . . . . . . . . . . . . . . -- -- -- 755.8 518.2 434.3 349.0 329.3
1–4 years . . . . . . . . . . . . . . . . . -- -- -- 35.4 32.0 20.0 14.8 18.4
5–14 years . . . . . . . . . . . . . . . . -- -- -- 21.5 13.0 11.7 7.2 8.8
15–24 years . . . . . . . . . . . . . . . -- -- -- 32.3 28.8 22.4 18.4 17.7
25–34 years . . . . . . . . . . . . . . . -- -- -- 45.4 37.5 27.6 24.4 25.7
35–44 years . . . . . . . . . . . . . . . -- -- -- 89.7 69.9 65.6 50.4 51.5
45–54 years . . . . . . . . . . . . . . . -- -- -- 214.1 182.7 155.5 130.3 128.0
55–64 years . . . . . . . . . . . . . . . -- -- -- 440.8 483.4 390.9 301.5 287.2
65–74 years . . . . . . . . . . . . . . . -- -- -- 1,027.7 1,089.2 996.4 731.9 703.9
75–84 years . . . . . . . . . . . . . . . -- -- -- 2,833.6 3,127.9 2,882.4 2,330.6 2,346.7
85 years and over . . . . . . . . . . . -- -- -- 7,923.3 10,254.0 9,052.2 8,469.0 8,240.4
Hispanic or Latina female 3,6
All ages, age-adjusted 2 . . . . . . . -- -- -- -- 537.1 546.0 452.5 448.6
All ages, crude . . . . . . . . . . . . . -- -- -- -- 285.4 274.6 272.7 279.4
Under 1 year. . . . . . . . . . . . . . . -- -- -- -- 746.6 553.6 428.9 433.7
1–4 years . . . . . . . . . . . . . . . . . -- -- -- -- 42.1 27.5 20.0 18.4
5–14 years . . . . . . . . . . . . . . . . -- -- -- -- 17.3 13.4 10.0 9.9
15–24 years . . . . . . . . . . . . . . . -- -- -- -- 40.6 31.7 25.5 25.6
25–34 years . . . . . . . . . . . . . . . -- -- -- -- 62.9 43.4 40.0 41.4
35–44 years . . . . . . . . . . . . . . . -- -- -- -- 109.3 100.5 73.6 78.3
45–54 years . . . . . . . . . . . . . . . -- -- -- -- 253.3 223.8 192.0 189.6
55–64 years . . . . . . . . . . . . . . . -- -- -- -- 607.5 548.4 442.8 437.2
65–74 years . . . . . . . . . . . . . . . -- -- -- -- 1,453.8 1,423.2 1,046.7 1,039.9
75–84 years . . . . . . . . . . . . . . . -- -- -- -- 3,351.3 3,624.5 3,063.5 3,037.8
85 years and over . . . . . . . . . . . -- -- -- -- 10,098.7 11,202.8 9,805.6 9,651.3
1
Includes deaths of persons who were not residents of the 50 states and the District of Columbia (D.C.).
2
Age-adjusted rates are calculated using the year 2000 standard population. Prior to 2001, age-adjusted rates were calculated using standard million proportions based
on rounded population numbers. Starting with 2001 data, unrounded population numbers are used to calculate age-adjusted rates. See Appendix II, Age adjustment.
3
The race groups, white, black, Asian or Pacific Islander, and American Indian or Alaska Native, include persons of Hispanic and non-Hispanic origin. Persons of
Hispanic origin may be of any race. Death rates for Hispanic, American Indian or Alaska Native, and Asian or Pacific Islander persons should be interpreted with
caution because of inconsistencies in reporting Hispanic origin or race on the death certificate (death rate numerators) compared with population figures (death rate
denominators). The net effect of misclassification is an underestimation of deaths and death rates for races other than white and black. See Appendix II, Race, for a
detailed discussion of sources of bias in death rates by race and Hispanic origin.
4
In 1950, rate is for the age group under 5 years.
5
In 1950, rate is for the age group 75 years and over.
6
Prior to 1997, data from states that did not report Hispanic origin on the death certificate were excluded. See Appendix II, Hispanic origin.
NOTES: Starting with Health, United States, 2003, rates for 1991–1999 were revised using intercensal population estimates based on the 1990 and 2000 censuses.
For 2000, population estimates are bridged-race April 1 census counts. Starting with Health, United States, 2012, rates for 2001–2009 were revised using intercensal
population estimates based on the 2000 and 2010 censuses. For 2010, population estimates are bridged-race April 1 census counts. Rates for 2011 and beyond were
computed using 2010-based postcensal estimates. See Appendix I, Population Census and Population Estimates. Starting with 2003 data, some states allowed the
reporting of more than one race on the death certificate. The multiple-race data for these states were bridged to the single-race categories of the 1977 Office of
Management and Budget standards, for comparability with other states. See Appendix II, Race. Data for additional years are available. See the Excel spreadsheet on
SOURCE: CDC/NCHS, National Vital Statistics System; Grove RD, Hetzel AM. Vital statistics rates in the United States, 1940–1960. Washington, DC: U.S. Government
Printing Office, 1968; numerator data from National Vital Statistics System, annual public-use Mortality Files; denominator data from national population estimates for
race groups from Table 1 and unpublished Hispanic population estimates for 1985–1996 prepared by the Housing and Household Economic Statistics Division, U.S.
Census Bureau; Xu JQ, Murphy SL, Kochanek KD, et al. Deaths: Final data for 2013. National vital statistics reports; vol 64 no 2. Hyattsville, MD: NCHS; 2015.
Available from: http://www.cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_02.pdf. See Appendix I, National Vital Statistics System (NVSS).
Male
All ages, age-adjusted 4 . . . . . . . 699.0 687.6 634.0 538.9 412.4 320.0 214.7 214.5
All ages, crude . . . . . . . . . . . . . 424.7 439.5 422.5 368.6 297.6 249.8 202.3 206.5
Under 1 year. . . . . . . . . . . . . . . 4.7 7.8 15.1 25.5 21.9 13.3 9.6 8.7
1–4 years . . . . . . . . . . . . . . . . . 1.7 1.4 1.9 2.8 1.9 1.4 1.0 1.2
5–14 years . . . . . . . . . . . . . . . . 3.5 1.4 0.9 1.0 0.9 0.8 0.5 0.4
15–24 years . . . . . . . . . . . . . . . 8.3 4.2 3.7 3.7 3.1 3.2 2.9 2.8
25–34 years . . . . . . . . . . . . . . . 24.4 20.1 15.2 11.4 10.3 9.6 10.4 10.2
35–44 years . . . . . . . . . . . . . . . 120.4 112.7 103.2 68.7 48.1 41.4 35.8 35.5
45–54 years . . . . . . . . . . . . . . . 441.2 420.4 376.4 282.6 183.0 140.2 114.3 115.1
55–64 years . . . . . . . . . . . . . . . 1,100.5 1,066.9 987.2 746.8 537.3 371.7 266.4 267.3
65–74 years . . . . . . . . . . . . . . . 2,310.2 2,291.3 2,170.3 1,728.0 1,250.0 898.3 527.7 530.9
75–84 years . . . . . . . . . . . . . . . 4,825.8 4,742.4 4,534.8 3,834.3 2,968.2 2,248.1 1,388.1 1,382.4
85 years and over . . . . . . . . . . . 9,661.4 9,788.9 8,426.2 8,752.7 7,418.4 6,430.0 4,582.7 4,564.2
Female
All ages, age-adjusted 4 . . . . . . . 486.6 447.0 381.6 320.8 257.0 210.9 135.5 134.3
All ages, crude . . . . . . . . . . . . . 289.7 300.6 304.5 305.1 281.8 255.3 180.2 180.6
Under 1 year. . . . . . . . . . . . . . . 3.4 5.4 10.9 20.0 18.3 12.5 7.3 6.9
1–4 years . . . . . . . . . . . . . . . . . 1.6 1.1 1.6 2.5 1.9 1.0 0.9 0.9
5–14 years . . . . . . . . . . . . . . . . 4.3 1.2 0.8 0.9 0.8 0.5 0.4 0.4
15–24 years . . . . . . . . . . . . . . . 8.2 3.7 2.3 2.1 1.8 2.1 1.5 1.5
25–34 years . . . . . . . . . . . . . . . 17.6 11.3 7.7 5.3 5.0 5.2 4.8 4.9
35–44 years . . . . . . . . . . . . . . . 57.0 38.2 32.2 21.4 15.1 17.2 16.0 15.7
45–54 years . . . . . . . . . . . . . . . 177.8 127.5 109.9 84.5 61.0 49.8 46.0 46.6
55–64 years . . . . . . . . . . . . . . . 507.0 429.4 351.6 272.1 215.7 159.3 108.4 107.5
65–74 years . . . . . . . . . . . . . . . 1,434.9 1,261.3 1,082.7 828.6 616.8 474.0 266.2 266.8
75–84 years . . . . . . . . . . . . . . . 3,873.0 3,582.7 3,120.8 2,497.0 1,893.8 1,475.1 893.0 879.8
85 years and over . . . . . . . . . . . 8,798.1 9,016.8 7,591.8 7,350.5 6,478.1 5,720.9 3,777.5 3,732.9
White male 5
All ages, age-adjusted 4 . . . . . . . 701.4 694.5 640.2 539.6 409.2 316.7 213.1 213.1
All ages, crude . . . . . . . . . . . . . 434.2 454.6 438.3 384.0 312.7 265.8 218.0 222.6
45–54 years . . . . . . . . . . . . . . . 424.1 413.2 365.7 269.8 170.6 130.7 108.3 109.8
55–64 years . . . . . . . . . . . . . . . 1,082.6 1,056.0 979.3 730.6 516.7 351.8 253.2 254.0
65–74 years . . . . . . . . . . . . . . . 2,309.4 2,297.9 2,177.2 1,729.7 1,230.5 877.8 513.5 516.0
75–84 years . . . . . . . . . . . . . . . 4,908.0 4,839.9 4,617.6 3,883.2 2,983.4 2,247.0 1,392.6 1,389.0
85 years and over . . . . . . . . . . . 9,952.3 10,135.8 8,818.0 8,958.0 7,558.7 6,560.8 4,712.4 4,701.6
Black or
African American male 5
All ages, age-adjusted 4 . . . . . . . 641.5 615.2 607.3 561.4 485.4 392.5 265.3 262.8
All ages, crude . . . . . . . . . . . . . 348.4 330.6 330.3 301.0 256.8 211.1 174.7 177.2
45–54 years . . . . . . . . . . . . . . . 624.1 514.0 512.8 433.4 328.9 247.2 182.4 178.3
55–64 years . . . . . . . . . . . . . . . 1,434.0 1,236.8 1,135.4 987.2 824.0 631.2 435.9 430.0
65–74 years . . . . . . . . . . . . . . . 2,140.1 2,281.4 2,237.8 1,847.2 1,632.9 1,268.8 805.5 807.5
75–84 years 6 . . . . . . . . . . . . . . 4,107.9 3,533.6 3,783.4 3,578.8 3,107.1 2,597.6 1,677.7 1,660.0
85 years and over . . . . . . . . . . . -- 6,037.9 5,367.6 6,819.5 6,479.6 5,633.5 3,822.1 3,754.5
American Indian or
Alaska Native male 5 Deaths per 100,000 resident population
All ages, age-adjusted 4 . . . . . . . -- -- -- 320.5 264.1 222.2 152.5 152.3
All ages, crude . . . . . . . . . . . . . -- -- -- 130.6 108.0 90.1 78.3 82.3
45–54 years . . . . . . . . . . . . . . . -- -- -- 238.1 173.8 108.5 87.4 101.6
55–64 years . . . . . . . . . . . . . . . -- -- -- 496.3 411.0 285.0 198.5 206.2
65–74 years . . . . . . . . . . . . . . . -- -- -- 1,009.4 839.1 748.2 451.5 465.2
75–84 years . . . . . . . . . . . . . . . -- -- -- 2,062.2 1,788.8 1,655.7 1,138.9 1,071.8
85 years and over . . . . . . . . . . . -- -- -- 4,413.7 3,860.3 3,318.3 2,278.2 2,269.1
Asian or
Pacific Islander male 5
All ages, age-adjusted 4 . . . . . . . -- -- -- 286.9 220.7 185.5 116.1 118.4
All ages, crude . . . . . . . . . . . . . -- -- -- 119.8 88.7 90.6 76.8 81.9
45–54 years . . . . . . . . . . . . . . . -- -- -- 112.0 70.4 61.1 51.8 50.9
55–64 years . . . . . . . . . . . . . . . -- -- -- 306.7 226.1 182.6 118.4 133.3
65–74 years . . . . . . . . . . . . . . . -- -- -- 852.4 623.5 482.5 255.1 274.9
75–84 years . . . . . . . . . . . . . . . -- -- -- 2,010.9 1,642.2 1,354.7 748.7 754.6
85 years and over . . . . . . . . . . . -- -- -- 5,923.0 4,617.8 4,154.2 2,842.2 2,848.5
Hispanic or Latino male 5,7
All ages, age-adjusted 4 . . . . . . . -- -- -- -- 270.0 238.2 151.6 151.5
All ages, crude . . . . . . . . . . . . . -- -- -- -- 91.0 74.7 64.3 66.9
45–54 years . . . . . . . . . . . . . . . -- -- -- -- 116.4 84.3 61.7 63.5
55–64 years . . . . . . . . . . . . . . . -- -- -- -- 363.0 264.8 177.5 178.0
65–74 years . . . . . . . . . . . . . . . -- -- -- -- 829.9 684.8 406.1 416.6
75–84 years . . . . . . . . . . . . . . . -- -- -- -- 1,971.3 1,733.2 1,069.1 1,057.5
85 years and over . . . . . . . . . . . -- -- -- -- 4,711.9 4,897.5 3,147.0 3,106.2
White, not Hispanic
or Latino male 7
All ages, age-adjusted 4 . . . . . . . -- -- -- -- 413.6 319.9 217.7 217.9
All ages, crude . . . . . . . . . . . . . -- -- -- -- 336.5 297.5 253.2 259.0
45–54 years . . . . . . . . . . . . . . . -- -- -- -- 172.8 134.3 115.2 117.2
55–64 years . . . . . . . . . . . . . . . -- -- -- -- 521.3 356.3 259.1 260.2
65–74 years . . . . . . . . . . . . . . . -- -- -- -- 1,243.4 885.1 518.3 520.2
75–84 years . . . . . . . . . . . . . . . -- -- -- -- 3,007.7 2,261.9 1,409.6 1,408.1
85 years and over . . . . . . . . . . . -- -- -- -- 7,663.4 6,606.6 4,796.1 4,794.2
White female 5
All ages, age-adjusted 4 . . . . . . . 479.2 441.7 376.7 315.9 250.9 205.6 133.4 132.0
All ages, crude . . . . . . . . . . . . . 290.5 306.5 313.8 319.2 298.4 274.5 196.7 196.8
45–54 years . . . . . . . . . . . . . . . 142.4 103.4 91.4 71.2 50.2 40.9 40.7 41.0
55–64 years . . . . . . . . . . . . . . . 460.7 383.0 317.7 248.1 192.4 141.3 97.8 95.9
65–74 years . . . . . . . . . . . . . . . 1,401.6 1,229.8 1,044.0 796.7 583.6 445.2 251.7 252.5
75–84 years . . . . . . . . . . . . . . . 3,926.2 3,629.7 3,143.5 2,493.6 1,874.3 1,452.4 888.1 871.8
85 years and over . . . . . . . . . . . 9,086.9 9,280.8 7,839.9 7,501.6 6,563.4 5,801.4 3,855.8 3,821.0
Black or
African American female 5
All ages, age-adjusted 4 . . . . . . . 538.9 488.9 435.6 378.6 327.5 277.6 172.7 172.1
All ages, crude . . . . . . . . . . . . . 289.9 268.5 261.0 249.7 237.0 212.6 150.9 153.4
45–54 years . . . . . . . . . . . . . . . 526.8 360.7 290.9 202.4 155.3 125.0 92.6 94.2
55–64 years . . . . . . . . . . . . . . . 1,210.7 952.3 710.5 530.1 442.0 332.8 211.1 213.0
65–74 years . . . . . . . . . . . . . . . 1,659.4 1,680.5 1,553.2 1,210.3 1,017.5 815.2 449.3 450.8
75–84 years 6 . . . . . . . . . . . . . . 3,499.3 2,926.9 2,964.1 2,707.2 2,250.9 1,913.1 1,114.8 1,122.2
85 years and over . . . . . . . . . . . -- 5,650.0 5,003.8 5,796.5 5,766.1 5,298.7 3,513.5 3,425.3
American Indian or
Alaska Native female 5 Deaths per 100,000 resident population
All ages, age-adjusted 4 . . . . . . . -- -- -- 175.4 153.1 143.6 92.9 93.9
All ages, crude . . . . . . . . . . . . . -- -- -- 80.3 77.5 71.9 55.7 58.4
45–54 years . . . . . . . . . . . . . . . -- -- -- 65.2 62.0 40.2 39.4 37.3
55–64 years . . . . . . . . . . . . . . . -- -- -- 193.5 197.0 149.4 83.9 100.5
65–74 years . . . . . . . . . . . . . . . -- -- -- 577.2 492.8 391.8 245.0 220.1
75–84 years . . . . . . . . . . . . . . . -- -- -- 1,364.3 1,050.3 1,044.1 698.2 664.6
85 years and over . . . . . . . . . . . -- -- -- 2,893.3 2,868.7 3,146.3 1,874.7 2,089.2
Asian or
Pacific Islander female 5
All ages, age-adjusted 4 . . . . . . . -- -- -- 132.3 149.2 115.7 74.0 73.3
All ages, crude . . . . . . . . . . . . . -- -- -- 57.0 62.0 65.0 59.6 61.8
45–54 years . . . . . . . . . . . . . . . -- -- -- 28.6 17.5 15.9 10.5 12.5
55–64 years . . . . . . . . . . . . . . . -- -- -- 92.9 99.0 68.8 40.9 41.7
65–74 years . . . . . . . . . . . . . . . -- -- -- 313.3 323.9 229.6 126.8 124.7
75–84 years . . . . . . . . . . . . . . . -- -- -- 1,053.2 1,130.9 866.2 505.2 521.0
85 years and over . . . . . . . . . . . -- -- -- 3,211.0 4,161.2 3,367.2 2,381.5 2,272.4
1
Includes deaths of persons who were not residents of the 50 states and the District of Columbia (D.C.).
2
Underlying cause of death was coded according to the 6th Revision of the International Classification of Diseases (ICD) in 1950, 7th Revision in 1960, 8th Revision in
1970, and 9th Revision in 1980–1998. See Appendix II, Cause of death; Table III; Table IV.
3
Starting with 1999 data, cause of death is coded according to ICD–10. See Appendix II, Cause of death; Comparability ratio; Table IV; Table V.
4
Age-adjusted rates are calculated using the year 2000 standard population. Prior to 2001, age-adjusted rates were calculated using standard million proportions based
on rounded population numbers. Starting with 2001 data, unrounded population numbers are used to calculate age-adjusted rates. See Appendix II, Age adjustment.
5
The race groups, white, black, Asian or Pacific Islander, and American Indian or Alaska Native, include persons of Hispanic and non-Hispanic origin. Persons of
Hispanic origin may be of any race. Death rates for Hispanic, American Indian or Alaska Native, and Asian or Pacific Islander persons should be interpreted with
caution because of inconsistencies in reporting Hispanic origin or race on the death certificate (death rate numerators) compared with population figures (death rate
denominators). The net effect of misclassification is an underestimation of deaths and death rates for races other than white and black. See Appendix II, Race, for a
detailed discussion of sources of bias in death rates by race and Hispanic origin.
6
In 1950, rate is for the age group 75 years and over.
7
Prior to 1997, data from states that did not report Hispanic origin on the death certificate were excluded. See Appendix II, Hispanic origin.
NOTES: Starting with Health, United States, 2003, rates for 1991–1999 were revised using intercensal population estimates based on the 1990 and 2000 censuses.
For 2000, population estimates are bridged-race April 1 census counts. Starting with Health, United States, 2012, rates for 2001–2009 were revised using intercensal
population estimates based on the 2000 and 2010 censuses. For 2010, population estimates are bridged-race April 1 census counts. Rates for 2011 and beyond were
computed using 2010-based postcensal estimates. See Appendix I, Population Census and Population Estimates. Age groups were selected to minimize the
presentation of unstable age-specific death rates based on small numbers of deaths and for consistency among comparison groups. Starting with 2003 data, some
states allowed the reporting of more than one race on the death certificate. The multiple-race data for these states were bridged to the single-race categories of the
1977 Office of Management and Budget standards, for comparability with other states. See Appendix II, Race. Data for additional years are available. See the Excel
SOURCE: CDC/NCHS, National Vital Statistics System; numerator data from National Vital Statistics System, annual public-use Mortality Files; denominator data from
national population estimates for race groups from Table 1 and unpublished Hispanic population estimates for 1985–1996 prepared by the Housing and Household
Economic Statistics Division, U.S. Census Bureau; Xu JQ, Murphy SL, Kochanek KD, et al. Deaths: Final data for 2013. National vital statistics reports; vol 64 no 2.
Hyattsville, MD: NCHS; 2015. Available from: http://www.cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_02.pdf. See Appendix I, National Vital Statistics System (NVSS).
Male
All ages, age-adjusted 4 . . . . . . . 186.4 186.1 157.4 102.2 68.5 62.4 37.1 36.7
All ages, crude . . . . . . . . . . . . . 102.5 104.5 94.5 63.4 46.7 46.9 34.1 34.5
Under 1 year. . . . . . . . . . . . . . . 6.4 5.0 5.8 5.0 4.4 3.8 2.6 3.0
1–4 years . . . . . . . . . . . . . . . . . 1.1 0.9 1.2 0.4 0.3 * 0.4 0.3
5–14 years . . . . . . . . . . . . . . . . 0.5 0.7 0.8 0.3 0.2 0.2 0.2 0.2
15–24 years . . . . . . . . . . . . . . . 1.8 1.9 1.8 1.1 0.7 0.5 0.5 0.4
25–34 years . . . . . . . . . . . . . . . 4.2 4.5 4.4 2.6 2.1 1.5 1.4 1.3
35–44 years . . . . . . . . . . . . . . . 17.5 14.6 15.7 8.7 6.8 5.8 4.8 4.7
45–54 years . . . . . . . . . . . . . . . 67.9 52.2 44.4 27.2 20.5 17.5 14.2 14.2
55–64 years . . . . . . . . . . . . . . . 205.2 163.8 138.7 74.6 54.3 47.2 34.5 35.1
65–74 years . . . . . . . . . . . . . . . 589.6 530.7 449.5 258.6 166.6 145.0 85.7 85.0
75–84 years . . . . . . . . . . . . . . . 1,543.6 1,555.9 1,361.6 866.3 551.1 490.8 277.7 277.9
85 years and over . . . . . . . . . . . 3,048.6 3,643.1 2,895.2 2,193.6 1,528.5 1,484.3 832.1 808.4
Female
All ages, age-adjusted 4 . . . . . . . 175.8 170.7 140.0 91.7 62.6 59.1 36.1 35.2
All ages, crude . . . . . . . . . . . . . 105.6 111.4 109.0 85.9 68.4 71.8 47.6 46.9
Under 1 year. . . . . . . . . . . . . . . 3.7 3.2 4.0 3.8 3.1 2.7 2.6 2.5
1–4 years . . . . . . . . . . . . . . . . . 0.7 0.7 0.7 0.5 0.3 0.4 0.3 *
5–14 years . . . . . . . . . . . . . . . . 0.4 0.6 0.6 0.3 0.2 0.2 0.2 0.2
15–24 years . . . . . . . . . . . . . . . 1.5 1.6 1.4 0.8 0.6 0.5 0.3 0.3
25–34 years . . . . . . . . . . . . . . . 4.3 4.9 4.7 2.6 2.2 1.5 1.1 1.1
35–44 years . . . . . . . . . . . . . . . 19.9 14.8 15.6 8.4 6.1 5.7 3.8 3.7
45–54 years . . . . . . . . . . . . . . . 72.9 46.3 39.0 23.3 17.0 14.5 11.4 10.6
55–64 years . . . . . . . . . . . . . . . 183.1 131.8 95.3 56.8 42.2 35.3 23.3 23.1
65–74 years . . . . . . . . . . . . . . . 522.1 415.7 333.3 188.7 126.7 115.1 67.0 64.8
75–84 years . . . . . . . . . . . . . . . 1,462.2 1,441.1 1,183.1 740.1 466.2 442.1 268.2 262.1
85 years and over . . . . . . . . . . . 2,949.4 3,704.4 3,081.0 2,323.1 1,667.6 1,632.0 980.9 955.8
White male 5
All ages, age-adjusted 4 . . . . . . . 182.1 181.6 153.7 98.7 65.5 59.8 35.4 35.0
All ages, crude . . . . . . . . . . . . . 100.5 102.7 93.5 63.1 46.9 48.4 35.3 35.8
45–54 years . . . . . . . . . . . . . . . 53.7 40.9 35.6 21.7 15.4 13.6 11.4 11.7
55–64 years . . . . . . . . . . . . . . . 182.2 139.0 119.9 64.0 45.7 39.7 29.4 29.9
65–74 years . . . . . . . . . . . . . . . 569.7 501.0 420.0 239.8 152.9 133.8 78.1 77.6
75–84 years . . . . . . . . . . . . . . . 1,556.3 1,564.8 1,361.6 852.7 539.2 480.0 270.9 271.1
85 years and over . . . . . . . . . . . 3,127.1 3,734.8 3,018.1 2,230.8 1,545.4 1,490.7 838.2 815.2
Black or
African American male 5
All ages, age-adjusted 4 . . . . . . . 228.8 238.5 206.4 142.0 102.2 89.6 53.8 54.1
All ages, crude . . . . . . . . . . . . . 122.0 122.9 108.8 73.0 53.0 46.1 34.1 35.1
45–54 years . . . . . . . . . . . . . . . 211.9 166.1 136.1 82.1 68.4 49.5 33.4 30.7
55–64 years . . . . . . . . . . . . . . . 522.8 439.9 343.4 189.7 141.7 115.4 76.0 78.1
65–74 years . . . . . . . . . . . . . . . 783.6 899.2 780.1 472.3 326.9 268.5 164.9 165.0
75–84 years 6 . . . . . . . . . . . . . . 1,504.9 1,475.2 1,445.7 1,066.3 721.5 659.2 385.0 387.4
85 years and over . . . . . . . . . . . -- 2,700.0 1,963.1 1,873.2 1,421.5 1,458.8 796.8 814.1
American Indian or
Alaska Native male 5 Deaths per 100,000 resident population
All ages, age-adjusted 4 . . . . . . . -- -- -- 66.4 44.3 46.1 25.5 22.7
All ages, crude . . . . . . . . . . . . . -- -- -- 23.1 16.0 16.8 12.0 11.3
45–54 years . . . . . . . . . . . . . . . -- -- -- * * 13.3 10.7 9.2
55–64 years . . . . . . . . . . . . . . . -- -- -- 72.0 39.8 48.6 26.9 23.8
65–74 years . . . . . . . . . . . . . . . -- -- -- 170.5 120.3 144.7 84.4 72.5
75–84 years . . . . . . . . . . . . . . . -- -- -- 523.9 325.9 373.3 172.2 191.0
85 years and over . . . . . . . . . . . -- -- -- 1,384.7 949.8 834.9 506.3 348.3
Asian or
Pacific Islander male 5
All ages, age-adjusted 4 . . . . . . . -- -- -- 71.4 59.1 58.0 33.2 31.2
All ages, crude . . . . . . . . . . . . . -- -- -- 28.7 23.3 27.2 21.7 21.3
45–54 years . . . . . . . . . . . . . . . -- -- -- 17.0 15.6 15.0 13.2 15.7
55–64 years . . . . . . . . . . . . . . . -- -- -- 59.9 51.8 49.3 30.0 27.7
65–74 years . . . . . . . . . . . . . . . -- -- -- 197.9 167.9 135.6 78.1 73.0
75–84 years . . . . . . . . . . . . . . . -- -- -- 619.5 483.9 438.7 239.3 230.5
85 years and over . . . . . . . . . . . -- -- -- 1,399.0 1,196.6 1,415.6 776.0 686.7
Hispanic or Latino male 5,7
All ages, age-adjusted 4 . . . . . . . -- -- -- -- 46.5 50.5 32.0 31.8
All ages, crude . . . . . . . . . . . . . -- -- -- -- 15.6 15.8 13.5 14.0
45–54 years . . . . . . . . . . . . . . . -- -- -- -- 20.0 18.1 13.5 13.8
55–64 years . . . . . . . . . . . . . . . -- -- -- -- 49.2 48.8 33.3 33.9
65–74 years . . . . . . . . . . . . . . . -- -- -- -- 126.4 136.1 75.5 82.1
75–84 years . . . . . . . . . . . . . . . -- -- -- -- 356.6 392.9 248.1 242.1
85 years and over . . . . . . . . . . . -- -- -- -- 866.3 1,029.9 644.9 620.6
White, not Hispanic
or Latino male 7
All ages, age-adjusted 4 . . . . . . . -- -- -- -- 66.3 59.9 35.3 34.9
All ages, crude . . . . . . . . . . . . . -- -- -- -- 50.6 53.9 40.3 40.8
45–54 years . . . . . . . . . . . . . . . -- -- -- -- 14.9 13.0 10.8 11.0
55–64 years . . . . . . . . . . . . . . . -- -- -- -- 45.1 38.7 28.5 29.0
65–74 years . . . . . . . . . . . . . . . -- -- -- -- 154.5 133.1 77.7 76.6
75–84 years . . . . . . . . . . . . . . . -- -- -- -- 547.3 482.3 271.2 272.0
85 years and over . . . . . . . . . . . -- -- -- -- 1,578.7 1,505.9 848.0 825.6
White female 5
All ages, age-adjusted 4 . . . . . . . 169.7 165.0 135.5 89.0 60.3 57.3 35.2 34.2
All ages, crude . . . . . . . . . . . . . 103.3 110.1 109.8 88.6 71.6 76.9 51.5 50.6
45–54 years . . . . . . . . . . . . . . . 55.0 33.8 30.5 18.6 13.5 11.2 9.3 9.0
55–64 years . . . . . . . . . . . . . . . 156.9 103.0 78.1 48.6 35.8 30.2 19.8 19.8
65–74 years . . . . . . . . . . . . . . . 498.1 383.3 303.2 172.5 116.1 107.3 62.3 60.0
75–84 years . . . . . . . . . . . . . . . 1,471.3 1,444.7 1,176.8 728.8 456.5 434.2 265.4 257.7
85 years and over . . . . . . . . . . . 3,017.9 3,795.7 3,167.6 2,362.7 1,685.9 1,646.7 994.7 970.4
Black or
African American female 5
All ages, age-adjusted 4 . . . . . . . 238.4 232.5 189.3 119.6 84.0 76.2 45.4 44.7
All ages, crude . . . . . . . . . . . . . 128.3 127.7 112.2 77.8 60.7 58.3 39.2 39.2
45–54 years . . . . . . . . . . . . . . . 248.9 166.2 119.4 61.8 44.1 38.1 25.0 21.1
55–64 years . . . . . . . . . . . . . . . 567.7 452.0 272.4 138.4 96.9 76.4 48.8 47.7
65–74 years . . . . . . . . . . . . . . . 754.4 830.5 673.5 361.7 236.7 190.9 111.2 109.1
75–84 years 6 . . . . . . . . . . . . . . 1,496.7 1,413.1 1,338.3 917.5 595.0 549.2 321.6 333.0
85 years and over . . . . . . . . . . . -- 2,578.9 2,210.5 1,891.6 1,495.2 1,556.5 927.2 894.1
American Indian or
Alaska Native female 5 Deaths per 100,000 resident population
All ages, age-adjusted 4 . . . . . . . -- -- -- 51.2 38.4 43.7 24.8 25.5
All ages, crude . . . . . . . . . . . . . -- -- -- 22.0 19.3 21.5 14.4 15.4
45–54 years . . . . . . . . . . . . . . . -- -- -- * * 14.4 7.2 9.0
55–64 years . . . . . . . . . . . . . . . -- -- -- * 40.7 37.9 20.0 19.1
65–74 years . . . . . . . . . . . . . . . -- -- -- 128.3 100.5 79.5 58.8 60.6
75–84 years . . . . . . . . . . . . . . . -- -- -- 404.2 282.0 391.1 205.5 187.2
85 years and over . . . . . . . . . . . -- -- -- 1,095.5 776.2 931.5 531.3 593.6
Asian or
Pacific Islander female 5
All ages, age-adjusted 4 . . . . . . . -- -- -- 60.8 54.9 49.1 28.9 27.9
All ages, crude . . . . . . . . . . . . . -- -- -- 26.4 24.3 28.7 23.7 23.8
45–54 years . . . . . . . . . . . . . . . -- -- -- 20.3 19.7 13.3 9.2 8.6
55–64 years . . . . . . . . . . . . . . . -- -- -- 43.7 42.1 33.3 20.0 18.2
65–74 years . . . . . . . . . . . . . . . -- -- -- 136.1 124.0 102.8 56.3 54.0
75–84 years . . . . . . . . . . . . . . . -- -- -- 446.6 396.6 386.0 213.4 203.0
85 years and over . . . . . . . . . . . -- -- -- 1,545.2 1,395.0 1,246.6 770.1 754.6
Hispanic or Latina female 5,7
All ages, age-adjusted 4 . . . . . . . -- -- -- -- 43.7 43.0 28.2 27.6
All ages, crude . . . . . . . . . . . . . -- -- -- -- 20.1 19.4 15.8 16.1
45–54 years . . . . . . . . . . . . . . . -- -- -- -- 15.2 12.4 8.8 9.1
55–64 years . . . . . . . . . . . . . . . -- -- -- -- 38.5 31.9 19.9 19.7
65–74 years . . . . . . . . . . . . . . . -- -- -- -- 102.6 95.2 59.3 53.6
75–84 years . . . . . . . . . . . . . . . -- -- -- -- 308.5 311.3 217.6 211.4
85 years and over . . . . . . . . . . . -- -- -- -- 1,055.3 1,108.9 705.9 698.4
White, not Hispanic
or Latina female 7
All ages, age-adjusted 4 . . . . . . . -- -- -- -- 61.0 57.6 35.5 34.5
All ages, crude . . . . . . . . . . . . . -- -- -- -- 77.2 85.5 59.2 58.3
45–54 years . . . . . . . . . . . . . . . -- -- -- -- 13.2 10.9 9.2 8.8
55–64 years . . . . . . . . . . . . . . . -- -- -- -- 35.7 29.9 19.6 19.6
65–74 years . . . . . . . . . . . . . . . -- -- -- -- 116.9 107.6 62.1 60.2
75–84 years . . . . . . . . . . . . . . . -- -- -- -- 461.9 438.3 268.1 260.3
85 years and over . . . . . . . . . . . -- -- -- -- 1,714.7 1,661.6 1,008.1 984.3
* Rates based on fewer than 20 deaths are considered unreliable and are not shown.
1
Includes deaths of persons who were not residents of the 50 states and the District of Columbia (D.C.).
2
Underlying cause of death was coded according to the 6th Revision of the International Classification of Diseases (ICD) in 1950, 7th Revision in 1960, 8th Revision in
1970, and 9th Revision in 1980–1998. See Appendix II, Cause of death; Table III; Table IV.
3
Starting with 1999 data, cause of death is coded according to ICD–10. See Appendix II, Cause of death; Comparability ratio; Table IV; Table V.
4
Age-adjusted rates are calculated using the year 2000 standard population. Prior to 2001, age-adjusted rates were calculated using standard million proportions based
on rounded population numbers. Starting with 2001 data, unrounded population numbers are used to calculate age-adjusted rates. See Appendix II, Age adjustment.
5
The race groups, white, black, Asian or Pacific Islander, and American Indian or Alaska Native, include persons of Hispanic and non-Hispanic origin. Persons of
Hispanic origin may be of any race. Death rates for Hispanic, American Indian or Alaska Native, and Asian or Pacific Islander persons should be interpreted with
caution because of inconsistencies in reporting Hispanic origin or race on the death certificate (death rate numerators) compared with population figures (death rate
denominators). The net effect of misclassification is an underestimation of deaths and death rates for races other than white and black. See Appendix II, Race, for a
detailed discussion of sources of bias in death rates by race and Hispanic origin.
6
In 1950, rate is for the age group 75 years and over.
7
Prior to 1997, data from states that did not report Hispanic origin on the birth certificate were excluded. See Appendix II, Hispanic origin.
NOTES: Starting with Health, United States, 2003, rates for 1991–1999 were revised using intercensal population estimates based on the 1990 and 2000 censuses.
For 2000, population estimates are bridged-race April 1 census counts. Starting with Health, United States, 2012, rates for 2001–2009 were revised using intercensal
population estimates based on the 2000 and 2010 censuses. For 2010, population estimates are bridged-race April 1 census counts. Rates for 2011 and beyond were
computed using 2010-based postcensal estimates. See Appendix I, Population Census and Population Estimates. Age groups were selected to minimize the
presentation of unstable age-specific death rates based on small numbers of deaths and for consistency among comparison groups. Starting with 2003 data, some
states allowed the reporting of more than one race on the death certificate. The multiple-race data for these states were bridged to the single-race categories of the
1977 Office of Management and Budget standards, for comparability with other states. See Appendix II, Race. Data for additional years are available. See the Excel
spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC/NCHS, National Vital Statistics System; Grove RD, Hetzel AM. Vital statistics rates in the United States, 1940–1960. Washington, DC: U.S. Government
Printing Office. 1968; numerator data from National Vital Statistics System, annual public-use Mortality Files; denominator data from national population estimates for
race groups from Table 1 and unpublished Hispanic population estimates for 1985–1996 prepared by the Housing and Household Economic Statistics Division, U.S.
Census Bureau; Xu JQ, Murphy SL, Kochanek KD, et al. Deaths: Final data for 2013. National vital statistics reports; vol 64 no 2. Hyattsville, MD: NCHS; 2015.
Available from: http://www.cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_02.pdf. See Appendix I, National Vital Statistics System (NVSS).
Male
All ages, age-adjusted 4 . . . . . . . 208.1 225.1 247.6 271.2 280.4 248.9 200.3 196.0
All ages, crude . . . . . . . . . . . . . 142.9 162.5 182.1 205.3 221.3 207.2 197.9 197.6
Under 1 year. . . . . . . . . . . . . . . 9.7 7.7 4.4 3.7 2.4 2.6 1.7 1.5
1–4 years . . . . . . . . . . . . . . . . . 12.5 12.4 8.3 5.2 3.7 3.0 2.7 2.2
5–14 years . . . . . . . . . . . . . . . . 7.4 7.6 6.7 4.9 3.5 2.7 2.4 2.2
15–24 years . . . . . . . . . . . . . . . 9.7 10.2 10.4 7.8 5.7 5.1 4.1 3.8
25–34 years . . . . . . . . . . . . . . . 17.7 18.8 16.3 13.4 12.6 9.2 8.4 8.6
35–44 years . . . . . . . . . . . . . . . 45.6 48.9 53.0 44.0 38.5 32.7 24.0 24.0
45–54 years . . . . . . . . . . . . . . . 156.2 170.8 183.5 188.7 162.5 130.9 110.1 106.5
55–64 years . . . . . . . . . . . . . . . 413.1 459.9 511.8 520.8 532.9 415.8 336.9 331.3
65–74 years . . . . . . . . . . . . . . . 791.5 890.5 1,006.8 1,093.2 1,122.2 1,001.9 746.7 726.2
75–84 years . . . . . . . . . . . . . . . 1,332.6 1,389.4 1,588.3 1,790.5 1,914.4 1,760.6 1,447.6 1,414.5
85 years and over . . . . . . . . . . . 1,668.3 1,741.2 1,720.8 2,369.5 2,739.9 2,710.7 2,303.1 2,272.6
Female
All ages, age-adjusted 4 . . . . . . . 182.3 168.7 163.2 166.7 175.7 167.6 142.1 139.5
All ages, crude . . . . . . . . . . . . . 136.8 136.4 144.4 163.6 186.0 186.2 173.7 172.8
Under 1 year. . . . . . . . . . . . . . . 7.6 6.8 5.0 2.7 2.2 2.3 1.5 1.8
1–4 years . . . . . . . . . . . . . . . . . 10.8 9.3 6.7 3.7 3.2 2.5 2.2 1.9
5–14 years . . . . . . . . . . . . . . . . 6.0 6.0 5.2 3.6 2.8 2.2 2.0 2.1
15–24 years . . . . . . . . . . . . . . . 7.6 6.5 6.2 4.8 4.1 3.6 3.0 3.0
25–34 years . . . . . . . . . . . . . . . 22.2 20.1 16.7 14.0 12.6 10.4 8.9 8.6
35–44 years . . . . . . . . . . . . . . . 79.3 70.0 65.6 53.1 48.1 40.4 31.9 32.1
45–54 years . . . . . . . . . . . . . . . 194.0 183.0 181.5 171.8 155.5 124.2 107.0 104.6
55–64 years . . . . . . . . . . . . . . . 368.2 337.7 343.2 361.7 375.2 321.3 252.5 248.1
65–74 years . . . . . . . . . . . . . . . 612.3 560.2 557.9 607.1 677.4 663.6 531.9 520.8
75–84 years . . . . . . . . . . . . . . . 1,000.7 924.1 891.9 903.1 1,010.3 1,058.5 950.0 933.3
85 years and over . . . . . . . . . . . 1,299.7 1,263.9 1,096.7 1,255.7 1,372.1 1,456.4 1,336.4 1,310.1
White male 5
All ages, age-adjusted 4 . . . . . . . 210.0 224.7 244.8 265.1 272.2 243.9 199.7 195.5
All ages, crude . . . . . . . . . . . . . 147.2 166.1 185.1 208.7 227.7 218.1 213.1 213.0
25–34 years . . . . . . . . . . . . . . . 17.7 18.8 16.2 13.6 12.3 9.2 8.5 8.5
35–44 years . . . . . . . . . . . . . . . 44.5 46.3 50.1 41.1 35.8 30.9 24.2 23.9
45–54 years . . . . . . . . . . . . . . . 150.8 164.1 172.0 175.4 149.9 123.5 108.2 105.7
55–64 years . . . . . . . . . . . . . . . 409.4 450.9 498.1 497.4 508.2 401.9 329.4 323.1
65–74 years . . . . . . . . . . . . . . . 798.7 887.3 997.0 1,070.7 1,090.7 984.3 742.8 723.3
75–84 years . . . . . . . . . . . . . . . 1,367.6 1,413.7 1,592.7 1,779.7 1,883.2 1,736.0 1,453.0 1,421.7
85 years and over . . . . . . . . . . . 1,732.7 1,791.4 1,772.2 2,375.6 2,715.1 2,693.7 2,318.7 2,290.7
Black or
African American male 5
All ages, age-adjusted 4 . . . . . . . 178.9 227.6 291.9 353.4 397.9 340.3 246.1 238.7
All ages, crude . . . . . . . . . . . . . 106.6 136.7 171.6 205.5 221.9 188.5 166.4 165.6
25–34 years . . . . . . . . . . . . . . . 18.0 18.4 18.8 14.1 15.7 10.1 9.1 10.2
35–44 years . . . . . . . . . . . . . . . 55.7 72.9 81.3 73.8 64.3 48.4 26.6 27.3
45–54 years . . . . . . . . . . . . . . . 211.7 244.7 311.2 333.0 302.6 214.2 145.0 132.4
55–64 years . . . . . . . . . . . . . . . 490.8 579.7 689.2 812.5 859.2 626.4 468.8 464.0
65–74 years . . . . . . . . . . . . . . . 636.5 938.5 1,168.9 1,417.2 1,613.9 1,363.8 970.2 941.5
75–84 years 6 . . . . . . . . . . . . . . 853.5 1,053.3 1,624.8 2,029.6 2,478.3 2,351.8 1,685.7 1,633.2
85 years and over . . . . . . . . . . . -- 1,155.2 1,387.0 2,393.9 3,238.3 3,264.8 2,540.2 2,465.6
American Indian or
Alaska Native male 5 Deaths per 100,000 resident population
All ages, age-adjusted 4 . . . . . . . -- -- -- 140.5 145.8 155.8 127.9 132.3
All ages, crude . . . . . . . . . . . . . -- -- -- 58.1 61.4 67.0 70.5 73.6
25–34 years . . . . . . . . . . . . . . . -- -- -- * * * * 6.2
35–44 years . . . . . . . . . . . . . . . -- -- -- * 22.8 21.4 14.2 13.1
45–54 years . . . . . . . . . . . . . . . -- -- -- 86.9 86.9 70.3 65.9 61.9
55–64 years . . . . . . . . . . . . . . . -- -- -- 213.4 246.2 255.6 216.2 233.5
65–74 years . . . . . . . . . . . . . . . -- -- -- 613.0 530.6 648.0 558.4 477.8
75–84 years . . . . . . . . . . . . . . . -- -- -- 936.4 1,038.4 1,152.5 885.2 1,009.1
85 years and over . . . . . . . . . . . -- -- -- 1,471.2 1,654.4 1,584.2 1,288.7 1,488.1
Asian or
Pacific Islander male 5
All ages, age-adjusted 4 . . . . . . . -- -- -- 165.2 172.5 150.8 123.1 120.9
All ages, crude . . . . . . . . . . . . . -- -- -- 81.9 82.7 85.2 89.0 90.5
25–34 years . . . . . . . . . . . . . . . -- -- -- 6.3 9.2 7.4 7.4 6.5
35–44 years . . . . . . . . . . . . . . . -- -- -- 29.4 27.7 26.1 19.4 20.3
45–54 years . . . . . . . . . . . . . . . -- -- -- 108.2 92.6 78.5 65.9 67.6
55–64 years . . . . . . . . . . . . . . . -- -- -- 298.5 274.6 229.2 186.7 186.4
65–74 years . . . . . . . . . . . . . . . -- -- -- 581.2 687.2 559.4 396.5 387.5
75–84 years . . . . . . . . . . . . . . . -- -- -- 1,147.6 1,229.9 1,086.1 936.3 899.5
85 years and over . . . . . . . . . . . -- -- -- 1,798.7 1,837.0 1,823.2 1,577.7 1,575.3
Black or
African American female 5 Deaths per 100,000 resident population
All ages, age-adjusted 4 . . . . . . . 174.1 174.3 173.4 189.5 205.9 193.8 161.7 158.5
All ages, crude . . . . . . . . . . . . . 111.8 113.8 117.3 136.5 156.1 151.8 146.3 146.2
25–34 years . . . . . . . . . . . . . . . 34.3 31.0 20.9 18.3 18.7 13.5 12.1 10.4
35–44 years . . . . . . . . . . . . . . . 119.8 102.4 94.6 73.5 67.4 58.9 42.5 40.7
45–54 years . . . . . . . . . . . . . . . 277.0 254.8 228.6 230.2 209.9 173.9 140.2 134.8
55–64 years . . . . . . . . . . . . . . . 484.6 442.7 404.8 450.4 482.4 391.0 320.9 320.0
65–74 years . . . . . . . . . . . . . . . 477.3 541.6 615.8 662.4 773.2 753.1 617.8 593.4
75–84 years 6 . . . . . . . . . . . . . . 605.3 696.3 763.3 923.9 1,059.9 1,124.0 985.6 984.3
85 years and over . . . . . . . . . . . -- 728.9 791.5 1,159.9 1,431.3 1,527.7 1,318.4 1,306.5
American Indian or
Alaska Native female 5
All ages, age-adjusted 4 . . . . . . . -- -- -- 94.0 106.9 108.3 99.1 94.3
All ages, crude . . . . . . . . . . . . . -- -- -- 50.4 62.1 61.3 66.7 65.8
25–34 years . . . . . . . . . . . . . . . -- -- -- * * * * 6.4
35–44 years . . . . . . . . . . . . . . . -- -- -- 36.9 31.0 23.7 16.1 18.8
45–54 years . . . . . . . . . . . . . . . -- -- -- 96.9 104.5 59.7 62.5 69.1
55–64 years . . . . . . . . . . . . . . . -- -- -- 198.4 213.3 200.9 176.2 155.1
65–74 years . . . . . . . . . . . . . . . -- -- -- 350.8 438.9 458.3 394.4 373.0
75–84 years . . . . . . . . . . . . . . . -- -- -- 446.4 554.3 714.0 753.5 656.2
85 years and over . . . . . . . . . . . -- -- -- 786.5 843.7 983.2 763.3 844.8
Asian or
Pacific Islander female 5
All ages, age-adjusted 4 . . . . . . . -- -- -- 93.0 103.0 100.7 90.9 86.0
All ages, crude . . . . . . . . . . . . . -- -- -- 54.1 60.5 72.1 80.9 78.6
25–34 years . . . . . . . . . . . . . . . -- -- -- 9.5 7.3 8.1 5.6 6.4
35–44 years . . . . . . . . . . . . . . . -- -- -- 38.7 29.8 28.9 23.2 22.1
45–54 years . . . . . . . . . . . . . . . -- -- -- 99.8 93.9 78.2 71.2 63.6
55–64 years . . . . . . . . . . . . . . . -- -- -- 174.7 196.2 176.5 149.9 139.7
65–74 years . . . . . . . . . . . . . . . -- -- -- 301.9 346.2 357.4 290.3 280.7
75–84 years . . . . . . . . . . . . . . . -- -- -- 522.1 641.4 650.1 626.5 601.5
85 years and over . . . . . . . . . . . -- -- -- 800.0 971.7 988.5 1,012.6 925.7
1
Includes deaths of persons who were not residents of the 50 states and the District of Columbia (D.C.).
2
Underlying cause of death was coded according to the 6th Revision of the International Classification of Diseases (ICD) in 1950, 7th Revision in 1960, 8th Revision in
1970, and 9th Revision in 1980–1998. See Appendix II, Cause of death; Tables III; and IV.
3
Starting with 1999 data, cause of death is coded according to ICD–10. See Appendix II, Cause of death; Comparability ratio; Table IV; Table V.
4
Age-adjusted rates are calculated using the year 2000 standard population. Prior to 2001, age-adjusted rates were calculated using standard million proportions based
on rounded population numbers. Starting with 2001 data, unrounded population numbers are used to calculate age-adjusted rates. See Appendix II, Age adjustment.
5
The race groups, white, black, Asian or Pacific Islander, and American Indian or Alaska Native, include persons of Hispanic and non-Hispanic origin. Persons of
Hispanic origin may be of any race. Death rates for Hispanic, American Indian or Alaska Native, and Asian or Pacific Islander persons should be interpreted with
caution because of inconsistencies in reporting Hispanic origin or race on the death certificate (death rate numerators) compared with population figures (death rate
denominators). The net effect of misclassification is an underestimation of deaths and death rates for races other than white and black. See Appendix II, Race, for a
detailed discussion of sources of bias in death rates by race and Hispanic origin.
6
In 1950, rate is for the age group 75 years and over.
7
Prior to 1997, data from states that did not report Hispanic origin on the death certificate were excluded. See Appendix II, Hispanic origin.
NOTES: Starting with Health, United States, 2003, rates for 1991–1999 were revised using intercensal population estimates based on the 1990 and 2000 censuses.
For 2000, population estimates are bridged-race April 1 census counts. Starting with Health, United States, 2012, rates for 2001–2009 were revised using intercensal
population estimates based on the 2000 and 2010 censuses. For 2010, population estimates are bridged-race April 1 census counts. Rates for 2011 and beyond were
computed using 2010-based postcensal estimates. See Appendix I, Population Census and Population Estimates. Age groups were selected to minimize the
presentation of unstable age-specific death rates based on small numbers of deaths and for consistency among comparison groups. Starting with 2003 data, some
states allowed the reporting of more than one race on the death certificate. The multiple-race data for these states were bridged to the single-race categories of the
1977 Office of Management and Budget standards, for comparability with other states. See Appendix II, Race. Data for additional years are available. See the Excel
spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC/NCHS, National Vital Statistics System; Grove RD, Hetzel AM. Vital statistics rates in the United States, 1940–1960. Washington, DC: U.S. Government
Printing Office. 1968; numerator data from National Vital Statistics System, annual public-use Mortality Files; denominator data from national population estimates for
race groups from Table 1 and unpublished Hispanic population estimates for 1985–1996 prepared by the Housing and Household Economic Statistics Division, U.S.
Census Bureau; Xu JQ, Murphy SL, Kochanek KD, et al. Deaths: Final data for 2013. National vital statistics reports; vol 64 no 2. Hyattsville, MD: NCHS; 2015.
Available from: http://www.cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_02.pdf. See Appendix I, National Vital Statistics System (NVSS).
Asian or
Pacific Islander male 5 Deaths per 100,000 resident population
All ages, age-adjusted 4 . . . . . . . -- -- -- 43.3 44.2 40.9 32.7 30.6
All ages, crude . . . . . . . . . . . . . -- -- -- 22.1 20.7 22.7 22.9 22.3
45–54 years . . . . . . . . . . . . . . . -- -- -- 33.3 18.8 17.2 13.0 12.7
55–64 years . . . . . . . . . . . . . . . -- -- -- 94.4 74.4 61.4 45.3 42.5
65–74 years . . . . . . . . . . . . . . . -- -- -- 174.3 215.8 183.2 114.8 110.3
75–84 years . . . . . . . . . . . . . . . -- -- -- 301.3 307.5 323.2 279.4 257.5
85 years and over . . . . . . . . . . . -- -- -- * 421.3 378.0 411.4 387.3
Hispanic or Latino male 5,7
All ages, age-adjusted 4 . . . . . . . -- -- -- -- 44.1 39.0 26.8 26.2
All ages, crude . . . . . . . . . . . . . -- -- -- -- 16.2 13.3 11.7 11.8
45–54 years . . . . . . . . . . . . . . . -- -- -- -- 21.5 14.8 8.5 8.0
55–64 years . . . . . . . . . . . . . . . -- -- -- -- 80.7 58.6 35.6 35.6
65–74 years . . . . . . . . . . . . . . . -- -- -- -- 195.5 167.3 116.4 110.8
75–84 years . . . . . . . . . . . . . . . -- -- -- -- 313.4 327.5 237.3 225.4
85 years and over . . . . . . . . . . . -- -- -- -- 420.7 368.8 258.0 282.7
White, not Hispanic
or Latino male 7
All ages, age-adjusted 4 . . . . . . . -- -- -- -- 91.1 77.9 58.5 56.3
All ages, crude . . . . . . . . . . . . . -- -- -- -- 84.7 78.9 72.2 71.0
45–54 years . . . . . . . . . . . . . . . -- -- -- -- 57.8 37.7 29.9 28.7
55–64 years . . . . . . . . . . . . . . . -- -- -- -- 221.0 157.7 102.8 101.0
65–74 years . . . . . . . . . . . . . . . -- -- -- -- 431.4 387.3 261.3 246.6
75–84 years . . . . . . . . . . . . . . . -- -- -- -- 580.4 537.7 448.1 430.8
85 years and over . . . . . . . . . . . -- -- -- -- 520.9 527.3 488.3 478.0
White female 5
All ages, age-adjusted 4 . . . . . . . 5.9 6.8 13.1 24.5 37.6 42.3 37.6 36.7
All ages, crude . . . . . . . . . . . . . 4.7 5.9 12.3 25.6 42.4 49.9 49.4 48.9
45–54 years . . . . . . . . . . . . . . . 5.7 9.0 20.9 33.0 34.6 24.8 23.0 22.6
55–64 years . . . . . . . . . . . . . . . 13.7 15.1 37.2 71.9 105.7 96.1 68.0 66.0
65–74 years . . . . . . . . . . . . . . . 23.7 24.8 42.9 104.6 181.3 213.2 174.3 169.0
75–84 years . . . . . . . . . . . . . . . 34.0 32.7 52.6 95.2 194.6 272.7 280.7 274.1
85 years and over . . . . . . . . . . . 29.3 39.1 50.6 92.4 138.3 215.9 254.5 250.9
Black or
African American female 5
All ages, age-adjusted 4 . . . . . . . 4.5 6.8 13.7 24.8 36.8 39.8 34.7 34.1
All ages, crude . . . . . . . . . . . . . 2.8 4.3 9.4 18.3 28.1 30.8 31.1 31.3
45–54 years . . . . . . . . . . . . . . . 7.5 11.3 23.9 43.4 41.3 32.9 25.9 24.0
55–64 years . . . . . . . . . . . . . . . 12.9 17.9 33.5 79.9 117.9 95.3 71.0 71.9
65–74 years . . . . . . . . . . . . . . . 14.0 18.1 46.1 88.0 164.3 194.1 158.2 151.0
75–84 years 6 . . . . . . . . . . . . . . * 31.3 49.1 79.4 148.1 224.3 239.8 235.8
85 years and over . . . . . . . . . . . -- 34.2 44.8 85.8 134.9 185.9 211.2 224.9
American Indian or
Alaska Native female 5
All ages, age-adjusted 4 . . . . . . . -- -- -- 11.7 19.3 24.8 25.6 22.9
All ages, crude . . . . . . . . . . . . . -- -- -- 6.0 11.2 14.0 16.9 15.6
45–54 years . . . . . . . . . . . . . . . -- -- -- * 22.9 12.1 13.0 12.3
55–64 years . . . . . . . . . . . . . . . -- -- -- * 53.7 52.6 44.9 31.1
65–74 years . . . . . . . . . . . . . . . -- -- -- * 78.5 151.5 116.5 124.9
75–84 years . . . . . . . . . . . . . . . -- -- -- * 111.8 136.3 203.3 174.6
85 years and over . . . . . . . . . . . -- -- -- * * * 183.2 137.0
Asian or
Pacific Islander female 5 Deaths per 100,000 resident population
All ages, age-adjusted 4 . . . . . . . -- -- -- 15.4 18.9 18.4 17.8 18.0
All ages, crude . . . . . . . . . . . . . -- -- -- 8.4 10.5 12.6 15.5 16.0
45–54 years . . . . . . . . . . . . . . . -- -- -- 13.5 11.3 9.9 10.9 9.3
55–64 years . . . . . . . . . . . . . . . -- -- -- 24.6 38.3 30.4 25.1 24.3
65–74 years . . . . . . . . . . . . . . . -- -- -- 62.4 71.6 77.0 68.6 63.9
75–84 years . . . . . . . . . . . . . . . -- -- -- 117.7 137.9 135.0 142.8 150.2
85 years and over . . . . . . . . . . . -- -- -- * 172.9 175.3 181.7 207.4
Hispanic or Latina female 5,7
All ages, age-adjusted 4 . . . . . . . -- -- -- -- 14.1 14.7 13.6 13.2
All ages, crude . . . . . . . . . . . . . -- -- -- -- 7.2 7.2 8.0 8.0
45–54 years . . . . . . . . . . . . . . . -- -- -- -- 8.7 7.1 6.0 5.4
55–64 years . . . . . . . . . . . . . . . -- -- -- -- 25.1 22.2 20.5 18.9
65–74 years . . . . . . . . . . . . . . . -- -- -- -- 66.8 66.0 51.7 52.9
75–84 years . . . . . . . . . . . . . . . -- -- -- -- 94.3 112.3 110.8 107.2
85 years and over . . . . . . . . . . . -- -- -- -- 118.2 137.5 152.4 146.7
White, not Hispanic
or Latina female 7
All ages, age-adjusted 4 . . . . . . . -- -- -- -- 39.0 44.1 39.9 39.0
All ages, crude . . . . . . . . . . . . . -- -- -- -- 46.2 56.4 58.6 58.2
45–54 years . . . . . . . . . . . . . . . -- -- -- -- 36.6 26.4 25.8 25.6
55–64 years . . . . . . . . . . . . . . . -- -- -- -- 111.3 102.2 73.3 71.4
65–74 years . . . . . . . . . . . . . . . -- -- -- -- 186.4 222.9 185.5 179.5
75–84 years . . . . . . . . . . . . . . . -- -- -- -- 199.1 279.2 294.2 288.1
85 years and over . . . . . . . . . . . -- -- -- -- 139.0 218.0 259.6 256.8
* Rates based on fewer than 20 deaths are considered unreliable and are not shown.
1
Includes deaths of persons who were not residents of the 50 states and the District of Columbia (D.C.).
2
Underlying cause of death was coded according to the 6th Revision of the International Classification of Diseases (ICD) in 1950, 7th Revision in 1960, 8th Revision in
1970, and 9th Revision in 1980–1998. See Appendix II, Cause of death; Table III; Table IV.
3
Starting with 1999 data, cause of death is coded according to ICD–10. See Appendix II, Cause of death; Comparability ratio; Table IV; Table V.
4
Age-adjusted rates are calculated using the year 2000 standard population. Prior to 2001, age-adjusted rates were calculated using standard million proportions based
on rounded population numbers. Starting with 2001 data, unrounded population numbers are used to calculate age-adjusted rates. See Appendix II, Age adjustment.
5
The race groups, white, black, Asian or Pacific Islander, and American Indian or Alaska Native, include persons of Hispanic and non-Hispanic origin. Persons of
Hispanic origin may be of any race. Death rates for Hispanic, American Indian or Alaska Native, and Asian or Pacific Islander persons should be interpreted with
caution because of inconsistencies in reporting Hispanic origin or race on the death certificate (death rate numerators) compared with population figures (death rate
denominators). The net effect of misclassification is an underestimation of deaths and death rates for races other than white and black. See Appendix II, Race, for a
detailed discussion of sources of bias in death rates by race and Hispanic origin.
6
In 1950, rate is for the age group 75 years and over.
7
Prior to 1997, data from states that did not report Hispanic origin on the death certificate were excluded. See Appendix II, Hispanic origin.
NOTES: Starting with Health, United States, 2003, rates for 1991–1999 were revised using intercensal population estimates based on the 1990 and 2000 censuses.
For 2000, population estimates are bridged-race April 1 census counts. Starting with Health, United States, 2012, rates for 2001–2009 were revised using intercensal
population estimates based on the 2000 and 2010 censuses. For 2010, population estimates are bridged-race April 1 census counts. Rates for 2011 and beyond were
computed using 2010-based postcensal estimates. See Appendix I, Population Census and Population Estimates. Age groups were selected to minimize the
presentation of unstable age-specific death rates based on small numbers of deaths and for consistency among comparison groups. Starting with 2003 data, some
states allowed the reporting of more than one race on the death certificate. The multiple-race data for these states were bridged to the single-race categories of the
1977 Office of Management and Budget standards, for comparability with other states. See Appendix II, Race. Data for additional years are available. See the Excel
spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC/NCHS, National Vital Statistics System; Grove RD, Hetzel AM. Vital statistics rates in the United States, 1940–1960. Washington, DC: U.S. Government
Printing Office. 1968; numerator data from National Vital Statistics System, annual public-use Mortality Files; denominator data from national population estimates for
race groups from Table 1 and unpublished Hispanic population estimates for 1985–1996 prepared by the Housing and Household Economic Statistics Division, U.S.
Census Bureau; Xu JQ, Murphy SL, Kochanek KD, et al. Deaths: Final data for 2013. National vital statistics reports; vol 64 no 2. Hyattsville, MD: NCHS; 2015.
Available from: http://www.cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_02.pdf. See Appendix I, National Vital Statistics System (NVSS).
Black or
African American 5
All ages, age-adjusted 4 . . . . . . . 25.3 27.9 28.9 31.7 38.1 34.5 30.3 29.4 28.3
All ages, crude . . . . . . . . . . . . . 16.4 18.7 19.7 22.9 29.0 27.9 27.5 27.5 26.7
35–44 years . . . . . . . . . . . . . . . 21.0 24.8 24.4 24.1 25.8 20.9 18.3 16.8 16.3
45–54 years . . . . . . . . . . . . . . . 46.5 54.4 52.0 52.7 60.5 51.5 40.9 40.1 39.2
55–64 years . . . . . . . . . . . . . . . 64.3 63.2 64.7 79.9 93.1 80.9 70.5 67.6 63.7
65–74 years . . . . . . . . . . . . . . . 67.0 72.3 77.3 84.3 112.2 98.6 97.4 89.7 86.6
75–84 years 6 . . . . . . . . . . . . . . 81.0 87.5 101.8 114.1 140.5 139.8 123.2 129.7 126.1
85 years and over . . . . . . . . . . . -- 92.1 112.1 149.9 201.5 238.7 214.6 204.4 193.1
American Indian or
Alaska Native 5
All ages, age-adjusted 4 . . . . . . . -- -- -- 10.8 13.7 13.6 11.5 10.8 10.1
All ages, crude . . . . . . . . . . . . . -- -- -- 6.1 8.6 8.7 8.0 7.9 7.5
35–44 years . . . . . . . . . . . . . . . -- -- -- * * * * * *
45–54 years . . . . . . . . . . . . . . . -- -- -- * 23.9 14.4 13.2 10.8 11.2
55–64 years . . . . . . . . . . . . . . . -- -- -- * * 40.0 25.2 22.5 20.6
65–74 years . . . . . . . . . . . . . . . -- -- -- * * 42.5 34.3 46.8 38.2
75–84 years . . . . . . . . . . . . . . . -- -- -- * * 71.8 61.1 64.1 50.5
85 years and over . . . . . . . . . . . -- -- -- * * * * * *
Asian or
Pacific Islander 5
All ages, age-adjusted 4 . . . . . . . -- -- -- 11.9 13.7 12.3 11.9 11.3 11.1
All ages, crude . . . . . . . . . . . . . -- -- -- 8.2 9.3 10.2 10.8 10.9 10.8
35–44 years . . . . . . . . . . . . . . . -- -- -- 10.4 8.4 8.1 5.4 6.4 5.7
45–54 years . . . . . . . . . . . . . . . -- -- -- 23.4 26.4 22.3 17.0 16.7 15.6
55–64 years . . . . . . . . . . . . . . . -- -- -- 35.7 33.8 31.3 28.4 27.8 27.2
65–74 years . . . . . . . . . . . . . . . -- -- -- * 38.5 34.7 37.9 37.1 32.7
75–84 years . . . . . . . . . . . . . . . -- -- -- * 48.0 37.5 53.2 40.3 48.6
85 years and over . . . . . . . . . . . -- -- -- * * 68.2 77.5 77.4 82.8
* Rates based on fewer than 20 deaths are considered unreliable and are not shown.
1
Includes deaths of persons who were not residents of the 50 states and the District of Columbia (D.C.).
2
Underlying cause of death was coded according to the 6th Revision of the International Classification of Diseases (ICD) in 1950, 7th Revision in 1960, 8th Revision in
1970, and 9th Revision in 1980–1998. See Appendix II, Cause of death; Table III; Table IV.
3
Starting with 1999 data, cause of death is coded according to ICD–10. See Appendix II, Cause of death; Comparability ratio; Table IV; Table V.
4
Age-adjusted rates are calculated using the year 2000 standard population. Prior to 2001, age-adjusted rates were calculated using standard million proportions based
on rounded population numbers. Starting with 2001 data, unrounded population numbers are used to calculate age-adjusted rates. See Appendix II, Age adjustment.
5
The race groups, white, black, Asian or Pacific Islander, and American Indian or Alaska Native, include persons of Hispanic and non-Hispanic origin. Persons of
Hispanic origin may be of any race. Death rates for Hispanic, American Indian or Alaska Native, and Asian or Pacific Islander persons should be interpreted with
caution because of inconsistencies in reporting Hispanic origin or race on the death certificate (death rate numerators) compared with population figures (death rate
denominators). The net effect of misclassification is an underestimation of deaths and death rates for races other than white and black. See Appendix II, Race, for a
detailed discussion of sources of bias in death rates by race and Hispanic origin.
6
In 1950, rate is for the age group 75 years and over.
7
Prior to 1997, data from states that did not report Hispanic origin on the death certificate were excluded. See Appendix II, Hispanic origin.
NOTES: Starting with Health, United States, 2003, rates for 1991–1999 were revised using intercensal population estimates based on the 1990 and 2000 censuses.
For 2000, population estimates are bridged-race April 1 census counts. Starting with Health, United States, 2012, rates for 2001–2009 were revised using intercensal
population estimates based on the 2000 and 2010 censuses. For 2010, population estimates are bridged-race April 1 census counts. Rates for 2011 and beyond were
computed using 2010-based postcensal estimates. See Appendix I, Population Census and Population Estimates. Age groups were selected to minimize the
presentation of unstable age-specific death rates based on small numbers of deaths and for consistency among comparison groups. Starting with 2003 data, some
states allowed the reporting of more than one race on the death certificate. The multiple-race data for these states were bridged to the single-race categories of the
1977 Office of Management and Budget standards, for comparability with other states. See Appendix II, Race. Data for additional years are available. See the Excel
spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC/NCHS, National Vital Statistics System; numerator data from National Vital Statistics System, annual public-use Mortality Files; denominator data from
national population estimates for race groups from Table 1 and unpublished Hispanic population estimates for 1985–1996 prepared by the Housing and Household
Economic Statistics Division, U.S. Census Bureau; Xu JQ, Murphy SL, Kochanek KD, et al. Deaths: Final data for 2013. National vital statistics reports; vol 64 no 2.
Hyattsville, MD: NCHS; 2015. Available from: http://www.cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_02.pdf. See Appendix I, National Vital Statistics System (NVSS).
Female
All ages, age-adjusted 4 . . . . . . . . . . . . 1.1 2.2 5.3 4.2 2.6 2.2 2.5 2.5 1.4 1.2 1.1
All ages, crude . . . . . . . . . . . . . . . . . . 1.1 2.2 5.3 4.3 2.6 2.2 2.5 2.5 1.4 1.2 1.2
Under 1 year . . . . . . . . . . . . . . . . . . . 2.5 3.0 1.2 * * * * * * * *
1–4 years . . . . . . . . . . . . . . . . . . . . . . 0.7 0.8 1.5 1.0 0.4 * * * * * *
5–14 years . . . . . . . . . . . . . . . . . . . . . * 0.2 0.5 0.4 0.2 0.2 0.2 0.1 * * *
15–24 years . . . . . . . . . . . . . . . . . . . . 0.3 0.7 1.4 0.9 0.7 0.5 0.5 0.4 0.2 0.2 0.1
25–34 years . . . . . . . . . . . . . . . . . . . . 2.8 4.9 10.9 8.2 4.9 4.2 4.1 4.2 1.3 0.9 0.8
35–44 years . . . . . . . . . . . . . . . . . . . . 2.1 5.2 13.3 11.2 6.7 5.7 6.7 6.5 2.9 2.4 2.0
45–54 years . . . . . . . . . . . . . . . . . . . . 0.8 1.9 6.6 5.6 3.7 3.1 4.1 4.4 3.4 3.1 2.8
55–64 years . . . . . . . . . . . . . . . . . . . . 0.5 1.1 2.8 2.5 1.6 1.6 1.6 1.8 2.3 2.1 2.2
65–74 years . . . . . . . . . . . . . . . . . . . . 0.5 0.8 1.4 0.8 0.5 0.6 0.8 0.8 0.9 0.8 1.1
75–84 years . . . . . . . . . . . . . . . . . . . . 0.5 0.4 0.3 0.3 0.4 0.3 0.3 0.3 0.4 0.3 0.5
85 years and over . . . . . . . . . . . . . . . . * * * * * * * * * * *
* Rates based on fewer than 20 deaths are considered unreliable and are not shown.
1
The race groups, white, black, Asian or Pacific Islander, and American Indian or Alaska Native, include persons of Hispanic and non-Hispanic origin. Persons of
Hispanic origin may be of any race. Death rates for Hispanic, American Indian or Alaska Native, and Asian or Pacific Islander persons should be interpreted with
caution because of inconsistencies in reporting Hispanic origin or race on the death certificate (death rate numerators) compared with population figures (death rate
denominators). The net effect of misclassification is an underestimation of deaths and death rates for races other than white and black. See Appendix II, Race, for a
detailed discussion of sources of bias in death rates by race and Hispanic origin.
2
Categories for the coding and classification of human immunodeficiency virus (HIV) disease were introduced in the United States in 1987. For the period 1987–1998,
underlying cause of death was coded according to the 9th Revision of the International Classification of Diseases (ICD). See Appendix II, Cause of death; Human
3
Starting with 1999 data, cause of death is coded according to ICD–10. See Appendix II, Cause of death; Comparability ratio; Table IV; Table V.
4
Age-adjusted rates are calculated using the year 2000 standard population. Prior to 2001, age-adjusted rates were calculated using standard million proportions based
on rounded population numbers. Starting with 2001 data, unrounded population numbers are used to calculate age-adjusted rates. See Appendix II, Age adjustment.
5
Prior to 1997, data from states that did not report Hispanic origin on the death certificate were excluded. See Appendix II, Hispanic origin.
NOTES: Starting with Health, United States, 2003, rates for 1991–1999 were revised using intercensal population estimates based on the 1990 and 2000 censuses.
For 2000, population estimates are bridged-race April 1 census counts. Starting with Health, United States, 2012, rates for 2001–2009 were revised using intercensal
population estimates based on the 2000 and 2010 censuses. For 2010, population estimates are bridged-race April 1 census counts. Rates for 2011 and beyond were
computed using 2010-based postcensal estimates. See Appendix I, Population Census and Population Estimates. Starting with 2003 data, some states allowed the
reporting of more than one race on the death certificate. The multiple-race data for these states were bridged to the single-race categories of the 1977 Office of
Management and Budget standards, for comparability with other states. See Appendix II, Race. Data for additional years are available. See the Excel spreadsheet on
the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC/NCHS, National Vital Statistics System; numerator data from annual public-use Mortality Files; denominator data from national population estimates for
race groups from Table 1 and unpublished Hispanic population estimates for 1987–1996 prepared by the Housing and Household Economic Statistics Division, U.S.
Census Bureau; Xu JQ, Murphy SL, Kochanek KD, et al. Deaths: Final data for 2013. National vital statistics reports; vol 64 no 2. Hyattsville, MD: NCHS; 2015.
Available from: http://www.cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_02.pdf. See Appendix I, National Vital Statistics System (NVSS).
and Hispanic origin 1999 2000 2004 2005 2009 2010 2011 2012 2013
All persons Drug poisoning deaths involving opioid analgesics per 100,000 resident population 4
All ages, age-adjusted 2 . . . . . . . . . . . . 1.4 1.5 3.4 3.7 5.0 5.4 5.4 5.1 5.1
All ages, crude . . . . . . . . . . . . . . . . . . 1.4 1.6 3.4 3.7 5.1 5.4 5.4 5.1 5.1
Under 15 years . . . . . . . . . . . . . . . . . . * 0.0 0.1 0.1 0.1 0.1 0.1 0.1 0.1
15–24 years . . . . . . . . . . . . . . . . . . . . 0.7 0.8 2.7 2.7 3.6 3.9 3.6 2.8 2.6
25–34 years . . . . . . . . . . . . . . . . . . . . 1.9 1.9 4.4 5.3 7.6 8.5 8.5 7.7 7.5
35–44 years . . . . . . . . . . . . . . . . . . . . 3.5 3.7 6.8 6.9 8.6 9.1 9.3 8.8 8.6
45–54 years . . . . . . . . . . . . . . . . . . . . 2.9 3.2 7.1 7.9 10.6 10.9 11.2 10.6 10.6
55–64 years . . . . . . . . . . . . . . . . . . . . 1.0 1.1 2.6 3.1 5.8 6.2 6.3 6.6 7.5
65–74 years . . . . . . . . . . . . . . . . . . . . 0.4 0.4 0.8 1.0 1.7 1.5 1.8 2.0 2.3
75–84 years . . . . . . . . . . . . . . . . . . . . 0.3 0.2 0.5 0.6 0.8 0.7 0.7 0.9 0.8
85 years and over . . . . . . . . . . . . . . . . * * 0.5 0.9 0.7 1.1 0.8 0.8 0.9
Male
All ages, age-adjusted 2 . . . . . . . . . . . . 2.0 2.0 4.2 4.6 6.2 6.5 6.5 6.0 5.9
All ages, crude . . . . . . . . . . . . . . . . . . 2.0 2.1 4.2 4.6 6.2 6.6 6.5 6.0 5.9
15–24 years . . . . . . . . . . . . . . . . . . . . 1.0 1.2 4.2 4.2 5.3 5.6 5.3 4.2 3.9
25–34 years . . . . . . . . . . . . . . . . . . . . 2.7 2.7 6.1 7.2 10.6 11.7 11.4 10.0 10.0
35–44 years . . . . . . . . . . . . . . . . . . . . 5.0 4.9 8.2 8.3 10.4 10.9 10.9 10.3 9.6
45–54 years . . . . . . . . . . . . . . . . . . . . 3.9 4.3 8.3 9.4 11.6 12.0 12.1 11.1 11.1
55–64 years . . . . . . . . . . . . . . . . . . . . 1.1 1.0 2.8 3.5 6.3 7.0 6.9 7.3 8.0
65–74 years . . . . . . . . . . . . . . . . . . . . 0.5 0.3 0.7 0.7 1.6 1.2 1.7 2.0 2.2
Female
All ages, age-adjusted 2 . . . . . . . . . . . . 0.9 1.1 2.5 2.8 3.9 4.2 4.3 4.2 4.3
All ages, crude . . . . . . . . . . . . . . . . . . 0.9 1.1 2.5 2.8 4.0 4.2 4.4 4.2 4.4
15–24 years . . . . . . . . . . . . . . . . . . . . 0.3 0.4 1.1 1.2 1.7 2.1 1.9 1.5 1.4
25–34 years . . . . . . . . . . . . . . . . . . . . 1.1 1.2 2.8 3.4 4.7 5.3 5.5 5.3 5.0
35–44 years . . . . . . . . . . . . . . . . . . . . 2.1 2.5 5.4 5.6 6.9 7.3 7.8 7.3 7.6
45–54 years . . . . . . . . . . . . . . . . . . . . 1.9 2.2 5.9 6.5 9.7 9.8 10.2 10.1 10.1
55–64 years . . . . . . . . . . . . . . . . . . . . 0.8 1.1 2.4 2.8 5.2 5.5 5.7 6.0 6.9
65–74 years . . . . . . . . . . . . . . . . . . . . 0.3 0.4 0.9 1.2 1.7 1.7 1.8 2.0 2.4
75–84 years . . . . . . . . . . . . . . . . . . . . 0.4 * 0.6 0.6 0.9 0.7 0.7 0.9 0.7
Black or African American . . . . . . . . . 1.2 1.2 1.8 2.1 2.4 2.2 2.4 2.3 2.7
American Indian or Alaska Native . . . * 1.9 4.5 4.4 7.5 5.3 5.5 5.8 4.8
Asian or Pacific Islander . . . . . . . . . . * * 0.4 0.5 0.7 0.8 1.0 0.7 0.9
Hispanic or Latino . . . . . . . . . . . . . . 2.9 1.7 2.1 2.2 2.6 2.4 2.6 2.5 2.7
White, not Hispanic or Latino . . . . . . 2.1 2.3 5.3 5.9 8.2 9.0 8.8 8.1 7.9
Female:
White . . . . . . . . . . . . . . . . . . . . . . . 1.0 1.2 2.9 3.2 4.5 4.8 5.1 4.9 5.0
Black or African American . . . . . . . . . 0.6 0.6 1.2 1.4 1.8 2.0 2.0 2.0 2.2
American Indian or Alaska Native . . . * * 2.7 3.8 4.7 4.9 4.6 5.4 5.4
Asian or Pacific Islander . . . . . . . . . . * * * 0.4 0.4 0.5 0.4 0.4 0.3
Hispanic or Latina . . . . . . . . . . . . . . 0.5 0.5 1.0 1.0 1.3 1.3 1.4 1.5 1.5
White, not Hispanic or Latina . . . . . . 1.1 1.3 3.2 3.5 5.2 5.6 5.8 5.6 5.8
* Rates based on fewer than 20 deaths are considered unreliable and are not shown.
0.0 Rate more than zero but less than 0.05.
1
Drug poisoning was coded using underlying cause of death according to the 10th Revision of the International Classification of Diseases (ICD–10). See Appendix II,
Cause of death; Table IV. Drug poisoning deaths include those resulting from accidental or intentional overdoses of a drug, being given the wrong drug, taking the
wrong drug in error, taking a drug inadvertently, or other misuses of drugs. These deaths are from all manners and intents, including unintentional, suicide, homicide,
undetermined intent, legal intervention, and operations of war.
2
Age-adjusted rates are calculated using the year 2000 standard population with unrounded population numbers. See Appendix II, Age adjustment.
3
The race groups, white, black, Asian or Pacific Islander, and American Indian or Alaska Native, include persons of Hispanic and non-Hispanic origin. Persons of
Hispanic origin may be of any race. Death rates for Hispanic, American Indian or Alaska Native, and Asian or Pacific Islander persons should be interpreted with
caution because of inconsistencies in reporting Hispanic origin or race on the death certificate (death rate numerators) compared with population figures (death rate
denominators). The net effect of misclassification is an underestimation of deaths and death rates for races other than white and black. See Appendix II, Race, for a
detailed discussion of sources of bias in death rates by race and Hispanic origin.
4
Opioid analgesics include pharmaceutical opioids such as hydrocodone, codeine, and methadone, and synthetic narcotics such as fentanyl and propoxyphene. Drug
poisoning deaths involving opioid analgesics include those with an underlying cause of drug poisoning and with opioid analgesics mentioned in the ICD–10 multiple
causes of death. See NCHS Health E-Stat for more information on this topic, available from: http://www.cdc.gov/nchs/data/hestat/drug_poisoning/drug_poisoning.htm
See Appendix I, National Vital Statistics System (NVSS), Mortality Multiple Cause-of-Death File, for information about tabulating cause-of-death data in this table. These
deaths include all manners and intents. See Appendix II, Cause of death; Table IV. In 1999–2013, 21%–25% of drug poisoning deaths did not include specific
information on the death certificate on the type of drug that was involved.
NOTES: Rates for 1999 were computed using intercensal population estimates based on the 1990 and 2000 censuses. Rates for 2000 were computed based on 2000
bridged-race April 1 census counts. Starting with Health, United States, 2012, rates for 2001–2009 were revised using intercensal population estimates based on the
2000 and 2010 censuses. Rates for 2010 were based on 2010 bridged-race April 1 census counts. Rates for 2011 and beyond were computed using 2010-based
postcensal estimates. See Appendix I, Population Census and Population Estimates. Age groups were selected to minimize the presentation of unstable age-specific
death rates based on small numbers of deaths and for consistency among comparison groups. For additional injury-related statistics, see the Web-based Injury
Statistics Query and Reporting System, available from: http://www.cdc.gov/injury/wisqars/index.html. Starting with 2003 data, some states allowed the reporting of more
than one race on the death certificate. The multiple-race data for these states were bridged to the single-race categories of the 1977 Office of Management and Budget
standards, for comparability with other states. See Appendix II, Race. Data for additional years are available. See the Excel spreadsheet on the Health, United States
website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC/NCHS, National Vital Statistics System; numerator data from National Vital Statistics System, annual public-use Mortality Files; denominator data from
national population estimates for race groups from Table 1; Xu JQ, Murphy SL, Kochanek KD, et al. Deaths: Final data for 2013. National vital statistics reports; vol 64
no 2. Hyattsville, MD: NCHS; 2015. Available from: http://www.cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_02.pdf. See Appendix I, National Vital Statistics System (NVSS).
Male
All ages, age-adjusted 4 . . . . . . . 38.5 35.4 41.5 33.6 26.5 21.7 16.2 16.5 15.9
All ages, crude . . . . . . . . . . . . . 35.4 31.8 39.7 35.3 26.7 21.3 16.3 16.6 16.1
Under 1 year. . . . . . . . . . . . . . . 9.1 8.6 9.3 7.3 5.0 4.6 2.2 1.9 1.7
1–14 years . . . . . . . . . . . . . . . . 12.3 10.7 13.0 10.0 7.0 4.9 2.7 2.5 2.5
1–4 years . . . . . . . . . . . . . . . 13.0 11.5 12.9 10.2 6.9 4.7 3.0 3.1 3.0
5–14 years . . . . . . . . . . . . . . 11.9 10.4 13.1 9.9 7.0 5.0 2.5 2.3 2.4
15–24 years . . . . . . . . . . . . . . . 56.7 61.2 73.2 68.4 49.5 37.4 23.1 22.5 21.2
15–19 years. . . . . . . . . . . . . . 46.3 51.7 64.1 62.6 45.5 33.9 17.8 16.2 14.7
20–24 years. . . . . . . . . . . . . . 66.7 73.2 84.4 74.3 53.3 41.2 28.5 28.4 27.3
25–34 years . . . . . . . . . . . . . . . 40.8 40.1 49.4 46.3 35.7 25.5 21.0 21.5 20.8
35–44 years . . . . . . . . . . . . . . . 32.5 29.9 37.7 31.7 24.7 22.0 16.9 17.6 16.9
45–64 years . . . . . . . . . . . . . . . 37.7 33.3 38.9 26.5 21.9 20.2 17.9 18.6 18.2
45–54 years. . . . . . . . . . . . . . 33.6 31.6 37.2 27.6 22.0 20.4 17.9 18.8 18.3
55–64 years. . . . . . . . . . . . . . 43.1 35.6 40.9 25.4 21.7 19.8 17.8 18.5 18.1
65 years and over . . . . . . . . . . . 66.6 52.1 54.4 33.9 32.1 29.5 22.2 22.1 21.5
65–74 years. . . . . . . . . . . . . . 59.1 45.8 47.3 27.3 24.2 21.7 17.1 18.5 17.5
75–84 years. . . . . . . . . . . . . . 85.0 66.0 68.2 44.3 41.2 35.6 25.9 24.8 24.9
85 years and over . . . . . . . . . 78.1 62.7 63.1 56.1 64.5 57.5 40.2 35.3 35.3
Female
All ages, age-adjusted 4 . . . . . . . 11.5 11.7 14.9 11.8 11.0 9.5 6.5 6.5 6.2
All ages, crude . . . . . . . . . . . . . 10.9 11.0 14.7 12.3 11.3 9.7 6.8 6.7 6.4
Under 1 year. . . . . . . . . . . . . . . 7.6 7.5 10.4 6.7 4.9 4.2 1.8 1.8 1.8
1–14 years . . . . . . . . . . . . . . . . 7.2 6.3 7.9 6.3 4.9 3.7 2.0 1.9 1.9
1–4 years . . . . . . . . . . . . . . . 10.0 8.4 10.0 8.1 5.6 3.8 2.5 2.6 2.3
5–14 years . . . . . . . . . . . . . . 5.7 5.4 7.2 5.7 4.7 3.6 1.8 1.7 1.8
15–24 years . . . . . . . . . . . . . . . 12.6 15.1 21.6 20.8 17.9 15.9 9.9 9.3 8.9
15–19 years. . . . . . . . . . . . . . 12.9 16.0 22.7 22.8 20.0 17.5 9.2 8.9 7.9
20–24 years. . . . . . . . . . . . . . 12.2 14.0 20.4 18.9 16.0 14.2 10.5 9.8 9.9
25–34 years . . . . . . . . . . . . . . . 9.3 9.2 13.0 12.2 11.5 8.8 6.9 7.4 6.9
35–44 years . . . . . . . . . . . . . . . 8.5 9.1 12.9 10.4 9.2 8.8 6.2 6.2 5.9
45–64 years . . . . . . . . . . . . . . . 12.6 13.1 15.3 10.3 10.1 8.7 6.3 6.4 6.3
45–54 years. . . . . . . . . . . . . . 10.9 11.6 14.5 10.2 9.6 8.2 6.3 6.5 6.3
55–64 years. . . . . . . . . . . . . . 14.9 15.2 16.2 10.5 10.8 9.5 6.3 6.4 6.2
65 years and over . . . . . . . . . . . 21.9 20.3 23.1 15.0 17.2 15.8 11.3 10.8 10.0
65–74 years. . . . . . . . . . . . . . 20.6 19.0 21.6 13.0 14.1 12.3 8.2 8.2 7.5
75–84 years. . . . . . . . . . . . . . 25.2 23.0 27.2 18.5 21.9 19.2 13.7 12.9 12.5
85 years and over . . . . . . . . . 22.1 22.0 18.0 15.2 18.3 19.3 15.9 15.5 13.7
White male 5
All ages, age-adjusted 4 . . . . . . . 37.9 34.8 40.4 33.8 26.3 21.8 16.7 17.0 16.3
All ages, crude . . . . . . . . . . . . . 35.1 31.5 39.1 35.9 26.7 21.6 17.0 17.3 16.7
Under 1 year. . . . . . . . . . . . . . . 9.1 8.8 9.1 7.0 4.8 4.2 2.0 1.9 1.7
1–14 years . . . . . . . . . . . . . . . . 12.4 10.6 12.5 9.8 6.6 4.8 2.7 2.4 2.4
15–24 years . . . . . . . . . . . . . . . 58.3 62.7 75.2 73.8 52.5 39.6 24.6 24.5 22.9
25–34 years . . . . . . . . . . . . . . . 39.1 38.6 47.0 46.6 35.4 25.1 21.4 22.0 21.1
35–44 years . . . . . . . . . . . . . . . 30.9 28.4 35.2 30.7 23.7 21.8 17.4 18.0 17.3
45–64 years . . . . . . . . . . . . . . . 36.2 31.7 36.5 25.2 20.6 19.7 18.3 19.0 18.5
65 years and over . . . . . . . . . . . 67.1 52.1 54.2 32.7 31.4 29.4 22.7 22.6 22.1
Black or
African American male 5 Deaths per 100,000 resident population
All ages, age-adjusted 4 . . . . . . . 34.8 39.6 51.0 34.2 29.9 24.4 16.7 17.4 17.0
All ages, crude . . . . . . . . . . . . . 37.2 33.1 44.3 31.1 28.1 22.5 15.9 16.6 16.4
Under 1 year. . . . . . . . . . . . . . . -- * 10.6 7.8 * 6.7 * * *
1–14 years 6 . . . . . . . . . . . . . . . 10.4 11.2 16.3 11.4 8.9 5.5 3.0 3.2 3.3
15–24 years . . . . . . . . . . . . . . . 42.5 46.4 58.1 34.9 36.1 30.2 19.4 17.5 17.6
25–34 years . . . . . . . . . . . . . . . 54.4 51.0 70.4 44.9 39.5 32.6 24.9 25.6 25.1
35–44 years . . . . . . . . . . . . . . . 46.7 43.6 59.5 41.2 33.5 27.2 19.4 20.8 20.5
45–64 years . . . . . . . . . . . . . . . 54.6 47.8 61.7 39.5 33.3 27.1 19.1 20.8 21.1
65 years and over . . . . . . . . . . . 52.6 48.2 53.4 42.4 36.3 32.1 20.0 21.8 18.5
American Indian or
Alaska Native male 5
All ages, age-adjusted 4 . . . . . . . -- -- -- 78.9 48.3 35.8 21.1 22.2 20.0
All ages, crude . . . . . . . . . . . . . -- -- -- 74.6 47.6 33.6 19.8 22.2 19.0
1–14 years . . . . . . . . . . . . . . . . -- -- -- 15.1 11.6 7.8 * 6.8 3.9
15–24 years . . . . . . . . . . . . . . . -- -- -- 126.1 75.2 56.8 31.9 27.3 26.8
25–34 years . . . . . . . . . . . . . . . -- -- -- 107.0 78.2 49.8 23.8 32.0 30.3
35–44 years . . . . . . . . . . . . . . . -- -- -- 82.8 57.0 36.3 24.5 30.4 19.8
45–64 years . . . . . . . . . . . . . . . -- -- -- 77.4 45.9 32.0 23.2 27.0 20.4
65 years and over . . . . . . . . . . . -- -- -- 97.0 43.0 48.5 26.6 * 25.8
Asian or
Pacific Islander male 5
All ages, age-adjusted 4 . . . . . . . -- -- -- 19.0 17.9 10.6 6.5 5.9 6.4
All ages, crude . . . . . . . . . . . . . -- -- -- 17.1 15.8 9.8 6.2 5.6 5.9
1–14 years . . . . . . . . . . . . . . . . -- -- -- 8.2 6.3 2.5 * * 1.5
15–24 years . . . . . . . . . . . . . . . -- -- -- 27.2 25.7 17.0 9.6 8.9 8.1
25–34 years . . . . . . . . . . . . . . . -- -- -- 18.8 17.0 10.4 7.8 5.8 5.9
35–44 years . . . . . . . . . . . . . . . -- -- -- 13.1 12.2 6.9 4.1 3.5 5.3
45–64 years . . . . . . . . . . . . . . . -- -- -- 13.7 15.1 10.1 6.0 6.3 5.9
65 years and over . . . . . . . . . . . -- -- -- 37.3 33.6 21.1 14.6 12.5 14.3
Hispanic or Latino male 5,7
All ages, age-adjusted 4 . . . . . . . -- -- -- -- 29.5 21.3 14.0 13.9 14.2
All ages, crude . . . . . . . . . . . . . -- -- -- -- 29.2 20.1 12.8 13.1 13.3
1–14 years . . . . . . . . . . . . . . . . -- -- -- -- 7.2 4.4 2.5 2.5 2.5
15–24 years . . . . . . . . . . . . . . . -- -- -- -- 48.2 34.7 20.2 20.3 20.5
25–34 years . . . . . . . . . . . . . . . -- -- -- -- 41.0 24.9 18.0 19.9 18.2
35–44 years . . . . . . . . . . . . . . . -- -- -- -- 28.0 21.6 13.9 13.9 14.5
45–64 years . . . . . . . . . . . . . . . -- -- -- -- 28.9 21.7 14.3 14.7 15.9
65 years and over . . . . . . . . . . . -- -- -- -- 35.3 28.9 20.7 17.5 18.8
White female 5
All ages, age-adjusted 4 . . . . . . . 11.4 11.7 14.9 12.2 11.2 9.8 6.8 6.8 6.4
All ages, crude . . . . . . . . . . . . . 10.9 11.2 14.8 12.8 11.6 10.0 7.1 7.1 6.7
Under 1 year. . . . . . . . . . . . . . . 7.8 7.5 10.2 7.1 4.7 3.5 1.9 1.6 1.7
1–14 years . . . . . . . . . . . . . . . . 7.2 6.2 7.5 6.2 4.8 3.7 2.1 1.9 1.8
15–24 years . . . . . . . . . . . . . . . 12.6 15.6 22.7 23.0 19.5 17.1 10.8 10.0 9.5
25–34 years . . . . . . . . . . . . . . . 9.0 9.0 12.7 12.2 11.6 8.9 7.1 7.6 7.1
35–44 years . . . . . . . . . . . . . . . 8.1 8.9 12.3 10.6 9.2 8.9 6.5 6.6 6.1
45–64 years . . . . . . . . . . . . . . . 12.7 13.1 15.1 10.4 9.9 8.7 6.4 6.5 6.4
65 years and over . . . . . . . . . . . 22.2 20.8 23.7 15.3 17.4 16.2 11.5 11.3 10.4
Black or
African American female 5 Deaths per 100,000 resident population
All ages, age-adjusted 4 . . . . . . . 9.3 10.4 14.1 8.5 9.6 8.4 5.9 5.9 5.7
All ages, crude . . . . . . . . . . . . . 10.2 9.7 13.4 8.3 9.4 8.2 5.8 5.9 5.7
Under 1 year. . . . . . . . . . . . . . . -- 8.1 11.9 * 7.0 * * * *
1–14 years 6 . . . . . . . . . . . . . . . 7.2 6.9 10.2 6.3 5.3 3.9 2.0 2.4 2.3
15–24 years . . . . . . . . . . . . . . . 11.6 9.9 13.4 8.0 9.9 11.7 7.8 7.7 7.7
25–34 years . . . . . . . . . . . . . . . 10.8 9.8 13.3 10.6 11.1 9.4 6.8 7.4 7.2
35–44 years . . . . . . . . . . . . . . . 11.1 11.0 16.1 8.3 9.4 8.2 5.8 5.7 6.4
45–64 years . . . . . . . . . . . . . . . 11.8 12.7 16.7 9.2 10.7 9.0 6.3 6.5 6.2
65 years and over . . . . . . . . . . . 14.3 13.2 15.7 9.5 13.5 10.4 8.6 7.7 5.9
American Indian or
Alaska Native female 5
All ages, age-adjusted 4 . . . . . . . -- -- -- 32.0 17.5 19.5 10.6 10.2 11.0
All ages, crude . . . . . . . . . . . . . -- -- -- 32.0 17.3 18.6 10.0 10.1 10.7
1–14 years . . . . . . . . . . . . . . . . -- -- -- 15.0 8.1 6.5 * * 4.9
15–24 years . . . . . . . . . . . . . . . -- -- -- 42.3 31.4 30.3 13.4 16.2 13.6
25–34 years . . . . . . . . . . . . . . . -- -- -- 52.5 18.8 22.3 17.7 15.1 17.0
35–44 years . . . . . . . . . . . . . . . -- -- -- 38.1 18.2 22.0 13.1 11.6 14.2
45–64 years . . . . . . . . . . . . . . . -- -- -- 32.6 17.6 17.8 8.4 10.5 8.7
65 years and over . . . . . . . . . . . -- -- -- * * 24.0 14.8 * *
Asian or
Pacific Islander female 5
All ages, age-adjusted 4 . . . . . . . -- -- -- 9.3 10.4 6.7 3.9 3.3 3.4
All ages, crude . . . . . . . . . . . . . -- -- -- 8.2 9.0 5.9 3.6 3.3 3.4
1–14 years . . . . . . . . . . . . . . . . -- -- -- 7.4 3.6 2.3 * * *
15–24 years . . . . . . . . . . . . . . . -- -- -- 7.4 11.4 6.0 3.3 3.0 3.0
25–34 years . . . . . . . . . . . . . . . -- -- -- 7.3 7.3 4.5 3.1 2.8 2.5
35–44 years . . . . . . . . . . . . . . . -- -- -- 8.6 7.5 4.9 2.0 1.7 *
45–64 years . . . . . . . . . . . . . . . -- -- -- 8.5 11.8 6.4 4.3 4.2 4.1
65 years and over . . . . . . . . . . . -- -- -- 18.6 24.3 18.5 12.2 8.7 10.8
Hispanic or Latina female 5,7
All ages, age-adjusted 4 . . . . . . . -- -- -- -- 9.6 7.9 5.3 5.3 5.2
All ages, crude . . . . . . . . . . . . . -- -- -- -- 8.9 7.2 4.9 4.9 4.8
1–14 years . . . . . . . . . . . . . . . . -- -- -- -- 4.8 3.9 2.0 1.9 1.7
15–24 years . . . . . . . . . . . . . . . -- -- -- -- 11.6 10.6 7.7 7.2 7.4
25–34 years . . . . . . . . . . . . . . . -- -- -- -- 9.4 6.5 5.0 5.4 5.1
35–44 years . . . . . . . . . . . . . . . -- -- -- -- 8.0 7.3 4.5 4.5 4.7
45–64 years . . . . . . . . . . . . . . . -- -- -- -- 11.4 8.3 5.6 5.6 5.3
65 years and over . . . . . . . . . . . -- -- -- -- 14.9 13.4 9.4 9.2 9.0
1
Includes deaths of persons who were not residents of the 50 states and the District of Columbia (D.C.).
2
Underlying cause of death was coded according to the 6th Revision of the International Classification of Diseases (ICD) in 1950, 7th Revision in 1960, 8th Revision in
1970, and 9th Revision in 1980–1998. See Appendix II, Cause of death; Table III; Table IV.
3
Starting with 1999 data, cause of death is coded according to ICD–10. See Appendix II, Cause of death; Comparability ratio; Table IV; Table V.
4
Age-adjusted rates are calculated using the year 2000 standard population. Prior to 2001, age-adjusted rates were calculated using standard million proportions based
on rounded population numbers. Starting with 2001 data, unrounded population numbers are used to calculate age-adjusted rates. See Appendix II, Age adjustment.
5
The race groups, white, black, Asian or Pacific Islander, and American Indian or Alaska Native, include persons of Hispanic and non-Hispanic origin. Persons of
Hispanic origin may be of any race. Death rates for Hispanic, American Indian or Alaska Native, and Asian or Pacific Islander persons should be interpreted with
caution because of inconsistencies in reporting Hispanic origin or race on the death certificate (death rate numerators) compared with population figures (death rate
denominators). The net effect of misclassification is an underestimation of deaths and death rates for races other than white and black. See Appendix II, Race, for a
detailed discussion of sources of bias in death rates by race and Hispanic origin.
6
In 1950, rate is for the age group under 15 years.
7
Prior to 1997, data from states that did not report Hispanic origin on the death certificate were excluded. See Appendix II, Hispanic origin.
NOTES: Starting with Health, United States, 2003, rates for 1991–1999 were revised using intercensal population estimates based on the 1990 and 2000 censuses.
For 2000, population estimates are bridged-race April 1 census counts. Starting with Health, United States, 2012, rates for 2001–2009 were revised using intercensal
population estimates based on the 2000 and 2010 censuses. For 2010, population estimates are bridged-race April 1 census counts. Rates for 2011 and beyond were
computed using 2010-based postcensal estimates. See Appendix I, Population Census and Population Estimates. Age groups were selected to minimize the
presentation of unstable age-specific death rates based on small numbers of deaths and for consistency among comparison groups. For additional injury-related
statistics, see Web-based Injury Statistics Query and Reporting System (WISQARS), available from: http://www.cdc.gov/injury/wisqars/index.html. Starting with 2003
data, some states allowed the reporting of more than one race on the death certificate. The multiple-race data for these states were bridged to the single-race
categories of the 1977 Office of Management and Budget standards, for comparability with other states. See Appendix II, Race. Data for additional years are available.
See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC/NCHS, National Vital Statistics System; Grove RD, Hetzel AM. Vital statistics rates in the United States, 1940–1960. Washington, DC: U.S. Government
Printing Office, 1968; numerator data from National Vital Statistics System, annual public-use Mortality Files; denominator data from national population estimates for
race groups from Table 1 and unpublished Hispanic population estimates for 1985–1996 prepared by the Housing and Household Economic Statistics Division, U.S.
Census Bureau; Xu JQ, Murphy SL, Kochanek KD, et al. Deaths: Final data for 2013. National vital statistics reports; vol 64 no 2. Hyattsville, MD: NCHS; 2015.
Available from: http://www.cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_02.pdf. See Appendix I, National Vital Statistics System (NVSS).
Male
All ages, age-adjusted 4 . . . . . . . 7.9 7.5 14.3 16.6 14.8 9.0 8.4 8.5 8.2
All ages, crude . . . . . . . . . . . . . 7.7 6.8 13.1 17.1 15.9 9.3 8.4 8.5 8.2
Under 1 year. . . . . . . . . . . . . . . 4.5 4.7 4.5 6.3 8.8 10.4 8.8 8.1 8.7
1–14 years . . . . . . . . . . . . . . . . 0.6 0.6 1.2 1.6 2.0 1.5 1.4 1.3 1.2
1–4 years . . . . . . . . . . . . . . . 0.5 0.7 1.9 2.7 2.7 2.5 2.8 2.4 2.3
5–14 years . . . . . . . . . . . . . . 0.6 0.5 1.0 1.2 1.7 1.1 0.8 0.9 0.8
15–24 years . . . . . . . . . . . . . . . 8.6 8.4 18.2 24.0 32.5 20.9 18.2 17.7 16.7
15–19 years. . . . . . . . . . . . . . 5.5 5.7 12.1 15.9 27.8 15.5 14.0 12.8 11.4
20–24 years. . . . . . . . . . . . . . 13.5 11.8 25.6 32.2 36.9 26.7 22.6 22.4 21.6
25–44 years . . . . . . . . . . . . . . . 13.8 12.8 24.4 28.9 23.5 13.3 13.3 13.9 13.4
25–34 years. . . . . . . . . . . . . . 14.4 13.9 26.8 31.9 27.7 16.7 17.3 17.1 16.4
35–44 years. . . . . . . . . . . . . . 13.2 11.7 21.7 24.5 18.6 10.3 9.2 10.6 10.1
45–64 years . . . . . . . . . . . . . . . 8.1 8.1 14.8 15.2 10.2 6.0 5.6 5.8 5.7
45–54 years. . . . . . . . . . . . . . 9.5 9.4 16.8 18.4 11.9 6.9 6.7 7.0 6.9
55–64 years. . . . . . . . . . . . . . 6.3 6.4 12.1 11.8 8.0 4.6 4.3 4.4 4.3
65 years and over . . . . . . . . . . . 4.8 4.3 7.7 8.8 5.8 3.3 2.6 2.8 2.8
65–74 years. . . . . . . . . . . . . . 5.2 4.6 8.5 9.2 5.8 3.4 2.9 3.0 2.9
75–84 years. . . . . . . . . . . . . . 3.9 3.7 5.9 8.1 5.7 3.2 2.1 2.5 2.5
85 years and over . . . . . . . . . 2.5 3.6 7.4 7.5 6.7 3.3 2.2 2.2 2.9
Female
All ages, age-adjusted 4 . . . . . . . 2.4 2.6 3.7 4.4 4.0 2.8 2.3 2.2 2.1
All ages, crude . . . . . . . . . . . . . 2.4 2.4 3.4 4.5 4.2 2.8 2.2 2.2 2.1
Under 1 year. . . . . . . . . . . . . . . 4.2 4.9 4.1 5.6 8.0 7.9 6.9 6.5 5.5
1–14 years . . . . . . . . . . . . . . . . 0.6 0.5 1.0 1.4 1.6 1.1 0.9 1.0 0.9
1–4 years . . . . . . . . . . . . . . . 0.7 0.7 1.9 2.2 2.3 2.1 1.9 1.8 2.0
5–14 years . . . . . . . . . . . . . . 0.5 0.4 0.7 1.1 1.2 0.7 0.5 0.6 0.5
15–24 years . . . . . . . . . . . . . . . 3.0 2.8 4.6 6.6 6.2 3.9 2.9 2.9 2.6
15–19 years. . . . . . . . . . . . . . 2.4 1.9 3.2 4.9 5.4 3.1 2.3 2.0 1.6
20–24 years. . . . . . . . . . . . . . 3.7 3.8 6.2 8.2 7.0 4.7 3.4 3.7 3.6
25–44 years . . . . . . . . . . . . . . . 4.2 4.3 5.8 6.4 6.0 4.0 3.1 3.0 3.0
25–34 years. . . . . . . . . . . . . . 4.5 4.6 6.0 6.9 7.1 4.1 3.3 3.3 3.2
35–44 years. . . . . . . . . . . . . . 3.8 4.0 5.7 5.7 4.8 4.0 2.9 2.8 2.7
45–64 years . . . . . . . . . . . . . . . 1.9 2.5 3.1 3.4 2.8 2.1 2.0 2.0 2.0
45–54 years. . . . . . . . . . . . . . 2.3 2.9 3.7 4.1 3.2 2.5 2.3 2.3 2.3
55–64 years. . . . . . . . . . . . . . 1.4 2.0 2.5 2.8 2.3 1.6 1.7 1.6 1.7
65 years and over . . . . . . . . . . . 1.4 1.3 2.3 3.3 2.8 1.8 1.6 1.5 1.4
65–74 years. . . . . . . . . . . . . . 1.3 1.3 2.2 3.0 2.2 1.6 1.4 1.3 1.3
75–84 years. . . . . . . . . . . . . . 1.4 1.3 2.7 3.5 3.4 2.0 1.8 1.7 1.7
85 years and over . . . . . . . . . 2.1 1.6 2.5 4.3 3.8 2.0 2.0 1.7 1.4
American Indian or
Alaska Native male 5
All ages, age-adjusted 4 . . . . . . . -- -- -- 23.3 16.7 10.7 8.8 9.0 8.2
All ages, crude . . . . . . . . . . . . . -- -- -- 23.1 16.6 10.7 9.5 9.4 8.3
15–24 years . . . . . . . . . . . . . . . -- -- -- 35.4 25.1 17.0 17.6 12.4 7.1
25–44 years . . . . . . . . . . . . . . . -- -- -- 39.2 25.7 17.0 14.8 15.3 15.4
45–64 years . . . . . . . . . . . . . . . -- -- -- 22.1 14.8 * 6.5 9.7 8.0
Asian or
Pacific Islander male 5
All ages, age-adjusted 4 . . . . . . . -- -- -- 9.1 7.3 4.3 2.6 2.5 2.3
All ages, crude . . . . . . . . . . . . . -- -- -- 8.3 7.9 4.4 2.7 2.7 2.3
15–24 years . . . . . . . . . . . . . . . -- -- -- 9.3 14.9 7.8 4.0 3.8 3.5
25–44 years . . . . . . . . . . . . . . . -- -- -- 11.3 9.6 4.6 3.3 3.7 2.7
45–64 years . . . . . . . . . . . . . . . -- -- -- 10.4 7.0 6.1 3.1 2.9 2.5
Asian or
Pacific Islander female 5
All ages, age-adjusted 4 . . . . . . . -- -- -- 3.1 2.8 1.7 1.2 1.2 0.9
All ages, crude . . . . . . . . . . . . . -- -- -- 3.1 2.8 1.7 1.2 1.2 0.9
15–24 years . . . . . . . . . . . . . . . -- -- -- * * * * * *
25–44 years . . . . . . . . . . . . . . . -- -- -- 4.6 3.8 2.2 1.3 1.2 1.3
45–64 years . . . . . . . . . . . . . . . -- -- -- * * 2.0 1.4 1.6 1.1
1
Includes deaths of persons who were not residents of the 50 states and the District of Columbia (D.C.).
2
Underlying cause of death was coded according to the 6th Revision of the International Classification of Diseases (ICD) in 1950, 7th Revision in 1960, 8th Revision in
1970, and 9th Revision in 1980–1998. See Appendix II, Cause of death; Table III; Table IV.
3
Starting with 1999 data, cause of death is coded according to ICD–10. See Appendix II, Cause of death; Comparability ratio; Table IV; Table V.
4
Age-adjusted rates are calculated using the year 2000 standard population. Prior to 2001, age-adjusted rates were calculated using standard million proportions based
on rounded population numbers. Starting with 2001 data, unrounded population numbers are used to calculate age-adjusted rates. See Appendix II, Age adjustment.
5
The race groups, white, black, Asian or Pacific Islander, and American Indian or Alaska Native, include persons of Hispanic and non-Hispanic origin. Persons of
Hispanic origin may be of any race. Death rates for Hispanic, American Indian or Alaska Native, and Asian or Pacific Islander persons should be interpreted with
caution because of inconsistencies in reporting Hispanic origin or race on the death certificate (death rate numerators) compared with population figures (death rate
denominators). The net effect of misclassification is an underestimation of deaths and death rates for races other than white and black. See Appendix II, Race, for a
detailed discussion of sources of bias in death rates by race and Hispanic origin.
6
In 1950, rate is for the age group under 15 years.
7
Prior to 1997, data from states that did not report Hispanic origin on the death certificate were excluded. See Appendix II, Hispanic origin.
NOTES: Starting with Health, United States, 2003, rates for 1991–1999 were revised using intercensal population estimates based on the 1990 and 2000 censuses.
For 2000, population estimates are bridged-race April 1 census counts. Starting with Health, United States, 2012, rates for 2001–2009 were revised using intercensal
population estimates based on the 2000 and 2010 censuses. For 2010, population estimates are bridged-race April 1 census counts. Rates for 2011 and beyond were
computed using 2010-based postcensal estimates. See Appendix I, Population Census and Population Estimates. Figures for 2001 include September 11-related
deaths for which death certificates were filed as of October 24, 2002. See Appendix II, Cause of death; Table IV for terrorism-related ICD–10 codes. Age groups were
selected to minimize the presentation of unstable age-specific death rates based on small numbers of deaths and for consistency among comparison groups. For
additional injury-related statistics, see Web-based Injury Statistics Query and Reporting System (WISQARS), available from:
http://www.cdc.gov/injury/wisqars/index.html. Starting with 2003 data, some states allowed the reporting of more than one race on the death certificate. The
multiple-race data for these states were bridged to the single-race categories of the 1977 Office of Management and Budget standards, for comparability with other
states. See Appendix II, Race. Data for additional years are available. See the Excel spreadsheet on the Health, United States website at:
http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC/NCHS, National Vital Statistics System; Grove RD, Hetzel AM. Vital statistics rates in the United States, 1940–1960. Washington, DC: U.S. Government
Printing Office, 1968; numerator data from National Vital Statistics System, annual public-use Mortality Files; denominator data from national population estimates for
race groups from Table 1 and unpublished Hispanic population estimates for 1985–1996 prepared by the Housing and Household Economic Statistics Division, U.S.
Census Bureau; Xu JQ, Murphy SL, Kochanek KD, et al. Deaths: Final data for 2013. National vital statistics reports; vol 64 no 2. Hyattsville, MD: NCHS; 2015.
Available from: http://www.cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_02.pdf. See Appendix I, National Vital Statistics System (NVSS).
Male
All ages, age-adjusted 4 ....... 21.2 20.0 19.8 19.9 21.5 17.7 19.8 20.4 20.3
All ages, crude . . . . . . ....... 17.8 16.5 16.8 18.6 20.4 17.1 19.9 20.6 20.6
Under 1 year. . . . . . . . . . . . . . . ... ... ... ... ... ... ... ... ...
1–4 years . . . . . . . . . . . . . . . . . ... ... ... ... ... ... ... ... ...
5–14 years . . . . . . . . . . . . . . . . 0.3 0.4 0.5 0.6 1.1 1.2 0.9 1.1 1.2
15–24 years . . . . . . . . . . . . . . . 6.5 8.2 13.5 20.2 22.0 17.1 16.9 17.4 17.3
15–19 years. . . . . . . . . . . . . . 3.5 5.6 8.8 13.8 18.1 13.0 11.7 12.5 12.4
20–24 years. . . . . . . . . . . . . . 9.3 11.5 19.3 26.8 25.7 21.4 22.2 22.0 21.9
25–44 years . . . . . . . . . . . . . . . 17.2 17.9 20.9 24.0 24.4 21.3 23.6 24.5 24.1
25–34 years. . . . . . . . . . . . . . 13.4 14.7 19.8 25.0 24.8 19.6 22.5 23.4 23.4
35–44 years. . . . . . . . . . . . . . 21.3 21.0 22.1 22.5 23.9 22.8 24.6 25.7 24.8
45–64 years . . . . . . . . . . . . . . . 37.1 34.4 30.0 23.7 24.3 21.3 29.2 29.5 29.0
45–54 years. . . . . . . . . . . . . . 32.0 31.6 27.9 22.9 23.2 22.4 30.4 30.2 29.6
55–64 years. . . . . . . . . . . . . . 43.6 38.1 32.7 24.5 25.7 19.4 27.7 28.7 28.3
65 years and over . . . . . . . . . . . 52.8 44.0 38.4 35.0 41.6 31.1 29.0 29.5 30.9
65–74 years. . . . . . . . . . . . . . 50.5 39.6 36.0 30.4 32.2 22.7 23.9 24.1 26.0
75–84 years. . . . . . . . . . . . . . 58.3 52.5 42.8 42.3 56.1 38.6 32.3 34.2 34.7
85 years and over . . . . . . . . . 58.3 57.4 42.4 50.6 65.9 57.5 47.3 46.9 48.5
Female
All ages, age-adjusted 4 . . . . . . . 5.6 5.6 7.4 5.7 4.8 4.0 5.0 5.4 5.5
All ages, crude . . . . . . . . . . . . . 5.1 4.9 6.6 5.5 4.8 4.0 5.2 5.5 5.7
Under 1 year. . . . . . . . . . . . . . . ... ... ... ... ... ... ... ... ...
1–4 years . . . . . . . . . . . . . . . . . ... ... ... ... ... ... ... ... ...
5–14 years . . . . . . . . . . . . . . . . 0.1 0.1 0.2 0.2 0.4 0.3 0.4 0.4 0.7
15–24 years . . . . . . . . . . . . . . . 2.6 2.2 4.2 4.3 3.9 3.0 3.9 4.5 4.5
15–19 years. . . . . . . . . . . . . . 1.8 1.6 2.9 3.0 3.7 2.7 3.1 3.9 3.9
20–24 years. . . . . . . . . . . . . . 3.3 2.9 5.7 5.5 4.1 3.2 4.7 4.9 5.2
25–44 years . . . . . . . . . . . . . . . 6.2 6.6 10.2 7.7 6.2 5.4 6.4 6.8 6.8
25–34 years. . . . . . . . . . . . . . 4.9 5.5 8.6 7.1 5.6 4.3 5.3 5.9 6.1
35–44 years. . . . . . . . . . . . . . 7.5 7.7 11.9 8.5 6.8 6.4 7.5 7.7 7.6
45–64 years . . . . . . . . . . . . . . . 9.9 10.2 12.0 8.9 7.1 6.2 8.6 9.1 9.4
45–54 years. . . . . . . . . . . . . . 9.9 10.2 12.6 9.4 6.9 6.7 9.0 10.2 10.0
55–64 years. . . . . . . . . . . . . . 9.9 10.2 11.4 8.4 7.3 5.4 8.0 8.0 8.7
65 years and over . . . . . . . . . . . 9.4 8.4 8.1 6.1 6.4 4.0 4.2 4.5 4.6
65–74 years. . . . . . . . . . . . . . 10.1 8.4 9.0 6.5 6.7 4.0 4.8 5.2 5.4
75–84 years. . . . . . . . . . . . . . 8.1 8.9 7.0 5.5 6.3 4.0 3.7 3.9 3.9
85 years and over . . . . . . . . . 8.2 6.0 5.9 5.5 5.4 4.2 3.3 3.2 3.3
White male 5
All ages, age-adjusted 4 . . . . . . . 22.3 21.1 20.8 20.9 22.8 19.1 22.0 22.6 22.6
All ages, crude . . . . . . . . . . . . . 19.0 17.6 18.0 19.9 22.0 18.8 22.6 23.3 23.4
15–24 years . . . . . . . . . . . . . . . 6.6 8.6 13.9 21.4 23.2 17.9 18.3 19.0 18.7
25–44 years . . . . . . . . . . . . . . . 17.9 18.5 21.5 24.6 25.4 22.9 26.2 27.2 26.8
45–64 years . . . . . . . . . . . . . . . 39.3 36.5 31.9 25.0 26.0 23.2 33.0 33.5 33.0
65 years and over . . . . . . . . . . . 55.8 46.7 41.1 37.2 44.2 33.3 31.7 32.2 34.1
65–74 years. . . . . . . . . . . . . . 53.2 42.0 38.7 32.5 34.2 24.3 26.3 26.4 28.9
75–84 years. . . . . . . . . . . . . . 61.9 55.7 45.5 45.5 60.2 41.1 34.9 37.0 38.1
85 years and over . . . . . . . . . 61.9 61.3 45.8 52.8 70.3 61.6 50.8 50.7 52.6
Black or
African American male 5 Deaths per 100,000 resident population
All ages, age-adjusted 4 . . . . . . . 7.5 8.4 10.0 11.4 12.8 10.0 9.1 9.6 9.3
All ages, crude . . . . . . . . . . . . . 6.3 6.4 8.0 10.3 12.0 9.4 8.7 9.2 9.0
15–24 years . . . . . . . . . . . . . . . 4.9 4.1 10.5 12.3 15.1 14.2 11.1 11.4 11.5
25–44 years . . . . . . . . . . . . . . . 9.8 12.6 16.1 19.2 19.6 14.3 14.5 15.3 14.4
45–64 years . . . . . . . . . . . . . . . 12.7 13.0 12.4 11.8 13.1 9.9 9.5 9.6 10.0
65 years and over . . . . . . . . . . . 9.0 9.9 8.7 11.4 14.9 11.5 8.3 9.6 8.4
65–74 years. . . . . . . . . . . . . . 10.0 11.3 8.7 11.1 14.7 11.1 7.6 8.4 7.8
75–84 years 6 . . . . . . . . . . . . . * * * 10.5 14.4 12.1 9.9 12.5 9.1
85 years and over . . . . . . . . . -- * * * * * * * *
American Indian or
Alaska Native male 5
All ages, age-adjusted 4 . . . . . . . -- -- -- 19.3 20.1 16.0 15.5 17.4 18.1
All ages, crude . . . . . . . . . . . . . -- -- -- 20.9 20.9 15.9 16.1 17.5 17.9
15–24 years . . . . . . . . . . . . . . . -- -- -- 45.3 49.1 26.2 30.6 29.3 29.1
25–44 years . . . . . . . . . . . . . . . -- -- -- 31.2 27.8 24.5 20.9 24.3 26.6
45–64 years . . . . . . . . . . . . . . . -- -- -- * * 15.4 17.8 19.1 18.3
65 years and over . . . . . . . . . . . -- -- -- * * * * * *
Asian or
Pacific Islander male 5
All ages, age-adjusted 4 . . . . . . . -- -- -- 10.7 9.6 8.6 9.5 9.4 9.1
All ages, crude . . . . . . . . . . . . . -- -- -- 8.8 8.7 7.9 9.3 9.3 9.2
15–24 years . . . . . . . . . . . . . . . -- -- -- 10.8 13.5 9.1 10.9 9.7 11.9
25–44 years . . . . . . . . . . . . . . . -- -- -- 11.0 10.6 9.9 10.6 11.8 11.9
45–64 years . . . . . . . . . . . . . . . -- -- -- 13.0 9.7 9.7 12.8 12.3 10.9
65 years and over . . . . . . . . . . . -- -- -- 18.6 16.8 15.4 14.9 12.9 10.9
American Indian or
Alaska Native female 5 Deaths per 100,000 resident population
All ages, age-adjusted 4 . . . . . . . -- -- -- 4.7 3.6 3.8 6.1 4.3 5.3
All ages, crude . . . . . . . . . . . . . -- -- -- 4.7 3.7 4.0 5.9 4.5 5.4
15–24 years . . . . . . . . . . . . . . . -- -- -- * * * 10.4 9.7 9.4
25–44 years . . . . . . . . . . . . . . . -- -- -- 10.7 * 7.2 7.4 6.6 7.5
45–64 years . . . . . . . . . . . . . . . -- -- -- * * * 6.2 * 6.6
65 years and over . . . . . . . . . . . -- -- -- * * * * * *
Asian or
Pacific Islander female 5
All ages, age-adjusted 4 . . . . . . . -- -- -- 5.5 4.1 2.8 3.4 3.6 3.0
All ages, crude . . . . . . . . . . . . . -- -- -- 4.7 3.4 2.7 3.4 3.7 3.1
15–24 years . . . . . . . . . . . . . . . -- -- -- * 3.9 2.7 3.5 5.5 3.6
25–44 years . . . . . . . . . . . . . . . -- -- -- 5.4 3.8 3.3 4.1 3.9 3.7
45–64 years . . . . . . . . . . . . . . . -- -- -- 7.9 5.0 3.2 4.7 4.3 3.9
65 years and over . . . . . . . . . . . -- -- -- * 8.5 5.2 4.3 5.3 3.3
1
Includes deaths of persons who were not residents of the 50 states and the District of Columbia (D.C.).
2
Underlying cause of death was coded according to the 6th Revision of the International Classification of Diseases (ICD) in 1950, 7th Revision in 1960, 8th Revision in
1970, and 9th Revision in 1980–1998. See Appendix II, Cause of death; Table III; Table IV.
3
Starting with 1999 data, cause of death is coded according to ICD–10. See Appendix II, Cause of death; Comparability ratio; Table IV; Table V.
4
Age-adjusted rates are calculated using the year 2000 standard population. Prior to 2001, age-adjusted rates were calculated using standard million proportions based
on rounded population numbers. Starting with 2001 data, unrounded population numbers are used to calculate age-adjusted rates. See Appendix II, Age adjustment.
5
The race groups, white, black, Asian or Pacific Islander, and American Indian or Alaska Native, include persons of Hispanic and non-Hispanic origin. Persons of
Hispanic origin may be of any race. Death rates for Hispanic, American Indian or Alaska Native, and Asian or Pacific Islander persons should be interpreted with
caution because of inconsistencies in reporting Hispanic origin or race on the death certificate (death rate numerators) compared with population figures (death rate
denominators). The net effect of misclassification is an underestimation of deaths and death rates for races other than white and black. See Appendix II, Race, for a
detailed discussion of sources of bias in death rates by race and Hispanic origin.
6
In 1950, rate is for the age group 75 years and over.
7
Prior to 1997, data from states that did not report Hispanic origin on the death certificate were excluded. See Appendix II, Hispanic origin.
NOTES: Starting with Health, United States, 2003, rates for 1991–1999 were revised using intercensal population estimates based on the 1990 and 2000 censuses.
For 2000, population estimates are bridged-race April 1 census counts. Starting with Health, United States, 2012, rates for 2001–2009 were revised using intercensal
population estimates based on the 2000 and 2010 censuses. For 2010, population estimates are bridged-race April 1 census counts. Rates for 2011 and beyond were
computed using 2010-based postcensal estimates. See Appendix I, Population Census and Population Estimates. Figures for 2001 include September 11-related
deaths for which death certificates were filed as of October 24, 2002. See Appendix II, Cause of death; Table IV for terrorism-related ICD–10 codes. Age groups were
selected to minimize the presentation of unstable age-specific death rates based on small numbers of deaths and for consistency among comparison groups. For
additional injury-related statistics, see Web-based Injury Statistics Query and Reporting System (WISQARS), available from:
http://www.cdc.gov/injury/wisqars/index.html. Starting with 2003 data, some states allowed the reporting of more than one race on the death certificate. The
multiple-race data for these states were bridged to the single-race categories of the 1977 Office of Management and Budget standards, for comparability with other
states. See Appendix II, Race. Data for additional years are available. See the Excel spreadsheet on the Health, United States website at:
http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC/NCHS, National Vital Statistics System; Grove RD, Hetzel AM. Vital statistics rates in the United States, 1940–1960. Washington, DC: U.S. Government
Printing Office, 1968; numerator data from National Vital Statistics System, annual public-use Mortality Files; denominator data from national population estimates for
race groups from Table 1 and unpublished Hispanic population estimates for 1985–1996 prepared by the Housing and Household Economic Statistics Division, U.S.
Census Bureau; Xu JQ, Murphy SL, Kochanek KD, et al. Deaths: Final data for 2013. National vital statistics reports; vol 64 no 2. Hyattsville, MD: NCHS; 2015.
Available from: http://www.cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_02.pdf. See Appendix I, National Vital Statistics System (NVSS).
Black or
African American male 4 Deaths per 100,000 resident population
All ages, age-adjusted 3 . . . . . . . 70.8 60.1 56.3 49.2 34.2 31.8 33.4 32.1
All ages, crude . . . . . . . . . . . . . 60.8 57.7 61.9 52.9 36.1 33.4 34.8 33.5
1–14 years . . . . . . . . . . . . . . . . 5.3 3.0 4.4 4.4 1.8 1.9 1.5 1.4
15–24 years . . . . . . . . . . . . . . . 97.3 77.9 138.0 138.7 89.3 73.2 74.2 69.9
25–44 years . . . . . . . . . . . . . . . 126.2 114.1 90.3 70.2 54.1 57.3 61.1 60.2
25–34 years. . . . . . . . . . . . . . 145.6 128.4 108.6 92.3 74.8 78.2 77.1 76.6
35–44 years. . . . . . . . . . . . . . 104.2 92.3 66.1 46.3 34.3 35.2 43.1 41.5
45–64 years . . . . . . . . . . . . . . . 71.1 55.6 34.5 28.3 18.4 16.5 17.0 16.7
65 years and over . . . . . . . . . . . 30.6 29.7 23.9 21.8 13.8 9.4 11.1 8.8
American Indian or
Alaska Native male 4
All ages, age-adjusted 3 . . . . . . . -- 24.0 19.4 19.4 13.1 11.7 13.5 12.9
All ages, crude . . . . . . . . . . . . . -- 27.5 20.5 20.9 13.2 12.5 13.4 12.5
15–24 years . . . . . . . . . . . . . . . -- 55.3 49.1 40.9 26.9 26.0 21.2 18.4
25–44 years . . . . . . . . . . . . . . . -- 43.9 25.4 31.2 16.6 16.9 20.1 18.8
45–64 years . . . . . . . . . . . . . . . -- * * 14.2 12.2 11.1 14.3 13.5
65 years and over . . . . . . . . . . . -- * * * * * * *
Asian or
Pacific Islander male 4
All ages, age-adjusted 3 . . . . . . . -- 7.8 8.8 9.2 6.0 4.2 4.4 4.1
All ages, crude . . . . . . . . . . . . . -- 8.2 9.4 10.0 6.2 4.4 4.6 4.3
15–24 years . . . . . . . . . . . . . . . -- 10.8 21.0 24.3 9.3 6.8 6.3 5.9
25–44 years . . . . . . . . . . . . . . . -- 12.8 10.9 10.6 8.1 6.0 6.4 6.4
45–64 years . . . . . . . . . . . . . . . -- 10.4 8.1 8.2 7.4 4.4 5.0 4.6
65 years and over . . . . . . . . . . . -- * * * * 3.9 4.0 *
Hispanic or Latino male 4,5
All ages, age-adjusted 3 . . . . . . . -- -- 27.6 23.8 13.6 10.5 10.1 9.4
All ages, crude . . . . . . . . . . . . . -- -- 29.9 26.2 14.2 10.5 10.1 9.4
1–14 years . . . . . . . . . . . . . . . . -- -- 2.6 2.8 1.0 0.6 0.6 0.5
15–24 years . . . . . . . . . . . . . . . -- -- 55.5 61.7 30.8 20.9 19.6 17.4
25–44 years . . . . . . . . . . . . . . . -- -- 42.7 31.4 17.3 14.4 14.4 13.8
25–34 years. . . . . . . . . . . . . . -- -- 47.3 36.4 20.3 18.0 17.3 16.2
35–44 years. . . . . . . . . . . . . . -- -- 35.4 24.2 13.2 10.2 11.0 11.1
45–64 years . . . . . . . . . . . . . . . -- -- 21.4 17.2 12.0 9.1 8.2 8.2
65 years and over . . . . . . . . . . . -- -- 19.1 16.5 12.2 9.9 9.7 8.1
Black or
African American female 4 Deaths per 100,000 resident population
All ages, age-adjusted 3 . . . . . . . 11.1 8.7 7.3 6.2 3.9 3.3 3.6 3.4
All ages, crude . . . . . . . . . . . . . 10.0 8.8 7.8 6.5 4.0 3.3 3.7 3.4
15–24 years . . . . . . . . . . . . . . . 15.2 12.3 13.3 13.2 7.6 6.4 7.2 6.1
25–44 years . . . . . . . . . . . . . . . 19.4 16.1 12.4 9.8 6.5 5.6 5.8 6.0
45–64 years . . . . . . . . . . . . . . . 10.2 8.2 4.8 4.1 3.1 2.2 2.7 2.5
65 years and over . . . . . . . . . . . 4.3 3.1 3.1 2.6 1.3 * 1.3 0.9
American Indian or
Alaska Native female 4
All ages, age-adjusted 3 . . . . . . . -- 5.8 3.3 3.8 2.9 2.6 1.8 2.0
All ages, crude . . . . . . . . . . . . . -- 5.8 3.4 4.1 2.9 2.4 1.8 2.0
15–24 years . . . . . . . . . . . . . . . -- * * * * * * *
25–44 years . . . . . . . . . . . . . . . -- 10.2 * 7.0 5.5 3.7 * *
45–64 years . . . . . . . . . . . . . . . -- * * * * * * *
65 years and over . . . . . . . . . . . -- * * * * * * *
Asian or
Pacific Islander female 4
All ages, age-adjusted 3 . . . . . . . -- 2.0 1.9 2.0 1.1 0.6 0.9 0.9
All ages, crude . . . . . . . . . . . . . -- 2.1 2.1 2.1 1.2 0.6 0.9 0.9
15–24 years . . . . . . . . . . . . . . . -- * * 3.9 * * * *
25–44 years . . . . . . . . . . . . . . . -- 3.2 2.7 2.7 1.5 1.1 1.1 1.5
45–64 years . . . . . . . . . . . . . . . -- * * * * * 0.9 0.8
65 years and over . . . . . . . . . . . -- * * * * * * *
* Rates based on fewer than 20 deaths are considered unreliable and are not shown.
1
Underlying cause of death was coded according to the 8th Revision of the International Classification of Diseases (ICD) in 1970 and 9th Revision in 1980–1998. See
2
Starting with 1999 data, cause of death is coded according to ICD–10. See Appendix II, Cause of death; Comparability ratio; Table IV; Table V.
3
Age-adjusted rates are calculated using the year 2000 standard population. Prior to 2001, age-adjusted rates were calculated using standard million proportions based
on rounded population numbers. Starting with 2001 data, unrounded population numbers are used to calculate age-adjusted rates. See Appendix II, Age adjustment.
4
The race groups, white, black, Asian or Pacific Islander, and American Indian or Alaska Native, include persons of Hispanic and non-Hispanic origin. Persons of
Hispanic origin may be of any race. Death rates for Hispanic, American Indian or Alaska Native, and Asian or Pacific Islander persons should be interpreted with
caution because of inconsistencies in reporting Hispanic origin or race on the death certificate (death rate numerators) compared with population figures (death rate
denominators). The net effect of misclassification is an underestimation of deaths and death rates for races other than white and black. See Appendix II, Race, for a
detailed discussion of sources of bias in death rates by race and Hispanic origin.
5
Prior to 1997, data from states that did not report Hispanic origin on the death certificate were excluded. See Appendix II, Hispanic origin.
NOTES: Starting with Health, United States, 2003, rates for 1991–1999 were revised using intercensal population estimates based on the 1990 and 2000 censuses.
For 2000, population estimates are bridged-race April 1 census counts. Starting with Health, United States, 2012, rates for 2001–2009 were revised using intercensal
population estimates based on the 2000 and 2010 censuses. For 2010, population estimates are bridged-race April 1 census counts. Rates for 2011 and beyond were
computed using 2010-based postcensal estimates. See Appendix I, Population Census and Population Estimates. Age groups were selected to minimize the
presentation of unstable age-specific death rates based on small numbers of deaths and for consistency among comparison groups. For additional injury-related
statistics, see Web-based Injury Statistics Query and Reporting System (WISQARS), available from: http://www.cdc.gov/injury/wisqars/index.html. Starting with 2003
data, some states allowed the reporting of more than one race on the death certificate. The multiple-race data for these states were bridged to the single-race
categories of the 1977 Office of Management and Budget standards, for comparability with other states. See Appendix II, Race. Data for additional years are available.
See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC/NCHS, National Vital Statistics System; numerator data from National Vital Statistics System, annual public-use Mortality Files; denominator data from
national population estimates for race groups from Table 1 and unpublished Hispanic population estimates for 1985–1996 prepared by the Housing and Household
Economic Statistics Division, U.S. Census Bureau; Xu JQ, Murphy SL, Kochanek KD, et al. Deaths: Final data for 2013. National vital statistics reports; vol 64 no 2.
Hyattsville, MD: NCHS; 2015. Available from: http://www.cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_02.pdf. See Appendix I, National Vital Statistics System (NVSS).
Cause of death 1980 1 1985 1 1990 1 2000 2 2005 2 2010 2 2012 2 2013 2
Multiple cause of death Number of death certificates with cause of death code(s) mentioned
3
Angiosarcoma of liver . . . . . . . . . . . . . . . -- -- -- 16 26 29 29 22
Malignant mesothelioma 4 . . . . . . . . . . . . . 699 715 874 2,531 2,704 2,744 2,874 2,686
Pneumoconiosis 5 . . . . . . . . . . . . . . . . . . . 4,151 3,783 3,644 2,859 2,425 2,028 1,850 1,859
Coal workers’ pneumoconiosis . . . . . . . . 2,576 2,615 1,990 949 652 486 399 361
Asbestosis . . . . . . . . . . . . . . . . . . . . . . 339 534 948 1,486 1,416 1,308 1,208 1,229
Silicosis . . . . . . . . . . . . . . . . . . . . . . . . 448 334 308 151 160 101 103 111
Other (including unspecified) . . . . . . . . . 814 321 413 290 222 146 153 170
1
For the period 1980–1998, underlying cause of death was coded according to the 9th Revision of the International Classification of Diseases (ICD). See Appendix II,
2
Starting with 1999 data, ICD–10 was introduced for coding cause of death. Discontinuities exist between 1998 and 1999 due to ICD–10 coding and classification
changes. Caution should be exercised in interpreting trends for the causes of death in this table, especially for those with major ICD–10 changes (e.g., malignant
mesothelioma). See Appendix II, International Classification of Diseases (ICD); Table IV.
3
Prior to 1999, there was no discrete code for this condition.
4
Prior to 1999, the combined ICD–9 categories of malignant neoplasm of peritoneum and malignant neoplasm of pleura served as a crude surrogate for malignant
5
For multiple cause of death, counts for pneumoconiosis subgroups may sum to slightly more than total pneumoconiosis due to the reporting of more than one type of
NOTES: Multiple cause of death includes underlying and nonunderlying causes of death. Cause-of-death titles for selected occupational diseases and corresponding
code numbers according to the International Classification of Diseases, 9th and 10th Revisions. See Appendix II, Cause of death; Table IV. See Appendix I, National
Vital Statistics System (NVSS), Mortality Multiple Cause-of-Death File, for information about tabulating cause-of-death data in this table. Selection of occupational
diseases is based on definitions in Mullan RJ, Murthy LI. Occupational sentinel health events: An updated list for physician recognition and public health surveillance.
1991; Am J Ind Med 19(6):775–99. For more detailed information about pneumoconiosis deaths, see: Work-Related Lung Disease Surveillance System available from:
http://www2a.cdc.gov/drds/WorldReportData/. Data for additional years are available. See the Excel spreadsheet on the Health, United States website at:
http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC/NCHS, National Vital Statistics System; annual public-use Mortality Files for underlying and multiple cause of death. See Appendix I, National Vital
Number of deaths
Total workforce . . . . . . . . . . . . . . . . . . . . . . . 5,575 5,734 5,214 4,551 4,690 4,693 4,628
Sex
Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5,129 5,328 4,827 4,216 4,322 4,308 4,277
Female . . . . . . . . . . . . . . . . . . . . . . . . . . . . 446 406 387 335 368 385 351
Age
Under 16 years. . . . . . . . . . . . . . . . . . . . . . . 25 23 11 13 16 10 19
16–17 years . . . . . . . . . . . . . . . . . . . . . . . . . 28 31 23 14 18 13 10
18–19 years . . . . . . . . . . . . . . . . . . . . . . . . . 84 111 66 57 56 61 59
20–24 years . . . . . . . . . . . . . . . . . . . . . . . . . 462 403 353 275 245 292 287
25–34 years . . . . . . . . . . . . . . . . . . . . . . . . . 1,018 1,017 850 704 785 714 736
35–44 years . . . . . . . . . . . . . . . . . . . . . . . . . 1,329 1,243 1,113 908 868 875 829
45–54 years . . . . . . . . . . . . . . . . . . . . . . . . . 1,301 1,389 1,292 1,173 1,169 1,222 1,161
55–64 years . . . . . . . . . . . . . . . . . . . . . . . . . 802 933 920 853 948 936 936
65 years and over . . . . . . . . . . . . . . . . . . . . . 523 578 580 551 582 569 588
Unspecified . . . . . . . . . . . . . . . . . . . . . . . . . 3 6 6 3 3 1 3
Race and Hispanic origin
Hispanic or Latino . . . . . . . . . . . . . . . . . . . . . 794 923 804 713 707 749 748
Not Hispanic or Latino . . . . . . . . . . . . . . . . . . 4,781 4,811 4,410 3,838 3,983 3,944 3,880
White . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,988 3,977 3,663 3,204 3,363 3,323 3,177
Black or African American. . . . . . . . . . . . . . 543 584 533 421 412 440 486
American Indian or Alaska Native . . . . . . . . 42 50 32 33 32 30 37
Asian . . . . . . . . . . . . . . . . . . . . . . . . . . . . 147 154 145 141 143 121 147
Native Hawaiian or Other Pacific Islander . . 11 9 7 7 6 3 7
Multiple races . . . . . . . . . . . . . . . . . . . . . . 3 * 6 7 8 15 5
Other races or not reported . . . . . . . . . . . . 47 35 24 25 19 12 21
Industry 1
Private sector . . . . . . . . . . . . . . . . . . . . . . . . 5,043 5,214 4,670 4,090 4,206 4,188 4,175
Agriculture, forestry, fishing, and hunting . . . 709 715 672 575 621 566 509
Mining 2 . . . . . . . . . . . . . . . . . . . . . . . . . . 141 159 176 99 172 155 181
Utilities . . . . . . . . . . . . . . . . . . . . . . . . . . . 32 30 37 16 26 39 23
Construction . . . . . . . . . . . . . . . . . . . . . . . 1,131 1,192 975 834 774 738 806
Manufacturing . . . . . . . . . . . . . . . . . . . . . . 420 393 411 319 329 327 327
Wholesale trade . . . . . . . . . . . . . . . . . . . . 191 209 180 190 191 190 204
Retail trade . . . . . . . . . . . . . . . . . . . . . . . . 344 400 301 307 311 268 273
Transportation and warehousing . . . . . . . . . 808 885 796 633 661 749 741
Information . . . . . . . . . . . . . . . . . . . . . . . . 64 65 47 33 43 56 42
Finance and insurance . . . . . . . . . . . . . . . . 45 42 24 33 24 36 21
Real estate and rental and leasing . . . . . . . 84 57 82 75 89 62 64
Professional and technical services . . . . . . . 97 83 69 85 76 74 57
Management, administrative, and waste
services 3 . . . . . . . . . . . . . . . . . . . . . . . . -- -- -- -- -- 359 352
Educational services . . . . . . . . . . . . . . . . . 41 46 28 27 30 37 34
Health care and social assistance . . . . . . . . 102 104 113 123 141 117 107
Arts, entertainment, and recreation . . . . . . . 88 77 92 80 84 93 80
Accommodation and food services . . . . . . . 187 136 146 151 154 138 152
Other services (except public
administration) . . . . . . . . . . . . . . . . . . ... 194 210 178 173 192 183 199
Government 4 . . . . . . . . . . . . . . . . . . . . . ... 532 520 544 461 484 505 453
1
Industry data from 2003 to 2008 are based on the North American Industry Classification System (NAICS), 2002. Industry data from 2009 to the present are based on
NAICS 2007. NAICS replaces the Standard Industrial Classification (SIC) system. Because of substantial differences between these systems, industry data classified by
these two systems are not comparable. Industry data for 1995–2002 classified by SIC are presented in Health, United States, 2004, Table 49, available from:
2
Includes fatal injuries at all establishments categorized as Mining (Sector 21) in the NAICS, including establishments not governed by the Mine Safety and Health
Administration (MSHA) rules and reporting, such as those in Oil and Gas Extraction.
3
Starting with 2011 data, CFOI combined the categories ‘‘Management of companies and enterprises’’ and ‘‘Administrative and support and waste management and
remediation services’’ into one category entitled ‘‘Management, administrative, and waste services.’’
4
Includes fatal work injuries to workers employed by governmental organizations, regardless of industry.
NOTES: Fatal work injuries are based on revised data and may differ from originally published data from CFOI. See Appendix I, Census of Fatal Occupational Injuries
(CFOI). Private sector totals include injuries with unknown industry. Data for additional years are available. See the Excel spreadsheet on the Health, United States
website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: Department of Labor, Bureau of Labor Statistics, Census of Fatal Occupational Injuries. Revised annual data. See Appendix I, Census of Fatal Occupational
Injuries (CFOI).
Disease 1950 1960 1970 1980 1990 2000 2010 2011 2012
– Quantity zero.
1
National surveillance case definition revised in 2008; probable cases not previously reported.
2
Cases of vaccine-associated paralytic poliomyelitis caused by polio vaccine virus.
3
Starting with 2010 data, cases of Rocky Mountain spotted fever were reported as Spotted fever rickettsiosis.
4
Case reporting for tuberculosis began in 1953. Data prior to 1975 are not comparable with subsequent years because of changes in reporting criteria effective in 1975.
5
For 1950, data for Alaska and Hawaii were not included. Starting with 1991, data include both civilian and military cases. Adjustments to the number of cases reported
from state health departments were made for hardcopy forms and for electronic data submissions through June 9, 2010. Cases and rates shown do not include U.S.
6
Includes stage of syphilis not stated.
7
Includes cases of unknown duration.
8
Rates include all cases of congenitally acquired syphilis per 100,000 live births. Cases of congenitally acquired syphilis were reported through 1994. Starting with 1995
data, only congenital syphilis for cases under 1 year of age were reported. See STD Surveillance Report for congenital syphilis rates.
9
Prior to 1994, chlamydia was not notifiable. In 1994–1999, cases for New York were exclusively reported by New York City. Starting with 2000 data, cases for New
10
Data for 1994 do not include cases from Georgia.
NOTES: The total resident population was used to calculate all rates except sexually transmitted diseases (STDs), which used the civilian resident population prior to
1991. See Appendix I, Sexually Transmitted Disease (STD) Surveillance; Population Census and Population Estimates. Population data from states where diseases
were not notifiable or not available were excluded from the rate calculation; see Appendix II, Notifiable disease. See Appendix I, National Notifiable Disease
Surveillance System (NNDSS), for information on underreporting of notifiable diseases. Data for additional years are available. See the Excel spreadsheet on the
Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC, Office of Public Health Scientific Services (OPHSS); Center for Surveillance, Epidemiology and Laboratory Services (CSELS); Division of Health
Informatics and Surveillance (DHIS). MMWR 2014;61(53):1–121 and CDC. Available from: http://www.cdc.gov/mmwr/mmwr_nd/index.html. Sexually transmitted disease
surveillance, 2012. Atlanta, GA: U.S. Department of Health and Human Services, 2014. Available from: http://www.cdc.gov/std/stats/. See Appendix I, National Notifiable
Diseases Surveillance System (NNDSS); Sexually Transmitted Disease (STD) Surveillance.
Age at diagnosis
Under 13 years . . . . . . . . . . . . . . . . . . . . . . . 243 220 222 187 242
13–14 years. . . . . . . . . . . . . . . . . . . . . . . . . . 40 29 41 45 51
15–19 years. . . . . . . . . . . . . . . . . . . . . . . . . . 2,187 2,199 2,132 2,082 2,053
20–24 years. . . . . . . . . . . . . . . . . . . . . . . . . . 6,527 6,815 7,260 7,498 8,187
25–29 years. . . . . . . . . . . . . . . . . . . . . . . . . . 6,867 6,616 6,520 6,723 7,589
30–34 years. . . . . . . . . . . . . . . . . . . . . . . . . . 6,049 5,792 5,657 5,574 6,388
35–39 years. . . . . . . . . . . . . . . . . . . . . . . . . . 6,450 5,733 5,218 4,739 4,939
40–44 years. . . . . . . . . . . . . . . . . . . . . . . . . . 6,789 6,073 5,404 5,119 5,145
45–49 years. . . . . . . . . . . . . . . . . . . . . . . . . . 5,932 5,370 5,016 4,891 5,183
50–54 years. . . . . . . . . . . . . . . . . . . . . . . . . . 3,862 3,705 3,625 3,564 3,800
55–59 years. . . . . . . . . . . . . . . . . . . . . . . . . . 2,288 2,201 2,123 2,122 2,269
60–64 years. . . . . . . . . . . . . . . . . . . . . . . . . . 1,153 1,026 1,113 1,141 1,221
65 years and over . . . . . . . . . . . . . . . . . . . . . 917 844 822 853 921
Region of residence
Northeast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9,896 9,292 8,864 8,514 9,025
Midwest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5,821 5,879 5,684 5,669 6,226
South . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24,899 23,200 22,480 22,496 24,266
West . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8,687 8,252 8,124 7,861 8,471
Age at diagnosis
Under 13 years . . . . . . . . . . . . . . . . . . . . . . . 0.5 0.4 0.4 0.4 0.5
Region of residence
Northeast . . . ................ . . . . . . . . . . 18.0 16.8 16.0 15.3 16.2
1
Based on diagnoses that occurred during 2008–2012 that were reported to CDC through June 30, 2013.
2
Numbers and rates are point estimates that result from statistical adjustments for reporting delays and missing risk factor information. The estimates do not include
adjustments for incomplete reporting. See Appendix I, National HIV Surveillance System.
3
All persons totals were calculated independent of values for subpopulations. Consequently, sums of subpopulations may not equal totals for all persons.
4
Hispanic origin and race categories are mutually exclusive.
5
Persons of Hispanic origin may be of any race. See Appendix II, Hispanic origin.
NOTES: See Appendix II, Human immunodeficiency virus (HIV) disease for discussion of HIV diagnoses reporting definitions and other issues affecting interpretation of
trends. Data shown are for the 50 states and the District of Columbia, and include newly diagnosed and reported cases. This table does not present HIV incidence or
prevalence data. Rates for 2008 and 2009 were calculated using vintage 2009 postcensal population estimates and rates for 2010–2012 were calculated using vintage
2012 population estimates from the U.S. Census Bureau. Variations in trends among subpopulations may be due to differences in testing behaviors, targeted HIV
testing initiatives, or the numbers of new HIV infections in some subpopulations. Caution should be used when interpreting data on diagnoses of HIV infection. HIV
surveillance reports may not be representative of all persons with HIV for several reasons, including that not all infected persons have been tested and diagnosed, and
that the results of anonymous tests are not reported to the name-based HIV registries of state and local health departments, testing patterns are influenced by the
extent to which testing is routinely offered to specific groups, and surveillance and reporting practices among jurisdictions differ. The data presented here are estimates
of the minimum number of persons for whom HIV infection has been diagnosed and reported to the surveillance system.
SOURCE: CDC, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. Division of HIV/AIDS Prevention. HIV Surveillance Report. Diagnoses of HIV
infection in the United States and Dependent Areas, 2012 (vol. 24). Atlanta, GA: U.S. Department of Health and Human Services, CDC. Available from:
Percent of children
Under 18 years 3 . . . . . . . . . . . . . . . . . . . -- -- 8.7 9.0 5.4 5.7 5.4 5.3
Age
0–4 years . . . . . . . . . . . . . . . . . . . . . . . . -- -- 6.1 5.5 4.3 4.7 4.2 3.6
5–17 years . . . . . . . . . . . . . . . . . . . . . . . -- -- 9.6 10.4 5.7 6.1 5.8 5.9
5–9 years. . . . . . . . . . . . . . . . . . . . . . . -- -- 9.1 9.8 5.6 6.3 6.1 6.2
10–17 years . . . . . . . . . . . . . . . . . . . . . -- -- 9.9 10.8 5.8 5.9 5.7 5.7
Sex
Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . -- -- 9.9 9.8 6.2 6.6 6.3 5.9
Female . . . . . . . . . . . . . . . . . . . . . . . . . . -- -- 7.3 8.2 4.5 4.7 4.4 4.7
Race 4
White only . . . . . . . . . . . . . . . . . . . . . . . . -- -- 7.7 7.8 5.0 5.2 4.9 4.7
Black or African American only . . . . . . . . . -- -- 13.0 15.3 7.0 8.0 7.6 8.5
American Indian or Alaska Native only . . . . -- -- 12.2 9.5 6.4 *8.7 *6.1 *5.8
Asian only . . . . . . . . . . . . . . . . . . . . . . . . -- -- 4.8 5.6 4.3 4.7 3.3 3.2
Native Hawaiian or Other Pacific
Islander only . . . . . . . . . . . . . . . . . . ... -- -- * * -- * * *
2 or more races . . . . . . . . . . . . . . . . . ... -- -- 13.5 13.1 -- 7.3 8.8 7.1
Sex
Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.6 10.8 10.7 14.0 -- -- 6.1 6.8
Female . . . . . . . . . . . . . . . . . . . . . . . . . . 3.2 4.2 4.4 5.9 -- -- 4.1 4.1
Race 4
White only . . . . . . . . . . . . . . . . . . . . . . . . 7.1 8.1 7.8 10.6 -- -- 5.1 5.5
Black or African American only . . . . . . . . . 5.0 7.0 7.7 9.4 -- -- 5.3 5.9
American Indian or Alaska Native only . . . . *8.5 * *9.4 *10.4 -- -- * *5.2
Asian only . . . . . . . . . . . . . . . . . . . . . . . . *1.7 * *1.6 2.6 -- -- *1.7 *1.8
Native Hawaiian or Other Pacific
Islander only . . . . . . . . . . . . . . . . . . ... -- * * * -- -- * *
2 or more races . . . . . . . . . . . . . . . . . ... -- 7.4 9.7 11.8 -- -- 8.2 8.4
Percent of children
Under 18 years 3 . . . . . . . . . . . . . . . . . . . 3.4 3.6 3.8 5.6 7.4 8.1 9.6 12.2
Age
0–4 years . . . . . . . . . . . . . . . . . . . . . . . . 3.8 4.0 4.3 5.6 8.1 8.7 11.0 14.1
5–17 years . . . . . . . . . . . . . . . . . . . . . . . 3.3 3.4 3.6 5.6 7.2 7.9 9.1 11.5
5–9 years. . . . . . . . . . . . . . . . . . . . . . . 3.1 3.6 3.5 6.0 7.5 8.6 10.0 12.5
10–17 years . . . . . . . . . . . . . . . . . . . . . 3.4 3.3 3.6 5.3 7.1 7.5 8.6 10.8
Sex
Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.4 3.7 3.8 5.7 7.3 7.9 9.5 12.2
Female . . . . . . . . . . . . . . . . . . . . . . . . . . 3.5 3.4 3.8 5.5 7.6 8.4 9.8 12.2
Race 4
White only . . . . . . . . . . . . . . . . . . . . . . . . 3.5 3.6 3.8 5.3 7.1 7.6 9.0 10.9
Black or African American only . . . . . . . . . 3.1 3.0 3.7 6.6 9.0 10.4 12.4 17.5
American Indian or Alaska Native only . . . . * *4.8 * *5.1 *4.1 *9.1 11.3 11.6
Asian only . . . . . . . . . . . . . . . . . . . . . . . . 3.9 4.4 4.3 6.2 8.0 8.4 7.5 11.9
Native Hawaiian or Other Pacific
Islander only . . . . . . . . . . . . . . . . . . ... -- * * * -- * * *
2 or more races . . . . . . . . . . . . . . . . . ... -- 5.2 4.6 6.5 -- 10.9 14.0 16.5
Percent of children
Under 18 years 3 . . . . . . . . . . . . . . . . . . . 17.5 17.7 17.3 16.5 7.1 6.7 5.8 5.6
Age
0–4 years . . . . . . . . . . . . . . . . . . . . . . . . 10.7 10.4 10.1 10.6 13.7 12.8 11.0 10.2
5–17 years . . . . . . . . . . . . . . . . . . . . . . . 19.9 20.3 20.0 18.8 4.8 4.5 3.8 3.9
5–9 years. . . . . . . . . . . . . . . . . . . . . . . 17.3 18.1 17.9 16.6 7.1 6.9 5.7 6.1
10–17 years . . . . . . . . . . . . . . . . . . . . . 21.6 21.7 21.2 20.2 3.2 2.9 2.7 2.4
Sex
Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18.6 18.8 18.9 17.8 7.3 6.9 5.9 5.9
Female . . . . . . . . . . . . . . . . . . . . . . . . . . 16.3 16.5 15.6 15.2 6.9 6.5 5.6 5.2
Race 4
White only . . . . . . . . . . . . . . . . . . . . . . . . 17.9 18.5 17.8 16.8 7.4 7.2 6.3 6.1
Black or African American only . . . . . . . . . 16.2 15.6 15.2 15.4 5.9 5.0 4.1 3.9
American Indian or Alaska Native only . . . . 15.2 16.4 16.5 14.9 *10.8 *6.3 *5.1 *7.2
Asian only . . . . . . . . . . . . . . . . . . . . . . . . 15.3 12.6 11.3 14.1 3.7 2.6 3.3 3.4
Native Hawaiian or Other Pacific
Islander only . . . . . . . . . . . . . . . . . . ... -- * * * -- * * *
2 or more races . . . . . . . . . . . . . . . . . ... -- 20.9 20.8 18.8 -- 7.4 5.0 5.4
NOTES: Answers to questions are supplied by the parents or a knowledgeable adult in the family. Standard errors are available in the spreadsheet version of this table.
Available from: http://www.cdc.gov/nchs/hus.htm. Data for additional years are available. See the Excel spreadsheet on the Health, United States website at:
http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC/NCHS, National Health Interview Survey, family core and sample child questionnaires. See Appendix I, National Health Interview Survey (NHIS).
1990–2011
Site, sex, race, and Hispanic origin 1990 1995 2000 2002 2003 2005 2009 2010 2011 APC 1
1990–2011
Site, sex, race, and Hispanic origin 1990 1995 2000 2002 2003 2005 2009 2010 2011 APC 1
Ovary
†
Female. . . . . . . . . . . . . . . . . . . . . . . . 15.6 14.5 14.2 13.9 13.6 13.1 12.7 12.4 12.0 –1.1
†
White . . . . . . . . . . . . . . . . . . . . . . . 16.4 15.4 15.1 14.7 14.3 13.9 13.5 13.3 12.8 –1.0
Black or African American . . . . . . . . . 11.3 10.8 10.7 9.8 11.5 10.7 10.0 9.3 9.7 –0.5
American Indian or Alaska Native 3 . . 21.9 * 18.9 * 13.4 12.2 16.1 11.8 10.7 *
†
Asian or Pacific Islander . . . . . . . . . . 11.2 10.4 10.2 12.1 10.1 10.8 9.4 9.5 9.3 –0.5
Hispanic or Latina 4 . . . . . . . . . . . . . 12.2 11.7 10.6 13.8 11.6 11.8 10.4 11.7 10.9 –0.4
White, not Hispanic or Latina 4 . . . . . . 16.7 15.9 15.7 14.7 14.7 14.1 13.9 13.3 13.0 †
–1.0
1990–2011
Site, sex, race, and Hispanic origin 1990 1995 2000 2002 2003 2005 2009 2010 2011 APC 1
Urinary bladder
†
Male . . . . . . . . . . . . . . . . . . . . . . . . . 37.2 35.4 36.8 35.8 36.9 37.0 35.0 35.7 33.5 –0.2
White . . . . . . . . . . . . . . . . . . . . . . . 40.7 38.9 40.8 39.4 40.8 41.0 38.4 39.8 37.5 –0.1
Black or African American . . . . . . . . . 19.5 19.3 20.2 20.6 22.8 22.9 22.1 22.0 20.3 0.4
American Indian or Alaska Native 3 . . * * * * * 16.8 20.2 16.0 16.5 *
Asian or Pacific Islander . . . . . . . . . . 15.4 16.7 16.6 19.4 17.8 17.0 17.3 17.0 14.5 0.5
Hispanic or Latino 4 . . . . . . . . . . . . . 22.4 17.8 20.4 21.1 20.2 20.0 19.1 18.5 19.7 –0.3
White, not Hispanic or Latino 4 . . . . . . 42.4 41.0 43.2 41.7 43.4 43.7 41.3 43.0 40.3 0.0
†
Female. . . . . . . . . . . . . . . . . . . . . . . . 9.5 9.3 9.1 9.1 9.2 9.0 8.4 8.6 8.2 –0.5
†
White . . . . . . . . . . . . . . . . . . . . . . . 10.0 10.1 10.0 10.1 10.0 9.7 9.2 9.4 9.1 –0.4
Black or African American . . . . . . . . . 8.6 7.2 7.7 8.5 7.7 7.8 6.9 6.9 7.0 –0.4
American Indian or Alaska Native 3 . . * * * * * * * * * *
Asian or Pacific Islander . . . . . . . . . . 5.3 4.4 4.1 3.2 5.0 5.1 3.8 4.6 4.1 –0.2
Hispanic or Latina 4 . . . . . . . . . . . . . 5.8 5.3 5.8 6.5 4.6 6.0 5.1 4.6 5.5 –0.3
White, not Hispanic or Latina 4 . . . . . . 10.3 10.6 10.5 10.6 10.8 10.3 9.9 10.2 9.7 †
–0.2
Non-Hodgkin lymphoma
†
Male . . . . . . . . . . . . . . . . . . . . . . . . . 22.6 25.1 23.5 23.8 24.2 24.7 24.7 25.2 23.5 0.2
†
White . . . . . . . . . . . . . . . . . . . . . . . 23.6 26.2 25.0 25.1 25.7 25.9 26.2 26.4 24.8 0.3
Black or African American . . . . . . . . . 17.4 21.5 17.5 18.0 19.1 19.5 18.9 21.1 17.1 0.1
American Indian or Alaska Native 3 . . * * 15.3 16.6 * 23.2 20.3 18.2 10.7 *
Asian or Pacific Islander . . . . . . . . . . 16.7 16.5 15.9 16.3 16.2 17.9 17.0 17.2 17.4 0.2
Hispanic or Latino 4 . . . . . . . . . . . . . 17.3 21.0 20.4 20.6 19.6 19.9 20.2 22.8 19.8 †
0.5
White, not Hispanic or Latino 4 . . . . . . 24.3 26.7 25.5 25.7 26.5 26.9 27.3 27.0 25.5 †
0.4
†
Female. . . . . . . . . . . . . . . . . . . . . . . . 14.5 15.2 16.0 16.5 17.2 16.5 16.9 16.9 15.7 0.7
†
White . . . . . . . . . . . . . . . . . . . . . . . 15.4 16.0 16.9 17.5 18.0 17.7 18.0 18.0 16.3 0.7
†
Black or African American . . . . . . . . . 10.3 10.2 11.8 11.8 13.3 13.2 12.2 12.6 12.8 1.4
American Indian or Alaska Native 3 . . * * 13.5 * * 13.1 15.6 12.9 15.0 *
Asian or Pacific Islander . . . . . . . . . . 9.1 11.8 11.4 12.3 12.6 9.5 11.8 11.7 11.9 0.6
Hispanic or Latina 4 . . . . . . . . . . . . . 13.7 13.1 13.8 13.7 15.3 15.0 17.2 15.4 14.3 †
0.9
White, not Hispanic or Latina 4 . . . . . . 15.6 16.2 17.3 18.0 18.4 18.1 18.1 18.3 16.7 †
0.8
1990–2011
Site, sex, race, and Hispanic origin 1990 1995 2000 2002 2003 2005 2009 2010 2011 APC 1
Male . . . . . . . . . . . . . . . . . . . . . . . . . 17.2 17.6 17.1 17.1 17.3 17.3 17.0 17.4 16.9 0.0
White . . . . . . . . . . . . . . . . . . . . . . . 18.0 19.0 18.2 18.5 18.4 18.8 18.2 18.8 18.0 0.1
Black or African American . . . . . . . . . 16.0 13.4 14.1 12.7 14.6 12.6 14.8 13.2 13.9 0.0
American Indian or Alaska Native 3 . . * * * 7.9 * 12.3 * * 9.7 *
Asian or Pacific Islander . . . . . . . . . . 8.5 10.0 10.4 9.4 10.3 9.1 9.7 9.8 10.0 –0.2
Hispanic or Latino 4 . . . . . . . . . . . . . 12.2 14.6 13.1 12.3 12.2 13.2 12.4 12.6 12.9 0.3
White, not Hispanic or Latino 4 . . . . . . 18.3 19.3 18.7 19.1 19.0 19.2 18.8 19.3 18.6 0.1
Female. . . . . . . . . . . . . . . . . . . . . . . . 9.9 10.2 10.4 10.0 10.1 10.0 10.1 10.4 10.0 0.2
†
White . . . . . . . . . . . . . . . . . . . . . . . 10.3 10.9 11.0 10.8 10.7 10.5 10.7 11.1 10.8 0.3
Black or African American . . . . . . . . . 8.5 8.2 9.7 7.4 9.0 9.4 7.7 8.7 8.6 –0.2
American Indian or Alaska Native 3 . . * * * * * * * 7.7 * *
Asian or Pacific Islander . . . . . . . . . . 5.7 6.4 6.3 6.3 6.5 6.3 6.7 5.8 6.0 –0.1
Hispanic or Latina 4 . . . . . . . . . . . . . 8.5 8.2 7.8 8.6 7.2 8.2 8.3 8.6 8.4 0.3
White, not Hispanic or Latina 4 . . . . . . 10.3 11.1 11.0 10.9 11.1 10.6 10.8 11.4 11.0 †
0.4
†
Annual percent change (APC) is significantly different from zero (p < 0.05).
0.0 APC is greater than –0.05 but less than 0.05.
* Estimates are considered unreliable. Data not shown if the rate is based on fewer than 16 cases for the time interval. The trend is not shown if it is based on fewer
1
APC was calculated by fitting a linear regression model to the natural logarithm of the yearly rates from 1990–2011.
2
Age-adjusted by 5-year age groups to the year 2000 U.S. standard population. Age-adjusted rates are based on at least 16 cases. See Appendix II, Age adjustment.
3
Estimates for the American Indian or Alaska Native populations are based on the Contract Health Service Delivery Area (CHSDA) counties within SEER areas.
4
Hispanic data exclude cases from Alaska. The race groups, white, black, Asian or Pacific Islander, and American Indian or Alaska Native, include persons of Hispanic
and non-Hispanic origin. Persons of Hispanic origin may be of any race. The North American Association of Central Cancer Registries (NAACCR) Hispanic Identification
Algorithm was used on a combination of variables to classify cases as Hispanic for analytic purposes. See the report, NAACCR Guideline for Enhancing
Hispanic-Latino Identification, for more information. Available from: http://seer.cancer.gov/seerstat/variables/seer/yr1973_2006/race_ethnicity/. See Appendix II, Hispanic
origin.
NOTES: See Appendix II, Incidence. Estimates are based on 13 SEER areas (November 2013 submission) and differ from published estimates based on 9 SEER
areas or other submission dates. See Appendix I, Surveillance, Epidemiology, and End Results Program (SEER). The site variable distinguishes Kaposi Sarcoma and
Mesothelioma as individual cancer sites. As a result, Kaposi Sarcoma and Mesothelioma cases do not contribute to other cancer sites. Estimates for 2001–2009 were
computed using intercensal population estimates based on the 2000 and 2010 censuses. Data have been revised and differ from previous editions of Health, United
States. Data for additional years are available. See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: National Institutes of Health, National Cancer Institute, Surveillance, Epidemiology, and End Results Program. Available from: http://www.seer.cancer.gov.
See Appendix I, Surveillance, Epidemiology, and End Results Program (SEER).
1975– 1981– 1987– 1999– 2004– 1975– 1981– 1987– 1999– 2004–
Sex and site 1977 1983 1989 2003 2010 1977 1983 1989 2003 2010
Male
All sites . . . . . . . . . . . . . . . . . . . . . 42.7 46.6 52.8 68.1 70.0 32.7 34.1 38.8 61.9 64.9
Oral cavity and pharynx . . . . . . . . . 53.7 52.8 54.1 63.5 67.4 29.7 25.3 29.8 39.8 42.3
Esophagus . . . . . . . . . . . . . . . . . . 4.8 6.5 11.0 18.7 20.9 2.0 3.7 5.3 9.5 12.8
Stomach . . . . . . . . . . . . . . . . . . . . 13.1 15.4 15.5 22.0 26.7 16.1 16.2 16.6 24.0 23.0
Colon . . . . . . . . . . . . . . . . . . . . . . 50.5 56.1 61.4 66.9 67.3 44.0 44.5 50.6 54.2 55.4
Rectum . . . . . . . . . . . . . . . . . . . . . 47.3 51.0 58.9 67.9 68.3 41.4 37.7 47.7 60.1 58.1
Pancreas . . . . . . . . . . . . . . . . . . . . 2.7 2.1 3.1 5.6 6.9 2.5 3.7 5.1 3.0 7.6
Lung and bronchus. . . . . . . . . . . . . 11.1 11.7 12.0 13.7 15.8 10.6 10.1 10.8 11.3 13.0
Prostate gland . . . . . . . . . . . . . . . . 68.5 73.1 84.4 99.8 99.8 60.7 62.7 71.1 97.5 97.9
Urinary bladder . . . . . . . . . . . . . . . 74.3 78.5 81.9 81.9 81.4 56.5 64.9 67.5 71.0 68.0
Non-Hodgkin lymphoma . . . . . . . . . 46.3 50.5 48.1 65.7 71.5 42.6 49.0 41.7 54.0 58.8
Leukemia. . . . . . . . . . . . . . . . . . . . 33.6 37.8 45.5 54.6 61.9 30.0 33.4 32.7 46.3 58.1
Female
All sites . . . . . . . . . . . . . . . . . . . . . 56.5 56.0 60.6 67.2 68.7 46.2 44.4 47.7 54.3 57.7
Colon . . . . . . . . . . . . . . . . . . . . . . 51.3 54.8 59.9 65.6 65.8 45.3 51.5 53.6 54.0 56.1
Rectum . . . . . . . . . . . . . . . . . . . . . 49.4 53.2 58.4 67.8 67.5 46.8 42.2 56.9 60.0 68.3
Pancreas . . . . . . . . . . . . . . . . . . . . 2.3 3.0 3.3 5.1 7.4 1.9 3.2 5.8 5.8 5.9
Lung and bronchus. . . . . . . . . . . . . 15.4 16.5 15.3 18.3 20.7 13.8 14.9 11.1 14.5 17.1
Melanoma of skin . . . . . . . . . . . . . . 86.2 87.1 91.3 95.0 95.0 * * 89.5 71.4 81.2
Breast . . . . . . . . . . . . . . . . . . . . . . 75.6 77.1 85.1 91.2 91.8 62.0 63.3 71.0 78.1 80.0
Cervix uteri . . . . . . . . . . . . . . . . . . 69.7 67.8 72.5 72.6 71.0 64.6 59.2 57.0 64.5 62.0
Corpus and uterus, not otherwise
specified . . . . . . . . . . . . . . . . . .. 88.0 82.2 83.9 85.9 85.3 60.2 50.7 56.9 60.5 64.7
Ovary . . . . . . . . . . . . . . . . . . . . .. 35.3 38.5 38.1 43.3 44.3 41.8 37.5 33.7 35.7 36.4
Non-Hodgkin lymphoma . . . . . . . .. 47.3 51.1 55.3 69.4 73.6 54.8 49.8 51.2 64.9 67.7
* Data for population groups with fewer than 25 cases are not shown because estimates are considered unreliable.
NOTES: Rates are based on follow-up of patients through 2011. The rate is the ratio of the observed survival rate for the patient group to the expected survival rate for
persons in the general population similar to the patient group with respect to age, sex, race, and calendar year of observation. It estimates the chance of surviving the
effects of cancer. The site variable distinguishes Kaposi Sarcoma and Mesothelioma as individual cancer sites. As a result, Kaposi Sarcoma and Mesothelioma cases
are excluded from each of the sites shown except all sites combined. The race groups, white and black, include persons of Hispanic and non-Hispanic origin. Due to
death certificate race-ethnicity classification and other methodological issues related to developing life tables, survival rates for race-ethnicity groups other than white
and black are not calculated. Data have been revised and differ from previous editions of Health, United States. Data for additional years are available. See the Excel
spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: National Institutes of Health, National Cancer Institute, Surveillance, Epidemiology, and End Results Program. Available from: http://www.seer.cancer.gov.
See Appendix I, Surveillance, Epidemiology, and End Results Program (SEER).
1997– 2001– 2010– 2012– 1997– 2001– 2010– 2012– 1997– 2001– 2010– 2012–
Characteristic 1998 2002 2011 2013 1998 2002 2011 2013 1998 2002 2011 2013
Percent of adults
18 years and over, age-adjusted 4,5 . . . . . . 12.0 11.5 11.1 10.6 4.9 5.3 6.0 5.9 2.3 2.4 2.6 2.5
18 years and over, crude 5 . . . . . . . . . . . . 11.6 11.3 11.6 11.4 4.8 5.2 6.3 6.4 2.2 2.4 2.7 2.7
Age
18–44 years . . . . . . . . . . . . . . . . . . . . . . 4.6 4.3 4.0 3.8 1.7 1.7 1.7 1.6 0.4 0.4 0.6 0.5
18–24 years . . . . . . . . . . . . . . . . . . . . . 3.2 3.3 3.0 2.6 0.8 0.8 0.7 *0.5 * * * *
25–44 years . . . . . . . . . . . . . . . . . . . . . 5.0 4.6 4.4 4.2 2.0 2.1 2.0 1.9 0.4 0.5 0.7 0.6
45–64 years . . . . . . . . . . . . . . . . . . . . . . 13.5 12.9 13.0 12.1 5.4 5.7 6.9 6.7 2.3 2.4 2.9 2.8
45–54 years . . . . . . . . . . . . . . . . . . . . . 10.9 10.0 9.6 8.9 4.0 4.2 4.9 4.4 1.4 1.8 2.1 2.0
55–64 years . . . . . . . . . . . . . . . . . . . . . 17.4 17.4 17.1 15.8 7.4 7.9 9.3 9.3 3.8 3.3 3.9 3.8
65 years and over . . . . . . . . . . . . . . . . . . 31.8 31.3 30.5 29.8 14.1 15.6 18.5 18.4 8.1 8.8 8.2 8.4
65–74 years . . . . . . . . . . . . . . . . . . . . . 27.8 26.6 25.6 25.0 12.4 13.9 15.9 16.2 6.7 6.6 6.3 6.4
75 years and over. . . . . . . . . . . . . . . . . 37.0 36.8 36.5 36.3 16.2 17.6 21.7 21.4 9.8 11.2 10.6 11.1
Sex 4
Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.3 12.4 12.4 11.9 4.1 4.7 5.5 5.4 2.6 2.6 2.6 2.6
Female . . . . . . . . . . . . . . . . . . . . . . . . . . 11.8 10.8 10.2 9.6 5.8 6.0 6.6 6.5 2.1 2.3 2.6 2.5
Race 4,6
White only . . . . . . . . . . . . . . . . . . . . . . . . 12.2 11.7 11.2 10.8 5.2 5.6 6.3 6.2 2.2 2.3 2.3 2.4
Black or African American only . . . . . . . . . 11.4 10.6 10.7 10.5 3.5 3.3 5.1 4.8 3.3 3.3 4.1 3.7
American Indian or Alaska Native only . . . . 18.6 11.4 12.5 10.1 *6.5 * 6.5 *4.3 *5.0 * *4.7 *3.3
Asian only . . . . . . . . . . . . . . . . . . . . . . . . 6.9 8.8 7.2 6.4 2.4 *1.6 3.0 3.4 *1.2 *3.1 2.4 1.8
Native Hawaiian or Other Pacific
Islander only . . . . . . . . . . . . . . . . . . ... -- * * * -- * * * -- * * *
2 or more races . . . . . . . . . . . . . . . . . ... -- 16.5 16.7 15.5 -- 7.1 7.9 8.9 -- *4.9 *3.9 4.7
Education 7,8
No high school diploma or GED . . . . . . . . 15.1 14.3 14.6 13.7 5.3 5.4 5.8 5.3 3.9 3.8 4.4 4.5
High school diploma or GED . . . . . . . . . . . 12.8 12.4 12.4 12.1 5.5 6.3 6.8 7.0 2.5 2.9 3.4 3.1
Some college or more . . . . . . . . . . . . . . . 12.7 12.4 11.9 11.3 6.0 6.2 7.4 7.0 2.1 2.3 2.3 2.4
1997– 2001– 2010– 2012– 1997– 2001– 2010– 2012– 1997– 2001– 2010– 2012–
Characteristic 1998 2002 2011 2013 1998 2002 2011 2013 1998 2002 2011 2013
Geographic region 4
Northeast . . . . . . . . . . . . . . . . . . . . . . . . 11.6 10.9 10.1 9.7 4.5 5.0 5.6 6.1 1.8 2.1 2.0 2.1
Midwest . . . . . . . . . . . . . . . . . . . . . . . . . 12.1 12.1 11.5 11.8 5.1 5.7 6.7 6.4 2.3 2.4 2.6 2.5
South . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.5 11.7 12.1 11.2 5.0 5.3 6.2 5.8 2.6 2.5 2.9 2.9
West. . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.1 10.9 9.9 9.3 5.1 5.1 5.5 5.5 2.1 2.7 2.4 2.4
* Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error (RSE) of 20%–30%. Data not shown have an RSE greater than 30%.
1
Heart disease is based on self-reported responses to questions about whether respondents had ever been told by a doctor or other health professional that they had coronary
heart disease, angina (angina pectoris), a heart attack (myocardial infarction), or any other kind of heart disease or heart condition.
2
Cancer is based on self-reported responses to a question about whether respondents had ever been told by a doctor or other health professional that they had cancer or a
malignancy of any kind. Excludes squamous cell and basal cell carcinomas.
3
Stroke is based on self-reported responses to a question about whether respondents had ever been told by a doctor or other health professional that they had a stroke.
4
Estimates are age-adjusted to the year 2000 standard population using five age groups: 18–44 years, 45–54 years, 55–64 years, 65–74 years, and 75 years and over.
Age-adjusted estimates in this table may differ from other age-adjusted estimates based on the same data and presented elsewhere if different age groups are used in the
5
Includes all other races not shown separately and unknown education level.
6
The race groups, white, black, American Indian or Alaska Native, Asian, Native Hawaiian or Other Pacific Islander, and 2 or more races, include persons of Hispanic and
non-Hispanic origin. Persons of Hispanic origin may be of any race. Starting with 1999 data, race-specific estimates are tabulated according to the 1997 Revisions to the
Standards for the Classification of Federal Data on Race and Ethnicity and are not strictly comparable with estimates for earlier years. The five single-race categories plus
multiple-race categories shown in the table conform to the 1997 Standards. Starting with 1999 data, race-specific estimates are for persons who reported only one racial group;
the category 2 or more races includes persons who reported more than one racial group. Prior to 1999, data were tabulated according to the 1977 Standards with four racial
groups, and the Asian only category included Native Hawaiian or Other Pacific Islander. Estimates for single-race categories prior to 1999 included persons who reported one
race or, if they reported more than one race, identified one race as best representing their race. Starting with 2003 data, race responses of other race and unspecified multiple
race were treated as missing, and then race was imputed if these were the only race responses. Almost all persons with a race response of other race were of Hispanic origin.
7
Estimates are for persons aged 25 and over and are age-adjusted to the year 2000 standard population using five age groups: 25–44 years, 45–54 years, 55–64 years,
65–74 years, and 75 years and over. See Appendix II, Age adjustment.
8
GED is General Educational Development high school equivalency diploma. See Appendix II, Education.
9
Percent of poverty level is based on family income and family size and composition using U.S. Census Bureau poverty thresholds. Missing family income data were imputed
for 1997–1998 and beyond. See Appendix II, Family income; Poverty; Table VI.
10
MSA is metropolitan statistical area. Starting with 2006 data, MSA status is determined using 2000 census data and the 2000 standards for defining MSAs. For data prior to
2006, see Appendix II, Metropolitan statistical area (MSA) for the applicable standards.
NOTES: Standard errors are available in the spreadsheet version of this table. Available from: http://www.cdc.gov/nchs/hus.htm. Data for additional years are available.
See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC/NCHS, National Health Interview Survey, family core and sample adult questionnaires. See Appendix I, National Health Interview Survey (NHIS).
Characteristic 2002 2005 2012 2013 2002 2005 2012 2013 2002 2005 2012 2013
Percent distribution
Total, age-adjusted 2,3 . . . . . . . . . . . . . . . . 78.5 77.4 76.5 76.7 17.9 18.7 19.1 19.0 3.6 3.9 4.3 4.3
Total, crude 2 . . . . . . . . . . . . . . . . . . . . . . 78.5 77.0 74.6 74.5 17.9 19.0 20.7 20.8 3.6 4.0 4.7 4.7
Age
18–64 years . . . . . . . . . . . . . . . . . . . . . . 85.1 84.0 82.2 82.4 12.9 13.9 15.1 14.9 2.0 2.2 2.7 2.6
18–44 years . . . . . . . . . . . . . . . . . . . . . . 93.3 93.0 93.0 93.2 6.2 6.4 6.5 6.3 0.5 0.6 0.5 0.4
18–24 years . . . . . . . . . . . . . . . . . . . . . 96.4 96.6 96.6 97.1 3.5 3.3 3.3 2.8 * * * *
25–44 years . . . . . . . . . . . . . . . . . . . . . 92.3 91.7 91.6 91.8 7.1 7.5 7.7 7.6 0.7 0.8 0.7 0.6
45–64 years . . . . . . . . . . . . . . . . . . . . . . 71.4 70.2 67.7 67.7 24.2 25.2 26.6 26.6 4.4 4.6 5.7 5.6
45–54 years . . . . . . . . . . . . . . . . . . . . . 78.4 77.8 75.3 76.2 18.6 19.3 21.1 20.1 3.1 2.9 3.6 3.7
55–64 years . . . . . . . . . . . . . . . . . . . . . 60.9 59.6 58.9 58.4 32.7 33.4 33.1 33.8 6.4 7.0 8.0 7.8
65 years and over . . . . . . . . . . . . . . . . . . 44.6 40.7 39.2 39.1 43.4 46.0 46.7 46.8 12.0 13.3 14.1 14.1
65–74 years . . . . . . . . . . . . . . . . . . . . . 47.6 44.3 42.4 42.6 41.4 43.7 45.4 45.2 11.0 12.0 12.2 12.2
75 years and over. . . . . . . . . . . . . . . . . 41.1 36.7 35.0 34.4 45.8 48.6 48.4 48.9 13.2 14.7 16.6 16.7
Sex 3
Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79.7 78.9 77.5 77.6 16.5 17.6 18.1 18.2 3.8 3.5 4.4 4.3
Female . . . . . . . . . . . . . . . . . . . . . . . . . . 77.3 76.0 75.7 75.9 19.1 19.6 20.0 19.8 3.6 4.4 4.3 4.3
Race 3,4
White only . . . . . . . . . . . . . . . . . . . . . . . . 78.8 77.7 77.0 76.9 17.7 18.4 18.9 19.0 3.5 3.8 4.1 4.1
Black or African American only . . . . . . . . . 74.3 73.3 71.7 72.9 21.3 22.1 22.6 21.4 4.4 4.6 5.8 5.7
American Indian or Alaska Native only . . . . 69.5 77.6 69.8 71.4 25.5 13.1 23.9 21.4 * *9.3 *6.3 *7.2
Asian only . . . . . . . . . . . . . . . . . . . . . . . . 86.5 84.3 82.5 84.6 11.3 13.6 15.0 12.8 * *2.1 2.4 2.7
Native Hawaiian or Other Pacific
Islander only . . . . . . . . . . . . . . . . . . ... * * * * * * * * * * * *
2 or more races . . . . . . . . . . . . . . . . . ... 72.3 67.1 69.7 70.3 20.2 23.9 20.5 21.4 *7.6 9.0 9.8 8.3
Characteristic 2002 2005 2012 2013 2002 2005 2012 2013 2002 2005 2012 2013
Midwest . . . . . . . . . . . . . . . . . . . . . . . . . 78.4 76.7 75.9 75.5 17.9 19.2 19.4 20.2 3.7 4.2 4.7 4.3
South . . . . . . . . . . . . . . . . . . . . . . . . . . . 77.3 76.1 74.7 75.4 18.6 19.5 20.3 20.0 4.0 4.4 4.9 4.6
West. . . . . . . . . . . . . . . . . . . . . . . . . . . . 79.7 79.3 78.6 78.9 17.0 17.4 18.0 17.4 3.3 3.3 3.4 3.6
Outside MSA . . . . . . . . . . . . . . . . . . . . . . 76.0 73.6 71.8 72.3 19.6 21.5 22.7 22.2 4.4 4.9 5.5 5.6
* Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error (RSE) of 20%–30%. Data not shown have an RSE greater than 30%.
1
Adults were categorized as having 0 to 1, 2 to 3, or 4 or more of the following chronic conditions: hypertension, coronary heart disease, stroke, diabetes, cancer, arthritis,
hepatitis, weak or failing kidneys, chronic obstructive pulmonary disease, or current asthma. Data from the National Health Interview Survey capture 10 of 20 chronic conditions
used in a standardized approach for defining chronic conditions in the United States. Thus, these estimates are conservative in nature. For more information, see: Goodman
RA, Posner SF, Huang ES, Parekh AK, Koh HK. Defining and measuring chronic conditions: imperatives for research, policy, program, and practice. Prev Chronic Dis
2013;10:120239. Available from: DOI: http://www.cdc.gov/pcd/issues/2013/12_0239.htm, and Ward BW, Schiller JS. Prevalence of multiple chronic conditions among US adults:
estimates from the National Health Interview Survey, 2010. Prev Chronic Dis 2013;10:120203. Available from: DOI: http://dx.doi.org/10.5888/pcd10.120203.
2
Includes all other races not shown separately and unknown health insurance status.
3
Estimates are age-adjusted to the year 2000 standard population using five age groups: 18–44 years, 45–54 years, 55–64 years, 65–74 years, and 75 years and over. See
4
The race groups, white, black, American Indian or Alaska Native, Asian, Native Hawaiian or Other Pacific Islander, and 2 or more races, include persons of Hispanic and
non-Hispanic origin. Persons of Hispanic origin may be of any race. Race-specific estimates are tabulated according to the 1997 Revisions to the Standards for the
Classification of Federal Data on Race and Ethnicity. The five single-race categories plus multiple-race categories shown in the table conform to the 1997 Standards.
Race-specific estimates are for persons who reported only one racial group; the category 2 or more races includes persons who reported more than one racial group. Starting
with 2003 data, race responses of other race and unspecified multiple race were treated as missing, and then race was imputed if these were the only race responses. Almost
all persons with a race response of other race were of Hispanic origin. See Appendix II, Hispanic origin; Race.
5
Percent of poverty level is based on family income and family size and composition using U.S. Census Bureau poverty thresholds. Missing family income data were imputed.
6
Estimates are age-adjusted to the year 2000 standard population using three age groups: 18–44 years, 45–54 years, and 55–64 years. See Appendix II, Age adjustment.
7
Health insurance categories are mutually exclusive. Persons who reported both Medicaid and private coverage are classified as having private coverage. State-sponsored
health plan coverage is included as Medicaid coverage. Coverage by the Children’s Health Insurance Program (CHIP) is included with Medicaid coverage. In addition to private
and Medicaid, the insured category also includes military plans, other government-sponsored health plans, and Medicare, not shown separately. Persons not covered by
private insurance, Medicaid, CHIP, state-sponsored or other government-sponsored health plans (starting in 1997), Medicare, or military plans are considered to have no health
insurance coverage. Persons with only Indian Health Service coverage are considered to have no health insurance coverage. See Appendix II, Health insurance coverage.
8
MSA is metropolitan statistical area. Starting with 2006 data, MSA status is determined using 2000 census data and the 2000 standards for defining MSAs. For data prior to
2006, see Appendix II, Metropolitan statistical area (MSA) for the applicable standards.
NOTES: In 1997, the National Health Interview Survey questionnaire was redesigned. See Appendix I, National Health Interview Survey (NHIS). Standard errors are
available in the spreadsheet version of this table. See http://www.cdc.gov/nchs/hus.htm. Data for additional years are available. See the Excel spreadsheet on the
Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC/NCHS, National Health Interview Survey, family core and sample adult questionnaires. See Appendix I, National Health Interview Survey (NHIS).
Physician-diagnosed and
undiagnosed diabetes 1,2 Physician-diagnosed diabetes 1 Undiagnosed diabetes 2
Sex, age, and race 1988– 1999– 2003– 2009– 1988– 1999– 2003– 2009– 1988– 1999– 2003– 2009–
and Hispanic origin 3 1994 2002 2006 2012 1994 2002 2006 2012 1994 2002 2006 2012
Age
20–44 years . . . . . . . . . . . . . . . . . . . . *2.1 4.4 3.9 3.7 * 3.2 2.8 2.1 1.1 * *1.1 1.6
45–64 years . . . . . . . . . . . . . . . . . . . . 14.0 12.8 13.7 16.2 7.9 8.3 10.1 11.4 6.0 4.5 3.5 4.8
65 years and over . . . . . . . . . . . . . . . . 19.4 20.4 24.9 26.8 12.7 13.7 17.5 21.2 6.7 6.7 7.4 5.5
Poor glycemic control (A1c greater than 9%) among persons with physician-diagnosed diabetes
Sex, age, and race
and Hispanic origin 3 1988–1994 1999–2002 2003–2006 2009–2012
400% or more . . . . . . . . . . . . . . . . * * * *
Age
20–44 years . . . . . . . . . . . . . . . . . . . . . . 29.5 *32.7 25.2 30.1
* Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error (RSE) of 20%–30%. Data not shown have an RSE greater than
30%.
1
Physician-diagnosed diabetes was obtained by self-report and excludes women who are pregnant.
2
Undiagnosed diabetes is defined as a fasting plasma glucose (FPG) of at least 126 mg/dL or a hemoglobin A1c of at least 6.5% and no reported physician diagnosis.
Respondents had fasted for at least 8 hours and less than 24 hours. Pregnant females are excluded. Estimates in some prior editions of Health, United States included
data from respondents who had fasted for at least 9 hours and less than 24 hours. Starting in 2005–2006, testing was performed at a different laboratory and using
different instruments than testing in earlier years. The National Health and Nutrition Examination Survey (NHANES) conducted crossover studies to evaluate the impact
of these changes on FPG and A1c measurements and recommended adjustments to the FPG data. The adjustments recommended by NHANES were incorporated
into the data presented here. For more information, see http://www.cdc.gov/nchs/nhanes/nhanes2005-2006/GLU_D.htm. Prior to Health, United States, 2010, the
definition of undiagnosed diabetes did not consider hemoglobin A1c. The revised definition of undiagnosed diabetes was based on recommendations from the American
Diabetes Association. For more information, see Standards of medical care in diabetes-2010. Diabetes Care 2010;33(suppl 1):S11-S61. To ensure data comparability,
the revised definition of undiagnosed diabetes was applied to all data in this table. Also see Appendix II, Diabetes.
3
Persons of Mexican origin may be of any race. Starting with 1999 data, race-specific estimates are tabulated according to the 1997 Revisions to the Standards for the
Classification of Federal Data on Race and Ethnicity and are not strictly comparable with estimates for earlier years. The two non-Hispanic race categories shown in the
table conform to the 1997 Standards. Starting with 1999 data, race-specific estimates are for persons who reported only one racial group. Prior to data year 1999,
estimates were tabulated according to the 1977 Standards. Estimates for single-race categories prior to 1999 included persons who reported one race or, if they
reported more than one race, identified one race as best representing their race. See Appendix II, Hispanic origin; Race.
4
Estimates are age-adjusted to the year 2000 standard population using three age groups: 20–44 years, 45–64 years, and 65 years and over. Age-adjusted estimates
in this table may differ from other age-adjusted estimates based on the same data and presented elsewhere if different age groups are used in the adjustment
procedure. See Appendix II, Age adjustment.
5
Includes all other races and Hispanic origins not shown separately.
6
Percent of poverty level was calculated by dividing family income by the U.S. Department of Health and Human Services’ poverty guideline specific to family size, as
well as the appropriate year, and state. Persons with unknown percent of poverty level are excluded (7% in 2009–2012). See Appendix II, Family income; Poverty.
NOTES: Pregnant women are excluded. Fasting weights were used to obtain estimates of total, physician-diagnosed, and undiagnosed diabetes prevalence.
Examination weights were used to obtain the poor glycemic control estimates. Estimates in this table may differ from other estimates based on the same data and
presented elsewhere if different weights, age adjustment groups, definitions, or trend adjustments are used. Standard errors are available in the spreadsheet version of
this table. Available from: http://www.cdc.gov/nchs/hus.htm. Data for additional years are available. See the Excel spreadsheet on the Health, United States website at:
http://www.cdc.gov/nchs/hus.htm. Data have been revised and differ from previous editions of Health, United States.
SOURCE: CDC/NCHS, National Health and Nutrition Examination Survey. See Appendix I, National Health and Nutrition Examination Survey (NHANES).
Incidence Prevalence
Age
Under 20 years . . . . . . . . . . . . . . . 1,148 1,167 1,172 1,113 6,039 7,015 7,066 7,020
20–44 years. . . . . . . . . . . . . . . . . . 12,687 13,050 12,734 12,836 86,043 96,067 96,936 98,142
45–64 years. . . . . . . . . . . . . . . . . . 31,736 43,456 43,294 44,120 154,117 259,855 268,220 275,940
65–74 years. . . . . . . . . . . . . . . . . . 23,148 27,100 26,318 27,409 75,480 119,941 127,391 136,859
75 years and over . . . . . . . . . . . . . 22,522 28,607 27,691 27,118 56,395 94,797 98,007 102,175
Sex
Male . . . . . . . . . . . . . . . . . . . . . . . 48,769 64,553 63,600 64,524 206,248 327,379 339,676 353,372
Female . . . . . . . . . . . . . . . . . . . . . 42,472 48,827 47,609 48,072 171,826 250,296 257,944 266,764
Race 1
White . . . . . . . . . . . . . . . . . . . . . . 59,472 75,214 73,229 74,667 231,829 353,938 364,579 377,797
Black or African American . . . . . . . . 26,204 31,828 31,530 31,148 123,654 185,683 192,745 199,632
American Indian or Alaska Native. . . * 1,233 1,234 1,260 * 7,571 7,840 8,080
Asian or Pacific Islander . . . . . . . . . 3,460 5,105 5,216 5,521 16,064 30,483 32,456 34,627
Hispanic origin 1
Hispanic . . . . . . . . . . . . . . . . . . . . 10,053 15,251 15,582 15,399 40,627 85,228 90,856 95,819
Not Hispanic 2 . . . . . . . . . . . . . . . . 81,188 98,129 95,627 97,197 337,447 492,447 506,764 524,317
Primary diagnosis
Diabetes . . . . . . . . . . . . . . . . . . . . 40,489 50,020 49,151 49,258 133,128 217,165 225,110 234,160
Hypertension . . . . . . . . . . . . . . . . . 24,490 32,317 31,506 32,293 92,817 143,951 149,710 156,595
Glomerulonephritis . . . . . . . . . . . . . 9,958 9,311 9,218 8,988 75,477 98,822 101,103 103,312
Cystic kidney . . . . . . . . . . . . . . . . . 2,140 2,582 2,476 2,495 17,685 27,492 28,407 29,389
Other urologic . . . . . . . . . . . . . . . . 1,610 526 429 533 7,996 7,499 7,287 7,253
Other cause. . . . . . . . . . . . . . . . . . 8,486 13,662 13,633 12,157 33,250 54,967 57,266 58,717
Unknown cause . . . . . . . . . . . . . . . 3,712 4,262 4,026 3,469 15,539 24,232 24,733 24,923
Missing disease . . . . . . . . . . . . . . . 356 700 770 3,403 2,182 3,547 4,004 5,787
Incidence Prevalence
Age
Under 20 years . . . . . . . . . . . . . . . 14.2 14.0 14.1 13.4 74.7 84.5 85.4 85.2
20–44 years. . . . . . . . . . . . . . . . . . 121.8 125.6 121.7 121.7 825.8 921.5 923.2 927.4
45–64 years. . . . . . . . . . . . . . . . . . 508.3 531.4 522.8 532.4 2,428.5 3,157.8 3,238.2 3,329.3
65–74 years. . . . . . . . . . . . . . . . . . 1,259.1 1,239.8 1,170.4 1,142.7 4,105.7 5,409.7 5,482.5 5,532.9
75 years and over . . . . . . . . . . . . . 1,349.7 1,536.3 1,466.1 1,415.3 3,357.6 5,054.8 5,151.9 5,294.9
Sex
Male . . . . . . . . . . . . . . . . . . . . . . . 352.2 424.4 414.9 417.6 1,482.0 2,144.2 2,207.4 2,278.2
Female . . . . . . . . . . . . . . . . . . . . . 295.5 310.5 300.7 301.5 1,189.9 1,586.3 1,623.5 1,667.5
Race 1
White . . . . . . . . . . . . . . . . . . . . . . 257.9 306.0 296.5 300.8 1,001.9 1,436.7 1,472.4 1,518.1
Black or African American . . . . . . . . 713.4 754.2 738.4 720.9 3,342.9 4,374.5 4,487.7 4,593.7
American Indian or Alaska Native. . . * 288.3 284.5 286.4 * 1,758.1 1,795.0 1,824.2
Asian or Pacific Islander . . . . . . . . . 290.9 298.3 296.4 305.2 1,320.9 1,756.7 1,819.1 1,888.6
Hispanic origin 1
Hispanic . . . . . . . . . . . . . . . . . . . . 281.8 300.5 300.3 290.3 1,116.0 1,660.8 1,732.0 1,787.6
Not Hispanic 2 . . . . . . . . . . . . . . . . 329.3 379.4 368.2 372.5 1,365.2 1,900.2 1,946.8 2,005.2
Primary diagnosis
Diabetes . . . . . . . . . . . . . . . . . . . . 143.4 161.7 157.7 156.9 469.4 699.5 719.7 743.1
Hypertension . . . . . . . . . . . . . . . . . 86.7 104.4 101.1 102.8 327.3 463.6 478.6 497.0
Glomerulonephritis . . . . . . . . . . . . . 35.2 30.1 29.5 28.6 266.1 318.3 323.2 327.8
Cystic kidney . . . . . . . . . . . . . . . . . 7.5 8.3 7.9 7.9 62.3 88.5 90.8 93.2
Other urologic . . . . . . . . . . . . . . . . 5.7 1.7 1.3 1.6 28.1 24.1 23.2 23.0
Other cause. . . . . . . . . . . . . . . . . . 30.0 44.1 43.7 38.7 117.2 177.0 183.1 186.3
Unknown cause . . . . . . . . . . . . . . . 13.1 13.7 12.9 11.0 54.7 78.0 79.0 79.1
Missing disease . . . . . . . . . . . . . . . 1.2 2.2 2.4 10.8 7.6 11.4 12.8 18.3
1
The race groups, white, black or African American, American Indian or Alaska Native, and Asian or Pacific Islander, include persons of Hispanic and non-Hispanic
origin. Persons of Hispanic origin may be of any race. See Appendix II, Hispanic origin; Race.
2
Not Hispanic includes unknown ethnicity.
NOTES: Persons with unknown age, gender, or race are excluded. For incidence estimates, age is determined as of the date of end-stage renal disease initiation. For
prevalence estimates, age is calculated as of December 31 of each year. Prevalence estimates are for patients alive on end-stage renal disease therapy and not lost to
follow-up at any time during each year. Prevalence estimates include patients with a functioning transplant. In 2012, the methodology was revised and all data were
reestimated. See the USRDS Annual data report, available from:http://www.usrds.org/adr.aspx. See Appendix II, End-stage renal disease (ESRD); Incidence;
Prevalence. Data have been revised and differ from previous editions of Health, United States.
SOURCE: United States Renal Data System, USRDS 2014 Annual data report: An overview of the epidemiology of kidney disease in the United States, National
Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, 2014. Tables A1(2), A2, B1(2), B2. Available from:
http://www.usrds.org/adr.aspx. See Appendix I, United States Renal Data System (USRDS).
Characteristic 1997 2010 2013 1997 2010 2013 1997 2010 2013
Age
18–44 years . . . . . . . . . . . . . . . . . . . . . . 18.7 20.4 18.8 26.1 25.2 23.8 13.3 13.1 11.2
18–24 years . . . . . . . . . . . . . . . . . . . . . 18.7 19.6 17.1 21.9 19.4 18.0 9.8 8.3 6.7
25–44 years . . . . . . . . . . . . . . . . . . . . . 18.7 20.7 19.5 27.3 27.2 26.0 14.3 14.8 12.9
45–64 years . . . . . . . . . . . . . . . . . . . . . . 15.8 15.6 15.6 31.3 32.4 33.7 17.0 20.0 19.4
45–54 years . . . . . . . . . . . . . . . . . . . . . 17.8 16.7 17.9 31.3 31.3 32.5 17.3 19.1 19.4
55–64 years . . . . . . . . . . . . . . . . . . . . . 12.7 14.1 13.0 31.2 33.8 35.0 16.6 21.0 19.4
65 years and over . . . . . . . . . . . . . . . . . . 7.0 6.4 7.3 29.5 31.8 33.7 15.0 14.8 15.9
65–74 years . . . . . . . . . . . . . . . . . . . . . 8.2 7.4 8.1 30.2 32.5 33.3 15.0 15.5 17.3
75 years and over. . . . . . . . . . . . . . . . . 5.4 5.1 6.2 28.6 30.9 34.2 15.0 14.0 14.1
Sex 2
Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.9 11.0 10.1 26.5 26.3 26.4 12.6 13.1 12.2
Female . . . . . . . . . . . . . . . . . . . . . . . . . . 21.4 22.1 21.6 29.6 30.3 30.2 16.6 17.6 16.5
Race 2,4
White only . . . . . . . . . . . . . . . . . . . . . . . . 15.9 16.7 16.0 28.7 29.1 29.0 15.1 16.0 14.8
Black or African American only . . . . . . . . . 16.7 18.2 16.9 26.9 27.2 27.9 13.3 13.3 13.1
American Indian or Alaska Native only . . . . 18.9 18.8 18.9 33.3 33.6 31.2 16.2 16.9 17.3
Asian only . . . . . . . . . . . . . . . . . . . . . . . . 11.7 10.1 10.9 21.0 19.1 18.8 9.2 9.6 9.5
Native Hawaiian or Other Pacific
Islander only . . . . . . . . . . . . . . . . . . ... -- * * -- * * -- * *
2 or more races . . . . . . . . . . . . . . . . . ... -- 21.5 24.7 -- 35.6 33.0 -- 22.0 21.3
Education 5,6
25 years and over:
No high school diploma or GED . . . . . . . 19.2 18.2 18.7 33.6 34.5 34.5 16.5 18.9 17.6
High school diploma or GED . . . . . . . . . 16.0 17.4 16.5 30.2 31.9 31.9 15.5 16.8 16.4
Some college or more . . . . . . . . . . . . . . 13.8 15.1 15.0 26.9 28.0 28.4 14.6 15.8 15.0
Characteristic 1997 2010 2013 1997 2010 2013 1997 2010 2013
Percent of poverty level 2,7 Percent of adults with pain during the past 3 months
Below 100% . . . . . . . . . . . . . . . . . . . . . . 23.3 22.7 24.9 35.4 34.9 37.6 18.6 20.2 21.6
100%–199% . . . . . . . . . . . . . . . . . . . . . . 18.9 19.5 18.4 30.8 32.5 32.8 16.1 17.7 16.3
200%–399% . . . . . . . . . . . . . . . . . . . . . . 15.5 16.6 15.5 27.9 28.5 27.7 14.8 15.2 14.2
400% or more . . . . . . . . . . . . . . . . . . . . . 12.4 13.3 12.1 24.8 24.7 23.8 12.8 13.1 11.8
Geographic region 2
Northeast . . . . . . . . . . . . . . . . . . . . . . . . 14.5 15.4 13.7 27.1 28.0 26.9 14.0 14.9 13.2
Midwest . . . . . . . . . . . . . . . . . . . . . . . . . 15.6 16.8 17.1 28.7 28.1 29.7 15.3 16.0 14.5
South . . . . . . . . . . . . . . . . . . . . . . . . . . . 17.1 18.2 16.5 27.5 28.3 27.9 13.9 14.6 13.8
West. . . . . . . . . . . . . . . . . . . . . . . . . . . . 15.3 15.1 15.9 30.0 29.3 29.0 16.1 16.5 16.2
1
In three separate questions, respondents were asked, ‘‘During the past 3 months, did you have a severe headache or migraine? ...low back pain? ...neck pain?’’ Respondents
were instructed to report pain that had lasted a whole day or more, and not to report fleeting or minor aches or pains. Persons may be represented in more than one column.
2
Estimates are age-adjusted to the year 2000 standard population using five age groups: 18–44 years, 45–54 years, 55–64 years, 65–74 years, and 75 years and over.
Age-adjusted estimates in this table may differ from other age-adjusted estimates based on the same data and presented elsewhere if different age groups are used in the
3
Includes all other races not shown separately, unknown education level, and unknown disability status.
4
The race groups, white, black, American Indian or Alaska Native, Asian, Native Hawaiian or Other Pacific Islander, and 2 or more races, include persons of Hispanic and
non-Hispanic origin. Persons of Hispanic origin may be of any race. Starting with 1999 data, race-specific estimates are tabulated according to the 1997 Revisions to the
Standards for the Classification of Federal Data on Race and Ethnicity and are not strictly comparable with estimates for earlier years. The five single-race categories plus
multiple-race categories shown in the table conform to the 1997 Standards. Starting with 1999 data, race-specific estimates are for persons who reported only one racial group;
the category 2 or more races includes persons who reported more than one racial group. Prior to 1999, data were tabulated according to the 1977 Standards with four racial
groups, and the Asian only category included Native Hawaiian or Other Pacific Islander. Estimates for single-race categories prior to 1999 included persons who reported one
race or, if they reported more than one race, identified one race as best representing their race. Starting with 2003 data, race responses of other race and unspecified multiple
race were treated as missing, and then race was imputed if these were the only race responses. Almost all persons with a race response of other race were of Hispanic origin.
5
Estimates are for persons aged 25 and over and are age-adjusted to the year 2000 standard population using five age groups: 25–44 years, 45–54 years, 55–64 years,
65–74 years, and 75 years and over. See Appendix II, Age adjustment.
6
GED is General Educational Development high school equivalency diploma. See Appendix II, Education.
7
Percent of poverty level is based on family income and family size and composition using U.S. Census Bureau poverty thresholds. Missing family income data were imputed
for 1997 and beyond. See Appendix II, Family income; Poverty; Table VI.
8
Any basic actions difficulty or complex activity limitation is defined as having one or more of the following limitations or difficulties: movement difficulty, emotional difficulty,
sensory (seeing or hearing) difficulty, cognitive difficulty, self-care (activities of daily living or instrumental activities of daily living) limitation, social limitation, or work limitation.
For more information, see Appendix II, Basic actions difficulty; Complex activity limitation. Starting with 2007 data, the hearing question, a component of the basic actions
difficulty measure, was revised. Consequently, data prior to 2007 are not comparable with data for 2007 and beyond. For more information on the impact of the revised hearing
9
MSA is metropolitan statistical area. Starting with 2006 data, MSA status is determined using 2000 census data and the 2000 standards for defining MSAs. For data prior to
2006, see Appendix II, Metropolitan statistical area (MSA) for the applicable standards.
NOTES: Standard errors are available in the spreadsheet version of this table. Available from: http://www.cdc.gov/nchs/hus.htm. Data for additional years are available.
See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC/NCHS, National Health Interview Survey, sample adult questionnaire. See Appendix I, National Health Interview Survey (NHIS).
Number, in millions
At least one basic actions difficulty or
complex activity limitation 2,3 . . . . . . . . . . . . . 60.9 59.0 73.7 75.4 41.3 39.3 50.7 49.8 19.6 19.7 23.0 25.6
At least one basic actions difficulty 2 . . . . . . 56.7 55.2 69.2 70.9 38.1 36.4 47.2 46.3 18.6 18.7 22.0 24.6
At least one complex activity limitation 3 . . . . 29.0 27.2 35.0 37.5 18.1 16.7 22.9 23.9 11.0 10.5 12.1 13.6
Sex
Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25.6 23.8 26.3 26.3 20.7 18.9 21.4 21.0 54.5 53.4 53.8 52.8
Female . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32.9 31.0 35.1 35.2 26.4 24.3 28.8 28.3 61.9 61.5 63.6 63.7
Race 6
White only . . . . . . . . . . . . . . . . . . . . . . . . . . 29.6 28.1 31.2 31.4 23.5 21.8 25.1 24.7 58.5 58.0 59.2 58.4
Black or African American only . . . . . . . . . . . . 31.4 27.2 32.3 33.6 26.9 22.7 28.4 29.0 64.4 60.6 62.9 63.8
American Indian or Alaska Native only . . . . . . 43.8 36.8 41.6 35.7 41.9 34.1 38.5 30.4 66.0 70.2 74.0 74.3
Asian only . . . . . . . . . . . . . . . . . . . . . . . . . . 15.5 15.5 17.5 17.6 13.0 12.6 12.8 12.3 46.4 44.7 50.1 53.4
Native Hawaiian or Other Pacific
Islander only. . . . . . . . . . . . . . . . . . ...... -- * * * -- * * * -- * * *
2 or more races . . . . . . . . . . . . . . . . ...... -- 38.0 36.3 34.7 -- 34.4 33.9 30.8 -- 70.7 65.4 71.6
Location of residence 8
Within MSA . . . . . . . . . . . . . . . . . . . . . . . . . 27.7 25.9 29.2 29.3 22.3 20.3 23.6 23.3 56.6 56.7 59.2 58.3
Outside MSA . . . . . . . . . . . . . . . . . . . . . . . . 35.6 33.6 39.3 40.0 28.6 26.8 33.8 33.2 65.8 62.6 59.9 61.3
Total, crude 4 . . . . . . . . . . . . . . . . . . . . . . . . 15.1 13.4 15.5 16.0 11.2 9.8 12.1 12.4 35.1 32.0 32.3 32.0
Sex
Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13.7 12.0 14.0 14.8 10.6 9.4 11.3 12.0 31.9 28.1 30.1 29.1
Female . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.5 14.7 16.8 17.0 11.9 10.3 12.9 12.9 37.4 34.9 34.0 34.3
Race 6
White only . . . . . . . . . . . . . . . . . . . . . . . . . . 15.0 13.6 15.2 16.0 10.9 9.8 11.7 12.2 34.3 31.5 31.7 31.4
Black or African American only . . . . . . . . . . . . 19.0 15.0 19.7 19.0 15.2 11.7 17.0 15.9 47.1 40.4 39.9 39.7
American Indian or Alaska Native only . . . . . . 23.7 20.6 15.4 22.2 22.1 17.8 14.5 19.4 *42.6 *54.9 * 42.7
Asian only . . . . . . . . . . . . . . . . . . . . . . . . . . 5.7 4.7 7.7 7.4 4.9 3.6 5.0 4.7 *14.8 *15.5 26.7 26.0
Native Hawaiian or Other Pacific
Islander only. . . . . . . . . . . . . . . . . . ...... --- * * * --- * * * --- * * *
2 or more races . . . . . . . . . . . . . . . . ...... --- 22.5 19.6 19.7 --- 20.3 17.0 17.8 --- *42.2 53.6 37.9
Not Hispanic or Latino. . . . . . . . . . . . . . . . . . 15.5 14.0 16.3 16.9 11.4 10.2 12.9 13.3 35.1 32.0 31.9 31.9
White only. . . . . . . . . . . . . . . . . . . . . . . . . 15.4 14.1 16.1 17.1 11.1 10.1 12.5 13.2 34.4 31.5 31.1 31.4
Black or African American only . . . . . . . . . . 18.8 15.1 20.0 19.4 15.0 11.7 17.3 16.3 46.8 40.3 40.0 39.7
100%–199%. . . . . . . . . . . . . . . . . . . . . . . . . 23.3 22.0 23.7 23.9 16.7 15.1 18.4 17.9 43.9 42.8 43.7 45.1
200%–399%. . . . . . . . . . . . . . . . . . . . . . . . . 13.3 12.8 14.5 14.9 9.3 9.2 10.8 10.7 30.6 27.5 29.3 31.6
400% or more . . . . . . . . . . . . . . . . . . . . . . . 7.3 6.4 7.7 7.8 5.8 5.0 5.8 6.0 20.2 19.6 19.8 17.2
Location of residence 8
Within MSA . . . . . . . . . . . . . . . . . . . . . . . . . 14.1 12.1 14.2 14.8 10.6 8.9 10.9 11.5 32.7 29.8 31.6 31.2
Outside MSA . . . . . . . . . . . . . . . . . . . . . . . . 19.0 18.2 22.2 22.3 13.6 13.4 18.8 18.2 42.8 38.8 35.2 35.3
1
Starting with 2007 data, the hearing question, a component of the basic actions difficulty measure, was revised. Consequently, data for basic actions difficulty prior to 2007 are
not comparable with 2007 data and beyond. For more information on the impact of the revised hearing question, see Appendix II, Hearing trouble.
2
A basic actions difficulty is defined as having one or more of the following difficulties: movement, emotional, sensory (seeing or hearing), or cognitive. For more information,
see Appendix II, Basic actions difficulty. Starting with 2007 data, the hearing question, a component of basic actions difficulty, was revised. Consequently, data prior to 2007 are
not comparable with data for 2007 and beyond. For more information on the impact of the revised hearing question, see Appendix II, Hearing trouble.
3
A complex activity limitation is defined as having one or more of the following limitations: self-care (activities of daily living or instrumental activities of daily living), social, or
work. For more information, see Appendix II, Complex activity limitation.
4
Includes all other races not shown separately.
5
Estimates are age-adjusted to the year 2000 standard population using five age groups: 18–44 years, 45–54 years, 55–64 years, 65–74 years, and 75 years and over. See
6
The race groups, white, black, American Indian or Alaska Native, Asian, Native Hawaiian or Other Pacific Islander, and 2 or more races, include persons of Hispanic and
non-Hispanic origin. Persons of Hispanic origin may be of any race. Starting with 1999 data, race-specific estimates are tabulated according to the 1997 Revisions to the
Standards for the Classification of Federal Data on Race and Ethnicity and are not strictly comparable with estimates for earlier years. The five single-race categories plus
multiple-race categories shown in the table conform to the 1997 Standards. Starting with 1999 data, race-specific estimates are for persons who reported only one racial group;
the category 2 or more races includes persons who reported more than one racial group. Prior to 1999, data were tabulated according to the 1977 Standards with four racial
groups, and the Asian only category included Native Hawaiian or Other Pacific Islander. Estimates for single-race categories prior to 1999 included persons who reported one
race or, if they reported more than one race, identified one race as best representing their race. Starting with 2003 data, race responses of other race and unspecified multiple
race were treated as missing, and then race was imputed if these were the only race responses. Almost all persons with a race response of other race were of Hispanic origin.
7
Percent of poverty level is based on family income and family size and composition using U.S. Census Bureau poverty thresholds. Missing family income data were imputed
for 1997 and beyond. See Appendix II, Family income; Poverty; Table VI.
8
MSA is metropolitan statistical area. Starting with 2006 data, MSA status is determined using 2000 census data and the 2000 standards for defining MSAs. For data prior to
2006, see Appendix II, Metropolitan statistical area (MSA) for the applicable standards.
NOTES: Standard errors are available in the spreadsheet version of this table. Available from: http://www.cdc.gov/nchs/hus.htm. Data for additional years are available.
See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC/NCHS, National Health Interview Survey, sample adult questionnaire. See Appendix I, National Health Interview Survey (NHIS).
Characteristic 1997 2000 2005 2007 2008 2009 2010 2011 2012 2013
Percent of adults
18 years and over, age-adjusted 2,3 . . . . . . . . . 10.0 9.0 9.2 9.9 10.9 8.3 9.1 8.8 8.4 8.7
18 years and over, crude 3 . . . . . . . . . . . . . . . 9.8 8.9 9.3 10.0 11.2 8.6 9.4 9.2 8.8 9.1
Age
18–44 years . . . . . . . . . . . . . . . . . . . . . . . . . 6.2 5.3 5.5 6.9 7.2 5.3 6.2 5.5 5.4 5.5
18–24 years . . . . . . . . . . . . . . . . . . . . . . . 5.4 4.2 5.0 6.9 7.8 4.8 5.8 5.2 5.1 5.5
25–44 years . . . . . . . . . . . . . . . . . . . . . . . 6.5 5.7 5.7 6.8 7.0 5.6 6.3 5.6 5.5 5.5
45–64 years . . . . . . . . . . . . . . . . . . . . . . . . . 12.0 10.7 11.2 12.2 13.8 10.8 11.6 12.0 11.3 11.1
45–54 years . . . . . . . . . . . . . . . . . . . . . . . 12.2 10.9 11.0 12.3 13.3 10.5 10.7 11.7 11.2 10.6
55–64 years . . . . . . . . . . . . . . . . . . . . . . . 11.6 10.5 11.5 12.1 14.4 11.2 12.7 12.4 11.5 11.7
65 years and over. . . . . . . . . . . . . . . . . . . . . 18.1 17.4 17.4 15.3 17.5 13.1 13.9 13.6 12.7 14.3
65–74 years . . . . . . . . . . . . . . . . . . . . . . . 14.2 13.6 13.2 12.9 14.3 10.3 12.2 12.2 11.0 11.5
75 years and over . . . . . . . . . . . . . . . . . . . 23.1 21.9 22.0 17.9 21.1 16.5 16.1 15.2 14.9 18.0
Sex 2
Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.8 7.9 7.9 8.5 9.3 7.2 7.9 7.6 7.1 7.5
Female . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.1 10.1 10.5 11.2 12.5 9.3 10.3 10.1 9.7 9.8
Race 2,4
White only . . . . . . . . . . . . . . . . . . . . . . . . . . 9.7 8.8 9.1 9.9 10.9 8.1 8.8 8.6 8.4 8.7
Black or African American only . . . . . . . . . . . . 12.8 10.6 10.9 10.5 11.7 10.4 12.1 10.8 9.2 10.0
American Indian or Alaska Native only . . . . . . 19.2 16.6 *14.9 18.0 14.2 *12.3 15.0 15.0 13.0 13.7
Asian only . . . . . . . . . . . . . . . . . . . . . . . . . . 6.2 6.3 5.5 5.7 8.9 5.5 5.3 6.3 5.7 4.9
Native Hawaiian or Other Pacific
Islander only. . . . . . . . . . . . . . . . . . ...... -- * * * * * * * * *
2 or more races . . . . . . . . . . . . . . . . ...... -- 16.2 16.4 16.9 16.1 14.8 13.1 12.4 15.6 11.8
Education 5,6
25 years of age and over:
No high school diploma or GED . . . . . . . . . 15.0 12.2 13.5 13.4 15.9 12.6 14.1 13.9 12.9 12.8
High school diploma or GED. . . . . . . . . . . . 10.6 9.5 10.3 10.9 11.2 9.2 10.5 10.4 9.3 10.0
Some college or more . . . . . . . . . . . . . . . . 8.9 8.9 8.6 9.2 10.4 7.6 8.0 7.9 7.9 8.0
Characteristic 1997 2000 2005 2007 2008 2009 2010 2011 2012 2013
Geographic region 2
Northeast . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.6 7.4 8.1 8.1 9.3 7.3 7.8 7.6 6.4 7.4
Midwest . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.5 9.6 9.7 10.3 10.7 8.2 9.1 8.7 8.7 9.0
South . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.4 9.2 9.8 10.1 12.4 8.7 10.6 9.4 9.1 8.9
West . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.7 9.9 8.6 10.5 10.2 8.6 8.0 9.1 8.9 9.1
* Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error (RSE) of 20%–30%. Data not shown have an RSE greater than 30%.
1
Respondents were asked, ‘‘Do you have any trouble seeing, even when wearing glasses or contact lenses?’’ Respondents were also asked, ‘‘Are you blind or unable to see
at all?’’ In this analysis, any trouble seeing and blind are combined into one category.
2
Estimates are age-adjusted to the year 2000 standard population using five age groups: 18–44 years, 45–54 years, 55–64 years, 65–74 years, and 75 years and over.
Age-adjusted estimates in this table may differ from other age-adjusted estimates based on the same data and presented elsewhere if different age groups are used in the
3
Includes all other races not shown separately and unknown education level.
4
The race groups, white, black, American Indian or Alaska Native, Asian, Native Hawaiian or Other Pacific Islander, and 2 or more races, include persons of Hispanic and
non-Hispanic origin. Persons of Hispanic origin may be of any race. Starting with 1999 data, race-specific estimates are tabulated according to the 1997 Revisions to the
Standards for the Classification of Federal Data on Race and Ethnicity and are not strictly comparable with estimates for earlier years. The five single-race categories plus
multiple-race categories shown in the table conform to the 1997 Standards. Starting with 1999 data, race-specific estimates are for persons who reported only one racial group;
the category 2 or more races includes persons who reported more than one racial group. Prior to 1999, data were tabulated according to the 1977 Standards with four racial
groups, and the Asian only category included Native Hawaiian or Other Pacific Islander. Estimates for single-race categories prior to 1999 included persons who reported one
race or, if they reported more than one race, identified one race as best representing their race. Starting with 2003 data, race responses of other race and unspecified multiple
race were treated as missing, and then race was imputed if these were the only race responses. Almost all persons with a race response of other race were of Hispanic origin.
5
Estimates are for persons aged 25 and over and are age-adjusted to the year 2000 standard population using five age groups: 25–44 years, 45–54 years, 55–64 years,
65–74 years, and 75 years and over. See Appendix II, Age adjustment.
6
GED is General Educational Development high school equivalency diploma. See Appendix II, Education.
7
Percent of poverty level is based on family income and family size and composition using U.S. Census Bureau poverty thresholds. Missing family income data were imputed
for 1997 and beyond. See Appendix II, Family income; Poverty; Table VI.
8
MSA is metropolitan statistical area. Starting with 2006 data, MSA status is determined using 2000 census data and the 2000 standards for defining MSAs. For data prior to
2006, see Appendix II, Metropolitan statistical area (MSA) for the applicable standards.
NOTES: Standard errors are available in the spreadsheet version of this table. Available from: http://www.cdc.gov/nchs/hus.htm. Data for additional years are available.
See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC/NCHS, National Health Interview Survey, sample adult questionnaire. See Appendix I, National Health Interview Survey (NHIS).
Characteristic 2007 2010 2012 2013 2007 2010 2012 2013 2007 2010 2012 2013
Percent of adults
18 years and over, age-adjusted 2,3 . . . . . . . . . 14.7 15.6 15.1 14.3 5.6 5.7 5.4 5.4 2.3 2.1 2.0 2.0
18 years and over, crude 3 . . . . . . . . . . . . . . . 14.9 16.2 16.0 15.3 5.7 5.9 5.7 5.7 2.3 2.2 2.0 2.1
Age
18–44 years . . . . . . . . . . . . . . . . . . . . . . . . . 6.0 6.7 6.2 5.3 1.3 1.7 1.6 1.3 0.4 0.5 0.4 0.4
18–24 years . . . . . . . . . . . . . . . . . . . . . . . 4.1 5.4 4.3 3.4 * *1.2 *1.2 *1.0 * * * *
25–44 years . . . . . . . . . . . . . . . . . . . . . . . 6.6 7.2 6.8 6.0 1.6 1.8 1.7 1.5 0.5 0.5 0.5 0.4
45–64 years . . . . . . . . . . . . . . . . . . . . . . . . . 17.6 18.9 19.2 17.3 6.0 6.1 5.8 5.6 2.0 1.9 1.7 1.7
45–54 years . . . . . . . . . . . . . . . . . . . . . . . 14.7 15.6 16.0 13.6 4.1 4.8 4.6 3.9 1.2 1.2 1.3 1.1
55–64 years . . . . . . . . . . . . . . . . . . . . . . . 21.5 23.2 22.9 21.5 8.5 7.8 7.1 7.5 3.0 2.7 2.0 2.4
65 years and over. . . . . . . . . . . . . . . . . . . . . 36.9 37.5 35.9 37.3 18.6 17.7 16.3 17.3 8.7 7.6 7.0 7.4
65–74 years . . . . . . . . . . . . . . . . . . . . . . . 29.8 31.2 29.4 29.7 11.9 12.9 10.7 12.1 4.7 4.6 4.0 4.4
75 years and over . . . . . . . . . . . . . . . . . . . 45.0 45.2 44.4 47.7 26.3 23.7 23.6 24.4 13.3 11.1 11.1 11.4
Sex 2
Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18.3 18.9 18.2 17.3 7.7 7.4 7.2 6.9 3.1 2.8 2.6 2.5
Female . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.5 12.7 12.3 11.7 3.9 4.3 3.9 4.1 1.6 1.6 1.5 1.6
Race 2,4
White only . . . . . . . . . . . . . . . . . . . . . . . . . . 15.6 16.5 16.0 15.3 6.0 6.1 5.8 5.8 2.4 2.3 2.1 2.2
Black or African American only . . . . . . . . . . . . 8.5 10.3 10.0 9.4 2.7 3.3 2.7 2.8 1.2 1.1 1.1 1.0
American Indian or Alaska Native only . . . . . . 17.9 21.1 13.0 18.8 *8.8 *7.1 * *7.4 *3.8 * * *
Asian only . . . . . . . . . . . . . . . . . . . . . . . . . . 8.0 8.0 9.7 8.2 2.8 2.6 3.4 2.6 * *1.0 *1.2 *1.1
Native Hawaiian or Other Pacific
Islander only. . . . . . . . . . . . . . . . . . ...... * * * * * * * * * * * *
2 or more races . . . . . . . . . . . . . . . . ...... 24.4 23.3 19.3 17.1 11.5 8.7 *5.4 6.6 *4.9 * * *1.4
Education 5,6
25 years and over:
No high school diploma or GED . . . . . . . . . 17.9 19.7 17.2 17.8 7.6 8.1 5.7 6.7 4.1 3.2 2.5 3.0
High school diploma or GED. . . . . . . . . . . . 17.2 18.1 18.3 17.7 6.4 6.5 6.8 6.6 2.8 2.5 2.6 2.5
Some college or more . . . . . . . . . . . . . . . . 15.4 16.2 15.9 14.9 6.1 6.0 5.7 5.7 1.9 2.0 1.9 1.9
Characteristic 2007 2010 2012 2013 2007 2010 2012 2013 2007 2010 2012 2013
Geographic region 2
Northeast . . . . . . . . . . . . . . . . . . . . . . . . . . . 13.3 13.9 12.7 13.1 5.2 4.4 4.1 5.0 1.7 1.4 1.6 1.8
Midwest . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.0 17.5 17.1 16.5 6.1 6.3 5.8 6.4 2.3 2.3 2.0 2.3
South . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14.0 16.0 15.0 13.8 5.4 6.3 5.8 5.0 2.5 2.6 2.2 2.1
West . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15.5 14.4 15.1 14.1 5.9 5.3 5.4 5.2 2.4 1.9 1.9 1.8
* Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error (RSE) of 20%–30%. Data not shown have an RSE greater than 30%.
1
Starting in 2007, respondents were asked, ‘‘WITHOUT the use of hearing aids or other listening devices, is your hearing excellent, good, a little trouble hearing, moderate
2
Estimates are age-adjusted to the year 2000 standard population using five age groups: 18–44 years, 45–54 years, 55–64 years, 65–74 years, and 75 years and over.
Age-adjusted estimates in this table may differ from other age-adjusted estimates based on the same data and presented elsewhere if different age groups are used in the
3
Includes all other races not shown separately and unknown education level.
4
The race groups, white, black, American Indian or Alaska Native, Asian, Native Hawaiian or Other Pacific Islander, and 2 or more races, include persons of Hispanic and
non-Hispanic origin. Persons of Hispanic origin may be of any race. Starting with 1999 data, race-specific estimates are tabulated according to the 1997 Revisions to the
Standards for the Classification of Federal Data on Race and Ethnicity and are not strictly comparable with estimates for earlier years. The five single-race categories plus
multiple-race categories shown in the table conform to the 1997 Standards. Starting with 1999 data, race-specific estimates are for persons who reported only one racial group;
the category 2 or more races includes persons who reported more than one racial group. Prior to 1999, data were tabulated according to the 1977 Standards with four racial
groups, and the Asian only category included Native Hawaiian or Other Pacific Islander. Estimates for single-race categories prior to 1999 included persons who reported one
race or, if they reported more than one race, identified one race as best representing their race. Starting with 2003 data, race responses of other race and unspecified multiple
race were treated as missing, and then race was imputed if these were the only race responses. Almost all persons with a race response of other race were of Hispanic origin.
5
Estimates are for persons aged 25 and over and are age-adjusted to the year 2000 standard population using five age groups: 25–44 years, 45–54 years, 55–64 years,
65–74 years, and 75 years and over. See Appendix II, Age adjustment.
6
GED is General Educational Development high school equivalency diploma. See Appendix II, Education.
7
Percent of poverty level is based on family income and family size and composition using U.S. Census Bureau poverty thresholds. Missing family income data were imputed
for 1997 and beyond. See Appendix II, Family income; Poverty; Table VI.
8
MSA is metropolitan statistical area. Starting with 2006 data, MSA status is determined using 2000 census data and the 2000 standards for defining MSAs. For data prior to
2006, see Appendix II, Metropolitan statistical area (MSA) for the applicable standards.
NOTES: Starting with Health, United States, 2013, the hearing measures shown in this table were revised to provide a consistent definition over time. For a longer
trend, see Health, United States, 2012. Available from: http://www.cdc.gov/nchs/hus.htm. Standard errors are available in the spreadsheet version of this table. Available
from: http://www.cdc.gov/nchs/hus.htm. Data for additional years are available. See the Excel spreadsheet on the Health, United States website at:
http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC/NCHS, National Health Interview Survey, sample adult questionnaire. See Appendix I, National Health Interview Survey (NHIS).
Race 3,5
White only . . . . . . . . . . . . . . . . . . . . . . . . . . 9.6 9.7 8.3 8.2 8.6 8.8 8.8 8.7
Black or African American only . . . . . . . . . . . . 16.8 17.2 15.8 14.6 14.3 14.9 14.9 14.3
American Indian or Alaska Native only . . . . . . 18.3 18.7 17.3 17.2 13.2 17.8 16.5 15.3
Asian only . . . . . . . . . . . . . . . . . . . . . . . . . . 7.8 9.3 7.8 7.4 6.8 8.1 7.9 7.7
Native Hawaiian or Other Pacific
Islander only. . . . . . . . . . . . . . . . . . ...... -- -- -- * * * * *
2 or more races . . . . . . . . . . . . . . . . ...... -- -- -- 16.2 14.5 15.6 13.0 13.9
Black or African American; White. . . ...... -- -- -- *14.5 8.3 *16.7 16.3 *19.0
American Indian or Alaska Native;
White . . . . . . . . . . . . . . . . . . . . . ...... -- -- -- 18.7 17.2 19.0 14.4 16.2
3,5
Hispanic origin and race
Hispanic or Latino . . . . . . . . . . . . . . . . . . . . . 15.6 15.1 13.0 12.8 13.3 13.1 13.3 12.7
Mexican . . . . . . . . . . . . . . . . . . . . . . . . . . 17.0 16.7 13.1 12.8 14.3 13.7 13.6 13.3
Not Hispanic or Latino. . . . . . . . . . . . . . . . . . 10.0 10.1 8.9 8.7 8.7 9.2 9.1 9.0
White only. . . . . . . . . . . . . . . . . . . . . . . . . 9.1 9.1 8.0 7.9 8.0 8.2 8.1 8.2
Black or African American only . . . . . . . . . . 16.8 17.3 15.8 14.6 14.4 14.9 15.0 14.2
NOTES: Standard errors for selected years are available in the spreadsheet version of this table. Available from: http://www.cdc.gov/nchs/hus.htm. Data for additional
years are available. See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC/NCHS, National Health Interview Survey, family core and sample adult questionnaires. See Appendix I, National Health Interview Survey (NHIS).
Age
18–44 years . . . . . . . . . . . . . . . . . . . . . . . . . 2.9 2.3 2.9 2.8 2.9 3.1
18–24 years . . . . . . . . . . . . . . . . . . . . . . . 2.7 2.2 2.8 2.5 2.4 2.4
25–44 years . . . . . . . . . . . . . . . . . . . . . . . 3.0 2.4 3.0 2.9 3.1 3.3
45–64 years . . . . . . . . . . . . . . . . . . . . . . . . . 3.7 3.2 3.9 3.7 4.5 4.4
45–54 years . . . . . . . . . . . . . . . . . . . . . . . 3.9 3.5 4.2 3.9 4.2 4.4
55–64 years . . . . . . . . . . . . . . . . . . . . . . . 3.4 2.6 3.4 3.4 4.7 4.4
65 years and over. . . . . . . . . . . . . . . . . . . . . 3.1 2.4 2.4 2.5 2.4 2.5
65–74 years . . . . . . . . . . . . . . . . . . . . . . . 2.5 2.3 2.4 2.2 2.6 2.7
75 years and over . . . . . . . . . . . . . . . . . . . 3.8 2.5 2.4 2.9 2.1 2.2
Sex 2
Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.5 2.0 2.4 2.3 2.8 2.7
Female . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.8 3.1 3.8 3.7 3.7 4.0
Race 2,4
White only . . . . . . . . . . . . . . . . . . . . . . . . . . 3.1 2.5 3.0 2.9 3.2 3.3
Black or African American only . . . . . . . . . . . . 4.0 2.9 3.5 3.6 3.7 3.3
American Indian or Alaska Native only . . . . . . 7.8 *7.2 8.1 *3.5 5.6 4.1
Asian only . . . . . . . . . . . . . . . . . . . . . . . . . . 2.0 *1.4 *1.8 1.7 1.7 2.1
Native Hawaiian or Other Pacific
Islander only. . . . . . . . . . . . . . . . . . ...... -- * * * * *
2 or more races . . . . . . . . . . . . . . . . ...... -- 4.8 5.0 7.9 5.6 7.8
Hispanic origin and race 2,4
Hispanic or Latino . . . . . . . . . . . . . . . . . . . . . 5.0 3.5 4.0 3.7 4.0 3.8
Mexican . . . . . . . . . . . . . . . . . . . . . . . . . . 5.2 2.9 3.8 3.6 3.6 3.6
Not Hispanic or Latino. . . . . . . . . . . . . . . . . . 3.0 2.5 3.1 3.0 3.2 3.3
White only. . . . . . . . . . . . . . . . . . . . . . . . . 2.9 2.4 3.0 2.9 3.2 3.3
Black or African American only . . . . . . . . . . 3.9 2.9 3.5 3.6 3.7 3.2
* Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error (RSE) of 20%–30%. Data not shown have an RSE greater than 30%.
1
Serious psychological distress is measured by a six-question scale that asks respondents how often they experienced each of six symptoms of psychological distress in the
2
Estimates are age-adjusted to the year 2000 standard population using five age groups: 18–44 years, 45–54 years, 55–64 years, 65–74 years, and 75 years and over. See
3
Includes all other races not shown separately.
4
The race groups, white, black, American Indian or Alaska Native, Asian, Native Hawaiian or Other Pacific Islander, and 2 or more races, include persons of Hispanic and
non-Hispanic origin. Persons of Hispanic origin may be of any race. Starting with 1999 data, race-specific estimates are tabulated according to the 1997 Revisions to the
Standards for the Classification of Federal Data on Race and Ethnicity and are not strictly comparable with estimates for earlier years. The five single-race categories plus
multiple-race categories shown in the table conform to the 1997 Standards. Starting with 1999 data, race-specific estimates are for persons who reported only one racial group;
the category 2 or more races includes persons who reported more than one racial group. Prior to 1999, data were tabulated according to the 1977 Standards with four racial
groups, and the Asian only category included Native Hawaiian or Other Pacific Islander. Estimates for single-race categories prior to 1999 included persons who reported one
race or, if they reported more than one race, identified one race as best representing their race. Starting with 2003 data, race responses of other race and unspecified multiple
race were treated as missing, and then race was imputed if these were the only race responses. Almost all persons with a race response of other race were of Hispanic origin.
5
Percent of poverty level is based on family income and family size and composition using U.S. Census Bureau poverty thresholds. Missing family income data were imputed
for 1997 and beyond. See Appendix II, Family income; Poverty; Table VI.
6
MSA is metropolitan statistical area. Starting with 2006–2007 data (shown in spreadsheet), MSA status is determined using 2000 census data and the 2000 standards for
defining MSAs. For data prior to 2006, see Appendix II, Metropolitan statistical area (MSA) for the applicable standards.
NOTES: Standard errors for selected years are available in the spreadsheet version of this table. Available from: http://www.cdc.gov/nchs/hus.htm. Data for additional
years are available. See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC/NCHS, National Health Interview Survey, sample adult questionnaire. See Appendix I, National Health Interview Survey (NHIS).
Sex, race, and age 1965 1 1974 1 1979 1 1985 1 1990 1 2000 2005 2010 2011 2012 2013
18 years and over, age-adjusted 2 Percent of adults who were current cigarette smokers 3
All persons . . . . . . . . . . . . . . . . . . . . . . . 41.9 37.0 33.3 29.9 25.3 23.1 20.8 19.3 19.0 18.2 17.9
Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51.2 42.8 37.0 32.2 28.0 25.2 23.4 21.2 21.2 20.6 20.5
Female . . . . . . . . . . . . . . . . . . . . . . . . . . 33.7 32.2 30.1 27.9 22.9 21.1 18.3 17.5 16.8 15.9 15.5
White male 4 . . . . . . . . . . . . . . . . . . . . . . 50.4 41.7 36.4 31.3 27.6 25.4 23.3 21.4 21.4 20.7 20.5
Black or African American male 4 . . . . . . . . 58.8 53.6 43.9 40.2 32.8 25.7 25.9 23.3 23.2 22.0 21.8
White female 4 . . . . . . . . . . . . . . . . . . . . . 33.9 32.0 30.3 27.9 23.5 22.0 19.1 18.3 17.7 16.9 16.3
Black or African American female 4 . . . . . . . 31.8 35.6 30.5 30.9 20.8 20.7 17.1 16.6 15.2 14.2 14.9
18 years and over, crude
All persons . . . . . . . . . . . . . . . . . . . . . . . 42.4 37.1 33.5 30.1 25.5 23.2 20.9 19.3 19.0 18.1 17.8
Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51.9 43.1 37.5 32.6 28.4 25.6 23.9 21.5 21.6 20.5 20.5
Female . . . . . . . . . . . . . . . . . . . . . . . . . . 33.9 32.1 29.9 27.9 22.8 20.9 18.1 17.3 16.5 15.8 15.3
White male 4 . . . . . . . . . . . . . . . . . . . . . . 51.1 41.9 36.8 31.7 28.0 25.7 23.6 21.4 21.6 20.3 20.3
Black or African American male 4 . . . . . . . . 60.4 54.3 44.1 39.9 32.5 26.2 26.5 24.3 23.8 22.0 21.9
White female 4 . . . . . . . . . . . . . . . . . . . . . 34.0 31.7 30.1 27.7 23.4 21.4 18.7 17.9 17.2 16.6 15.9
Black or African American female 4 . . . . . . . 33.7 36.4 31.1 31.0 21.2 20.8 17.3 17.0 15.3 14.7 15.1
All males
18–44 years . . . . . . . . . . . . . . . . . . . . . . 57.9 47.9 40.4 35.2 31.4 29.2 27.1 23.9 23.6 24.0 22.9
18–24 years . . . . . . . . . . . . . . . . . . . . . 54.1 42.1 35.0 28.0 26.6 28.1 28.0 22.8 21.3 20.1 21.9
25–34 years . . . . . . . . . . . . . . . . . . . . . 60.7 50.5 43.9 38.2 31.6 28.9 27.7 26.1 27.5 28.0 24.4
35–44 years . . . . . . . . . . . . . . . . . . . . . 58.2 51.0 41.8 37.6 34.5 30.2 26.0 22.5 21.2 22.8 22.1
45–64 years . . . . . . . . . . . . . . . . . . . . . . 51.9 42.6 39.3 33.4 29.3 26.4 25.2 23.2 24.4 20.2 21.9
45–54 years . . . . . . . . . . . . . . . . . . . . . 55.9 46.8 42.0 34.9 32.1 28.8 28.1 25.2 27.0 21.4 21.4
55–64 years . . . . . . . . . . . . . . . . . . . . . 46.6 37.7 36.4 31.9 25.9 22.6 21.1 20.7 21.4 18.8 22.6
65 years and over . . . . . . . . . . . . . . . . . . 28.5 24.8 20.9 19.6 14.6 10.2 8.9 9.7 8.9 10.6 10.6
White male 4
18–44 years . . . . . . ..... . . . . . . . . . . . 57.1 46.8 40.0 34.6 31.3 30.2 27.7 24.6 24.3 24.8 23.4
18–24 years . . . . . ..... . . . . . . . . . . . 53.0 40.8 34.3 28.4 27.4 30.4 29.7 23.8 22.1 21.9 23.5
25–34 years . . . . . ..... . . . . . . . . . . . 60.1 49.5 43.6 37.3 31.6 29.7 27.7 26.6 28.6 28.4 24.6
35–44 years . . . . . ..... . . . . . . . . . . . 57.3 50.1 41.3 36.6 33.5 30.6 26.3 23.1 21.4 23.3 21.9
45–64 years . . . . . . ..... . . . . . . . . . . . 51.3 41.2 38.3 32.1 28.7 25.8 24.5 22.5 24.0 19.4 21.7
45–54 years . . . . . ..... . . . . . . . . . . . 55.3 45.0 40.9 33.7 31.3 28.0 27.4 24.5 26.6 20.7 21.2
55–64 years . . . . . ..... . . . . . . . . . . . 46.1 36.6 35.3 30.5 25.6 22.5 20.4 20.1 20.8 17.9 22.2
65 years and over . . ..... . . . . . . . . . . . 27.7 24.3 20.5 18.9 13.7 9.8 7.9 9.6 8.6 10.3 10.0
Sex, race, and age 1965 1 1974 1 1979 1 1985 1 1990 1 2000 2005 2010 2011 2012 2013
* Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error of 20%–30%.
1
Data prior to 1997 are not strictly comparable with data for later years due to the 1997 questionnaire redesign. See Appendix I, National Health Interview Survey
(NHIS).
2
Estimates are age-adjusted to the year 2000 standard population using five age groups: 18–24 years, 25–34 years, 35–44 years, 45–64 years, and 65 years and over.
Age-adjusted estimates in this table may differ from other age-adjusted estimates based on the same data and presented elsewhere if different age groups are used in
the adjustment procedure. See Appendix II, Age adjustment.
3
Starting with 1993 data (shown in spreadsheet version), current cigarette smokers were defined as ever smoking 100 cigarettes in their lifetime and smoking now
every day or some days. For previous definition, see Appendix II, Cigarette smoking.
4
The race groups, white and black, include persons of Hispanic and non-Hispanic origin. Starting with 1999 data, race-specific estimates are tabulated according to the
1997 Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity and are not strictly comparable with estimates for earlier years. The
single-race categories shown in the table conform to the 1997 Standards. Starting with 1999 data, race-specific estimates are for persons who reported only one racial
group. Prior to 1999, data were tabulated according to the 1977 Standards. Estimates for single-race categories prior to 1999 included persons who reported one race
or, if they reported more than one race, identified one race as best representing their race. Starting with 2003 data, race responses of other race and unspecified
multiple race were treated as missing, and then race was imputed if these were the only race responses. Almost all persons with a race response of other race were of
Hispanic origin. See Appendix II, Hispanic origin; Race.
NOTES: Standard errors for selected years are available in the spreadsheet version of this table. Available from: http://www.cdc.gov/nchs/hus.htm. Data for additional
years are available. See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC/NCHS, National Health Interview Survey. Data are from the core questionnaire (1965) and the following questionnaire supplements: hypertension
(1974), smoking (1979), alcohol and health practices (1983), health promotion and disease prevention (1985, 1990–1991), cancer control and cancer epidemiology
(1992), and year 2000 objectives (1993–1995). Starting with 1997, data are from the family core and sample adult questionnaires. See Appendix I, National Health
Interview Survey (NHIS).
Sex, race, and education level 1974 1 1979 1 1985 1 1990 1 1995 1 2000 2005 2010 2012 2013
25 years and over, age-adjusted 2 Percent of adults who were current cigarette smokers 3
All persons 4 . . . . . . . . . . . . . . . . . ..... 36.9 33.1 30.0 25.4 24.5 22.6 20.3 19.2 18.3 17.8
No high school diploma or GED . . . . . . . . 43.7 40.7 40.8 36.7 35.6 31.6 28.2 26.9 26.3 25.8
High school diploma or GED . . . . . . . . . . . 36.2 33.6 32.0 29.1 29.1 29.2 27.0 27.0 26.3 25.6
Some college, no bachelor’s degree . . . . . 35.9 33.2 29.5 23.4 22.6 21.7 21.8 21.3 19.6 19.5
Bachelor’s degree or higher . . . . . . . . . . . 27.2 22.6 18.5 13.9 13.6 10.9 9.1 8.3 7.8 7.7
All males 4 . . . . . . . . . . . . . . . . . . . ..... 42.9 37.3 32.8 28.2 26.4 24.7 22.7 21.0 20.6 20.3
No high school diploma or GED . . . . . . . . 52.3 47.6 45.7 42.0 39.7 36.0 31.7 29.7 30.3 31.6
High school diploma or GED . . . . . . . . . . . 42.4 38.9 35.5 33.1 32.7 32.1 29.9 29.3 29.6 28.8
Some college, no bachelor’s degree . . . . . 41.8 36.5 32.9 25.9 23.7 23.3 24.9 23.2 21.0 20.4
Bachelor’s degree or higher . . . . . . . . . . . 28.3 22.7 19.6 14.5 13.8 11.6 9.7 8.7 8.5 8.7
White males 4,5. . . . . . . . . . . . . . . . ..... 41.9 36.7 31.7 27.6 25.9 24.7 22.4 21.0 20.5 20.1
No high school diploma or GED . . . . . . . . 51.5 47.6 45.0 41.8 38.7 38.2 31.6 29.4 29.6 30.2
High school diploma or GED . . . . . . . . . . . 42.0 38.5 34.8 32.9 32.9 32.4 30.0 29.6 29.8 28.4
Some college, no bachelor’s degree . . . . . 41.6 36.4 32.2 25.4 23.3 23.5 24.5 23.4 20.3 20.3
Bachelor’s degree or higher . . . . . . . . . . . 27.8 22.5 19.1 14.4 13.4 11.3 9.3 8.8 8.9 8.8
Black or African American males 4,5 . . . . . . 53.4 44.4 42.1 34.5 31.6 26.4 26.5 23.9 23.3 23.1
No high school diploma or GED . . . . . . . . 58.1 49.7 50.5 41.6 41.9 38.2 35.9 34.4 34.1 41.5
High school diploma or GED . . . . . . . . . . . *50.7 48.6 41.8 37.4 36.6 29.0 30.1 28.8 28.0 31.9
Some college, no bachelor’s degree . . . . . *45.3 39.2 41.8 28.1 26.4 19.9 27.4 24.2 24.9 18.0
Bachelor’s degree or higher . . . . . . . . . . . *41.4 *36.8 *32.0 *20.8 *17.3 14.6 10.0 8.1 *7.3 7.7
All females 4 . . . . . . . . . . . . . . . . . . . . . . 32.0 29.5 27.5 22.9 22.9 20.5 18.0 17.5 16.1 15.5
No high school diploma or GED . . . . . . . . 36.6 34.8 36.5 31.8 31.7 27.1 24.6 23.7 22.2 19.8
High school diploma or GED . . . . . . . . . . . 32.2 29.8 29.5 26.1 26.4 26.6 24.1 24.9 22.6 22.0
Some college, no bachelor’s degree . . . . . 30.1 30.0 26.3 21.0 21.6 20.4 19.1 19.6 18.4 18.8
Bachelor’s degree or higher . . . . . . . . . . . 25.9 22.5 17.1 13.3 13.3 10.1 8.5 7.9 7.2 6.8
White females 4,5 . . . . . . . . . . . . . . . . . . . 31.7 29.7 27.3 23.3 23.1 21.0 18.6 18.3 16.9 16.2
No high school diploma or GED . . . . . . . . 36.8 35.8 36.7 33.4 32.4 28.4 24.6 24.0 22.4 19.0
High school diploma or GED . . . . . . . . . . . 31.9 29.9 29.4 26.5 26.8 27.8 25.9 25.8 24.0 23.5
Some college, no bachelor’s degree . . . . . 30.4 30.7 26.7 21.2 22.2 21.1 19.5 21.0 19.0 19.8
Bachelor’s degree or higher . . . . . . . . . . . 25.5 21.9 16.5 13.4 13.5 10.2 9.1 8.7 7.7 7.3
Black or African American females 4,5 . .... 35.6 30.3 32.0 22.4 25.7 21.6 17.5 17.0 15.2 15.3
No high school diploma or GED . . . . . . . . 36.1 31.6 39.4 26.3 32.3 31.1 27.8 25.8 25.8 26.5
High school diploma or GED . . . . . . . . . . . 40.9 32.6 32.1 24.1 27.8 25.4 18.2 22.9 17.0 17.0
Some college, no bachelor’s degree . . . . . 32.3 *28.9 23.9 22.7 20.8 20.4 17.5 15.0 16.9 15.3
Bachelor’s degree or higher . . . . . . . . . . . *36.3 *43.3 26.6 17.0 17.3 10.8 *6.6 *6.6 7.1 7.3
* Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error (RSE) of 20%–30%.
1
Data prior to 1997 are not strictly comparable with data for later years due to the 1997 questionnaire redesign. See Appendix I, National Health Interview Survey
(NHIS).
2
Estimates are age-adjusted to the year 2000 standard population using four age groups: 25–34 years, 35–44 years, 45–64 years, and 65 years and over. See
Appendix II, Age adjustment. For age groups where smoking was 0% or 100%, the age-adjustment procedure was modified to substitute the percentage smoking from
the next lower education group.
3
Starting with 1993 data (shown in spreadsheet version), current cigarette smokers were defined as ever smoking 100 cigarettes in their lifetime and smoking now
every day or some days. For previous definition, see Appendix II, Cigarette smoking.
4
Includes unknown education level. Education categories shown are for 1997 and subsequent years. GED is General Educational Development high school equivalency
diploma. In 1974–1995 the following categories based on number of years of school completed were used: less than 12 years, 12 years, 13–15 years, 16 years or
more. See Appendix II, Education.
5
The race groups, white and black, include persons of Hispanic and non-Hispanic origin. Starting with 1999 data, race-specific estimates are tabulated according to the
1997 Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity and are not strictly comparable with estimates for earlier years. The
single-race categories shown in the table conform to the 1997 Standards. Starting with 1999 data, race-specific estimates are for persons who reported only one racial
group. Prior to 1999, data were tabulated according to the 1977 Standards. Estimates for single-race categories prior to 1999 included persons who reported one race
or, if they reported more than one race, identified one race as best representing their race. Starting with 2003 data, race responses of other race and unspecified
multiple race were treated as missing, and then race was imputed if these were the only race responses. Almost all persons with a race response of other race were of
Hispanic origin. See Appendix II, Hispanic origin; Race.
NOTES: Standard errors for selected years are available in the spreadsheet version of this table. Available from: http://www.cdc.gov/nchs/hus.htm. Data for additional
years are available. See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC/NCHS, National Health Interview Survey. Data are from the following questionnaire supplements: hypertension (1974), smoking (1979), alcohol and
health practices (1983), health promotion and disease prevention (1985, 1990–1991), cancer control and cancer epidemiology (1992), and year 2000 objectives
(1993–1995). Starting with 1997, data are from the family core and sample adult questionnaires. See Appendix I, National Health Interview Survey (NHIS).
Male Female
1 1
Characteristic 1990–1992 1999–2001 2011–2013 1990–1992 1999–2001 2011–2013
18 years and over, age-adjusted 2 Percent of adults who were current cigarette smokers 3
4
All persons ...................... 27.9 25.0 20.8 23.7 21.1 16.1
Race 5
White only . . . . . . . . . . . . . . . . . . . . . . . . 27.4 25.1 20.9 24.3 22.2 17.0
Black or African American only . . . . . . . . . 33.9 27.2 22.3 23.1 19.7 14.8
American Indian or Alaska Native only . . . . 34.2 30.3 25.6 36.7 34.7 19.1
Asian only . . . . . . . . . . . . . . . . . . . . . . . . 24.8 20.3 14.8 6.3 6.7 5.2
Native Hawaiian or Other Pacific
Islander only . . . . . . . . . . . . . . . . . . ... --- * * --- * *
2 or more races . . . . . . . . . . . . . . . . . ... --- 34.4 27.1 --- 30.7 23.4
American Indian or Alaska Native;
White . . . . . . . . . . . . . . . . . . . . . . ... --- 38.7 35.1 --- 38.9 32.3
Hispanic origin and race 5
Hispanic or Latino . . . . . . . . . . . . . . . . . . 25.7 22.2 16.7 15.8 12.1 7.5
Black or African American only . . . . . . . . 33.9 27.2 22.5 23.2 19.7 14.9
Race 5
White only . . . . . . . . . . . . . . . . . . . . . . . . 27.8 25.4 20.8 24.1 21.7 16.6
Black or African American only . . . . . . . . . 33.2 27.5 22.6 23.3 19.8 15.0
American Indian or Alaska Native only . . . . 35.5 31.8 26.2 37.3 36.9 19.5
Asian only . . . . . . . . . . . . . . . . . . . . . . . . 24.9 21.4 15.6 6.3 6.9 5.4
Native Hawaiian or Other Pacific
Islander only . . . . . . . . . . . . . . . . . . ... --- * * --- * *
2 or more races . . . . . . . . . . . . . . . . . ... --- 35.9 27.8 --- 31.5 22.9
American Indian or Alaska Native;
White . . . . . . . . . . . . . . . . . . . . . . ... --- 41.1 33.5 --- 40.1 32.3
Hispanic origin and race 5
Hispanic or Latino . . . . . . . . . . . . . . . . . . 26.5 23.2 17.2 16.6 12.6 7.7
Black or African American only . . . . . . . . 33.3 27.5 22.7 23.3 19.8 15.2
Male Female
1 1
Characteristic 1990–1992 1999–2001 2011–2013 1990–1992 1999–2001 2011–2013
Percent of poverty level 2,6 Percent of adults who were current cigarette smokers 3
Below 100% . . . . . . . . . . . . . . . . . . . . . . 40.5 36.5 34.2 30.7 29.1 25.1
100%–199% . . . . . . . . . . . . . . . . . . . . . . 35.0 32.8 27.6 26.9 25.6 20.6
200%–399% . . . . . . . . . . . . . . . . . . . . . . 26.5 27.3 21.8 22.6 22.3 16.5
400% or more . . . . . . . . . . . . . . . . . . . . . 22.5 18.8 13.7 19.0 15.9 9.7
NOTES: Standard errors for selected years are available in the spreadsheet version of this table. Available from: http://www.cdc.gov/nchs/hus.htm. Data for additional
years are available. See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC/NCHS, National Health Interview Survey. Data are from the following questionnaire supplements: health promotion and disease prevention
(1990–1991), cancer control and cancer epidemiology (1992), and year 2000 objectives (1993–1995). Starting with 1997, data are from the family core and sample
adult questionnaires. See Appendix I, National Health Interview Survey (NHIS).
Percent of population
12 years and over . . . . . . . . . . . . . . . . . . . 8.3 9.2 9.4 6.2 7.3 7.5 2.7 2.6 2.5
Age
12–13 years. .... . . . . . . . . . . . . . . . . . . . 4.2 3.5 2.6 1.4 1.2 1.0 1.7 1.7 1.3
14–15 years. .... . . . . . . . . . . . . . . . . . . . 11.2 8.2 7.8 7.6 6.1 5.8 4.0 2.5 2.2
16–17 years. .... . . . . . . . . . . . . . . . . . . . 19.8 16.6 15.8 15.7 14.0 14.2 6.3 4.0 3.1
18–25 years. .... . . . . . . . . . . . . . . . . . . . 20.2 21.3 21.5 17.3 18.7 19.1 5.5 5.3 4.8
26–34 years. .... . . . . . . . . . . . . . . . . . . . 10.5 13.8 15.3 7.7 11.3 12.6 3.7 4.1 4.4
35 years and over . . . . . . . . . . . . . . . . . . . 4.6 5.5 5.6 3.1 3.9 4.0 1.6 1.7 1.6
Sex
Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.3 11.6 11.5 8.1 9.6 9.7 2.8 2.8 2.6
Female . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.4 6.9 7.3 4.4 5.0 5.6 2.6 2.4 2.3
Percent of population
12 years and over . . . . . . . . . . . . . . . . . . . 51.0 52.1 52.2 22.9 23.0 22.9 6.7 6.5 6.3
Age
12–13 years. .... . . . . . . . . . . . . . . . . . . . 4.3 2.2 2.1 1.8 0.9 0.8 0.3 0.2 0.1
14–15 years. .... . . . . . . . . . . . . . . . . . . . 16.6 11.1 9.5 9.2 5.4 4.5 1.9 0.6 0.7
16–17 years. .... . . . . . . . . . . . . . . . . . . . 32.6 24.8 22.7 21.4 15.0 13.1 5.6 3.1 2.7
18–25 years. .... . . . . . . . . . . . . . . . . . . . 60.5 60.2 59.6 40.9 39.5 37.9 14.9 12.7 11.3
26–34 years. .... . . . . . . . . . . . . . . . . . . . 61.4 64.5 66.1 33.1 35.6 37.4 9.0 9.4 10.9
35 years and over . . . . . . . . . . . . . . . . . . . 52.1 53.6 53.6 18.6 19.0 19.0 5.2 5.4 5.0
Sex
Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57.4 56.5 57.1 31.2 30.4 30.2 10.8 9.9 9.5
Female . . . . . . . . . . . . . . . . . . . . . . . . . . . 44.9 47.9 47.5 15.1 16.0 16.0 3.0 3.4 3.3
Percent of population
12 years and over . . . . . . . . . . . . . . . . . . . 30.4 26.7 25.5 26.0 22.1 21.3 5.4 5.2 4.7
Age
12–13 years. .... . . . . . . . . . . . . . . . . . . . 3.8 1.6 1.3 3.2 1.2 0.9 0.7 0.4 0.2
14–15 years. .... . . . . . . . . . . . . . . . . . . . 13.4 6.3 6.4 11.2 4.6 4.3 3.8 1.7 1.4
16–17 years. .... . . . . . . . . . . . . . . . . . . . 29.0 17.6 15.5 24.9 13.6 11.4 9.3 5.6 5.2
18–25 years. .... . . . . . . . . . . . . . . . . . . . 45.3 38.1 37.0 40.8 31.8 30.6 11.0 10.7 10.0
26–34 years. .... . . . . . . . . . . . . . . . . . . . 38.2 37.5 38.3 32.7 32.6 33.0 6.6 7.3 7.8
35 years and over . . . . . . . . . . . . . . . . . . . 27.9 24.7 22.8 23.4 20.1 19.0 4.1 3.9 3.3
Sex
Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37.0 33.0 31.1 28.7 24.6 23.6 9.4 8.5 7.7
Female . . . . . . . . . . . . . . . . . . . . . . . . . . . 24.3 20.9 20.2 23.4 19.8 19.0 1.7 2.0 2.0
* Estimates are considered unreliable. Data not shown if the relative standard error is greater than 17.5% of the log transformation of the proportion, the minimum
effective sample size is less than 68, the minimum nominal sample size is less than 100, or the prevalence is close to 0% or 100%.
1
Any illicit drug includes marijuana/hashish, cocaine (including crack), heroin, hallucinogens (including LSD and PCP), inhalants, or any prescription-type
psychotherapeutic drug used nonmedically. See Appendix II, Illicit drug use.
2
Nonmedical use of prescription-type psychotherapeutic drugs includes the nonmedical use of pain relievers, tranquilizers, stimulants, or sedatives and does not include
over-the-counter drugs. Special questions on methamphetamine were added in 2005 and 2006. Data for years prior to 2007 have been adjusted for comparability.
3
Persons of Hispanic origin may be of any race. Data on race and Hispanic origin were collected using the 1997 Revisions to the Standards for the Classification of
Federal Data on Race and Ethnicity. Single-race categories shown include persons who reported only one racial group. The category 2 or more races includes persons
who reported more than one racial group. See Appendix II, Hispanic origin; Race.
4
Binge alcohol use is defined as drinking five or more drinks on the same occasion on at least 1 day in the past 30 days. Occasion is defined as at the same time or
within a couple of hours of each other. See Appendix II, Alcohol consumption; Binge drinking.
5
Heavy alcohol use is defined as drinking five or more drinks on the same occasion on each of 5 or more days in the past 30 days. By definition, all heavy alcohol
6
Any tobacco product includes cigarettes, smokeless tobacco (i.e., chewing tobacco or snuff), cigars, or pipe tobacco. See Appendix II, Cigarette smoking.
NOTES: The National Survey on Drug Use & Health (NSDUH), formerly called the National Household Survey on Drug Abuse (NHSDA), began a new baseline in 2002
and cannot be compared with previous years. Starting with 2011 data, 2010-census based control totals were used in the weighting process. Because of
methodological differences among the National Survey on Drug Use & Health, the Monitoring the Future (MTF) Study, and the Youth Risk Behavior Survey (YRBS),
rates of substance use measured by these surveys are not directly comparable. See Appendix I, Monitoring the Future (MTF) Study; National Survey on Drug Use &
Health (NSDUH); Youth Risk Behavior Survey (YRBS). See Appendix II, Substance use. Data for additional years are available. See the Excel spreadsheet on the
Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use & Health.
Available from: http://www.samhsa.gov/data/population-data-nsduh. See Appendix I, National Survey on Drug Use & Health (NSDUH).
Marijuana
All 12th graders . . . . . . . . . . . . . . . 33.7 25.7 14.0 21.2 21.6 19.8 21.4 22.6 22.9 22.7
Male . . . . . . . . . . . . . . . . . . . . . 37.8 28.7 16.1 24.6 24.7 23.6 25.2 26.4 26.5 26.4
Female. . . . . . . . . . . . . . . . . . . . 29.1 22.4 11.5 17.2 18.3 15.8 16.9 18.4 18.8 18.7
White . . . . . . . . . . . . . . . . . . . . . 34.2 26.4 15.6 21.5 22.0 21.7 21.6 22.9 22.3 21.3
Black or African American . . . . . . 26.5 21.7 5.2 17.8 17.5 15.1 19.7 22.2 22.4 25.7
All 10th graders . . . . . . . . . . . . . . . -- -- -- 17.2 19.7 15.2 16.7 17.6 17.0 18.0
Male . . . . . . . . . . . . . . . . . . . . . -- -- -- 19.2 23.3 16.7 20.1 20.8 19.8 20.6
Female. . . . . . . . . . . . . . . . . . . . -- -- -- 15.0 16.2 13.4 13.3 14.5 14.4 15.3
White . . . . . . . . . . . . . . . . . . . . . -- -- -- 17.7 20.1 15.7 15.9 16.9 16.6 16.5
Black or African American . . . . . . -- -- -- 15.1 17.0 13.5 15.9 20.0 17.6 20.7
All 8th graders . . . . . . . . . . . . . . . . -- -- -- 9.1 9.1 6.6 8.0 7.2 6.5 7.0
Male . . . . . . . . . . . . . . . . . . . . . -- -- -- 9.8 10.2 7.6 9.2 8.5 7.0 6.7
Female. . . . . . . . . . . . . . . . . . . . -- -- -- 8.2 7.8 5.7 6.8 5.7 6.0 7.2
White . . . . . . . . . . . . . . . . . . . . . -- -- -- 9.0 8.3 6.0 7.1 5.9 4.7 4.8
Black or African American . . . . . . -- -- -- 7.0 8.5 8.2 8.2 8.0 7.1 9.3
Cocaine
All 12th graders . . . . . . . . . . . . . . . 5.2 6.7 1.9 1.8 2.1 2.3 1.3 1.1 1.1 1.1
Male . . . . . . . . . . . . . . . . . . . . . 6.0 7.7 2.3 2.2 2.7 2.6 1.9 1.5 1.5 1.4
Female. . . . . . . . . . . . . . . . . . . . 4.3 5.6 1.3 1.3 1.6 1.8 0.7 0.7 0.6 0.5
White . . . . . . . . . . . . . . . . . . . . . 5.4 7.0 1.8 1.7 2.2 2.3 1.2 1.2 1.0 0.7
Black or African American . . . . . . 2.0 2.7 0.5 0.4 1.0 0.5 0.9 0.8 0.5 0.6
All 10th graders . . . . . . . . . . . . . . . -- -- -- 1.7 1.8 1.5 0.9 0.7 0.8 0.8
Male . . . . . . . . . . . . . . . . . . . . . -- -- -- 1.8 2.1 1.9 1.1 0.8 0.8 1.2
Female. . . . . . . . . . . . . . . . . . . . -- -- -- 1.5 1.4 1.2 0.5 0.5 0.7 0.5
White . . . . . . . . . . . . . . . . . . . . . -- -- -- 1.7 1.7 1.5 0.7 0.5 0.5 0.6
Black or African American . . . . . . -- -- -- 0.4 0.4 0.8 0.6 0.6 1.2 0.9
All 8th graders . . . . . . . . . . . . . . . . -- -- -- 1.2 1.2 1.0 0.6 0.8 0.5 0.5
Male . . . . . . . . . . . . . . . . . . . . . -- -- -- 1.1 1.3 0.9 0.6 0.7 0.5 0.4
Female. . . . . . . . . . . . . . . . . . . . -- -- -- 1.2 1.1 1.0 0.6 0.7 0.4 0.5
White . . . . . . . . . . . . . . . . . . . . . -- -- -- 1.0 1.1 0.9 0.5 0.5 0.3 0.4
Black or African American . . . . . . -- -- -- 0.4 0.5 0.3 0.3 0.5 0.5 0.5
MDMA (Ecstasy)
All 12th graders . . . . . . . . . . . . . . . -- -- -- -- 3.6 1.0 1.4 2.3 0.9 1.5
Male . . . . . . . . . . . . . . . . . . . . . -- -- -- -- 4.1 1.0 1.5 2.8 1.2 2.1
Female. . . . . . . . . . . . . . . . . . . . -- -- -- -- 3.1 1.0 1.2 1.8 0.6 0.9
White . . . . . . . . . . . . . . . . . . . . . -- -- -- -- 3.9 1.0 0.9 2.1 0.9 1.5
Black or African American . . . . . . -- -- -- -- 1.9 0.9 1.1 1.1 0.4 0.7
All 10th graders . . . . . . . . . . . . . . . -- -- -- -- 2.6 1.0 1.9 1.6 1.0 1.2
Male . . . . . . . . . . . . . . . . . . . . . -- -- -- -- 2.5 1.0 2.3 1.7 1.1 1.5
Female. . . . . . . . . . . . . . . . . . . . -- -- -- -- 2.5 0.9 1.5 1.3 1.0 1.0
White . . . . . . . . . . . . . . . . . . . . . -- -- -- -- 2.5 1.0 1.5 1.1 1.0 0.9
Black or African American . . . . . . -- -- -- -- 1.8 0.3 1.1 1.1 1.1 0.4
All 8th graders . . . . . . . . . . . . . . . . -- -- -- -- 1.4 0.6 1.1 0.6 0.5 0.5
Male . . . . . . . . . . . . . . . . . . . . . -- -- -- -- 1.6 0.8 1.2 0.7 0.4 0.4
Female. . . . . . . . . . . . . . . . . . . . -- -- -- -- 1.2 0.4 1.1 0.5 0.6 0.5
White . . . . . . . . . . . . . . . . . . . . . -- -- -- -- 1.4 0.6 1.0 0.4 0.4 0.3
Black or African American . . . . . . -- -- -- -- 0.8 0.9 0.5 0.2 0.5 0.6
Alcohol 1
All 12th graders . . . . . . . . . . . . . . . 72.0 65.9 57.1 51.3 50.0 47.0 41.2 40.0 41.5 39.2
Male . . . . . . . . . . . . . . . . . . . . . 77.4 69.8 61.3 55.7 54.0 50.7 44.2 42.1 43.8 41.8
Female. . . . . . . . . . . . . . . . . . . . 66.8 62.1 52.3 47.0 46.1 43.3 37.9 37.5 38.8 36.3
White . . . . . . . . . . . . . . . . . . . . . 75.8 70.2 62.2 54.8 55.3 52.2 44.1 43.4 44.3 42.8
Black or African American . . . . . . 47.7 43.6 32.9 37.4 29.3 28.8 30.8 29.4 29.8 27.0
All 10th graders . . . . . . . . . . . . . . . -- -- -- 38.8 41.0 33.2 28.9 27.2 27.6 25.7
Male . . . . . . . . . . . . . . . . . . . . . -- -- -- 39.7 43.3 32.8 30.1 28.2 28.0 26.0
Female. . . . . . . . . . . . . . . . . . . . -- -- -- 37.8 38.6 33.6 27.7 26.0 27.1 25.3
White . . . . . . . . . . . . . . . . . . . . . -- -- -- 41.3 44.3 36.7 29.2 28.9 29.2 26.9
Black or African American . . . . . . -- -- -- 24.9 24.7 20.8 21.3 20.3 20.1 17.7
All 8th graders . . . . . . . . . . . . . . . . -- -- -- 24.6 22.4 17.1 13.8 12.7 11.0 10.2
Male . . . . . . . . . . . . . . . . . . . . . -- -- -- 25.0 22.5 16.2 13.2 12.1 10.3 9.3
Female. . . . . . . . . . . . . . . . . . . . -- -- -- 24.0 22.0 17.9 14.3 12.8 11.5 11.2
White . . . . . . . . . . . . . . . . . . . . . -- -- -- 25.4 23.9 17.3 12.8 11.8 9.6 9.4
Black or African American . . . . . . -- -- -- 17.3 15.1 13.9 12.7 10.5 9.4 9.9
1
In 1993, the alcohol question was changed to indicate that a drink meant more than a few sips. Data for 1993, available in the spreadsheet version of this table, are
2
Five or more alcoholic drinks in a row at least once in the prior 2-week period. See Appendix II, Binge drinking.
NOTES: Estimates for Hispanic students are not shown due to small sample size. For 2-year estimates for Hispanic students, see Johnston LD, O’Malley PM,
Bachman JG, Schulenberg JE, Miech RA. Monitoring the Future National Survey results on drug use: 1975–2013. Volume I: Secondary school students. Ann Arbor:
Institute for Social Research, The University of Michigan. 2014. Available from: http://www.monitoringthefuture.org//pubs/monographs/mtf-vol1_2013.pdf. Because of
methodological differences among the National Survey on Drug Use & Health (NSDUH), the Monitoring the Future Study (MTF), and the Youth Risk Behavior Survey
(YRBS), rates of substance use measured by these surveys are not directly comparable. See Appendix I, National Survey on Drug Use & Health (NSDUH); Monitoring
the Future (MTF) Study; Youth Risk Behavior Survey (YRBS). See Appendix II, Cigarette smoking; Illicit drug use; Substance use. Data for additional years are
available. See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: Monitoring the Future (MTF) Study. Institute for Social Research, the University of Michigan. Supported by National Institutes of Health, National
Institute on Drug Abuse. See Appendix I,
Monitoring the Future (MTF) Study.
Percent of students
Total . . . . . . . . . . . . . . . . . . . . . . . . . 29.0 19.0 15.8 17.0 42.5 33.2 32.8 24.7 26.1 17.4 16.6 17.9
Male
Total . . . . . . . . . . . . . . . . . . . . . . . . . 20.8 14.2 12.5 11.6 50.2 43.1 40.7 30.2 40.6 29.3 25.9 28.1
9th grade . . . . . . . . . . . . . . . . . . . . . . 17.6 14.7 12.9 9.9 57.8 50.0 46.0 33.2 44.4 33.7 26.6 26.4
10th grade . . . . . . . . . . . . . . . . . . . . . 19.5 13.8 11.4 11.3 50.2 45.0 44.2 30.9 41.5 28.4 26.4 26.4
11th grade . . . . . . . . . . . . . . . . . . . . . 25.3 14.1 14.3 14.0 51.0 38.0 36.3 31.6 44.0 28.1 25.9 30.5
12th grade . . . . . . . . . . . . . . . . . . . . . 20.7 13.7 11.5 11.0 42.3 36.5 34.1 23.8 33.1 25.6 24.1 29.5
Not Hispanic or Latino:
White . . . . . . . . . . . . . . . . . . . . . . . 21.7 14.9 12.8 11.4 49.1 43.1 37.7 27.1 41.2 31.3 27.2 33.4
Black or African American . . . . . . . . . 13.3 9.2 9.0 10.2 58.4 43.9 45.8 37.5 43.4 22.4 21.0 18.2
Hispanic or Latino . . . . . . . . . . . . . . . . 18.0 12.2 12.6 11.5 48.5 42.4 44.4 34.2 40.0 26.0 24.5 23.8
Female
Total . . . . . . . . . . . . . . . . . . . . . . . . . 37.2 23.6 19.3 22.4 34.4 23.9 24.4 19.2 10.9 6.2 6.8 7.9
9th grade . . . . . . . . . . . . . . . . . . . . . . 40.3 26.2 21.5 24.6 42.9 30.3 28.8 23.3 10.4 7.4 7.6 8.6
10th grade . . . . . . . . . . . . . . . . . . . . . 39.7 24.1 22.3 23.4 35.4 24.9 25.5 21.9 11.1 5.4 6.1 9.2
11th grade . . . . . . . . . . . . . . . . . . . . . 38.4 23.6 16.7 22.3 34.5 20.3 22.7 16.7 12.9 5.9 6.2 5.9
12th grade . . . . . . . . . . . . . . . . . . . . . 30.7 18.9 15.8 18.7 25.4 16.9 19.4 13.9 9.5 5.3 7.1 7.5
Not Hispanic or Latina:
White . . . . . . . . . . . . . . . . . . . . . . . 38.6 24.2 18.4 21.1 32.2 21.7 20.4 14.6 7.5 5.1 6.2 8.3
Black or African American . . . . . . . . . 29.4 17.2 17.4 18.6 43.8 29.6 32.3 32.1 23.6 8.6 7.5 7.2
Hispanic or Latina . . . . . . . . . . . . . . . . 34.6 26.5 21.0 26.0 34.8 29.3 28.7 22.8 12.9 7.4 7.5 7.7
Percent of students
Total . . . . . . . . . . . . . . . . . . . . . . . . . 25.9 14.1 7.7 7.6 39.9 30.7 24.1 21.9 16.7 13.3 8.2 10.0
Male
Total . . . . . . . . . . . . . . . . . . . . . . . . . 30.0 18.1 8.9 9.1 40.0 31.8 23.3 21.4 21.5 17.2 9.5 12.0
9th grade . . . . . . . . . . . . . . . . . . . . . . 30.0 19.4 10.3 9.8 33.9 29.2 20.7 18.1 8.6 9.9 6.1 9.6
10th grade . . . . . . . . . . . . . . . . . . . . . 25.5 16.6 9.0 8.4 36.6 31.5 23.1 19.9 16.1 12.5 6.0 7.4
11th grade . . . . . . . . . . . . . . . . . . . . . 29.5 17.5 7.0 9.7 45.0 32.8 22.4 23.4 26.4 22.1 10.4 14.0
12th grade . . . . . . . . . . . . . . . . . . . . . 34.7 18.6 8.5 8.3 44.7 34.5 27.4 25.3 34.5 27.2 16.0 15.7
Not Hispanic or Latino:
White . . . . . . . . . . . . . . . . . . . . . . . 28.6 17.7 7.3 8.5 40.2 31.2 20.5 19.6 23.3 18.6 8.9 12.4
Black or African American . . . . . . . . . 37.5 20.3 12.6 11.8 37.5 31.2 22.5 18.9 14.0 12.5 7.8 6.9
Hispanic or Latino . . . . . . . . . . . . . . . . 37.1 17.7 10.1 8.9 47.2 37.1 30.7 28.9 25.1 15.8 11.5 14.5
Female
Total . . . . . . . . . . . . . . . . . . . . . . . . . 21.6 10.2 6.3 6.1 39.8 29.6 24.9 22.4 11.7 9.5 6.7 7.8
9th grade . . . . . . . . . . . . . . . . . . . . . . 25.0 10.8 8.4 7.1 36.0 31.3 22.9 20.8 3.3 3.7 3.3 6.1
10th grade . . . . . . . . . . . . . . . . . . . . . 20.4 10.3 5.9 5.7 38.8 29.9 23.5 23.8 7.3 8.4 5.2 4.6
11th grade . . . . . . . . . . . . . . . . . . . . . 20.8 9.7 4.9 6.3 39.7 25.4 25.2 21.8 14.2 11.1 7.8 8.0
12th grade . . . . . . . . . . . . . . . . . . . . . 20.2 9.4 5.5 5.1 44.8 31.3 28.0 23.2 21.7 17.3 11.2 10.5
Not Hispanic or Latina:
White . . . . . . . . . . . . . . . . . . . . . . . 18.7 9.7 5.1 4.7 40.9 29.4 23.8 19.9 13.6 10.9 7.0 8.2
Black or African American . . . . . . . . . 31.9 12.2 8.0 7.1 33.8 24.2 23.2 24.8 6.2 3.3 4.0 5.4
Hispanic or Latina . . . . . . . . . . . . . . . . 25.9 11.3 8.4 8.7 46.7 39.3 30.7 29.2 9.5 10.5 7.8 8.4
Ever had sexual intercourse Did not use a condom at last sex 6,7 Ever physically forced to have sex 8
Sex, grade level, race,
and Hispanic origin 1991 2001 2011 2013 1991 2001 2011 2013 1991 2001 2011 2013
Percent of students
Total . . . . . . . . . . . . . . . . . . . . . . . . . 54.1 45.6 47.4 46.8 53.8 42.1 39.8 40.9 -- 7.7 8.0 7.3
Male
Total . . . . . . . . . . . . . . . . . . . . . . . . . 57.4 48.5 49.2 47.5 45.5 34.9 33.0 34.2 -- 5.1 4.5 4.2
9th grade . . . . . . . . . . . . . . . . . . . . . . 45.6 40.5 37.8 32.0 44.1 31.1 33.0 30.5 -- 5.9 3.5 3.8
10th grade . . . . . . . . . . . . . . . . . . . . . 50.9 42.2 44.5 41.1 43.1 30.7 30.1 30.7 -- 4.1 4.2 2.8
11th grade . . . . . . . . . . . . . . . . . . . . . 64.5 54.0 54.5 54.3 43.2 34.7 33.0 29.4 -- 4.3 5.2 4.7
12th grade . . . . . . . . . . . . . . . . . . . . . 68.3 61.0 62.6 65.4 49.3 40.8 35.3 42.0 -- 5.8 4.7 5.5
Not Hispanic or Latino:
White . . . . . . . . . . . . . . . . . . . . . . . 52.7 45.1 44.0 42.2 44.8 36.2 33.7 38.2 -- 3.8 3.2 3.1
Black or African American . . . . . . . . . 88.1 68.8 66.9 68.4 43.0 27.3 24.6 27.0 -- 8.5 6.1 5.2
Hispanic or Latino . . . . . . . . . . . . . . . . 64.1 53.0 53.0 51.7 53.0 40.9 36.6 33.5 -- 6.2 5.4 5.2
Female
Total . . . . . . . . . . . . . . . . . . . . . . . . . 50.8 42.9 45.6 46.0 62.0 48.7 46.4 46.9 -- 10.3 11.8 10.5
9th grade . . . . . . . . . . . . . . . . . . . . . . 32.2 29.1 27.8 28.1 49.7 33.4 43.7 43.5 -- 8.6 8.2 8.3
10th grade . . . . . . . . . . . . . . . . . . . . . 45.3 39.3 43.0 41.7 63.6 47.8 43.3 44.5 -- 10.7 12.2 11.8
11th grade . . . . . . . . . . . . . . . . . . . . . 60.2 49.7 51.9 53.9 59.3 47.3 44.5 45.2 -- 9.9 12.7 10.5
12th grade . . . . . . . . . . . . . . . . . . . . . 65.1 60.1 63.6 62.8 67.4 58.8 51.1 51.6 -- 12.2 14.5 11.2
Not Hispanic or Latina:
White . . . . . . . . . . . . . . . . . . . . . . . 47.1 41.3 44.5 45.3 62.0 49.0 46.6 46.8 -- 9.8 12.0 9.1
Black or African American . . . . . . . . . 75.9 53.4 53.6 53.4 60.6 39.3 46.2 44.7 -- 10.6 11.0 11.5
Hispanic or Latina . . . . . . . . . . . . . . . . 43.3 44.0 43.9 46.9 73.1 52.4 47.0 49.3 -- 11.6 11.2 12.2
Percent of students
Total . . . . . . . . . . . . . . . . . . . . . . . . . -- 38.3 32.4 32.5 -- -- 71.3 72.9 -- -- 68.6 68.3
Male
Total . . . . . . . . . . . . . . . . . . . . . . . . . -- 41.8 33.3 32.8 -- -- 61.7 63.4 -- -- 66.4 65.5
9th grade . . . . . . . . . . . . . . . . . . . . . . -- 51.4 33.9 34.6 -- -- 61.2 59.5 -- -- 56.9 55.0
10th grade . . . . . . . . . . . . . . . . . . . . . -- 42.3 35.3 32.4 -- -- 57.4 65.4 -- -- 64.1 62.9
11th grade . . . . . . . . . . . . . . . . . . . . . -- 36.8 32.3 32.3 -- -- 63.8 63.0 -- -- 71.3 70.6
12th grade . . . . . . . . . . . . . . . . . . . . . -- 33.5 30.9 31.9 -- -- 65.1 66.5 -- -- 75.2 75.7
Not Hispanic or Latino:
White . . . . . . . . . . . . . . . . . . . . . . . -- 35.7 27.3 25.7 -- -- 59.6 62.5 -- -- 65.0 64.6
Black or African American . . . . . . . . . -- 69.1 54.4 55.3 -- -- 64.8 62.8 -- -- 72.1 71.2
Hispanic or Latino . . . . . . . . . . . . . . . . -- 49.7 38.4 36.5 -- -- 64.4 66.1 -- -- 66.3 64.6
Female
Total . . . . . . . . . . . . . . . . . . . . . . . . . -- 35.0 31.6 32.2 -- -- 81.5 82.3 -- -- 70.9 71.1
9th grade . . . . . . . . . . . . . . . . . . . . . . -- 39.6 33.8 35.3 -- -- 77.8 79.9 -- -- 63.2 65.2
10th grade . . . . . . . . . . . . . . . . . . . . . -- 36.2 31.7 32.2 -- -- 81.9 79.5 -- -- 69.2 70.1
11th grade . . . . . . . . . . . . . . . . . . . . . -- 32.5 30.4 30.4 -- -- 82.0 85.6 -- -- 75.5 72.4
12th grade . . . . . . . . . . . . . . . . . . . . . -- 29.2 29.9 30.6 -- -- 85.1 84.7 -- -- 77.2 77.6
Not Hispanic or Latina:
White . . . . . . . . . . . . . . . . . . . . . . . -- 26.5 23.9 24.3 -- -- 80.3 81.3 -- -- 69.8 70.6
Black or African American . . . . . . . . . -- 68.6 54.9 52.2 -- -- 83.1 84.0 -- -- 72.0 72.4
Hispanic or Latina . . . . . . . . . . . . . . . . -- 46.0 37.2 39.0 -- -- 83.1 82.6 -- -- 72.3 69.8
1
During the past 12 months.
2
During the past 30 days.
3
Such as a gun, knife, or club.
4
When riding in a car driven by someone else.
5
Among students who drove a vehicle during the past 30 days.
6
Among students who had sexual intercourse during the past 3 months.
7
Percent is 100 minus percent presented in MMWR Youth Risk Behavior Surveillance Summaries. See Surveillance Summaries at
http://www.cdc.gov/healthyyouth/yrbs/cdcreports.htm.
8
Data prior to 1999 are not available.
9
On an average school day. Data prior to 1999 are not available.
10
During the past 7 days. Data prior to 2011 are not available.
11
On an average school night. Data prior to 2007 are not available.
NOTES: Only youths attending school participated in the survey. YRBS is conducted biennially. Persons of Hispanic origin may be of any race. See Appendix II,
Hispanic origin; Race; Suicidal ideation. Standard errors for selected years are available in the spreadsheet version of this table. Data for additional years are available.
See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC/National Center for HIV, Hepatitis, STD, and TB Prevention, Youth Risk Behavior Survey. See Youth Online website at http://nccd.cdc.gov/youthonline.
Characteristic 1997 2000 2010 2013 1997 2000 2010 2013 1997 2000 2010 2013
Age
All persons:
18–44 years. . . . . . . . . . . . . . . . . . . . . . . . . . 5.2 4.7 5.7 5.2 29.2 26.9 32.5 31.9 13.2 12.2 13.7 12.5
18–24 years . . . . . . . . . . . . . . . . . . . . . . . . 5.3 5.8 6.2 5.2 31.8 30.3 34.0 31.3 15.2 15.5 16.2 12.8
25–44 years . . . . . . . . . . . . . . . . . . . . . . . . 5.2 4.3 5.5 5.1 28.5 25.8 31.9 32.2 12.6 11.1 12.7 12.4
45–64 years. . . . . . . . . . . . . . . . . . . . . . . . . . 5.5 4.6 5.4 6.0 15.9 14.4 19.0 18.6 7.6 6.4 8.1 8.0
45–54 years . . . . . . . . . . . . . . . . . . . . . . . . 5.5 4.4 5.9 5.9 19.0 16.4 22.9 21.7 8.7 7.0 9.3 9.3
55–64 years . . . . . . . . . . . . . . . . . . . . . . . . 5.4 5.0 4.7 6.1 11.1 11.3 14.1 15.1 5.8 5.4 6.7 6.6
65 years and over . . . . . . . . . . . . . . . . . . . . . 3.1 2.6 3.7 4.3 4.9 3.8 5.5 6.4 2.2 1.8 2.6 3.0
65–74 years . . . . . . . . . . . . . . . . . . . . . . . . 3.9 3.1 4.4 5.4 6.7 5.2 7.9 9.1 3.0 2.5 3.5 4.2
75 years and over . . . . . . . . . . . . . . . . . . . . 2.1 2.0 2.8 2.9 2.4 2.1 2.7 2.6 1.1 *0.9 *1.4 *1.4
Race 2,3
White only. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.2 4.5 5.6 5.7 22.9 20.8 26.3 26.0 10.3 9.2 11.1 10.5
Black or African American only . . . . . . . . . . . . . . 4.0 3.5 4.1 3.5 11.7 11.6 14.0 14.4 6.5 6.5 6.1 5.7
American Indian or Alaska Native only . . . . . . . . . * * * *7.8 29.2 23.7 15.3 23.3 17.4 *12.1 *9.5 *12.4
Asian only. . . . . . . . . . . . . . . . . . . . . . . . . . . . . *1.9 *2.3 *1.3 *2.5 11.4 8.8 12.1 11.7 *4.8 3.6 4.3 4.2
Native Hawaiian or Other Pacific
Islander only . . . . . . . . . . . . . . . . . . ........ -- * * * -- * * * -- * * *
2 or more races. . . . . . . . . . . . . . . . . . . . . . . . . - - *7.5 *5.9 *6.5 -- 28.0 25.7 26.3 -- 15.9 12.5 10.9
Male
18 years and over, age-adjusted 2 . . . . . . . . . . . . 6.1 5.1 5.7 5.7 30.7 28.3 32.4 32.1 15.8 14.4 15.6 15.1
18 years and over, crude . . . . . . . . . . . . . . . . . . 6.1 5.2 5.7 5.7 31.7 29.0 32.2 31.3 16.3 14.7 15.6 14.7
Age
Male:
18–44 years. . . . . . . . . . . . . . . . . . . . . . . . . . 6.5 5.6 6.1 5.5 40.6 37.8 42.5 41.4 21.1 19.6 20.6 19.1
18–24 years . . . . . . . . . . . . . . . . . . . . . . . . 6.0 6.3 6.0 5.4 40.6 38.0 39.9 37.7 22.9 22.9 21.5 17.9
25–44 years . . . . . . . . . . . . . . . . . . . . . . . . 6.6 5.3 6.2 5.6 40.6 37.7 43.5 42.8 20.6 18.5 20.2 19.6
45–64 years. . . . . . . . . . . . . . . . . . . . . . . . . . 6.6 5.5 5.8 6.3 25.3 23.5 27.3 27.0 12.7 11.3 13.2 13.0
45–54 years . . . . . . . . . . . . . . . . . . . . . . . . 6.6 5.7 5.9 6.4 29.4 26.3 32.0 30.3 14.5 12.3 14.5 14.3
55–64 years . . . . . . . . . . . . . . . . . . . . . . . . 6.6 5.4 5.7 6.3 18.9 19.0 21.4 23.5 10.0 9.8 11.6 11.5
65 years and over . . . . . . . . . . . . . . . . . . . . . 3.7 3.1 4.0 5.2 9.3 7.4 9.8 11.4 4.7 3.7 4.7 6.0
65–74 years . . . . . . . . . . . . . . . . . . . . . . . . 4.8 3.9 4.4 6.3 12.2 9.5 13.5 15.2 6.1 4.9 6.3 7.6
75 years and over . . . . . . . . . . . . . . . . . . . . *2.1 *2.0 *3.5 *3.4 5.1 4.4 4.6 5.4 *2.5 *2.0 *2.5 *3.4
Characteristic 1997 2000 2010 2013 1997 2000 2010 2013 1997 2000 2010 2013
Female
18 years and over, age-adjusted 2 . . . . . . . . . . . . 3.9 3.5 4.8 4.9 12.2 10.8 15.6 15.7 3.9 3.4 4.8 4.3
18 years and over, crude . . . . . . . . . . . . . . . . . . 3.9 3.5 4.8 4.9 12.1 10.6 14.9 14.6 3.9 3.3 4.6 4.1
Age
Female:
18–44 years. . . . . . . . . . . . . . . . . . . . . . . . . . 4.0 3.8 5.2 4.8 18.3 16.5 22.6 22.8 5.5 5.2 6.9 6.1
18–24 years . . . . . . . . . . . . . . . . . . . . . . . . 4.5 5.2 6.4 5.0 23.0 22.8 28.1 25.0 7.6 8.3 10.9 7.7
25–44 years . . . . . . . . . . . . . . . . . . . . . . . . 3.9 3.4 4.8 4.7 16.9 14.5 20.6 22.1 4.9 4.2 5.4 5.5
45–64 years. . . . . . . . . . . . . . . . . . . . . . . . . . 4.4 3.8 4.9 5.7 7.2 6.0 11.1 10.6 2.9 1.9 3.4 3.4
45–54 years . . . . . . . . . . . . . . . . . . . . . . . . 4.5 3.2 5.9 5.4 9.2 7.1 14.3 13.6 3.3 2.1 4.3 4.6
55–64 years . . . . . . . . . . . . . . . . . . . . . . . . 4.4 4.6 3.8 6.0 4.1 4.4 7.3 7.4 2.1 1.5 2.3 2.0
65 years and over . . . . . . . . . . . . . . . . . . . . . 2.6 2.2 3.4 3.7 1.6 1.2 2.3 2.4 *0.4 *0.4 * *0.7
65–74 years . . . . . . . . . . . . . . . . . . . . . . . . 3.1 2.5 4.5 4.6 2.3 1.7 *3.1 3.8 * * * *1.2
75 years and over . . . . . . . . . . . . . . . . . . . . 2.0 1.9 2.3 2.5 *0.7 * *1.4 *0.7 * * * *
Race 2,3
White only. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.2 4.0 5.2 5.3 13.5 12.1 17.4 17.5 4.2 3.7 5.2 4.8
Black or African American only . . . . . . . . . . . . . . 2.9 2.0 3.8 3.0 6.5 5.2 9.0 9.2 2.9 1.9 3.1 2.6
American Indian or Alaska Native only . . . . . . . . . * * * *4.0 18.1 *19.0 *11.7 *13.3 * * * *
Asian only. . . . . . . . . . . . . . . . . . . . . . . . . . . . . * * * *2.3 *5.2 *3.7 7.3 7.0 * * * *2.2
Native Hawaiian or Other Pacific
Islander only . . . . . . . . . . . . . . . . . . ........ -- * * * -- * * * -- * * *
2 or more races. . . . . . . . . . . . . . . . . ........ -- * * * -- 17.0 16.4 18.8 -- *8.2 *6.3 *6.4
Characteristic 1997 2000 2010 2013 1997 2000 2010 2013 1997 2000 2010 2013
Mexican. . . . . . . . . . . . . . . . . . . . . . . . . . . . . *1.9 *1.1 *1.7 2.1 8.2 7.1 10.4 10.4 3.2 *2.2 3.7 2.7
Not Hispanic or Latina . . . . . . . . . . . . . . . . . . . . 4.1 3.8 5.3 5.4 12.6 11.5 16.6 16.7 4.0 3.6 5.0 4.6
White only . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.4 4.3 5.9 6.1 14.2 13.0 19.1 19.4 4.3 4.0 5.6 5.3
Black or African American only. . . . . . . . . . . . . 2.9 2.0 3.8 3.1 6.2 5.2 8.9 9.2 2.9 1.9 3.0 2.6
100%–199% . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.1 2.9 4.1 3.6 10.5 9.0 13.5 13.3 4.0 3.5 5.1 4.1
200%–399% . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.3 3.2 3.9 4.4 12.1 10.7 15.3 15.9 4.0 3.5 4.2 4.4
400% or more . . . . . . . . . . . . . . . . . . . . . . . . . . 5.2 4.5 6.7 6.6 14.2 12.6 19.2 17.8 3.4 3.3 5.6 4.6
Any basic actions difficulty. . . . . . . . . . . . . . . . 4.5 4.2 4.7 4.3 13.2 11.6 15.4 14.9 5.1 4.1 5.4 4.5
Any complex activity limitation . . . . . . . . . . . . . 3.7 *3.2 4.6 3.2 10.8 9.1 12.3 11.5 4.2 *3.1 5.0 3.7
No disability . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.9 3.5 5.1 5.4 12.0 10.9 16.1 16.3 3.6 3.3 4.7 4.3
* Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error (RSE) of 20%–30%. Data not shown have an RSE greater than 30%.
- - - Data not available.
1
Heavier drinking is based on self-reported responses to questions about average alcohol consumption and is defined as more than 14 drinks per week for men and more than
7 drinks per week for women on average. U.S. Department of Agriculture: Dietary Guidelines for Americans, 2010. Available from:
http://www.health.gov/dietaryguidelines/dga2010/DietaryGuidelines2010.pdf. Respondents were also asked, ‘‘In the past year, on how many days did you have five or more
drinks of any alcoholic beverage?’’ See Appendix II, Alcohol consumption.
2
Estimates are age-adjusted to the year 2000 standard population using four age groups: 18–24 years, 25–44 years, 45–64 years, and 65 years and over. Age-adjusted
estimates in this table may differ from other age-adjusted estimates based on the same data and presented elsewhere if different age groups are used in the adjustment
procedure. See Appendix II, Age adjustment.
3
The race groups, white, black, American Indian or Alaska Native, Asian, Native Hawaiian or Other Pacific Islander, and 2 or more races, include persons of Hispanic and
non-Hispanic origin. Persons of Hispanic origin may be of any race. Starting with 1999 data, race-specific estimates are tabulated according to the 1997 Revisions to the
Standards for the Classification of Federal Data on Race and Ethnicity and are not strictly comparable with estimates for earlier years. The five single-race categories plus
multiple-race categories shown in the table conform to the 1997 Standards. Starting with 1999 data, race-specific estimates are for persons who reported only one racial group;
the category 2 or more races includes persons who reported more than one racial group. Prior to 1999, data were tabulated according to the 1977 Standards with four racial
groups, and the Asian only category included Native Hawaiian or Other Pacific Islander. Estimates for single-race categories prior to 1999 included persons who reported one
race or, if they reported more than one race, identified one race as best representing their race. Starting with 2003 data, race responses of other race and unspecified multiple
race were treated as missing, and then race was imputed if these were the only race responses. Almost all persons with a race response of other race were of Hispanic origin.
See Appendix II, Hispanic origin; Race.
4
Percent of poverty level is based on family income and family size and composition using U.S. Census Bureau poverty thresholds. Missing family income data were imputed
for 1997 and beyond. See Appendix II, Family income; Poverty; Table VI.
5
Any basic actions difficulty or complex activity limitation is defined as having one or more of the following limitations or difficulties: movement difficulty, emotional difficulty,
sensory (seeing or hearing) difficulty, cognitive difficulty, self-care (activities of daily living or instrumental activities of daily living) limitation, social limitation, or work limitation.
For more information, see Appendix II, Basic actions difficulty; Complex activity limitation. Starting with 2007 data, the hearing question, a component of the basic actions
difficulty measure, was revised. Consequently, data prior to 2007 are not comparable with data for 2007 and beyond. For more information on the impact of the revised hearing
question, see Appendix II, Hearing trouble.
NOTES: Standard errors are available in the spreadsheet version of this table. Available from: http://www.cdc.gov/nchs/hus.htm. For more data on alcohol consumption,
see the Early Release reports on the National Health Interview Survey home page: http://www.cdc.gov/nchs/nhis.htm. Data for additional years are available. See the
Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC/NCHS, National Health Interview Survey, family core and sample adult questionnaires. See Appendix I, National Health Interview Survey (NHIS).
Health condition 1988–1994 1999–2000 2001–2002 2003–2004 2005–2006 2007–2008 2009–2010 2011–2012
Hypercholesterolemia 3
Total, age-adjusted 4 . . . . . . . . . . . . . . 22.8 25.5 24.6 27.9 27.4 27.6 27.2 28.2
Total, crude. . . . . . . . . . . . . . . . . . . . . 21.5 24.5 24.2 27.9 28.1 28.8 28.6 30.4
High cholesterol 5
Total, age-adjusted 4 . . . . . . . . . . . . . . 20.8 18.3 16.5 16.9 15.6 14.2 13.2 12.7
Total, crude. . . . . . . . . . . . . . . . . . . . . 19.6 17.7 16.4 17.0 15.9 14.6 13.6 13.1
Hypertension 6
Total, age-adjusted 4 . . . . . . . . . . . . . . 25.5 30.0 29.7 32.1 30.5 31.2 30.0 30.0
Total, crude. . . . . . . . . . . . . . . . . . . . . 24.1 28.9 28.9 32.5 31.7 32.6 31.9 32.5
Obesity 9
Total, age-adjusted 4 . . . . . . . . . . . . . 22.9 30.5 30.5 32.3 34.4 33.7 35.7 34.9
Total, crude . . . . . . . . . . . . . . . . . . . 22.3 30.3 30.6 32.3 34.7 33.9 35.9 35.1
NOTES: Standard errors are available in the spreadsheet version of this table. Available from: http://www.cdc.gov/nchs/hus.htm. Some data have been revised and
differ from previous editions of Health, United States.
SOURCE: CDC/NCHS, National Health and Nutrition Examination Survey. See Appendix I, National Health and Nutrition Examination Survey (NHANES).
Hypertension 2,3
(measured high blood pressure and/or Uncontrolled high blood pressure
Sex, age, race taking antihypertensive medication) among persons with hypertension 4
and Hispanic origin 1,
and percent of poverty level 1988–1994 1999–2002 2003–2006 2009–2012 1988–1994 1999–2002 2003–2006 2009–2012
Mexican origin female. . . . . . . . . . . . . . . . 25.0 27.9 28.6 29.3 77.6 71.5 66.1 47.1
Below 100% . . . ...... . . . . . . . . . . . . 31.7 33.9 35.0 33.4 75.0 71.2 69.8 56.3
100%–199%. . . ...... . . . . . . . . . . . . 26.6 33.5 34.1 33.1 76.0 73.4 68.2 57.6
200%–399%. . . ...... . . . . . . . . . . . . 24.7 30.2 31.9 30.6 76.2 67.8 63.9 51.5
400% or more . ...... . . . . . . . . . . . . 22.6 26.4 28.9 27.3 81.5 70.3 56.8 60.2
Mexican origin female. . . . . . . . . . . . . . . . 15.9 18.8 20.0 22.0 80.6 74.5 68.6 52.8
Below 100% . . . ...... . . . . . . . . . . . . 25.7 30.3 28.8 27.3 74.0 71.3 67.3 54.8
100%–199%. . . ...... . . . . . . . . . . . . 26.7 34.8 36.8 35.3 75.1 70.7 63.2 49.8
200%–399%. . . ...... . . . . . . . . . . . . 22.4 29.9 33.1 33.4 73.4 64.4 58.0 45.7
400% or more . ...... . . . . . . . . . . . . 22.0 26.8 29.2 31.5 74.3 63.8 53.4 43.1
Male
20–44 years . . . . . . . . . . . . . . . . . . . . . . 10.9 12.1 14.2 11.2 90.5 79.7 71.1 70.3
20–34 years . . . . . . . . . . . . . . . . . . . . . 7.1 *8.1 9.2 5.8 92.6 89.9 83.1 88.4
35–44 years . . . . . . . . . . . . . . . . . . . . . 17.1 17.1 21.1 19.1 89.0 73.3 63.6 62.0
45–64 years . . . . . . . . . . . . . . . . . . . . . . 34.2 36.4 41.2 42.2 73.1 61.4 57.0 50.2
45–54 years . . . . . . . . . . . . . . . . . . . . . 29.2 31.0 36.2 33.6 76.2 66.4 59.3 47.7
55–64 years . . . . . . . . . . . . . . . . . . . . . 40.6 45.0 50.2 51.9 70.3 55.9 53.9 52.0
65–74 years . . . . . . . . . . . . . . . . . . . . . . 54.4 59.6 64.1 61.7 74.3 59.1 45.9 36.9
75 years and over . . . . . . . . . . . . . . . . . . 60.4 69.0 65.0 75.1 82.5 74.3 59.7 48.9
Female
20–44 years . . . . . . . . . . . . . . . . . . . . . . 6.5 8.3 6.9 8.7 63.4 58.3 49.1 46.5
20–34 years . . . . . . . . . . . . . . . . . . . . . 2.9 *2.7 *2.2 3.9 82.2 56.9 *47.9 49.0
35–44 years . . . . . . . . . . . . . . . . . . . . . 11.2 15.1 12.6 15.5 56.8 58.6 49.4 45.5
45–64 years . . . . . . . . . . . . . . . . . . . . . . 32.8 40.0 43.4 39.5 62.1 60.5 55.5 36.5
45–54 years . . . . . . . . . . . . . . . . . . . . . 23.9 31.8 36.2 29.5 58.5 61.1 57.4 36.2
55–64 years . . . . . . . . . . . . . . . . . . . . . 42.6 53.9 54.4 51.0 64.3 60.0 53.6 36.8
65–74 years . . . . . . . . . . . . . . . . . . . . . . 56.2 72.7 70.8 66.7 68.7 73.5 58.5 45.4
75 years and over . . . . . . . . . . . . . . . . . . 73.6 83.1 80.2 79.3 81.9 78.1 70.3 57.8
* Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error of 20%–30%.
1
Persons of Mexican origin may be of any race. Starting with 1999 data, race-specific estimates are tabulated according to the 1997 Revisions to the Standards for the
Classification of Federal Data on Race and Ethnicity and are not strictly comparable with estimates for earlier years. The two non-Hispanic race categories shown in the
table conform to the 1997 Standards. Starting with 1999 data, race-specific estimates are for persons who reported only one racial group. Prior to data year 1999,
estimates were tabulated according to the 1977 Standards. Estimates for single-race categories prior to 1999 included persons who reported one race or, if they
reported more than one race, identified one race as best representing their race. See Appendix II, Hispanic origin; Race.
2
Hypertension is defined as having measured high blood pressure and/or taking antihypertensive medication. High blood pressure is defined as having measured
systolic pressure of at least 140 mm Hg or diastolic pressure of at least 90 mm Hg. Those with high blood pressure also may be taking prescribed medicine for high
blood pressure. Those taking antihypertensive medication may not have measured high blood pressure but are still classified as having hypertension. See Appendix II,
3
Respondents were asked, ‘‘Are you now taking prescribed medicine for your high blood pressure?’’
4
Uncontrolled high blood pressure among persons with hypertension is defined as measured systolic pressure of at least 140 mm Hg or diastolic pressure of at least 90
mm Hg, among those with measured high blood pressure or reporting taking antihypertensive medication. See Appendix II, Blood pressure, high.
5
Estimates are age-adjusted to the year 2000 standard population using five age groups: 20–34 years, 35–44 years, 45–54 years, 55–64 years, and 65 years and over.
Age-adjusted estimates in this table may differ from other age-adjusted estimates based on the same data and presented elsewhere if different age groups are used in
6
Includes persons of all races and Hispanic origins, not just those shown separately.
7
Percent of poverty level was calculated by dividing family income by the U.S. Department of Health and Human Services’ poverty guideline specific to family size, as
well as the appropriate year, and state. Persons with unknown percent of poverty level are excluded (7% in 2009–2012). See Appendix II, Family income; Poverty.
NOTES: Percentages are based on the average of blood pressure measurements taken. In 2009–2012, 84% of participants had three systolic or diastolic blood
pressure readings. Excludes pregnant women. Standard errors are available in the spreadsheet version of this table. Available from: http://www.cdc.gov/nchs/hus.htm.
Data for additional years are available. See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC/NCHS, National Health and Nutrition Examination Survey. See Appendix I, National Health and Nutrition Examination Survey (NHANES).
Male
20–44 years. . . . . .......... .. .. . . .. . 13.1 16.1 16.5 12.6
Female
20–44 years. . . . . .......... .. .. . . .. . 9.9 11.4 12.9 9.4
Male
20–44 years. . . . . .......... .. .. . . .. . 12.5 14.2 14.1 10.0
Female
20–44 years. . . . . .......... .. .. . . .. . 9.4 10.4 11.3 7.6
20 years and over, age-adjusted 2 Mean serum total cholesterol level, mg/dL
Both sexes 4 . . . . . . . . . . . . . . . . . . . . . . . . 206
203 200 195
Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 204
202 198 192
Female . . . . . . . . . . . . . . . . . . . . . . . . . . . 207
204 202 198
100%–199% . . . . . . . . . . . . . . . . . . . . . . 205
204 201 194
200%–399% . . . . . . . . . . . . . . . . . . . . . . 207
205 199 195
Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 202
202 198 193
Female . . . . . . . . . . . . . . . . . . . . . . . . . . . 206
204 202 199
100%–199% . . . . . . . . . . . . . . . . . . . . . . 202
202 199 193
200%–399% . . . . . . . . . . . . . . . . . . . . . . 205
204 199 196
Male
20–44 years. . . . . .............. ..... 194
196 196 191
Female
20–44 years. . . . . .............. ..... 189
191 192 187
1
Persons of Mexican origin may be of any race. Starting with 1999 data, race-specific estimates are tabulated according to the 1997 Revisions to the Standards for the
Classification of Federal Data on Race and Ethnicity and are not strictly comparable with estimates for earlier years. The two non-Hispanic race categories shown in the
table conform to the 1997 Standards. Starting with 1999 data, race-specific estimates are for persons who reported only one racial group. Prior to data year 1999,
estimates were tabulated according to the 1977 Standards. Estimates for single-race categories prior to 1999 included persons who reported one race or, if they
reported more than one race, identified one race as best representing their race. See Appendix II, Hispanic origin; Race.
2
Estimates are age-adjusted to the year 2000 standard population using five age groups: 20–34 years, 35–44 years, 45–54 years, 55–64 years, and 65 years and over.
Age-adjusted estimates may differ from other age-adjusted estimates based on the same data and presented elsewhere if different age groups are used in the
3
Hypercholesterolemia is defined as measured serum total cholesterol greater than or equal to 240 mg/dL or reporting taking cholesterol-lowering medications.
Respondents were asked, ‘‘Are you now following this advice [from a doctor or health professional] to take prescribed medicine [to lower your cholesterol]?’’
4
Includes persons of all races and Hispanic origins, not just those shown separately.
5
Percent of poverty level was calculated by dividing family income by the U.S. Department of Health and Human Services’ poverty guideline specific to family size, as
well as the appropriate year, and state. Persons with unknown percent of poverty level are excluded (7% in 2009–2012). See Appendix II, Family income; Poverty.
6
High cholesterol is defined as serum total cholesterol greater than or equal to 240 mg/dL (6.20 mmol/L), regardless of whether the respondent reported taking
cholesterol-lowering medications.
NOTES: Risk levels for cholesterol have been defined by the Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and
Treatment of High Blood Cholesterol in Adults. National Heart, Lung, and Blood Institute, National Institutes of Health. September 2002. (Available from:
http://www.nhlbi.nih.gov/guidelines/cholesterol/index.htm and summarized in JAMA 2001;285(19):2486–97). Serum total cholesterol greater than or equal to 240 mg/dL
(6.20 mmol/L) is considered high. See Appendix II, Cholesterol. Standard errors for selected years are available in the spreadsheet version of this table. Available from:
http://www.cdc.gov/nchs/hus.htm. Data for additional years are available. See the Excel spreadsheet on the Health, United States website at:
http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC/NCHS, National Health and Nutrition Examination Survey. See Appendix I, National Health and Nutrition Examination Survey (NHANES).
NOTES: Starting in 2001, 24-hour dietary recall data were collected in the mobile examination center (day 1 file) and on a second day by telephone interview (day 2
file). For comparability across survey years, this table is based on day 1 data only. It is recognized that usual intake of macronutrients based on 2 or more days of
dietary data would be more precise (Freedman LS, Guenther PM, Dodd KW, Krebs-Smith SM, Midthune D. The population distribution of ratios of usual intakes of
dietary components that are consumed every day can be estimated from repeated 24-hour recalls. J Nutr 2010 Jan;140(1):111–6.) Two days of data are available only
in later years of the continuous NHANES survey. Thus, in order to present trends, macronutrient intake estimates on a given day are presented in this table. This table
excludes individuals who reported no energy intake. Energy intake included kilocalories from all foods and beverages, including alcoholic beverages, consumed during
the previous 24-hour period. Macronutrients (carbohydrates, protein, and fat) do not sum to 100% because information for alcohol is not shown in the table. See Health,
United States, 2013, Table 67, for earlier data years. Standard errors are available in the spreadsheet version of this table. Available from:
http://www.cdc.gov/nchs/hus.htm. Data for additional years are available. See the Excel spreadsheet on the Health, United States website at:
http://www.cdc.gov/nchs/hus.htm. Data have been revised and differ from previous editions of Health, United States.
SOURCE: CDC/NCHS, National Health and Nutrition Examination Survey. U.S. Department of Agriculture, Agriculture Research Service. Beltsville Human Nutrition
Research Center, Food Surveys Research Group, What We Eat in America. See Appendix I, National Health and Nutrition Examination Survey (NHANES).
Met both aerobic activity and muscle- Met neither aerobic activity nor muscle-
strengthening guidelines strengthening guideline
Characteristic 1998 2000 2010 2012 2013 1998 2000 2010 2012 2013
Percent
18 years and over, age-adjusted 2,3 . . . . . . . . . . . 14.3 15.0 20.7 20.8 21.0 56.6 54.7 49.1 46.6 46.5
18 years and over, crude 3 . . . . . . . . . . . . . . . . . 14.5 15.1 20.4 20.3 20.4 56.3 54.6 49.5 47.1 47.2
Age
18–44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . 18.9 18.9 25.7 25.7 25.7 50.7 49.1 43.1 41.0 40.3
18–24 years. . . . . . . . . . . . . . . . . . . . . . . . . . 23.8 23.8 29.6 29.7 30.3 46.5 44.5 39.4 37.9 35.5
25–44 years. . . . . . . . . . . . . . . . . . . . . . . . . . 17.4 17.3 24.3 24.2 24.0 51.9 50.6 44.4 42.2 42.0
45–64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.4 12.8 17.7 17.2 17.8 58.8 57.6 51.0 49.6 50.2
45–54 years. . . . . . . . . . . . . . . . . . . . . . . . . . 13.2 14.5 19.2 18.2 20.1 56.9 55.4 48.9 48.3 48.4
55–64 years. . . . . . . . . . . . . . . . . . . . . . . . . . 8.6 10.1 15.9 16.0 15.3 61.8 61.0 53.7 51.2 52.1
65 years and over . . . . . . . . . . . . . . . . . . . . . . . 5.5 6.8 10.4 11.9 11.7 71.0 67.0 64.6 58.4 59.4
65–74 years. . . . . . . . . . . . . . . . . . . . . . . . . . 7.0 8.4 13.6 14.8 14.7 65.6 60.3 59.9 51.7 54.0
75 years and over . . . . . . . . . . . . . . . . . . . . . 3.5 4.9 6.4 7.9 7.6 77.8 75.0 70.3 67.2 66.8
Sex 2
Male. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17.5 17.9 25.1 24.6 25.0 50.8 49.6 43.8 42.2 42.0
Female . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.4 12.3 16.5 17.1 17.2 61.9 59.4 54.0 50.7 50.7
Race 2,4
White only. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14.8 15.7 21.4 21.5 21.7 55.2 53.1 47.6 45.4 45.2
Black or African American only . . . . . . . . . . . . . . 11.7 12.2 17.2 16.8 17.7 65.7 64.6 58.5 55.0 54.7
American Indian or Alaska Native only . . . . . . . . . 16.0 *10.6 *12.7 18.7 16.8 57.6 67.1 54.0 50.8 50.8
Asian only. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13.5 14.1 17.8 17.1 18.3 59.1 55.0 51.7 47.8 47.6
Native Hawaiian or Other Pacific
Islander only . . . . . . . . . . . . . . . . . . ........ -- * * * * -- * * * *
2 or more races. . . . . . . . . . . . . . . . . ........ -- 19.0 25.9 28.7 22.4 -- 52.8 45.0 40.5 44.4
Education 5,6
No high school diploma or GED . . . . . . . . . . . . . 4.6 4.3 7.7 7.6 8.0 76.3 74.0 69.8 66.3 66.6
High school diploma or GED. . . . . . . . . . . . . . . . 8.6 9.5 12.7 12.4 13.8 64.6 61.7 59.0 57.4 57.0
Some college or more . . . . . . . . . . . . . . . . . . . . 18.2 18.9 25.0 24.9 24.4 48.0 47.1 42.1 39.7 40.6
Met both aerobic activity and muscle- Met neither aerobic activity nor muscle-
strengthening guidelines strengthening guideline
Characteristic 1998 2000 2010 2012 2013 1998 2000 2010 2012 2013
2,7
Percent of poverty level Percent
Below 100% . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.0 9.3 12.0 11.6 12.6 71.3 68.0 63.9 60.5 59.5
100%–199% . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.0 9.0 12.7 14.5 14.3 67.1 65.5 60.6 56.3 56.7
200%–399% . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.6 13.2 19.2 18.8 19.2 58.0 56.8 50.6 47.9 48.0
400% or more . . . . . . . . . . . . . . . . . . . . . . . . . . 20.2 20.5 29.1 29.4 29.1 46.2 45.0 36.9 35.5 35.6
Geographic region 2
Northeast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14.2 17.0 20.2 20.6 22.2 57.0 51.8 49.1 48.7 47.1
Midwest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15.0 16.4 20.7 21.7 21.7 54.9 53.4 49.7 47.0 46.3
South . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.8 12.1 18.8 18.7 18.2 61.4 59.7 51.8 49.9 49.5
West . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18.5 16.7 24.0 23.3 23.7 49.5 50.1 44.5 39.3 41.5
Characteristic 1998 2000 2010 2012 2013 1998 2000 2010 2012 2013
Percent
18 years and over, age-adjusted 2,3 . . . . . . . . . . . 40.0 42.2 47.3 50.1 50.1 17.7 18.0 24.4 24.1 24.4
18 years and over, crude 3 . . . . . . . . . . . . . . . . . 40.3 42.4 46.9 49.6 49.4 17.9 18.1 24.0 23.6 23.9
Age
18–44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . 45.7 47.7 53.8 56.1 56.9 22.5 22.1 28.8 28.6 28.5
18–24 years. . . . . . . . . . . . . . . . . . . . . . . . . . 49.3 52.2 57.2 59.6 61.5 28.0 27.2 32.8 32.1 33.3
25–44 years. . . . . . . . . . . . . . . . . . . . . . . . . . 44.6 46.3 52.5 54.9 55.1 20.8 20.5 27.4 27.2 26.8
45–64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . 38.2 39.7 45.2 46.9 46.4 14.4 15.5 21.5 20.7 21.3
45–54 years. . . . . . . . . . . . . . . . . . . . . . . . . . 40.1 42.1 47.6 48.5 48.4 16.2 17.0 22.6 21.4 23.3
55–64 years. . . . . . . . . . . . . . . . . . . . . . . . . . 35.3 36.1 42.1 45.0 44.1 11.5 13.1 20.1 19.8 19.0
65 years and over . . . . . . . . . . . . . . . . . . . . . . . 26.0 30.1 30.5 37.5 35.8 8.6 9.8 15.4 16.1 16.7
65–74 years. . . . . . . . . . . . . . . . . . . . . . . . . . 31.7 36.8 35.9 44.6 41.8 9.7 11.3 17.9 18.7 19.2
75 years and over . . . . . . . . . . . . . . . . . . . . . 18.7 22.1 23.9 28.1 27.6 7.2 8.0 12.3 12.7 13.4
Sex 2
Male. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45.4 47.4 52.1 54.0 54.3 21.2 20.8 29.1 28.4 28.7
Female . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35.1 37.6 42.7 46.6 46.2 14.4 15.4 19.8 20.0 20.2
Race 2,4
White only. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41.5 44.1 48.9 51.5 51.5 18.0 18.5 24.8 24.6 25.0
Black or African American only . . . . . . . . . . . . . . 30.4 31.7 37.3 41.2 41.4 15.6 16.0 21.4 20.7 21.7
American Indian or Alaska Native only . . . . . . . . . 39.7 29.7 42.0 46.1 47.4 18.2 13.9 16.7 21.9 20.0
Asian only. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37.1 41.7 44.2 48.8 49.5 17.2 17.2 21.9 20.5 21.0
Native Hawaiian or Other Pacific
Islander only . . . . . . . . . . . . . . . . . . ........ -- * * * * -- * * * *
2 or more races. . . . . . . . . . . . . . . . . ........ -- 43.9 50.2 55.6 51.6 -- 22.2 30.4 32.5 26.7
Education 5,6
No high school diploma or GED . . . . . . . . . . . . . 21.4 23.9 27.1 31.5 30.7 7.0 6.6 10.9 10.0 10.9
High school diploma or GED. . . . . . . . . . . . . . . . 32.6 35.7 37.3 38.8 39.9 11.4 12.1 16.2 16.1 16.9
Some college or more . . . . . . . . . . . . . . . . . . . . 48.1 49.4 53.9 56.7 55.7 22.1 22.4 28.9 28.5 28.1
Characteristic 1998 2000 2010 2012 2013 1998 2000 2010 2012 2013
Geographic region 2
Northeast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39.6 45.3 46.9 47.8 49.2 17.5 20.0 24.3 24.0 26.0
Midwest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42.0 43.5 46.1 49.5 50.0 18.2 19.3 24.7 25.0 25.3
South . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35.3 37.3 45.0 47.2 47.3 15.0 15.1 22.0 21.6 21.5
West . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46.7 46.9 52.0 57.1 55.4 22.3 19.7 27.5 27.1 26.9
* Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error (RSE) of 20%–30%. Data not shown have an RSE greater than 30%.
- - - Data not available.
1
Starting with Health, United States, 2010, measures of physical activity shown in this table changed to reflect the federal 2008 Physical Activity Guidelines for Americans
(available from: http://www.health.gov/PAGuidelines/). This table presents four measures of physical activity that are of interest to the public health community: the percentage
of adults who met the federal 2008 guidelines for both aerobic activity and muscle strengthening; the percentage who met neither the aerobic activity guideline nor the
muscle-strengthening guideline; the percentage who met the aerobic activity guideline; and the percentage who met the muscle-strengthening guideline. Persons who met
neither the aerobic activity nor the muscle-strengthening guideline were unable to be active, were completely inactive, or had some aerobic or muscle-strengthening activities
but amounts were insufficient to meet the guidelines. The percentage of persons who met the aerobic activity guideline includes those who may or may not have also met the
muscle-strengthening guideline. Similarly, the percentage of persons who met the muscle-strengthening guideline includes those who may or may not have also met the
aerobic activity guideline. The federal 2008 guidelines recommend that for substantial health benefits adults perform at least 150 minutes (2 hours and 30 minutes) a week of
moderate-intensity, or 75 minutes (1 hour and 15 minutes) a week of vigorous-intensity aerobic physical activity, or an equivalent combination of moderate- and
vigorous-intensity aerobic activity. Aerobic activity should be performed in episodes of at least 10 minutes, and preferably should be spread throughout the week. The 2008
guidelines also recommend that adults perform muscle-strengthening activities that are moderate or high intensity and involve all major muscle groups on 2 or more days a
week, because these activities provide additional health benefits. See Appendix II, Physical activity, leisure-time.
2
Estimates are age-adjusted to the year 2000 standard population using five age groups: 18–44 years, 45–54 years, 55–64 years, 65–74 years, and 75 years and over.
Age-adjusted estimates in this table may differ from other age-adjusted estimates based on the same data and presented elsewhere if different age groups are used in the
adjustment procedure. See Appendix II, Age adjustment.
3
Includes all other races not shown separately, unknown education level, and unknown disability status.
4
The race groups, white, black, American Indian or Alaska Native, Asian, Native Hawaiian or Other Pacific Islander, and 2 or more races, include persons of Hispanic and
non-Hispanic origin. Persons of Hispanic origin may be of any race. Starting with 1999 data, race-specific estimates are tabulated according to the 1997 Revisions to the
Standards for the Classification of Federal Data on Race and Ethnicity and are not strictly comparable with estimates for earlier years. The five single-race categories plus
multiple-race categories shown in the table conform to the 1997 Standards. Starting with 1999 data, race-specific estimates are for persons who reported only one racial group;
the category 2 or more races includes persons who reported more than one racial group. Prior to 1999, data were tabulated according to the 1977 Standards with four racial
groups, and the Asian only category included Native Hawaiian or Other Pacific Islander. Estimates for single-race categories prior to 1999 included persons who reported one
race or, if they reported more than one race, identified one race as best representing their race. Starting with 2003 data, race responses of other race and unspecified multiple
race were treated as missing, and then race was imputed if these were the only race responses. Almost all persons with a race response of other race were of Hispanic origin.
See Appendix II, Hispanic origin; Race.
5
Estimates are for persons aged 25 and over and are age-adjusted to the year 2000 standard population using five age groups: 25–44 years, 45–54 years, 55–64 years,
65–74 years, and 75 years and over. See Appendix II, Age adjustment.
6
GED is General Educational Development high school equivalency diploma. See Appendix II, Education.
7
Percent of poverty level is based on family income and family size and composition using U.S. Census Bureau poverty thresholds. Missing family income data were imputed
for 1997 and beyond. See Appendix II, Family income; Poverty; Table VI.
8
Any basic actions difficulty or complex activity limitation is defined as having one or more of the following limitations or difficulties: movement difficulty, emotional difficulty,
sensory (seeing or hearing) difficulty, cognitive difficulty, self-care (activities of daily living or instrumental activities of daily living) limitation, social limitation, or work limitation.
For more information, see Appendix II, Basic actions difficulty; Complex activity limitation. Starting with 2007 data, the hearing question, a component of the basic actions
difficulty measure, was revised. Consequently, data prior to 2007 are not comparable with data for 2007 and beyond. For more information on the impact of the revised hearing
question, see Appendix II, Hearing trouble.
9
MSA is metropolitan statistical area. Starting with 2006 data, MSA status is determined using 2000 census data and the 2000 standards for defining MSAs. For data prior to
2006, see Appendix II, Metropolitan statistical area (MSA) for the applicable standards.
NOTES: Standard errors are available in the spreadsheet version of this table. Available from: http://www.cdc.gov/nchs/hus.htm. Data for additional years are available.
See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC/NCHS, National Health Interview Survey, family core and sample adult questionnaires. See Appendix I, National Health Interview Survey (NHIS).
Male
20–34 years . . . . . . . . . . . . . . . . . . . . . . . . . 51.1 40.3 35.9 37.5
35–44 years . . . . . . . . . . . . . . . . . . . . . . . . . 33.4 29.0 24.1 21.0
45–54 years . . . . . . . . . . . . . . . . . . . . . . . . . 33.6 24.0 20.8 20.0
55–64 years . . . . . . . . . . . . . . . . . . . . . . . . . 28.6 23.8 19.3 21.9
65–74 years . . . . . . . . . . . . . . . . . . . . . . . . . 30.1 22.8 21.2 22.4
75 years and over. . . . . . . . . . . . . . . . . . . . . 40.9 32.0 33.1 28.2
Female
20–34 years . . . . . . . . . . . . . . . . . . . . . . . . . 57.9 42.5 45.1 40.8
35–44 years . . . . . . . . . . . . . . . . . . . . . . . . . 47.1 37.1 37.6 35.2
45–54 years . . . . . . . . . . . . . . . . . . . . . . . . . 37.2 33.1 31.1 27.3
55–64 years . . . . . . . . . . . . . . . . . . . . . . . . . 31.5 27.6 29.5 23.8
65–74 years . . . . . . . . . . . . . . . . . . . . . . . . . 37.0 26.4 28.5 23.5
75 years and over. . . . . . . . . . . . . . . . . . . . . 43.0 36.9 35.4 35.3
Sex, age, race Overweight (includes obesity; BMI greater than or equal to 25.0) 2
and Hispanic origin 1,
and percent of poverty level 1988–1994 1999–2002 2003–2006 2009–2012
Male
20–34 years . . . . . . . . . . . . . . . . . . . . . . . . . 47.5 57.4 61.6 60.9
Female
20–34 years . . . . . . . . . . . . . . . . . . . . . . . . . 37.0 52.9 50.9 55.2
Male
20–34 years . . . . . . . . . . . . . . . . . . . . . . . . . 14.1 21.7 26.2 28.9
35–44 years . . . . . . . . . . . . . . . . . . . . . . . . . 21.5 28.5 37.0 38.1
45–54 years . . . . . . . . . . . . . . . . . . . . . . . . . 23.2 30.6 34.6 38.1
55–64 years . . . . . . . . . . . . . . . . . . . . . . . . . 27.2 35.5 39.3 38.1
65–74 years . . . . . . . . . . . . . . . . . . . . . . . . . 24.1 31.9 33.0 36.4
75 years and over. . . . . . . . . . . . . . . . . . . . . 13.2 18.0 24.0 27.4
Female
20–34 years . . . . . . . . . . . . . . . . . . . . . . . . . 18.5 28.3 28.4 30.0
35–44 years . . . . . . . . . . . . . . . . . . . . . . . . . 25.5 32.1 36.1 36.0
45–54 years . . . . . . . . . . . . . . . . . . . . . . . . . 32.4 36.9 40.0 38.3
55–64 years . . . . . . . . . . . . . . . . . . . . . . . . . 33.7 42.1 41.0 42.9
65–74 years . . . . . . . . . . . . . . . . . . . . . . . . . 26.9 39.3 36.4 44.2
75 years and over. . . . . . . . . . . . . . . . . . . . . 19.2 23.6 24.2 29.8
Male
20–34 years . . . . . . . . . . . . . . . . . . . . . . . . . 9.8 13.7 18.1 19.6
35–44 years . . . . . . . . . . . . . . . . . . . . . . . . . 14.7 19.3 24.9 22.7
45–54 years . . . . . . . . . . . . . . . . . . . . . . . . . 17.3 17.8 22.4 24.4
55–64 years . . . . . . . . . . . . . . . . . . . . . . . . . 20.6 25.3 27.0 25.6
65–74 years . . . . . . . . . . . . . . . . . . . . . . . . . 19.4 22.1 20.5 21.9
75 years and over. . . . . . . . . . . . . . . . . . . . . 10.9 15.7 18.5 21.1
Female
20–34 years . . . . . . . . . . . . . . . . . . . . . . . . . 10.8 15.9 14.2 14.4
35–44 years . . . . . . . . . . . . . . . . . . . . . . . . . 13.9 14.8 19.7 19.3
45–54 years . . . . . . . . . . . . . . . . . . . . . . . . . 17.5 19.4 18.4 19.0
55–64 years . . . . . . . . . . . . . . . . . . . . . . . . . 20.0 21.6 19.8 22.7
65–74 years . . . . . . . . . . . . . . . . . . . . . . . . . 16.0 23.4 20.3 21.1
75 years and over. . . . . . . . . . . . . . . . . . . . . 14.4 14.1 18.2 19.1
Male
20–34 years . . . . . . . . . . . . . . . . . . . . . . . . . 2.9 4.1 4.5 6.3
35–44 years . . . . . . . . . . . . . . . . . . . . . . . . . *3.5 5.9 7.9 9.7
45–54 years . . . . . . . . . . . . . . . . . . . . . . . . . *3.5 8.5 8.3 8.2
55–64 years . . . . . . . . . . . . . . . . . . . . . . . . . 5.5 *7.4 8.4 7.1
65–74 years . . . . . . . . . . . . . . . . . . . . . . . . . *3.8 6.9 10.3 10.8
75 years and over. . . . . . . . . . . . . . . . . . . . . * * *3.9 *4.7
Female
20–34 years . . . . . . . . . . . . . . . . . . . . . . . . . 5.1 8.0 7.9 7.9
35–44 years . . . . . . . . . . . . . . . . . . . . . . . . . 7.1 9.4 9.2 8.4
45–54 years . . . . . . . . . . . . . . . . . . . . . . . . . 8.4 10.4 12.4 10.7
55–64 years . . . . . . . . . . . . . . . . . . . . . . . . . 9.4 10.9 11.4 11.1
65–74 years . . . . . . . . . . . . . . . . . . . . . . . . . 6.7 9.8 9.6 12.3
75 years and over. . . . . . . . . . . . . . . . . . . . . 3.7 7.2 *3.9 6.6
Sex, age, race Grade 3 Obesity (BMI greater than or equal to 40.0) 2
and Hispanic origin 1,
and percent of poverty level 1988–1994 1999–2002 2003–2006 2009–2012
Male
20–34 years . . . . . . . . . . . . . . . . . . . . . . . . . *1.3 3.9 3.6 3.0
35–44 years . . . . . . . . . . . . . . . . . . . . . . . . . * *3.2 4.2 5.6
45–54 years . . . . . . . . . . . . . . . . . . . . . . . . . * *4.2 *3.9 *5.5
55–64 years . . . . . . . . . . . . . . . . . . . . . . . . . * *2.8 3.9 *5.4
65–74 years . . . . . . . . . . . . . . . . . . . . . . . . . * * *2.1 *
75 years and over. . . . . . . . . . . . . . . . . . . . . * * * *
Female
20–34 years . . . . . . . . . . . . . . . . . . . . . . . . . 2.7 4.5 6.3 7.7
35–44 years . . . . . . . . . . . . . . . . . . . . . . . . . 4.5 7.9 7.2 8.3
45–54 years . . . . . . . . . . . . . . . . . . . . . . . . . 6.4 7.2 9.2 8.6
55–64 years . . . . . . . . . . . . . . . . . . . . . . . . . 4.2 9.5 9.8 9.1
65–74 years . . . . . . . . . . . . . . . . . . . . . . . . . 4.2 6.2 *6.4 10.7
75 years and over. . . . . . . . . . . . . . . . . . . . . * * *2.1 *4.1
* Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error (RSE) of 20%–30%. Data not shown have an RSE greater than
30%.
1
Persons of Mexican origin may be of any race. Starting with 1999 data, race-specific estimates are tabulated according to the 1997 Revisions to the Standards for the
Classification of Federal Data on Race and Ethnicity and are not strictly comparable with estimates for earlier years. The two non-Hispanic race categories shown in the
table conform to the 1997 Standards. Starting with 1999 data, race-specific estimates are for persons who reported only one racial group. Prior to data year 1999,
estimates were tabulated according to the 1977 Standards. Estimates for single-race categories prior to 1999 included persons who reported one race or, if they
reported more than one race, identified one race as best representing their race. See Appendix II, Hispanic origin; Race.
2
Body mass index (BMI) equals weight in kilograms divided by height in meters squared. In Health, United States the NHANES variable, Body Mass Index, is used to
assign persons to BMI categories. See Appendix II, Body mass index (BMI).
3
Estimates are age-adjusted to the year 2000 standard population using five age groups: 20–34 years, 35–44 years, 45–54 years, 55–64 years, and 65 years and over.
Age-adjusted estimates in this table may differ from other age-adjusted estimates based on the same data and presented elsewhere if different age groups are used in
4
Includes all other races not shown separately.
5
Percent of poverty level was calculated by dividing family income by the U.S. Department of Health and Human Services’ poverty guideline specific to family size, as
well as the appropriate year, and state. Persons with unknown percent of poverty level are excluded (7% in 2009–2012). See Appendix II, Family income; Poverty.
NOTES: Percents do not sum to 100 because the percentage of persons with BMI less than healthy weight (18.5 kilograms per meters squared) is not shown and the
percentage of persons with obesity is a subset of the percentage with overweight. Height was measured without shoes. Excludes pregnant women. See Health, United
States, 2013, Table 69, for earlier data years. Standard errors for selected years are available in the spreadsheet version of this table. Available from:
http://www.cdc.gov/nchs/hus.htm. Data for additional years are available. See the Excel spreadsheet on the Health, United States website at:
http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC/NCHS, National Health and Nutrition Examination Survey, Hispanic Health and Nutrition Examination Survey (1982–1984), and National Health
Examination Survey (1960–1962). See Appendix I, National Health and Nutrition Examination Survey (NHANES).
6–11 years
Both sexes 2 . . . . . . . . . . . . . . . . ...... 11.3 15.9 17.0 17.9
12–19 years
Both sexes 2 . . . . . . . . . . . . . . . . ...... 10.5 16.0 17.6 19.4
* Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error (RSE) of 20%–30%. Data not shown have an RSE greater than
30%.
1
Persons of Mexican origin may be of any race. Starting with 1999 data, race-specific estimates are tabulated according to the 1997 Revisions to the Standards for the
Classification of Federal Data on Race and Ethnicity and are not strictly comparable with estimates for earlier years. The two non-Hispanic race categories shown in the
table conform to the 1997 Standards. Starting with 1999 data, race-specific estimates are for persons who reported only one racial group. Prior to data year 1999,
estimates were tabulated according to the 1977 Standards. Estimates for single-race categories prior to 1999 included persons who reported one race or, if they
reported more than one race, identified one race as best representing their race. See Appendix II, Hispanic origin; Race.
2
Includes persons of all races and Hispanic origins, not just those shown separately.
3
Percent of poverty level was calculated by dividing family income by the U.S. Department of Health and Human Services’ poverty guideline specific to family size, as
well as the appropriate year, and state. Persons with unknown percent of poverty level are excluded (7% in 2009–2012). See Appendix II, Family income; Poverty.
NOTES: Obesity is defined as body mass index (BMI) at or above the sex- and age-specific 95th percentile from the 2000 CDC Growth Charts: United States.
Kuczmarski RJ, Ogden CL, Guo SS, Grummer-Strawn LM, Flegal KM, Mei Z, Wei R, Curtin LR, Roche AF, Johnson CL. 2000 CDC Growth Charts for the United
States: methods and development. Vital Health Stat 11. 2002 May;(246):1–190. Available at: http://www.cdc.gov/nchs/data/series/sr_11/sr11_246.pdf. In Health, United
States the NHANES variable, Body Mass Index, is used to assign persons to BMI categories. Starting with Health, United States, 2010, the terminology describing
weight for height among children changed from prior editions. The term ‘‘obesity’’ now refers to children who were formerly labeled as overweight. This is a change in
terminology only and not measurement; the previous definition of overweight is now the definition of obesity. Ogden CL, Flegal KM. Changes in terminology for
childhood overweight and obesity. National health statistics report; no. 25. Hyattsville, MD: NCHS; 2010. Available from: http://www.cdc.gov/nchs/data/nhsr/nhsr025.pdf.
Age is at time of examination at the mobile examination center. Crude rates, not age-adjusted rates, are shown. Height was measured without shoes. Excludes
pregnant females. See Health, United States, 2013, Table 70, for earlier data years. Standard errors for selected years are available in the spreadsheet version of this
table. Available from: http://www.cdc.gov/nchs/hus.htm. Data for additional years are available. See the Excel spreadsheet on the Health, United States website at:
http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC/NCHS, National Health and Nutrition Examination Survey, Hispanic Health and Nutrition Examination Survey (1982–1984), and National Health
Examination Survey (1963–1965 and 1966–1970). See Appendix I, National Health and Nutrition Examination Survey (NHANES).
Sex
Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23.6 23.7 17.6 18.9 32.8 27.0 28.4 29.0
Female . . . . . . . . . . . . . . . . . . . . . . . . . . 25.0 21.3 15.5 16.1 26.4 24.9 21.8 25.9
Below 100% . . . ...... . . . . . . . . . . . . 39.0 31.9 25.4 24.6 47.8 42.4 39.8 40.2
100%–199%. . . ...... . . . . . . . . . . . . 29.6 29.7 19.3 21.6 43.7 36.7 37.7 38.0
200%–399%. . . ...... . . . . . . . . . . . . 16.6 18.0 14.7 15.4 24.5 24.9 22.3 22.0
400% or more . ...... . . . . . . . . . . . . *10.4 8.9 9.3 *4.8 12.5 9.8 12.4 *11.3
Sex
Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28.5 24.0 25.4 31.7 31.2 21.8 25.1 20.8
Female . . . . . . . . . . . . . . . . . . . . . . . . . . 22.6 16.5 18.0 20.3 24.1 15.7 15.6 17.3
Below 100% . . . ...... . . . . . . . . . . . . 49.5 39.3 47.6 51.6 46.8 30.5 41.3 39.5
100%–199%. . . ...... . . . . . . . . . . . . 42.5 35.9 37.7 41.0 37.6 25.3 22.5 33.1
200%–399%. . . ...... . . . . . . . . . . . . 25.0 24.8 27.6 28.1 24.1 15.6 16.6 *12.2
400% or more . ...... . . . . . . . . . . . . 13.0 9.6 10.0 11.7 15.6 11.1 13.1 *
* Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error (RSE) of 20%–30%. Data not shown have an RSE of greater than 30%.
1
Persons of Mexican origin may be of any race. Starting with 1999 data, race-specific estimates are tabulated according to the 1997 Revisions to the Standards for the
Classification of Federal Data on Race and Ethnicity and are not strictly comparable with estimates for earlier years. The two non-Hispanic race categories shown in the table
conform to the 1997 Standards. Starting with 1999 data, race-specific estimates are for persons who reported only one racial group. Prior to data year 1999, estimates were
tabulated according to the 1977 Standards. Estimates for single-race categories prior to 1999 included persons who reported one race or, if they reported more than one race,
identified one race as best representing their race. See Appendix II, Hispanic origin; Race.
2
Includes persons of all races and Hispanic origins, not just those shown separately, and those with unknown percent of poverty level.
3
Percent of poverty level was calculated by dividing family income by the U.S. Department of Health and Human Services’ poverty guideline specific to family size, as well as
the appropriate year, and state. Persons with unknown percent of poverty level are excluded (6% in 2011–2012). See Appendix II, Family income; Poverty.
NOTES: Untreated dental caries refers to decay on the crown or enamel surface of a tooth (i.e., coronal caries) that has not been treated or filled. Decay in the root
(i.e., root caries) was not included. The presence of caries was evaluated in primary and permanent teeth for persons aged 5 and older. The third molars were not
included. Persons without at least one natural tooth (primary or permanent) were classified as edentulous (without any teeth) and were excluded. The majority of
edentulous persons are aged 65 and over. Estimates of edentulism among persons aged 65 and over are 33% in 1988–1994 23% in 2005–2008, and 19% in
2011–2012. Over time, there have been changes in the NHANES oral health examination process, ages examined, and methodology. Therefore, data trends need to be
interpreted with caution. For more information on the methodology changes, see Appendix II, Dental caries. Standard errors are available in the spreadsheet version of
this table. Available from: http://www.cdc.gov/nchs/hus.htm. Data for additional years are available. See the Excel spreadsheet on the Health, United States website at:
http://www.cdc.gov/nchs/hus.htm. The data have been revised and differ from previous editions of Health, United States.
SOURCE: CDC/NCHS, National Health and Nutrition Examination Survey. See Appendix I, National Health and Nutrition Examination Survey (NHANES).
All children 3 . . . . . . . . . . . . . . . . . . . . . . . . . . 7.7 6.9 4.1 5.2 4.6 2.6 9.0 8.0 4.8
Sex
Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.1 6.7 4.2 5.3 4.5 2.6 9.6 7.8 5.0
Female. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.3 7.1 3.9 5.0 4.7 2.6 8.5 8.2 4.6
Race 4
White only . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.0 6.3 4.1 4.7 4.4 2.7 8.3 7.2 4.7
Black or African American only . . . . . . . . . . . . . 10.3 7.7 3.8 7.6 4.4 *1.6 11.9 9.1 4.9
American Indian or Alaska Native only . . . . . . . *9.3 *9.4 *5.0 * * * *8.7 *9.4 *
Asian only . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.7 10.0 5.3 *3.4 *5.8 *3.8 13.5 12.2 6.1
Native Hawaiian or Other Pacific
Islander only . . . . . . . . . . . . . . . . . . ....... -- * * -- * * -- * *
2 or more races . . . . . . . . . . . . . . . . ....... -- *4.9 3.4 -- * * -- *7.2 4.2
Geographic region
Northeast . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.1 2.8 1.7 2.9 2.3 *1.5 4.8 3.0 1.8
Midwest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.2 5.3 3.3 4.1 3.7 *2.4 5.9 6.0 3.7
South . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.9 8.5 4.9 7.3 5.8 3.0 12.7 9.8 5.8
West . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.6 9.7 5.3 5.3 5.7 2.8 10.6 11.7 6.5
Location of residence 7
Within MSA . . . . . . . . . . . . . . . . . . . . . . . . . . 7.7 6.8 4.1 5.0 4.7 2.6 9.2 7.8 4.9
Outside MSA . . . . . . . . . . . . . . . . . . . . . . . . . 7.8 7.4 3.8 6.0 4.2 *2.5 8.7 8.7 4.4
* Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error (RSE) of 20%–30%. Data not shown have an RSE greater than 30%.
- - - Data not available.
1
Data prior to 1997 are not strictly comparable with data for later years due to the 1997 questionnaire redesign. See Appendix I, National Health Interview Survey (NHIS).
2
Persons who report the emergency department as their usual source of care are defined as having no usual source of care. See Appendix II, Usual source of care.
3
Includes all other races not shown separately and unknown health insurance status.
4
The race groups, white, black, American Indian or Alaska Native, Asian, Native Hawaiian or Other Pacific Islander, and 2 or more races, include persons of Hispanic and
non-Hispanic origin. Persons of Hispanic origin may be of any race. Starting with 1999 data, race-specific estimates are tabulated according to the 1997 Revisions to the
Standards for the Classification of Federal Data on Race and Ethnicity and are not strictly comparable with estimates for earlier years. The five single-race categories plus
multiple-race categories shown in the table conform to the 1997 Standards. Starting with 1999 data, race-specific estimates are for persons who reported only one racial group;
the category 2 or more races includes persons who reported more than one racial group. Prior to 1999, data were tabulated according to the 1977 Standards with four racial
groups, and the Asian only category included Native Hawaiian or Other Pacific Islander. Estimates for single-race categories prior to 1999 included persons who reported one
race or, if they reported more than one race, identified one race as best representing their race. Starting with 2003 data, race responses of other race and unspecified multiple
race were treated as missing, and then race was imputed if these were the only race responses. Almost all persons with a race response of other race were of Hispanic origin.
See Appendix II, Hispanic origin; Race.
5
Percent of poverty level is based on family income and family size and composition using U.S. Census Bureau poverty thresholds. Missing family income data were imputed
starting in 1993. See Appendix II, Family income; Poverty; Table VI.
6
Health insurance categories are mutually exclusive. Persons who reported both Medicaid and private coverage are classified as having private coverage. Medicaid includes
other public assistance through 1996. Starting with 1997 data, state-sponsored health plan coverage is included as Medicaid coverage. Starting with 1999 data, coverage by
the Children’s Health Insurance Program (CHIP) is included with Medicaid coverage. In addition to private and Medicaid, the insured category also includes military, other
government, and Medicare coverage. Persons not covered by private insurance, Medicaid, CHIP, public assistance (through 1996), state-sponsored or other
government-sponsored health plans (starting in 1997), Medicare, or military plans are considered to have no health insurance coverage. Persons with only Indian Health
Service coverage are considered to have no health insurance coverage. Health insurance status was unknown for 8%–9% of children in 1993–1996 and about 1% in
1997–2013. See Appendix II, Health insurance coverage.
7
MSA is metropolitan statistical area. Starting with 2005–2006 data, MSA status is determined using 2000 census data and the 2000 standards for defining MSAs. For data
prior to 2005, see Appendix II, Metropolitan statistical area (MSA) for the applicable standards.
NOTES: Standard errors are available in the spreadsheet version of this table. Available from: http://www.cdc.gov/nchs/hus.htm. Data for additional years are available.
See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC/NCHS, National Health Interview Survey, access to care and health insurance supplements (1993–1996). Starting in 1997, data are from the family
core and sample child questionnaires. See Appendix I, National Health Interview Survey (NHIS).
Sex
Male. . . . . . . . . . . . . . . . . . . . . . . . . . . 23.9 24.1 21.6 22.5 23.9 23.9 25.9 24.5
Female . . . . . . . . . . . . . . . . . . . . . . . . . 14.1 11.8 11.4 12.4 13.0 13.1 14.8 15.1
Race 4
White only. . . . . . . . . . . . . . . . . . . . . . . 18.4 16.7 15.4 17.0 18.1 18.0 19.7 19.2
Black or African American only . . . . . . . . 20.0 19.2 16.9 18.4 19.8 20.5 22.4 21.4
American Indian or Alaska Native only . . . 19.7 19.2 16.3 21.5 21.9 24.4 26.7 26.6
Asian only. . . . . . . . . . . . . . . . . . . . . . . 24.8 22.1 20.1 19.3 17.9 17.8 20.8 19.9
Native Hawaiian or Other Pacific
Islander only . . . . . . . . . . . . . . . . . . .. -- * * * * * * *
2 or more races. . . . . . . . . . . . . . . . . .. -- 21.0 20.1 18.4 20.9 21.4 27.5 23.5
American Indian or Alaska Native;
White . . . . . . . . . . . . . . . . . . . . . .. -- 25.8 18.1 17.8 21.4 20.9 27.1 19.7
4
Hispanic origin and race
Hispanic or Latino . . . . . . . . . . . . . . . . . 30.3 32.6 32.5 32.9 35.1 32.5 33.3 32.6
Mexican. . . . . . . . . . . . . . . . . . . . . . . 32.4 36.5 36.5 36.4 39.3 36.6 35.7 34.5
Not Hispanic or Latino . . . . . . . . . . . . . . 17.7 15.8 14.0 14.9 15.6 16.0 17.9 17.1
White only . . . . . . . . . . . . . . . . . . . . . 17.1 14.9 13.1 14.0 14.8 15.1 16.8 16.0
Black or African American only. . . . . . . 19.7 19.2 16.8 18.1 19.2 20.2 22.2 21.3
Percent of poverty level 5
Below 100% . . . . . . . . . . . . . . . . . . . . . 29.5 29.6 29.3 28.9 32.1 30.4 33.8 32.9
100%–199% . . . . . . . . . . . . . . . . . . . . . 25.4 27.1 25.6 26.6 27.8 29.1 30.5 29.4
200%–399% . . . . . . . . . . . . . . . . . . . . . 15.6 17.2 16.0 17.3 17.8 18.9 20.5 19.3
400% or more . . . . . . . . . . . . . . . . . . . . 13.4 11.6 9.6 10.1 10.4 10.2 10.8 10.1
Hispanic origin and race and
percent of poverty level 4,5
Hispanic or Latino:
Below 100% . . . . . . . . . . . . . . . . . . . 40.0 44.4 46.3 42.8 46.7 43.7 45.5 43.5
100%–199% . . . . . . . . . . . . . . . . . . . 36.9 40.6 40.0 39.7 41.8 40.6 39.7 37.7
200%–399% . . . . . . . . . . . . . . . . . . . 20.7 26.9 27.9 28.2 31.2 28.0 29.1 28.8
400% or more . . . . . . . . . . . . . . . . . . 13.8 16.1 13.7 16.4 16.4 16.9 14.0 15.1
Not Hispanic or Latino:
White only:
Below 100% . . . . . . . . . . . . . . . . . . 28.2 24.2 23.4 23.0 26.2 25.2 28.8 28.9
100%–199% . . . . . . . . . . . . . . . . . . 23.3 23.0 20.7 22.0 23.5 24.9 26.6 25.5
200%–399% . . . . . . . . . . . . . . . . . . 14.8 15.3 13.6 15.4 15.3 16.7 18.6 16.8
400% or more. . . . . . . . . . . . . . . . . 13.4 11.2 9.1 9.4 9.8 9.5 10.3 9.5
Black or African American only:
Below 100% . . . . . . . . . . . . . . . . . . 24.7 23.7 22.8 24.3 29.5 27.1 30.1 28.3
100%–199% . . . . . . . . . . . . . . . . . . 22.3 24.4 20.4 22.8 22.6 25.7 28.5 27.3
200%–399% . . . . . . . . . . . . . . . . . . 16.5 18.2 16.2 16.3 16.2 19.7 20.1 19.7
400% or more. . . . . . . . . . . . . . . . . 11.7 12.0 9.6 11.3 10.3 10.2 10.5 9.7
Location of residence 8
Within MSA. . . . . . . . . . . . . . . . . . . . . . 19.3 18.1 16.6 17.6 18.7 18.7 20.3 19.9
Outside MSA. . . . . . . . . . . . . . . . . . . . . 17.5 16.8 15.4 16.2 16.7 16.9 20.4 18.4
NOTES: Standard errors are available in the spreadsheet version of this table. Available from: http://www.cdc.gov/nchs/hus.htm. Data for additional years are available.
See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC/NCHS, National Health Interview Survey, access to care and health insurance supplements (1993–1996). Starting in 1997, data are from the family
core and sample adult questionnaires. See Appendix I, National Health Interview Survey (NHIS).
Characteristic 1997 2003 2010 2013 1997 2003 2010 2013 1997 2003 2010 2013
Percent
Total 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.3 8.3 10.9 9.1 4.8 6.3 8.3 6.4 8.6 9.2 13.5 11.1
Age
Under 19 years. . . . . . . . . . . . . . . . . . . . . . . 4.5 4.3 4.5 3.2 2.1 2.7 2.8 2.2 6.0 5.7 6.6 5.3
Under 18 years. . . . . . . . . . . . . . . . . . . . . . . 4.4 4.3 4.4 3.1 2.2 2.7 2.7 2.0 6.0 5.6 6.6 4.9
Under 6 years . . . . . . . . . . . . . . . . . . . . . . 3.3 3.4 3.7 2.2 1.6 2.1 2.5 1.7 3.9 3.0 3.9 2.7
6–17 years . . . . . . . . . . . . . . . . . . . . . . . . 4.9 4.7 4.8 3.5 2.4 3.0 2.8 2.2 6.8 6.5 7.5 5.7
18–64 years . . . . . . . . . . . . . . . . . . . . . . . . . 10.7 10.6 14.7 12.4 6.3 8.1 11.2 8.8 10.6 11.5 17.3 14.3
18–44 years . . . . . . . . . . . . . . . . . . . . . . . 11.0 10.8 14.5 11.9 6.9 8.4 11.2 8.2 11.7 12.3 17.9 14.2
18–24 years. . . . . . . . . . . . . . . . . . . . . . 10.2 10.7 13.5 10.1 6.7 7.8 9.7 7.2 11.6 11.8 17.4 11.4
25–34 years. . . . . . . . . . . . . . . . . . . . . . 11.4 11.4 15.3 13.0 6.9 9.2 12.0 9.3 12.3 13.2 18.3 16.0
35–44 years. . . . . . . . . . . . . . . . . . . . . . 11.0 10.4 14.4 12.1 7.1 8.0 11.3 8.0 11.2 11.8 17.8 14.3
19–25 years . . . . . . . . . . . . . . . . . . . . . . . 11.1 11.6 14.8 11.2 7.7 12.8 10.9 7.6 13.1 12.8 18.9 11.8
45–64 years . . . . . . . . . . . . . . . . . . . . . . . 10.1 10.3 14.9 13.2 5.1 7.6 11.3 9.6 8.4 10.2 16.5 14.5
45–54 years. . . . . . . . . . . . . . . . . . . . . . 10.6 10.4 15.0 13.4 5.6 8.1 11.5 10.3 9.4 11.2 17.8 15.1
55–64 years. . . . . . . . . . . . . . . . . . . . . . 9.3 10.1 14.6 13.0 4.2 6.9 11.0 8.8 7.0 8.9 14.9 13.8
65 years and over. . . . . . . . . . . . . . . . . . . . . 4.6 4.5 5.0 4.2 2.8 4.4 4.7 3.4 3.5 4.0 6.9 6.4
65–74 years . . . . . . . . . . . . . . . . . . . . . . . 5.0 5.1 6.3 4.9 3.4 5.5 6.3 4.1 4.2 5.3 9.0 7.5
75 years and over . . . . . . . . . . . . . . . . . . . 4.1 3.8 3.4 3.2 2.0 3.1 2.8 2.4 2.6 2.4 4.3 4.9
18–64 years
Sex
Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.3 9.7 13.5 11.2 5.1 6.3 8.8 6.9 8.8 9.8 15.2 12.3
Female . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.0 11.5 15.7 13.6 7.4 9.8 13.5 10.6 12.4 13.1 19.4 16.2
Race 5
White only . . . . . . . . . . . . . . . . . . . . . . . . . . 10.8 10.8 14.5 12.3 5.9 7.8 10.8 8.5 10.6 11.4 17.1 14.2
Black or African American only . . . . . . . . . . . . 10.8 10.8 17.4 14.6 9.5 10.8 15.6 11.6 10.8 12.9 20.7 16.5
American Indian or Alaska Native only . . . . . . 14.5 15.1 *15.7 15.2 *10.1 *14.0 18.6 *11.3 18.8 *16.0 23.1 13.5
Asian only . . . . . . . . . . . . . . . . . . . . . . . . . . 6.3 4.9 8.0 7.3 *2.8 3.1 4.2 3.9 7.8 5.6 8.7 9.0
Native Hawaiian or Other Pacific
Islander only. . . . . . . . . . . . . . . . . . ...... -- * * * -- * * * -- * * *
2 or more races . . . . . . . . . . . . . . . . ...... -- 18.9 24.0 19.8 -- 14.9 16.6 14.8 -- 18.5 25.6 19.5
Education 6
No high school diploma or GED . . . . . . . . . . . 16.2 15.7 20.6 18.1 11.5 13.4 18.1 14.4 14.5 15.8 26.3 22.1
High school diploma or GED . . . . . . . . . . . . . 11.1 11.4 16.1 14.8 7.0 9.5 13.8 10.9 11.4 13.0 20.1 17.0
Some college or more . . . . . . . . . . . . . . . . . . 9.2 9.4 13.4 11.2 4.3 6.3 9.2 7.4 8.8 9.7 14.4 12.7
Characteristic 1997 2003 2010 2013 1997 2003 2010 2013 1997 2003 2010 2013
Characteristic 1997 2003 2010 2013 1997 2003 2010 2013 1997 2003 2010 2013
Geographic region
Northeast . . . .............. . . . . . . . . . . 8.8 8.1 10.2 9.0 4.9 6.8 7.7 6.4 8.9 9.5 12.9 10.4
Midwest . . . . .............. . . . . . . . . . . 10.5 10.5 14.8 12.1 5.9 6.9 11.6 8.5 9.7 10.5 16.0 12.5
South . . . . . .............. . . . . . . . . . . 11.8 11.9 16.5 13.6 7.3 9.3 13.5 10.4 10.9 12.4 19.6 15.3
West . . . . . . .............. . . . . . . . . . . 10.8 10.8 15.1 13.6 6.3 8.6 10.0 8.4 13.1 13.1 18.4 17.4
Location of residence10
Within MSA . . . . . . . . . . . . . . . . . . . . . . . . . 10.2 10.0 14.2 12.1 5.9 7.5 10.8 8.5 10.0 10.9 17.0 14.0
Outside MSA . . . . . . . . . . . . . . . . . . . . . . . . 12.5 13.1 17.4 14.6 7.9 10.6 13.6 10.8 12.9 13.9 19.1 15.9
* Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error (RSE) of 20%–30%. Data not shown have an RSE greater than 30%.
1
Based on persons responding to the questions, ‘‘During the past 12 months was there any time when person needed medical care but did not get it because person couldn’t
afford it?’’ and ‘‘During the past 12 months has medical care been delayed because of worry about the cost?’’
2
Based on persons responding to the question, ‘‘During the past 12 months was there any time when person needed prescription medicine but didn’t get it because person
3
Based on persons responding to the question, ‘‘During the past 12 months was there any time when person needed dental care (including checkups) but didn’t get it because
4
Includes all other races not shown separately, unknown health insurance status, unknown education level, and unknown disability status.
5
The race groups, white, black, American Indian or Alaska Native, Asian, Native Hawaiian or Other Pacific Islander, and 2 or more races, include persons of Hispanic and
non-Hispanic origin. Persons of Hispanic origin may be of any race. Starting with 1999 data, race-specific estimates are tabulated according to the 1997 Revisions to the
Standards for the Classification of Federal Data on Race and Ethnicity and are not strictly comparable with estimates for earlier years. The five single-race categories plus
multiple-race categories shown in the table conform to the 1997 Standards. Starting with 1999 data, race-specific estimates are for persons who reported only one racial group;
the category 2 or more races includes persons who reported more than one racial group. Prior to 1999, data were tabulated according to the 1977 Standards with four racial
groups, and the Asian only category included Native Hawaiian or Other Pacific Islander. Estimates for single-race categories prior to 1999 included persons who reported one
race or, if they reported more than one race, identified one race as best representing their race. Starting with 2003 data, race responses of other race and unspecified multiple
race were treated as missing, and then race was imputed if these were the only race responses. Almost all persons with a race response of other race were of Hispanic origin.
6
Estimates are for persons aged 25–64. GED is General Educational Development high school equivalency diploma. See Appendix II, Education.
7
Percent of poverty level is based on family income and family size and composition using U.S. Census Bureau poverty thresholds. Missing family income data were imputed
for 1997 and beyond. See Appendix II, Family income; Poverty; Table VI.
8
For information on the health insurance categories, see Appendix II, Health insurance coverage.
9
Any basic actions difficulty or complex activity limitation is defined as having one or more of the following limitations or difficulties: movement difficulty, emotional difficulty,
sensory (seeing or hearing) difficulty, cognitive difficulty, self-care (activities of daily living or instrumental activities of daily living) limitation, social limitation, or work limitation.
For more information, see Appendix II, Basic actions difficulty; Complex activity limitation. Starting with 2007 data, the hearing question, a component of the basic actions
difficulty measure, was revised. Consequently, data prior to 2007 are not comparable with data for 2007 and beyond. For more information on the impact of the revised hearing
10
MSA is metropolitan statistical area. Starting with 2006 data, MSA status is determined using 2000 census data and the 2000 standards for defining MSAs. For data prior to
2006, see Appendix II, Metropolitan statistical area (MSA) for the applicable standards.
NOTES: Standard errors and additional data years are available in the spreadsheet version of this table. Available from: http://www.cdc.gov/nchs/hus.htm. Data for
additional years are available. See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC/NCHS, National Health Interview Survey, family core, sample child, and sample adult questionnaires. See Appendix I, National Health Interview Survey
(NHIS).
Sex
Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.9 12.3 8.8 4.9 6.4 4.9 16.8 15.1 10.7
Female . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.7 11.9 8.7 6.5 6.1 5.0 15.8 14.6 10.6
Race 3
White only . . . . . . . . . . . . . . . . . . . . . . . . . . 12.2 11.5 9.0 5.5 6.4 4.9 15.5 13.9 10.9
Black or African American only . . . . . . . . . . . . 14.3 13.3 8.1 6.5 5.9 5.3 18.1 16.8 9.5
American Indian or Alaska Native only . . . . . . 13.8 *18.6 *6.8 * * * *17.6 *23.0 *8.7
Asian only . . . . . . . . . . . . . . . . . . . . . . . . . . 16.3 15.6 9.9 *5.6 *6.8 *4.9 22.1 20.5 12.2
Native Hawaiian or Other Pacific
Islander only. . . . . . . . . . . . . . . . . . ...... -- * * -- * * -- * *
2 or more races . . . . . . . . . . . . . . . . ...... -- 8.3 7.5 -- *3.3 *4.4 -- 12.4 9.3
insurance status prior to interview 4,5 Percent of children without a health care visit 1
Below 100%:
Insured continuously all 12 months . . . . . . . 12.6 11.7 8.9 5.7 6.1 6.6 17.6 14.9 10.3
Uninsured for any period up to 12 months . . 19.9 21.8 11.4 *9.9 *14.4 * 26.1 26.6 14.1
Uninsured more than 12 months . . . . . . . . . 39.9 48.2 42.0 24.9 *28.0 *31.2 45.2 55.7 45.0
100%–199%:
Insured continuously all 12 months . . . . . . . 12.6 10.9 8.2 4.8 4.2 4.5 16.7 14.5 10.0
Uninsured for any period up to 12 months . . 15.6 18.9 15.5 *8.7 *10.7 * 20.2 23.2 19.5
Uninsured more than 12 months . . . . . . . . . 33.7 41.3 37.7 21.3 35.4 * 37.9 43.6 40.9
200%–399%:
Insured continuously all 12 months . . . . . . . 10.5 10.0 7.8 4.5 4.6 3.9 13.2 12.4 9.6
Uninsured for any period up to 12 months . . 12.8 14.5 10.8 * *7.1 * 17.2 18.7 14.1
Uninsured more than 12 months . . . . . . . . . 29.9 30.8 27.2 *11.8 *24.2 * 36.5 32.9 30.7
400% or more:
Insured continuously all 12 months . . . . . . . 7.0 7.2 5.3 2.9 3.9 2.7 8.8 8.7 6.4
Uninsured for any period up to 12 months . . *10.8 *11.4 * * * * *15.1 *14.1 *
Uninsured more than 12 months . . . . . . . . . *28.8 *38.4 *30.3 * * * *37.7 *40.3 *34.0
Geographic region
Northeast . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.0 6.0 5.8 3.1 3.9 4.2 8.9 6.9 6.5
Midwest . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.2 10.3 8.3 5.9 5.1 3.1 15.3 12.8 10.9
South . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14.3 14.0 9.2 5.6 7.0 5.9 18.5 17.4 10.8
West . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.3 16.0 10.7 7.9 8.1 5.7 20.7 20.0 13.1
Location of residence 6
Within MSA . . . . . . . . . . . . . . . . . . . . . . . . . 12.3 11.7 8.3 5.4 6.1 4.6 15.9 14.5 10.2
Outside MSA . . . . . . . . . . . . . . . . . . . . . . . . 14.6 13.5 11.3 6.9 6.9 *7.0 17.9 16.3 13.4
* Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error (RSE) of 20%–30%. Data not shown have an RSE greater than 30%.
- - - Data not available.
1
Respondents were asked how many times a doctor or other health care professional was seen in the past 12 months at a doctor’s office, clinic, or some other place.
Excluded are visits to emergency rooms, hospitalizations, home visits, and telephone calls. Starting with 2000 data, dental visits were also excluded. See Appendix II, Health
care contact.
2
Includes all other races not shown separately and unknown health insurance status.
3
The race groups, white, black, American Indian or Alaska Native, Asian, Native Hawaiian or Other Pacific Islander, and 2 or more races, include persons of Hispanic and
non-Hispanic origin. Persons of Hispanic origin may be of any race. Starting with 1999 data, race-specific estimates are tabulated according to the 1997 Revisions to the
Standards for the Classification of Federal Data on Race and Ethnicity and are not strictly comparable with estimates for earlier years. The five single-race categories plus
multiple-race categories shown in the table conform to the 1997 Standards. Starting with 1999 data, race-specific estimates are for persons who reported only one racial group;
the category 2 or more races includes persons who reported more than one racial group. Prior to 1999, data were tabulated according to the 1977 Standards with four racial
groups, and the Asian only category included Native Hawaiian or Other Pacific Islander. Estimates for single-race categories prior to 1999 included persons who reported one
race or, if they reported more than one race, identified one race as best representing their race. Starting with 2003 data, race responses of other race and unspecified multiple
race were treated as missing, and then race was imputed if these were the only race responses. Almost all persons with a race response of other race were of Hispanic origin.
See Appendix II, Hispanic origin; Race.
4
Percent of poverty level is based on family income and family size and composition using U.S. Census Bureau poverty thresholds. Missing family income data were imputed
starting in 1997. See Appendix II, Family income; Poverty; Table VI.
5
Health insurance categories are mutually exclusive. Persons who reported both Medicaid and private coverage are classified as having private coverage. Starting with 1997
data, state-sponsored health plan coverage is included as Medicaid coverage. Starting with 1999 data, coverage by the Children’s Health Insurance Program (CHIP) is
included with Medicaid coverage. In addition to private and Medicaid, the insured category also includes military, other government, and Medicare coverage. Persons not
covered by private insurance, Medicaid, CHIP, state-sponsored or other government-sponsored health plans (starting in 1997), Medicare, or military plans are considered to
have no health insurance coverage. Persons with only Indian Health Service coverage are considered to have no health insurance coverage. See Appendix II, Health
insurance coverage.
6
MSA is metropolitan statistical area. Starting with 2005–2006 data, MSA status is determined using 2000 census data and the 2000 standards for defining MSAs. For data
prior to 2005, see Appendix II, Metropolitan statistical area (MSA) for the applicable standards.
NOTES: In 1997, the National Health Interview Survey questionnaire was redesigned. See Appendix I, National Health Interview Survey (NHIS). Standard errors for
selected years are available in the spreadsheet version of this table. Available from: http://www.cdc.gov/nchs/hus.htm. Data for additional years are available. See the
Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC/NCHS, National Health Interview Survey, family core and sample child questionnaires. See Appendix I, National Health Interview Survey (NHIS).
Characteristic 1997 2010 2013 1997 2010 2013 1997 2010 2013 1997 2010 2013
Percent distribution
Total, age-adjusted 2,3 . . . . . . . . . . . . . . . . . . . . . 16.5 15.6 16.1 46.2 45.4 47.6 23.6 25.8 24.0 13.7 13.2 12.3
Total, crude 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.5 15.4 15.8 46.5 45.2 47.0 23.5 26.0 24.5 13.5 13.5 12.7
Age
Under 18 years . . . . . . . . . . . . . . . . . . . . . . . . . 11.8 8.1 8.2 54.1 55.6 59.7 25.2 28.2 25.1 8.9 8.2 7.1
Under 6 years . . . . . . . . . . . . . . . . . . . . . . . . 5.0 3.7 4.7 44.9 48.9 49.6 37.0 36.8 37.1 13.0 10.6 8.6
6–17 years . . . . . . . . . . . . . . . . . . . . . . . . . . 15.3 10.4 9.9 58.7 59.1 64.5 19.3 23.6 19.3 6.8 6.9 6.3
18–44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . 21.7 24.2 24.8 46.7 43.9 45.9 19.0 20.6 18.5 12.6 11.3 10.7
18–24 years. . . . . . . . . . . . . . . . . . . . . . . . . . 22.0 25.9 26.9 46.8 43.4 46.8 20.0 21.1 17.5 11.2 9.6 8.8
25–44 years. . . . . . . . . . . . . . . . . . . . . . . . . . 21.6 23.6 24.0 46.7 44.1 45.6 18.7 20.5 18.9 13.0 11.9 11.5
45–64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.9 14.8 15.2 42.9 42.8 43.0 24.7 26.1 26.7 15.5 16.4 15.0
45–54 years. . . . . . . . . . . . . . . . . . . . . . . . . . 17.9 17.6 17.2 43.9 43.5 44.2 23.4 23.9 25.2 14.8 15.0 13.4
55–64 years. . . . . . . . . . . . . . . . . . . . . . . . . . 15.3 11.1 13.1 41.3 41.9 41.6 26.7 28.8 28.5 16.7 18.2 16.8
65 years and over . . . . . . . . . . . . . . . . . . . . . . . 8.9 5.3 6.4 34.7 33.8 35.9 32.5 36.7 34.4 23.8 24.2 23.2
65–74 years. . . . . . . . . . . . . . . . . . . . . . . . . . 9.8 6.3 7.8 36.9 36.1 37.4 31.6 35.7 33.7 21.6 21.9 21.0
75 years and over . . . . . . . . . . . . . . . . . . . . . 7.7 4.1 4.5 31.8 31.0 33.7 33.8 38.0 35.4 26.6 27.0 26.3
Sex 3
Male. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21.3 20.4 21.0 47.1 46.4 47.7 20.6 22.7 21.2 11.0 10.5 10.1
Female . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.8 10.9 11.4 45.4 44.4 47.5 26.5 28.8 26.7 16.3 15.9 14.4
Race 3,4
White only. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.0 15.3 16.1 46.1 44.9 47.3 23.9 26.1 24.0 14.0 13.7 12.7
Black or African American only . . . . . . . . . . . . . . 16.8 15.7 15.2 46.1 47.2 47.6 23.2 24.7 25.7 13.9 12.4 11.5
American Indian or Alaska Native only . . . . . . . . . 17.1 19.4 16.1 38.0 40.3 43.2 24.2 28.1 28.3 20.7 12.2 12.4
Asian only. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22.8 20.4 18.4 49.1 49.9 53.1 19.7 22.1 21.3 8.3 7.6 7.2
Native Hawaiian or Other Pacific
Islander only . . . . . . . . . . . . . . . . . . ........ -- * * -- * * -- * * -- * *
2 or more races. . . . . . . . . . . . . . . . . ........ -- 13.9 15.8 -- 42.3 42.6 -- 25.2 24.9 -- 18.6 16.8
Characteristic 1997 2010 2013 1997 2010 2013 1997 2010 2013 1997 2010 2013
Characteristic 1997 2010 2013 1997 2010 2013 1997 2010 2013 1997 2010 2013
Any basic actions difficulty. . . . . . . . . . . . . . . . 11.1 11.5 11.9 31.9 30.3 28.1 27.5 29.2 30.9 29.4 29.0 29.1
Any complex activity limitation . . . . . . . . . . . . . 7.1 6.9 8.7 23.7 23.0 21.5 27.5 29.1 29.2 41.7 41.0 40.7
No disability . . . . . . . . . . . . . . . . . . . . . . . . . . . 20.9 20.5 21.4 49.6 47.5 49.8 20.8 23.4 21.5 8.7 8.5 7.3
Geographic region 3
Northeast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13.2 12.6 12.4 45.9 46.3 48.9 26.0 26.4 26.3 14.9 14.7 12.4
Midwest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15.9 13.4 14.9 47.7 46.8 48.8 22.8 26.4 23.2 13.6 13.3 13.1
South . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17.2 16.1 16.7 46.1 44.2 46.2 23.3 26.6 24.8 13.5 13.2 12.3
West . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19.1 19.1 19.1 44.8 45.2 47.6 22.8 23.5 21.8 13.3 12.2 11.6
Outside MSA. . . . . . . . . . . . . . . . . . . . . . . . . . . 17.3 15.9 17.6 45.4 42.7 44.5 23.3 27.0 24.8 13.9 14.4 13.1
NOTES: In 1997, the National Health Interview Survey questionnaire was redesigned. See Appendix I, National Health Interview Survey (NHIS). Standard errors are
available in the spreadsheet version of this table. See http://www.cdc.gov/nchs/hus.htm. Data for additional years are available. See the Excel spreadsheet on the
Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC/NCHS, National Health Interview Survey, family core and sample adult questionnaires. See Appendix I, National Health Interview Survey (NHIS).
American Native At or
Vaccination African Alaska Other Pacific more Hispanic poverty poverty Central Remaining Outside
and year All White American Native Asian 4 Islander 4 races or Latino level level city area MSA 3
2009 . . . . . . . . . . . . . . . . . . 44 45 40 * 39 * 41 46 41 46 45 45 42
2010 . . . . . . . . . . . . . . . . . . 57 57 55 64 59 * 61 56 53 59 57 57 55
2011 . . . . . . . . . . . . . . . . . . 69 69 64 66 71 * 71 70 64 72 70 68 67
2012 . . . . . . . . . . . . . . . . . . 68 69 65 * 72 * 72 68 63 72 67 69 68
2013 . . . . . . . . . . . . . . . . . . 70 72 65 70 73 * 72 69 64 74 69 73 69
DTP/DT/DTaP (4 doses or
more): 6
1995 . . . . . . . . . . . . . . . . . . 78 80 74 71 84 * --- 75 71 81 77 79 78
2000 . . . . . . . . . . . . . . . . . . 82 84 76 75 85 * --- 79 76 84 80 83 83
2005 . . . . . . . . . . . . . . . . . . 86 87 84 * 89 * 86 84 82 87 85 87 85
2006 . . . . . . . . . . . . . . . . . . 85 87 81 83 86 * 84 85 81 87 84 86 85
2007 . . . . . . . . . . . . . . . . . . 85 85 82 86 88 * 84 84 81 86 85 85 83
2008 . . . . . . . . . . . . . . . . . . 85 85 80 82 92 * 88 85 80 87 85 85 82
2009 . . . . . . . . . . . . . . . . . . 84 86 79 82 87 93 82 83 80 86 84 84 84
2010 . . . . . . . . . . . . . . . . . . 84 85 84 82 88 * 83 84 81 86 84 85 84
2011 . . . . . . . . . . . . . . . . . . 85 85 81 73 92 93 87 84 81 87 86 84 82
2012 . . . . . . . . . . . . . . . . . . 83 84 80 88 88 * 86 81 79 85 82 83 81
2013 . . . . . . . . . . . . . . . . . . 83 85 75 78 89 * 83 82 78 86 82 85 82
1995 . . . . . . . . . . . . . . . . . . 88 89 84 86 90 * --- 87 85 89 87 88 89
2000 . . . . . . . . . . . . . . . . . . 90 91 87 90 93 * --- 88 87 90 88 90 91
2005 . . . . . . . . . . . . . . . . . . 92 91 91 * 93 * 94 92 90 92 91 93 92
2006 . . . . . . . . . . . . . . . . . . 93 93 90 91 92 96 92 93 92 93 93 93 93
2007 . . . . . . . . . . . . . . . . . . 93 93 91 95 95 87 92 93 92 93 92 93 94
2008 . . . . . . . . . . . . . . . . . . 94 94 92 91 97 * 94 94 92 94 94 94 93
2009 . . . . . . . . . . . . . . . . . . 93 93 91 92 94 97 93 93 92 93 94 92 92
2010 . . . . . . . . . . . . . . . . . . 93 93 94 95 93 95 90 94 92 94 93 94 93
2011 . . . . . . . . . . . . . . . . . . 94 94 94 88 97 97 94 94 94 94 94 93 94
2012 . . . . . . . . . . . . . . . . . . 93 93 93 95 92 * 93 93 92 93 93 93 93
2013 . . . . . . . . . . . . . . . . . . 93 94 91 92 96 * 91 92 89 94 92 93 93
1995 . . . . . . . . . . . . . . . . . . 90 91 87 88 95 * --- 88 86 91 90 90 89
2000 . . . . . . . . . . . . . . . . . . 91 92 88 87 90 * --- 90 89 91 90 91 91
2005 . . . . . . . . . . . . . . . . . . 92 91 92 90 92 90 94 91 89 92 92 92 90
2006 . . . . . . . . . . . . . . . . . . 92 93 91 89 95 94 91 92 91 93 93 93 92
2007 . . . . . . . . . . . . . . . . . . 92 92 92 96 94 88 95 93 91 93 92 93 92
2008 . . . . . . . . . . . . . . . . . . 92 91 92 96 95 97 94 93 92 92 93 92 90
2009 . . . . . . . . . . . . . . . . . . 90 91 88 95 91 97 89 89 89 91 91 89 89
2010 . . . . . . . . . . . . . . . . . . 92 91 92 93 92 97 90 93 91 91 92 91 91
2011 . . . . . . . . . . . . . . . . . . 92 91 91 95 94 99 91 92 91 92 92 91 92
2012 . . . . . . . . . . . . . . . . . . 91 91 91 92 90 * 92 91 90 91 90 91 92
2013 . . . . . . . . . . . . . . . . . . 92 92 91 96 97 90 92 92 91 93 92 92 91
2009 . . . . . . . . . . . . . . . . . . 55 55 51 * 55 * 54 55 51 57 56 55 53
2010 . . . . . . . . . . . . . . . . . . 67 68 65 77 70 * 70 65 61 70 67 68 63
2011 . . . . . . . . . . . . . . . . . . 80 81 75 74 84 * 82 82 76 83 81 80 78
2012 . . . . . . . . . . . . . . . . . . 81 82 78 85 86 * 83 80 76 84 81 82 80
2013 . . . . . . . . . . . . . . . . . . 82 84 75 83 82 * 85 81 76 85 81 84 80
American Native At or
Vaccination African Alaska Other Pacific more Hispanic poverty poverty Central Remaining Outside
and year All White American Native Asian 4 Islander 4 races or Latino level level city area MSA 3
2008 . . . . . . . . . . . . . . . . . . 40 --- --- --- --- --- --- --- --- --- --- --- --
2009 . . . . . . . . . . . . . . . . . . 47 46 41 33 51 * 48 49 47 46 48 47 47
2010 . . . . . . . . . . . . . . . . . . 50 46 49 * 51 * 50 57 51 49 52 49 45
2011 . . . . . . . . . . . . . . . . . . 52 50 51 * 57 * 50 56 51 53 55 51 48
2012 . . . . . . . . . . . . . . . . . . 53 53 52 * 58 * 49 54 49 55 55 53 48
2013 . . . . . . . . . . . . . . . . . . 55 53 49 * 67 * 58 57 54 56 56 55 50
2005 . . . .. ............. 93 93 93 90 93 * 94 93 91 94 92 94 93
2006 . . . .. ............. 93 94 92 95 92 97 92 94 93 94 93 94 93
2007 . . . .. ............. 93 93 91 97 94 * 92 94 92 93 92 93 94
2008 . . . .. ............. 94 93 92 92 98 * 95 94 91 94 93 94 93
2009 . . . .. ............. 92 92 92 93 93 96 93 93 92 93 93 92 92
2010 . . . .. ............. 92 91 92 97 92 97 90 93 92 92 91 92 93
2011 . . . .. ............. 91 90 92 93 96 91 91 92 92 91 91 91 93
2012 . . . .. ............. 90 89 90 94 93 * 92 89 89 90 90 90 91
2013 . . . .. ............. 91 91 91 96 92 95 91 90 88 92 90 92 91
Varicella: 8
1998 . . . . . . . . . . . . . . . . . . 43 42 42 28 53 * --- 47 41 44 45 45 34
2000 . . . . . . . . . . . . . . . . . . 68 66 67 62 77 * --- 70 64 69 69 70 60
2005 . . . . . . . . . . . . . . . . . . 88 86 91 82 92 * 90 89 87 88 88 88 86
2006 . . . . . . . . . . . . . . . . . . 89 89 89 85 93 90 91 90 88 90 90 90 86
2007 . . . . . . . . . . . . . . . . . . 90 89 90 95 94 89 92 91 89 90 90 90 89
2008 . . . . . . . . . . . . . . . . . . 91 90 90 94 94 92 91 92 90 91 92 90 88
2009 . . . . . . . . . . . . . . . . . . 90 89 88 89 90 98 91 91 89 90 91 89 89
2010 . . . . . . . . . . . . . . . . . . 90 89 92 96 93 93 89 92 90 91 91 90 90
2011 . . . . . . . . . . . . . . . . . . 91 90 91 90 94 99 92 92 90 91 91 91 90
2012 . . . . . . . . . . . . . . . . . . 90 90 90 93 92 * 91 91 90 91 90 90 91
2013 . . . . . . . . . . . . . . . . . . 91 90 92 95 96 89 91 92 90 92 91 92 90
2005 . . . . . . . . . . . . . . . . . . 54 57 46 * 56 * 54 51 45 57 52 58 48
2006 . . . . . . . . . . . . . . . . . . 68 71 61 63 65 * 71 67 62 71 69 71 62
2007 . . . . . . . . . . . . . . . . . . 75 77 70 80 75 * 74 75 73 76 75 77 71
2008 . . . . . . . . . . . . . . . . . . 80 81 76 71 82 * 85 79 74 83 81 81 75
2009 . . . . . . . . . . . . . . . . . . 80 83 73 76 73 * 73 81 75 83 80 82 82
2010 . . . . . . . . . . . . . . . . . . 83 84 80 85 79 * 83 84 79 86 83 84 83
2011 . . . . . . . . . . . . . . . . . . 84 85 81 75 85 93 84 85 81 87 85 85 82
2012 . . . . . . . . . . . . . . . . . . 82 84 77 * 81 * 84 82 77 85 80 84 81
2013 . . . . . . . . . . . . . . . . . . 82 84 76 79 86 * 83 80 75 86 81 84 80
Rotavirus vaccine:10
2009 . . ........ . . . . . . . . 44 46 38 * 42 * 38 44 38 47 45 47 36
2010 . . ........ . . . . . . . . 59 60 53 * 63 * 58 61 52 63 59 62 52
2011 . . ........ . . . . . . . . 67 68 63 58 67 * 68 68 61 71 69 67 63
2012 . . ........ . . . . . . . . 69 71 60 * 70 * 69 70 63 73 69 71 63
2013 . . ........ . . . . . . . . 73 75 62 * 75 * 73 74 64 77 72 75 67
Black or
African Hispanic or
White American Latino
At or At or At or
Below above Below above Below above
Vaccination poverty poverty poverty poverty poverty poverty
and year level 2 level 2 level 2 level 2 level 2 level 2
NOTES: Final estimates from the National Immunization Survey include an adjustment for children with missing immunization provider data. Additional information on
childhood immunizations is available from: http://www.cdc.gov/vaccines/schedules/index.html. Data for additional years are available. See the Excel spreadsheet on the
Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC/NCHS and National Center for Immunization and Respiratory Diseases, National Immunization Survey. Available from:
http://www.cdc.gov/vaccines/imz-managers/coverage/imz-coverage.html and http://www.cdc.gov/nchs/nis.htm. See Appendix I, National Immunization Survey (NIS).
5 6
Race and Hispanic origin Poverty level Location of residence
American At or
Black or Indian or Below above
Vaccination African Alaska Hispanic poverty poverty Central Remaining Outside
coverage, 2013 White American Native Asian or Latino level level city area MSA 7
1
Varicella is chickenpox.
2
Tdap refers to tetanus toxoid-diphtheria vaccine (Td) or tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine (Tdap) or tetanus-unknown type
3
Includes persons receiving MenACWY or meningococcal-unknown type vaccine.
4
For 2008, refers to HPV vaccine quadrivalent; for 2009 and beyond, refers to HPV vaccine quadrivalent or bivalent.
5
Persons of Hispanic origin may be of any race. Estimates were tabulated using the 1997 Revisions to the Standards for the Classification of Federal Data on Race
and Ethnicity. Data for Native Hawaiian and Other Pacific Islander persons and persons of multiple races were not included because of small sample sizes. See
6
Poverty level is based on family income and family size using U.S. Census Bureau poverty thresholds. In 2013, less than 2.4% (unweighted) of adolescents with
provider-reported vaccination data were missing information about poverty level and were not included in the estimates of vaccination coverage by poverty level. See
7
MSA is metropolitan statistical area. See Appendix II, Metropolitan statistical area (MSA).
NOTES: Vaccination coverage estimates are based on provider-verified responses from parents who live in households with telephones. Complex statistical methods
are used to adjust vaccination estimates to account for adolescents whose parents refuse to participate in the survey, for adolescents who live in households without
telephones, or for adolescents whose vaccination histories cannot be verified through their providers. Starting in 2011, the NIS sampling frame was expanded from a
single-landline frame to dual-landline and cellular telephone sampling frames. See Appendix I, National Immunization Survey (NIS). Detailed vaccination data among
adolescents, by race and Hispanic origin, percent of poverty level, and MSA were not available prior to 2008. Interpretation of vaccination data needs to take into
account when specific vaccines were licensed and recommended for use among adolescents. Quadrivalent HPV vaccine was licensed by the U.S. Food and Drug
Administration (FDA) in June 2006. For the initial recommendations on HPV vaccination, see: CDC. Quadrivalent human papillomavirus vaccine: Recommendations of
the Advisory Committee on Immunization Practices. MMWR 2007;56(RR–02):1–24. Available from:
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5602a1.htm?s_cid=rr5602a1_e; HPV vaccine was recommended for males in October 2011. CDC. Recommendations on
the use of quadrivalent human papillomavirus vaccine in males– Advisory Committee on Immunization Practices (ACIP), 2011. MMWR 2011;60(50):1705–8. Available
from: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6050a3.htm. Meningococcal vaccine was licensed for use by the FDA in January 2005. For the initial
recommendations on meningococcal vaccination, see: CDC. Prevention and control of meningococcal disease: Recommendations of the Advisory Committee on
Immunization Practices. MMWR 2005;54(RR–07):1–21. Available from: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5407a1.htm. Tdap vaccines were licensed by the
FDA in May and June of 2005. For the initial recommendations on Tdap vaccination, see: CDC. Preventing tetanus, diphtheria, and pertussis among adolescents: Use
of tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccines. Recommendations of the Advisory Committee on Immunization Practices. MMWR
2006;55(RR–03):1–34. Available from: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5503a1.htm. See Appendix I, National Immunization Survey (NIS). Additional
information on the recommended schedule for adolescent vaccination is available from: http://www.cdc.gov/vaccines/schedules/index.html.
SOURCE: CDC/NCHS and National Center for Immunization and Respiratory Diseases, National Immunization Survey-Teen. Available from:
http://www.cdc.gov/vaccines/imz-managers/coverage/imz-coverage.html. See Appendix I, National Immunization Survey (NIS).
Characteristic 1989 1995 2000 2005 2009 2010 2011 2012 2013
Race 4
White only. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20.9 43.6 49.8 39.7 52.4 51.5 53.8 53.7 57.0
Black or African American only . . . . . . . . . . . . . . 12.5 28.2 33.2 26.9 41.7 40.4 40.8 43.0 43.2
American Indian or Alaska Native only . . . . . . . . . 26.2 * 43.6 *22.9 42.8 54.7 51.2 50.9 60.9
Asian only. . . . . . . . . . . . . . . . . . . . . . . . . . . . . *9.2 35.6 43.3 30.6 50.4 55.9 53.4 52.3 54.7
Native Hawaiian or Other Pacific
Islander only . . . . . . . . . . . . . . . . . . ........ -- -- * * * * * * *
2 or more races . . . . . . . . . . . . . . . . . ........ -- -- 50.7 30.4 47.7 49.8 47.7 46.8 50.0
Hispanic origin and race 4
Hispanic or Latino . . . . . . . . . . . . . . . . . . . . . . . 13.2 33.8 34.4 24.7 40.3 40.6 43.2 42.9 45.5
Mexican. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13.0 35.4 33.0 26.1 40.4 41.3 44.9 42.7 48.0
Not Hispanic or Latino . . . . . . . . . . . . . . . . . . . . 20.3 42.4 48.8 39.1 52.1 51.5 53.3 53.4 56.4
White only . . . . . . . . . . . . . . . . . . . . . . . . . . . 21.3 44.3 50.6 41.0 53.7 52.7 54.9 54.9 58.2
Black or African American only. . . . . . . . . . . . . 12.4 28.5 33.2 26.9 41.7 40.0 41.0 43.2 43.3
Characteristic 1989 1995 2000 2005 2009 2010 2011 2012 2013
* Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error (RSE) of 20%–30%. Data not shown have an RSE greater than
30%.
- - - Data not available.
1
Questions concerning use of influenza vaccination differed slightly on the National Health Interview Survey across the years for which data are shown. See Appendix
II, Vaccination.
2
Estimates are age-adjusted to the year 2000 standard population using four age groups: 18–49 years, 50–64 years, 65–74 years, and 75 years and over. See
Appendix II, Age adjustment.
3
Includes all other races not shown separately, unknown disability status, and unknown poverty level in 1989.
4
The race groups, white, black, American Indian or Alaska Native, Asian, Native Hawaiian or Other Pacific Islander, and 2 or more races, include persons of Hispanic
and non-Hispanic origin. Persons of Hispanic origin may be of any race. Starting with 1999 data, race-specific estimates are tabulated according to the 1997 Revisions
to the Standards for the Classification of Federal Data on Race and Ethnicity and are not strictly comparable with estimates for earlier years. The five single-race
categories plus multiple-race categories shown in the table conform to the 1997 Standards. Starting with 1999 data, race-specific estimates are for persons who
reported only one racial group; the category 2 or more races includes persons who reported more than one racial group. Prior to 1999, data were tabulated according
to the 1977 Standards with four racial groups, and the Asian only category included Native Hawaiian or Other Pacific Islander. Estimates for single-race categories prior
to 1999 included persons who reported one race or, if they reported more than one race, identified one race as best representing their race. Starting with 2003 data,
race responses of other race and unspecified multiple race were treated as missing, and then race was imputed if these were the only race responses. Almost all
persons with a race response of other race were of Hispanic origin. See Appendix II, Hispanic origin; Race.
5
Percent of poverty level is based on family income and family size and composition using U.S. Census Bureau poverty thresholds. Poverty level was unknown for 11%
of persons aged 18 and over in 1989. Missing family income data were imputed for 1991 and beyond. See Appendix II, Family income; Poverty; Table VI.
6
Any basic actions difficulty or complex activity limitation is defined as having one or more of the following limitations or difficulties: movement difficulty, emotional
difficulty, sensory (seeing or hearing) difficulty, cognitive difficulty, self-care (activities of daily living or instrumental activities of daily living) limitation, social limitation, or
work limitation. For more information, see Appendix II, Basic actions difficulty; Complex activity limitation. Starting with 2007 data, the hearing question, a component of
the basic actions difficulty measure, was revised. Consequently, data prior to 2007 are not comparable with data for 2007 and beyond. For more information on the
impact of the revised hearing question, see Appendix II, Hearing trouble.
7
MSA is metropolitan statistical area. Starting with 2006 data, MSA status is determined using 2000 census data and the 2000 standards for defining MSAs. For data
prior to 2006, see Appendix II, Metropolitan statistical area (MSA) for the applicable standards.
NOTES: In 2000, CDC’s Advisory Committee on Immunization Practices (ACIP) recommended universal influenza vaccination for persons aged 50 and
over. Medicare payment for the costs of the vaccine and its administration began in 1993. For current ACIP recommendation, see:
http://www.cdc.gov/flu/professionals/acip/index.htm. Standard errors for selected years are available in the spreadsheet version of this table. Available from:
http://www.cdc.gov/nchs/hus.htm. Data for additional years are available. See the Excel spreadsheet on the Health, United States website at:
http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC/NCHS, National Health Interview Survey. Data are from the following questionnaire supplements: immunization (1981), health promotion and disease
prevention (1991), and the year 2000 objectives (1993–1995). Starting in 1997, data are from the sample adult questionnaire. See Appendix I, National Health Interview
Survey (NHIS).
Characteristic 1989 1995 2000 2005 2009 2010 2011 2012 2013
18 years and over, crude 3 . . . . . . . . . . . . . . . . . 4.4 11.7 15.1 16.5 19.3 19.6 21.1 20.7 21.0
Age
18–49 years . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.1 6.5 5.4 5.8 7.5 7.3 8.8 8.7 8.3
50–64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.4 10.0 14.7 17.1 19.2 21.0 20.9 20.0 20.8
65 years and over . . . . . . . . . . . . . . . . . . . . . . . 14.1 34.0 53.1 56.2 60.6 59.7 62.3 59.9 59.7
65–74 years. . . . . . . . . . . . . . . . . . . . . . . . . . 13.1 31.4 48.2 49.4 54.6 54.6 56.0 55.0 54.4
75 years and over . . . . . . . . . . . . . . . . . . . . . 15.7 37.8 59.1 63.9 68.0 66.0 70.0 66.4 67.1
High-risk group 4
Total, 18–64 years . . . . . . . . . . . . . . . . . . . . . . . --- --- 18.3 22.6 17.4 18.3 20.0 19.9 21.0
18–49 years. . . . . . . . . . . . . . . . . . . . . . . . . . --- --- 12.2 15.0 11.2 10.6 13.6 13.0 13.6
50–64 years. . . . . . . . . . . . . . . . . . . . . . . . . . --- --- 26.0 30.6 28.2 30.8 30.1 30.6 31.7
Sex
Male. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13.9 34.6 52.1 53.4 59.2 57.6 59.5 55.8 57.1
Female . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14.3 33.6 53.9 58.4 61.7 61.3 64.5 63.1 61.8
Race 5
White only. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14.8 35.3 55.6 58.4 63.1 61.6 64.7 62.3 61.7
Black or African American only . . . . . . . . . . . . . . 6.4 21.9 30.6 40.2 44.2 45.5 47.5 46.0 48.4
American Indian or Alaska Native only . . . . . . . . . 31.2 * 70.1 * * *48.5 53.0 *36.3 52.9
Asian only. . . . . . . . . . . . . . . . . . . . . . . . . . . . . * *23.4 40.9 35.0 44.8 47.9 40.3 41.1 45.0
2 or more races. . . . . . . . . . . . . . . . . ........ --- --- 55.6 64.8 67.9 65.5 77.1 45.4 50.8
Mexican. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.9 *18.8 32.0 31.3 42.8 41.4 47.1 45.5 47.4
Not Hispanic or Latino . . . . . . . . . . . . . . . . . . . . 14.3 34.5 54.4 58.1 62.2 61.3 63.8 61.2 61.4
White only . . . . . . . . . . . . . . . . . . . . . . . . . . . 15.0 35.9 56.8 60.6 64.8 63.5 66.5 64.0 63.6
Black or African American only. . . . . . . . . . . . . 6.2 21.8 30.6 40.4 44.7 46.2 47.6 46.1 48.7
100%–199% . . . . . . . . . . . . . . . . . . . . . . . . . . . 15.1 30.7 51.4 54.5 60.6 57.2 60.3 59.8 58.0
200%–399% . . . . . . . . . . . . . . . . . . . . . . . . . . . 15.1 36.1 55.8 60.8 62.9 62.2 63.4 63.6 61.7
400% or more . . . . . . . . . . . . . . . . . . . . . . . . . . 15.5 39.5 56.9 55.3 61.5 64.0 66.4 61.4 61.6
Hispanic or Latino:
Below 100% . . . . . . . . . . . . . . . . . . . . . . . . . * *14.1 23.8 20.9 32.6 30.2 34.8 30.9 35.3
100%–199% . . . . . . . . . . . . . . . . . . . . . . . . . *11.0 *15.6 32.3 26.9 41.8 36.9 49.3 42.0 39.1
200%–399% . . . . . . . . . . . . . . . . . . . . . . . . . *11.1 *34.4 37.6 35.2 40.0 45.8 39.2 54.5 36.1
400% or more . . . . . . . . . . . . . . . . . . . . . . . . * *55.1 *26.4 *25.2 49.1 43.0 49.1 46.4 49.1
Below 100% . . . . . . . . . . . . . . . . . . . . . . . . 13.3 32.5 47.9 55.6 61.0 51.1 60.3 46.5 59.1
100%–199% . . . . . . . . . . . . . . . . . . . . . . . . 16.0 33.5 56.1 60.5 66.3 61.3 64.6 66.1 63.3
200%–399% . . . . . . . . . . . . . . . . . . . . . . . . 15.7 37.1 57.6 64.1 66.3 64.9 66.9 65.9 65.2
400% or more. . . . . . . . . . . . . . . . . . . . . . . 15.9 39.3 59.5 57.4 62.9 66.0 68.6 63.5 63.2
Below 100% . . . . . . . . . . . . . . . . . . . . . . . . *5.0 *22.6 28.8 42.3 33.8 34.9 39.5 36.1 48.9
100%–199% . . . . . . . . . . . . . . . . . . . . . . . . 7.8 *20.9 28.1 36.6 46.9 46.4 45.6 44.5 46.9
200%–399% . . . . . . . . . . . . . . . . . . . . . . . . *5.9 *21.7 35.5 41.6 49.3 51.8 54.2 54.1 49.4
Characteristic 1989 1995 2000 2005 2009 2010 2011 2012 2013
Characteristic 1987 1993 1994 2000 2003 2005 2008 2010 2013
40 years and over, crude 2 . . . . . . . . . . . . . . . 28.7 59.7 60.9 70.4 69.7 66.8 67.6 67.1 66.8
50 years and over, age-adjusted 2,3 . . . . . . . . . 27.3 59.7 60.9 73.7 72.4 68.2 70.3 68.8 69.1
50 years and over, crude 2 . . . . . . . . . . . . . . . 27.4 59.7 60.6 73.6 72.4 68.4 70.5 69.2 69.5
Age
40–49 years . . . . . . .... . . . . . . . . . . . . . . . 31.9 59.9 61.3 64.3 64.4 63.5 61.5 62.3 59.6
50–64 years . . . . . . .... . . . . . . . . . . . . . . . 31.7 65.1 66.5 78.7 76.2 71.8 74.2 72.6 71.4
65 years and over. . .... . . . . . . . . . . . . . . . 22.8 54.2 55.0 67.9 67.7 63.8 65.5 64.4 66.9
65–74 years . . . . .... . . . . . . . . . . . . . . . 26.6 64.2 63.0 74.0 74.6 72.5 72.6 71.9 75.3
75 years and over .... . . . . . . . . . . . . . . . 17.3 41.0 44.6 61.3 60.6 54.7 57.9 55.7 56.5
Race 4
40 years and over, crude:
White only. . . . . . . . . . . . . . . . . . . . . . . . . 29.6 60.0 60.6 71.4 70.1 67.4 67.9 67.4 66.8
Black or African American only . . . . . . . . . . 24.0 59.1 64.3 67.8 70.4 64.9 68.0 67.9 67.1
American Indian or Alaska Native only . . . . . * 49.8 65.8 47.4 63.1 72.8 62.7 71.2 62.6
Asian only. . . . . . . . . . . . . . . . . . . . . . . . . * 55.1 55.8 53.5 57.6 54.6 66.1 62.4 66.6
Native Hawaiian or Other Pacific
Islander only . . . . . . . . . . . . . . . . . . .... --- --- --- * * * * * *
2 or more races. . . . . . . . . . . . . . . . . .... --- --- --- 69.2 65.3 63.7 55.2 51.4 65.4
Black or African American only. . . . . . . . . 23.8 59.2 64.4 67.9 70.5 65.2 68.3 67.4 67.2
Black or African American only. . . . . . . . . 27.8 55.6 67.2 60.9 68.2 62.1 59.5 63.5 59.4
50–64 years:
Hispanic or Latina . . . . . . . . . . . ........ 23.0 59.2 60.1 66.5 69.4 61.5 71.3 68.6 65.6
Not Hispanic or Latina:
White only . . . . . . . . . . . . . . . ........ 33.6 66.2 67.5 80.6 77.2 73.5 74.1 73.5 72.1
Black or African American only. ........ 26.4 65.5 63.6 77.7 76.2 71.6 76.7 74.0 71.7
Black or African American only. ........ 14.1 56.3 61.0 65.5 65.4 60.5 66.4 60.9 68.8
Below 100% . . . . . . . . . . . . . . . . . . . . . . . 14.6 41.1 44.2 54.8 55.4 48.5 51.4 51.4 49.9
100%–199% . . . . . . . . . . . . . . . . . . . . . . . 20.9 47.5 48.6 58.1 60.8 55.3 55.8 53.8 56.7
200%–399% . . . . . . . . . . . . . . . . . . . . . . . 29.7 63.2 65.0 68.8 69.9 67.2 64.4 66.2 66.0
400% or more . . . . . . . . . . . . . . . . . . . . . . 42.9 74.1 74.1 81.5 77.7 76.6 79.0 78.1 77.2
40–49 years:
Below 100% . . . . . . . . . . . . . . . . . . . . . 18.6 36.1 43.0 47.4 50.6 42.5 46.6 48.1 43.3
100%–199% . . . . . . . . . . . . . . . . . . . . . 18.4 47.8 47.6 43.6 54.0 49.8 46.5 46.2 52.0
200%–399% . . . . . . . . . . . . . . . . . . . . . 31.2 63.0 64.5 60.2 63.0 61.8 56.8 59.2 58.5
400% or more . . . . . . . . . . . . . . . . . . . . 44.1 69.6 69.9 75.8 71.6 73.6 72.5 73.6 69.0
50–64 years:
Below 100% . . . . . . . . . . . . . . . . . . . . . 14.6 47.3 46.2 61.7 58.3 50.4 57.5 54.7 55.0
100%–199% . . . . . . . . . . . . . . . . . . . . . 24.2 47.0 49.0 68.3 64.0 58.8 58.9 57.3 57.2
200%–399% . . . . . . . . . . . . . . . . . . . . . 29.7 66.1 69.6 75.1 74.1 70.7 69.8 70.7 69.5
400% or more . . . . . . . . . . . . . . . . . . . . 44.7 78.7 78.0 86.9 84.9 80.6 84.3 82.8 80.9
Below 100% . . . . . . . . . . . . . . . . . . . . . 13.1 40.4 43.9 54.8 57.0 52.3 49.1 50.6 49.8
100%–199% . . . . . . . . . . . . . . . . . . . . . 19.9 47.6 48.8 60.3 62.8 56.1 59.4 55.5 59.3
200%–399% . . . . . . . . . . . . . . . . . . . . . 27.7 60.3 61.0 71.1 72.3 68.6 65.0 67.2 68.1
400% or more . . . . . . . . . . . . . . . . . . . . 34.7 71.3 73.0 81.9 73.0 72.6 78.3 74.5 79.0
Characteristic 1987 1993 1994 2000 2003 2005 2008 2010 2013
* Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error (RSE) of 20%–30%. Data not shown have an RSE greater than 30%.
- - - Data not available.
1
Questions concerning use of mammography differed slightly on the National Health Interview Survey across the years for which data are shown. See Appendix II,
Mammography.
2
Includes all other races not shown separately, unknown poverty level in 1987, unknown health insurance status, unknown education level, and unknown disability status.
3
Estimates for women aged 40 and over are age-adjusted to the year 2000 standard population using four age groups: 40–49 years, 50–64 years, 65–74 years, and 75 years
and over. Estimates for women 50 years of age and over are age-adjusted using three age groups. See Appendix II, Age adjustment.
4
The race groups, white, black, American Indian or Alaska Native, Asian, Native Hawaiian or Other Pacific Islander, and 2 or more races, include persons of Hispanic and
non-Hispanic origin. Persons of Hispanic origin may be of any race. Starting with 1999 data, race-specific estimates are tabulated according to the 1997 Revisions to the
Standards for the Classification of Federal Data on Race and Ethnicity and are not strictly comparable with estimates for earlier years. The five single-race categories plus
multiple-race categories shown in the table conform to the 1997 Standards. Starting with 1999 data, race-specific estimates are for persons who reported only one racial group;
the category 2 or more races includes persons who reported more than one racial group. Prior to 1999, data were tabulated according to the 1977 Standards with four racial
groups, and the Asian only category included Native Hawaiian or Other Pacific Islander. Estimates for single-race categories prior to 1999 included persons who reported one
race or, if they reported more than one race, identified one race as best representing their race. Starting with 2003 data, race responses of other race and unspecified multiple
race were treated as missing, and then race was imputed if these were the only race responses. Almost all persons with a race response of other race were of Hispanic origin.
See Appendix II, Hispanic origin; Race.
5
Percent of poverty level is based on family income and family size and composition using U.S. Census Bureau poverty thresholds. Poverty level was unknown for 11% of
women aged 40 and over in 1987. Missing family income data were imputed for 1997 and beyond. See Appendix II, Family income; Poverty; Table VI.
6
Health insurance categories are mutually exclusive. Persons who reported both Medicaid and private coverage are classified as having private coverage. Starting with 1997
data, state-sponsored health plan coverage is included as Medicaid coverage. Starting with 1999 data, coverage by the Children’s Health Insurance Program (CHIP) is
included with Medicaid coverage. In addition to private and Medicaid, the insured category also includes military plans, other government-sponsored health plans, and
Medicare, not shown separately. Persons not covered by private insurance, Medicaid, CHIP, public assistance (through 1996), state-sponsored or other government-sponsored
health plans (starting in 1997), Medicare, or military plans are considered to have no health insurance coverage. Persons with only Indian Health Service coverage are
considered to have no health insurance coverage. See Appendix II, Health insurance coverage.
7
Education categories shown are for 1998 and subsequent years. GED is General Educational Development high school equivalency diploma. In years prior to 1998, the
following categories based on number of years of school completed were used: less than 12 years, 12 years, 13 years or more. See Appendix II, Education.
8
Any basic actions difficulty or complex activity limitation is defined as having one or more of the following limitations or difficulties: movement difficulty, emotional difficulty,
sensory (seeing or hearing) difficulty, cognitive difficulty, self-care (activity of daily living or instrumental activities of daily living) limitation, social limitation, or work limitation. For
more information, see Appendix II, Basic actions difficulty; Complex activity limitation. Starting with 2007 data, the hearing question, a component of the basic actions difficulty
measure, was revised. Consequently, data prior to 2007 are not comparable with 2007 data and beyond. For more information on the impact of the revised hearing question,
see Appendix II, Hearing trouble.
NOTES: See Appendix II, Mammography, for a discussion of the U.S. Preventive Services Task Force recommendations for mammography screening. Standard errors
are available in the spreadsheet version of this table. Available from: http://www.cdc.gov/nchs/hus.htm. Data starting in 1997 are not strictly comparable with data for
earlier years due to the 1997 questionnaire redesign. See Appendix I, National Health Interview Survey (NHIS). Data for additional years are available. See the Excel
spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC/NCHS, National Health Interview Survey. Data are from the following supplements: cancer control (1987), health promotion and disease prevention
(1990–1991), and year 2000 objectives (1993–1994). Starting in 1998, data are from the family core and sample adult questionnaires. See Appendix I, National Health
Interview Survey (NHIS).
Characteristic 1987 1993 1994 1999 2000 2005 2008 2010 2013
Characteristic 1987 1993 1994 1999 2000 2005 2008 2010 2013
Characteristic 1987 1993 1994 1999 2000 2005 2008 2010 2013
Characteristic 1987 1993 1994 1999 2000 2005 2008 2010 2013
Health insurance status Percent of women having a Pap smear within the past 3 years,
at the time of interview 6 among those who have not had a hysterectomy 9
18–64 years, crude:
Insured . . . . . . . . . . . . . . . . . . . . . . . . . . . -- 85.9 85.2 87.8 88.7 87.1 85.8 85.1 82.3
Private . . . . . . . . . . . . . . . . . . . . . . . . . -- 86.0 85.0 88.1 88.8 87.9 86.6 86.2 83.5
Medicaid . . . . . . . . . . . . . . . . . . . . . . . . -- 83.9 87.0 84.2 86.9 82.6 82.4 79.7 77.6
Uninsured . . . . . . . . . . . . . . . . . . . . . . . . . -- 70.2 70.2 74.3 70.8 68.0 67.9 63.1 59.6
Health insurance status
prior to interview 6
18–64 years, crude:
Insured continuously all 12 months . . . . . . . -- 86.1 85.1 88.0 88.9 87.2 86.1 85.4 82.9
Uninsured for any period up to 12 months . . -- 81.7 83.8 84.4 84.4 82.7 80.9 79.7 74.5
Uninsured more than 12 months . . . . . . . . . -- 66.5 65.7 69.9 65.5 62.7 62.4 56.6 54.6
NOTES: Currently, the U.S. Preventive Services Task Force (USPSTF) recommends pap smears every three years for women aged 21 to 65, although the USPSTF
recommendations have changed over time. See Appendix II, Pap smear. Standard errors are available in the spreadsheet version of this table. Available from:
http://www.cdc.gov/nchs/hus.htm. Data starting in 1997 are not strictly comparable with data for earlier years due to the 1997 questionnaire redesign. See Appendix I,
National Health Interview Survey (NHIS). Data for additional years are available. See the Excel spreadsheet on the Health, United States website at:
http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC/NCHS, National Health Interview Survey. Data are from the following supplements: cancer control (1987) and year 2000 objectives (1993–1994).
Starting in 1998, data are from the family core and sample adult questionnaires. See Appendix I, National Health Interview Survey (NHIS).
Characteristic 2000 2005 2008 2010 2013 2000 2005 2008 2010 2013
Sex
Male. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33.1 44.4 51.4 58.5 56.7 19.5 37.9 46.9 54.7 53.4
Female . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34.5 44.2 51.9 58.8 58.9 18.8 37.4 46.6 55.1 55.5
Race 5
White only. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34.9 45.6 52.8 59.8 58.4 19.7 38.9 47.8 56.0 55.3
Black or African American only . . . . . . . . . . . . . . 29.6 38.1 46.9 55.2 58.0 17.4 32.2 43.1 51.8 54.1
American Indian or Alaska Native only . . . . . . . . . *35.2 *33.9 28.5 48.9 49.3 * * *26.7 46.7 45.8
Asian only. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20.4 30.8 47.1 47.1 49.8 *8.6 24.4 39.3 43.6 43.7
Native Hawaiian or Other Pacific
Islander only . . . . . . . . . . . . . . . . . . ........ * * * * * * * * * *
2 or more races. . . . . . . . . . . . . . . . . ........ 37.5 33.8 38.4 51.9 50.5 *25.1 29.6 37.4 48.4 48.4
Education 7
No high school diploma or GED . . . . . . . . . . . . . 25.9 34.5 36.2 44.6 43.5 14.9 29.0 31.8 41.5 39.9
High school diploma or GED. . . . . . . . . . . . . . . . 33.1 42.1 48.5 53.7 53.4 19.0 35.7 44.6 50.8 50.4
Some college or more . . . . . . . . . . . . . . . . . . . . 37.8 48.7 57.5 64.7 63.1 20.9 41.6 52.1 60.4 59.6
Characteristic 2000 2005 2008 2010 2013 2000 2005 2008 2010 2013
Geographic region
Northeast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34.4 50.9 54.7 64.3 61.0 19.1 44.8 51.0 61.7 59.4
Midwest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35.2 43.5 52.5 58.4 59.5 19.8 36.6 47.8 55.2 57.3
South . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32.5 43.9 51.6 57.4 56.4 20.0 38.1 47.4 54.4 53.8
West . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34.1 39.6 48.2 56.3 55.9 16.3 31.3 41.1 49.7 48.7
Location of residence 9
Within MSA. . . . . . . . . . . . . . . . . . . . . . . . . . . . 34.1 44.7 52.4 59.6 58.3 19.0 37.9 47.6 55.8 54.8
Outside MSA. . . . . . . . . . . . . . . . . . . . . . . . . . . 33.2 42.7 48.5 54.4 55.6 19.6 36.7 43.3 50.9 52.8
* Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error (RSE) of 20%–30%. Data not shown have an RSE greater than 30%.
1
Includes reports of home fecal occult blood test (FOBT) in the past year, sigmoidoscopy procedure in the past 5 years with FOBT in the past 3 years, or colonoscopy in the
past 10 years. Colorectal procedures are performed for diagnostic and screening purposes.
2
Questions differed slightly on the National Health Interview Survey across the years for which data are shown. See Appendix II, Colorectal tests or procedures.
3
Includes any colonoscopy in the past 10 years, alone or in addition to another type of colorectal test or procedure.
4
Includes all other races not shown separately, unknown disability status, and unknown education level.
5
The race groups, white, black, American Indian or Alaska Native, Asian, Native Hawaiian or Other Pacific Islander, and 2 or more races include persons of Hispanic and
non-Hispanic origin. Persons of Hispanic origin may be of any race. The five single-race and multiple-race categories shown in the table conform to the 1997 Revisions to the
Standards for the Classification of Federal Data on Race and Ethnicity. Starting with 2003 data, race responses of other race and unspecified multiple race were treated as
missing, and then race was imputed if these were the only race responses. Almost all persons with a race response of other race were of Hispanic origin. See Appendix II,
6
Based on family income and family size and composition using U.S. Census Bureau poverty thresholds. Missing family income data were imputed. See Appendix II, Family
7
GED is General Educational Development high school equivalency diploma. See Appendix II, Education.
8
Any basic actions difficulty or complex activity limitation is defined as having one or more of the following limitations or difficulties: movement difficulty, emotional difficulty,
sensory (seeing or hearing) difficulty, cognitive difficulty, self-care (activities of daily living or instrumental activities of daily living) limitation, social limitation, or work limitation.
For more information, see Appendix II, Basic actions difficulty; Complex activity limitation. Starting with 2007 data, the hearing question, a component of the basic actions
difficulty measure, was revised. Consequently, data prior to 2007 are not comparable with data for 2007 and beyond. For more information on the impact of the revised hearing
9
MSA is metropolitan statistical area. Starting with 2006 data, MSA status is determined using 2000 census data and the 2000 standards for defining MSAs. For data prior to
2006, see Appendix II, Metropolitan statistical area (MSA) for the applicable standards.
NOTES: In 2008, the U.S. Preventive Services Task Force (USPSTF) recommended screening for colorectal cancer annually using FOBT, every 5 years using
sigmoidoscopy with FOBT every 3 years, or every 10 years using colonoscopy, in adults, beginning at age 50 and continuing until age 75. See:
http://www.uspreventiveservicestaskforce.org/uspstf08/colocancer/colors.htm for more information. Colonoscopy is one of the three modalities currently recommended
by USPSTF for colorectal cancer screening. USPSTF does not recommend one screening method over another, and the risks and benefits of these screening methods
vary. Colonoscopy estimates are shown separately because of the recent large increase in its utilization. The American College of Gastroenterology recommends that
African American persons start routine testing for colorectal cancer at age 45. See: http://www.acg.gi.org/patients/ccrk/ for more information. Standard errors for
selected years are available in the spreadsheet version of this table. Available from: http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC/NCHS, National Health Interview Survey. Family core and sample adult questionnaires. See Appendix I, National Health Interview Survey (NHIS).
Characteristic 1997 2010 2013 1997 2010 2013 1997 2010 2013
All children 2 . . . . . . . . . . . . . . . . . . . . . . . . . 19.9 22.1 17.6 24.3 27.8 23.6 17.7 19.1 14.8
Sex
Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21.5 23.3 18.4 25.2 29.3 25.4 19.6 20.1 15.0
Female . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18.3 20.9 16.9 23.3 26.3 21.7 15.7 18.2 14.5
Race 3
White only . . . . . . . . . . . . . . . . . . . . . . . . . . 19.4 21.2 17.1 22.6 26.6 22.5 17.8 18.4 14.6
Black or African American only . . . . . . . . . . . . 24.0 27.6 22.6 33.1 34.0 31.3 19.4 24.2 18.3
American Indian or Alaska Native only . . . . . . *24.1 20.9 18.8 *24.3 *35.4 *22.2 *24.0 * *16.3
Asian only . . . . . . . . . . . . . . . . . . . . . . . . . . 12.6 15.0 8.8 20.8 18.4 15.1 8.6 13.3 5.9
Native Hawaiian or Other Pacific
Islander only. . . . . . . . . . . . . . . . . . ...... --- * * --- * * --- * *
2 or more races . . . . . . . . . . . . . . . . ...... --- 27.2 19.9 --- 34.9 25.0 --- 21.6 16.8
Not Hispanic or Latino. . . . . . . . . . . . . . . . . . 19.7 21.7 17.8 24.0 27.0 23.9 17.6 19.0 14.9
White only. . . . . . . . . . . . . . . . . . . . . . . . . 19.2 20.4 17.2 22.2 25.1 22.8 17.7 18.2 14.7
Black or African American only . . . . . . . . . . 23.6 27.2 22.4 32.7 34.4 30.9 19.2 23.3 18.2
100%–199%. . . . . . . . . . . . . . . . . . . . . . . . . 22.0 25.7 20.1 28.0 31.6 27.5 19.0 22.3 16.4
200%–399%. . . . . . . . . . . . . . . . . . . . . . . . . 18.0 18.4 15.5 21.4 22.7 21.1 16.4 16.4 13.0
400% or more . . . . . . . . . . . . . . . . . . . . . . . 16.3 15.9 12.3 19.1 21.7 15.3 15.1 13.3 11.0
Hispanic or Latino:
Percent of poverty level:
Below 100% . . . . . . . . . . . . . . . . . . . . . 21.9 27.0 19.0 25.0 32.0 25.9 19.6 23.4 15.0
100%–199% . . . . . . . . . . . . . . . . . . . . . 20.8 23.3 17.6 28.8 31.6 21.4 15.6 18.0 15.6
200%–399% . . . . . . . . . . . . . . . . . . . . . 21.4 19.5 16.3 24.6 25.2 21.3 19.6 16.1 13.5
400% or more . . . . . . . . . . . . . . . . . . . . 17.7 21.4 12.1 *20.2 28.6 *16.7 16.4 18.0 *10.0
Below 100% . . . . . . . . . . . . . . . . . . . . 25.5 33.7 29.9 27.2 37.4 34.8 24.4 31.6 26.8
100%–199% . . . . . . . . . . . . . . . . . . . . 22.3 26.3 22.6 25.8 29.2 32.9 20.7 24.7 17.1
200%–399% . . . . . . . . . . . . . . . . . . . . 17.8 17.6 15.1 20.9 21.2 19.2 16.3 15.9 13.4
400% or more. . . . . . . . . . . . . . . . . . . 16.5 15.5 12.2 19.0 21.0 14.8 15.4 13.2 11.1
Below 100% . . . . . . . . . . . . . . . . . . . . 29.3 32.4 26.9 39.5 41.6 36.0 23.0 26.6 21.6
100%–199% . . . . . . . . . . . . . . . . . . . . 22.5 27.5 22.4 31.7 34.5 29.3 18.5 23.7 19.4
200%–399% . . . . . . . . . . . . . . . . . . . . 18.5 22.3 17.9 23.9 24.6 29.8 16.3 21.4 13.1
400% or more. . . . . . . . . . . . . . . . . . . 16.1 18.9 17.1 *18.8 *24.1 * 15.2 16.1 16.0
Insured . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19.8 22.3 17.8 24.4 28.1 23.5 17.5 19.2 15.0
Private . . . . . . . . . . . . . . . . . . . . . . . . . . . 17.5 17.1 13.2 20.9 21.8 17.2 15.9 14.9 11.5
Medicaid. . . . . . . . . . . . . . . . . . . . . . . . . . 28.2 30.0 24.0 33.0 35.5 29.9 24.1 26.4 20.4
Uninsured . . . . . . . . . . . . . . . . . . . . . . . . . . 20.2 19.4 15.1 23.0 24.0 23.3 18.9 17.6 12.1
prior to interview 5
Insured continuously all 12 months . . . . . . . . . 19.6 22.2 17.7 24.1 28.1 23.5 17.3 19.1 14.8
Uninsured for any period up to 12 months. . . . 24.0 23.7 21.7 27.1 28.0 26.3 21.9 21.3 19.2
Uninsured more than 12 months . . . . . . . . . . 18.4 17.6 10.0 19.3 *21.3 * 18.1 16.7 9.1
Characteristic 1997 2010 2013 1997 2010 2013 1997 2010 2013
insurance status prior to interview 4,5 Percent of children with one or more emergency department visits 1
Below 100%:
Insured continuously all 12 months . . . . . . . 26.3 31.7 25.1 30.9 36.3 31.9 22.8 28.7 20.9
Uninsured for any period up to 12 months . . 26.5 30.3 21.4 29.7 34.7 *23.0 24.4 27.5 20.4
Uninsured more than 12 months . . . . . . . . . 17.5 *19.6 *12.5 *16.0 * * 18.0 *16.0 *
100%–199%:
Insured continuously all 12 months . . . . . . . 21.8 26.2 20.4 28.0 32.4 27.6 18.6 22.4 16.7
Uninsured for any period up to 12 months . . 24.5 28.4 26.9 29.7 30.9 36.5 21.0 27.0 22.2
Uninsured more than 12 months . . . . . . . . . 19.5 17.6 *9.2 *22.5 * * 18.6 *17.2 *9.4
200%–399%:
Insured continuously all 12 months . . . . . . . 17.7 18.4 15.5 21.2 22.8 20.6 16.1 16.3 13.3
Uninsured for any period up to 12 months . . 21.1 16.2 17.3 *19.5 *22.7 *22.7 22.1 *12.6 *14.5
Uninsured more than 12 months . . . . . . . . . 19.2 *17.4 * *22.7 * * 17.6 *18.7 *
400% or more:
Insured continuously all 12 months . . . . . . . 16.2 16.1 12.1 18.9 22.0 14.9 15.1 13.5 10.9
Uninsured for any period up to 12 months . . *19.2 * * * * * * * *
Uninsured more than 12 months . . . . . . . . . * * * * * * * * *
Geographic region
Northeast . . . . . . . . . . . . . . . . . . . . . . . . . . . 18.5 22.3 19.3 20.7 27.8 24.5 17.4 19.6 16.8
Midwest . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19.5 23.3 18.5 26.0 28.8 26.0 16.4 20.7 15.1
South . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21.8 23.4 18.2 25.6 30.4 24.7 19.9 19.5 15.0
West . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18.5 19.1 14.8 23.5 23.3 19.1 15.9 16.8 12.7
Location of residence 6
Within MSA . . . . . . . . . . . . . . . . . . . . . . . . . 19.7 21.8 17.0 23.9 27.7 22.4 17.4 18.6 14.4
Outside MSA . . . . . . . . . . . . . . . . . . . . . . . . 20.8 24.2 21.2 26.2 28.6 30.3 18.6 22.1 16.7
All children 2 . . . . . . . . . . . . . . . . . . . . . . . . . 7.1 8.4 5.8 9.6 10.8 8.0 5.8 7.2 4.8
Sex
Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.3 8.5 5.8 9.9 11.3 8.6 6.0 7.0 4.5
Female . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.9 8.3 5.8 9.4 10.3 7.3 5.7 7.3 5.0
Race 3
White only . . . . . . . . . . . . . . . . . . . . . . . . . . 6.6 7.6 5.5 8.4 10.1 7.3 5.7 6.3 4.7
Black or African American only . . . . . . . . . . . . 9.6 12.6 8.3 14.9 15.7 12.6 6.9 11.0 6.1
American Indian and Alaska Native only . . . . . * * * * * * * * *
Asian only . . . . . . . . . . . . . . . . . . . . . . . . . . *5.7 7.3 * *12.9 * * * *7.1 *
Native Hawaiian and Other Pacific
Islander only. . . . . . . . . . . . . . . . . . . ..... --- * * --- * * --- * *
2 or more races . . . . . . . . . . . . . . . . . ..... --- 10.3 7.1 --- *11.7 *9.8 --- *9.2 *5.4
Not Hispanic or Latino. . . . . . . . . . . . . . . . . . 6.8 8.4 5.7 9.2 10.5 7.8 5.7 7.3 4.8
White only. . . . . . . . . . . . . . . . . . . . . . . . . 6.2 7.4 5.4 7.8 9.3 7.0 5.5 6.4 4.7
Black or African American only . . . . . . . . . . 9.3 12.3 8.1 14.6 15.8 11.9 6.8 10.4 6.2
100%–199%. . . . . . . . . . . . . . . . . . . . . . . . . 8.3 10.3 7.3 12.2 13.4 10.9 6.3 8.4 5.5
200%–399%. . . . . . . . . . . . . . . . . . . . . . . . . 6.2 6.3 4.8 7.4 7.3 5.9 5.6 5.9 4.3
400% or more . . . . . . . . . . . . . . . . . . . . . . . 4.0 5.0 2.7 5.0 7.3 *3.0 3.6 3.9 2.6
Characteristic 1997 2010 2013 1997 2010 2013 1997 2010 2013
Below 100% . . . . . . . . . . . . . . . . . . . . . 10.4 9.9 6.8 13.9 10.9 10.0 8.0 9.2 5.0
100%–199% . . . . . . . . . . . . . . . . . . . . . 8.2 9.4 7.1 12.0 15.4 9.5 5.7 5.5 5.9
Below 100% . . . . . . . . . . . . . . . . . . . . 10.7 14.0 11.8 12.2 15.5 14.0 9.8 13.1 10.4
100%–199% . . . . . . . . . . . . . . . . . . . . 8.0 10.4 7.8 11.2 12.3 12.7 6.4 9.4 *5.2
200%–399% . . . . . . . . . . . . . . . . . . . . 6.0 5.7 4.3 6.7 *6.5 *3.9 5.6 5.4 4.4
400% or more. . . . . . . . . . . . . . . . . . . 3.7 5.0 3.1 4.6 7.6 *3.4 3.3 3.9 2.9
Below 100% . . . . . . . . . . . . . . . . . . . . 12.7 16.1 10.7 19.1 22.1 15.6 8.8 12.4 *7.9
100%–199% . . . . . . . . . . . . . . . . . . . . 9.2 12.4 7.6 *13.5 *14.6 *9.8 *7.2 11.1 *6.6
Insured . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.0 8.5 5.9 9.6 11.0 8.0 5.7 7.1 4.8
Private . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.2 5.5 3.4 6.8 7.4 4.5 4.5 4.6 2.9
Medicaid. . . . . . . . . . . . . . . . . . . . . . . . . . 13.1 12.8 9.4 16.2 15.3 11.9 10.4 11.2 7.9
Uninsured . . . . . . . . . . . . . . . . . . . . . . . . . . 7.7 8.0 5.2 9.8 *8.5 *7.7 6.8 7.8 *4.3
prior to interview 5
Insured continuously all 12 months . . . . . . . . . 6.9 8.4 5.9 9.4 10.8 8.0 5.7 7.1 4.8
Uninsured for any period up to 12 months. . . . 8.5 10.1 6.0 11.5 13.3 *8.9 6.6 8.4 4.4
Uninsured more than 12 months . . . . . . . . . . 6.8 7.8 *4.5 *8.6 * * 6.2 *7.9 *
Geographic region
Northeast . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.2 7.8 6.3 7.6 10.3 8.7 5.4 6.6 5.1
Midwest . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.6 9.1 6.9 10.4 11.4 11.1 4.8 8.0 4.9
South . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.0 9.1 6.3 10.1 12.9 8.1 6.9 7.1 5.3
West . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.1 7.2 3.8 10.0 7.6 4.3 5.6 7.0 3.5
Location of residence 6
Within MSA . . . . . . . . . . . . . . . . . . . . . . . . . 7.2 8.3 5.6 9.6 10.6 7.4 5.9 7.0 4.7
Outside MSA . . . . . . . . . . . . . . . . . . . . . . . . 6.8 9.3 7.1 9.7 12.2 11.2 5.6 7.9 5.0
* Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error (RSE) of 20%–30%. Data not shown have an RSE greater than 30%.
- - - Data not available.
1
See Appendix II, Emergency department or emergency room visit.
2
Includes all other races not shown separately and unknown health insurance status.
3
The race groups, white, black, American Indian or Alaska Native, Asian, Native Hawaiian or Other Pacific Islander, and 2 or more races, include persons of Hispanic and
non-Hispanic origin. Persons of Hispanic origin may be of any race. Starting with 1999 data, race-specific estimates are tabulated according to the 1997 Revisions to the
Standards for the Classification of Federal Data on Race and Ethnicity and are not strictly comparable with estimates for earlier years. The five single-race categories plus
multiple-race categories shown in the table conform to the 1997 Standards. Starting with 1999 data, race-specific estimates are for persons who reported only one racial group;
the category 2 or more races includes persons who reported more than one racial group. Prior to 1999, data were tabulated according to the 1977 Standards with four racial
groups, and the Asian only category included Native Hawaiian or Other Pacific Islander. Estimates for single-race categories prior to 1999 included persons who reported one
race or, if they reported more than one race, identified one race as best representing their race. Starting with 2003 data, race responses of other race and unspecified multiple
race were treated as missing, and then race was imputed if these were the only race responses. Almost all persons with a race response of other race were of Hispanic origin.
See Appendix II, Hispanic origin; Race.
4
Percent of poverty level is based on family income and family size and composition using U.S. Census Bureau poverty thresholds. Missing family income data were imputed
for 1997 and beyond. See Appendix II, Family income; Poverty; Table VI.
5
Health insurance categories are mutually exclusive. Persons who reported both Medicaid and private coverage are classified as having private coverage. Starting with 1997
data, state-sponsored health plan coverage is included as Medicaid coverage. Starting with 1999 data, coverage by the Children’s Health Insurance Program (CHIP) is
included with Medicaid coverage. In addition to private and Medicaid, the insured category also includes military, other government, and Medicare coverage. Persons not
covered by private insurance, Medicaid, CHIP, state-sponsored or other government-sponsored health plans (starting in 1997), Medicare, or military plans are considered to
have no health insurance coverage. Persons with only Indian Health Service coverage are considered to have no health insurance coverage. See Appendix II, Health
insurance coverage.
6
MSA is metropolitan statistical area. Starting with 2006 data, MSA status is determined using 2000 census data and the 2000 standards for defining MSAs. For data prior to
2006, see Appendix II, Metropolitan statistical area (MSA) for the applicable standards.
NOTES: Standard errors are available in the spreadsheet version of this table. Available from: http://www.cdc.gov/nchs/hus.htm. Data for additional years are available.
See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC/NCHS, National Health Interview Survey, family core and sample child questionnaires. See Appendix I, National Health Interview Survey (NHIS).
Age
18–44 years. . . . . . . . . .... . . . . . . . . . . . . . . . . . 20.7 20.5 22.0 18.5 6.8 7.0 8.4 6.9
18–24 years . . . . . . . .... . . . . . . . . . . . . . . . . . 26.3 25.7 25.4 20.8 9.1 8.8 9.6 8.1
25–44 years . . . . . . . .... . . . . . . . . . . . . . . . . . 19.0 18.8 20.7 17.7 6.2 6.4 8.0 6.5
45–64 years. . . . . . . . . .... . . . . . . . . . . . . . . . . . 16.2 17.6 19.2 17.6 5.6 5.6 6.7 6.5
45–54 years . . . . . . . .... . . . . . . . . . . . . . . . . . 15.7 17.9 18.6 17.2 5.5 5.8 6.6 6.8
55–64 years . . . . . . . .... . . . . . . . . . . . . . . . . . 16.9 17.0 19.8 18.1 5.7 5.3 6.8 6.3
65 years and over . . . . .... . . . . . . . . . . . . . . . . . 22.0 23.7 23.7 21.3 8.1 8.6 7.7 7.0
65–74 years . . . . . . . .... . . . . . . . . . . . . . . . . . 20.3 21.6 20.7 18.4 7.1 7.4 6.4 6.0
75 years and over . . . .... . . . . . . . . . . . . . . . . . 24.3 26.2 27.4 25.3 9.3 10.0 9.4 8.4
Sex 3
Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19.1 18.7 18.5 16.5 5.9 5.7 6.0 5.4
Female . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20.2 21.6 24.3 21.0 7.5 7.9 9.6 8.3
Race 3,4
White only . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19.0 19.4 20.7 18.1 6.2 6.4 7.2 6.3
Black or African American only. . . . . . . . . . . . . . . . . 25.9 26.5 28.6 25.4 11.1 10.8 12.6 11.1
American Indian or Alaska Native only . . . . . . . . . . . 24.8 30.3 22.6 26.7 13.1 *12.6 *11.8 *9.0
Asian only . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.6 13.6 13.3 10.1 *2.9 *3.8 3.3 3.3
Native Hawaiian or Other Pacific
Islander only . . . . . . . . . . . . . . . . . ........... -- * * * -- * * *
2 or more races . . . . . . . . . . . . . . . . ........... -- 32.5 29.7 27.2 -- 11.3 11.1 13.1
American Indian or Alaska Native;
White . . . . . . . . . . . . . . . . . . . . . ........... -- 33.9 31.1 30.4 -- *9.4 *15.2 16.7
3,4
Hispanic origin and race
Hispanic or Latino . . . . . . . . . . . . . . . . . . . . . . . . . 19.2 18.3 19.8 17.4 7.4 7.0 6.9 6.1
Mexican . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17.8 17.4 18.1 16.0 6.4 7.1 6.1 5.4
Not Hispanic or Latino . . . . . . . . . . . . . . . . . . . . . . 19.7 20.6 21.9 19.1 6.7 6.9 8.1 7.1
White only . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19.1 19.8 21.1 18.5 6.2 6.4 7.4 6.5
Black or African American only . . . . . . . . . . . . . . . 25.9 26.5 29.0 25.5 11.0 10.8 12.7 11.2
Geographic region 3
Northeast. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19.5 20.0 22.6 19.9 6.9 6.2 8.4 6.6
Midwest. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19.3 20.1 22.3 20.0 6.2 6.9 8.2 7.6
South . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20.9 21.2 22.1 19.2 7.3 7.6 8.0 7.4
West . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17.7 18.6 18.9 16.3 6.0 6.3 6.7 5.4
* Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error (RSE) of 20%–30%. Data not shown have an RSE greater than 30%.
1
See Appendix II, Emergency department or emergency room visit.
2
Includes all other races not shown separately, unknown health insurance status, and unknown disability status.
3
Estimates are for persons aged 18 and over and are age-adjusted to the year 2000 standard population using five age groups: 18–44 years, 45–54 years, 55–64 years,
65–74 years, and 75 years and over. See Appendix II, Age adjustment.
4
The race groups, white, black, American Indian or Alaska Native, Asian, Native Hawaiian or Other Pacific Islander, and 2 or more races, include persons of Hispanic and
non-Hispanic origin. Persons of Hispanic origin may be of any race. Starting with 1999 data, race-specific estimates are tabulated according to the 1997 Revisions to the
Standards for the Classification of Federal Data on Race and Ethnicity and are not strictly comparable with estimates for earlier years. The five single-race categories plus
multiple-race categories shown in the table conform to the 1997 Standards. Starting with 1999 data, race-specific estimates are for persons who reported only one racial group;
the category 2 or more races includes persons who reported more than one racial group. Prior to 1999, data were tabulated according to the 1977 Standards with four racial
groups, and the Asian only category included Native Hawaiian or Other Pacific Islander. Estimates for single-race categories prior to 1999 included persons who reported one
race or, if they reported more than one race, identified one race as best representing their race. Starting with 2003 data, race responses of other race and unspecified multiple
race were treated as missing, and then race was imputed if these were the only race responses. Almost all persons with a race response of other race were of Hispanic origin.
5
Percent of poverty level is based on family income and family size and composition using U.S. Census Bureau poverty thresholds. Missing family income data were imputed
for 1997 and beyond. See Appendix II, Family income; Poverty; Table VI.
6
Estimates for persons aged 18–64 are age-adjusted to the year 2000 standard population using three age groups: 18–44 years, 45–54 years, and 55–64 years. See
7
Health insurance categories are mutually exclusive. Persons who reported both Medicaid and private coverage are classified as having private coverage. Starting with 1997
data, state-sponsored health plan coverage is included as Medicaid coverage. Starting with 1999 data, coverage by the Children’s Health Insurance Program (CHIP) is
included with Medicaid coverage. In addition to private and Medicaid, the insured category also includes military plans, other government-sponsored health plans, and
Medicare, not shown separately. Persons not covered by private insurance, Medicaid, CHIP, state-sponsored or other government-sponsored health plans (starting in 1997),
Medicare, or military plans are considered to have no health insurance coverage. Persons with only Indian Health Service coverage are considered to have no health
8
Any basic actions difficulty or complex activity limitation is defined as having one or more of the following limitations or difficulties: movement difficulty, emotional difficulty,
sensory (seeing or hearing) difficulty, cognitive difficulty, self-care (activities of daily living or instrumental activities of daily living) limitation, social limitation, or work limitation.
For more information, see Appendix II, Basic actions difficulty; Complex activity limitation. Starting with 2007 data, the hearing question, a component of the basic actions
difficulty measure, was revised. Consequently, data prior to 2007 are not comparable with data for 2007 and beyond. For more information on the impact of the revised hearing
9
MSA is metropolitan statistical area. Starting with 2006 data, MSA status is determined using 2000 census data and the 2000 standards for defining MSAs. For data prior to
2006, see Appendix II, Metropolitan statistical area (MSA) for the applicable standards.
NOTES: Standard errors are available in the spreadsheet version of this table. Available from: http://www.cdc.gov/nchs/hus.htm. Data for additional years are available.
See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC/NCHS, National Health Interview Survey, family core and sample adult questionnaires. See Appendix I, National Health Interview Survey (NHIS).
All ages, age-adjusted 2,3 . . . . . . . . . . . . . . . . 31,706 31,328 33,007 1,076.4 1,040.8 1,084.0
All ages, crude 2 . . . . . . . . . . . . . . . . . . . . . . 31,706 31,328 33,007 1,068.6 1,029.4 1,067.9
Unintentional injuries 4 . . . . . . . . . . . . . . . . 25,658 25,725 27,275 864.7 845.3 882.4
Falls . . . . . . . . . . . . . . . . . . . . . . . . . . . 8,100 8,900 9,932 273.0 292.4 321.3
Struck by or against objects or persons . . 2,935 2,916 3,166 98.9 95.8 102.4
Motor vehicle traffic . . . . . . . . . . . . . . . . 3,714 3,508 3,557 125.2 115.3 115.1
Cut or pierce . . . . . . . . . . . . . . . . . . . . . 2,145 2,008 1,922 72.3 66.0 62.2
Intentional injuries . . . . . . . . . . . . . . . . . . . 1,977 2,313 2,446 66.6 76.0 79.1
Male
All ages, age-adjusted 2,3 . . . . . . . . . . . . . . . . 16,966 16,640 17,483 1,166.1 1,118.0 1,164.5
All ages, crude 2 . . . . . . . . . . . . . . . . . . . . . . 16,966 16,640 17,483 1,164.2 1,111.8 1,150.5
Unintentional injuries 4 . . . . . . . . . . . . . . . . 13,736 13,590 14,451 942.5 908.0 951.0
Falls . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,685 3,944 4,689 252.9 263.5 308.6
Struck by or against objects or persons . . 1,833 1,863 2,008 125.8 124.4 132.2
Motor vehicle traffic . . . . . . . . . . . . . . . . 1,733 1,734 1,710 118.9 115.8 112.5
Cut or pierce . . . . . . . . . . . . . . . . . . . . . 1,392 1,263 1,236 95.5 84.4 81.4
Intentional injuries . . . . . . . . . . . . . . . . . . . 1,135 1,266 1,396 77.8 84.6 91.8
Under 18 years 2 . . . . . . . . . . . . . . . . . . . . . . 5,072 5,132 5,309 1,346.6 1,351.1 1,397.8
Unintentional injuries 4 . . . . . . . . . . . . . . . . 4,391 4,509 4,724 1,165.8 1,187.1 1,243.9
Falls . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,362 1,512 1,737 361.5 398.1 457.4
Struck by or against objects or persons . . 816 909 997 216.6 239.2 262.6
Motor vehicle traffic . . . . . . . . . . . . . . . . 357 305 301 94.8 80.3 79.1
Cut or pierce . . . . . . . . . . . . . . . . . . . . . 291 284 238 77.3 74.8 62.7
Intentional injuries . . . . . . . . . . . . . . . . . . . 190 194 167 50.4 51.1 44.1
18–24 years 2 . . . . . . . . . . . . . . . . . . . . . . . . 2,552 2,562 2,511 1,729.5 1,695.5 1,612.1
Unintentional injuries 4 . . . . . . . . . . . . . . . . 1,985 1,947 1,890 1,345.4 1,288.6 1,213.7
Falls . . . . . . . . . . . . . . . . . . . . . . . . . . . 318 366 390 215.2 242.4 250.4
Struck by or against objects or persons . . 290 283 259 196.9 187.4 166.6
Motor vehicle traffic . . . . . . . . . . . . . . . . 386 373 357 261.6 247.0 229.3
Cut or pierce . . . . . . . . . . . . . . . . . . . . . 265 215 192 179.5 142.6 123.5
Intentional injuries . . . . . . . . . . . . . . . . . . . 273 381 403 185.2 252.2 258.7
25–44 years 2 . . . . . . . . . . . . . . . . . . . . . . . . 5,199 4,611 4,850 1,243.6 1,109.5 1,184.3
Unintentional injuries 4 . . . . . . . . . . . . . . . . 4,001 3,540 3,690 957.1 851.8 901.1
Falls . . . . . . . . . . . . . . . . . . . . . . . . . . . 763 703 815 182.4 169.2 199.1
Struck by or against objects or persons . . 472 401 452 112.9 96.4 110.4
Motor vehicle traffic . . . . . . . . . . . . . . . . 629 578 591 150.5 139.1 144.3
Cut or pierce . . . . . . . . . . . . . . . . . . . . . 480 401 423 114.8 96.5 103.2
Intentional injuries . . . . . . . . . . . . . . . . . . . 436 495 589 104.4 119.2 143.8
45–64 years 2 . . . . . . . . . . . . . . . . . . . . . . . . 2,842 2,996 3,270 790.0 780.7 822.7
Unintentional injuries 4 . . . . . . . . . . . . . . . . 2,275 2,437 2,741 632.5 635.1 689.6
Falls . . . . . . . . . . . . . . . . . . . . . . . . . . . 599 669 909 166.6 174.2 228.6
Struck by or against objects or persons . . 208 216 204 57.9 56.4 51.4
Motor vehicle traffic . . . . . . . . . . . . . . . . 262 375 334 72.9 97.7 84.0
Cut or pierce . . . . . . . . . . . . . . . . . . . . . 285 306 294 79.2 79.7 73.9
Intentional injuries . . . . . . . . . . . . . . . . . . . 205 168 219 57.1 43.9 55.2
65 years and over 2 . . . . . . . . . . . . . . . . . . . . 1,301 1,340 1,544 837.5 805.1 871.6
Unintentional injuries 4 . . . . . . . . . . . . . . . . 1,082 1,157 1,406 696.8 695.2 793.5
Falls . . . . . . . . . . . . . . . . . . . . . . . . . . . 644 694 838 414.5 416.7 473.0
Struck by or against objects or persons . . 46 *54 95 29.8 *32.2 53.6
Motor vehicle traffic . . . . . . . . . . . . . . . . 98 103 128 63.4 61.7 72.1
Cut or pierce . . . . . . . . . . . . . . . . . . . . . 70 *57 90 45.3 *34.0 50.6
Intentional injuries . . . . . . . . . . . . . . . . . . . * * * * * *
All ages, age-adjusted 2,3 . . . . . . . . . . . . . . . . 14,740 14,688 15,524 980.5 955.6 997.2
All ages, crude 2 . . . . . . . . . . . . . . . . . . . . . . 14,740 14,688 15,524 976.3 949.7 988.0
Unintentional injuries 4 . . . . . . . . . . . . . . . . 11,922 12,134 12,824 789.7 784.6 816.1
Falls . . . . . . . . . . . . . . . . . . . . . . . . . . . 4,415 4,956 5,243 292.4 320.4 333.6
Struck by or against objects or persons . . 1,102 1,053 1,158 73.0 68.1 73.7
Motor vehicle traffic . . . . . . . . . . . . . . . . 1,981 1,774 1,847 131.2 114.7 117.6
Cut or pierce . . . . . . . . . . . . . . . . . . . . . 753 745 685 49.9 48.2 43.6
Intentional injuries . . . . . . . . . . . . . . . . . . . 843 1,048 1,050 55.8 67.7 66.8
Under 18 years 2 . . . . . . . . . . . . . . . . . . . . . . 3,625 3,508 3,673 1,008.7 967.5 1,013.2
Unintentional injuries 4 . . . . . . . . . . . . . . . . 3,058 3,008 3,120 851.1 829.5 860.7
Falls . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,039 1,096 1,138 289.1 302.3 314.0
Struck by or against objects or persons . . 419 439 425 116.7 121.1 117.2
Motor vehicle traffic . . . . . . . . . . . . . . . . 367 249 302 102.1 68.6 83.4
Cut or pierce . . . . . . . . . . . . . . . . . . . . . 160 154 158 44.4 42.4 43.7
Intentional injuries . . . . . . . . . . . . . . . . . . . 188 222 196 52.3 61.4 54.1
18–24 years 2 . . . . . . . . . . . . . . . . . . . . . . . . 1,882 1,736 1,936 1,329.3 1,194.5 1,297.1
Unintentional injuries 4 . . . . . . . . . . . . . . . . 1,431 1,325 1,530 1,010.5 911.7 1,025.0
Falls . . . . . . . . . . . . . . . . . . . . . . . . . . . 290 307 305 205.0 210.9 204.5
Struck by or against objects or persons . . 146 110 171 103.4 75.4 114.7
Motor vehicle traffic . . . . . . . . . . . . . . . . 397 360 460 280.6 247.5 308.1
Cut or pierce . . . . . . . . . . . . . . . . . . . . . 116 77 *94 82.2 53.2 *63.3
Intentional injuries . . . . . . . . . . . . . . . . . . . 176 232 251 124.2 159.7 168.4
25–44 years 2 . . . . . . . . . . . . . . . . . . . . . . . . 4,173 4,087 4,233 1,004.2 996.6 1,034.6
Unintentional injuries 4 . . . . . . . . . . . . . . . . 3,266 3,179 3,308 785.8 775.1 808.5
Falls . . . . . . . . . . . . . . . . . . . . . . . . . . . 873 1,004 941 210.1 244.7 229.9
Struck by or against objects or persons . . 309 198 284 74.3 48.3 69.4
Motor vehicle traffic . . . . . . . . . . . . . . . . 719 621 616 173.1 151.3 150.5
Cut or pierce . . . . . . . . . . . . . . . . . . . . . 269 270 219 64.7 65.9 53.6
Intentional injuries . . . . . . . . . . . . . . . . . . . 313 396 408 75.4 96.5 99.8
45–64 years 2 . . . . . . . . . . . . . . . . . . . . . . . . 2,904 3,061 3,101 767.8 760.0 741.9
Unintentional injuries 4 . . . . . . . . . . . . . . . . 2,278 2,539 2,519 602.2 630.4 602.7
Falls . . . . . . . . . . . . . . . . . . . . . . . . . . . 865 1,012 1,075 228.7 251.2 257.1
Struck by or against objects or persons . . 160 216 197 42.2 53.5 47.2
Motor vehicle traffic . . . . . . . . . . . . . . . . 359 399 345 94.8 99.0 82.6
Cut or pierce . . . . . . . . . . . . . . . . . . . . . 158 190 157 41.7 47.2 37.6
Intentional injuries . . . . . . . . . . . . . . . . . . . 149 161 182 39.4 39.9 43.5
65 years and over 2 . . . . . . . . . . . . . . . . . . . . 2,155 2,294 2,582 1,002.9 1,016.3 1,110.7
Unintentional injuries 4 . . . . . . . . . . . . . . . . 1,889 2,083 2,348 879.1 922.8 1,009.8
Falls . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,347 1,538 1,784 626.9 681.2 767.2
Struck by or against objects or persons . . 69 91 81 31.9 40.4 34.7
Motor vehicle traffic . . . . . . . . . . . . . . . . 139 146 124 64.5 64.7 53.5
Cut or pierce . . . . . . . . . . . . . . . . . . . . . *50 *54 *56 *23.3 *23.9 *24.2
Intentional injuries . . . . . . . . . . . . . . . . . . . * * * * * *
* Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error (RSE) of 20%–30%. Data not shown have an RSE greater than 30%.
1
Intent and mechanism of injury are based on the first-listed external cause of injury code (E code). Intentional injuries include suicide attempts and assaults. See Appendix II,
External cause of injury; Injury; Injury-related visit; Table IX for a listing of E codes.
2
Includes all injury-related visits not shown separately in table, including those with undetermined intent (1% in 2010–2011) and insufficient or no information to code cause of
3
Rates are age-adjusted to the year 2000 standard population using six age groups: under 18 years, 18–24 years, 25–44 years, 45–64 years, 65–74 years, and 75 years and
4
Includes unintentional injury-related visits with mechanism of injury not shown in table.
NOTES: An emergency department visit was considered injury-related if the first-listed diagnosis was injury-related (ICD–9-CM 800–909.2, 909.4, 909.9–994.9,
995.50–995.59, and 995.80–995.85) or the first-listed external cause code (E code) was injury-related (ICD–9–CM E800–E869, E880–E929, and E950–E999). See:
http://www.cdc.gov/nchs/injury/injury_tools.htm for code used to classify injury-related visits in this table. Visits with a first-listed diagnosis or first-listed E code
describing a complication or adverse effect of medical care were not considered injury related. For more information on injury-related visits, see Bergen G, Chen LH,
Warner M, Fingerhut LA. Injury in the United States: 2007 Chartbook. Hyattsville, MD: NCHS. 2008. Available from: http://www.cdc.gov/nchs/data/misc/injury2007.pdf.
Estimates for first-listed injury-related visits were further limited to those visits that were initial visits for the injury. This was determined using an imputed variable in
2005–2006; for 2007 and beyond this was determined by using the initial visit episode of care information collected on the questionnaire. Limiting the estimates to initial
visits decreases the total number of injury-related visits by 9% in 2005–2006, 14% in 2007–2008, 10% to 12% in 2008–2009 and 2009–2010 (shown in spreadsheet
version), and 10% in 2010–2011. Rates were calculated using estimates of the civilian population of the United States including institutionalized persons. Population
data are from unpublished tabulations provided by the U.S. Census Bureau. Rates for 2005–2010 were calculated using postcensal population estimates based on the
2000 census. Rates for 2011 and beyond were calculated using postcensal population estimates based on the 2010 census. Data for additional years are available.
See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm. Data have been revised and differ from previous editions of
Health, United States.
SOURCE: CDC/NCHS, National Hospital Ambulatory Medical Care Survey. See Appendix I, National Hospital Ambulatory Medical Care Survey (NHAMCS).
Age, sex, and race 1995 2000 2010 2011 1995 2000 2010 2011
Total, age-adjusted 2 . . . . . . . . . . . . . . . . . 334 374 401 -- 271 304 325 --
Total, crude . . . . . . . . . . . . . . . . . . . . . . . 329 370 408 -- 266 300 332 --
Under 18 years . . . . . . . . . . . . . . . . . . . . 275 293 331 -- 213 226 257 --
18–44 years . . . . . . . . . . . . . . . . . . . . . . 264 291 310 -- 203 224 237 --
45–64 years . . . . . . . . . . . . . . . . . . . . . . 364 422 441 -- 309 358 371 --
45–54 years . . . . . . . . . . . . . . . . . . . . . 339 385 388 -- 286 323 320 --
55–64 years . . . . . . . . . . . . . . . . . . . . . 401 481 505 -- 343 412 434 --
65 years and over . . . . . . . . . . . . . . . . . . 612 706 767 -- 534 612 666 --
65–74 years . . . . . . . . . . . . . . . . . . . . . 560 656 713 -- 494 577 624 --
75 years and over. . . . . . . . . . . . . . . . . 683 766 831 -- 588 654 715 --
Age, sex, and race 1995 2000 2010 2011 1995 2000 2010 2011
Total, age-adjusted 2 . . . . . . . . . . . . . . . . . 26 31 33 40 37 40 43 45
Total, crude . . . . . . . . . . . . . . . . . . . . . . . 26 30 33 41 37 39 43 44
Under 18 years . . . . . . . . . . . . . . . . . . . . 25 29 33 37 38 38 40 40
18–44 years . . . . . . . . . . . . . . . . . . . . . . 22 25 25 34 39 42 48 51
45–64 years . . . . . . . . . . . . . . . . . . . . . . 29 34 35 46 27 30 35 36
45–54 years . . . . . . . . . . . . . . . . . . . . . 26 31 31 44 28 30 38 40
55–64 years . . . . . . . . . . . . . . . . . . . . . 33 39 39 49 26 30 32 32
65 years and over . . . . . . . . . . . . . . . . . . 33 44 51 56 45 50 50 51
65–74 years . . . . . . . . . . . . . . . . . . . . . 33 42 50 56 33 37 39 37
75 years and over. . . . . . . . . . . . . . . . . 34 47 52 56 61 65 64 68
- - - Data not available. Estimates for all places and physician offices will be published on the Health, United States website when the data are available.
* Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error (RSE) of 20%–30%. Data not shown have an RSE greater than 30%.
1
All places includes visits to physician offices and hospital outpatient and emergency departments. See Appendix II, Emergency department; Emergency department or
2
Estimates are age-adjusted to the year 2000 standard population using six age groups: under 18 years, 18–44 years, 45–54 years, 55–64 years, 65–74 years, and 75 years
3
Estimates by racial group should be used with caution because information on race was collected from medical records. In 2010, race data were missing and imputed for
23% of visits to physician offices, and in 2011, for 17% of visits to hospital outpatient departments, and 15% of visits to hospital emergency departments. Information on the
race imputation process used in each data year is available in the public-use file documentation. Available from: http://www.cdc.gov/nchs/ahcd.htm. Starting with 1999 data, the
instruction for the race item on the Patient Record Form was changed so that more than one race could be recorded. In previous years only one race could be recorded.
Estimates for race in this table are for visits where only one race was recorded. Because of the small number of responses with more than one racial group recorded,
estimates for visits with multiple races recorded are unreliable and are not presented.
NOTES: Rates for 1995–2000 were computed using 1990-based postcensal estimates of the civilian noninstitutionalized population as of July 1, adjusted for net
underenumeration using the 1990 National Population Adjustment Matrix from the U.S. Census Bureau. For 2001–2010 data, rates were computed using 2000-based
postcensal estimates of the civilian noninstitutionalized population as of July 1. For 2011 data and beyond, rates were computed using 2010-based postcensal
estimates of the civilian noninstitutionalized population as of July 1. More information is available from: http://www.cdc.gov/nchs/ahcd.htm. Rates using the civilian
noninstitutionalized population will be overestimated to the extent that visits by institutionalized persons are counted in the numerator (for example, hospital emergency
department visits by nursing home residents) but institutionalized persons are omitted from the denominator (the civilian noninstitutionalized population). Starting with
Health, United States, 2005, data for physician offices for 2001 and beyond use a revised weighting scheme. See Appendix I, National Ambulatory Medical Care Survey
(NAMCS); National Hospital Ambulatory Medical Care Survey (NHAMCS). Data for additional years are available. See the Excel spreadsheet on the Health, United
States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC/NCHS, National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey. See Appendix I, National Ambulatory Medical
Care Survey (NAMCS); National Hospital Ambulatory Medical Care Survey (NHAMCS).
All primary care generalists General and family practice Internal medicine
Age, sex, and race 1980 1990 2000 2010 1980 1990 2000 2010 1980 1990 2000 2010
Age, sex, and race 1980 1990 2000 2010 1980 1990 2000 2010 1980 1990 2000 2010
* Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error (RSE) of 20%–30%. Data not shown have a RSE greater than 30%.
. . . Category not applicable.
1
Type of physician is based on physician’s self-designated primary area of practice. Primary care generalist physicians are defined as practitioners in the fields of
general and family practice, general internal medicine, general obstetrics and gynecology, and general pediatrics and exclude primary care specialists. Primary care
generalists in general and family practice exclude primary care specialties, such as sports medicine and geriatrics. Primary care internal medicine physicians exclude
internal medicine specialists, such as allergists, cardiologists, and endocrinologists. Primary care obstetrics and gynecology physicians exclude obstetrics and
gynecology specialties, such as gynecological oncology, maternal and fetal medicine, obstetrics and gynecology critical care medicine, and reproductive endocrinology.
Primary care pediatricians exclude pediatric specialists, such as adolescent medicine specialists, neonatologists, pediatric allergists, and pediatric cardiologists. See
Appendix II, Physician specialty.
2
Estimates by racial group should be used with caution because information on race was collected from medical records. In 2010, race data were missing and imputed
for 23% of visits. Information on the race imputation process used in each data year is available in the public-use file documentation. Available from:
http://www.cdc.gov/nchs/ahcd.htm. Starting with 1999 data, the instruction for the race item on the Patient Record Form was changed so that more than one race could
be recorded. In previous years only one racial category could be checked. Estimates for racial groups presented in this table are for visits where only one race was
recorded. Because of the small number of responses with more than one racial group checked, estimates for visits with multiple races checked are unreliable and are
not presented.
NOTES: This table presents data on visits to physician offices and excludes visits to other sites, such as hospital outpatient and emergency departments. See Appendix
II, Office visit. In 1980, the survey excluded Alaska and Hawaii. Data for all other years include all 50 states and the District of Columbia. Visits with specialty of
physician unknown are excluded. Starting with Health, United States, 2005, data for 2001 and later years for physician offices use a revised weighting scheme. See
Appendix I, National Ambulatory Medical Care Survey (NAMCS). Data for additional years are available. See the Excel spreadsheet on the Health, United States
website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC/NCHS, National Ambulatory Medical Care Survey. See Appendix I, National Ambulatory Medical Care Survey (NAMCS).
2 years and over 2–17 years 18–64 years 65 years and over 1
Characteristic 1997 2010 2013 1997 2010 2013 1997 2010 2013 1997 2010 2013
Total 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . 65.1 64.7 66.2 72.7 78.9 83.0 64.1 61.1 61.7 54.8 57.7 60.6
Sex
Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62.9 61.7 63.4 72.3 78.3 82.6 60.4 56.8 57.1 55.4 56.2 60.5
Female . . . . . . . . . . . . . . . . . . . . . . . . . . 67.1 67.5 68.9 73.0 79.6 83.5 67.7 65.4 66.2 54.4 58.9 60.8
Race 4
White only . . . . . . . . . . . . . . . . . . . . . . . . 66.4 65.6 67.1 74.0 79.2 83.6 65.7 62.4 62.9 56.8 59.3 62.5
Black or African American only . . . . . . . . . 58.9 58.8 61.0 68.8 79.0 80.8 57.0 53.1 55.9 35.4 40.6 42.6
American Indian or Alaska Native only . . . . 55.1 57.4 60.1 66.8 73.2 81.9 49.9 49.8 52.7 * 72.2 50.9
Asian only . . . . . . . . . . . . . . . . . . . . . . . . 62.5 66.5 67.0 69.9 74.8 80.9 60.3 64.6 63.7 53.9 61.9 63.0
Native Hawaiian or Other Pacific
Islander only . . . . . . . . . . . . . . . . . . ... -- * * -- * * -- * * -- * *
2 or more races . . . . . . . . . . . . . . . . . ... -- 65.2 67.4 -- 77.9 82.6 -- 54.7 55.8 -- 48.1 49.2
Black or African American; White . . . ... -- 72.5 72.9 -- 78.4 84.5 -- 62.1 54.2 -- * *
American Indian or Alaska Native;
White . . . . . . . . . . . . . . . . . . . . . . ... -- 54.7 58.7 -- 70.0 75.3 -- 49.0 53.7 -- *54.5 47.6
4
Hispanic origin and race
Hispanic or Latino . . . . . . . . . . . . . . . . . . 54.0 56.5 59.4 61.0 74.8 80.7 50.8 48.5 50.2 47.8 42.1 47.7
Not Hispanic or Latino . . . . . . . . . . . . . . . 66.4 66.2 67.6 74.7 80.1 83.8 65.7 63.4 64.1 55.2 59.0 61.7
White only . . . . . . . . . . . . . . . . . . . . . . 68.0 67.6 69.1 76.4 80.9 85.0 67.5 65.4 66.0 57.2 60.9 63.9
Black or African American only . . . . . . . . 58.8 58.7 60.6 68.8 79.2 80.5 56.9 53.1 55.7 35.3 40.5 42.4
2 years and over 2–17 years 18–64 years 65 years and over 1
Characteristic 1997 2010 2013 1997 2010 2013 1997 2010 2013 1997 2010 2013
Disability measure 6 Percent of persons with a dental visit in the past year 2
Any basic actions difficulty or complex
activity limitation . . . . . . . . . . . . . . . . . . . ... ... ... ... ... ... 55.1 53.5 52.9 49.0 50.7 53.6
Any basic actions difficulty . . . . . . . . . . . ... ... ... ... ... ... 54.7 53.2 53.1 48.7 50.5 53.6
Any complex activity limitation . . . . . . . . ... ... ... ... ... ... 51.0 47.4 49.1 44.6 43.1 45.9
No disability. . . . . . . . . . . . . . . . . . . . . . . ... ... ... ... ... ... 67.4 64.2 64.9 64.2 68.8 71.7
Geographic region
Northeast . . . . . . . . . . . . . . . . . . . . . . . . 69.6 70.1 71.2 77.5 83.8 86.9 69.6 67.9 68.5 55.5 61.5 62.2
Midwest . . . . . . . . . . . . . . . . . . . . . . . . . 68.4 67.3 68.1 76.4 80.8 85.5 67.4 64.3 63.9 57.6 58.2 60.6
South . . . . . . . . . . . . . . . . . . . . . . . . . . . 60.2 60.9 62.5 68.0 77.4 80.6 59.4 56.5 57.4 49.0 54.1 57.0
West. . . . . . . . . . . . . . . . . . . . . . . . . . . . 65.0 63.9 66.7 71.5 76.1 82.1 62.9 60.2 61.6 61.9 59.8 65.7
Location of residence 7
Within MSA . . . . . . . . . . . . . . . . . . . . . . . 66.7 65.9 67.4 73.6 79.3 83.3 65.7 62.4 63.0 57.6 59.4 62.6
Outside MSA . . . . . . . . . . . . . . . . . . . . . . 59.1 58.4 59.6 69.3 76.4 81.3 58.0 53.8 53.9 46.1 51.3 52.9
* Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error (RSE) of 20%–30%. Data not shown have an RSE greater than 30%.
1
Based on the 1997–2013 National Health Interview Surveys, about 21%–30% of persons aged 65 and over were edentulous (having lost all their natural teeth). In
1997–2013, about 69%–73% of older dentate persons, compared with 17%–23% of older edentate persons, had a dental visit in the past year.
2
Respondents were asked, ‘‘About how long has it been since you last saw or talked to a dentist?’’ See Appendix II, Dental visit.
3
Includes all other races not shown separately and unknown disability status.
4
The race groups, white, black, American Indian or Alaska Native, Asian, Native Hawaiian or Other Pacific Islander, and 2 or more races, include persons of Hispanic and
non-Hispanic origin. Persons of Hispanic origin may be of any race. Starting with 1999 data, race-specific estimates are tabulated according to the 1997 Revisions to the
Standards for the Classification of Federal Data on Race and Ethnicity and are not strictly comparable with estimates for earlier years. The five single-race categories plus
multiple-race categories shown in the table conform to the 1997 Standards. Starting with 1999 data, race-specific estimates are for persons who reported only one racial group;
the category 2 or more races includes persons who reported more than one racial group. Prior to 1999, data were tabulated according to the 1977 Standards with four racial
groups, and the Asian only category included Native Hawaiian or Other Pacific Islander. Estimates for single-race categories prior to 1999 included persons who reported one
race or, if they reported more than one race, identified one race as best representing their race. Starting with 2003 data, race responses of other race and unspecified multiple
race were treated as missing, and then race was imputed if these were the only race responses. Almost all persons with a race response of other race were of Hispanic origin.
5
Percent of poverty level is based on family income and family size and composition using U.S. Census Bureau poverty thresholds. Missing family income data were imputed
for 1997 and beyond. See Appendix II, Family income; Poverty; Table VI.
6
Any basic actions difficulty or complex activity limitation is defined as having one or more of the following limitations or difficulties: movement difficulty, emotional difficulty,
sensory (seeing or hearing) difficulty, cognitive difficulty, self-care (activities of daily living or instrumental activities of daily living) limitation, social limitation, or work limitation.
For more information, see Appendix II, Basic actions difficulty; Complex activity limitation. Starting with 2007 data, the hearing question, a component of the basic actions
difficulty measure, was revised. Consequently, data prior to 2007 are not comparable with data for 2007 and beyond. For more information on the impact of the revised hearing
7
MSA is metropolitan statistical area. Starting with 2006 data, MSA status is determined using 2000 census data and the 2000 standards for defining MSAs. For data prior to
2006, see Appendix II, Metropolitan statistical area (MSA) for the applicable standards.
NOTES: In 1997, the National Health Interview Survey questionnaire was redesigned. See Appendix I, National Health Interview Survey (NHIS). Standard errors for
selected years are available in the spreadsheet version of this table. Available from: http://www.cdc.gov/nchs/hus.htm. Data for additional years are available. See the
Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC/NCHS, National Health Interview Survey, sample child and sample adult questionnaires. See Appendix I, National Health Interview Survey (NHIS).
Black or African
All persons 1 White only 2 American only 2 Mexican origin 2,3
1988– 1999– 2009– 1988– 1999– 2009– 1988– 1999– 2009– 1988– 1999– 2009–
Sex and age 1994 2002 2012 1994 2002 2012 1994 2002 2012 1994 2002 2012
Black or African
All persons 1 White only 2 American only 2 Mexican origin 2,3
1988– 1999– 2009– 1988– 1999– 2009– 1988– 1999– 2009– 1988– 1999– 2009–
Sex and age 1994 2002 2012 1994 2002 2012 1994 2002 2012 1994 2002 2012
Male . . . . . . . . . . . . . . . . . . . . . 2.9 6.1 9.3 3.1 6.3 9.6 2.9 6.4 9.5 2.0 3.5 7.6
Female. . . . . . . . . . . . . . . . . . . . 4.9 8.7 10.8 5.1 9.2 11.5 4.5 8.7 12.0 3.7 5.2 8.9
Both sexes, crude . . . . . . . . . . . . . 3.6 7.4 10.7 4.2 8.7 12.8 2.6 6.2 9.8 1.4 2.1 4.4
Male . . . . . . . . . . . . . . . . . . . . . 2.5 5.6 9.3 2.9 6.6 11.1 1.8 4.8 8.1 0.9 1.6 4.1
Female. . . . . . . . . . . . . . . . . . . . 4.7 9.1 12.0 5.4 10.8 14.4 3.3 7.4 11.3 1.9 2.7 *4.6
18–44 years. . . . . . . . . . . . . . . . . . 1.2 2.3 3.3 1.4 2.5 4.3 1.0 3.2 *2.9 * * *
45–64 years. . . . . . . . . . . . . . . . . . 7.4 13.3 16.3 7.8 13.6 17.1 7.1 14.3 19.2 5.4 8.3 12.9
65 years and over . . . . . . . . . . . . . 13.8 27.1 39.1 13.9 28.6 38.8 14.3 24.6 41.4 11.6 17.4 38.2
Male:
45–64 years . . . . . . . . . . . . . . . . 4.8 9.5 14.2 5.0 9.4 14.7 5.9 13.0 16.9 *3.5 *5.9 12.8
65 years and over . . . . . . . . . . . . 11.3 24.7 37.9 11.6 25.9 37.5 9.9 21.0 37.1 *8.7 15.3 32.3
Female:
18–44 years . . . . . . . . . . . . . . . . 1.7 2.8 3.9 1.8 *3.0 5.1 1.2 *4.3 *3.9 *0.6 * *
45–64 years . . . . . . . . . . . . . . . . 9.7 16.8 18.3 10.3 17.6 19.5 8.0 15.3 21.1 *7.2 10.8 13.0
65 years and over . . . . . . . . . . . . 15.6 28.9 40.0 15.7 30.6 39.8 17.4 27.1 44.3 14.0 19.2 43.8
* Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error (RSE) of 20%–30%. Data not shown have an RSE greater than
30%.
1
Includes persons of all races and Hispanic origins, not just those shown separately.
2
Starting with 1999 data, race-specific estimates are tabulated according to the 1997 Revisions to the Standards for the Classification of Federal Data on Race and
Ethnicity and are not strictly comparable with estimates for earlier years. The two non-Hispanic race categories shown in the table conform to the 1997 Standards.
Starting with 1999 data, race-specific estimates are for persons who reported only one racial group. Prior to data year 1999, estimates were tabulated according to the
1977 Standards. Estimates for single-race categories prior to 1999 included persons who reported one race or, if they reported more than one race, identified one race
as best representing their race. See Appendix II, Hispanic origin; Race.
3
Persons of Mexican origin may be of any race.
4
Estimates are age-adjusted to the year 2000 standard population using four age groups: Under 18 years, 18–44 years, 45–64 years, and 65 years and over.
Age-adjusted estimates in this table may differ from other age-adjusted estimates based on the same data and presented elsewhere if different age groups are used in
NOTES: See Appendix II, Drug. Standard errors are available in the spreadsheet version of this table. Available from: http://www.cdc.gov/nchs/hus.htm. Data for
additional years are available. See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC/NCHS, National Health and Nutrition Examination Survey. See Appendix I, National Health and Nutrition Examination Survey (NHANES).
Age group and Multum Lexicon Plus 1988– 1999– 2009– 1988– 1999– 2009– 1988– 1999– 2009–
therapeutic class 1 (common indications for use) 1994 2002 2012 1994 2002 2012 1994 2002 2012
All ages Percent of population with at least one prescription drug in drug class in past 30 days
Antihyperlipidemic agents (high cholesterol) . . . . . . . . . . 1.7 6.5 13.1 1.5 7.1 13.9 1.8 5.8 12.3
Analgesics (pain relief). . . . . . . . . . . . . . . . . . . . . . . . . 7.2 9.4 8.8 5.4 7.3 7.5 9.0 11.3 10.0
Antidepressants (depression and related disorders) . . . . 1.8 6.4 9.0 1.2 4.4 6.0 2.3 8.3 11.8
Proton pump inhibitors or H2 antagonists
(gastric reflux, ulcers) 2 . . . . . . . . . . . . . . . . . . . . . . . . 2.8 5.3 8.2 2.4 4.7 7.3 3.0 5.9 9.1
Beta-adrenergic blocking agents (high blood pressure,
heart disease) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.1 4.4 7.7 2.7 4.1 7.3 3.5 4.6 8.1
ACE inhibitors (high blood pressure, heart disease) . . . . 2.4 4.6 6.8 2.4 4.7 7.6 2.4 4.5 6.1
Antidiabetic agents (diabetes). . . . . . . . . . . . . . . . . . . . 2.6 3.7 5.9 2.5 3.7 6.2 2.6 3.8 5.6
Diuretics (high blood pressure, heart disease,
kidney disease) 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.4 4.1 5.6 2.3 3.1 4.5 4.4 5.1 6.6
Thyroid hormones (hypothyroidism). . . . . . . . . . . . . . . . 2.3 3.9 5.0 0.8 1.5 2.3 3.7 6.2 7.5
Bronchodilators (asthma, breathing) . . . . . . . . . . . . . . . 2.6 3.5 5.0 2.5 3.1 4.6 2.7 3.8 5.3
Sex hormones (contraceptives, menopause, hot
flashes) 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... ... ... ... ... ... 9.8 15.2 8.6
Anxiolytics, sedatives, and hypnotics (anxiety,
insomnia, and related disorders) . . . . . . . . . . . . . . . . . 2.8 3.3 4.6 1.9 2.6 3.8 3.6 4.0 5.4
Antihypertensive combinations (high blood pressure) . . . 2.4 2.9 4.3 1.4 1.9 3.7 3.3 3.8 4.8
Anticonvulsants (epilepsy, seizure, and related
disorders) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.4 2.4 4.1 1.2 2.1 3.5 1.6 2.7 4.6
Calcium channel blocking agents (high blood pressure,
heart disease) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.6 4.2 4.0 3.4 3.5 3.9 3.8 4.8 4.1
Under 18 years
Bronchodilators (asthma, breathing) . . . . . . . . . . . . . . . 3.0 4.0 5.1 3.3 4.4 5.7 2.7 3.6 4.4
CNS stimulants (attention-deficit/hyperactivity disorder) . . *0.8 2.9 3.5 *1.2 4.4 5.0 * 1.4 1.9
Penicillins (bacterial infections) . . . . . . . . . . . . . . . . . . . 6.1 5.1 3.3 5.9 5.2 2.7 6.4 5.0 3.8
Leukotriene modifiers (asthma, allergies) . . . . . . . . . . . . ... 0.7 2.0 ... *0.9 2.3 ... * 1.7
Antihistamines (allergies) . . . . . . . . . . . . . . . . . . . . . . . 2.0 4.4 1.7 2.1 4.9 1.9 1.9 3.9 1.6
Respiratory inhalant products (asthma, chronic
obstructive pulmonary disease, and related
disorders) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . *0.7 1.5 2.0 * 1.7 2.4 * 1.3 1.5
Adrenal cortical steroids (anti-inflammatory) . . . . . . . . . . *0.5 0.8 1.4 * *0.7 1.5 *0.5 0.9 *1.2
Nasal preparations (nose symptoms) . . . . . . . . . . . . . . * 1.1 1.6 * *1.3 1.9 * 1.0 *1.3
Antidepressants (depression and related disorders) . . . . * 1.8 *1.2 * 2.2 * * *1.5 *
Upper respiratory combinations (cough and cold,
congestion) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.3 2.3 *0.8 2.6 *2.4 *0.9 2.0 *2.2 *
Analgesics (pain relief). . . . . . . . . . . . . . . . . . . . . . . . . 1.2 1.4 1.2 *1.2 1.3 *1.2 1.4 1.6 *1.1
Dermatological agents (skin symptoms). . . . . . . . . . . . . 0.7 1.1 1.4 * 1.1 *1.2 *1.0 *1.1 1.7
18–44 years
Analgesics (pain relief). . . . . . . . . . . . . . . . . . . . . . . . . 7.2 8.0 7.6 5.1 6.0 5.8 9.1 9.9 9.5
Antidepressants (depression and related disorders) . . .. 1.6 6.0 8.4 *1.0 3.6 5.9 2.3 8.5 10.8
Sex hormones (contraceptives, menopause, hot
flashes) 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. ... ... ... ... ... ... 11.5 13.5 14.0
Proton pump inhibitors or H2 antagonists
(gastric reflux, ulcers) 2 . . . . . . . . . . . . . . . . . . . . . . .. 2.0 3.0 4.8 1.6 3.0 5.1 2.4 3.0 4.4
Anxiolytics, sedatives, and hypnotics (anxiety,
insomnia, and related disorders) . . . . . . . . . . . . . . . .. 1.4 2.1 4.0 *1.0 *1.7 3.2 1.9 2.5 4.7
Anticonvulsants (epilepsy, seizure, and related
disorders) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.8 1.6 3.2 *0.6 1.6 2.9 1.0 *1.5 3.6
Bronchodilators (asthma, breathing) . . . . . . . . . . . . . . . 1.4 2.2 3.5 *1.1 1.6 2.7 *1.8 2.8 4.2
Antihyperlipidemic agents (high cholesterol) . . . . . . . . . . *0.4 1.3 2.3 * 2.0 *2.8 * * 1.8
Antihistamines (allergies) . . . . . . . . . . . . . . . . . . . . . . . 2.5 3.9 1.9 1.8 3.6 *1.5 3.2 4.2 2.2
Thyroid hormones (hypothyroidism). . . . . . . . . . . . . . . . 1.3 1.6 1.9 * * *0.8 2.1 2.8 3.1
ACE inhibitors (high blood pressure, heart disease) . . . . 0.7 1.4 1.8 *0.9 1.5 2.1 *0.6 *1.2 1.6
Antidiabetic agents (diabetes). . . . . . . . . . . . . . . . . . . . *1.0 1.5 2.1 * *1.5 2.0 *1.0 *1.6 2.1
Muscle relaxants (muscle spasm and related
disorders) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 1.0 1.3 1.7 *1.3 *1.1 *1.5 *0.7 *1.4 1.9
Beta-adrenergic blocking agents (high blood pressure,
heart disease) . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 1.1 *1.2 1.7 *0.9 *1.3 1.3 1.3 * 2.1
Nasal preparations (nose symptoms) . . . . . . . . . . . . .. *0.6 1.5 1.5 * *1.2 *1.1 *0.7 1.7 1.8
Age group and Multum Lexicon Plus 1988– 1999– 2009– 1988– 1999– 2009– 1988– 1999– 2009–
therapeutic class 1 (common indications for use) 1994 2002 2012 1994 2002 2012 1994 2002 2012
45–64 years Percent of population with at least one prescription drug in drug class in past 30 days
Antihyperlipidemic agents (high cholesterol) . . . . . . . . .. 4.3 13.8 23.8 4.4 17.2 26.3 4.2 10.7 21.4
Proton pump inhibitors or H2 antagonists
(gastric reflux, ulcers) 2 . . . . . . . . . . . . . . . . . . . . . . .. 5.2 9.9 13.2 5.3 8.4 11.7 5.2 11.3 14.6
Antidepressants (depression and related disorders) . . .. 3.5 10.5 14.3 *2.3 7.0 9.6 4.6 13.8 18.6
Sex hormones (contraceptives, menopause, hot
flashes) 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. ... ... ... ... ... ... 19.9 30.3 9.3
Analgesics (pain relief). . . . . . . . . . . . . . . . . . . . . . . .. 11.9 16.0 14.2 9.2 13.5 13.2 14.3 18.3 15.2
Beta-adrenergic blocking agents (high blood pressure,
heart disease) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.6 8.7 11.5 7.0 7.8 11.6 6.2 9.5 11.4
ACE inhibitors (high blood pressure, heart disease) . . . . 5.2 8.8 11.8 5.7 9.8 13.1 4.6 7.9 10.6
Antidiabetic agents (diabetes). . . . . . . . . . . . . . . . . . . . 5.5 7.0 10.0 5.9 7.8 11.0 5.1 6.3 9.1
Thyroid hormones (hypothyroidism). . . . . . . . . . . . . . . . 4.7 6.6 8.5 *1.2 *2.7 3.6 8.1 10.1 13.0
Antihypertensive combinations (high blood pressure) . . . 5.3 5.6 8.0 3.3 *3.7 8.1 7.1 7.3 7.9
Anxiolytics, sedatives, and hypnotics (anxiety,
insomnia, and related disorders) . . . . . . . . . . . . . . . .. 6.0 6.2 7.4 4.3 4.9 6.8 7.5 7.4 7.9
Diuretics (high blood pressure, heart disease,
kidney disease) 3 . . . . . . . . . . . . . . . . . . . . . . . . . . .. 6.1 6.6 8.8 4.8 4.8 7.6 7.3 8.3 9.8
Anticonvulsants (epilepsy, seizure, and related
disorders) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 2.7 4.3 6.3 *2.5 3.5 5.5 2.9 5.1 7.0
Bronchodilators (asthma, breathing) . . . . . . . . . . . . . .. 3.4 3.8 5.8 2.9 3.1 4.8 3.8 4.5 6.7
Calcium channel blocking agents (high blood
pressure, heart disease). . . . . . . . . . . . . . . . . . . . . .. 7.0 6.7 5.4 8.2 5.9 5.9 5.9 7.5 5.0
65–74 years
Antihyperlipidemic agents (high cholesterol) . . . . . . . . . . 7.3 26.2 45.8 6.2 26.6 49.4 8.1 25.9 42.6
Beta-adrenergic blocking agents (high blood pressure,
heart disease) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.3 14.8 26.2 10.6 16.0 29.4 11.9 13.9 23.3
ACE inhibitors (high blood pressure, heart disease) . . . . 9.6 17.2 21.9 10.6 18.1 28.5 8.9 16.4 16.0
Proton pump inhibitors or H2 antagonists
(gastric reflux, ulcers) 2 . . . . . . . . . . . . . . . . . . . . . . . . 7.0 14.7 19.4 6.3 13.4 16.8 7.5 15.8 21.7
Antidiabetic agents (diabetes). . . . . . . . . . . . . . . . . . . . 8.8 12.9 19.5 8.0 13.8 21.4 9.4 12.0 17.9
Diuretics (high blood pressure, heart disease,
kidney disease) 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14.2 15.9 18.7 10.8 14.6 16.1 17.0 16.9 21.0
Analgesics (pain relief). . . . . . . . . . . . . . . . . . . . . . . . . 13.0 18.5 15.8 10.5 14.9 14.7 15.0 21.4 16.9
Antihypertensive combinations (high blood pressure) . . . 8.1 8.0 13.1 4.8 *6.7 9.4 10.8 9.0 16.3
Anticoagulants or antiplatelet agents (blood clot
prevention) 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.4 6.7 11.3 6.3 9.8 16.0 4.6 *4.2 7.2
Antidepressants (depression and related disorders) . . . . 2.8 9.3 15.2 *2.3 5.8 10.8 3.1 12.1 19.1
Calcium channel blocking agents (high blood pressure,
heart disease) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15.0 16.1 13.6 14.0 15.3 14.9 15.8 16.8 12.5
Thyroid hormones (hypothyroidism). . . . . . . . . . . . . . . . 6.4 13.0 14.7 *3.4 *5.0 *8.5 8.9 19.7 20.2
Angiotensin II inhibitors (high blood pressure,
heart disease) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... 4.2 11.2 ... *3.5 9.7 ... 4.9 12.5
Antiarrhythmic agents (heart rhythm irregularities) . . . . . 20.2 13.0 6.7 19.0 15.5 7.4 21.1 10.8 6.1
Age group and Multum Lexicon Plus 1988– 1999– 2009– 1988– 1999– 2009– 1988– 1999– 2009–
therapeutic class 1 (common indications for use) 1994 2002 2012 1994 2002 2012 1994 2002 2012
75 years and over Percent of population with at least one prescription drug in drug class in past 30 days
Antihyperlipidemic agents (high cholesterol) . . . . . . . . . . 3.8 19.9 48.2 *3.5 21.1 55.7 4.0 19.2 43.1
Beta-adrenergic blocking agents (high blood pressure,
heart disease) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.5 17.3 37.9 9.8 19.6 37.6 14.1 15.8 38.1
Diuretics (high blood pressure, heart disease,
kidney disease) 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19.2 23.2 25.4 14.7 20.5 24.5 21.9 24.9 26.1
ACE inhibitors (high blood pressure, heart disease) . . . . 9.3 16.4 25.3 8.5 17.7 29.2 9.8 15.6 22.6
Anticoagulants or antiplatelet agents (blood clot
prevention) 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.2 12.0 22.8 7.8 13.9 27.0 6.9 10.9 20.0
Proton pump inhibitors or H2 antagonists
(gastric reflux, ulcers) 2 . . . . . . . . . . . . . . . . . . . . . . . . 8.3 14.6 24.6 9.0 15.3 22.1 7.9 14.2 26.4
Calcium channel blocking agents (high blood pressure,
heart disease) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17.8 22.8 22.2 15.3 20.5 19.3 19.2 24.2 24.1
Thyroid hormones (hypothyroidism). . . . . . . . . . . . . . . . 7.9 15.8 16.9 3.0 9.2 10.3 10.9 20.0 21.4
Analgesics (pain relief). . . . . . . . . . . . . . . . . . . . . . . . . 15.1 18.4 15.8 13.0 15.1 14.2 16.3 20.4 16.9
Antidiabetic agents (diabetes). . . . . . . . . . . . . . . . . . . . 9.3 11.8 18.3 10.7 11.5 22.9 8.5 12.0 15.2
Antihypertensive combinations (high blood pressure) . . . 11.9 12.0 13.2 8.3 *8.2 8.9 14.0 14.4 16.2
Antiarrhythmic agents (heart rhythm irregularities) . . . . . 27.7 21.0 12.9 26.3 21.3 11.8 28.6 20.7 13.7
Angiotensin II inhibitors (high blood pressure,
heart disease) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... 5.4 13.2 ... *4.9 14.6 ... 5.8 12.2
Antidepressants (depression and related disorders) . . . . 3.4 9.3 14.7 *2.3 9.2 9.6 4.0 9.4 18.3
* Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error (RSE) of 20%–30%. Data not shown have an RSE greater than
30%.
1
The drug therapeutic class is based on the December 2012 Lexicon Plus, a proprietary database of Cerner Multum, Inc. Lexicon Plus is a comprehensive database of
all prescription and some nonprescription drug products available in the U.S. drug market. Data on prescription drug use are collected by the National Health and
Nutrition Examination Survey. Respondents were asked if they had taken a prescription drug in the past 30 days. Those who answered ‘‘yes’’ were asked to show the
interviewer the medication containers for all prescriptions. If no container was available, the respondent was asked to verbally report the name of the medication. Each
drug’s complete name was recorded and classified. Data presented here are based on the second level classification of prescription drugs. Up to four classes are
assigned to each drug. Drugs classified into more than one class were counted in each class. For more information, see
2
The drugs classes proton pump inhibitors (272) and H2 antagonists (94) have been combined because of their similar indications for use.
3
This category includes carbonic anhydrase inhibitors which are primarily used to treat glaucoma.
4
Although sex hormones may be used by males, most are used by females. Therefore, data for sex hormones are only presented for females.
5
The drugs classes anticoagulants (82) and antiplatelet agents (83) have been combined because of their similar indications for use.
NOTES: Some drug classes were not available in 1988–1994 and are coded as not applicable. See Appendix II, Drug. Standard errors are available in the spreadsheet
version of this table. Available from: http://www.cdc.gov/nchs/hus.htm. Data have been revised and differ from previous editions of Health, United States.
SOURCE: CDC/NCHS, National Health and Nutrition Examination Survey. See Appendix I, National Health and Nutrition Examination Survey (NHANES).
Characteristic 1997 2000 2010 2012 2013 1997 2000 2010 2012 2013
Percent
1 year and over, age-adjusted 2,3 . . . . . . . . . . . . . 7.8 7.6 7.0 6.8 6.7 1.8 1.8 1.8 1.8 1.7
1 year and over, crude 2 . . . . . . . . . . . . . . . . . . . 7.7 7.5 7.2 7.0 6.9 1.7 1.8 1.9 1.9 1.8
Age
1–17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.8 2.5 2.4 2.0 2.1 0.5 0.4 0.5 0.4 0.4
1–5 years . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.9 3.8 3.4 2.9 3.4 0.7 0.7 0.6 0.6 0.6
6–17 years . . . . . . . . . . . . . . . . . . . . . . . . . . 2.3 1.9 1.9 1.7 1.6 0.4 0.3 0.5 0.3 0.3
18–44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.4 7.0 6.3 6.1 6.1 1.2 1.1 1.3 1.3 1.1
18–24 years. . . . . . . . . . . . . . . . . . . . . . . . . . 7.9 7.0 5.7 5.6 5.3 1.3 1.1 1.1 1.0 1.0
25–44 years. . . . . . . . . . . . . . . . . . . . . . . . . . 7.3 7.0 6.6 6.3 6.4 1.2 1.2 1.3 1.4 1.2
45–64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.2 8.4 8.3 8.0 7.8 2.2 2.2 2.5 2.3 2.2
45–54 years. . . . . . . . . . . . . . . . . . . . . . . . . . 6.9 7.3 7.3 6.8 6.2 1.7 1.8 2.1 2.0 1.8
55–64 years. . . . . . . . . . . . . . . . . . . . . . . . . . 10.2 10.0 9.5 9.3 9.7 2.9 2.8 2.9 2.7 2.6
65 years and over . . . . . . . . . . . . . . . . . . . . . . . 18.0 18.2 16.1 15.9 15.3 5.4 5.8 4.9 5.3 4.7
65–74 years. . . . . . . . . . . . . . . . . . . . . . . . . . 16.1 16.1 13.6 13.6 12.6 4.8 4.9 3.8 4.7 3.4
75 years and over . . . . . . . . . . . . . . . . . . . . . 20.4 20.7 19.0 19.0 19.0 6.2 6.8 6.2 6.2 6.5
75–84 years . . . . . . . . . . . . . . . . . . . . . . . . 19.8 20.1 18.3 17.6 17.6 6.1 6.2 6.1 5.6 6.0
85 years and over . . . . . . . . . . . . . . . . . . . . 22.8 23.4 20.8 23.1 22.4 6.2 9.0 6.6 8.0 7.9
1–64 years
Total, 1–64 years 2,4 . . . . . . . . . . . . . . . . . . . . . . 6.3 6.1 5.7 5.4 5.3 1.3 1.2 1.3 1.3 1.2
Sex
Male, crude . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.4 4.2 4.2 4.2 4.1 0.9 1.0 1.1 1.2 1.0
1–17 years . . . . . . . . . . . . . . . . . . . . . . . . . . 2.9 2.4 2.4 2.1 2.1 0.6 0.4 0.5 0.4 0.4
18–44 years. . . . . . . . . . . . . . . . . . . . . . . . . . 3.6 3.1 2.9 3.1 2.9 0.6 0.6 0.7 0.9 0.7
45–54 years. . . . . . . . . . . . . . . . . . . . . . . . . . 6.0 7.0 6.4 6.0 5.9 1.4 1.8 1.9 1.8 1.7
55–64 years. . . . . . . . . . . . . . . . . . . . . . . . . . 11.1 10.2 9.3 9.2 9.8 3.0 3.0 2.8 2.6 2.4
Female, crude . . . . . . . . . . . . . . . . . . . . . . . . . . 8.0 7.9 7.6 7.0 7.0 1.6 1.5 1.7 1.6 1.5
1–17 years . . . . . . . . . . . . . . . . . . . . . . . . . . 2.6 2.5 2.3 2.0 2.1 0.5 0.4 0.5 0.4 0.4
18–44 years. . . . . . . . . . . . . . . . . . . . . . . . . . 11.2 10.8 9.8 9.0 9.2 1.8 1.7 1.9 1.7 1.6
45–54 years. . . . . . . . . . . . . . . . . . . . . . . . . . 7.6 7.6 8.3 7.6 6.5 2.0 1.9 2.3 2.2 2.0
55–64 years. . . . . . . . . . . . . . . . . . . . . . . . . . 9.4 9.8 9.7 9.4 9.6 2.9 2.7 2.9 2.7 2.7
Race 4,5
White only. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.2 5.9 5.6 5.3 5.2 1.2 1.1 1.3 1.2 1.1
Black or African American only . . . . . . . . . . . . . . 7.6 7.4 6.7 6.7 6.2 1.9 1.9 1.9 1.8 1.8
American Indian or Alaska Native only . . . . . . . . . 7.6 7.0 *7.6 6.2 8.9 * * *2.4 *1.8 *2.6
Asian only. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.9 3.9 3.6 3.6 3.6 *0.5 *0.6 *0.4 0.5 0.6
Native Hawaiian or Other Pacific
Islander only . . . . . . . . . . . . . . . . . . ........ -- * * * * -- * * * *
2 or more races . . . . . . . . . . . . . . . . . ........ -- 8.8 7.7 7.4 7.6 -- *1.6 *2.4 2.9 *1.7
Characteristic 1997 2000 2010 2012 2013 1997 2000 2010 2012 2013
Characteristic 1997 2000 2010 2012 2013 1997 2000 2010 2012 2013
Sex10
Male. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19.0 19.5 16.2 16.0 16.1 5.8 5.8 5.4 5.7 4.8
Female . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17.5 17.4 16.2 16.3 15.4 5.1 5.7 4.6 5.2 5.0
Geographic region10
Northeast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17.2 16.6 16.5 14.3 15.2 5.1 4.5 6.1 4.8 5.1
Midwest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18.2 19.5 16.4 18.3 16.2 5.6 7.2 4.7 6.7 4.6
South . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19.4 19.5 16.4 17.1 16.4 6.1 6.3 4.7 5.4 5.3
West . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.5 16.4 15.3 13.9 14.5 4.4 4.4 4.5 4.6 4.3
* Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error (RSE) of 20%–30%. Data not shown have an RSE greater than 30%.
1
These estimates exclude hospitalizations for institutionalized persons and those who died while hospitalized, because they are outside the scope of this survey.
2
Includes all other races not shown separately, unknown health insurance status, and unknown disability status.
3
Estimates are for persons 1 year of age and over and are age-adjusted to the year 2000 standard population using six age groups: 1–17 years, 18–44 years, 45–54 years,
55–64 years, 65–74 years, and 75 years and over. See Appendix II, Age adjustment.
4
Estimates are for persons aged 1–64 and are age-adjusted to the year 2000 standard population using four age groups: 1–17 years, 18–44 years, 45–54 years, and 55–64
years. The disability measure is age-adjusted using the three adult age groups. See Appendix II, Age adjustment.
5
The race groups, white, black, American Indian or Alaska Native, Asian, Native Hawaiian or Other Pacific Islander, and 2 or more races, include persons of Hispanic and
non-Hispanic origin. Persons of Hispanic origin may be of any race. Starting with 1999 data, race-specific estimates are tabulated according to the 1997 Revisions to the
Standards for the Classification of Federal Data on Race and Ethnicity and are not strictly comparable with estimates for earlier years. The five single-race categories plus
multiple-race categories shown in the table conform to the 1997 Standards. Starting with 1999 data, race-specific estimates are for persons who reported only one racial group;
the category 2 or more races includes persons who reported more than one racial group. Prior to 1999, data were tabulated according to the 1977 Standards with four racial
groups, and the Asian only category included Native Hawaiian or Other Pacific Islander. Estimates for single-race categories prior to 1999 included persons who reported one
race or, if they reported more than one race, identified one race as best representing their race. Starting with 2003 data, race responses of other race and unspecified multiple
race were treated as missing, and then race was imputed if these were the only race responses. Almost all persons with a race response of other race were of Hispanic origin.
6
Percent of poverty level is based on family income and family size and composition using U.S. Census Bureau poverty thresholds. Missing family income data were imputed
for 1997 and beyond. See Appendix II, Family income; Poverty; Table VI.
7
Health insurance categories are mutually exclusive. Persons who reported both Medicaid and private coverage are classified as having private coverage. Starting with 1997
data, state-sponsored health plan coverage is included as Medicaid coverage. Starting with 1999 data, coverage by the Children’s Health Insurance Program (CHIP) is
included with Medicaid coverage. In addition to private and Medicaid, the insured category also includes military, other government, and Medicare coverage. Persons not
covered by private insurance, Medicaid, CHIP, state-sponsored or other government-sponsored health plans (starting in 1997), Medicare, or military plans are considered to
have no health insurance coverage. Persons with only Indian Health Service coverage are considered to have no health insurance coverage. See Appendix II, Health
insurance coverage.
8
Any basic actions difficulty or complex activity limitation is defined as having one or more of the following limitations or difficulties: movement difficulty, emotional difficulty,
sensory (seeing or hearing) difficulty, cognitive difficulty, self-care (activities of daily living or instrumental activities of daily living) limitation, social limitation, or work limitation.
For more information, see Appendix II, Basic actions difficulty; Complex activity limitation. Starting with 2007 data, the hearing question, a component of the basic actions
difficulty measure, was revised. Consequently, data prior to 2007 are not comparable with data for 2007 and beyond. For more information on the impact of the revised hearing
9
MSA is metropolitan statistical area. Starting with 2006 data, MSA status is determined using 2000 census data and the 2000 standards for defining MSAs. For data prior to
2006, see Appendix II, Metropolitan statistical area (MSA) for the applicable standards.
10
Estimates are for persons aged 65 and over and are age-adjusted to the year 2000 standard population using two age groups: 65–74 years and 75 years and over. See
NOTES: Standard errors are available in the spreadsheet version of this table. Available from: http://www.cdc.gov/nchs/hus.htm. Data for additional years are available.
See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC/NCHS, National Health Interview Survey, family core and sample adult questionnaires. See Appendix I, National Health Interview Survey (NHIS).
Sex 3
Male . . . . . . . . . . . . . . . . . . . . . . . . . 1,543.9 1,382.5 1,130.0 1,048.5 990.8 1,013.0 973.8 975.3
Female. . . . . . . . . . . . . . . . . . . . . . . . 1,951.9 1,675.6 1,389.5 1,317.3 1,277.3 1,319.6 1,280.6 1,283.5
Geographic region 3
Northeast . . . . . . . . . . . . . . . . . . . . . . 1,622.9 1,428.7 1,332.2 1,335.3 1,274.8 1,245.9 1,274.6 1,299.6
Midwest . . . . . . . . . . . . . . . . . . . . . . . 1,925.2 1,584.7 1,287.5 1,132.8 1,109.2 1,174.9 1,125.5 1,146.8
South . . . . . . . . . . . . . . . . . . . . . . . . . 1,814.1 1,569.4 1,325.0 1,252.4 1,209.2 1,202.5 1,139.9 1,136.1
West . . . . . . . . . . . . . . . . . . . . . . . . . 1,519.7 1,469.6 1,006.6 967.4 894.0 1,005.9 966.0 932.7
Geographic region 3
Northeast . . . . . . . . . . . . . . . . . . . . . . 14,024.4 11,143.1 10,266.8 8,389.7 7,185.9 6,636.5 7,284.4 7,072.6
Midwest . . . . . . . . . . . . . . . . . . . . . . . 14,871.9 10,803.6 8,306.5 5,908.8 5,005.3 4,954.3 4,775.3 4,932.7
South . . . . . . . . . . . . . . . . . . . . . . . . . 12,713.5 9,642.6 8,204.1 6,659.9 5,925.1 5,830.4 5,555.7 5,514.2
West . . . . . . . . . . . . . . . . . . . . . . . . . 9,635.2 8,300.7 5,755.1 4,510.6 4,082.0 4,690.3 4,184.5 4,084.4
survey design rather than true changes in hospital use. See Appendix I, National Hospital Discharge Survey (NHDS).
2
Starting in 2008, the sample of nonfederal short-stay hospitals was cut in half. This smaller sample size has increased standard errors. Therefore, caution should be
exercised in interpreting trends in these data. See Appendix I, National Hospital Discharge Survey (NHDS).
3
Estimates are age-adjusted to the year 2000 standard population using six age groups: under 18 years, 18–44 years, 45–54 years, 55–64 years, 65–74 years, and 75
NOTES: Excludes newborn infants. Rates are based on the civilian population as of July 1. Starting with Health, United States, 2003, rates for 2000 and beyond are
based on the 2000 census. Rates for 1990–1999 use population estimates based on the 1990 census adjusted for net underenumeration using the 1990 National
Population Adjustment Matrix from the U.S. Census Bureau. Rates for 1990–1999 are not strictly comparable with rates for 2000 and beyond because population
estimates for 1990–1999 have not been revised to reflect the 2000 census. See Appendix I, National Hospital Discharge Survey (NHDS); Population Census and
Population Estimates. Data for additional years are available. See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC/NCHS, National Hospital Discharge Survey. See Appendix I, National Hospital Discharge Survey (NHDS).
Discharges
Age and first-listed diagnosis 1990 2000 2009–2010 1 1990 2000 2009–2010 1 1990 2000 2009–2010 1
All ages, crude 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,222.7 1,128.3 1,160.3 1,002.2 910.6 957.4 1,431.7 1,336.6 1,357.1
Under 18 years 3 . . . . . . . . . . . . . . . . . . . . . . . . . . 463.5 402.6 *336.2 463.1 408.6 *343.1 464.1 396.2 *329.0
Dehydration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.5 15.7 *8.6 9.4 17.2 *9.1 9.7 14.2 *8.0
Acute bronchitis and bronchiolitis . . . . . . . . . . . . . . . 17.2 27.8 *16.0 19.6 31.4 *19.1 14.6 24.1 *12.7
Pneumonia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33.3 25.2 *22.4 37.0 25.7 *22.0 29.5 24.6 *22.7
Asthma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27.5 29.6 *18.7 32.7 34.8 *23.1 22.0 24.0 *14.2
Appendicitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.6 11.9 *9.6 14.6 13.0 *11.9 10.5 10.8 *7.2
Injury. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49.7 33.6 *23.2 62.0 42.0 *27.2 36.8 24.8 *19.1
Fracture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17.7 13.8 *10.2 22.3 18.3 *12.6 12.9 9.0 *7.8
Complications of care and adverse effects . . . . . . . . 6.2 *7.3 *5.2 6.5 *7.9 *5.5 5.9 *6.6 *4.9
18–44 years 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,026.6 849.4 867.3 579.2 450.0 434.0 1,468.0 1,248.1 1,310.2
HIV/AIDS. . . . . . . . . . . . . . . . . . . . . . . . ........ *1.8 4.3 2.2 *2.8 5.8 3.1 * 2.8 *1.2
Cancer, all . . . . . . . . . . . . . . . . . . . . . . . ........ 16.6 10.5 10.1 11.9 7.3 7.0 21.3 13.7 13.3
Childbirth . . . . . . . . . . . . . . . . . . . . . . . . ........ ... ... ... ... ... ... 698.6 645.2 693.1
Uterine fibroids. . . . . . . . . . . . . . . . . . . . ........ ... ... ... ... ... ... 20.2 21.7 15.2
Diabetes . . . . . . . . . . . . . . . . . . . . . . . . ........ 9.7 11.5 14.2 11.3 13.0 13.9 8.1 9.9 14.5
Alcohol and drug . . . . . . . . . . . . . . . . . . ........ 26.2 29.7 19.2 37.0 39.1 25.8 15.5 *20.2 12.4
nonorganic psychoses. . . . . . . . . . . . . . ........ 35.4 *53.6 48.2 34.1 *53.2 47.6 36.7 *53.9 48.7
Schizophrenia . . . . . . . . . . . . . . . . . . . ........ 13.4 *14.4 12.4 16.4 *18.6 14.8 10.5 *10.1 10.0
Mood disorders . . . . . . . . . . . . . . . . . . ........ 19.4 *35.9 32.8 15.4 *31.0 29.3 23.4 *40.9 36.3
Heart disease. . . . . . . . . . . . . . . . . . . . . ........ 21.7 21.8 20.3 30.2 26.6 24.6 13.4 17.0 15.8
Ischemic heart disease . . . . . . . . . . . . ........ 11.9 9.9 6.0 17.7 14.2 8.3 6.3 5.6 3.7
Pneumonia . . . . . . . . . . . . . . . . . . . . . . ........ 12.5 10.9 9.5 12.8 10.0 8.9 12.2 11.9 10.1
Asthma . . . . . . . . . . . . . . . . . . . . . . . . . ........ 9.8 9.0 7.6 5.1 5.4 4.6 14.4 12.6 10.7
Intervertebral disc disorders. . . . . . . . . . . ........ 20.5 12.5 8.5 25.6 14.5 8.6 15.4 10.4 8.4
Injury. . . . . . . . . . . . . . . . . . . . . . . . . . . ........ 86.2 45.8 44.8 119.0 62.3 55.7 53.8 29.4 33.6
Fracture . . . . . . . . . . . . . . . . . . . . . . . ........ 27.8 17.8 18.1 40.2 25.4 25.0 15.5 10.2 11.0
Poisoning and toxic effects. . . . . . . . . . ........ 11.4 8.5 11.2 10.0 6.7 9.7 12.7 10.3 12.6
Complications of care and adverse effects ........ 12.5 12.2 16.6 11.7 11.2 13.1 13.3 13.1 20.3
45–64 years 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,354.5 1,114.2 1,200.5 1,402.7 1,127.4 1,209.8 1,309.7 1,101.7 1,191.6
Cancer, all . . . . . . . . . . . . . . . . . . . . . . . ........ 118.3 62.9 62.2 106.3 62.1 62.6 129.5 63.6 61.8
Colorectal cancer . . . . . . . . . . . . . . . . ........ 12.7 7.9 7.5 14.8 8.9 7.8 10.8 6.9 7.2
Lung/bronchus/tracheal cancer . . . . . . . ........ 21.8 6.9 7.8 26.8 8.6 7.2 17.2 5.2 8.3
Breast cancer 4 . . . . . . . . . . . . . . . . . . ........ ... ... ... ... ... ... 29.0 14.2 11.5
Prostate cancer. . . . . . . . . . . . . . . . . . ........ ... ... ... 8.5 9.6 *13.5 ... ... . . .
Uterine fibroids. . . . . . . . . . . . . . . . . . . . ........ ... ... ... ... ... ... 29.3 35.6 23.3
Diabetes . . . . . . . . . . . . . . . . . . . . . . . . ........ 29.1 33.1 32.0 29.1 37.4 32.9 29.2 29.0 31.1
Alcohol and drug . . . . . . . . . . . . . . . . . . ........ 21.7 23.3 24.2 34.6 33.5 36.4 9.6 13.7 12.7
nonorganic psychoses. . . . . . . . . . . . . . ........ 32.9 42.7 47.5 25.4 *39.6 43.5 39.8 45.6 51.3
Schizophrenia . . . . . . . . . . . . . . . . . . . ........ 10.1 12.8 14.4 8.4 *14.4 15.7 11.7 11.3 13.2
Mood disorders . . . . . . . . . . . . . . . . . . ........ 19.6 *26.9 30.4 14.5 *21.6 24.9 24.4 *32.0 35.6
Heart disease. . . . . . . . . . . . . . . . . . . . . ........ 238.7 203.6 145.6 316.8 264.0 187.5 166.1 146.4 105.6
Ischemic heart disease . . . . . . . . . . . . ........ 160.3 126.4 68.2 226.1 177.3 95.4 99.2 78.2 42.3
Heart attack. . . . . . . . . . . . . . . . . . . ........ 50.6 38.8 26.4 74.4 58.7 37.8 28.4 19.9 15.4
Arrhythmias . . . . . . . . . . . . . . . . . . . . ........ 28.5 25.1 24.7 35.5 31.8 31.1 22.1 18.7 18.6
Heart failure . . . . . . . . . . . . . . . . . . . . ........ 26.4 31.4 31.8 30.7 33.5 37.3 22.4 29.3 26.6
Hypertension . . . . . . . . . . . . . . . . . . . . . ........ 16.3 19.0 17.9 16.9 17.6 17.6 15.6 20.3 18.2
Stroke . . . . . . . . . . . . . . . . . . . . . . . . . . ........ 35.2 36.7 36.0 40.8 38.3 41.2 30.1 35.2 31.1
Pneumonia . . . . . . . . . . . . . . . . . . . . . . ........ 33.5 35.3 32.6 34.0 34.2 34.7 33.0 36.4 30.7
Chronic obstructive pulmonary disease. . . ........ 15.8 30.8 28.9 17.4 30.8 24.1 14.3 30.8 33.5
Asthma . . . . . . . . . . . . . . . . . . . . . . . . . ........ 18.6 13.4 15.7 11.8 6.2 8.7 24.9 20.2 22.4
Osteoarthritis . . . . . . . . . . . . . . . . . . . . . ........ 18.9 24.0 61.5 16.3 20.8 54.1 21.2 27.0 68.4
Intervertebral disc disorders. . . . . . . . . . . ........ 31.5 21.2 20.3 36.8 22.5 21.2 26.5 20.0 19.4
Injury. . . . . . . . . . . . . . . . . . . . . . . . . . . ........ 72.5 47.9 56.4 79.9 51.2 62.2 65.6 44.7 50.8
Fracture . . . . . . . . . . . . . . . . . . . . . . . ........ 32.4 26.2 29.2 33.4 25.3 31.3 31.5 27.0 27.2
Poisoning and toxic effects. . . . . . . . . . ........ 6.3 6.3 11.9 4.5 5.5 11.0 8.0 7.1 12.7
Internal organ injury. . . . . . . . . . . . . . . ........ 7.9 4.5 7.1 10.2 5.9 9.1 5.7 3.2 *5.1
Complications of care and adverse effects ........ 32.0 34.5 49.8 35.6 36.3 51.0 28.7 32.7 48.7
Discharges
Age and first-listed diagnosis 1990 2000 2009–2010 1 1990 2000 2009–2010 1 1990 2000 2009–2010 1
Septicemia. . . . . . . . . . . . . . . . . . . . . . . ........ 27.2 35.6 71.3 34.9 40.1 77.9 21.2 32.0 65.5
Cancer, all . . . . . . . . . . . . . . . . . . . . . . . ........ 243.1 159.0 147.5 281.4 176.4 175.3 213.0 144.7 123.6
Colorectal cancer . . . . . . . . . . . . . . . . ........ 27.0 22.8 16.6 30.6 29.9 20.1 24.1 16.9 13.5
Lung/bronchus/tracheal cancer . . . . . . . ........ 42.9 26.1 27.3 63.9 28.2 33.6 26.4 24.5 21.9
Breast cancer 4 . . . . . . . . . . . . . . . . . . ........ ... ... ... ... ... ... 42.3 31.2 16.7
Prostate cancer. . . . . . . . . . . . . . . . . . ........ ... ... ... 50.6 37.1 30.1 ... ... . . .
Diabetes . . . . . . . . . . . . . . . . . . . . . . . . ........ 51.8 46.4 45.4 43.6 46.8 45.7 58.3 46.2 45.2
Schizophrenia, mood disorders, delusional disorders,
nonorganic psychoses. . . . . . . . . . . . . . ........ 32.7 37.1 *29.2 25.3 *34.2 *21.6 38.6 39.6 *35.7
Dementia and Alzheimer’s disease. . . . . . ........ 5.6 *11.2 *8.3 4.9 *16.2 * *6.1 *7.0 *7.6
Heart disease. . . . . . . . . . . . . . . . . . . . . ........ 558.1 604.8 407.4 694.2 706.4 509.0 451.3 521.0 319.8
Ischemic heart disease . . . . . . . . . . . . ........ 321.3 307.0 170.2 419.9 396.5 233.9 243.9 233.2 115.2
Heart attack. . . . . . . . . . . . . . . . . . . ........ 103.3 100.3 62.0 139.8 124.7 82.8 74.6 80.2 44.1
Arrhythmias . . . . . . . . . . . . . . . . . . . . ........ 69.1 102.6 85.1 84.7 108.3 99.4 56.9 97.9 72.7
Heart failure . . . . . . . . . . . . . . . . . . . . ........ 105.2 131.6 93.9 118.0 136.4 112.3 95.1 127.6 78.0
Hypertension . . . . . . . . . . . . . . . . . . . . . ........ 21.8 21.5 29.1 16.2 16.5 *24.3 26.2 25.5 33.2
Stroke . . . . . . . . . . . . . . . . . . . . . . . . . . ........ 123.9 127.1 109.5 137.5 131.8 126.6 113.1 123.2 94.7
Pneumonia . . . . . . . . . . . . . . . . . . . . . . ........ 98.1 121.3 83.8 113.6 127.7 86.8 85.9 116.1 81.2
Chronic obstructive pulmonary disease. . . ........ 45.3 102.3 98.5 52.6 102.6 92.8 39.6 102.0 103.4
Gallstones . . . . . . . . . . . . . . . . . . . . . . . ........ 44.2 33.4 22.2 38.2 30.2 23.6 48.9 36.0 21.1
Kidney disease. . . . . . . . . . . . . . . . . . . . ........ 9.9 19.1 57.1 11.0 21.0 71.3 9.0 17.5 44.9
Urinary tract infection . . . . . . . . . . . . . . . ........ 30.2 25.5 38.0 21.7 19.7 25.4 36.9 30.3 49.0
Hyperplasia of the prostate . . . . . . . . . . . ........ ... ... ... 143.5 53.6 21.6 ... ... . . .
Osteoarthritis . . . . . . . . . . . . . . . . . . . . . ........ 68.0 101.4 160.7 55.2 103.1 136.4 78.0 100.1 181.7
Injury. . . . . . . . . . . . . . . . . . . . . . . . . . . ........ 107.7 101.5 96.4 90.7 83.8 77.1 121.1 116.2 112.9
Fracture . . . . . . . . . . . . . . . . . . . . . . . ........ 67.2 63.3 59.5 45.2 46.8 38.0 84.4 76.9 77.9
Hip fracture . . . . . . . . . . . . . . . . . . . ........ 26.7 26.4 18.3 15.3 *20.0 12.2 35.7 31.7 23.6
Complications of care and adverse effects ........ 69.7 80.0 96.3 85.7 95.7 104.5 57.2 67.1 89.3
75–84 years 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,957.0 4,124.4 3,982.8 4,417.3 4,294.1 4,137.3 3,678.9 4,013.5 3,871.9
Septicemia. . . . . . . . . . . . . . . . . . . . . . . ........ 53.9 68.3 138.7 63.8 78.1 151.6 47.9 61.9 129.3
Cancer, all . . . . . . . . . . . . . . . . . . . . . . . ........ 300.3 194.0 172.3 420.8 211.0 197.3 227.6 182.9 154.3
Colorectal cancer . . . . . . . . . . . . . . . . ........ 49.8 33.0 29.8 54.0 37.5 30.8 47.3 30.1 29.1
Lung/bronchus/tracheal cancer . . . . . . . ........ 36.5 27.0 33.5 57.2 32.2 40.5 *24.0 23.6 28.5
Breast cancer 4 . . . . . . . . . . . . . . . . . . ........ ... ... ... ... ... ... 38.7 30.8 16.5
Prostate cancer. . . . . . . . . . . . . . . . . . ........ ... ... ... 99.2 27.4 *11.1 ... ... . . .
Diabetes . . . . . . . . . . . . . . . . . . . . . . . . ........ 44.3 63.4 66.9 44.8 68.1 67.5 44.0 60.3 66.5
Schizophrenia, mood disorders, delusional disorders,
nonorganic psychoses. . . . . . . . . . . . . . ........ 38.8 41.4 * *27.3 *30.6 * 45.7 48.5 *31.3
Dementia and Alzheimer’s disease. . . . . . ........ 20.0 36.5 44.0 22.8 36.8 46.2 18.3 36.3 42.3
Heart disease. . . . . . . . . . . . . . . . . . . . . ........ 866.6 954.8 739.5 1,003.8 1,062.5 844.7 783.7 884.3 663.8
Ischemic heart disease . . . . . . . . . . . . ........ 382.4 416.7 248.7 470.5 528.5 312.9 329.1 343.6 202.7
Heart attack. . . . . . . . . . . . . . . . . . . ........ 155.9 166.9 112.8 220.9 212.8 127.7 116.7 136.9 102.2
Arrhythmias . . . . . . . . . . . . . . . . . . . . ........ 133.4 176.8 168.7 153.3 174.4 165.9 121.4 178.3 170.7
Heart failure . . . . . . . . . . . . . . . . . . . . ........ 261.4 263.1 220.7 286.2 271.1 248.3 246.4 257.9 200.9
Hypertension . . . . . . . . . . . . . . . . . . . . . ........ 22.6 39.7 38.0 * *28.4 *31.7 30.7 47.1 42.5
Stroke . . . . . . . . . . . . . . . . . . . . . . . . . . ........ 259.0 255.5 196.9 277.7 278.4 210.6 247.7 240.6 187.1
Pneumonia . . . . . . . . . . . . . . . . . . . . . . ........ 224.6 263.5 179.3 297.8 310.8 193.3 180.4 232.6 169.3
Chronic obstructive pulmonary disease. . . ........ 55.4 146.2 131.4 89.4 179.6 149.9 34.8 124.3 118.0
Gallstones . . . . . . . . . . . . . . . . . . . . . . . ........ 47.6 39.6 39.1 51.9 41.4 39.0 45.0 38.5 39.1
Kidney disease. . . . . . . . . . . . . . . . . . . . ........ 24.5 37.6 110.2 27.6 48.7 123.9 *22.6 30.4 100.3
Urinary tract infection . . . . . . . . . . . . . . . ........ 86.0 85.6 123.0 66.6 72.5 87.6 97.8 94.2 148.5
Hyperplasia of the prostate . . . . . . . . . . . ........ ... ... ... 183.3 67.2 38.5 ... ... . . .
Osteoarthritis . . . . . . . . . . . . . . . . . . . . . ........ 68.6 100.6 161.4 65.2 76.5 152.6 70.7 116.4 167.8
Injury. . . . . . . . . . . . . . . . . . . . . . . . . . . ........ 259.1 229.1 237.0 153.4 171.7 189.0 323.0 266.6 271.5
Fracture . . . . . . . . . . . . . . . . . . . . . . . ........ 195.8 170.2 166.2 92.6 116.4 111.8 258.1 205.4 205.3
Hip fracture . . . . . . . . . . . . . . . . . . . ........ 115.2 99.0 69.4 53.7 68.6 45.6 152.4 118.8 86.5
Complications of care and adverse effects ........ 81.5 101.4 123.1 101.4 136.0 150.8 69.4 78.8 103.2
Discharges
Age and first-listed diagnosis 1990 2000 2009–2010 1 1990 2000 2009–2010 1 1990 2000 2009–2010 1
Septicemia. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 135.6 153.9 261.4 139.0 207.3 320.8 134.3 131.9 232.8
Cancer, all . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 254.0 194.5 144.0 370.6 250.5 209.0 208.7 171.5 112.8
Colorectal cancer . . . . . . . . . . . . . . . . ........ 47.6 49.7 17.0 *59.1 *58.8 *20.7 43.2 45.9 *15.2
Breast cancer 4 . . . . . . . . . . . . . . . . . . ........ ... ... ... ... ... ... *41.7 *20.5 *12.0
Prostate cancer. . . . . . . . . . . . . . . . . . ........ ... ... ... *87.8 *49.3 *20.0 ... ... . . .
Diabetes . . . . . . . . . . . . . . . . . . . . . . . . ........ 53.0 65.6 58.7 *53.5 *54.2 69.4 52.8 70.3 *53.6
Schizophrenia, mood disorders, delusional disorders,
nonorganic psychoses. . . . . . . . . . . . . . ........ *27.9 *37.3 * * * *40.6 *30.7 *43.0 *
Dementia and Alzheimer’s disease. . . . . . ........ 49.7 107.0 77.2 *28.9 94.3 96.2 57.7 112.2 68.0
Heart disease. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,107.0 1,298.2 1,054.7 1,320.3 1,407.4 1,224.2 1,024.1 1,253.4 973.4
Ischemic heart disease . . . . . . . . . . . . . . . . . . . . 423.0 427.2 246.9 581.6 534.4 323.5 361.3 383.2 210.2
Heart attack. . . . . . . . . . . . . . . . . . . . . . . . . . . 199.8 251.1 161.0 274.2 296.0 197.1 170.9 232.7 143.6
Arrhythmias . . . . . . . . . . . . . . . . . . . . . . . . . . . . 167.2 232.4 212.3 189.6 247.1 213.2 158.5 226.4 211.9
Heart failure . . . . . . . . . . . . . . . . . . . . . . . . . . . . 416.7 480.4 451.7 460.5 455.7 528.8 399.7 490.5 414.7
Hypertension . . . . . . . . . . . . . . . . . . . . . ........ *17.9 41.1 49.1 * *18.3 *47.6 *19.3 50.4 49.8
Stroke . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 427.2 373.8 284.1 408.2 396.7 278.5 434.6 364.3 286.8
Pneumonia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 501.0 514.9 355.3 753.7 607.8 429.2 402.8 476.8 319.9
Chronic obstructive pulmonary disease. . . ........ 44.1 130.9 144.0 *72.9 150.4 173.4 *32.9 123.0 129.8
Gallstones . . . . . . . . . . . . . . . . . . . . . . . ........ 60.7 39.2 39.7 *68.2 *29.7 *40.6 57.8 *43.1 39.3
Kidney disease. . . . . . . . . . . . . . . . . . . . ........ 47.1 49.5 167.4 92.4 *68.1 230.5 *29.4 *41.9 137.1
Urinary tract infection . . . . . . . . . . . . . . . . . . . . . . . 216.5 191.5 321.9 239.3 153.1 217.0 207.6 207.2 372.1
Hyperplasia of the prostate . . . . . . . . . . . ........ ... ... ... 158.6 *69.9 *31.8 ... ... . . .
Injury. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 542.0 545.5 525.3 435.4 355.6 428.4 583.4 623.5 571.7
Fracture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 439.0 450.9 396.6 335.7 252.4 275.7 479.2 532.4 454.6
Hip fracture . . . . . . . . . . . . . . . . . . . . . . . . . . . 272.3 275.1 211.6 224.4 146.5 155.4 291.0 327.9 238.6
Complications of care and adverse effects ........ 96.6 79.1 127.1 132.3 90.5 160.0 82.7 74.4 111.4
* Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error (RSE) of 20%–30%. Data not shown have an RSE greater than
30%.
1
Starting with 2008 data, the sample of nonfederal short-stay hospitals was cut in half. This smaller sample size has increased standard errors. Therefore, caution
should be exercised in interpreting trends in these data. See Appendix I, National Hospital Discharge Survey (NHDS).
2
Estimates are age-adjusted to the year 2000 standard population using six age groups: under 18 years, 18–44 years, 45–54 years, 55–64 years, 65–74 years, and 75
3
Includes discharges with first-listed diagnoses not shown in table.
4
Shown for females only.
NOTES: Excludes newborn infants. Diagnostic categories are based on the International Classification of Diseases, 9th Revision, Clinical Modification (ICD–9-CM). See
Appendix II, Diagnosis; Human immunodeficiency virus (HIV) disease; International Classification of Diseases, 9th Revision, Clinical Modification (ICD–9-CM); Table X
for ICD–9-CM codes. Rates are based on the civilian population as of July 1. Starting with Health, United States, 2003, rates for 2000 and beyond are based on the
2000 census. Rates for 1990–1999 use population estimates based on the 1990 census adjusted for net underenumeration using the 1990 National Population
Adjustment Matrix from the U.S. Census Bureau. Rates for 1990–1999 are not strictly comparable with rates for 2000 and beyond because population estimates for
1990–1999 have not been revised to reflect the 2000 census. See Appendix I, National Hospital Discharge Survey (NHDS); Population Census and Population
Estimates. Additional data and diagnosis categories are available from: http://www.cdc.gov/nchs/hdi.htm. Data for additional years are available. See the Excel
spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC/NCHS, National Hospital Discharge Survey. See Appendix I, National Hospital Discharge Survey (NHDS).
*Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error (RSE) of 20%–30%. Data not shown have an RSE greater than 30%.
1
Starting with 2008 data, the sample of nonfederal short-stay hospitals was cut in half. This smaller sample size has increased standard errors. Therefore, caution
should be exercised in interpreting trends in these data. See Appendix I, National Hospital Discharge Survey (NHDS).
2
Includes discharges for procedures not shown separately.
3
Estimates are age-adjusted to the year 2000 standard population using five age groups: 18–44 years, 45–54 years, 55–64 years, 65–74 years, and 75 years and over.
NOTES: Up to four procedures were coded for each hospital discharge. Starting with 2010 data, up to eight procedure codes were available on the file. To maintain
comparability with previous years, the number of procedure codes for the 2010 data was limited to four codes. If more than one procedure with the same code (e.g., a
coronary artery bypass graft) was performed during the hospital stay, it was counted only once (any listed). Procedure categories are based on the International
Classification of Diseases, 9th Revision, Clinical Modification (ICD–9-CM). See Appendix II, International Classification of Diseases, 9th Revision, Clinical Modification
(ICD–9-CM); Procedure; Table XI for ICD–9-CM codes. Rates are based on the civilian population as of July 1. Starting with Health, United States, 2003, rates for 2000
and beyond are based on the 2000 census. Rates for 1990–1999 use population estimates based on the 1990 census adjusted for net underenumeration using the
1990 National Population Adjustment Matrix from the U.S. Census Bureau. Rates for 1990–1999 are not strictly comparable with rates for 2000 and beyond because
population estimates for 1990–1999 have not been revised to reflect the 2000 census. See Appendix I, National Hospital Discharge Survey (NHDS); Population Census
and Population Estimates. Data for additional years are available. See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC/NCHS, National Hospital Discharge Survey. See Appendix I, National Hospital Discharge Survey (NHDS).
Type of ownership
and size of hospital 1975 1980 1990 2000 2005 2010 2011 2012
1
The category of nonfederal hospitals comprises psychiatric, tuberculosis and other respiratory diseases hospitals, and long-term and short-term general and other
2
Community hospitals are nonfederal short-term general and special hospitals whose facilities and services are available to the public. The types of facilities included in
the community hospitals category have changed over time. See Appendix II, Hospital.
3
Average length of stay is the number of inpatient days divided by the number of admissions. See Appendix II, Average length of stay.
4
Outpatient visits include visits to the emergency department, outpatient department, referred visits (pharmacy, EKG, radiology), and outpatient surgery. See
5
Total surgeries is a measure of patients with at least one surgical procedure. Persons with multiple surgical procedures during the same outpatient visit or inpatient
stay are counted only once. See Appendix II, Outpatient surgery.
SOURCE: American Hospital Association (AHA) Annual Survey of Hospitals. Hospital Statistics, 1976, 1981, 1991–92, 2002, 2007, 2012, 2013, and 2014 editions.
Chicago, IL. (Reprinted from AHA Hospital Statistics by permission, Copyright 1976, 1981, 1991–92, 2002, 2007, 2012, 2013, and 2014 by Health Forum, LLC, an
American Hospital Association company.) See Appendix I, American Hospital Association (AHA) Annual Survey of Hospitals.
State 1975 1985 2000 4 2010 2011 2012 1975 1985 2000 4 2010 2011 2012
2
Starting with 2003 data, federal and nonfederal physicians are included. Data prior to 2003 included nonfederal physicians only.
3
Prior to 2006, excludes DOs. Excludes physicians in medical teaching, administration, research, and other nonpatient care activities. Includes residents.
4
Data for DOs are as of January 2001.
NOTES: Data for MDs are as of December 31. Data for DOs are as of May 31, unless otherwise specified. Starting with Health, United States, 2012, data for DOs for
2009 and beyond are from the American Medical Association (AMA). Prior to 2009, data for DOs are from the American Osteopathic Association (AOA).
SOURCE: American Medical Association (AMA): Physician distribution and medical licensure in the U.S., 1975; Physician characteristics and distribution in the U.S.,
1986, 2002–2003, 2012, 2013, 2014 editions; Department of Physician Practice and Communications Information, Division of Survey and Data Resources, AMA.
(Copyright 1976, 1986, 2003, 2012, 2013, 2014: Used with permission of the AMA); American Osteopathic Association: 1975–1976 Yearbook and Directory of
Osteopathic Physicians, 1985–1986 Yearbook and Directory of Osteopathic Physicians. See Appendix I, American Medical Association (AMA) Physician Masterfile;
Place of medical education and activity 1975 1985 1995 2000 2005 2010 2011 2012
1
Doctors of medicine who are inactive, have unknown address, or primary specialty not classified are excluded. See Appendix II, Physician.
2
International medical graduates received their medical education in schools outside of the United States and Canada.
3
Specialty information is based on the physician’s self-designated primary area of practice. Categories include generalists and specialists. See Appendix II, Physician
specialty.
4
Starting with 2003 data, estimates include federal and nonfederal doctors of medicine. Prior to 2003, estimates were for nonfederal doctors of medicine only. See
Health, United States, 2004, Table 103, for data on federal doctors of medicine.
5
Starting with 1990 data, clinical fellows are included in this category. In prior years, clinical fellows were included in the other professional activity category.
6
Includes medical teaching, administration, research, and other. Prior to 1990, this category also included clinical fellows.
NOTES: Data for doctors of medicine are as of December 31, except for 1990–1994 data, which are as of January 1. Outlying areas include Puerto Rico, the U.S.
SOURCE: American Medical Association (AMA). Physician distribution and medical licensure in the U.S., 1975; Physician characteristics and distribution in the U.S.,
1986, 1996–1997, 2002–2003, 2007, 2012, 2013, 2014 editions, Department of Physician Practice and Communications Information, Division of Survey and Data
Resources, AMA. (Copyright 1976, 1986, 1997, 2003, 2007, 2012–2014: Used with permission of the AMA.) See Appendix I, American Medical Association (AMA)
Physician Masterfile.
Specialty 1949 1 1960 1 1970 1980 1990 2000 2010 2011 2012
Number
Total doctors of medicine 2 . . . . . . . . . . 201,277 260,484 334,028 467,679 615,421 813,770 985,375 1,004,635 1,026,788
Active doctors of medicine 3 . . . . . . . . . 191,577 247,257 310,845 414,916 547,310 692,368 794,862 809,492 826,001
General primary care specialists . . . . 113,222 125,359 134,354 170,705 213,514 274,653 304,687 309,672 313,793
General practice/family medicine . . 95,980 88,023 57,948 60,049 70,480 86,312 94,746 95,274 96,552
Internal medicine . . . . . . . . . . . . . 12,453 26,209 39,924 58,462 76,295 101,353 113,591 116,715 118,504
Obstetrics/Gynecology. . . . . . . . . . -- -- 18,532 24,612 30,220 35,922 38,520 38,957 39,324
Pediatrics. . . . . . . . . . . . . . . . . . . 4,789 11,127 17,950 27,582 36,519 51,066 57,830 58,726 59,413
Primary care subspecialists. . . . . . . . -- -- 3,161 16,642 30,911 52,294 76,122 79,751 83,532
Family medicine . . . . . . . . . . . . . . -- -- -- -- -- 483 1,445 1,593 1,764
Internal medicine . . . . . . . . . . . . . -- -- 1,948 13,069 22,054 34,831 50,730 52,929 55,357
Obstetrics/Gynecology. . . . . . . . . . -- -- 344 1,693 3,477 4,319 4,277 4,229 4,186
Pediatrics. . . . . . . . . . . . . . . . . . . -- -- 869 1,880 5,380 12,661 19,670 21,000 22,225
1
Estimated by the Bureau of Health Professions, Health Resources and Services Administration. Active doctors of medicine (MDs) include those with address unknown
2
Includes MDs engaged in federal and nonfederal patient care (office-based or hospital-based) and other professional activities.
3
Starting with 1970 data, MDs who are inactive, have unknown address, or primary specialty not classified are excluded. See Appendix II, Physician.
NOTES: See Appendix II, Physician specialty. Data are as of December 31 except for 1990–1994 data, which are as of January 1, and 1949 data, which are as of
midyear. Outlying areas include Puerto Rico, the U.S. Virgin Islands, and the U.S. Pacific islands.
SOURCE: Health Manpower Source Book: Medical Specialists, USDHEW, 1962; American Medical Association (AMA). Distribution of physicians in the United States,
1970; Physician characteristics and distribution in the U.S., 1981, 1992, 2002–2003, 2011, 2012, 2013, 2014 editions, Department of Physician Practice and
Communications Information, Division of Survey and Data Resources, AMA. (Copyright 1971, 1982, 1992, 2003, 2012, 2013, 2014: Used with permission of the AMA.)
See Appendix I, American Medical Association (AMA) Physician Masterfile.
State 1993 2000 2009 2010 2011 1993 2000 2009 2010 2011
United States . . . . . . . . . . . . . . 155,087 166,383 186,416 189,151 193,300 6.0 5.9 6.1 6.1 6.2
Alabama . . . . . . . . . . . . . . . . 1,779 1,912 2,090 2,073 2,105 4.2 4.3 4.4 4.3 4.4
Alaska. . . . . . . . . . . . . . . . . . 421 467 548 554 585 7.0 7.4 7.8 7.8 8.1
Arizona . . . . . . . . . . . . . . . . . 2,032 2,322 3,440 3,511 3,567 5.0 4.5 5.4 5.5 5.5
Arkansas . . . . . . . . . . . . . . . . 1,001 1,080 1,164 1,213 1,226 4.1 4.0 4.0 4.2 4.2
California . . . . . . . . . . . . . . . . 20,909 22,963 28,557 28,767 29,395 6.7 6.8 7.7 7.7 7.8
Colorado . . . . . . . . . . . . . . . . 2,503 2,818 3,363 3,470 3,552 6.9 6.6 6.8 6.9 6.9
Connecticut . . . . . . . . . . . . . . 2,587 2,636 2,707 2,731 2,831 7.8 7.7 7.6 7.6 7.9
Delaware . . . . . . . . . . . . . . . . 331 357 416 419 433 4.7 4.6 4.7 4.7 4.8
District of Columbia . . . . . . . . 810 728 622 625 665 13.6 12.7 10.5 10.4 10.8
Florida. . . . . . . . . . . . . . . . . . 7,110 8,170 9,930 10,092 10,429 5.1 5.1 5.3 5.4 5.5
Georgia . . . . . . . . . . . . . . . . . 3,251 3,611 4,439 4,512 4,640 4.7 4.4 4.6 4.7 4.7
Hawaii. . . . . . . . . . . . . . . . . . 976 992 1,043 1,063 1,089 8.3 8.2 7.7 7.8 7.9
Idaho . . . . . . . . . . . . . . . . . . 573 678 933 940 940 5.2 5.2 6.0 6.0 5.9
Illinois . . . . . . . . . . . . . . . . . . 7,978 8,205 8,459 8,518 8,692 6.8 6.6 6.6 6.6 6.8
Indiana . . . . . . . . . . . . . . . . . 2,716 2,867 3,109 3,127 3,170 4.7 4.7 4.8 4.8 4.9
Iowa . . . . . . . . . . . . . . . . . . . 1,545 1,564 1,621 1,664 1,707 5.4 5.3 5.3 5.5 5.6
Kansas . . . . . . . . . . . . . . . . . 1,316 1,329 1,449 1,478 1,494 5.1 4.9 5.1 5.2 5.2
Kentucky . . . . . . . . . . . . . . . . 2,129 2,258 2,430 2,418 2,464 5.6 5.6 5.6 5.6 5.6
Louisiana. . . . . . . . . . . . . . . . 2,029 2,086 2,163 2,185 2,267 4.7 4.7 4.8 4.8 5.0
Maine . . . . . . . . . . . . . . . . . . 592 601 669 655 679 4.8 4.7 5.0 4.9 5.1
Maryland . . . . . . . . . . . . . . . . 3,753 3,986 4,213 4,258 4,353 7.5 7.5 7.4 7.4 7.5
Massachusetts . . . . . . . . . . . . 4,652 5,137 5,498 5,558 5,639 7.7 8.1 8.4 8.5 8.6
Michigan . . . . . . . . . . . . . . . . 5,884 5,913 6,120 6,139 6,152 6.2 5.9 6.2 6.2 6.2
Minnesota . . . . . . . . . . . . . . . 2,913 2,960 3,248 3,272 3,335 6.4 6.0 6.2 6.2 6.2
Mississippi . . . . . . . . . . . . . . . 1,040 1,115 1,206 1,220 1,247 3.9 3.9 4.1 4.1 4.2
Missouri. . . . . . . . . . . . . . . . . 2,773 2,680 2,872 2,910 3,001 5.3 4.8 4.8 4.9 5.0
Montana . . . . . . . . . . . . . . . . 476 485 586 594 615 5.6 5.4 6.0 6.0 6.2
Nebraska. . . . . . . . . . . . . . . . 1,054 1,087 1,144 1,148 1,168 6.5 6.4 6.3 6.3 6.3
Nevada . . . . . . . . . . . . . . . . . 570 763 1,367 1,393 1,460 4.0 3.8 5.1 5.2 5.4
New Hampshire . . . . . . . . . . . 642 707 838 848 855 5.7 5.7 6.4 6.4 6.5
New Jersey . . . . . . . . . . . . . . 6,144 6,607 7,058 7,226 7,318 7.7 7.9 8.1 8.2 8.3
New Mexico. . . . . . . . . . . . . . 719 809 937 973 1,019 4.4 4.4 4.6 4.7 4.9
New York. . . . . . . . . . . . . . . . 14,395 15,159 15,128 15,391 15,481 7.8 8.0 7.8 7.9 8.0
North Carolina . . . . . . . . . . . . 2,968 3,394 4,327 4,504 4,509 4.2 4.2 4.6 4.7 4.7
North Dakota . . . . . . . . . . . . . 315 300 341 359 384 4.9 4.7 5.1 5.3 5.6
Ohio . . . . . . . . . . . . . . . . . . . 5,981 6,108 6,128 6,146 6,238 5.4 5.4 5.3 5.3 5.4
Oklahoma . . . . . . . . . . . . . . . 1,584 1,683 1,852 1,875 1,903 4.9 4.9 5.0 5.0 5.0
Oregon . . . . . . . . . . . . . . . . . 2,034 2,273 2,656 2,675 2,734 6.6 6.6 7.0 7.0 7.1
Pennsylvania . . . . . . . . . . . . . 7,915 8,031 7,821 7,976 8,102 6.5 6.5 6.2 6.3 6.4
Rhode Island . . . . . . . . . . . . . 581 589 580 597 621 5.7 5.6 5.5 5.7 5.9
South Carolina . . . . . . . . . . . . 1,601 1,803 2,132 2,175 2,229 4.4 4.5 4.6 4.7 4.8
South Dakota . . . . . . . . . . . . . 347 359 420 423 442 4.8 4.8 5.2 5.2 5.4
Tennessee . . . . . . . . . . . . . . . 2,748 2,993 3,108 3,143 3,262 5.3 5.3 4.9 5.0 5.1
Texas . . . . . . . . . . . . . . . . . . 8,860 9,873 11,554 11,923 12,565 4.9 4.7 4.7 4.7 4.9
Utah . . . . . . . . . . . . . . . . . . . 1,162 1,398 1,808 1,872 1,895 6.1 6.3 6.6 6.8 6.7
Vermont . . . . . . . . . . . . . . . . 323 353 360 370 376 5.6 5.8 5.8 5.9 6.0
Virginia . . . . . . . . . . . . . . . . . 3,686 4,036 4,765 4,886 4,989 5.7 5.7 6.0 6.1 6.2
Washington . . . . . . . . . . . . . . 3,271 3,860 4,765 4,829 4,940 6.2 6.5 7.1 7.2 7.2
West Virginia . . . . . . . . . . . . . 816 828 870 877 877 4.5 4.6 4.7 4.7 4.7
Wisconsin . . . . . . . . . . . . . . . 3,054 3,119 3,244 3,253 3,331 6.0 5.8 5.7 5.7 5.8
Wyoming . . . . . . . . . . . . . . . . 235 267 285 285 294 5.0 5.4 5.1 5.1 5.2
NOTES: Data include professionally active dentists only. Professionally active dentists include those whose primary and/or secondary occupation is one of the following:
private practice (full- or part-time), dental school/faculty staff member, armed forces, other federal services (i.e., Veterans’ Affairs, Public Health Service), state or local
government employee, hospital staff dentist, graduate student/intern/resident, or other health/dental organization staff member. U.S. totals include dentists with unknown
state of practice not shown separately.
SOURCE: American Dental Association, Survey Center, Dentist Supply in the US: 1993–2011, Tables 1 and 5 (Copyright 2013 American Dental Association. Reprinted
with permission. All rights reserved.) Any form of reproduction is strictly prohibited without prior written permission of the American Dental Association.
Occupation title 2001 2005 2012 2013 2001 2005 2012 2013
owners and partners in unincorporated firms, household workers, or unpaid family workers. Estimates were rounded to the nearest 10.
2
The mean hourly wage rate for an occupation is the total wages that all workers in the occupation earn in an hour, divided by the total number of employees in the
3
2012 and 2013 data are not comparable to earlier data. Starting with 2012 data, the radiologic technologists and technicians occupation category was split into two
occupations as part of the 2010 SOC revision: Radiologic technologists (29–2034) and Magnetic resonance imaging technologists (29–2035).
4
2012 and 2013 data are not comparable to earlier data. Starting with 2012 data, the registered nurses occupation category was split into four occupations as part of
the 2010 SOC revision: Registered nurses (29–1141), plus three advanced practice nursing occupations: Nurse anesthetists (29–1151), Nurse midwives (29–1161), and
5
2012 and 2013 data are not comparable to earlier data. Starting with 2012 data, the nursing aides, orderlies, and attendants occupation category was split into two
occupations as part of the 2010 SOC revision: Nursing assistants (31–1014) and Orderlies (31–1015).
NOTES: This table excludes occupations such as dentists, physicians, and chiropractors, which have a large percentage of workers who are self-employed. Challenges
in using Occupational Employment Statistics (OES) data as a time series include changes in the occupational, industrial, and geographical classification systems,
changes in the way data are collected, changes in the survey reference period, and changes in mean wage estimation methodology, as well as permanent features of
SOURCE: U.S. Department of Labor, Bureau of Labor Statistics. Occupational Employment Statistics. Available from: http://www.bls.gov/oes/. See Appendix I, Occupational
Academic years
2
Includes new entrants and those repeating the initial year.
3
May also include persons enrolled in first-year classes for data years 1980–1981 and 2006–2007.
4
Starting with 2005–2006 data, first-year enrollment for pharmacy schools include Pharm.D.1 enrollments only. Prior to 2005, first-year enrollment data include both
Pharm.D.1, B.S. Pharmacy, and B.Pharm. enrollments. Includes second from last year for baccalaureate and third from last year for Pharm.D.1 and does not include
5
Starting with 2008–2009 data, first-year enrollment data for public health schools include spring, summer, and fall enrollment. All other data years include fall
6
Includes data from a school of public health in Mexico as of 2007 school year.
7
Excludes graduates of ‘‘special’’ optometry degree programs which include, but are not limited to, accelerated programs for those entering optometry schools with a
doctoral degree or graduates of foreign optometry programs and modified extended programs for those returning to schools after an absence, changing professional
8
Includes schools with preliminary and provisional accreditation, in addition to fully accredited schools.
NOTE: Data on the number of schools and first-year enrollments are reported as of the beginning of the academic year, while data on the number of graduates are
SOURCE: American Dental Association: 2012–2013 Survey of Dental Education Series, Report 1: Academic Programs, Enrollment and Graduates. Available from:
http://www.ada.org/en/science-research/health-policy-institute/data-center/dental-education (Copyright 2014 American Dental Association. Reprinted with permission. All
rights reserved.) Any form of reproduction is strictly prohibited without prior written permission of the American Dental Association; Association of American Medical
Colleges (AAMC): AAMC Data Book 2014 - Medical Schools and Teaching Hospitals by the Numbers, Washington, DC. 2014. Table A1 (number of schools) and Table
B1 (number of first-year enrollment students and number of graduates). Used with permission of the AAMC; American Association of Colleges of Osteopathic Medicine:
Trends in Osteopathic Medical School Applicants, Enrollment and Graduates, 2014. Chevy Chase, MD. 2014. Available from:
http://www.aacom.org/reports-programs-initiatives/aacom-reports. Reprinted with permission from AACOM, All rights reserved; Association of Schools and Colleges of
Optometry: Annual Student Data Report Academic Years 2013–2014 and unpublished data. Available from: http://www.opted.org/data-surveys/; American Association of
Podiatric Medicine: Applicant, Matriculant, and Graduate Statistics, 2006 through 2013 and unpublished data. Available from: http://www.aacpm.org. Used with
permission of the AACPM; Association of Schools & Programs of Public Health: unpublished data. Washington, DC. Used with permission of the ASPPH; Bureau of
Health Professions: United States Health Personnel FACTBOOK. Health Resources and Services Administration. Rockville, MD. 2003. See Appendix I, American Dental
Association (ADA); Association of American Medical Colleges (AAMC); American Association of Colleges of Osteopathic Medicine (AACOM); Association of Schools
and Colleges of Optometry (ASCO); American Association of Colleges of Pharmacy (AACP); American Association of Colleges of Podiatric Medicine (AACPM);
Type of ownership
and size of hospital 1975 1980 1990 2000 2005 2010 2011 2012
Hospitals Number
All hospitals . . . . . . . . . . . . . . . . . . 7,156 6,965 6,649 5,810 5,756 5,754 5,724 5,723
Federal . . . . . ......... . . . . . 382 359 337 245 226 213 208 211
Nonfederal 1 . . ......... . . . . . 6,774 6,606 6,312 5,565 5,530 5,541 5,516 5,512
Community 2 ......... . . . . . 5,875 5,830 5,384 4,915 4,936 4,985 4,973 4,999
Nonprofit . ......... . . . . . 3,339 3,322 3,191 3,003 2,958 2,904 2,903 2,894
For profit . ......... . . . . . 775 730 749 749 868 1,013 1,025 1,068
State-local government . . . . . 1,761 1,778 1,444 1,163 1,110 1,068 1,045 1,037
6–24 beds . . . . . . . . . . . . . . 299 259 226 288 370 424 445 462
25–49 beds . . . . . . . . . . . . . 1,155 1,029 935 910 1,032 1,167 1,177 1,192
50–99 beds . . . . . . . . . . . . . 1,481 1,462 1,263 1,055 1,001 970 955 954
100–199 beds . . . . . . . . . . . 1,363 1,370 1,306 1,236 1,129 1,029 1,005 1,012
200–299 beds . . . . . . . . . . . 678 715 739 656 619 585 582 570
300–399 beds . . . . . . . . . . . 378 412 408 341 368 352 353 348
400–499 beds . . . . . . . . . . . 230 266 222 182 173 185 184 189
500 beds or more . . . . . . . . . 291 317 285 247 244 273 272 272
Beds
All hospitals . . . . . . . . . . . . . . . . . . 1,465,828 1,364,516 1,213,327 983,628 946,997 941,995 924,333 920,829
Federal . . . . . . . . . . . . . . . . . . . 131,946 117,328 98,255 53,067 45,837 44,940 38,065 38,557
Nonfederal 1 . . . . . . . . . . . . . . . . 1,333,882 1,247,188 1,115,072 930,561 901,160 897,055 886,268 882,272
Community 2 . . . . . . . . . . . . . . 941,844 988,387 927,360 823,560 802,311 804,943 797,403 800,566
Nonprofit . . . . . . . . . . . . . . . 658,195 692,459 656,755 582,988 561,106 555,768 547,804 545,287
For profit . . . . . . . . . . . . . . . 73,495 87,033 101,377 109,883 113,510 124,652 128,371 135,008
State-local government . . . . . 210,154 208,895 169,228 130,689 127,695 124,523 121,228 120,271
6–24 beds . . . . . . . . . . . . . . 5,615 4,932 4,427 5,156 6,316 7,261 7,616 7,791
25–49 beds . . . . . . . . . . . . . 41,783 37,478 35,420 33,333 33,726 37,446 37,680 38,338
50–99 beds . . . . . . . . . . . . . 106,776 105,278 90,394 75,865 71,737 69,470 67,844 67,879
100–199 beds . . . . . . . . . . . 192,438 192,892 183,867 175,778 161,593 148,090 143,843 145,556
200–299 beds . . . . . . . . . . . 164,405 172,390 179,670 159,807 151,290 142,616 141,308 139,212
300–399 beds . . . . . . . . . . . 127,728 139,434 138,938 117,220 126,899 121,749 122,269 120,554
400–499 beds . . . . . . . . . . . 101,278 117,724 98,833 80,763 76,894 82,071 81,699 84,007
500 beds or more . . . . . . . . . 201,821 218,259 195,811 175,638 173,856 196,240 195,144 197,229
2
Community hospitals are nonfederal short-term general and special hospitals whose facilities and services are available to the public. The types of facilities included in
the community hospitals category have changed over time. See Appendix II, Hospital.
3
Estimated percentage of staffed beds that are occupied. Occupancy rate is calculated as the average daily census (from the American Hospital Association) divided by
SOURCE: American Hospital Association (AHA) Annual Survey of Hospitals. Hospital Statistics, 1976, 1981, 1991–92, 2002, 2007, 2012, 2013, and 2014 editions.
Chicago, IL. (Reprinted from AHA Hospital Statistics by permission, Copyright 1976, 1981, 1991–92, 2002, 2007, 2012, 2013, and 2014 by Health Forum, LLC, an
American Hospital Association company.) See Appendix I, American Hospital Association (AHA) Annual Survey of Hospitals.
State 1980 1990 2000 2010 2011 2012 1980–1990 1990–2000 2000–2010 2010–2012
United States . . . . . . . . . . . . . . 4.5 3.7 2.9 2.6 2.6 2.6 –1.9 –2.4 –1.1 –
Alabama . . . . . . . . . . . . . . . . 5.1 4.6 3.7 3.2 3.2 3.1 –1.0 –2.2 –1.4 –1.6
Alaska. . . . . . . . . . . . . . . . . . 2.7 2.3 2.3 2.2 2.2 2.1 –1.6 – –0.4 –2.3
Arizona . . . . . . . . . . . . . . . . . 3.6 2.7 2.1 2.0 2.1 2.1 –2.8 –2.5 –0.5 2.5
Arkansas . . . . . . . . . . . . . . . . 5.0 4.6 3.7 3.2 3.2 3.2 –0.8 –2.2 –1.4 –
California . . . . . . . . . . . . . . . . 3.6 2.7 2.1 1.9 1.9 1.9 –2.8 –2.5 –1.0 –
Colorado . . . . . . . . . . . . . . . . 4.2 3.2 2.2 2.0 2.0 2.0 –2.7 –3.7 –0.9 –
Connecticut . . . . . . . . . . . . . . 3.5 2.9 2.3 2.3 2.2 2.3 –1.9 –2.3 – –
Delaware . . . . . . . . . . . . . . . . 3.6 3.0 2.3 2.4 2.4 2.2 –1.8 –2.6 0.4 –4.3
District of Columbia . . . . . . . . 7.3 7.6 5.8 5.7 5.9 5.7 0.4 –2.7 –0.2 –
Florida. . . . . . . . . . . . . . . . . . 5.1 3.9 3.2 2.9 2.8 2.8 –2.6 –2.0 –1.0 –1.7
Georgia . . . . . . . . . . . . . . . . . 4.6 4.0 2.9 2.6 2.6 2.5 –1.4 –3.2 –1.1 –1.9
Hawaii. . . . . . . . . . . . . . . . . . 3.1 2.7 2.5 2.4 1.9 2.0 –1.4 –0.8 –0.4 –8.7
Idaho . . . . . . . . . . . . . . . . . . 3.7 3.2 2.7 2.2 2.1 2.1 –1.4 –1.7 –2.0 –2.3
Illinois . . . . . . . . . . . . . . . . . . 5.1 4.0 3.0 2.6 2.5 2.5 –2.4 –2.8 –1.4 –1.9
Indiana . . . . . . . . . . . . . . . . . 4.5 3.9 3.2 2.8 2.7 2.7 –1.4 –2.0 –1.3 –1.8
Iowa . . . . . . . . . . . . . . . . . . . 5.7 5.1 4.0 3.3 3.3 3.2 –1.1 –2.4 –1.9 –1.5
Kansas . . . . . . . . . . . . . . . . . 5.8 4.8 4.0 3.5 3.5 3.5 –1.9 –1.8 –1.3 –
Kentucky . . . . . . . . . . . . . . . . 4.5 4.3 3.7 3.3 3.2 3.2 –0.5 –1.5 –1.1 –1.5
Louisiana. . . . . . . . . . . . . . . . 4.8 4.6 3.9 3.4 3.4 3.3 –0.4 –1.6 –1.4 –1.5
Maine . . . . . . . . . . . . . . . . . . 4.7 3.7 2.9 2.7 2.7 2.7 –2.4 –2.4 –0.7 –
Maryland . . . . . . . . . . . . . . . . 3.6 2.8 2.1 2.0 2.0 2.1 –2.5 –2.8 –0.5 2.5
Massachusetts . . . . . . . . . . . . 4.4 3.6 2.6 2.4 2.4 2.4 –2.0 –3.2 –0.8 –
Michigan . . . . . . . . . . . . . . . . 4.4 3.7 2.6 2.6 2.6 2.5 –1.7 –3.5 – –1.9
Minnesota . . . . . . . . . . . . . . . 5.7 4.4 3.4 2.9 2.8 2.8 –2.6 –2.5 –1.6 –1.7
Mississippi . . . . . . . . . . . . . . . 5.3 5.0 4.8 4.4 4.3 4.3 –0.6 –0.4 –0.9 –1.1
Missouri. . . . . . . . . . . . . . . . . 5.7 4.8 3.6 3.1 3.1 3.2 –1.7 –2.8 –1.5 1.6
Montana . . . . . . . . . . . . . . . . 5.9 5.8 4.7 3.8 3.6 3.7 –0.2 –2.1 –2.1 –1.3
Nebraska. . . . . . . . . . . . . . . . 6.0 5.5 4.8 4.0 3.6 3.8 –0.9 –1.4 –1.8 –2.5
Nevada . . . . . . . . . . . . . . . . . 4.2 2.8 1.9 2.0 2.0 2.0 –4.0 –3.8 0.5 –
New Hampshire . . . . . . . . . . . 3.9 3.1 2.3 2.2 2.2 2.1 –2.3 –2.9 –0.4 –2.3
New Jersey . . . . . . . . . . . . . . 4.2 3.7 3.0 2.4 2.3 2.4 –1.3 –2.1 –2.2 –
New Mexico. . . . . . . . . . . . . . 3.1 2.8 1.9 2.0 2.0 2.0 –1.0 –3.8 0.5 –
New York. . . . . . . . . . . . . . . . 4.5 4.1 3.5 3.0 3.0 2.9 –0.9 –1.6 –1.5 –1.7
North Carolina . . . . . . . . . . . . 4.2 3.3 2.9 2.4 2.4 2.3 –2.4 –1.3 –1.9 –2.1
North Dakota . . . . . . . . . . . . . 7.4 7.0 6.0 5.1 4.6 4.7 –0.6 –1.5 –1.6 –4.0
Ohio . . . . . . . . . . . . . . . . . . . 4.7 4.0 3.0 3.0 2.9 2.9 –1.6 –2.8 – –1.7
Oklahoma . . . . . . . . . . . . . . . 4.6 4.0 3.2 3.0 3.0 3.0 –1.4 –2.2 –0.6 –
Oregon . . . . . . . . . . . . . . . . . 3.5 2.8 1.9 1.7 1.8 1.7 –2.2 –3.8 –1.1 –
Pennsylvania . . . . . . . . . . . . . 4.8 4.4 3.4 3.2 3.1 3.1 –0.9 –2.5 –0.6 –1.6
Rhode Island . . . . . . . . . . . . . 3.8 3.2 2.3 2.3 2.3 2.3 –1.7 –3.2 – –
South Carolina . . . . . . . . . . . . 3.9 3.3 2.9 2.7 2.6 2.7 –1.7 –1.3 –0.7 –
South Dakota . . . . . . . . . . . . . 5.5 6.1 5.7 5.0 5.0 5.0 1.0 –0.7 –1.3 –
Tennessee . . . . . . . . . . . . . . . 5.5 4.8 3.6 3.3 3.1 3.1 –1.4 –2.8 –0.9 –3.1
Texas . . . . . . . . . . . . . . . . . . 4.7 3.5 2.7 2.4 2.4 2.4 –2.9 –2.6 –1.2 –
Utah . . . . . . . . . . . . . . . . . . . 3.1 2.6 1.9 1.8 1.8 1.8 –1.7 –3.1 –0.5 –
Vermont . . . . . . . . . . . . . . . . 4.4 3.0 2.7 2.1 1.9 2.0 –3.8 –1.0 –2.5 –2.4
Virginia . . . . . . . . . . . . . . . . . 4.1 3.3 2.4 2.2 2.2 2.2 –2.1 –3.1 –0.9 –
Washington . . . . . . . . . . . . . . 3.1 2.5 1.9 1.7 1.7 1.8 –2.1 –2.7 –1.1 2.9
West Virginia . . . . . . . . . . . . . 5.5 4.7 4.4 4.0 4.0 3.9 –1.6 –0.7 –0.9 –1.3
Wisconsin . . . . . . . . . . . . . . . 4.9 3.8 2.9 2.4 2.3 2.3 –2.5 –2.7 –1.9 –2.1
Wyoming . . . . . . . . . . . . . . . . 3.6 4.8 3.9 3.6 3.4 3.3 2.9 –2.1 –0.8 –4.3
– Quantity zero.
1
See Appendix II, Average annual rate of change (percent change).
NOTES: Community hospitals are nonfederal short-term general and special hospitals whose facilities and services are available to the public. The types of facilities
included in the community hospitals category have changed over time. See Appendix II, Hospital. See Health, United States, 2013, Table 108, for 1970 hospital data.
SOURCE: American Hospital Association (AHA): Annual Survey of Hospitals. Hospital Statistics, 1981, 1991–92, 2002, 2012, 2013, and 2014 editions. Chicago, IL.
(Reprinted from AHA Hospital Statistics by permission, Copyright 1981, 1991–92, 2002, 2012, 2013, and 2014 by Health Forum, LLC, an American Hospital Association
Company.) See Appendix I, American Hospital Association (AHA) Annual Survey of Hospitals.
State 1980 1990 2000 2010 2011 2012 1980–1990 1990–2000 2000–2010 2010–2012
– Quantity zero.
1
Estimated percent of staffed beds that are occupied. Occupancy rate is calculated as the average daily census (inpatient days divided by 365) divided by the number
2
See Appendix II, Average annual rate of change (percent change).
NOTES: Community hospitals are nonfederal short-term general and special hospitals whose facilities and services are available to the public. The types of facilities
included in the community hospitals category have changed over time. See Appendix II, Hospital. See Health, United States, 2013, Table 109, for 1970 hospital data.
SOURCE: American Hospital Association (AHA): Annual Survey of Hospitals. Hospital Statistics, 1981, 1991–92, 2002, 2012, 2013, and 2014 editions. Chicago, IL.
(Reprinted from AHA Hospital Statistics by permission, Copyright 1981, 1991–92, 2002, 2012, 2013, and 2014 by Health Forum, LLC, an American Hospital Association
Company.) See Appendix I, American Hospital Association (AHA) Annual Survey of Hospitals.
Number
United States . . . . . . . . . . . . . . 16,389 16,886 15,673 15,663 1,751,302 1,795,388 1,703,213 1,697,484
Alabama . . . . . . . . . . . . . . . . 221 225 228 228 23,353 25,248 26,685 26,685
Alaska. . . . . . . . . . . . . . . . . . 15 15 16 17 814 821 679 779
Arizona . . . . . . . . . . . . . . . . . 152 150 145 146 16,162 17,458 16,609 16,607
Arkansas . . . . . . . . . . . . . . . . 256 255 232 230 29,952 25,715 24,568 24,546
California . . . . . . . . . . . . . . . . 1,382 1,369 1,231 1,226 140,203 131,762 121,873 121,381
Colorado . . . . . . . . . . . . . . . . 219 225 214 211 19,912 20,240 20,374 20,371
Connecticut . . . . . . . . . . . . . . 267 259 231 231 32,827 32,433 27,882 27,841
Delaware . . . . . . . . . . . . . . . . 42 43 46 46 4,739 4,906 4,923 4,986
District of Columbia . . . . . . . . 19 20 19 19 3,206 3,078 2,766 2,766
Florida. . . . . . . . . . . . . . . . . . 627 732 682 687 72,656 83,365 82,989 83,178
Georgia . . . . . . . . . . . . . . . . . 352 363 358 358 38,097 39,817 39,870 39,883
Hawaii. . . . . . . . . . . . . . . . . . 34 45 47 47 2,513 4,006 4,219 4,215
Idaho . . . . . . . . . . . . . . . . . . 76 84 77 77 5,747 6,181 5,933 5,930
Illinois . . . . . . . . . . . . . . . . . . 827 869 775 769 103,230 110,766 99,804 98,883
Indiana . . . . . . . . . . . . . . . . . 556 564 515 515 59,538 56,762 59,314 58,764
Iowa . . . . . . . . . . . . . . . . . . . 419 467 444 444 39,959 37,034 35,058 32,183
Kansas . . . . . . . . . . . . . . . . . 429 392 341 345 30,016 27,067 25,426 25,653
Kentucky . . . . . . . . . . . . . . . . 288 307 283 283 23,221 25,341 26,001 26,170
Louisiana. . . . . . . . . . . . . . . . 337 337 280 280 37,769 39,430 35,648 35,189
Maine . . . . . . . . . . . . . . . . . . 132 126 108 107 9,243 8,248 7,057 7,020
Maryland . . . . . . . . . . . . . . . . 218 255 233 230 28,394 31,495 28,860 28,487
Massachusetts . . . . . . . . . . . . 550 526 422 421 54,532 56,030 48,702 48,660
Michigan . . . . . . . . . . . . . . . . 432 439 426 432 49,473 50,696 46,698 46,970
Minnesota . . . . . . . . . . . . . . . 432 433 380 380 43,865 42,149 30,919 30,405
Mississippi . . . . . . . . . . . . . . . 183 190 204 205 16,059 17,068 18,530 18,550
Missouri. . . . . . . . . . . . . . . . . 546 551 513 513 52,679 54,829 55,134 55,106
Montana . . . . . . . . . . . . . . . . 100 104 83 83 7,210 7,667 6,779 6,713
Nebraska. . . . . . . . . . . . . . . . 231 236 218 217 18,169 17,877 15,972 15,855
Nevada . . . . . . . . . . . . . . . . . 42 51 51 51 3,998 5,547 5,992 5,979
New Hampshire . . . . . . . . . . . 74 83 76 76 7,412 7,837 7,564 7,510
New Jersey . . . . . . . . . . . . . . 300 361 366 365 43,967 52,195 52,119 52,417
New Mexico. . . . . . . . . . . . . . 83 80 72 71 6,969 7,289 6,894 6,716
New York. . . . . . . . . . . . . . . . 624 665 632 631 107,750 120,514 117,360 116,448
North Carolina . . . . . . . . . . . . 391 410 418 421 38,322 41,376 44,036 44,598
North Dakota . . . . . . . . . . . . . 87 88 83 81 7,125 6,954 6,281 6,138
Ohio . . . . . . . . . . . . . . . . . . . 943 1,009 959 955 106,884 105,038 92,180 91,563
Oklahoma . . . . . . . . . . . . . . . 405 392 308 311 33,918 33,903 28,876 29,396
Oregon . . . . . . . . . . . . . . . . . 161 150 137 138 13,885 13,500 12,225 12,276
Pennsylvania . . . . . . . . . . . . . 726 770 707 703 92,625 95,063 88,552 88,284
Rhode Island . . . . . . . . . . . . . 94 99 84 84 9,612 10,271 8,678 8,715
South Carolina . . . . . . . . . . . . 166 178 189 189 16,682 18,102 19,636 19,689
South Dakota . . . . . . . . . . . . . 114 114 112 111 8,296 7,844 6,950 6,909
Tennessee . . . . . . . . . . . . . . . 322 349 322 320 37,074 38,593 37,507 37,140
Texas . . . . . . . . . . . . . . . . . . 1,266 1,215 1,202 1,205 123,056 125,052 134,357 135,350
Utah . . . . . . . . . . . . . . . . . . . 91 93 100 98 7,101 7,651 8,481 8,500
Vermont . . . . . . . . . . . . . . . . 23 44 38 38 1,862 3,743 3,199 3,199
Virginia . . . . . . . . . . . . . . . . . 271 278 284 286 30,070 30,595 32,302 32,638
Washington . . . . . . . . . . . . . . 285 277 226 225 28,464 25,905 21,767 21,641
West Virginia . . . . . . . . . . . . . 129 139 125 126 10,903 11,413 10,849 10,888
Wisconsin . . . . . . . . . . . . . . . 413 420 392 392 48,754 46,395 35,153 34,730
Wyoming . . . . . . . . . . . . . . . . 37 40 39 39 3,035 3,119 2,983 2,984
Number
United States . . . . . . . . . . . . . . 1,479,550 1,480,076 1,383,488 1,371,926 84.5 82.4 81.2 80.8
Alabama . . . . . . . . . . . . . . . . 21,691 23,089 22,673 22,764 92.9 91.4 85.0 85.3
Alaska. . . . . . . . . . . . . . . . . . 634 595 591 498 77.9 72.5 87.0 63.9
Arizona . . . . . . . . . . . . . . . . . 12,382 13,253 11,426 11,344 76.6 75.9 68.8 68.3
Arkansas . . . . . . . . . . . . . . . . 20,823 19,317 17,982 17,774 69.5 75.1 73.2 72.4
California . . . . . . . . . . . . . . . . 109,805 106,460 102,587 102,324 78.3 80.8 84.2 84.3
Colorado . . . . . . . . . . . . . . . . 17,055 17,045 16,136 15,957 85.7 84.2 79.2 78.3
Connecticut . . . . . . . . . . . . . . 29,948 29,657 24,948 24,610 91.2 91.4 89.5 88.4
Delaware . . . . . . . . . . . . . . . . 3,819 3,900 4,268 4,217 80.6 79.5 86.7 84.6
District of Columbia . . . . . . . . 2,576 2,858 2,604 2,569 80.3 92.9 94.1 92.9
Florida. . . . . . . . . . . . . . . . . . 61,845 69,050 72,286 72,679 85.1 82.8 87.1 87.4
Georgia . . . . . . . . . . . . . . . . . 35,933 36,559 34,122 33,889 94.3 91.8 85.6 85.0
Hawaii. . . . . . . . . . . . . . . . . . 2,413 3,558 3,738 3,714 96.0 88.8 88.6 88.1
Idaho . . . . . . . . . . . . . . . . . . 4,697 4,640 4,074 3,909 81.7 75.1 68.7 65.9
Illinois . . . . . . . . . . . . . . . . . . 83,696 83,604 73,849 72,856 81.1 75.5 74.0 73.7
Indiana . . . . . . . . . . . . . . . . . 44,328 42,328 39,310 38,649 74.5 74.6 66.3 65.8
Iowa . . . . . . . . . . . . . . . . . . . 27,506 29,204 25,077 24,980 68.8 78.9 71.5 77.6
Kansas . . . . . . . . . . . . . . . . . 25,140 22,230 18,596 18,400 83.8 82.1 73.1 71.7
Kentucky . . . . . . . . . . . . . . . . 20,696 22,730 23,051 22,818 89.1 89.7 88.7 87.2
Louisiana. . . . . . . . . . . . . . . . 32,493 30,735 25,906 25,600 86.0 77.9 72.7 72.8
Maine . . . . . . . . . . . . . . . . . . 8,587 7,298 6,395 6,342 92.9 88.5 90.6 90.3
Maryland . . . . . . . . . . . . . . . . 24,716 25,629 24,543 24,360 87.0 81.4 85.0 85.5
Massachusetts . . . . . . . . . . . . 49,765 49,805 42,204 41,595 91.3 88.9 86.7 85.5
Michigan . . . . . . . . . . . . . . . . 43,271 42,615 39,307 39,288 87.5 84.1 84.2 83.6
Minnesota . . . . . . . . . . . . . . . 41,163 38,813 27,789 27,201 93.8 92.1 89.9 89.5
Mississippi . . . . . . . . . . . . . . . 15,247 15,815 16,304 16,165 94.9 92.7 88.0 87.1
Missouri. . . . . . . . . . . . . . . . . 39,891 38,586 37,998 37,828 75.7 70.4 68.9 68.7
Montana . . . . . . . . . . . . . . . . 6,415 5,973 4,657 4,689 89.0 77.9 68.7 69.9
Nebraska. . . . . . . . . . . . . . . . 16,166 14,989 12,235 12,070 89.0 83.8 76.6 76.1
Nevada . . . . . . . . . . . . . . . . . 3,645 3,657 4,625 4,749 91.2 65.9 77.2 79.4
New Hampshire . . . . . . . . . . . 6,877 7,158 6,938 6,813 92.8 91.3 91.7 90.7
New Jersey . . . . . . . . . . . . . . 40,397 45,837 45,499 45,450 91.9 87.8 87.3 86.7
New Mexico. . . . . . . . . . . . . . 6,051 6,503 5,669 5,531 86.8 89.2 82.2 82.4
New York. . . . . . . . . . . . . . . . 103,409 112,957 107,481 105,965 96.0 93.7 91.6 91.0
North Carolina . . . . . . . . . . . . 35,511 36,658 37,313 36,908 92.7 88.6 84.7 82.8
North Dakota . . . . . . . . . . . . . 6,868 6,343 5,694 5,702 96.4 91.2 90.7 92.9
Ohio . . . . . . . . . . . . . . . . . . . 79,026 81,946 78,075 77,129 73.9 78.0 84.7 84.2
Oklahoma . . . . . . . . . . . . . . . 26,377 23,833 19,315 19,376 77.8 70.3 66.9 65.9
Oregon . . . . . . . . . . . . . . . . . 11,673 9,990 7,334 7,373 84.1 74.0 60.0 60.1
Pennsylvania . . . . . . . . . . . . . 84,843 83,880 80,055 79,554 91.6 88.2 90.4 90.1
Rhode Island . . . . . . . . . . . . . 8,823 9,041 7,978 7,986 91.8 88.0 91.9 91.6
South Carolina . . . . . . . . . . . . 14,568 15,739 16,900 16,744 87.3 86.9 86.1 85.0
South Dakota . . . . . . . . . . . . . 7,926 7,059 6,371 6,335 95.5 90.0 91.7 91.7
Tennessee . . . . . . . . . . . . . . . 33,929 34,714 31,189 29,990 91.5 89.9 83.2 80.7
Texas . . . . . . . . . . . . . . . . . . 89,354 85,275 93,710 93,712 72.6 68.2 69.8 69.2
Utah . . . . . . . . . . . . . . . . . . . 5,832 5,703 5,423 5,383 82.1 74.5 63.9 63.3
Vermont . . . . . . . . . . . . . . . . 1,792 3,349 2,761 2,726 96.2 89.5 86.3 85.2
Virginia . . . . . . . . . . . . . . . . . 28,119 27,091 28,260 28,249 93.5 88.5 87.5 86.6
Washington . . . . . . . . . . . . . . 24,954 21,158 17,272 17,199 87.7 81.7 79.4 79.5
West Virginia . . . . . . . . . . . . . 10,216 10,334 9,535 9,524 93.7 90.5 87.9 87.5
Wisconsin . . . . . . . . . . . . . . . 43,998 38,911 29,000 28,062 90.2 83.9 82.5 80.8
Wyoming . . . . . . . . . . . . . . . . 2,661 2,605 2,435 2,377 87.7 83.5 81.6 79.7
1
Percentage of beds occupied (number of nursing home residents per 100 nursing home beds).
NOTES: Annual numbers of nursing homes, beds, and residents are based on the Centers for Medicare & Medicaid Services’ reporting cycle. Starting with 2013 data, a
new editing rule was used for number of beds. For the U.S., the number of beds decreased by less than 1%. For most states, this caused little or no change in the
data. For some states, the number of beds changed by up to 8%. The change in the number of beds also caused a change in some occupancy rates. Because of the
methodology change, trends should be interpreted with caution. Data for additional years are available. See the Excel spreadsheet on the Health, United States website
at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: Cowles CM ed., 2013 Nursing Home Statistical Yearbook. Anacortes, WA: Cowles Research Group, 2014 and previous editions; and Cowles Research
Group, unpublished data. Based on data from the Centers for Medicare & Medicaid Services’ Quality Improvement Evaluation System (QIES) and its predecessor, the
Online Survey Certification and Reporting Database (OSCAR). See Appendix I, Quality Improvement Evaluation System (QIES).
Amount, in billions
Gross domestic product (GDP) . . . . . . . . . $543 $1,076 $2,863 $5,980 $10,285 $14,419 $14,964 $16,163 $16,768
Deflator (2009 = 100.0)
Price deflator for GDP 1 . . . . . . . . . . . . . . 17.5 22.8 44.5 66.8 81.9 100.0 101.2 105.2 106.7
Amount, in billions
National health expenditures . . . . . . ..... $27.4 $74.9 $255.8 $724.3 $1,378.0 $2,505.8 $2,604.1 $2,817.3 $2,919.1
Health consumption expenditures . ..... 24.8 67.1 235.7 675.6 1,290.0 2,359.5 2,454.5 2,653.6 2,754.5
Personal health care . . . . . . . . ..... 23.4 63.1 217.2 616.8 1,165.7 2,117.9 2,196.2 2,379.3 2,468.6
Administration and net cost of
private health insurance . . . . . ..... 1.1 2.6 12.0 38.8 81.3 167.6 182.8 199.5 210.6
Public health . . . . . . . . . . . . . . ..... 0.4 1.4 6.4 20.0 43.0 74.0 75.5 74.8 75.4
Investment 2 . . . . . . . . . . . . . . . . ..... 2.6 7.8 20.1 48.7 88.0 146.3 149.7 163.7 164.6
Deflator (2009 = 100.0)
Chain-weighted national health expenditure
deflator 1 . . . . . . . . . . . . . . . . . . . . . . . . -- -- -- -- -- 100.0 102.7 106.9 108.3
Percent
National health expenditures as
percent of GDP . . . . . . . . . . . . . . . . . . . 5.0 7.0 8.9 12.1 13.4 17.4 17.4 17.4 17.4
Percent distribution
National health expenditures . . . . . . ..... 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0
Health consumption expenditures . ..... 90.6 89.6 92.1 93.3 93.6 94.2 94.3 94.2 94.4
Personal health care . . . . . . . . ..... 85.4 84.3 84.9 85.2 84.6 84.5 84.3 84.5 84.6
Administration and net cost of
private health insurance . . . . . ..... 3.9 3.5 4.7 5.4 5.9 6.7 7.0 7.1 7.2
Public health . . . . . . . . . . . . . . ..... 1.4 1.8 2.5 2.8 3.1 3.0 2.9 2.7 2.6
Investment 2 . . . . . . . . . . . . . . . . ..... 9.4 10.4 7.9 6.7 6.4 5.8 5.7 5.8 5.6
1
Year 2009 = 100. For more information on the detailed price series recommended for deflating each category of spending see the National Health Expenditure
Accounts Methodology Paper, 2013 and NHE Deflator Methodology paper. Available from:
http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/.
2
Investment consists of research and structures and equipment.
3
See Appendix II, Average annual rate of change (percent change).
NOTES: Dollar amounts shown are in current dollars. See Appendix II, Gross domestic product (GDP); Health expenditures, national. Percents are calculated using
unrounded data. Estimates may not add to totals because of rounding. Census resident-based population less armed forces overseas and population of outlying areas
used to calculate per capita. For more information on NHE categories, sources, and methods, see the National Health Expenditure Accounts Methodology Paper, 2013.
Appendix I, National Health Expenditure Accounts (NHEA). Data have been revised and differ from previous editions of Health, United States.
SOURCE: Centers for Medicare & Medicaid Services, Office of the Actuary, National Health Statistics Group, National Health Expenditure Accounts, National health
http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NationalHealthAccountsHistorical.html, accessed
on December 12, 2014. U.S. Department of Commerce Bureau of Economic Analysis, National Economic Accounts, National Income and Product Accounts,
Table 1.1.4, accessed on December 12, 2014. Available from: http://www.bea.gov/iTable/iTable.cfm?ReqID=9&step=1. See Appendix I, National Health Expenditure
Type of national health expenditure 1960 1970 1980 1990 2000 2009 2012 2013
Amount, in billions
National health expenditures . . . . . . . . . . . . . . . . . . $27.4 $74.9 $255.8 $724.3 $1,378.0 $2,505.8 $2,817.3 $2,919.1
Health consumption expenditures . . . . . . . . . . . . . 24.8 67.1 235.7 675.6 1,290.0 2,359.5 2,653.6 2,754.5
Personal health care . . . . . . . . . . . . . . . . . . . . 23.4 63.1 217.2 616.8 1,165.7 2,117.9 2,379.3 2,468.6
Hospital care . . . . . . . . . . . . . . . . . . . . . . . . 9.0 27.2 100.5 250.4 415.5 776.8 898.5 936.9
Professional services . . . . . . . . . . . . . . . . . . 8.0 19.8 64.6 208.1 390.2 672.4 752.0 777.9
Physician and clinical services . . . . . . . . . . 5.6 14.3 47.7 158.9 290.9 503.2 565.3 586.7
Other professional services. . . . . . . . . . . . . 0.4 0.7 3.5 17.4 37.0 66.8 76.8 80.2
Dental services . . . . . . . . . . . . . . . . . . . . . 2.0 4.7 13.4 31.7 62.3 102.5 110.0 111.0
Other health, residential, and personal care. . . 0.5 1.3 8.5 24.3 64.5 122.5 140.1 148.2
Home health care 1 . . . . . . . . . . . . . . . . . . . . 0.1 0.2 2.4 12.6 32.4 67.2 77.1 79.8
Nursing care facilities and continuing
care retirement communities 1 . . . . . . . . . . . . 0.8 4.0 15.3 44.9 85.1 138.5 152.2 155.8
Retail outlet sales of medical products . . . . . . 5.0 10.6 25.9 76.5 177.9 340.3 359.4 370.0
Prescription drugs . . . . . . . . . . . . . . . . . . . 2.7 5.5 12.0 40.3 121.2 255.0 264.4 271.1
Durable medical equipment . . . . . . . . . . . . 0.7 1.7 4.1 13.8 25.2 35.0 41.3 43.0
Other nondurable medical products . . . . . . . 1.6 3.3 9.8 22.4 31.6 50.3 53.7 55.9
Government administration 2 . . . . . . . . . . . . . . . 0.1 0.7 2.8 7.2 17.1 29.8 34.2 37.0
Net cost of health insurance 3 . . . . . . . . . . . . . . 1.0 1.9 9.3 31.6 64.2 137.8 165.3 173.6
Government public health activities 4 . . . . . . . . . 0.4 1.4 6.4 20.0 43.0 74.0 74.8 75.4
Structures and equipment . . . . . . . . . . . . . . . . . 1.9 5.8 14.7 36.0 62.5 101.1 115.7 117.9
Health consumption expenditures . . . . . . . . . . . . . ... 10.5 13.4 11.1 6.7 6.9 4.0 3.8
Personal health care . . . . . . . . . . . . . . . . . . . . ... 10.4 13.2 11.0 6.6 6.9 4.0 3.8
Hospital care . . . . . . . . . . . . . . . . . . . . . . . . ... 11.7 14.0 9.6 5.2 7.2 5.0 4.3
Professional services . . . . . . . . . . . . . . . . . . ... 9.5 12.6 12.4 6.5 6.2 3.8 3.4
Physician and clinical services . . . . . . . . . . ... 9.8 12.8 12.8 6.2 6.3 4.0 3.8
Other professional services. . . . . . . . . . . . . ... 6.4 17.0 17.5 7.8 6.8 4.7 4.5
Dental services . . . . . . . . . . . . . . . . . . . . . ... 9.0 11.0 9.0 7.0 5.7 2.4 0.9
Other health, residential, and personal care. . . ... 11.4 20.4 11.1 10.2 7.4 4.6 5.8
Home health care 1 . . . . . . . . . . . . . . . . . . . . ... 14.5 26.9 18.1 9.9 8.4 4.7 3.4
Nursing care facilities and continuing
care retirement communities 1 . . . . . . . . . . . . ... 17.4 14.2 11.4 6.6 5.6 3.2 2.4
Retail outlet sales of medical products . . . . . . ... 7.7 9.4 11.4 8.8 7.5 1.8 2.9
Prescription drugs . . . . . . . . . . . . . . . . . . . ... 7.5 8.2 12.8 11.6 8.6 1.2 2.5
Durable medical equipment . . . . . . . . . . . . ... 9.0 8.8 13.0 6.2 3.7 5.6 4.2
Other nondurable medical products . . . . . . . ... 7.4 11.4 8.6 3.5 5.3 2.2 4.0
Government administration 2 . . . . . . . . . . . . . . . ... 29.9 14.1 10.0 9.1 6.4 4.7 8.2
Net cost of health insurance 3 . . . . . . . . . . . . . . ... 6.4 17.3 13.1 7.3 8.9 6.3 5.0
Government public health activities 4 . . . . . . . . . ... 13.8 16.9 12.0 8.0 6.2 0.3 0.8
Structures and equipment . . . . . . . . . . . . . . . . . ... 12.0 9.7 9.4 5.7 5.5 4.6 1.9
Percent distribution
National health expenditures . . . . . . . . . . . . . . . . . . 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0
Health consumption expenditures . . . . . . . . . . . . . 90.6 89.6 92.1 93.3 93.6 94.2 94.2 94.4
Personal health care . . . . . . . . . . . . . . . . . . . . 85.4 84.3 84.9 85.2 84.6 84.5 84.5 84.6
Hospital care . . . . . . . . . . . . . . . . . . . . . . . . 32.8 36.3 39.3 34.6 30.2 31.0 31.9 32.1
Professional services . . . . . . . . . . . . . . . . . . 29.3 26.4 25.3 28.7 28.3 26.8 26.7 26.6
Physician and clinical services . . . . . . . . . . 20.6 19.1 18.7 21.9 21.1 20.1 20.1 20.1
Other professional services. . . . . . . . . . . . . 1.4 1.0 1.4 2.4 2.7 2.7 2.7 2.7
Dental services . . . . . . . . . . . . . . . . . . . . . 7.3 6.3 5.2 4.4 4.5 4.1 3.9 3.8
Other health, residential, and personal care. . . 1.6 1.8 3.3 3.4 4.7 4.9 5.0 5.1
Home health care 1 . . . . . . . . . . . . . . . . . . . . 0.2 0.3 0.9 1.7 2.4 2.7 2.7 2.7
Nursing care facilities and continuing
care retirement communities 1 . . . . . . . . . . . . 3.0 5.4 6.0 6.2 6.2 5.5 5.4 5.3
Retail outlet sales of medical products . . . . . . 18.4 14.1 10.1 10.6 12.9 13.6 12.8 12.7
Prescription drugs . . . . . . . . . . . . . . . . . . . 9.8 7.3 4.7 5.6 8.8 10.2 9.4 9.3
Durable medical equipment . . . . . . . . . . . . 2.7 2.3 1.6 1.9 1.8 1.4 1.5 1.5
Other nondurable medical products . . . . . . . 5.9 4.4 3.8 3.1 2.3 2.0 1.9 1.9
Government administration 2 . . . . . . . . . . . . . . . 0.2 1.0 1.1 1.0 1.2 1.2 1.2 1.3
Net cost of health insurance 3 . . . . . . . . . . . . . . 3.7 2.5 3.6 4.4 4.7 5.5 5.9 5.9
Government public health activities 4 . . . . . . . . . 1.4 1.8 2.5 2.8 3.1 3.0 2.7 2.6
Structures and equipment . . . . . . . . . . . . . . . . . 6.8 7.8 5.7 5.0 4.5 4.0 4.1 4.0
Type of national health expenditure 1960 1970 1980 1990 2000 2009 2012 2013
Percent distribution
Personal health care . . . . . . . . . . . . . . . . . . . . 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0
Hospital care . . . . . . . . . . . . . . . . . . . . . . . . 38.5 43.1 46.3 40.6 35.6 36.7 37.8 38.0
Professional services . . . . . . . . . . . . . . . . . . 34.3 31.3 29.8 33.7 33.5 31.8 31.6 31.5
Physician and clinical services . . . . . . . . . . 24.1 22.7 22.0 25.8 25.0 23.8 23.8 23.8
Other professional services. . . . . . . . . . . . . 1.7 1.2 1.6 2.8 3.2 3.2 3.2 3.3
Dental services . . . . . . . . . . . . . . . . . . . . . 8.5 7.5 6.2 5.1 5.3 4.8 4.6 4.5
Other health, residential, and personal care. . . 1.9 2.1 3.9 3.9 5.5 5.8 5.9 6.0
Home health care 1 . . . . . . . . . . . . . . . . . . . . 0.2 0.3 1.1 2.0 2.8 3.2 3.2 3.2
Nursing care facilities and continuing
care retirement communities 1 . . . . . . . . . . . . 3.5 6.4 7.0 7.3 7.3 6.5 6.4 6.3
Retail outlet sales of medical products . . . . . . 21.6 16.8 11.9 12.4 15.3 16.1 15.1 15.0
Prescription drugs . . . . . . . . . . . . . . . . . . . 11.5 8.7 5.5 6.5 10.4 12.0 11.1 11.0
Durable medical equipment . . . . . . . . . . . . 3.2 2.8 1.9 2.2 2.2 1.7 1.7 1.7
Other nondurable medical products . . . . . . . 7.0 5.3 4.5 3.6 2.7 2.4 2.3 2.3
1
Includes expenditures for care in freestanding facilities only. Additional services of this type are provided in hospital-based facilities and are considered hospital care.
2
Includes all administrative costs (federal and state and local employees’ salaries; contracted employees, including fiscal intermediaries; rent and building costs;
computer systems and programs; other materials and supplies; and other miscellaneous expenses) associated with insuring individuals enrolled in the following health
insurance programs: Medicare, Medicaid, Children’s Health Insurance Program, Department of Defense, Department of Veterans Affairs, Indian Health Service, workers’
compensation, maternal and child health, vocational rehabilitation, Substance Abuse and Mental Health Services Administration, and other federal programs.
3
Net cost of health insurance is calculated as the difference between calendar year incurred premiums earned and benefits incurred for private health insurance. This
includes administrative costs, and in some cases additions to reserves, rate credits and dividends, premium taxes, and net underwriting gains or losses. Also included
in this category is the difference between premiums earned and benefits incurred for the private health insurance companies that insure the enrollees of the following
programs: Medicare, Medicaid, Children’s Health Insurance Program, and workers’ compensation (health portion only).
4
Includes health care services delivered by government public health agencies.
5
Research and development expenditures of drug companies and other manufacturers and providers of medical equipment and supplies are excluded. These are
included in the expenditure class in which the product falls because such expenditures are covered by the payment received for that product.
6
See Appendix II, Average annual rate of change (percent change).
NOTES: Percents and average annual percent change are calculated using unrounded data. For more information on NHE categories, sources, and methods, see the
Health Expenditure Accounts (NHEA). Data have been revised and differ from previous editions of Health, United States.
SOURCE: Centers for Medicare & Medicaid Services, Office of the Actuary, National Health Statistics Group, National Health Expenditure Accounts, National health
http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NationalHealthAccountsHistorical.html, accessed
on December 12, 2014. See Appendix I, National Health Expenditure Accounts (NHEA).
Amount
Per capita . . . . . . . . . . . . . . . . . . . . . . . . . . $125 $300 $943 $2,431 $4,129 $6,909 $7,107 $7,597 $7,826
Amount, in billions
All personal health care expenditures 1 . . . . . . $23.4 $63.1 $217.2 $616.8 $1,165.7 $2,117.9 $2,196.2 $2,379.3 $2,468.6
Out-of-pocket payments . . . . . . . . . . . . . . . 13.1 25.0 58.4 138.6 201.5 300.9 306.2 328.8 339.4
Health insurance . . . . . . . . . . . . . . . . . . . . 6.6 29.6 131.9 403.2 845.5 1,639.2 1,701.4 1,842.0 1,907.9
Private health insurance . . . . . . . . . . . . . 4.9 14.0 61.4 205.1 407.3 736.1 755.4 822.9 846.0
Medicare . . . . . . . . . . . . . . . . . . . . . . . . ... 7.3 36.3 107.3 216.3 471.2 489.2 532.2 550.5
Medicaid . . . . . . . . . . . . . . . . . . . . . . . . ... 5.0 24.7 69.7 186.9 346.4 366.2 389.0 410.8
Federal . . . . . . . . . . . . . . . . . . . . . . . ... 2.7 13.7 40.3 109.3 230.7 247.5 224.0 236.7
State and local . . . . . . . . . . . . . . . . . . ... 2.3 11.0 29.4 77.6 115.6 118.6 165.0 174.1
CHIP 2 . . . . . . . . . . . . . . . . . . . . . . . . . . ... ... ... ... 2.5 9.5 9.7 10.6 11.3
Federal . . . . . . . . . . . . . . . . . . . . . . . ... ... ... ... 1.8 6.7 6.8 7.4 7.8
State and local . . . . . . . . . . . . . . . . . . ... ... ... ... 0.8 2.8 2.9 3.2 3.5
Other health insurance programs 3 . . . . . . 1.7 3.3 9.6 21.2 32.4 76.1 80.9 87.2 89.3
Other third-party payers and programs 4 . . . . 3.7 8.5 26.9 74.9 118.7 177.8 188.6 208.5 221.2
Deflator (2009 = 100.0)
Chain-weighted personal health care
deflator 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.3 13.5 28.5 56.4 75.7 100.0 102.7 106.8 108.4
Percent distribution
All sources of funds . . . . . . . . . . . . . . . . . . . 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0
Out-of-pocket payments . . . . . . . . . . . . . . . 55.9 39.6 26.9 22.5 17.3 14.2 13.9 13.8 13.7
Health insurance . . . . . . . . . . . . . . . . . . . . 28.3 46.9 60.7 65.4 72.5 77.4 77.5 77.4 77.3
Private health insurance . . . . . . . . . . . . . 21.1 22.2 28.3 33.2 34.9 34.8 34.4 34.6 34.3
Medicare . . . . . . . . . . . . . . . . . . . . . . . . ... 11.5 16.7 17.4 18.6 22.2 22.3 22.4 22.3
Medicaid . . . . . . . . . . . . . . . . . . . . . . . . ... 8.0 11.4 11.3 16.0 16.4 16.7 16.3 16.6
Federal . . . . . . . . . . . . . . . . . . . . . . . ... 4.3 6.3 6.5 9.4 10.9 11.3 9.4 9.6
State and local . . . . . . . . . . . . . . . . . . ... 3.7 5.1 4.8 6.7 5.5 5.4 6.9 7.1
CHIP 2 . . . . . . . . . . . . . . . . . . . . . . . . . . ... ... ... ... 0.2 0.5 0.4 0.4 0.5
Federal . . . . . . . . . . . . . . . . . . . . . . . ... ... ... ... 0.2 0.3 0.3 0.3 0.3
State and local . . . . . . . . . . . . . . . . . . ... ... ... ... 0.1 0.1 0.1 0.1 0.1
Other health insurance programs 3 . . . . . . 7.2 5.2 4.4 3.4 2.8 3.6 3.7 3.7 3.6
Other third-party payers and programs 4 . . . . 15.8 13.5 12.4 12.1 10.2 8.4 8.6 8.8 9.0
Amount, in billions
Hospital expenditures 6 . . . . . . . . . . . . . . . . . $9.0 $27.2 $100.5 $250.4 $415.5 $776.8 $814.9 $898.5 $936.9
Percent distribution
All sources of funds . . . . . . . . . . . . . . . . . . . 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0
Out-of-pocket payments . . . . . . . . . . . . . . . 20.6 9.0 5.4 4.5 3.2 3.2 3.3 3.4 3.5
Health insurance . . . . . . . . . . . . . . . . . . . . 50.7 71.4 79.6 82.6 86.2 87.6 87.2 86.8 86.3
Private health insurance . . . . . . . . . . . . . 35.6 32.5 36.7 38.7 34.1 36.1 35.9 37.2 37.1
Medicare . . . . . . . . . . . . . . . . . . . . . . . . ... 19.7 26.1 26.9 29.7 27.8 27.1 26.3 25.9
Medicaid . . . . . . . . . . . . . . . . . . . . . . . . ... 9.7 9.2 10.6 17.1 17.6 18.0 17.4 17.5
Federal . . . . . . . . . . . . . . . . . . . . . . . ... 5.2 5.0 6.3 10.3 11.7 12.2 10.1 10.1
State and local . . . . . . . . . . . . . . . . . . ... 4.5 4.2 4.3 6.8 6.0 5.9 7.3 7.4
CHIP 2 . . . . . . . . . . . . . . . . . . . . . . . . . . ... ... ... ... 0.2 0.4 0.4 0.4 0.4
Federal . . . . . . . . . . . . . . . . . . . . . . . ... ... ... ... 0.2 0.3 0.3 0.3 0.3
State and local . . . . . . . . . . . . . . . . . . ... ... ... ... 0.1 0.1 0.1 0.1 0.1
Other health insurance programs 3 . . . . . . 15.1 9.5 7.7 6.3 5.0 5.7 5.8 5.5 5.4
Other third-party payers and programs 4 . . . . 28.7 19.5 15.0 13.0 10.6 9.2 9.5 9.7 10.2
Amount, in billions
Physician and clinical
expenditures. . . . . . . . . . . . . . . . . . . . . . . . $5.6 $14.3 $47.7 $158.9 $290.9 $503.2 $519.0 $565.3 $586.7
Percent distribution
All sources of funds . . . . . . . . . . . . . . . . . . . 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0
Out-of-pocket payments . . . . . . . . . . . . . . . 60.1 45.1 29.8 18.9 11.2 9.5 9.8 9.6 9.4
Health insurance . . . . . . . . . . . . . . . . . . . . 32.6 48.8 59.8 67.8 76.6 81.4 81.0 80.7 80.5
Private health insurance . . . . . . . . . . . . . 28.3 29.4 34.8 42.2 47.4 47.3 46.5 45.9 45.6
Medicare . . . . . . . . . . . . . . . . . . . . . . . . ... 11.5 17.4 19.2 20.2 22.2 22.2 22.5 22.2
Medicaid . . . . . . . . . . . . . . . . . . . . . . . . ... 4.5 5.1 4.4 6.6 7.9 8.2 8.1 8.5
Federal . . . . . . . . . . . . . . . . . . . . . . . ... 2.4 2.9 2.6 3.9 5.5 5.7 4.9 5.3
State and local . . . . . . . . . . . . . . . . . . ... 2.1 2.2 1.8 2.7 2.5 2.5 3.1 3.2
CHIP 2 . . . . . . . . . . . . . . . . . . . . . . . . . . ... ... ... ... 0.3 0.6 0.6 0.6 0.6
Federal . . . . . . . . . . . . . . . . . . . . . . . ... ... ... ... 0.2 0.4 0.4 0.4 0.4
State and local . . . . . . . . . . . . . . . . . . ... ... ... ... 0.1 0.2 0.2 0.2 0.2
Other health insurance programs 3 . . . . . . 4.3 3.4 2.4 2.1 2.1 3.5 3.5 3.6 3.5
Other third-party payers and programs 4 . . . . 7.3 6.1 10.4 13.3 12.3 9.1 9.2 9.8 10.1
Amount, in billions
Dental services expenditures . . . . . . . . . . . . . $2.0 $4.7 $13.4 $31.7 $62.3 $102.5 $105.4 $110.0 $111.0
Percent distribution
All sources of funds . . . . . . . . . . . . . . . . . . . 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0
Out-of-pocket payments . . . . . . . . . . . . . . . 96.0 90.0 65.8 48.1 44.4 42.0 41.5 42.1 42.5
Health insurance . . . . . . . . . . . . . . . . . . . . 3.2 9.5 33.3 51.3 55.0 57.5 57.9 57.4 57.0
Private health insurance . . . . . . . . . . . . . 1.9 4.5 28.4 48.1 50.2 48.7 48.5 48.1 47.4
Medicare . . . . . . . . . . . . . . . . . . . . . . . . ... ... ... 0.0 0.1 0.3 0.2 0.3 0.4
Medicaid . . . . . . . . . . . . . . . . . . . . . . . . ... 3.4 3.7 2.4 3.7 6.6 7.0 6.6 6.8
Federal . . . . . . . . . . . . . . . . . . . . . . . ... 1.8 2.0 1.3 2.1 4.5 4.8 3.8 3.9
State and local . . . . . . . . . . . . . . . . . . ... 1.6 1.7 1.0 1.6 2.1 2.2 2.8 2.8
CHIP 2 . . . . . . . . . . . . . . . . . . . . . . . . . . ... ... ... ... 0.4 0.7 1.0 1.2 1.3
Federal . . . . . . . . . . . . . . . . . . . . . . . ... ... ... ... 0.3 0.5 0.7 0.8 0.9
State and local . . . . . . . . . . . . . . . . . . ... ... ... ... 0.1 0.2 0.3 0.4 0.4
Other health insurance programs 3 . . . . . . 1.3 1.6 1.2 0.9 0.6 1.1 1.2 1.1 1.1
Other third-party payers and programs 4 . . . . 0.8 0.4 0.8 0.6 0.6 0.5 0.5 0.5 0.5
Amount, in billions
Home health care expenditures 7 . . . . . . . . . . $0.1 $0.2 $2.4 $12.6 $32.4 $67.2 $71.2 $77.1 $79.8
Percent distribution
All sources of funds . . . . . . . . . . . . . . . . . . . 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0
Out-of-pocket payments . . . . . . . . . . . . . . . 12.3 9.5 15.3 17.9 19.6 7.6 7.5 7.9 8.1
Health insurance . . . . . . . . . . . . . . . . . . . . 5.3 37.7 53.7 66.1 71.4 89.1 89.5 88.9 88.9
Private health insurance . . . . . . . . . . . . . 1.8 3.2 14.7 22.9 23.8 7.0 6.8 7.4 7.9
Medicare . . . . . . . . . . . . . . . . . . . . . . . . ... 26.8 26.8 26.0 26.4 45.1 44.6 43.6 43.1
Medicaid . . . . . . . . . . . . . . . . . . . . . . . . ... 6.8 11.6 17.1 20.9 36.2 37.0 36.7 36.5
Federal . . . . . . . . . . . . . . . . . . . . . . . ... 3.2 6.2 9.1 11.3 23.5 24.3 20.0 20.1
State and local . . . . . . . . . . . . . . . . . . ... 3.2 5.4 7.9 9.6 12.6 12.6 16.6 16.4
CHIP 2 . . . . . . . . . . . . . . . . . . . . . . . . . . ... ... ... ... 0.0 0.0 0.0 0.0 0.0
Federal . . . . . . . . . . . . . . . . . . . . . . . ... ... ... ... 0.0 0.0 0.0 0.0 0.0
State and local . . . . . . . . . . . . . . . . . . ... ... ... ... 0.0 0.0 0.0 0.0 0.0
Other health insurance programs 3 . . . . . . 3.5 1.4 0.5 0.3 0.3 0.9 1.2 1.3 1.4
Other third-party payers and programs 4 . . . . 80.7 52.7 31.1 16.0 9.0 3.2 3.0 3.1 3.0
Amount, in billions
Nursing care facilities and continuing care
retirement communities expenditures 8. . . . . . $0.8 $4.0 $15.3 $44.9 $85.1 $138.5 $143.0 $152.2 $155.8
Percent distribution
All sources of funds . . . . . . . . . . . . . . . . . . . 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0
Out-of-pocket payments . . . . . . . . . . . . . . . 74.7 49.5 40.7 40.3 31.9 28.9 28.1 29.1 29.4
Health insurance . . . . . . . . . . . . . . . . . . . . ... 28.5 51.9 48.8 61.1 64.5 64.7 63.5 63.2
Private health insurance . . . . . . . . . . . . . ... 0.2 1.3 6.2 8.8 7.5 7.6 8.0 8.1
Medicare . . . . . . . . . . . . . . . . . . . . . . . . ... 3.5 2.0 3.8 12.7 21.7 22.5 22.2 22.2
Medicaid . . . . . . . . . . . . . . . . . . . . . . . . ... 23.3 46.2 36.6 37.4 32.4 31.8 30.4 30.1
Federal . . . . . . . . . . . . . . . . . . . . . . . ... 12.5 26.1 20.6 21.7 21.6 21.5 17.3 17.1
State and local . . . . . . . . . . . . . . . . . . ... 10.8 20.1 16.0 15.7 10.9 10.3 13.1 12.9
CHIP 2 . . . . . . . . . . . . . . . . . . . . . . . . . . ... ... ... ... 0.0 0.0 0.0 0.0 0.0
Federal . . . . . . . . . . . . . . . . . . . . . . . ... ... ... ... 0.0 0.0 0.0 0.0 0.0
State and local . . . . . . . . . . . . . . . . . . ... ... ... ... 0.0 0.0 0.0 0.0 0.0
Other health insurance programs 3 . . . . . . 0.0 1.5 2.4 2.2 2.2 2.8 2.8 2.9 2.9
Other third-party payers and programs 4 . . . . 25.3 21.9 7.4 10.9 6.9 6.7 7.2 7.4 7.4
Amount, in billions
Prescription drug expenditures . . . . . . . . . . . . $2.7 $5.5 $12.0 $40.3 $121.2 $255.0 $256.2 $264.4 $271.1
Percent distribution
All sources of funds . . . . . . . . . . . . . . . . . . . 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0
Out-of-pocket payments . . . . . . . . . . . . . . . 96.0 82.4 71.3 56.8 27.8 19.4 18.0 17.6 16.9
Health insurance . . . . . . . . . . . . . . . . . . . . 1.5 16.5 26.9 40.3 70.3 79.2 80.6 81.4 82.1
Private health insurance . . . . . . . . . . . . . 1.3 8.8 15.0 27.0 50.5 46.4 46.4 44.8 43.5
Medicare . . . . . . . . . . . . . . . . . . . . . . . . ... ... ... 0.5 1.7 21.4 23.0 25.5 27.5
Medicaid . . . . . . . . . . . . . . . . . . . . . . . . ... 7.6 11.7 12.6 16.3 7.9 7.8 7.6 7.8
Federal . . . . . . . . . . . . . . . . . . . . . . . ... 4.1 6.8 7.2 9.3 5.3 5.3 4.1 4.3
State and local . . . . . . . . . . . . . . . . . . ... 3.5 4.9 5.4 7.0 2.6 2.5 3.5 3.5
CHIP 2 . . . . . . . . . . . . . . . . . . . . . . . . . . ... ... ... ... 0.2 0.5 0.6 0.5 0.5
Federal . . . . . . . . . . . . . . . . . . . . . . . ... ... ... ... 0.2 0.4 0.4 0.4 0.4
State and local . . . . . . . . . . . . . . . . . . ... ... ... ... 0.1 0.2 0.2 0.2 0.2
Other health insurance programs 3 . . . . . . 0.1 0.1 0.2 0.2 1.5 2.9 2.8 2.9 2.8
Other third-party payers and programs 4 . . . . 2.5 1.1 1.8 3.0 1.9 1.4 1.3 1.0 0.9
Amount, in billions
All other personal health care expenditures9 . . $3.2 $7.1 $25.8 $77.9 $158.3 $274.6 $286.6 $311.9 $327.4
Percent distribution
All sources of funds . . . . . . . . . . . . . . . . . . . 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0
Out-of-pocket payments . . . . . . . . . . . . . . . 84.9 74.5 57.1 49.9 38.3 32.9 32.6 32.3 32.4
Health insurance . . . . . . . . . . . . . . . . . . . . 3.4 8.3 25.0 33.3 44.3 50.6 51.1 52.0 52.5
Private health insurance . . . . . . . . . . . . . 2.0 3.4 6.7 12.0 12.6 12.5 12.5 12.6 12.5
Medicare . . . . . . . . . . . . . . . . . . . . . . . . ... 1.0 2.8 5.5 8.0 10.4 10.4 10.7 10.2
Medicaid . . . . . . . . . . . . . . . . . . . . . . . . ... 2.9 14.7 14.9 22.6 26.7 27.0 27.2 28.2
Federal . . . . . . . . . . . . . . . . . . . . . . . ... 1.6 8.1 8.5 12.9 17.7 18.2 15.4 16.0
State and local . . . . . . . . . . . . . . . . . . ... 1.3 6.7 6.4 9.7 8.9 8.8 11.8 12.3
CHIP 2 . . . . . . . . . . . . . . . . . . . . . . . . . . ... ... ... ... 0.2 0.4 0.4 0.4 0.4
Federal . . . . . . . . . . . . . . . . . . . . . . . ... ... ... ... 0.1 0.3 0.3 0.3 0.3
State and local . . . . . . . . . . . . . . . . . . ... ... ... ... 0.1 0.1 0.1 0.1 0.1
Other health insurance programs 3 . . . . . . 1.4 0.9 0.8 0.9 0.8 0.6 0.8 1.0 1.1
Other third-party payers and programs 4 . . . . 11.7 17.2 17.9 16.9 17.5 16.5 16.4 15.7 15.1
1
Includes all expenditures other than expenses for government administration, net cost of health insurance, public health activities, research, and structures and
equipment.
2
The Children’s Health Insurance Program (CHIP) including Medicaid CHIP expansions.
3
Includes Department of Defense and Department of Veterans Affairs.
4
Includes worksite health care, other private revenues, Indian Health Service, workers’ compensation, general assistance, maternal and child health, vocational
rehabilitation, other federal programs, Substance Abuse and Mental Health Services Administration, other state and local programs, and school health.
5
The personal health care deflator is calculated as a chain-weighted price index using the Producer Price Indexes for hospitals, offices of physicians, medical and
diagnostic laboratories, home health care services, and nursing care facilities; and Consumer Price Indices specific to each of the remaining personal health care
components. For more information on the detailed price series recommended for deflating each category of spending see the National Health Expenditure Accounts
Methodology Paper, 2013 and NHE Deflator Methodology paper. Available from:
http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/.
6
Includes expenditures for hospital-based nursing home and home health agency care.
7
Includes expenditures for care in freestanding facilities only. Additional services of this type are provided in hospital-based facilities and are considered hospital care.
8
Includes expenditures for care in freestanding nursing homes. Expenditures for care in hospital-based nursing homes are included with hospital care.
9
Includes expenditures for other professional services, other nondurable medical products, durable medical equipment, and other health, residential, and personal care,
NOTES: Percents may not add to totals because of rounding. Census resident-based population less armed forces overseas and population of outlying areas used to
calculate per capita. The Medicare and Medicaid programs began coverage in 1965. The Children’s Health Insurance Program began coverage in 1997. For more
information on NHE sources and methods, see the National Health Expenditure Accounts Methodology Paper, 2013. Available from:
http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/downloads/dsm-13.pdf. See Appendix I, National
Health Expenditure Accounts (NHEA). Data for additional years are available. See the Excel spreadsheet on the Health, United States website at:
http://www.cdc.gov/nchs/hus.htm. Data have been revised and differ from previous editions of Health, United States.
SOURCE: Centers for Medicare & Medicaid Services, Office of the Actuary, National Health Statistics Group, National Health Expenditure Accounts, National health
expenditures. Available from:
http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NationalHealthAccountsHistorical.html, accessed
on December 12, 2014. Hartman M, Martin AB, Lassman D, Catlin A. National Health Spending in 2013: Growth slows, remains in step with the overall economy.
Health Aff 2015;34(1):150–160. See Appendix I, National Health Expenditure Accounts (NHEA).
Age and principal operating room procedure 1 2000 2005 2012 2000 2005 2012 2000 2005 2012
All ages
Hospital discharges with an operating
room principal procedure 3 . . . . . . . . . . . . . . . . . . $13,317 $15,980 $18,521 8,743,631 9,964,151 8,870,290 $115,725 $159,370 $164,141
Laminectomy (back surgery) . . . . . . . . . . . . . . ... 8,207 9,293 13,384 285,636 248,800 184,060 2,354 2,313 2,478
Heart valve procedures. . . . . . . . . . . . . . . . . . ... 43,107 52,827 52,625 79,719 93,802 104,200 3,430 4,975 5,481
Coronary artery bypass graft (CABG). . . . . . . . ... 31,425 38,266 40,142 337,972 221,325 153,635 10,657 8,483 6,170
Percutaneous coronary angioplasty (PTCA)
(balloon angioplasty of heart) . . . . . . . . . . . . ... 15,063 18,559 19,225 581,183 727,912 455,635 8,753 13,516 8,767
Insertion, revision, replacement, removal of
cardiac pacemaker or cardioverter/defibrillator. ... 27,789 35,585 35,028 66,286 160,629 100,270 1,856 5,709 3,509
Colorectal resection (removal of part
of the bowel) . . . . . . . . . . . . . . . . . . . . . . . . . . . 19,560 22,789 23,204 253,780 274,599 249,415 5,067 6,266 5,783
Appendectomy. . . . . . . . . . . . . . . . . . . . . . . . . . . 7,359 8,542 9,649 269,089 298,829 226,210 1,959 2,552 2,188
Cholecystectomy (gall bladder removal) . . . . . . . . . 10,447 12,152 12,846 389,079 376,158 337,575 4,030 4,572 4,344
Hysterectomy . . . . . . . . . . . . . . . . . . . . . . . . . . . 6,562 7,300 9,799 580,019 550,659 266,400 3,779 4,027 2,612
Cesarean section . . . . . . . . . . . . . . . . . . . . . . . . . 5,456 5,487 5,892 898,859 1,258,990 1,159,970 4,789 6,913 6,839
Treatment, fracture or dislocation of hip
and femur . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12,633 15,353 17,309 237,615 251,071 233,705 3,052 3,852 4,045
Arthroplasty knee (knee replacement) . . . . . . . . . . 13,873 15,691 16,556 318,854 533,216 671,374 4,398 8,370 11,117
Hip replacement. . . . . . . . . . . . . . . . . . . . . . . . . . 15,045 17,171 17,486 295,940 369,634 436,815 4,507 6,340 7,637
Spinal fusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17,509 24,954 28,190 204,320 322,610 406,995 3,492 8,060 11,484
Under 18 years
Hospital discharges with an operating
room principal procedure 3 . . . . . . . . . . . . . . . . . . 13,366 19,442 25,470 382,455 535,472 343,670 4,940 10,365 8,697
Incision and excision of CNS (a type
of brain surgery). . . . . . . . . . . . . . . . . . ....... 29,016 35,228 43,217 6,352 11,436 7,600 177 405 327
Tonsillectomy and/or adenoidectomy . . . . ....... 4,443 5,748 7,041 12,045 16,288 11,145 55 95 79
Small bowel resection (removal of part of
the small bowel). . . . . . . . . . . . . . . . . . . . . . . . . 36,440 50,816 46,904 1,712 2,993 2,125 62 150 99
Appendectomy. . . . . . . . . . . . . . . . . . . . . . . . . . . 6,603 8,160 9,158 75,481 85,790 60,045 485 700 551
Cesarean section . . . . . . . . . . . . . . . . . . . . . . . . . 6,058 5,756 6,118 23,690 28,609 15,945 130 165 98
Spinal fusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29,437 46,330 56,398 7,463 12,880 10,170 217 591 571
18–44 years
Hospital discharges with an operating
room principal procedure 3 . . . . . . . . . . . . . . . . . . 8,800 9,960 11,819 2,806,078 3,101,461 2,571,636 24,163 30,922 30,371
Incision and excision of CNS (a type
of brain surgery). . . . . . . . . . . . . . . . . . . . . . . . . 25,586 30,692 37,981 19,510 18,229 17,890 480 563 678
Laminectomy (back surgery) . . . . . . . . . . . . . . . . . 7,385 8,654 12,342 95,687 67,321 37,080 712 583 459
Appendectomy. . . . . . . . . . . . . . . . . . . . . . . . . . . 6,779 7,773 8,721 133,662 135,504 97,850 894 1,053 855
Cholecystectomy (gall bladder removal) . . . . . . . . . 8,556 9,458 10,287 132,538 128,987 119,540 1,089 1,221 1,232
Oophorectomy (removal of one or both ovaries) . . . 6,379 7,427 10,150 38,252 33,384 20,150 247 248 205
Ligation of fallopian tubes (‘‘tying’’ of
fallopian tubes) . . . . . . . . . . . . . . . . . . . . . . ... 4,717 4,544 6,016 75,221 74,449 61,305 335 338 369
Hysterectomy . . . . . . . . . . . . . . . . . . . . . . . . ... 6,084 6,628 8,856 291,704 255,025 108,685 1,749 1,692 963
Cesarean section . . . . . . . . . . . . . . . . . . . . . . ... 5,439 5,477 5,884 873,231 1,226,170 1,140,550 4,647 6,721 6,715
Treatment, fracture or dislocation of lower
extremity (other than hip or femur) . . . . . . . . . ... 9,376 11,904 15,044 68,015 59,527 47,940 627 708 722
Spinal fusion . . . . . . . . . . . . . . . . . . . . . . . . . ... 16,460 23,113 26,096 73,228 87,276 73,515 1,165 2,018 1,919
Age and principal operating room procedure 1 2000 2005 2012 2000 2005 2012 2000 2005 2012
45–64 years
Hospital discharges with an operating
room principal procedure 3 . . . . . . . . . . . . . . . . . . $14,568 $17,528 $20,776 2,435,212 2,909,930 2,806,265 $35,322 $51,076 $58,220
Laminectomy (back surgery) . . . . . . . . . . . . . . ... 8,279 9,174 14,122 107,720 96,084 73,155 893 883 1,038
Heart valve procedures. . . . . . . . . . . . . . . . . . ... 40,489 48,406 50,948 22,849 26,650 28,145 920 1,298 1,434
Coronary artery bypass graft (CABG). . . . . . . . ... 29,362 35,053 38,570 139,897 94,742 67,190 4,127 3,328 2,594
Percutaneous coronary angioplasty (PTCA)
(balloon angioplasty of heart) . . . . . . . . . . . . ... 14,578 17,923 18,892 252,151 318,811 202,975 3,668 5,718 3,837
Insertion, revision, replacement, removal of
cardiac pacemaker or cardioverter/defibrillator. ... 34,034 38,618 37,351 15,957 44,029 29,575 539 1,699 1,103
Colorectal resection (removal of part
of the bowel) . . . . . . . . . . . . . . . . . . . . . . . . . . . 17,594 20,300 21,803 76,604 95,108 95,070 1,374 1,933 2,071
Cholecystectomy (gall bladder removal) . . . . . . . . . 9,853 11,700 12,891 117,432 117,636 108,565 1,157 1,379 1,402
Oophorectomy . . . . . . . . . . . . . . . . . . . . . . . . . . . 7,637 8,738 12,333 21,232 22,459 22,780 162 196 280
Hysterectomy . . . . . . . . . . . . . . . . . . . . . . . . . . . 6,693 7,443 9,941 231,498 242,030 123,495 1,546 1,805 1,228
Arthroplasty knee (knee replacement) . . . . . . . . . . 14,193 15,744 16,710 95,902 199,682 281,825 1,355 3,144 4,710
Hip replacement. . . . . . . . . . . . . . . . . . . . . . . . . . 15,635 17,416 17,364 65,118 105,138 152,480 1,026 1,828 2,647
Spinal fusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16,805 23,196 26,806 87,388 150,313 195,235 1,431 3,490 5,237
65–74 years
Hospital discharges with an operating
room principal procedure 3 . . . . . . . . . . . . . . . . . . 16,321 19,492 21,488 1,511,467 1,602,345 1,630,700 24,797 31,284 35,019
Laminectomy (back surgery) . . . . . . . . . . . . . . ... 8,673 9,264 12,894 45,976 45,731 41,735 399 424 543
Heart valve procedures. . . . . . . . . . . . . . . . . . ... 44,119 53,721 51,726 23,236 24,774 27,895 1,016 1,335 1,444
Coronary artery bypass graft (CABG). . . . . . . . ... 31,979 39,029 39,725 112,652 70,404 51,505 3,600 2,750 2,047
Percutaneous coronary angioplasty (PTCA)
(balloon angioplasty of heart) . . . . . . . . . . . . ... 14,996 18,386 19,340 166,497 196,855 122,225 2,493 3,621 2,364
Insertion, revision, replacement, removal of
cardiac pacemaker or cardioverter/defibrillator. ... 30,360 36,723 36,133 19,096 44,900 27,275 583 1,646 985
Endarterectomy (plaque removal from artery
lining brain, head, neck) . . . . . . . . . . . . . . . . ... 8,740 9,377 10,395 51,292 40,715 31,305 460 383 326
Colorectal resection (removal of part
of the bowel) . . . . . . . . . . . . . . . . . . . . . . . . . . . 19,670 23,087 23,429 63,693 62,337 60,115 1,291 1,442 1,407
Cholecystectomy (gall bladder removal) . . . . . . . . . 11,542 13,864 14,866 65,953 55,566 50,890 774 771 758
Arthroplasty knee (knee replacement) . . . . . . . . . . 14,130 15,643 16,372 110,961 177,306 233,810 1,553 2,776 3,829
Hip replacement. . . . . . . . . . . . . . . . . . . . . . . . . . 14,986 16,885 17,322 71,986 86,918 115,385 1,094 1,467 1,998
Spinal fusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18,507 26,788 29,263 23,419 47,031 88,200 432 1,260 2,584
75–84 years
Hospital discharges with an operating
room principal procedure 3 . . . . . . . . . . . . . . . . . . 16,567 20,146 21,475 1,224,573 1,360,428 1,094,565 20,583 27,442 23,513
Laminectomy (back surgery) . . . . . . . . . . . . . . ... 9,358 10,164 12,818 31,059 31,945 25,285 293 325 326
Heart valve procedures. . . . . . . . . . . . . . . . . . ... 45,508 56,607 52,882 21,004 25,070 28,010 967 1,425 1,480
Coronary artery bypass graft (CABG). . . . . . . . ... 34,672 43,386 44,119 68,750 45,187 27,290 2,403 1,962 1,203
Percutaneous coronary angioplasty (PTCA)
(balloon angioplasty of heart) . . . . . . . . . . . . ... 15,877 19,647 19,715 111,169 144,906 81,495 1,776 2,847 1,609
Insertion, revision, replacement, removal of
cardiac pacemaker or cardioverter/defibrillator. ... 24,903 34,513 34,021 19,975 48,557 25,735 507 1,673 875
Endarterectomy (plaque removal from artery
lining brain, head, neck) . . . . . . . . . . . . . . . . ... 9,079 9,721 10,813 45,337 38,073 24,980 425 372 270
Colorectal resection (removal of part
of the bowel) . . . . . . . . . . . . . . . . . . . . . . . . ... 21,451 25,600 25,201 62,096 61,238 44,120 1,368 1,568 1,111
Cholecystectomy (gall bladder removal) . . . . . . ... 13,229 16,353 16,298 52,448 49,823 38,025 709 814 620
Treatment, fracture or dislocation of hip
and femur . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11,895 14,308 15,892 73,332 72,878 61,615 898 1,044 980
Arthroplasty knee (knee replacement) . . . . . . . . . . 14,124 15,743 16,370 79,138 121,865 123,025 1,119 1,919 2,015
Hip replacement. . . . . . . . . . . . . . . . . . . . . . . . . . 14,806 17,041 17,538 92,715 105,580 96,635 1,395 1,797 1,695
Spinal fusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19,256 27,950 29,264 11,770 22,902 35,875 226 640 1,052
Age and principal operating room procedure 1 2000 2005 2012 2000 2005 2012 2000 2005 2012
Coronary artery bypass graft (CABG). . . . . . . . ... 39,005 49,965 49,855 5,280 4,174 2,960 204 209 147
(balloon angioplasty of heart) . . . . . . . . . . . . ... 18,019 21,913 20,570 16,682 28,942 23,985 298 633 494
cardiac pacemaker or cardioverter/defibrillator. ... 14,779 25,124 25,449 7,071 13,675 10,355 107 343 264
of the bowel) . . . . . . . . . . . . . . . . . . . . . . . . ... 23,180 27,405 25,980 20,729 20,456 16,990 491 561 441
Cholecystectomy (gall bladder removal) . . . . . . ... 16,099 18,157 17,693 15,698 16,732 15,045 256 303 267
and femur . . . . . . . . . . . . . . . . . . . . . . . . . . ... 11,582 13,738 15,361 76,900 77,692 74,205 917 1,069 1,141
Arthroplasty knee . . . . . . . . . . . . . . . . . . . . . . ... 14,320 16,536 17,241 10,122 15,784 17,245 146 261 297
Hip replacement. . . . . . . . . . . . . . . . . . . . . . . ... 14,397 17,111 17,843 50,005 53,975 54,755 731 923 977
leg, foot or toe) . . . . . . . . . . . . . . . . . . . . . . ... 13,289 17,178 17,269 12,855 10,029 7,610 173 173 132
1
Data are based on valid operating room procedures. Operating room procedures were identified using the Centers for Medicare & Medicaid Services’ Diagnosis
Related Groups (DRGs). For DRGs, physician panels identified International Classification of Diseases (ICD–9-CM) procedure codes that would be performed in
operating rooms in most hospitals. Operating room procedures, as defined by DRGs, are classified by the Clinical Classifications Software (CCS) into 1 of 231 clinically
meaningful categories. Mean costs per hospitalization are based on the principal procedure as determined by the CCS. The number of discharges is based on the
first-listed (principal) major procedure. See Appendix II, Procedure.
2
Charges (the amount billed by the hospital) were converted to costs using cost-charge ratios from the Centers for Medicare & Medicaid Services. Costs are for the
entire hospitalization including the principal procedure. Costs were adjusted for inflation to 2012 dollars using the gross domestic product deflator
(http://www.bea.gov/iTable/iTable.cfm?ReqID=9&step=1, Table 1.1.4. Price Indexes for Gross Domestic Product, accessed on August 25, 2014). See Appendix II,
Cost-charge ratio.
3
Includes discharges for operating room principal procedures not shown separately.
NOTES: Excludes newborn infants. The number of states participating in the sample varied over time from 28 states in 2000 to 46 in 2011 and 44 in 2012. See
Appendix I, Healthcare Cost and Utilization Project (HCUP), Nationwide Inpatient Sample, for a list of states available in each year. In 2012, the HCUP-NIS was
redesigned and changed from a sample of hospitals to a sample of discharges from all participating community hospitals. The estimates are weighted to provide
national estimates. Because of sampling frame and methodological differences between the Healthcare Cost and Utilization Project, Nationwide Inpatient Sample, and
the National Hospital Discharge Survey (NHDS), estimates from these data sources are not directly comparable. Standard errors are available in the spreadsheet
version of this table. Available from: http://www.cdc.gov/nchs/hus.htm. Data for additional years are available. See the Excel spreadsheet on the Health, United States
website at: http://www.cdc.gov/nchs/hus.htm. Data have been revised and differ from previous editions of Health, United States.
SOURCE: Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project, National (Nationwide) Inpatient Sample. See Appendix I, Healthcare
Cost and Utilization Project (HCUP), National (Nationwide) Inpatient Sample.
Total expenses 1
Mean annual
Percent of expense
Population persons with per person
in millions 2 expense with expense 3
Characteristic 1997 2000 2011 1987 1997 2000 2011 1987 1997 2000 2011
All ages . . . . . . . . . . . . . . . . . . . . . . . . . . . 271.3 278.4 311.1 84.5 84.1 83.5 84.6 $3,083 $3,397 $3,527 $5,056
Under 65 years:
Total . . . . . . . . . . . . . . . . . . . . . . . . . . . 237.1 243.6 267.6 83.2 82.5 81.8 82.7 2,396 2,576 2,778 4,143
Under 6 years . . . . . . . . . . . . . . . . . . . 23.8 24.1 24.4 88.9 88.0 86.7 89.6 2,045 1,203 1,468 1,739
6–17 years . . . . . . . . . . . . . . . . . . . . . 48.1 48.4 49.7 80.2 81.7 80.0 84.9 1,332 1,350 1,459 1,886
18–44 years . . . . . . . . . . . . . . . . . . . . 108.9 109.0 111.1 81.5 78.3 77.7 75.6 2,105 2,334 2,488 3,618
45–64 years . . . . . . . . . . . . . . . . . . . . 56.3 62.1 82.4 87.0 89.2 88.5 88.8 4,086 4,521 4,653 6,763
Sex
Male . . . . . . . . . . . . . . . . . . . . . . . . . . . 118.0 120.9 132.8 78.8 77.6 76.6 78.0 2,265 2,328 2,660 3,948
Female. . . . . . . . . . . . . . . . . . . . . . . . . . 119.1 122.7 134.7 87.5 87.4 87.0 87.3 2,511 2,795 2,881 4,315
Sex
Male . . . . . . . . . . . . . . . . . . . . . . . . . . . 14.6 15.0 19.2 92.0 94.5 93.4 95.7 7,806 9,366 8,600 10,556
Female. . . . . . . . . . . . . . . . . . . . . . . . . . 19.6 19.8 24.3 94.9 95.7 97.1 97.0 7,508 7,576 7,599 9,322
Mean annual
Percent of out-of-pocket
persons with expense per person
expense with out-of-pocket expense 3
All ages . . . . . . . . . . . . . . . . . . . . . . . . . . . 57.3 62.1 62.3 62.7 $182 $284 $358 $300
Under 65 years:
Total . . . . . . . . . . . . . . . . . . . . . . . . . . . 54.0 58.7 58.5 58.0 135 201 260 245
Under 6 years . . . . . . . . . . . . . . . . . . . 61.8 61.3 56.9 49.0 47 49 48 38
6–17 years . . . . . . . . . . . . . . . . . . . . . 44.3 48.2 46.2 45.5 90 75 91 88
18–44 years . . . . . . . . . . . . . . . . . . . . 51.3 55.9 56.0 53.6 105 170 198 185
45–64 years . . . . . . . . . . . . . . . . . . . . 65.3 71.8 73.3 74.2 255 373 490 402
Sex
Male . . . . . . . . . . . . . . . . . . . . . . . . . . . 46.5 51.5 51.3 51.9 125 179 228 235
Female. . . . . . . . . . . . . . . . . . . . . . . . . . 61.4 65.8 65.6 64.0 142 218 285 253
Sex
Male . . . . . . . . . . . . . . . . . . . . . . . . . . . 78.0 82.8 83.9 90.3 391 609 611 499
Female. . . . . . . . . . . . . . . . . . . . . . . . . . 84.0 88.3 91.5 92.1 437 724 955 527
1
Includes expenses for inpatient hospital and physician services, ambulatory physician and nonphysician services, prescribed medicines, home health services, dental
services, and other medical equipment, supplies, and services that were purchased or rented during the year. Excludes expenses for over-the-counter medications,
phone contacts with health providers, and premiums for health insurance.
2
Includes persons in the civilian noninstitutionalized population for all or part of the year. Expenditures for persons in this population for only part of the year are
restricted to those incurred during periods of eligibility (e.g., expenses incurred during periods of institutionalization and military service are not included in estimates).
3
Estimates of expenses were converted to 2011 dollars using the Consumer Price Index (all items). See Appendix II, Consumer Price Index (CPI).
4
Persons of Hispanic origin may be of any race. Estimates for Asian persons as well as for American Indian, Alaska Native, Native Hawaiian, Other Pacific Islander, and
Multiple Race persons are not available for years prior to 2002 because Asian persons could not be distinguished separately and multiple race information was not
collected.
5
Any private insurance includes individuals with insurance that provided coverage for hospital and physician care at any time during the year, other than Medicare,
Medicaid, or other public coverage for hospital or physician services. Public insurance only includes individuals who were not covered by private insurance at any time
during the year but were covered by Medicare, Medicaid, other public coverage for hospital or physician services, and/or CHAMPUS/CHAMPVA (TRICARE) at any
point during the year. Uninsured includes persons not covered by either private or public insurance throughout the entire year or period of eligibility for the survey.
Individuals with Indian Health Service coverage only are considered uninsured.
6
Populations do not add to total because uninsured persons and persons with unknown insurance status were excluded.
7
Includes expenses for all prescribed medications that were purchased or refilled during the survey year.
NOTES: Estimates for 1987 are based on the National Medical Expenditure Survey (NMES); estimates for other years are based on the Medical Expenditure Panel
Survey (MEPS). Because expenditures in NMES were based primarily on charges and those for MEPS were based on payments, NMES data were adjusted to be
more comparable with MEPS by using estimated charge-to-payment ratios for 1987. Overall, this resulted in an approximate 11% reduction from the unadjusted 1987
NMES expenditure estimates. For a detailed explanation of this adjustment, see Zuvekas S, Cohen J. A guide to comparing health care expenditures in the 1996 MEPS
to the 1987 NMES. Inquiry 2002;39(1):76–86. See Appendix I, Medical Expenditure Panel Survey (MEPS). Data for additional years are available. See the Excel
spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm. Data have been revised and differ from previous editions of Health, United
States.
SOURCE: Agency for Healthcare Research and Quality, Center for Financing, Access, and Cost Trends. 1987 National Medical Expenditure Survey and 1996–2011
Medical Expenditure Panel Surveys. See Appendix I, Medical Expenditure Panel Survey (MEPS).
Characteristic All sources 1987 1997 2000 2011 1987 1997 2000 2011
Percent distribution
All ages . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 24.8 19.4 19.4 13.9 36.6 40.3 40.3 42.1
Under 65 years:
Total . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 26.2 21.1 20.3 14.6 46.6 53.1 52.5 54.5
Under 6 years . . . . . . . . . . . . . . . . . . . 100.0 18.5 14.2 10.3 8.2 39.5 49.3 51.2 49.7
6–17 years . . . . . . . . . . . . . . . . . . . . . 100.0 35.7 29.0 27.7 18.9 47.3 53.2 48.8 45.2
18–44 years . . . . . . . . . . . . . . . . . . . . 100.0 27.4 21.1 19.9 15.3 46.8 52.9 51.2 54.4
45–64 years . . . . . . . . . . . . . . . . . . . . 100.0 24.0 20.1 20.2 14.0 47.8 53.6 54.5 56.5
Sex
Male . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 24.5 21.3 18.1 13.5 44.6 50.3 52.2 51.5
Female. . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 27.5 21.0 22.1 15.5 48.1 55.1 52.7 57.0
Insurance status
Any private insurance 3 . . . . . . . . . . . . . . 100.0 29.0 21.6 21.2 16.2 60.0 67.6 70.2 75.8
Public insurance only 4 . . . . . . . . . . . . . . . 100.0 8.9 10.6 9.8 5.5 ... ... ... ...
Uninsured all year 5 . . . . . . . . . . . . . . . . . 100.0 40.6 41.3 40.4 33.6 ... ... ... ...
65 years and over . . . . . . . . . . . . . . . . . . . 100.0 22.0 16.3 17.5 12.3 15.8 16.5 14.9 14.7
Sex
Male . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 21.7 14.2 14.2 11.2 17.6 20.1 16.8 15.8
Female. . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 22.2 18.1 20.2 13.3 14.4 13.2 13.3 13.7
Insurance status
Medicare only . . . . . . . . . . . . . . . . . . . . . 100.0 29.8 19.8 22.2 13.5 ... ... ... ...
Medicare and private insurance . . . . . . . . 100.0 23.4 17.3 17.0 13.5 18.9 25.7 25.3 27.2
Medicare and other public coverage . . . . . 100.0 *6.2 5.2 9.1 5.8 ... ... ... ...
Percent distribution
All ages . . . . . . . . . . . . . . . . . . . . . . . . . . . 34.1 34.4 35.4 39.1 4.5 5.9 5.0 4.9
Under 65 years:
Total . . . . . . . . . . . . . . . . . . . . . . . . . . . 21.3 18.1 21.3 25.0 6.0 7.7 6.0 5.8
Under 6 years . . . . . . . . . . . . . . . . . . . 35.8 25.4 33.6 36.8 6.2 11.2 4.9 *5.4
6–17 years . . . . . . . . . . . . . . . . . . . . . 11.8 14.1 20.1 33.9 5.2 3.7 3.4 2.1
18–44 years . . . . . . . . . . . . . . . . . . . . 19.4 15.7 21.1 24.6 6.4 10.3 7.8 5.8
45–64 years . . . . . . . . . . . . . . . . . . . . 22.4 20.3 20.2 23.0 5.8 6.0 5.2 6.4
Sex
Male . . . . . . . . . . . . . . . . . . . . . . . . . . . 23.9 19.5 23.5 29.0 7.1 8.9 6.3 6.0
Female. . . . . . . . . . . . . . . . . . . . . . . . . . 19.2 17.0 19.5 21.9 5.2 6.8 5.7 5.6
Insurance status
Any private insurance 3 . . . . . . . . . . . . . . 6.2 6.6 5.3 5.6 4.8 4.2 3.3 2.3
Public insurance only 4 . . . . . . . . . . . . . . . 87.2 80.7 84.4 87.8 3.9 8.7 5.8 *6.7
Uninsured all year 5 . . . . . . . . . . . . . . . . . 28.6 7.5 *21.2 12.2 30.9 51.1 38.4 54.2
65 years and over . . . . . . . . . . . . . . . . . . . 60.8 64.8 64.7 70.2 1.5 2.5 2.9 2.9
Sex
Male . . . . . . . . . . . . . . . . . . . . . . . . . . . 58.8 63.4 66.9 71.0 *1.9 2.3 2.2 2.0
Female. . . . . . . . . . . . . . . . . . . . . . . . . . 62.3 65.9 63.0 69.4 1.1 2.7 3.5 3.6
Insurance status
Medicare only . . . . . . . . . . . . . . . . . . . . . 68.8 72.4 72.2 79.1 1.4 7.7 5.7 7.3
Medicare and private insurance . . . . . . . . 56.1 56.3 57.1 58.8 1.6 0.6 *0.6 *0.5
Medicare and other public coverage . . . . . 92.9 92.7 87.3 92.4 1.0 *2.1 *3.6 *1.8
1
Private insurance includes any type of private insurance payments reported for people with private health insurance coverage during the year.
2
Persons of Hispanic origin may be of any race. Estimates for Asian persons as well as for American Indian, Alaska Native, Native Hawaiian, Other Pacific Islander, and
Multiple Race persons are not available for years prior to 2002 because Asian persons could not be distinguished separately and multiple race information was not
collected.
3
Includes individuals with insurance that provided coverage for hospital and physician care at any time during the year, other than Medicare, Medicaid, or other public
4
Includes individuals who were not covered by private insurance at any time during the year but were covered by Medicare, Medicaid, other public coverage for hospital
or physician services, and/or CHAMPUS/CHAMPVA (TRICARE) at any point during the year.
5
Includes individuals not covered by either private or public insurance throughout the entire year or period of eligibility for the survey. However, some expenses for the
uninsured were paid by sources that were not defined as health insurance coverage, such as the Department of Veterans Affairs, community and neighborhood clinics,
the Indian Health Service, state and local health departments, state programs other than Medicaid, workers’ compensation, and other unclassified sources (e.g.,
automobile, home, or liability insurance). Individuals with Indian Health Service coverage only are considered uninsured.
6
Public sources include payments made by Medicare, Medicaid, the Department of Veterans Affairs, other federal sources (e.g., Indian Health Service, military
treatment facilities, and other care provided by the federal government), CHAMPUS/CHAMPVA (TRICARE), and various state and local sources (e.g., community and
neighborhood clinics, state and local health departments, and state programs other than Medicaid).
7
Other sources includes workers’ compensation, unclassified sources (automobile, home, or liability insurance, and other miscellaneous or unknown sources), Medicaid
payments reported for people who were not enrolled in the program at any time during the year, and any type of private insurance payments reported for people without
NOTES: Estimates for 1987 are based on the National Medical Expenditure Survey (NMES); estimates for other years are based on the Medical Expenditure Panel
Survey (MEPS). Because expenditures in NMES were based primarily on charges and those for MEPS were based on payments, NMES data were adjusted to be
more comparable with MEPS using estimated charge-to-payment ratios for 1987. Overall, this resulted in an approximate 11% reduction from the unadjusted 1987
NMES expenditure estimates. For a detailed explanation of this adjustment, see Zuvekas S, Cohen J. A guide to comparing health care expenditures in the 1996 MEPS
to the 1987 NMES. Inquiry 2002;39(1):76–86. Percents sum to 100 across sources within years. See Appendix I, Medical Expenditure Panel Survey (MEPS). Data for
additional years are available. See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm. Data have been revised and differ
from previous editions of Health, United States.
SOURCE: Agency for Healthcare Research and Quality, Center for Financing, Access, and Cost Trends. 1987 National Medical Expenditure Survey and 1996–2011
Medical Expenditure Panel Surveys. See Appendix I, Medical Expenditure Panel Survey (MEPS).
1997 . . . . . . ....... . . . . . . . . . . 84.1 100.0 8.5 25.4 34.7 14.5 9.7 7.0
2000 . . . . . . ....... . . . . . . . . . . 83.5 100.0 6.9 26.0 33.9 14.8 10.1 8.2
2005 . . . . . . ....... . . . . . . . . . . 84.7 100.0 8.7 20.8 30.9 16.0 12.2 11.5
2010 . . . . . . ....... . . . . . . . . . . 84.6 100.0 12.6 22.7 31.0 14.2 10.8 8.7
2011 . . . . . . ....... . . . . . . . . . . 84.6 100.0 12.1 22.2 31.8 14.8 11.0 8.2
Under 6 years
1987 . . . . ..... ...... . . . . . . . . 88.9 100.0 19.2 27.1 39.7 9.1 2.9 2.0
1997 . . . . ..... ...... . . . . . . . . 88.0 100.0 20.0 43.7 29.1 4.1 2.3 0.8
2000 . . . . ..... ...... . . . . . . . . 86.7 100.0 16.7 50.0 26.9 4.5 1.3 *0.6
2005 . . . . ..... ...... . . . . . . . . 88.9 100.0 27.2 36.0 27.8 6.2 1.9 0.8
2010 . . . . ..... ...... . . . . . . . . 88.9 100.0 40.0 33.8 21.1 3.2 1.5 *0.5
2011 . . . . ..... ...... . . . . . . . . 89.6 100.0 40.1 31.5 22.5 3.9 1.4 *0.7
6–17 years
1987 . . . . . ......... . . . . . . . . . 80.2 100.0 15.5 26.3 37.9 9.1 6.0 5.3
1997 . . . . . ......... . . . . . . . . . 81.7 100.0 16.5 35.3 32.4 7.7 3.9 4.2
2000 . . . . . ......... . . . . . . . . . 80.0 100.0 14.7 36.1 33.1 7.2 4.2 4.7
2005 . . . . . ......... . . . . . . . . . 83.0 100.0 18.6 31.9 31.1 9.5 4.8 4.1
2010 . . . . . ......... . . . . . . . . . 84.4 100.0 28.4 29.8 26.7 7.3 3.3 4.4
2011 . . . . . ......... . . . . . . . . . 84.9 100.0 28.5 30.2 26.1 7.1 3.7 4.4
18–44 years
1987 . . . . . .......... . . . . . . . . 81.5 100.0 10.1 20.8 39.4 15.2 8.7 5.7
1997 . . . . . .......... . . . . . . . . 78.3 100.0 7.3 27.7 39.2 14.4 7.2 4.3
2000 . . . . . .......... . . . . . . . . 77.7 100.0 5.8 28.8 39.1 14.3 7.5 4.6
2005 . . . . . .......... . . . . . . . . 77.1 100.0 7.0 24.3 37.1 15.6 9.2 6.9
2010 . . . . . .......... . . . . . . . . 76.0 100.0 9.5 28.0 36.2 13.1 7.9 5.4
2011 . . . . . .......... . . . . . . . . 75.6 100.0 8.7 26.7 37.6 13.2 8.1 5.6
45–64 years
1987 . . . . . .......... . . . . . . . . 87.0 100.0 5.6 11.9 35.2 20.8 15.3 11.1
1997 . . . . . .......... . . . . . . . . 89.2 100.0 3.4 16.3 35.3 19.9 15.4 9.7
2000 . . . . . .......... . . . . . . . . 88.5 100.0 2.6 15.3 34.2 20.8 15.6 11.5
2005 . . . . . .......... . . . . . . . . 89.7 100.0 2.4 12.6 28.7 21.4 19.0 15.8
2010 . . . . . .......... . . . . . . . . 89.2 100.0 4.0 16.3 32.1 18.9 15.6 13.1
2011 . . . . . .......... . . . . . . . . 88.8 100.0 3.7 16.6 32.2 19.4 16.2 11.9
65–74 years
1987 . . . . . .......... . . . . . . . . 92.8 100.0 5.3 9.3 26.7 21.8 19.5 17.3
1997 . . . . . .......... . . . . . . . . 94.6 100.0 3.2 10.5 30.7 22.9 17.6 15.0
2000 . . . . . .......... . . . . . . . . 94.7 100.0 1.5 9.8 26.4 21.9 20.9 19.5
2005 . . . . . .......... . . . . . . . . 95.9 100.0 1.7 6.3 23.9 20.6 21.9 25.7
2010 . . . . . .......... . . . . . . . . 95.8 100.0 2.4 9.1 28.8 22.5 21.3 15.8
2011 . . . . . .......... . . . . . . . . 96.2 100.0 2.6 9.8 30.1 23.9 20.0 13.6
1997 . . . .. ............ . . . . . . 95.8 100.0 2.4 9.3 26.7 19.6 21.3 20.7
2000 . . . .. ............ . . . . . . 96.5 100.0 2.6 9.4 24.4 21.5 19.6 22.5
2005 . . . .. ............ . . . . . . 97.4 100.0 1.6 6.1 20.2 19.7 20.0 32.4
2010 . . . .. ............ . . . . . . 97.0 100.0 3.0 9.7 27.6 19.9 22.1 17.7
2011 . . . .. ............ . . . . . . 96.7 100.0 2.4 11.1 29.7 22.1 19.3 15.5
* Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error equal to or greater than 30%.
1
Estimates of expenses were converted to 2011 dollars using the Consumer Price Index (all items). See Appendix II, Consumer Price Index (CPI).
NOTES: Includes persons in the civilian noninstitutionalized population for all or part of the year. Expenses for persons in this population for only part of the year are
restricted to those incurred during periods of eligibility (e.g., expenses incurred during periods of institutionalization and military service are not included in estimates).
Out-of-pocket expenses include expenditures for inpatient hospital and physician services, ambulatory physician and nonphysician services, prescribed medicines,
home health services, dental services, and various other medical equipment, supplies, and services that were purchased or rented during the year. Out-of-pocket
expenses for over-the-counter medications, phone contacts with health providers, and premiums for health insurance policies are not included in these estimates.
Estimates for 1987 are based on the National Medical Expenditure Survey (NMES); estimates for other years are based on the Medical Expenditure Panel Survey
(MEPS). Because expenditures in NMES were based primarily on charges and those for MEPS were based on payments, NMES data were adjusted to be more
comparable with MEPS using estimated charge to payment ratios for 1987. Overall, this resulted in an approximate 11% reduction from the unadjusted 1987 NMES
expenditure estimates. For a detailed explanation of this adjustment, see Zuvekas S, Cohen J. A guide to comparing health care expenditures in the 1996 MEPS to the
1987 NMES. Inquiry 2002;39(1):76–86. See Appendix I, Medical Expenditure Panel Survey (MEPS). Data for additional years are available. See the Excel spreadsheet
on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm. Data have been revised and differ from previous editions of Health, United States.
SOURCE: Agency for Healthcare Research and Quality, Center for Financing, Access, and Cost Trends. 1987 National Medical Expenditure Survey and 1997–2011
Medical Expenditure Panel Surveys. See Appendix I, Medical Expenditure Panel Survey (MEPS).
Type of sponsor 1987 1990 1995 2000 2009 2010 2012 2013
Amount, in billions
National health expenditures. . . . . . . . . . . . . . .. $519.1 $724.3 $1,027.4 $1,378.0 $2,505.8 $2,604.1 $2,817.3 $2,919.1
Businesses, households, and other private
revenue . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 354.0 488.2 642.3 888.4 1,415.2 1,446.6 1,592.7 1,652.8
Private business. . . . . . . . . . . . . . . . . . . . . .. 122.3 178.3 243.7 346.5 530.3 533.7 587.3 610.9
Employer contribution to private health
insurance premiums 1 . . . . . . . . . . . . . . . .. 84.3 129.5 176.3 255.1 411.8 413.5 453.9 471.1
Employer contribution to Medicare
hospital insurance trust fund 2 . . . . . . . . . .. 24.6 29.4 43.1 62.3 77.9 79.7 88.0 91.7
Workers’ compensation and temporary
disability insurance and worksite
health care . . . . . . . . . . . . . . . . . . . . . . .. 13.4 19.3 24.3 29.1 40.6 40.5 45.4 48.2
Household . . . . . . . . . . . . . . . . . . . . . . . . . .. 189.9 253.0 318.9 434.0 717.3 738.3 801.5 823.8
Employee contribution to private health
insurance premiums and individual
policy premiums 3 . . . . . . . . . . . . . . . . . .. 44.0 68.5 100.3 133.6 260.7 270.8 293.8 300.2
Employee and voluntary premiums
paid to Medicare hospital insurance
trust fund 4 . . . . . . . . . . . . . . . . . . . . . . .. 29.5 35.7 56.0 82.6 108.4 112.1 125.5 124.8
Premiums paid by individuals to Medicare
supplementary medical insurance
trust fund 5 . . . . . . . . . . . . . . . . . . . . . . . . 6.2 10.2 16.4 16.3 47.2 49.2 53.4 59.4
Out-of-pocket health spending . . . . . . . . . . . 110.2 138.6 146.2 201.5 300.9 306.2 328.8 339.4
Other private revenues . . . . . . . . . . . . . . . . . . 41.9 56.9 79.7 107.9 167.6 174.6 203.9 218.1
Governments . . . . . . . . . . . . . . . . . . . . . . . . . . 165.1 236.1 385.2 489.6 1,090.6 1,157.5 1,224.6 1,266.3
Federal government . . . . . . . . . . . . . . . . . . . . 86.2 125.3 217.3 261.9 682.8 733.1 731.5 757.5
Employer contributions to private health
insurance premiums . . . . . . . . . . . . . . . .. 4.9 9.9 11.4 14.3 26.8 28.5 31.0 32.4
Employer contributions to Medicare
hospital insurance trust fund . . . . . . . . . . .. 1.7 2.0 2.3 2.7 3.9 4.1 4.1 4.0
Adjusted Medicare 6 . . . . . . . . . . . . . . . . . .. 17.4 27.7 57.6 49.2 236.0 250.2 266.2 274.0
Health program expenditures (excluding
Medicare) . . . . . . . . . . . . . . . . . . . . . . . . . 62.2 85.8 146.0 195.8 416.1 450.3 430.2 447.1
Medicaid 7 . . . . . . . . . . . . . . . . . . . . . . . . 28.2 43.3 87.9 119.4 255.5 275.9 251.5 267.1
Other programs 8 . . . . . . . . . . . . . . . . . . . 34.0 42.5 58.1 76.4 160.6 174.5 178.8 180.0
State and local government . . . . . . . . . . . . . . . 78.9 110.8 167.9 227.7 407.9 424.5 493.1 508.8
Employer contributions to private health
insurance premiums 9 . . . . . . . . . . . . . . . .. 16.0 26.4 38.9 56.9 127.8 142.9 153.5 156.0
Employer contributions to Medicare
hospital insurance trust fund . . . . . . . . . . .. 3.1 4.1 5.6 7.5 11.3 11.2 11.3 11.4
Health expenditures by program 59.8 80.3 123.3 163.4 268.8 270.4 328.3 341.5
Medicaid 7 . . . . . . . . . . . . . . . . . . . . . . .. 22.7 31.5 60.3 85.3 130.8 135.0 185.5 196.3
Other programs10 . . . . . . . . . . . . . . . . . .. 37.1 48.8 63.1 78.0 138.0 135.3 142.8 145.2
Percent distribution
National health expenditures. . . . . . . . . . . . . . .. 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0
Businesses, households, and other private
revenue . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 68.2 67.4 62.5 64.5 56.5 55.6 56.5 56.6
Private business. . . . . . . . . . . . . . . . . . . . . .. 23.6 24.6 23.7 25.1 21.2 20.5 20.8 20.9
Employer contribution to private health
insurance premiums 1 . . . . . . . . . . . . . . . .. 16.2 17.9 17.2 18.5 16.4 15.9 16.1 16.1
Employer contribution to Medicare
hospital insurance trust fund 2 . . . . . . . . . .. 4.7 4.1 4.2 4.5 3.1 3.1 3.1 3.1
Workers’ compensation and temporary
disability insurance and worksite
health care . . . . . . . . . . . . . . . . . . . . . . .. 2.6 2.7 2.4 2.1 1.6 1.6 1.6 1.7
Household . . . . . . . . . . . . . . . . . . . . . . . . . .. 36.6 34.9 31.0 31.5 28.6 28.4 28.4 28.2
Employee contribution to private health
insurance premiums and individual
policy premiums 3 . . . . . . . . . . . . . . . . . .. 8.5 9.5 9.8 9.7 10.4 10.4 10.4 10.3
Employee and voluntary premiums
paid to Medicare hospital insurance
trust fund 4 . . . . . . . . . . . . . . . . . . . . . . .. 5.7 4.9 5.5 6.0 4.3 4.3 4.5 4.3
Premiums paid by individuals to Medicare
supplementary medical insurance
trust fund 5 . . . . . . . . . . . . . . . . . . . . . . .. 1.2 1.4 1.6 1.2 1.9 1.9 1.9 2.0
Out-of-pocket health spending . . . . . . . . . .. 21.2 19.1 14.2 14.6 12.0 11.8 11.7 11.6
Other private revenues . . . . . . . . . . . . . . . . .. 8.1 7.9 7.8 7.8 6.7 6.7 7.2 7.5
Type of sponsor 1987 1990 1995 2000 2009 2010 2012 2013
Percent distribution
Governments . . . . . . . . . . . . . . . . . . . . . . .... 31.8 32.6 37.5 35.5 43.5 44.4 43.5 43.4
Federal government . . . . . . . . . . . . . . . . .... 16.6 17.3 21.2 19.0 27.2 28.2 26.0 25.9
Employer contributions to private health
insurance premiums . . . . . . . . . . . . . .... 0.9 1.4 1.1 1.0 1.1 1.1 1.1 1.1
Employer contributions to Medicare
hospital insurance trust fund . . . . . . . . .... 0.3 0.3 0.2 0.2 0.2 0.2 0.1 0.1
Adjusted Medicare 6 . . . . . . . . . . . . . . . .... 3.4 3.8 5.6 3.6 9.4 9.6 9.4 9.4
Health program expenditures (excluding
Medicare) . . . . . . . . . . . . . . . . . . . . . . . . . 12.0 11.8 14.2 14.2 16.6 17.3 15.3 15.3
Medicaid 7 . . . . . . . . . . . . . . . . . . . . . . . . 5.4 6.0 8.6 8.7 10.2 10.6 8.9 9.2
Other programs 8 . . . . . . . . . . . . . . . . . . . 6.5 5.9 5.7 5.5 6.4 6.7 6.3 6.2
State and local government . . . . . . . . . . . . . . . 15.2 15.3 16.3 16.5 16.3 16.3 17.5 17.4
Employer contributions to private health
insurance premiums 9 . . . . . . . . . . . . . .... 3.1 3.6 3.8 4.1 5.1 5.5 5.4 5.3
Employer contributions to Medicare
hospital insurance trust fund . . . . . . . . .... 0.6 0.6 0.5 0.5 0.5 0.4 0.4 0.4
Health expenditures by program
Medicaid 7 . . . . . . . . . . . . . . . . . . . . .... 4.4 4.3 5.9 6.2 5.2 5.2 6.6 6.7
Other programs10 . . . . . . . . . . . . . . . .... 7.1 6.7 6.1 5.7 5.5 5.2 5.1 5.0
1
Excludes Medicare Retiree Drug Subsidy (RDS) payments to private plans beginning in 2006, small-business tax credits beginning in 2010 and Early Retirement
2
Includes one-half of self-employment contribution to the Medicare Hospital Insurance (HI) Trust Fund.
3
Excludes government-subsidized Consolidated Omnibus Budget Reconciliation Act (COBRA) payments in 2009–2011.
4
Includes one-half of self-employment contribution to Medicare HI Trust Fund and trust fund revenues from the income taxation of Social Security benefits.
5
Includes premiums paid for the Pre-Existing Condition Insurance Plan (PCIP) beginning in 2010.
6
Federal government Medicare expenditures equal Trust Fund interest income and Federal general revenue contributions to Medicare less the net change in Trust Fund
balances. Includes Medicare RDS paid to private and state and local government employer plans beginning in 2006. Excludes Part D state phase-down payments to
Medicare beginning in 2006 and Medicare premium buy-in programs by Medicaid for people eligible for both Medicaid and Medicare (dual eligibles).
7
Includes Medicare Premium buy-in programs by Medicaid for people eligible for both Medicaid and Medicare (dual eligibles).
8
Includes maternal and child health, vocational rehabilitation, Substance Abuse and Mental Health Services Administration, Indian Health Service, federal workers’
compensation, and other federal programs, public health activities, Department of Defense, Department of Veterans Affairs, Children’s Health Insurance Program
(CHIP), and investment (research, structures and equipment). Also includes government-subsidized COBRA payments in 2009–2011, small business tax credits
beginning in 2006, and ERRP payments in 2010–2011. Excludes premiums paid for the Pre-Existing Condition Insurance Plan (PCIP) premiums beginning in 2010.
9
Excludes Medicare RDS payments to state and local government employer plans beginning in 2006 and ERRP payments in 2010–2011.
10
Includes maternal and child health, vocational rehabilitation, general assistance, school health, CHIP, public health activities, other state and local programs,
investment (research, structures and equipment). Also includes Part D state phase-down payments to Medicare beginning in 2006. See Appendix II, Health
expenditures, national.
NOTES: This table disaggregates health expenditures according to five classes of sponsors: businesses, households (individuals), federal government, and state and
local governments, with a small amount of revenue coming from nonpatient revenue sources such as philanthropy. Where businesses or households pay dedicated
funds into government health programs (for example, Medicare) or employers and employees share in the cost of health premiums, these costs are assigned to
businesses or households accordingly. This results in a lower share of expenditures being assigned to the federal government than for tabulations of expenditures by
source of funds. Estimates of national health expenditure by source of funds aim to track government-sponsored health programs over time and do not delineate the
role of business employers in paying for health care. See Appendix I, National Health Expenditure Accounts (NHEA). Estimates may not sum to totals because of
rounding. For more information on NHE sponsors, sources, and methods, see the National Health Expenditure Accounts Methodology Paper, 2013. Available from:
SOURCE: Centers for Medicare & Medicaid Services, Office of the Actuary, National Health Statistics Group. Businesses, Households, and Governments. National
http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NationalHealthAccountsHistorical.html, accessed
on December 12, 2014. See Appendix I, National Health Expenditure Accounts (NHEA).
Characteristic 1999 2000 2005 2008 2009 2010 2011 2013 2014
NOTES: Costs are calculated annually from March survey data. Total compensation includes wages, salaries and benefits. See Appendix II, Employer costs for
employee compensation. See Health, United States, 2013, Table 121 for prior years of data. Data for additional years are available. See the Excel spreadsheet on the
Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: U.S. Department of Labor, Bureau of Labor Statistics, National Compensation Survey: Employer Costs for Employee Compensation Annual, 1999–2001;
Quarterly, 2002–2003; March release, 2004–2014. Available from: http://www.bls.gov/ncs/ect/. See Appendix I, National Compensation Survey (NCS).
Characteristic 1984 2 1989 2 1997 2000 3 2003 2005 2010 2012 2013
Number, in millions
Total 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . 157.5 162.7 165.8 174.0 173.6 174.7 163.9 164.9 165.3
Percent of population
Total 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . 76.8 75.9 70.7 71.5 68.9 68.2 61.7 61.8 61.8
Age
Under 19 years . . . . . . . . . . . . . . . . . . . . 72.6 71.9 66.1 66.7 63.2 62.3 54.3 53.6 53.5
Under 6 years . . . . . . . . . . . . . . . . . . . 68.1 67.9 61.3 62.7 58.2 56.6 48.3 48.4 47.3
6–18 years . . . . . . . . . . . . . . . . . . . . . . 74.8 73.9 68.4 68.5 65.4 64.9 57.2 56.0 56.3
Under 18 years . . . . . . . . . . . . . . . . . . . . 72.6 71.8 66.1 66.6 63.0 62.1 54.1 53.4 53.2
6–17 years . . . . . . . . . . . . . . . . . . . . . . 74.9 74.0 68.5 68.5 65.3 64.7 57.2 55.8 56.0
18–64 years . . . . . . . . . . . . . . . . . . . . . . 78.6 77.6 72.7 73.5 71.4 70.7 64.7 65.1 65.1
18–44 years . . . . . . . . . . . . . . . . . . . . . 76.5 75.5 69.4 70.5 67.7 66.6 60.0 61.4 61.8
18–24 years . . . . . . . . . . . . . . . . . . . 67.4 64.5 59.3 60.3 58.8 58.0 52.3 58.1 59.0
19–25 years . . . . . . . . . . . . . . . . . . . 67.4 63.8 58.3 59.1 57.8 56.3 51.8 58.1 58.9
25–34 years . . . . . . . . . . . . . . . . . . . 77.4 75.9 68.1 70.1 65.6 65.1 58.7 58.7 59.0
35–44 years . . . . . . . . . . . . . . . . . . . 83.9 82.7 76.4 77.0 75.1 73.7 66.9 66.7 67.0
45–64 years . . . . . . . . . . . . . . . . . . . . . 83.3 82.5 79.0 78.7 77.3 76.9 71.3 70.0 69.5
45–54 years . . . . . . . . . . . . . . . . . . . 83.3 83.4 80.4 80.0 77.9 77.4 70.9 69.6 69.8
55–64 years . . . . . . . . . . . . . . . . . . . 83.3 81.6 76.9 76.7 76.5 76.2 71.8 70.4 69.1
Sex
Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77.3 76.1 70.9 71.6 69.0 68.0 61.1 61.8 61.9
Female . . . . . . . . . . . . . . . . . . . . . . . . . . 76.2 75.7 70.5 71.3 68.9 68.4 62.4 61.9 61.7
Race 6
White only . . . . . . . . . . . . . . . . . . . . . . . . 79.9 79.1 74.2 75.7 71.5 70.9 64.9 64.8 64.7
Black or African American only . . . . . . . . . 58.1 57.7 54.7 55.9 54.9 52.9 44.8 45.8 45.4
American Indian or Alaska Native only . . . . 49.1 45.5 39.4 43.7 45.0 43.0 31.7 34.9 36.0
Asian only . . . . . . . . . . . . . . . . . . . . . . . . 69.9 71.9 68.0 72.1 71.4 72.2 68.1 67.6 69.4
Native Hawaiian or Other Pacific
Islander only . . . . . . . . . . . . . . . . . . ... -- -- -- * * * * * *
2 or more races . . . . . . . . . . . . . . . . . ... -- -- -- 61.4 56.3 57.6 52.4 52.9 50.0
Characteristic 1984 2 1989 2 1997 2000 3 2003 2005 2010 2012 2013
Percent of population
Under 19 years:
Below 100% . . . . . . . . . . . . . . . . . . . . . 29.6 24.1 19.3 20.3 17.3 15.0 9.8 10.0 9.3
100%–199% . . . . . . . . . . . . . . . . . . . . . 73.6 68.5 54.7 49.5 42.1 41.6 31.5 32.4 29.2
100%–133% . . . . . . . . . . . . . . . . . . . 63.8 56.9 39.3 37.1 30.8 32.6 20.1 22.3 18.3
134%–199% . . . . . . . . . . . . . . . . . . . 78.4 74.0 62.4 56.1 48.1 47.0 38.1 38.4 36.2
200%–399% . . . . . . . . . . . . . . . . . . . . . 91.1 92.1 83.5 80.8 77.6 76.6 72.6 72.5 71.8
400% or more . . . . . . . . . . . . . . . . . . . 96.2 96.2 93.3 93.0 93.1 92.5 91.2 91.2 92.3
Under 18 years:
Below 100% . . . . . . . . . . . . . . . . . . . . . 28.5 22.3 18.3 19.5 15.9 14.2 9.2 9.1 8.4
100%–199% . . . . . . . . . . . . . . . . . . . . . 73.9 68.9 54.7 49.4 41.9 41.4 31.5 32.1 28.5
100%–133% . . . . . . . . . . . . . . . . . . . 63.9 57.3 38.7 36.8 30.5 32.0 19.9 21.6 17.8
134%–199% . . . . . . . . . . . . . . . . . . . 78.6 74.5 62.8 56.2 48.2 47.0 38.3 38.4 35.3
200%–399% . . . . . . . . . . . . . . . . . . . . . 91.3 92.3 83.7 81.1 77.7 76.6 72.6 72.5 71.9
400% or more . . . . . . . . . . . . . . . . . . . 96.1 96.5 93.5 93.1 93.2 92.5 91.4 91.4 92.2
18–64 years:
Below 100% . . . . . . . . . . . . . . . . . . . . . 35.0 30.8 26.8 29.1 28.8 25.9 20.4 20.9 19.9
100%–199% . . . . . . . . . . . . . . . . . . . . . 68.3 61.5 52.8 50.5 46.2 46.5 36.4 38.9 38.2
100%–133% . . . . . . . . . . . . . . . . . . . 56.6 50.0 40.3 40.9 36.9 38.3 26.9 29.6 29.2
134%–199% . . . . . . . . . . . . . . . . . . . 73.3 66.6 58.6 54.9 50.9 50.7 41.3 44.2 43.2
200%–399% . . . . . . . . . . . . . . . . . . . . . 88.3 87.6 79.4 76.7 74.9 74.0 70.0 70.8 71.1
400% or more . . . . . . . . . . . . . . . . . . . 95.2 94.4 91.3 91.6 91.2 90.1 89.5 90.4 89.9
Disability measure
among adults 18–64 years 8
Geographic region
Northeast . . . . . . . . . . . . . . . . . . . . . . . . 80.5 82.0 74.2 76.3 74.7 74.0 68.2 67.2 66.1
Midwest . . . . . . . . . . . . . . . . . . . . . . . . . 80.6 81.5 77.1 78.8 75.9 74.6 66.7 68.4 68.0
South . . . . . . . . . . . . . . . . . . . . . . . . . . . 74.3 71.4 67.3 66.8 64.0 62.5 57.5 57.3 57.4
West. . . . . . . . . . . . . . . . . . . . . . . . . . . . 71.9 71.2 65.4 66.5 64.7 65.6 58.9 58.5 59.6
Location of residence 9
Within MSA . . . . . . . . . . . . . . . . . . . . . . . 77.5 76.5 71.2 72.3 70.2 69.0 62.9 63.0 63.0
Outside MSA . . . . . . . . . . . . . . . . . . . . . . 75.2 73.8 68.4 67.8 63.7 64.6 55.1 55.3 54.7
NOTES: In 1997, the National Health Interview Survey questionnaire was redesigned. See Appendix I, National Health Interview Survey (NHIS). Private health
insurance coverage is at the time of interview. The number of persons with private coverage was calculated by multiplying the percentage with private coverage by the
number of persons under age 65 in the civilian noninstitutionalized U.S. population, which was determined from the post-stratification Census control total for each
survey year. Percentages of persons with private coverage were calculated with unknown values excluded from denominators. See Appendix II, Health insurance
coverage. Standard errors are available in the spreadsheet version of this table. Available from: http://www.cdc.gov/nchs/hus.htm. Data for additional years are
available. See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC/NCHS, National Health Interview Survey, health insurance supplements (1984, 1989, 1994–1996). Starting with 1997, data are from the family core and
the sample adult questionnaires. See Appendix I, National Health Interview Survey (NHIS).
Characteristic 1984 2 1989 2 1997 2000 3 2003 2005 2010 2012 2013
Number, in millions
Total 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . 141.8 146.3 153.6 160.8 157.5 160.1 147.6 148.6 148.3
Percent of population
Total 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . 69.1 68.3 66.4 67.1 64.4 63.6 56.6 56.9 56.6
Age
Under 19 years . . . . . . . . . . . . . . . . . . . . 66.4 65.6 62.8 63.1 59.5 58.7 50.9 50.1 49.6
Under 6 years . . . . . . . . . . . . . . . . . . . 62.1 62.3 58.3 58.9 54.6 53.4 44.9 45.0 44.2
6–18 years . . . . . . . . . . . . . . . . . . . . . . 68.4 67.3 64.9 64.9 61.7 61.1 53.8 52.4 52.0
Under 18 years . . . . . . . . . . . . . . . . . . . . 66.5 65.8 62.8 63.0 59.4 58.6 50.7 49.9 49.3
6–17 years . . . . . . . . . . . . . . . . . . . . . . 68.7 67.7 65.1 65.0 61.7 61.1 53.8 52.3 51.8
18–64 years . . . . . . . . . . . . . . . . . . . . . . 70.3 69.4 68.0 68.8 66.5 65.7 58.9 59.6 59.5
18–44 years . . . . . . . . . . . . . . . . . . . . . 69.6 68.4 65.7 66.5 63.2 62.2 54.6 56.7 56.9
18–24 years . . . . . . . . . . . . . . . . . . . 58.7 55.3 54.9 55.5 53.3 52.1 45.3 52.7 53.1
19–25 years . . . . . . . . . . . . . . . . . . . 59.0 55.0 53.7 54.2 52.2 50.6 44.1 52.7 53.0
25–34 years . . . . . . . . . . . . . . . . . . . 71.2 69.5 64.6 66.4 61.3 61.1 53.3 53.8 53.8
35–44 years . . . . . . . . . . . . . . . . . . . 77.4 76.2 72.7 73.2 71.3 69.9 62.8 62.7 63.1
45–64 years . . . . . . . . . . . . . . . . . . . . . 71.8 71.6 72.8 72.9 71.7 70.9 64.8 63.6 62.9
45–54 years . . . . . . . . . . . . . . . . . . . 74.6 74.4 75.6 75.6 73.2 72.6 65.9 64.4 64.3
55–64 years . . . . . . . . . . . . . . . . . . . 69.0 68.3 68.4 68.6 69.5 68.6 63.4 62.6 61.3
Sex
Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69.8 68.7 66.7 67.3 64.4 63.6 56.1 57.1 56.9
Female . . . . . . . . . . . . . . . . . . . . . . . . . . 68.4 67.9 66.2 66.9 64.4 63.6 57.1 56.8 56.4
Race 6
White only . . . . . . . . . . . . . . . . . . . . . . . . 72.0 71.2 69.7 71.0 66.8 66.1 59.3 59.6 59.2
Black or African American only . . . . . . . . . 52.4 52.8 52.6 53.4 52.5 50.6 42.3 43.2 42.9
American Indian or Alaska Native only . . . . 45.8 40.9 37.2 41.7 41.6 39.9 *29.4 34.0 34.2
Asian only . . . . . . . . . . . . . . . . . . . . . . . . 59.0 61.1 61.7 65.8 63.5 64.4 60.6 60.1 61.4
Native Hawaiian or Other Pacific
Islander only . . . . . . . . . . . . . . . . . . ... -- -- -- * * * * * *
2 or more races . . . . . . . . . . . . . . . . . ... -- -- -- 59.8 53.5 54.8 49.5 48.8 46.9
Characteristic 1984 2 1989 2 1997 2000 3 2003 2005 2010 2012 2013
Percent of population
Under 19 years:
Below 100% . . . . . . . . . . . . . . . . . . . . . 23.6 18.6 17.0 17.1 15.3 13.3 8.2 8.7 7.8
100%–199% . . . . . . . . . . . . . . . . . . . . . 67.0 62.1 51.2 45.8 38.4 38.3 28.8 29.7 26.6
100%–133% . . . . . . . . . . . . . . . . . . . 56.1 49.9 35.8 33.6 26.7 29.1 17.9 20.5 16.4
134%–199% . . . . . . . . . . . . . . . . . . . 72.3 67.9 59.0 52.2 44.8 43.7 35.1 35.2 33.1
200%–399% . . . . . . . . . . . . . . . . . . . . . 85.7 86.0 80.0 76.9 73.8 72.4 68.7 68.0 66.7
400% or more . . . . . . . . . . . . . . . . . . . 90.8 90.3 89.7 89.5 89.0 88.3 86.5 86.3 86.9
Under 18 years:
Below 100% . . . . . . . . . . . . . . . . . . . . . 23.0 17.5 16.2 16.6 14.0 12.5 7.8 8.1 7.2
100%–199% . . . . . . . . . . . . . . . . . . . . . 67.5 62.5 51.2 45.8 38.4 38.2 28.8 29.4 26.0
100%–133% . . . . . . . . . . . . . . . . . . . 56.3 50.3 35.2 33.5 26.4 28.6 17.8 19.8 16.0
134%–199% . . . . . . . . . . . . . . . . . . . 72.8 68.4 59.4 52.4 44.9 43.9 35.2 35.2 32.4
200%–399% . . . . . . . . . . . . . . . . . . . . . 85.9 86.4 80.2 77.1 73.9 72.4 68.7 68.1 66.8
400% or more . . . . . . . . . . . . . . . . . . . 90.7 90.5 89.8 89.7 89.2 88.5 86.6 86.4 86.8
18–64 years:
Below 100% . . . . . . . . . . . . . . . . . . . . . 24.8 21.8 22.7 24.0 24.0 21.2 15.4 16.9 15.2
100%–199% . . . . . . . . . . . . . . . . . . . . . 58.3 52.3 47.6 45.2 40.2 41.1 30.9 33.6 33.3
100%–133% . . . . . . . . . . . . . . . . . . . 46.0 40.4 35.5 35.9 30.1 32.9 22.1 24.6 24.7
134%–199% . . . . . . . . . . . . . . . . . . . 63.6 57.5 53.2 49.5 45.3 45.3 35.3 38.7 38.0
200%–399% . . . . . . . . . . . . . . . . . . . . . 81.4 80.2 74.7 71.7 69.8 68.7 63.9 65.0 65.2
400% or more . . . . . . . . . . . . . . . . . . . 88.5 87.5 86.8 87.5 87.0 85.4 83.6 84.7 84.0
Disability measure
among adults 18–64 years 8
Geographic region
Northeast . . . . . . . . . . . . . . . . . . . . . . . . 74.0 75.0 71.0 72.5 71.0 70.6 64.4 63.4 62.3
Midwest . . . . . . . . . . . . . . . . . . . . . . . . . 72.0 73.3 72.6 74.9 71.6 70.1 61.8 63.8 62.6
South . . . . . . . . . . . . . . . . . . . . . . . . . . . 66.2 63.6 62.9 62.5 59.8 58.0 52.2 52.2 52.4
West. . . . . . . . . . . . . . . . . . . . . . . . . . . . 64.7 63.9 60.7 61.1 58.4 59.7 52.7 52.8 53.6
Location of residence 9
Within MSA . . . . . . . . . . . . . . . . . . . . . . . 70.9 69.6 67.3 68.2 65.8 64.5 57.9 58.1 57.8
Outside MSA . . . . . . . . . . . . . . . . . . . . . . 65.3 63.5 62.8 62.6 58.7 59.6 49.4 50.3 49.4
1
Any private insurance at the time of interview that was originally obtained through a present or former employer or union, or, starting with 1997 data, through the workplace,
self-employment, or a professional association; includes those who also had another type of coverage.
2
Data prior to 1997 are not strictly comparable with data for later years due to the 1997 questionnaire redesign. See Appendix I, National Health Interview Survey (NHIS) and
3
Estimates for 2000–2002 were calculated using 2000-based sample weights and may differ from estimates in other reports that used 1990-based sample weights for
2000–2002 estimates.
4
Includes all other races not shown separately, those with unknown marital status, unknown disability status, and, in 1984 and 1989, persons with unknown poverty level.
5
Includes persons aged 14–64.
6
The race groups, white, black, American Indian or Alaska Native, Asian, Native Hawaiian or Other Pacific Islander, and 2 or more races, include persons of Hispanic and
non-Hispanic origin. Persons of Hispanic origin may be of any race. Starting with 1999 data, race-specific estimates are tabulated according to the 1997 Revisions to the
Standards for the Classification of Federal Data on Race and Ethnicity and are not strictly comparable with estimates for earlier years. The five single-race categories plus
multiple-race categories shown in the table conform to the 1997 Standards. Starting with 1999 data, race-specific estimates are for persons who reported only one racial group;
the category 2 or more races includes persons who reported more than one racial group. Prior to 1999, data were tabulated according to the 1977 Standards with four racial
groups, and the Asian only category included Native Hawaiian or Other Pacific Islander. Estimates for single-race categories prior to 1999 included persons who reported one
race or, if they reported more than one race, identified one race as best representing their race. Starting with 2003 data, race responses of other race and unspecified multiple
race were treated as missing, and then race was imputed if these were the only race responses. Almost all persons with a race response of other race were of Hispanic origin.
7
Percent of poverty level is based on family income and family size and composition using U.S. Census Bureau poverty thresholds. Poverty level was unknown for 10%–11%
of persons under age 65 in 1984 and 1989. Missing family income data were imputed for 1995 and beyond. See Appendix II, Family income; Poverty; Table VI.
8
Any basic actions difficulty or complex activity limitation is defined as having one or more of the following limitations or difficulties: movement difficulty, emotional difficulty,
sensory (seeing or hearing) difficulty, cognitive difficulty, self-care (activities of daily living or instrumental activities of daily living) limitation, social limitation, or work limitation.
For more information, see Appendix II, Basic actions difficulty; Complex activity limitation. Starting with 2007 data, the hearing question, a component of the basic actions
difficulty measure, was revised. Consequently, data prior to 2007 are not comparable with data for 2007 and beyond. For more information on the impact of the revised hearing
9
MSA is metropolitan statistical area. Starting with 2006 data, MSA status is determined using 2000 census data and the 2000 standards for defining MSAs. For data prior to
2006, see Appendix II, Metropolitan statistical area (MSA) for the applicable standards.
NOTES: In 1997, the National Health Interview Survey questionnaire was redesigned. See Appendix I, National Health Interview Survey (NHIS). Private coverage
through the workplace is at the time of interview. The number of persons with private coverage through the workplace was calculated by multiplying the percentage with
private coverage through the workplace by the number of persons under age 65 in the civilian noninstitutionalized U.S. population, which was determined from the
post-stratification Census control total for each survey year. Percentages of persons with private coverage obtained through the workplace were calculated with
unknown values excluded from denominators. See Appendix II, Health insurance coverage. Standard errors are available in the spreadsheet version of this table.
Available from: http://www.cdc.gov/nchs/hus.htm. Data for additional years are available. See the Excel spreadsheet on the Health, United States website at:
http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC/NCHS, National Health Interview Survey, health insurance supplements (1984, 1989, 1994–1996). Starting with 1997, data are from the family core and
the sample adult questionnaires. See Appendix I, National Health Interview Survey (NHIS).
Characteristic 1984 1 1989 1 1997 2000 2 2003 2004(1) 3 2004(2) 3 2010 3 2012 3 2013 3
Number, in millions
Total 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . 14.0 15.4 22.9 23.2 30.9 31.1 31.6 44.8 48.1 48.5
Percent of population
Total 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.8 7.2 9.7 9.5 12.3 12.3 12.5 16.9 18.0 18.1
Age
Under 19 years . . . . . . . . . . . . . . . . . . . . 11.7 12.2 18.0 19.2 25.4 25.4 25.8 35.7 38.1 38.1
Under 6 years . . . . . . . . . . . . . . . . . . . 15.5 15.7 24.7 24.7 32.3 31.8 32.4 43.7 45.7 45.9
6–18 years. . . . . . . . . . . . . . . . . . . . . . 9.8 10.5 14.9 16.8 22.3 22.5 22.9 31.8 34.7 34.6
Under 18 years . . . . . . . . . . . . . . . . . . . . 11.9 12.6 18.4 19.6 26.0 25.9 26.4 36.4 38.9 38.9
6–17 years. . . . . . . . . . . . . . . . . . . . . . 10.1 10.9 15.2 17.2 23.0 23.1 23.4 32.5 35.5 35.5
18–64 years . . . . . . . . . . . . . . . . . . . . . . 4.5 4.9 5.9 5.2 6.6 6.7 6.8 9.2 10.0 10.2
18–44 years . . . . . . . . . . . . . . . . . . . . . 5.1 5.2 6.6 5.6 7.4 7.5 7.7 10.9 11.6 11.6
18–24 years . . . . . . . . . . . . . . . . . . . 6.4 6.8 8.8 8.1 9.6 10.3 10.4 14.5 15.4 14.2
19–25 years . . . . . . . . . . . . . . . . . . . 6.3 6.6 8.5 7.3 8.8 9.0 9.1 12.6 13.4 12.1
25–34 years . . . . . . . . . . . . . . . . . . . 5.3 5.2 6.8 5.5 7.8 7.6 7.8 11.1 11.4 11.7
35–44 years . . . . . . . . . . . . . . . . . . . 3.5 4.0 5.2 4.3 5.6 5.7 5.8 8.1 8.8 9.6
45–64 years . . . . . . . . . . . . . . . . . . . . . 3.4 4.3 4.6 4.5 5.3 5.4 5.5 6.8 8.0 8.4
45–54 years . . . . . . . . . . . . . . . . . . . 3.2 3.8 4.0 4.2 5.0 5.4 5.5 7.0 8.2 8.6
55–64 years . . . . . . . . . . . . . . . . . . . 3.6 4.9 5.6 4.9 5.8 5.4 5.5 6.6 7.7 8.2
Sex
Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.4 5.7 8.4 8.2 10.9 10.8 11.0 15.2 16.3 16.5
Female . . . . . . . . . . . . . . . . . . . . . . . . . . 8.1 8.6 11.1 10.8 13.6 13.7 13.9 18.5 19.7 19.8
Characteristic 1984 1 1989 1 1997 2000 2 2003 2004(1) 3 2004(2) 3 2010 3 2012 3 2013 3
Percent of population
Under 19 years:
Below 100% . . . . . . . . . . . . . . . . . . . . . 42.0 45.8 56.4 56.9 65.7 67.5 68.9 78.4 82.1 82.1
100%–199%. . . . . . . . . . . . . . . . . . . . . 6.5 8.6 20.3 27.8 40.8 38.7 39.5 53.5 56.3 58.9
100%–133% . . . . . . . . . . . . . . . . . . . 10.3 13.4 31.1 36.4 50.2 48.3 49.2 63.5 68.8 70.3
134%–199% . . . . . . . . . . . . . . . . . . . 4.7 6.3 14.8 23.3 35.7 33.9 34.6 47.7 48.8 51.6
200%–399%. . . . . . . . . . . . . . . . . . . . . 1.0 1.7 4.4 7.6 11.9 12.1 12.2 17.7 18.8 19.1
400% or more . . . . . . . . . . . . . . . . . . . * *1.2 1.3 2.1 2.6 3.2 3.2 4.3 3.6 3.2
Under 18 years:
Below 100% . . . . . . . . . . . . . . . . . . . . . 43.3 47.8 58.0 58.5 67.5 69.2 70.7 79.8 83.7 83.9
100%–199%. . . . . . . . . . . . . . . . . . . . . 6.6 8.7 20.8 28.4 41.7 39.5 40.2 54.3 57.3 60.1
100%–133% . . . . . . . . . . . . . . . . . . . 10.4 13.5 32.0 36.9 51.5 48.9 49.8 64.6 70.1 71.2
134%–199% . . . . . . . . . . . . . . . . . . . 4.8 6.4 15.1 23.8 36.5 34.7 35.4 48.2 49.6 52.9
200%–399%. . . . . . . . . . . . . . . . . . . . . 1.0 1.7 4.5 7.6 12.2 12.2 12.3 18.0 19.1 19.5
400% or more . . . . . . . . . . . . . . . . . . . * *1.1 1.3 2.2 2.6 3.3 3.3 4.3 3.6 3.3
18–64 years:
Below 100% . . . . . . . . . . . . . . . . . . . . . 25.3 29.1 28.0 24.9 28.3 28.6 28.9 32.4 34.0 35.4
100%–199%. . . . . . . . . . . . . . . . . . . . . 4.5 6.8 8.6 9.1 11.4 11.9 12.2 15.7 16.8 17.1
100%–133% . . . . . . . . . . . . . . . . . . . 7.6 10.8 13.0 13.2 15.3 17.0 17.4 21.0 21.8 22.0
134%–199% . . . . . . . . . . . . . . . . . . . 3.1 5.1 6.5 7.2 9.4 9.5 9.7 13.0 13.9 14.4
200%–399%. . . . . . . . . . . . . . . . . . . . . 0.7 1.1 1.9 2.4 3.3 3.4 3.4 4.8 5.1 5.1
400% or more . . . . . . . . . . . . . . . . . . . 0.2 0.4 0.7 0.6 0.7 1.0 1.0 1.3 1.2 1.6
Disability measure
among adults 18–64 years 8
Any basic actions difficulty or complex
activity limitation. . . . . . . . . . . . . . . . . . . -- -- 13.2 12.8 15.0 14.7 14.9 17.8 19.3 21.1
Any basic actions difficulty . . . . . . . . . . . -- -- 12.7 12.2 14.3 14.0 14.2 16.7 18.4 20.6
Any complex activity limitation . . . . . . . . -- -- 22.9 23.2 26.5 23.9 24.1 30.0 30.8 32.3
No disability. . . . . . . . . . . . . . . . . . . . . . . -- -- 3.5 3.0 4.3 4.5 4.7 6.8 7.0 6.8
Geographic region
Northeast . . . . . . . . . . . . . . . . . . . . . . . . 8.6 6.6 11.3 10.6 12.9 12.8 13.0 17.9 19.3 20.8
Midwest . . . . . . . . . . . . . . . . . . . . . . . . . 7.4 7.6 8.4 8.0 10.8 10.2 10.4 17.3 16.3 16.9
South . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.1 6.5 8.7 9.4 12.6 12.2 12.4 16.0 17.8 17.8
West. . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.0 8.5 11.7 10.4 12.8 14.2 14.4 17.1 19.1 18.0
Location of residence 9
Within MSA . . . . . . . . . . . . . . . . . . . . . . . 7.1 7.0 9.7 8.9 11.5 11.7 11.9 16.1 17.4 17.4
Outside MSA . . . . . . . . . . . . . . . . . . . . . . 6.1 7.9 10.1 11.9 15.3 14.8 15.0 21.4 21.4 22.5
1
Data prior to 1997 are not strictly comparable with data for later years due to the 1997 questionnaire redesign. See Appendix I, National Health Interview Survey (NHIS) and
2
Estimates for 2000–2002 were calculated using 2000-based sample weights and may differ from estimates in other reports that used 1990-based sample weights for
2000–2002 estimates.
3
Beginning in quarter 3 of the 2004 NHIS, persons under age 65 with no reported coverage were asked explicitly about Medicaid coverage. Estimates were calculated without
and with the additional information from this question in the columns labeled 2004(1) and 2004(2), respectively, and estimates were calculated with the additional information
4
Includes all other races not shown separately, those with unknown marital status, unknown disability status, and, in 1984 and 1989, persons with unknown poverty level.
5
Includes persons aged 14–64.
6
The race groups, white, black, American Indian or Alaska Native, Asian, Native Hawaiian or Other Pacific Islander, and 2 or more races, include persons of Hispanic and
non-Hispanic origin. Persons of Hispanic origin may be of any race. Starting with 1999 data, race-specific estimates are tabulated according to the 1997 Revisions to the
Standards for the Classification of Federal Data on Race and Ethnicity and are not strictly comparable with estimates for earlier years. The five single-race categories plus
multiple-race categories shown in the table conform to the 1997 Standards. Starting with 1999 data, race-specific estimates are for persons who reported only one racial group;
the category 2 or more races includes persons who reported more than one racial group. Prior to 1999, data were tabulated according to the 1977 Standards with four racial
groups, and the Asian only category included Native Hawaiian or Other Pacific Islander. Estimates for single-race categories prior to 1999 included persons who reported one
race or, if they reported more than one race, identified one race as best representing their race. Starting with 2003 data, race responses of other race and unspecified multiple
race were treated as missing, and then race was imputed if these were the only race responses. Almost all persons with a race response of other race were of Hispanic origin.
7
Percent of poverty level is based on family income and family size and composition using U.S. Census Bureau poverty thresholds. Poverty level was unknown for 10%–11%
of persons under age 65 in 1984 and 1989. Missing family income data were imputed for 1995 and beyond. See Appendix II, Family income; Poverty; Table VI.
8
Any basic actions difficulty or complex activity limitation is defined as having one or more of the following limitations or difficulties: movement difficulty, emotional difficulty,
sensory (seeing or hearing) difficulty, cognitive difficulty, self-care (activities of daily living or instrumental activities of daily living) limitation, social limitation, or work limitation.
For more information, see Appendix II, Basic actions difficulty; Complex activity limitation. Starting with 2007 data, the hearing question, a component of the basic actions
difficulty measure, was revised. Consequently, data prior to 2007 are not comparable with data for 2007 and beyond. For more information on the impact of the revised hearing
9
MSA is metropolitan statistical area. Starting with 2006 data, MSA status is determined using 2000 census data and the 2000 standards for defining MSAs. For data prior to
2006, see Appendix II, Metropolitan statistical area (MSA) for the applicable standards.
NOTES: In 1997, the National Health Interview Survey questionnaire was redesigned. See Appendix I, National Health Interview Survey (NHIS). The category Medicaid
coverage includes persons who had any of the following at the time of interview: Medicaid, other public assistance through 1996, state-sponsored health plan starting in
1997, or Children’s Health Insurance Program (CHIP) starting in 1999; it includes those who also had another type of coverage in addition to one of these. In 2013,
14.8% of persons under age 65 reported being covered by Medicaid, 1.7% by state-sponsored health plans, and 1.7% by CHIP. The number of persons with Medicaid
coverage was calculated by multiplying the percentage with Medicaid coverage by the number of persons under age 65 in the civilian noninstitutionalized U.S.
population, which was determined from the post-stratification Census control total for each survey year. Percentages of persons with Medicaid coverage were calculated
with unknown values excluded from denominators. See Appendix II, Health insurance coverage; Medicaid. Standard errors are available in the spreadsheet version of
this table. Available from: http://www.cdc.gov/nchs/hus.htm. Data for additional years are available. See the Excel spreadsheet on the Health, United States website at:
http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC/NCHS, National Health Interview Survey, health insurance supplements (1984, 1989, 1994–1996). Starting with 1997, data are from the family core and
the sample adult questionnaires. See Appendix I, National Health Interview Survey (NHIS).
Characteristic 1984 1 1989 1 1997 2000 2 2003 2004(1) 3 2004(2) 3 2010 3 2012 3 2013 3
Number, in millions
Total 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29.8 33.4 41.0 41.4 41.6 42.1 41.6 48.3 45.2 44.6
Percent of population
Total 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14.5 15.6 17.5 17.0 16.5 16.6 16.4 18.2 16.9 16.7
Age
Under 19 years . . . . . . . . . . . . . . . . . . . . . . . . . . . 14.1 15.0 14.4 12.9 10.2 10.1 9.6 8.3 7.0 7.1
Under 6 years. . . . . . . . . . . . . . . . . . . . . . . . . . . 14.9 15.1 12.5 11.8 8.2 8.9 8.2 6.3 4.6 5.0
6–18 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13.8 15.0 15.2 13.4 11.1 10.6 10.3 9.2 8.1 8.0
Under 18 years . . . . . . . . . . . . . . . . . . . . . . . . . . . 13.9 14.7 14.0 12.6 9.8 9.7 9.2 7.8 6.6 6.6
6–17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13.4 14.5 14.7 13.0 10.6 10.0 9.7 8.6 7.6 7.4
18–64 years. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14.8 16.0 19.0 18.9 19.3 19.4 19.3 22.3 20.9 20.5
18–44 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17.1 18.4 22.4 22.4 23.5 23.6 23.5 27.1 24.8 24.2
18–24 years . . . . . . . . . . . . . . . . . . . . . . . . . . 25.0 27.1 30.1 30.4 30.1 30.1 30.0 31.4 24.5 24.6
19–25 years . . . . . . . . . . . . . . . . . . . . . . . . . . 25.1 27.9 31.5 32.3 31.9 32.3 32.2 33.8 26.3 26.7
25–34 years . . . . . . . . . . . . . . . . . . . . . . . . . . 16.2 18.3 23.8 23.3 25.4 25.7 25.5 28.3 28.1 27.1
35–44 years . . . . . . . . . . . . . . . . . . . . . . . . . . 11.2 12.3 16.7 16.9 17.5 17.6 17.5 22.6 21.7 21.0
45–64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.6 10.5 12.4 12.6 12.5 12.9 12.8 15.7 15.6 15.4
45–54 years . . . . . . . . . . . . . . . . . . . . . . . . . . 10.5 11.0 12.8 12.8 13.6 13.7 13.6 17.9 17.7 17.1
55–64 years . . . . . . . . . . . . . . . . . . . . . . . . . . 8.7 10.0 11.8 12.4 10.9 11.7 11.6 12.8 13.2 13.5
Sex
Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15.3 16.8 18.7 18.1 17.7 18.1 17.9 20.3 18.5 18.1
Female . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13.8 14.4 16.3 15.9 15.3 15.2 14.9 16.1 15.4 15.2
Characteristic 1984 1 1989 1 1997 2000 2 2003 2004(1) 3 2004(2) 3 2010 3 2012 3 2013 3
Percent of population
Under 19 years:
Below 100% . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29.0 31.7 23.8 22.6 17.2 17.2 15.7 11.3 8.3 8.9
100%–199% . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18.0 20.7 23.7 22.1 16.3 16.5 15.8 13.5 11.1 11.7
100%–133% . . . . . . . . . . . . . . . . . . . . . . . . . . 24.4 27.6 28.2 26.5 17.7 18.4 17.6 15.9 9.6 11.6
134%–199% . . . . . . . . . . . . . . . . . . . . . . . . . . 14.9 17.4 21.4 19.7 15.6 15.5 14.9 12.0 12.0 11.7
200%–399% . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.1 4.9 9.7 9.6 8.5 8.1 8.0 7.4 6.8 6.7
400% or more. . . . . . . . . . . . . . . . . . . . . . . . . . . 1.8 2.1 4.0 3.5 2.8 2.8 2.8 2.3 2.2 1.9
Under 18 years:
Below 100% . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28.9 31.6 23.2 22.0 16.8 16.5 15.0 10.6 7.6 8.2
100%–199% . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17.5 20.2 23.2 21.7 15.6 15.8 15.1 12.7 10.4 11.1
100%–133% . . . . . . . . . . . . . . . . . . . . . . . . . . 24.0 27.1 28.1 26.4 16.8 17.9 17.1 15.1 9.0 11.2
134%–199% . . . . . . . . . . . . . . . . . . . . . . . . . . 14.4 16.9 20.7 19.1 14.9 14.7 14.1 11.3 11.3 11.1
200%–399% . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.9 4.7 9.4 9.3 8.1 7.7 7.6 7.0 6.7 6.3
400% or more. . . . . . . . . . . . . . . . . . . . . . . . . . . 1.8 1.9 3.9 3.3 2.7 2.6 2.6 2.1 2.1 1.8
18–64 years:
Below 100% . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37.6 38.2 41.2 42.4 39.9 41.4 41.0 42.7 40.5 40.0
100%–199% . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24.4 28.8 34.7 36.4 37.5 36.7 36.5 42.1 38.6 37.8
100%–133% . . . . . . . . . . . . . . . . . . . . . . . . . . 31.9 35.6 41.7 41.7 41.9 40.4 40.0 45.7 42.2 40.4
134%–199% . . . . . . . . . . . . . . . . . . . . . . . . . . 21.1 25.9 31.5 34.0 35.3 35.0 34.8 40.3 36.5 36.4
200%–399% . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.9 10.0 16.4 18.2 18.8 19.1 19.1 21.3 19.8 19.7
400% or more. . . . . . . . . . . . . . . . . . . . . . . . . . . 3.4 4.4 6.7 6.6 6.4 6.8 6.8 6.5 5.6 5.6
Disability measure
among adults 18–64 years 8
Any basic actions difficulty or complex
activity limitation . . . . . . . . . . . . . . . . . . . . . . . . . . -- -- 20.1 17.6 19.1 19.8 19.6 20.8 20.4 20.4
Any basic actions difficulty . . . . . . . . . . . . . . . . . . -- -- 20.1 17.6 19.3 20.0 19.8 20.9 20.3 20.4
Any complex activity limitation . . . . . . . . . . . . . . . -- -- 20.2 16.1 16.3 18.1 17.9 17.2 18.3 17.1
No disability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . -- -- 17.6 18.5 19.4 19.3 19.2 21.6 20.4 19.9
Geographic region
Northeast. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.2 10.9 13.5 12.2 11.3 11.9 11.8 12.4 11.5 11.2
Midwest. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.3 10.7 13.2 12.3 12.4 12.6 12.4 14.1 13.6 13.1
South . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17.7 19.7 20.9 20.5 19.8 20.2 19.9 21.9 20.3 19.9
West . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18.2 18.8 20.6 20.7 19.9 19.1 18.9 20.6 19.0 18.9
Location of residence 9
Within MSA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13.6 15.2 16.9 16.6 16.0 16.4 16.2 17.8 16.4 16.2
Outside MSA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.6 17.0 19.8 18.6 18.7 17.4 17.2 20.4 19.9 19.3
1
Data prior to 1997 are not strictly comparable with data for later years due to the 1997 questionnaire redesign. See Appendix I, National Health Interview Survey (NHIS) and
2
Estimates for 2000–2002 were calculated using 2000-based sample weights and may differ from estimates in other reports that used 1990-based sample weights for
2000–2002 estimates.
3
Beginning in quarter 3 of the 2004 NHIS, persons under age 65 with no reported coverage were asked explicitly about Medicaid coverage. Estimates were calculated without
and with the additional information from this question in the columns labeled 2004(1) and 2004(2), respectively, and estimates were calculated with the additional information
4
Includes all other races not shown separately, those with unknown marital status, unknown disability status, and, in 1984 and 1989, persons with unknown poverty level.
5
Includes persons aged 14–64.
6
The race groups, white, black, American Indian or Alaska Native, Asian, Native Hawaiian or Other Pacific Islander, and 2 or more races, include persons of Hispanic and
non-Hispanic origin. Persons of Hispanic origin may be of any race. Starting with 1999 data, race-specific estimates are tabulated according to the 1997 Revisions to the
Standards for the Classification of Federal Data on Race and Ethnicity and are not strictly comparable with estimates for earlier years. The five single-race categories plus
multiple-race categories shown in the table conform to the 1997 Standards. Starting with 1999 data, race-specific estimates are for persons who reported only one racial group;
the category 2 or more races includes persons who reported more than one racial group. Prior to 1999, data were tabulated according to the 1977 Standards with four racial
groups, and the Asian only category included Native Hawaiian or Other Pacific Islander. Estimates for single-race categories prior to 1999 included persons who reported one
race or, if they reported more than one race, identified one race as best representing their race. Starting with 2003 data, race responses of other race and unspecified multiple
race were treated as missing, and then race was imputed if these were the only race responses. Almost all persons with a race response of other race were of Hispanic origin.
7
Percent of poverty level is based on family income and family size and composition using U.S. Census Bureau poverty thresholds. Poverty level was unknown for 10%–11%
of persons under age 65 in 1984 and 1989. Missing family income data were imputed for 1995 and beyond. See Appendix II, Family income; Poverty; Table VI.
8
Any basic actions difficulty or complex activity limitation is defined as having one or more of the following limitations or difficulties: movement difficulty, emotional difficulty,
sensory (seeing or hearing) difficulty, cognitive difficulty, self-care (activities of daily living or instrumental activities of daily living) limitation, social limitation, or work limitation.
For more information, see Appendix II, Basic actions difficulty; Complex activity limitation. Starting with 2007 data, the hearing question, a component of the basic actions
difficulty measure, was revised. Consequently, data prior to 2007 are not comparable with data for 2007 and beyond. For more information on the impact of the revised hearing
9
MSA is metropolitan statistical area. Starting with 2006 data, MSA status is determined using 2000 census data and the 2000 standards for defining MSAs. For data prior to
2006, see Appendix II, Metropolitan statistical area (MSA) for the applicable standards.
NOTES: In 1997, the National Health Interview Survey questionnaire was redesigned. See Appendix I, National Health Interview Survey (NHIS). Persons not covered
by private insurance, Medicaid, Children’s Health Insurance Program (CHIP), public assistance (through 1996), state-sponsored or other government-sponsored health
plans (starting in 1997), Medicare, or military plans are considered to have no health insurance coverage. Persons with only Indian Health Service coverage are
considered to have no health insurance coverage. Health insurance coverage is at the time of interview. The number of persons with no health insurance coverage was
calculated by multiplying the percentage with no coverage by the number of persons under age 65 in the civilian noninstitutionalized U.S. population, which was
determined from the post-stratification Census control total for each survey year. Percentages of persons without coverage were calculated with unknown values
excluded from denominators. See Appendix II, Children’s Health Insurance Program (CHIP); Health insurance coverage; Medicaid. Standard errors are available in the
spreadsheet version of this table. Available from: http://www.cdc.gov/nchs/hus.htm. Data for additional years are available. See the Excel spreadsheet on the Health,
United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: CDC/NCHS, National Health Interview Survey, health insurance supplements (1984, 1989, 1994–1996). Starting with 1997, data are from the family core and
the sample adult questionnaires. See Appendix I, National Health Interview Survey (NHIS).
Characteristic 1992 1995 2000 2011 2012 1992 1995 2000 2011 2012
Percent distribution
65 years and over . . . . . . . . . . . 3.9 8.9 19.3 28.4 29.1 9.4 9.6 9.0 8.6 8.5
65–74 years. . . . . . . . . . . . . . 4.2 9.5 20.6 28.5 29.1 7.9 8.8 8.5 7.8 7.6
75–84 years. . . . . . . . . . . . . . 3.7 8.3 18.5 30.0 30.1 10.6 9.6 8.9 9.4 9.2
85 years and over . . . . . . . . . * 7.3 16.3 24.4 26.3 16.6 13.6 11.2 10.3 10.3
Sex
Male. . . . . . . . . . . . . . . . . . . . . 4.6 9.2 19.3 27.9 28.9 6.3 6.2 6.3 5.7 5.6
Female . . . . . . . . . . . . . . . . . . . 3.4 8.6 19.3 28.8 29.2 11.6 12.0 10.9 10.9 10.7
Marital status
Married. . . . . . . . . . . . . . . . . . . 4.6 9.5 18.7 28.4 28.6 4.0 4.3 4.3 3.9 3.9
Widowed . . . . . . . . . . . . . . . . . 2.3 7.7 19.4 26.6 28.6 14.9 15.0 13.6 13.3 13.8
Divorced . . . . . . . . . . . . . . . . . . * 9.7 24.4 32.9 32.4 23.4 24.5 20.2 16.8 15.7
Never married . . . . . . . . . . . . . . * * 15.8 25.5 27.4 19.2 19.0 17.0 17.7 14.5
Characteristic 1992 1995 2000 2011 2012 1992 1995 2000 2011 2012
Percent distribution
65 years and over . . . . . . . . . . . 42.8 38.6 35.2 28.8 28.1 33.9 32.5 25.0 19.8 18.9
65–74 years. . . . . . . . . . . . . . 46.9 41.1 36.6 30.6 29.8 31.4 29.9 21.7 18.4 17.5
75–84 years. . . . . . . . . . . . . . 38.2 37.1 35.0 26.7 25.9 37.5 35.2 27.8 20.0 20.2
85 years and over . . . . . . . . . 31.6 30.2 29.4 26.1 26.1 38.3 37.6 31.1 25.3 22.1
Sex
Male. . . . . . . . . . . . . . . . . . . . . 46.3 42.1 37.7 31.1 30.2 30.6 30.0 23.4 18.8 17.2
Female . . . . . . . . . . . . . . . . . . . 40.4 36.0 33.4 27.0 26.4 36.2 34.4 26.2 20.6 20.3
Marital status
Married. . . . . . . . . . . . . . . . . . . 49.9 44.6 41.0 34.2 32.9 33.0 32.6 25.6 20.5 20.1
Widowed . . . . . . . . . . . . . . . . . 34.1 30.3 28.7 23.6 22.6 37.5 35.2 26.7 21.1 19.9
Divorced . . . . . . . . . . . . . . . . . . 27.3 26.6 22.4 17.8 19.7 27.9 24.1 16.9 14.6 13.0
Never married . . . . . . . . . . . . . . 38.0 35.1 28.5 23.5 24.3 29.1 26.2 21.9 18.2 16.7
Percent distribution
65 years and over . . . . . . . . . . . 9.9 10.5 11.5 14.4 15.5
65–74 years. . . . . . . . . . . . . . 9.7 10.7 12.6 14.7 16.0
75–84 years. . . . . . . . . . . . . . 10.1 9.9 9.9 14.0 14.6
85 years and over . . . . . . . . . 10.8 11.3 12.1 14.0 15.1
Sex
Male. . . . . . . . . . . . . . . . . . . . . 12.2 12.6 13.3 16.5 18.0
Female . . . . . . . . . . . . . . . . . . . 8.3 8.9 10.2 12.8 13.4
Marital status
Married. . . . . . . . . . . . . . . . . . . 8.5 9.0 10.5 13.0 14.6
Widowed . . . . . . . . . . . . . . . . . 11.2 11.9 11.6 15.5 15.1
Divorced . . . . . . . . . . . . . . . . . . 15.7 15.1 16.1 17.9 19.3
Never married . . . . . . . . . . . . . . * 13.1 16.8 15.1 17.2
1
Enrollee has Medicare Risk Health Maintenance Organization (HMO) regardless of other insurance. See Appendix II, Managed care.
2
Enrolled in Medicaid and not enrolled in a Medicare Risk HMO. See Appendix II, Managed care.
3
Percent of poverty level is based on family income and family size and composition using U.S. Census Bureau poverty thresholds. See Appendix II, Family income;
Poverty.
4
Private insurance plans purchased through employers (own, current, or former employer, family business, union, or former employer or union of spouse) and not
5
Supplemental insurance purchased privately or through organizations such as American Association of Retired Persons or professional organizations, and not enrolled
6
Medicare fee-for-service only or other public plans (except Medicaid).
NOTES: Data for noninstitutionalized Medicare beneficiaries. Insurance categories are mutually exclusive. Persons with more than one type of coverage are
categorized according to the order in which the health insurance categories appear in the table. See Appendix I, Medicare Current Beneficiary Survey (MCBS). Data for
additional years are available. See the Excel spreadsheet on the Health, United States website at: http://www.cdc.gov/nchs/hus.htm.
SOURCE: Centers for Medicare & Medicaid Services, Medicare Current Beneficiary Survey, Access to Care file. See Appendix I, Medicare Current Beneficiary Survey
(MCBS).
1
Preliminary estimates.
2
Average number enrolled in the hospital insurance (HI) and/or supplementary medical insurance (SMI) programs for the period. See Appendix II, Medicare.
3
Starting with 2004 data, the SMI trust fund consists of two separate accounts: Part B (which pays for a portion of the costs of physicians’ services, outpatient hospital
services, and other related medical and health services for voluntarily enrolled individuals) and Part D (Medicare Prescription Drug Account, which pays private plans to
4
The Medicare Modernization Act, enacted December 8, 2003, established within SMI two Part D accounts related to prescription drug benefits: the Medicare
Prescription Drug Account and the Transitional Assistance Account. The Medicare Prescription Drug Account is used in conjunction with the broad, voluntary
prescription drug benefits that began in 2006. The Transitional Assistance Account was used to provide transitional assistance benefits, beginning in 2004 and
extending through 2005, for certain low-income beneficiaries prior to the start of the new prescription drug benefit. The amounts shown for Total Part D
expenditures—and thus for total SMI expenditures and total Medicare expenditures—for 2006 and later years include estimated amounts for premiums paid directly
5
Medicare-approved managed care organizations. See Appendix II, Managed care.
6
Includes Community-Based Care Transitions Program ($0.1 billion in each of 2011, 2012, and 2013), Electronic Health Records Incentive Program ($0.7 billion in 2011,
$2.7 billion in 2012, and $3.4 billion in 2013), and Sequestration per the Budget Control Act of 2011 (–$3.5 billion in 2013).
7
For 1998 to 2003 data, reflects annual home health HI to SMI transfer amounts.
8
When a beneficiary chooses a Medicare Advantage plan whose monthly premium exceeds the benchmark amount, the additional premiums (that is, amounts beyond
those paid by Medicare to the plan) are the responsibility of the beneficiary. Beneficiaries subject to such premiums may choose to either reimburse the plans directly or
have the additional premiums deducted from their Social Security checks. The amounts shown here are only those additional premiums deducted from Social Security
checks. These amounts are transferred to the HI trust and SMI trust funds and then transferred from the trust funds to the plans.
9
Represents misallocation of benefit payments between the HI trust fund and the Part B account of the SMI trust fund from May 2005 to September 2007, and the
10
Includes expenditures for research, experiments and demonstration projects, peer review activity (performed by Peer Review Organizations from 1983 to 2001 and by
Quality Review Organizations from 2002 to present), and to combat and prevent fraud and abuse.
11
Type-of-service reporting categories for fee-for-service reimbursement differ before and after 1991.
12
Includes payment for physicians, practitioners, durable medical equipment, and all suppliers other than independent laboratory through 1990. Starting with 1991 data,
physician services subject to the physician fee schedule are shown. Payments for laboratory services paid under the laboratory fee schedule and performed in a
physician office are included under Laboratory beginning in 1991. Payments for durable medical equipment are shown separately beginning in 1991. The remaining
13
Includes payments for hospital outpatient department services, skilled nursing facility outpatient services, Part B services received as an inpatient in a hospital or
skilled nursing facility setting, and other types of outpatient facilities. Starting with 1991 data, payments for hospital outpatient department services, except for laboratory
services, are listed under Hospital. Hospital outpatient laboratory services are included in the Laboratory line.
14
Starting with 1991 data, those independent laboratory services that were paid under the laboratory fee schedule (most of the independent laboratory category) are
included in the Laboratory line; the remaining services are included in the Physician fee schedule and Other lines.
15
Payments for laboratory services paid under the laboratory fee schedule performed in a physician office, independent laboratory, or in a hospital outpatient
department.
16
Includes payments for physician-administered drugs; freestanding ambulatory surgical center facility services; ambulance services; supplies; freestanding end-stage
renal disease (ESRD) dialysis facility services; rural health clinics; outpatient rehabilitation facilities; psychiatric hospitals; and federally qualified health centers.
17
Includes the hospital facility costs for Medicare Part B services that are predominantly in the outpatient department, with the exception of hospital outpatient
laboratory services, which are included on the Laboratory line. Physician reimbursement is included on the Physician fee schedule line.
18
Part D start-up costs were funded through the SMI Part B account in 2004–2008.
NOTES: Estimates are subject to change as more recent data become available. Totals may not equal the sum of the components because of rounding. Estimates are
for Medicare-covered services furnished to Medicare enrollees residing in the United States, Puerto Rico, Virgin Islands, Guam, other outlying areas, foreign countries,
and unknown residence. Estimates in this table have been revised and differ from previous editions of Health, United States.
SOURCE: Centers for Medicare & Medicaid Services (CMS), Office of the Actuary, Medicare and Medicaid Cost Estimates Group. Estimates are based on unpublished
data from CMS, the Office of the Actuary, and Treasury Department financial statements.
Black or
All White African American Hispanic or Latino
Characteristic 1992 2010 2011 1992 2010 2011 1992 2010 2011 1992 2010 2011
Living arrangement 6
All living arrangements . . . . . . . . 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0
Alone . . . . . . . . . . . . . . . . . . 27.0 29.1 28.8 27.5 30.1 29.5 27.7 31.1 32.4 20.2 23.1 22.0
With spouse. . . . . . . . . . . . . . 51.2 48.7 48.6 53.3 51.0 51.0 33.3 30.8 29.6 50.4 48.4 48.0
With children . . . . . . . . . . . . . 9.1 10.2 10.3 7.7 8.2 7.9 16.8 17.9 20.4 16.6 14.8 17.4
With others . . . . . . . . . . . . . . 7.6 7.9 8.7 6.2 6.5 7.7 18.1 16.4 14.3 10.8 11.0 10.3
Long-term care facility. . . . . . . 5.1 4.1 3.6 5.3 4.3 3.9 4.0 3.8 3.2 *2.0 *2.6 *2.3
Black or
All White African American Hispanic or Latino
Characteristic 1992 2010 2011 1992 2010 2011 1992 2010 2011 1992 2010 2011
* Estimates are based on 50 persons or fewer or have a relative standard error of 30% or higher and are considered unreliable.
1
Physician/supplier services include medical and osteopathic doctor and health practitioner visits, diagnostic laboratory and radiology services, medical and surgical
2
Total health care expenditures by Medicare beneficiaries, including expenses paid by Medicare and all other sources of payment for the following services: inpatient
hospital, outpatient hospital, physician/supplier, dental, prescription medicine, home health, and hospice and long-term care facility care. Excluded are health insurance
premiums.
3
Expenditures for long-term care in facilities for all beneficiaries include facility room and board expenses for beneficiaries who resided in a facility for the full year, for
beneficiaries who resided in a facility for part of the year and in the community for part of the year, and expenditures for short-term facility stays for full-year or part-year
4
Expenditures for facility-based long-term care for facility-based beneficiaries include facility room and board expenses for beneficiaries who resided in a facility for the
full year and for beneficiaries who resided in a facility for part of the year and in the community for part of the year. Excluded are expenditures for short-term facility
stays for full-year community residents. See Appendix II, Long-term care facility.
5
Medicare beneficiaries with end-stage renal disease (ESRD) are included within the subgroups Aged and Disabled. In 2011, less than 1% of Medicare beneficiaries
6
In 2011, less than 1% of Medicare beneficiaries had an unknown living arrangement.
7
IADL is instrumental activities of daily living; ADL is activities of daily living. Includes data for both community and long-term care facility residents. See Appendix II,
NOTES: Percentages and percent distributions are calculated using unrounded numbers. Expenditures include expenses for Medicare beneficiaries paid by Medicare
and all other sources of payment. Estimates include individuals enrolled in the hospital insurance (HI) and/or supplementary medical insurance (SMI) programs at any
time during the calendar year.
SOURCE: Centers for Medicare & Medicaid Services, Medicare Current Beneficiary Survey, Cost and Use file, Health and Health Care of the Medicare Population.
Available from: http://www.cms.hhs.gov/mcbs and unpublished data. See Appendix I, Medicare Current Beneficiary Survey (MCBS).
Percent distribution
Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0
Basis of eligibility:
Aged (65 years and over) . . . . . . . . . . . . . . . 27.7 26.4 23.1 23.1 20.7 20.6 19.7 19.4 18.2
Blind and disabled . . . . . . . . . . . . . . . . . . . . 42.9 43.2 43.3 43.4 43.3 43.5 43.4 43.4 42.4
Adults in families with dependent children 2 . . . 10.3 10.6 12.0 11.8 12.4 12.7 13.9 14.2 14.8
Children under age 213. . . . . . . . . . . . . . . . . 15.7 15.9 17.2 17.2 19.4 19.2 19.6 19.8 19.6
Other Title XIX 4 . . . . . . . . . . . . . . . . . . . . . . 3.4 3.9 4.5 4.6 4.2 4.0 3.3 3.1 5.0
Race and Hispanic origin: 5
White . . . . . . . . . . . . . . . . . . . . . . . . . . . . . -- -- 53.4 53.0 50.7 50.2 50.0 50.2 48.7
Black or African American . . . . . . . . . . . . . . . -- -- 19.8 19.8 20.8 20.6 20.7 20.5 20.6
American Indian or Alaska Native . . . . . . . . . -- -- 1.2 1.2 1.2 1.3 1.2 1.3 1.2
Asian or Pacific Islander . . . . . . . . . . . . . . . . -- -- 2.5 2.7 2.8 2.9 3.1 3.0 3.2
Asian. . . . . . . . . . . . . . . . . . . . . . . . . . . . -- -- 1.7 1.9 2.0 2.1 2.3 2.3 2.4
Pacific Islander . . . . . . . . . . . . . . . . . . . . . -- -- 0.8 0.8 0.8 0.8 0.8 0.7 0.8
Hispanic or Latino . . . . . . . . . . . . . . . . . . . . -- -- 10.7 12.2 13.1 13.7 14.2 14.2 14.2
Multiple race or unknown . . . . . . . . . . . . . . . -- -- 12.3 11.1 11.4 11.4 10.8 10.8 12.1
1
Beneficiaries include those who received services through Medicaid.
2
Includes adults who meet the requirements for the Aid to Families with Dependent Children (AFDC) program that were in effect in their state on July 16, 1996, or, at
state option, more liberal criteria (with some exceptions). Includes adults in the Temporary Assistance for Needy Families (TANF) program. Starting with 2001 data,
includes women in the Breast and Cervical Cancer Prevention and Treatment Program and unemployed adults. For more information on the eligibility requirements, see
3
Includes children (including those in the foster care system) in the TANF program. For more information on the eligibility requirements, see Appendix II, Medicaid.
4
Includes some participants in the Supplemental Security Income program and other people deemed medically needy in participating states. Prior to 2001, includes
unemployed adults. Excludes foster care children and includes unknown eligibility.
5
Race and Hispanic origin are as determined on initial Medicaid application. Categories are mutually exclusive. Starting with 2001 data, the Hispanic category included
Hispanic persons, regardless of race. Persons indicating more than one race were included in the multiple race category.
6
Medicaid payments exclude disproportionate share hospital (DSH) payments ($14.3 billion in FY2011) and DSH mental health facility payments ($2.9 billion in
NOTES: Data are for fiscal year ending September 30. See Appendix II, Medicaid; Medicaid payments. For more information, see: http://www.medicaid.gov. Maine had
SOURCE: Centers for Medicare & Medicaid Services, Center for Medicaid and State Operations, Medicaid Statistical Information System (MSIS). MSIS data for 2011
were accessed December 22, 2014. See Appendix I, Medicaid Statistical Information System (MSIS).
Type of service 1999 2000 2004 2005 2007 2008 2009 2010 2011
Percent distribution
Total . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0
Inpatient hospital . . . . . . . . . . . . . . . . . 14.5 14.4 13.5 12.8 13.4 12.5 11.8 9.9 10.1
Mental health facility . . . . . . . . . . . . . . 1.1 1.1 0.9 0.8 0.9 0.8 0.8 0.7 0.7
Intermediate care facility for the mentally
retarded . . . . . . . . . . . . . . . . . . . . . . 6.1 5.6 4.3 4.3 4.3 4.2 3.9 3.7 3.6
Nursing facility . . . . . . . . . . . . . . . . . . 21.7 20.5 16.3 16.3 16.8 16.1 14.9 14.4 13.2
Physician . . . . . . . . . . . . . . . . . . . . . . 4.3 4.0 4.0 4.1 3.6 3.5 3.5 3.5 3.3
Dental . . . . . . . . . . . . . . . . . . . . . . . . 0.8 0.8 1.1 1.1 1.2 1.3 1.4 1.6 1.6
Other practitioner . . . . . . . . . . . . . . . . 0.3 0.4 0.4 0.4 0.3 0.3 0.3 0.3 0.5
Outpatient hospital . . . . . . . . . . . . . . . 4.0 4.2 4.0 3.6 3.7 3.7 3.7 3.8 3.6
Clinic . . . . . . . . . . . . . . . . . . . . . . . . . 3.8 3.7 3.2 3.2 3.1 3.1 3.1 3.2 3.4
Laboratory and radiological . . . . . . . . . 0.8 0.8 1.0 1.1 1.1 1.0 1.0 1.0 1.0
Home health . . . . . . . . . . . . . . . . . . . . 1.9 1.9 1.8 2.0 2.3 2.2 2.2 2.1 2.0
Prescribed drugs . . . . . . . . . . . . . . . . . 10.8 11.9 15.3 15.6 8.0 7.9 7.8 8.0 8.1
Capitated care . . . . . . . . . . . . . . . . . . 14.0 14.5 16.5 16.9 21.2 23.0 25.5 27.2 29.8
Primary care case management . . . . . . 0.3 0.1 0.2 0.1 0.1 0.1 0.1 0.1 0.1
Personal support . . . . . . . . . . . . . . . . . 6.9 6.9 7.2 7.5 8.4 8.3 8.0 7.7 6.9
Other care 2 . . . . . . . . . . . . . . . . . . . . 8.6 8.8 10.3 10.2 11.6 12.0 11.9 12.7 12.3
2
Unknown services (0.2% of beneficiaries and 0.9% of payments in 2011) are included with Other care.
3
Medicaid payments exclude disproportionate share hospital (DSH) payments ($14.3 billion in FY2011) and DSH mental health facility payments ($2.9 billion in
NOTES: Data are for fiscal year ending September 30. See Appendix II, Medicaid; Medicaid payments. Beneficiaries receiving more than one type of service are
included in each category. For more information, see: http://www.medicaid.gov. Maine had not reported 2011 data as of the date accessed.
SOURCE: Centers for Medicare & Medicaid Services, Center for Medicaid and State Operations, Medicaid Statistical Information System (MSIS). MSIS data for 2011
were accessed December 22, 2014. See Appendix I, Medicaid Statistical Information System (MSIS).
[Data are compiled from patient records, enrollment information, and budgetary data by the Department of Veterans Affairs]
Type of expenditure and use 2000 2005 1 2007 1 2008 1 2009 1 2010 1 20111 2012 1 2013 1
care than inpatient hospital. Also in FY2005, the responsibility for residential rehabilitation programs including domiciliary care was reassigned from extended care to
2
Health care expenditures exclude construction, medical administration, and miscellaneous operating expenses at Department of Veterans Affairs headquarters.
3
Includes miscellaneous benefits and services, contract hospitals, education and training, subsidies to state veterans hospitals, nursing homes and residential
rehabilitation treatment programs (formerly domiciliaries), and the Civilian Health and Medical Program of the Department of Veterans Affairs.
4
Discharges from medicine, surgery, psychiatry, rehabilitation medicine, spinal cord, and neurology units. Starting with FY2005 data, includes domiciliary care. Does not
5
Until FY2004, includes Department of Veterans Affairs nursing home and residential rehabilitation treatment programs (formerly domiciliary) stays, and community
6
Hospital outpatient care. Includes the following services: physicians, laboratory tests, home-based primary care, or outpatient fee-basis care.
7
Includes state nursing home veteran patients.
8
Individuals receiving services. Individuals with multiple discharges or visits are only counted once in the inpatient or outpatient category. The inpatient and outpatient
totals are not additive because most inpatients are also treated as outpatients.
9
Includes veterans who are receiving aid and attendance or housebound benefit and veterans who have been determined by the Department of Veterans Affairs to be
catastrophically disabled.
10
Includes veterans who receive medical care subject to copayments according to income level, based on financial means testing.
11
Includes expenditures for services for veterans who were prisoners of war, exposed to Agent Orange, and other. Veterans reporting Agent Orange exposure but not
treated for it were means tested and placed in the low income or other group depending on income.
NOTES: Some veterans have multiple sources of health coverage, including Medicare or private insurance. Estimates in this table relate only to health care use paid
for by the Veteran’s Administration. At the end of FY2013, the veteran population was estimated at 22.0 million, with 45% aged 65 and over. Of all living veterans, 6%
had served during World War II, 9% during the Korean conflict, 33% during the Vietnam era, 30% during the Persian Gulf War (service from August 2, 1990 to present),
and 25% during peacetime. Percentages sum to more than 100% because some veterans serve during more than one war. See Appendix I, Department of Veterans
Affairs National Enrollment and Patient Databases. Data for additional years are available. See the Excel spreadsheet on the Health, United States website at:
http://www.cdc.gov/nchs/hus.htm.
SOURCE: Department of Veterans Affairs (VA), Office of the Assistant Deputy Under Secretary for Health, National Patient Care Database, National Enrollment
Database, budgetary data, and unpublished data. Veteran population estimates were provided by the VA’s Office of the Actuary. See Appendix I, Department of
Average
Percent of payment per
Enrollment, enrollees in fee-for-service Discharges per Average length
in thousands 1 managed care 2 enrollee 1,000 enrollees 3 of stay, in days 3
State 1994 2013 1994 2013 1994 2013 1994 2013 1994 2013
United States 4 . . . . . . . . . . . . . 36,190 51,274 7.9 28.0 $4,375 $9,329 345 292 7.5 5.4
Alabama . . . . . . . . . . . . . . . . 633 922 0.8 22.9 4,454 8,457 413 322 7.0 5.5
Alaska. . . . . . . . . . . . . . . . . . 33 76 0.6 0.9 3,687 7,861 269 190 6.3 5.6
Arizona . . . . . . . . . . . . . . . . . 578 1,051 24.8 37.3 4,442 8,681 292 246 5.9 4.7
Arkansas . . . . . . . . . . . . . . . . 416 572 0.2 18.6 3,719 8,029 366 296 7.0 5.2
California . . . . . . . . . . . . . . . . 3,582 5,294 30.0 37.5 5,219 9,807 366 251 6.1 5.3
Colorado . . . . . . . . . . . . . . . . 413 722 17.2 35.1 3,935 7,837 302 226 6.0 4.8
Connecticut . . . . . . . . . . . . . . 497 608 2.6 23.3 4,426 10,061 287 302 8.1 5.9
Delaware . . . . . . . . . . . . . . . . 99 168 0.2 7.2 4,712 9,494 326 286 8.1 5.4
District of Columbia . . . . . . . . 80 84 3.9 10.7 5,655 10,358 376 344 10.1 6.1
Florida. . . . . . . . . . . . . . . . . . 2,584 3,757 13.8 36.0 5,027 10,743 326 325 7.1 5.3
Georgia . . . . . . . . . . . . . . . . . 819 1,411 0.4 26.5 4,402 8,658 378 286 6.9 5.4
Hawaii. . . . . . . . . . . . . . . . . . 146 230 29.8 46.0 3,069 6,355 301 169 9.1 6.4
Idaho . . . . . . . . . . . . . . . . . . 146 261 2.5 30.5 3,045 7,504 274 186 5.2 4.6
Illinois . . . . . . . . . . . . . . . . . . 1,605 1,982 5.5 11.2 4,324 9,587 374 322 7.3 5.1
Indiana . . . . . . . . . . . . . . . . . 805 1,094 2.6 21.4 3,945 9,154 345 305 6.9 5.2
Iowa . . . . . . . . . . . . . . . . . . . 470 549 3.1 14.2 3,080 7,936 322 241 6.6 5.1
Kansas . . . . . . . . . . . . . . . . . 378 465 3.3 13.0 3,847 8,430 348 264 6.5 5.0
Kentucky . . . . . . . . . . . . . . . . 578 826 2.3 23.3 3,862 8,584 396 328 7.2 5.1
Louisiana. . . . . . . . . . . . . . . . 572 751 0.4 26.4 5,468 10,137 399 316 7.2 5.5
Maine . . . . . . . . . . . . . . . . . . 198 291 0.1 18.1 3,464 7,805 322 225 7.6 5.1
Maryland . . . . . . . . . . . . . . . . 596 876 1.4 8.7 4,997 10,767 362 316 7.5 5.3
Massachusetts . . . . . . . . . . . . 924 1,158 6.1 18.5 5,147 10,047 350 296 7.6 5.3
Michigan . . . . . . . . . . . . . . . . 1,331 1,805 0.7 27.5 4,307 10,077 328 340 7.6 5.2
Minnesota . . . . . . . . . . . . . . . 625 862 19.6 49.6 3,394 11,271 334 381 5.7 4.8
Mississippi . . . . . . . . . . . . . . . 391 537 0.1 12.7 4,189 9,537 423 328 7.4 5.7
Missouri. . . . . . . . . . . . . . . . . 821 1,086 3.4 24.8 4,191 8,659 349 309 7.3 5.1
Montana . . . . . . . . . . . . . . . . 128 188 0.4 15.7 3,114 7,047 306 194 5.9 4.8
Nebraska. . . . . . . . . . . . . . . . 247 298 2.2 12.4 2,926 8,381 281 241 6.3 4.9
Nevada . . . . . . . . . . . . . . . . . 187 414 19.0 31.4 4,306 9,568 291 254 7.0 5.7
New Hampshire . . . . . . . . . . . 152 250 0.2 6.3 3,414 8,208 281 220 7.6 5.3
New Jersey . . . . . . . . . . . . . . 1,158 1,430 2.6 16.2 4,531 10,417 354 306 10.2 5.8
New Mexico. . . . . . . . . . . . . . 205 349 13.6 29.3 3,110 7,409 301 221 6.0 4.9
New York. . . . . . . . . . . . . . . . 2,601 3,211 6.2 34.0 4,855 10,150 334 309 11.2 6.7
North Carolina . . . . . . . . . . . . 1,001 1,663 0.5 20.6 3,465 8,495 314 285 8.0 5.3
North Dakota . . . . . . . . . . . . . 101 114 0.6 13.9 3,218 8,424 327 244 6.3 5.3
Ohio . . . . . . . . . . . . . . . . . . . 1,649 2,055 2.4 37.4 3,982 9,595 350 340 7.1 5.0
Oklahoma . . . . . . . . . . . . . . . 481 650 2.5 16.3 4,098 8,750 355 305 7.0 5.2
Oregon . . . . . . . . . . . . . . . . . 469 700 27.7 42.0 3,285 7,040 305 193 5.2 4.7
Pennsylvania . . . . . . . . . . . . . 2,053 2,437 3.3 39.2 5,212 9,349 379 321 8.0 5.5
Rhode Island . . . . . . . . . . . . . 166 196 7.0 35.1 4,148 8,868 312 282 8.1 5.5
South Carolina . . . . . . . . . . . . 497 875 0.1 20.4 3,777 8,501 319 275 8.3 5.5
South Dakota . . . . . . . . . . . . . 114 147 0.1 14.8 2,952 8,016 356 256 6.1 5.0
Tennessee . . . . . . . . . . . . . . . 754 1,170 0.3 30.1 4,441 8,675 375 313 7.1 5.3
Texas . . . . . . . . . . . . . . . . . . 2,029 3,388 4.1 27.2 4,703 10,294 333 295 7.2 5.3
Utah . . . . . . . . . . . . . . . . . . . 182 320 9.4 33.3 3,443 7,740 238 217 5.4 4.3
Vermont . . . . . . . . . . . . . . . . 82 124 0.1 7.4 3,182 7,880 283 184 7.6 5.5
Virginia . . . . . . . . . . . . . . . . . 803 1,269 1.5 15.3 3,748 8,026 348 288 7.3 5.2
Washington . . . . . . . . . . . . . . 676 1,100 12.5 28.8 3,401 7,579 269 220 5.3 4.8
West Virginia . . . . . . . . . . . . . 326 404 8.3 24.7 3,798 8,554 420 327 7.1 5.4
Wisconsin . . . . . . . . . . . . . . . 752 994 2.0 33.7 3,246 8,241 310 263 6.8 4.9
Wyoming . . . . . . . . . . . . . . . . 58 89 3.3 4.1 3,537 7,705 315 210 5.6 4.8
1
Total persons enrolled in the hospital insurance (Part A) program, supplementary medical insurance (Part B) program, or both, as of July 1. Includes fee-for-service
2
Includes enrollees in Medicare managed care plans. See Appendix II, Managed care.
3
Data are for fee-for-service enrollees only.
4
Includes residents of any of the 50 states and the District of Columbia.
NOTES: In 1994, 92% of Medicare enrollees were in fee-for-service; in 2013, 72% of enrollees were in fee-for-service. See Appendix II, Medicare; Fee-for-service
health insurance. Prior to 2004, enrollment and percentage of enrollees in managed care were based on a 5% annual Denominator File derived from the Centers for
Medicare & Medicaid Services’ (CMS) Enrollment Database. Starting with 2004 data, the enrollee counts were pulled from the 100% Denominator File. Payments per
fee-for-service enrollee are based on fee-for-service billing reimbursement for a 5% sample of Medicare beneficiaries as recorded in CMS’ National Claims History File.
Prior to 2011, short-stay hospital utilization is based on the Medicare Provider Analysis and Review (MedPAR) stay records for a 20% sample of Medicare beneficiaries.
Beginning in 2011, short-stay hospital utilization is based on the MedPAR stay records for 100% of Medicare beneficiaries. Estimates may not sum to totals because of
rounding. State based on residence of the beneficiary. Data for additional years are available. See the Excel spreadsheet on the Health, United States website at:
http://www.cdc.gov/nchs/hus.htm.
SOURCE: Centers for Medicare & Medicaid Services; Office of Research, Development, and Information. Health Care Financing Review: Medicare and Medicaid
Statistical Supplements for publication years 1996 to 2010; Center for Strategic Planning. Medicare & Medicaid Research Review: Medicare and Medicaid Statistical
Supplement for publication year 2011; Office of Information Products and Data Analytics. Medicare and Medicaid Statistical Supplements for publication years 2012 and
State 2000 2010 2011 2000 2010 2011 2000 2010 2011
1
Beneficiaries include those who received services through Medicaid.
2
Medicaid managed care enrollment data include individuals in state health care reform programs that expand eligibility beyond traditional Medicaid eligibility standards.
The managed care enrollment data include enrollees receiving comprehensive and limited benefits. Managed care enrollment as of June 30 of year shown. Starting
with 2001 data, U.S. total excludes Puerto Rico and Virgin Islands. Managed care enrollment data may change year to year due to a variety of factors, including
changes in waiver programs, outreach efforts, and data reporting practices. For more information, see: http://www.medicaid.gov.
3
Medicaid payments exclude disproportionate share hospital (DSH) payments ($14.3 billion in FY2011) and DSH mental health facility payments ($2.9 billion in
4
In 2010, Idaho implemented a new Medicaid management information system. This system assigned new identification numbers to enrollees and redesigned Idaho’s
Medicaid Statistical Information System. These changes may have affected Idaho’s Medicaid data. Therefore, trends of data for Idaho should be interpreted with caution.
NOTES: See Appendix II, Medicaid; Medicaid payments. Maine had not reported 2011 data as of the date accessed.
SOURCE: Centers for Medicare & Medicaid Services, Center for Medicaid and State Operations, Medicaid Statistical Information System (MSIS). MSIS data for 2011
were accessed December 22, 2014. Managed care enrollment data from Medicaid managed care enrollment report as of July 1, 2011. Available from:
http://www.cms.gov/Research-Statistics-Data-and-Systems/Computer-Data-and-Systems/MedicaidDataSourcesGenInfo/MdManCrEnrllRep.html. See Appendix I,
Medicaid Statistical Information System (MSIS).
* Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error of 20%–30%. Data not shown have a relative standard error greater
than 30%.
1
Excludes data for Puerto Rico.
2
Data for Puerto Rico are collected in the Puerto Rico Community Survey. Data are not collected for the other territories.
NOTES: Health insurance estimates are shown for the civilian noninstitutionalized population. Data for 2009 use Census 2000 population controls, and data for 2010
and beyond use Census 2010 population controls. Questions on health insurance coverage ask about current coverage as of the day of American Community Survey
(ACS) interview. Persons were considered uninsured if they were not covered by private health insurance, Medicare, Medicaid, Medical Assistance, TRICARE or other
military health care, veteran’s coverage through the Veteran’s Administration, or other government coverage. People with Indian Health Service coverage only are
considered uninsured by ACS. Standard errors for selected years are available in the spreadsheet version of this table. Available from:
http://www.cdc.gov/nchs/hus.htm. Standard errors were computed with replicate weights using 80 balanced repeated replicate weights (BRR) with a Fay-modified BRR
adjustment factor of 0.5.
SOURCE: U.S. Census Bureau, American Community Survey, public-use microdata sample. See Appendix I, American Community Survey (ACS).
Appendix Contents
(NAMCS) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 366
Survey of Hospitals . . . . . . . . . . . . . . . . . . . . . . . . 391
(NHANES). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 368
American Osteopathic Association (AOA) . . . . . . . 391
(NHAMCS) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 372
Association of Schools & Programs of Public
(MEPS).
(NNDSS) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 377
Acquired immunodeficiency syndrome (AIDS) . . . 394
(NSDUH). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 378
Admission . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 394
rates.
Birthweight . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 398
Gross domestic product (GDP) . . . . . . . . . . . . . . . . 412
Cholesterol . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 400
Appendix II, Health expenditures, national.
Contraception . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 406
Human immunodeficiency virus (HIV) disease. . . . 420
related rates.
International Classification of Diseases (ICD).
related rates.
Incidence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 421
Diabetes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 407
Health maintenance organization (HMO).
Diagnosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 408
Industry of employment . . . . . . . . . . . . . . . . . . . . . 421
Discharge . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 408
Injury-related visit . . . . . . . . . . . . . . . . . . . . . . . . . . 422
Drug . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 408
Inpatient day—See Appendix II, Days of care.
Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 409
Insurance—See Appendix II, Health insurance
visit. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 409
home.
leisure-time.
Clinical Modification/Procedure Coding System
related rates.
Limitation of activity . . . . . . . . . . . . . . . . . . . . . . . . 425
Gestation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 412
Medicaid. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 428
Rate. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 442
specialty.
Registration area . . . . . . . . . . . . . . . . . . . . . . . . . . . 443
Medicare. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 429
Relative standard error (RSE) . . . . . . . . . . . . . . . . . . 443
Outpatient visit.
Vaccination. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 445
Physician. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 434
population and proportion distribution, by age, for
Population . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 434
Table III. Revision of the International Classification of
Poverty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 435
Table IV. Cause-of-death codes, by applicable revision of
Prevalence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 435
Table V. Comparability of selected causes of death
specialty.
Classification of Diseases (ICD) . . . . . . . . . . . . . . . . . . . . . 405
expenditures, national.
National Health Interview Survey, by selected
Procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 435
characteristics: United States, 1990–2013 . . . . . . . . . . . 412
Health, United States consolidates the most current data on categories. For example, cigarette use is measured by the
the health of the population of the United States, the National Health Interview Survey, the National Survey on
availability and use of health care resources, and health care Drug Use & Health, the Monitoring the Future Study, and the
expenditures. Information was obtained from the data files Youth Risk Behavior Survey. These surveys use slightly
and published reports of many federal government, private, different questions, cover persons of differing ages, and
and global agencies and organizations. In each case, the interview in diverse settings (e.g., at school compared with
sponsoring agency or organization collected data using its at home), so estimates may differ.
own methods and procedures. Therefore, data in this report
Overall estimates generally have relatively small sampling
may vary considerably with respect to source, method of
errors, but estimates for certain population subgroups may
collection, definitions, and reference period.
be based on a small sample size and have relatively large
Although a detailed description and comprehensive sampling errors. Numbers of births and deaths from the
evaluation of each data source are beyond the scope of this National Vital Statistics System represent complete counts
appendix, readers should be aware of the general strengths (except for births in those states where data are based on a
and weaknesses of the different data collection systems 50% sample for certain years). Therefore, these data are not
shown in Health, United States. For example, population- subject to sampling error. However, when the figures are
based surveys are able to collect socioeconomic data and used for analytical purposes, such as the comparison of rates
information on the impact of an illness, such as limitation of over a period, the number of events that actually occurred
activity. These data are limited by the amount of information may be considered as one of a large series of possible results
a respondent remembers or is willing to report. For example, that could have arisen under the same circumstances. When
a respondent may not know detailed medical information, the number of events is small and the probability of such an
such as a precise diagnosis or the type of medical procedure event is rare, estimates may be unstable, and considerable
performed, and therefore cannot report that information. In caution must be used in interpreting the statistics. Estimates
contrast, records-based surveys, which collect data from that are unreliable because of large sampling errors or small
physician and hospital records, usually contain good numbers of events are noted with asterisks in tables, and the
diagnostic information but little or no information about the criteria used to determine unreliable estimates are indicated
socioeconomic characteristics of individuals or the impact of in an accompanying footnote.
illnesses on individuals.
In this appendix, government data sources are listed
Different data collection systems may cover different alphabetically by data set name, and private and global
populations, and understanding these differences is critical sources are listed separately. To the extent possible,
to interpreting the resulting data. Data on vital statistics and government data systems are described using a standard
national expenditures cover the entire population. However, format. The Overview is a brief, general statement about the
most data on morbidity cover only the civilian purpose or objectives of the data system. The Coverage
noninstitutionalized population and thus may not include section describes the population or events that the data
data for military personnel, who are usually young; for system covers: for example, residents of the United States,
institutionalized people, including the prison population, the noninstitutionalized population, persons in specific
who may be of any age; or for nursing home residents, who population groups, or other entities that are included in the
are usually older. survey or data system. The Methodology section presents a
short description of the methods used to collect the data.
All data collection systems are subject to error, and records
The Sample Size and Response Rate section provides these
may be incomplete or contain inaccurate information.
statistics for surveys. The Issues Affecting Interpretation
Respondents may not remember essential information, a
section describes major changes in the data collection
question may not mean the same thing to different
methodology or other factors that must be considered
respondents, and some institutions or individuals may not
when analyzing trends shown in Health, United States: for
respond at all. It is not always possible to measure the
example, a major survey redesign that may introduce a
magnitude of these errors or their effect on the data. Where
discontinuity in the trend. For additional information about
possible, table notes describe the universe and method of
the methodology, data files, and history of a data source,
data collection, to assist users in evaluating data quality.
consult the References and For More Information sections
Some information is collected in more than one survey, and that follow each summary.
estimates of the same statistic may vary among surveys
because of different survey methodologies, sampling
frames, questionnaires, definitions, and tabulation
O'Hara B, Medalia C. CPS and ACS health insurance Issues Affecting Interpretation. The numbers of fatal
estimates: Consistent trends from 2009–2012. SEHSD occupational injuries are revised once after the initial
working paper 2014–29. Washington, DC: U.S. Census preliminary release. States have up to 8 months to update
Bureau, Social, Economic, and Housing Statistics Division; their initial published counts and may identify additional
2014. Available from: http://www.census.gov/hhes/ fatal work injuries after data collection has closed for a
www/hlthins/data/incpovhlth/2013/CPS_ACS_ reference year. Fatal work injuries initially excluded from the
Trends.pdf. published count because of insufficient information to
determine work relationship may subsequently be verified
For More Information. See the ACS website at: as work-related and included in the revised counts. Increases
http://www.census.gov/acs/www/. in the published counts over the last 5 years based on
Coverage. NCS provides information for the nation for the Compensation cost levels in state and local government
nine census divisions and for 152 selected areas (combined should not be directly compared with levels in private
statistical areas, metropolitan statistical areas, micropolitan industry. Differences between these sectors stem from
statistical areas, and county clusters). NCS includes both full- factors such as variation in work activities and occupational
and part-time workers who are paid a wage or salary and structures.
includes data for the civilian economy, including both
private industry and state and local government. It excludes References
agriculture, private household workers, the self-employed, Bureau of Labor Statistics. Employer costs for employee
and the federal government. compensation—March 2014 [press release USDL–14–
1075]. Washington, DC: U.S. Department of Labor;
rate for the NIS landline sample was 62.3% and 30.5% for the
mm6236a1.htm.
The CASRO response rate for the 2013 NIS-Teen landline Smith PJ, Hoaglin DC, Battaglia MP, et al. Statistical
sample was 51.1% and 23.3% for the cellular telephone methodology of the National Immunization Survey,
sample. Of the 10,148 age-eligible adolescents with 1994–2002. NCHS. Vital Health Stat 2005;2(138).
completed household interviews from the landline sample, Available from: http://www.cdc.gov/nchs/data/series/
6,039 (59.5%) had adequate provider data. From the cellular sr_02/sr02_138.pdf.
telephone sample, 12,225 (54.5%) of the 22,448 eligible
CDC. Announcement: Addition of households with only
adolescents with completed household interviews had
cellular telephone service to the National Immunization
adequate provider data.
Survey, 2011. Available from: http://www.cdc.gov/
Issues Affecting Interpretation. For data years 1998, 2002, mmwr/preview/mmwrhtml/mm6134a5.htm?s_cid=
2004, and 2005, slight modifications to the estimation mm6134a5_e%0d%0a.
procedure were implemented to obtain vaccination
CDC. Changes in measurement of Haemophilus
coverage rates from the provider data. Published estimates
influenzae serotype b (Hib) vaccination
of vaccination coverage based on NIS data for years prior to
coverage—National Immunization Survey, United States,
1998 (e.g., estimates published in Morbidity and Mortality
2009. MMWR 2010;59(33):1069–72. Available from:
Weekly Report [MMWR] articles) may differ slightly from
http://www.cdc.gov/mmwr/preview/mmwrhtml/
website for the same data. All released public-use data files
Coverage. Source data for NIPA domestic estimates cover all U.S. Bureau of Economic Analysis. A guide to the National
50 states and D.C. The U.S. national income and product Income and Product Accounts of the United States.
statistics were first presented as part of a complete and Washington, DC: BEA; 2006. Available from: http://
consistent double-entry accounting system in the summer www.bea.gov/national/pdf/nipaguid.pdf.
of 1947.
For More Information. See the BEA (NIPA) website at:
Methodology. NIPA estimates are revised on a quarterly, http://www.bea.gov/national/index.htm.
annual, and quinquennial basis. For GDP and most other
NIPA series, a set of three current quarterly estimates is National Medical Expenditure Survey
released each year. Quarterly estimates provide the first look
at the path of U.S. economic activity. Annual revisions of (NMES)—See Appendix I, Medical
NIPA are usually carried out each summer. These revisions Expenditure Panel Survey (MEPS).
incorporate source data that are based on more extensive
annual surveys, on annual data from other sources, and on
later revisions to the monthly and quarterly source data, and
they generally cover the three previous calendar years.
sr02_124.pdf.
Methodology. The data collection method is in-person
interviews conducted with a sample of individuals at their
Groves RM, Benson G, Mosher WD, et al. Plan and place of residence. Computer-assisted interviewing (CAI)
operation of cycle 6 of the National Survey of Family methods, including audio computer-assisted self
Overview. Vital statistics natality data are a fundamental For More Information. See the Birth Data website at:
source of demographic, geographic, and medical and health http://www.cdc.gov/nchs/births.htm, and Vitalstats at:
information on all births occurring in the United States. This http://www.cdc.gov/nchs/data_access/Vitalstatsonline.htm.
is one of the few sources of comparable health-related data
for small geographic areas over an extended time period. Fetal Death Data Set
The data are used to present the characteristics of babies
and their mothers, track trends such as birth rates for Overview. Fetal mortality refers to the intrauterine death of a
teenagers, and compare natality trends with those in other fetus at any gestational age. In Health, United States, data are
countries. presented for fetal deaths at 20 weeks or more. The Fetal
Death data set includes characteristics of the fetus, such as
The Birth file includes characteristics of the baby, such as sex, birthweight, and weeks of gestation; demographic
sex, birthweight, and weeks of gestation; demographic information about the mother, such as age, race, Hispanic
information about the parents, such as age, race, Hispanic origin, live-birth order, and marital status; and medical and
origin, parity, educational attainment, marital status, and health information, such as maternal diabetes and
state of residence; medical and health information, such as hypertension.
Coverage. To be included in the U.S. linked file, both the birth NCHS. Public use data file documentation: 2012 period
and death must have occurred in the 50 states, D.C., Puerto Linked Birth/Infant Death data set. Hyattsville, MD:
Rico, Virgin Islands, or Guam. Data for Puerto Rico, Virgin NCHS; 2014. Available from: ftp://ftp.cdc.gov/pub/
Islands, and Guam are shown in selected state tables but are Health_Statistics/NCHS/Dataset_Documentation/DVS/
not included in U.S. totals. Linked birth/infant death data are periodlinked/LinkPE12Guide.pdf.
not available for American Samoa and Northern Marianas. Mathews TJ, MacDorman MF. Infant mortality statistics
Methodology. Infant deaths are defined as a death before the from the 2010 period Linked Birth/Infant Death data set.
infant's first birthday. About 98%–99% of infant death National vital statistics report; vol 62 no 8. Hyattsville,
records can be linked to their corresponding birth MD: NCHS; 2013. Available from: http://www.cdc.gov/
certificates. The linkage makes available extensive nchs/data/nvsr/nvsr62/nvsr62_08.pdf.
information from the birth certificate about the pregnancy,
For More Information. See the NCHS Linked Birth and Infant
maternal risk factors, infant characteristics, and health items
Death Data website at: http://www.cdc.gov/nchs/
at birth that can be used for more detailed analyses of infant
linked.htm.
mortality. The linked file is used for calculating infant
mortality rates by race and ethnicity, which are more
accurately measured from the birth certificate. Compressed Mortality File (CMF)
Starting with 1995 data, linked birth/infant death data files Overview. The CMF is a county-level national mortality and
are available in two different formats: period data and birth population database. It contains mortality data derived from
cohort data. The numerator for the period linked file consists the detailed Mortality multiple cause-of-death files of NVSS
of all infant deaths occurring in a given data year linked to and estimates of U.S. national, state, and county resident
their corresponding birth certificates, whether the birth populations from the U.S. Census Bureau. For 1968–1998,
occurred in that year or the previous year. The numerator for the number of deaths, crude death rates, and age-adjusted
the birth cohort linked file consists of deaths to infants born death rates can be obtained by place of residence (total U.S.,
in a given year. In both cases, the denominator is all births state, and county), age group, race (white, black, and other),
occurring in the year. For example, the 2012 period linked sex, year of death, and underlying cause of death. For
file contains a numerator file that consists of all infant deaths 1999–2013, mortality statistics can be obtained by place of
occurring in 2012 that have been linked to their residence, age group, expanded race groups (white, black,
corresponding birth certificates, whether the birth occurred American Indian or Alaska Native, Asian or Pacific Islander),
in 2011 or 2012. In contrast, the 2012 birth cohort linked file Hispanic origin, sex, and year of death.
References Reference
Cowles CM, ed. Nursing home statistical yearbooks for CDC. Sexually transmitted disease surveillance 2012.
2003–2013. Anacortes, WA: CRG; published 2004–2014, Atlanta, GA: CDC; 2014. Available from:
respectively. http://www.cdc.gov/std/stats12/default.htm.
Centers for Medicare & Medicaid Services. Certification
For More Information. See the STD Data and Statistics
and compliance. Baltimore, MD: CMS; 2005. Available
website at: http://www.cdc.gov/std/stats and the STD
from: http://www.cms.gov/CertificationandComplianc/
Diseases & Related Conditions website at:
01_Overview.asp.
http://www.cdc.gov/std/default.htm.
For More Information. See the CMS website at: http://
www.cms.hhs.gov/NonIdentifiableDataFiles and the CRG
website at: http://www.longtermcareinfo.com/index.html.
American Hospital Association (AHA) American Medical Association, Division of Survey and
Data Resources. Physician characteristics and
Annual Survey of Hospitals distribution in the U.S., 2012. Chicago, IL: AMA; 2014.
Data from AHA's annual survey are based on questionnaires For More Information. See the AMA website at:
sent to all AHA-registered and nonregistered hospitals in the http://www.ama-assn.org.
United States and its associated areas: American Samoa,
Guam, the Marshall Islands, Puerto Rico, and the Virgin
Islands. U.S. government hospitals located outside the American Osteopathic Association (AOA)
United States are excluded. Overall, the average response
rate over the past 5 years has been approximately 83%. For AOA was established to promote the public health, to
nonreporting hospitals and for the survey questionnaires of encourage scientific research, and to maintain and improve
reporting hospitals on which some information was missing, high standards of medical education in osteopathic colleges.
estimates are made for all data except those on beds, Among its activities, AOA compiles the number of
bassinets, facilities, and services. Data for beds and bassinets osteopathic physicians (DOs); the number of active DOs by
of nonreporting hospitals are based on the most recent gender, age, and specialty and by 50 states and D.C.; and the
information available from those hospitals. Data for facilities number of osteopathic medical students by selected
and services are based only on reporting hospitals. characteristics.
Estimates of other types of missing data are based on data
reported the previous year, if available. When unavailable, Reference
estimates are based on data furnished by reporting hospitals American Osteopathic Association. Osteopathic medical
similar in size, control, major service provided, length of stay, profession report, 2010. Chicago, IL: AOA; 2012. Available
and geographic and demographic characteristics. from: http://www.osteopathic.org/inside-aoa/about/
who-we-are/Documents/Osteopathic-Medical
Reference Profession-Report-2010.pdf.
American Hospital Association. Hospital statistics, 2014.
For More Information. See the AOA website at:
Chicago, IL: AHA; 2014.
http://www.osteopathic.org.
For More Information. See the AHA website at:
http://www.aha.org. Association of American Medical Colleges
(AAMC)
American Medical Association (AMA)
Physician Masterfile As part of its mission to serve and lead the academic
medicine community to improve the health of all, AAMC
A master file of physicians has been maintained by AMA collects information on student enrollment in medical
since 1906. The Physician Masterfile contains data on all schools through a variety of sources. Among the data
physicians in the United States, both members and services and sources offered are the Medical College
nonmembers of AMA, and on those graduates of American Admission Test (MCAT), the American Medical College
medical schools temporarily practicing overseas. The file also Application Service (AMCAS), the Electronic Residency
includes information on international medical graduates Application Service (ERAS), the online portfolio Pivio, and
(IMGs) who are graduates of foreign medical schools, who the Student Records System. The AAMC Data Warehouse
reside in the United States, and who meet U.S. educational (DW) stores data relevant to both applicants and students,
standards for primary recognition as physicians. and from these two source files the association derives
summary statistics about applicants, accepted applicants,
A file is initiated on each individual upon entry into medical matriculants, enrollees, and graduates. AAMC has developed
school or, in the case of IMGs, upon entry into the United policies and procedures to ensure that the privacy of
States. Between 1969 and 1985, a mail questionnaire survey individual and institutional data are protected and meet
This appendix contains an alphabetical listing of terms used Activities of daily living (ADL)—ADLs are activities related
in Health, United States, and these definitions are specific to to personal care and include bathing or showering, dressing,
the data presented in this report. The methods used for getting into or out of bed or a chair, using the toilet, and
calculating age-adjusted rates, average annual rates of eating. In the National Health Interview Survey, respondents
change, relative standard errors, birth rates, death rates, and were asked whether they or family members aged 3 and
years of potential life lost are described. Included are over need the help of another person with personal care
standard populations used for age adjustment (Tables I and because of a physical, mental, or emotional problem.
II), the years when the revisions for International
In the Medicare Current Beneficiary Survey, if a sample
Classification of Diseases (ICD) codes were in effect (Table III),
person had any difficulty performing an activity by him- or
codes for cause of death from the 6th through 10th revisions
herself and without special equipment, or did not perform
of ICD (Table IV), and comparability ratios between the 9th
the activity at all because of health problems, the person
and 10th revisions (ICD–9 and ICD–10) for selected causes
was categorized as having a limitation in that activity. The
(Table V), imputed family income percentages from the
limitation may have been temporary or chronic at the time
National Health Interview Survey (NHIS) (Table VI), an
of interview. Sampled people who were administered a
analysis of the effect of added probe questions for Medicare
community interview answered questions about health
and Medicaid coverage on health insurance rates in NHIS
status and functioning themselves, if able to do so. If the
(Table VII), industry codes from the North American Industry
sample person was not able to respond, a proxy person
Classification System (NAICS) (Table VIII), and ICD–9 Clinical
answered the questions. For persons in a long-term care
Modification (ICD–9–CM) codes for external causes of injury,
facility, a proxy such as a nurse answered questions about
diagnostic, and procedure categories (Tables IX–XII).
the sample person's health status and functioning. Starting
Standards for presenting federal data on race and ethnicity
in 1997, interview questions for people residing in long-term
are described, and sample tabulations of NHIS data
care facilities were changed slightly from those administered
comparing the 1977 and 1997 Office of Management and
to people living in the community, in order to differentiate
Budget standards for the classification of federal data on
residents who were independent from those who received
race and ethnicity are presented in Tables XIII and XIV.
supervision or assistance with transferring, locomotion on
Acquired immunodeficiency syndrome (AIDS)—Human unit, dressing, eating, toilet use, and bathing. (Also see
immunodeficiency virus (HIV) is the pathogen that causes Appendix II, Complex activity limitation; Instrumental
AIDS, and HIV disease is the term that encompasses all of the activities of daily living [IADL]; Limitation of activity.)
condition's stages—from infection to the deterioration of
Admission—The American Hospital Association defines
the immune system and the onset of opportunistic diseases.
admissions as persons, excluding newborns, accepted for
However, AIDS is still the term most people use to refer to
inpatient services during the survey reporting period. (Also
the immune deficiency caused by HIV. An AIDS diagnosis
see Appendix II, Days of care; Discharge; Inpatient.)
indicates that the person has reached the late stages of the
disease and is given to people with HIV who have been Age—Age is reported as age at last birthday (i.e., age in
diagnosed with at least one of a set of opportunistic completed years), often calculated by subtracting the date
diseases or whose laboratory values indicate advanced of birth from the reference date, with the reference date
disease. All 50 states, the District of Columbia (D.C.), and six being the date of the examination, interview, or other
U.S. dependent areas (American Samoa, Guam, Northern contact with an individual.
Mariana Islands, Puerto Rico, Republic of Palau, and U.S.
Virgin Islands) report confirmed diagnoses of HIV infection Mother's (maternal) age is reported on the birth certificate
and AIDS cases to CDC using a uniform surveillance case by all states. Birth statistics are presented for mothers aged
definition and case report form. The case reporting 10–49 through 1996 and aged 10–54 starting in 1997, based
definitions have changed over time to incorporate a broader on mother's date of birth or age as reported on the birth
range of AIDS-indicator diseases and conditions and use HIV certificate. The age of the mother is edited for upper and
diagnostic tests to improve the sensitivity and specificity of lower limits. When the age of the mother is computed to be
the definition. Because of these case definition changes, under 10 or 55 and over (50 and over in 1964–1996), it is
caution should be used when interpreting AIDS trends. (Also considered not stated and is imputed according to the age
see Appendix II, Human immunodeficiency virus [HIV] of the mother from the previous birth record of the same
disease.) race and total birth order (total of fetal deaths and live
births). Before 1963, not-stated ages were distributed in
Active physician—See Appendix II, Physician. proportion to the known ages for each racial group.
394 Appendix II. Definitions and Methods Health, United States, 2014
Table I. United States projected year 2000 standard Table I. United States projected year 2000 standard
population and age groups used to age-adjust data population and age groups used to age-adjust data—Con.
Data system and age Population Data system and age Population
Under 75 years. . . . . . . . . . . . . . . . . . . . . . .
258,059,676 35–44 years. . . . . . . . . . . . . . . . . . . . . . . . 44,659,185
Under 1 year. . . . . . . . . . . . . . . . . . . . . . .
3,794,901 45–54 years. . . . . . . . . . . . . . . . . . . . . . . . 37,030,152
1–4 years . . . . . . . . . . . . . . . . . . . . . . . . .
15,191,619 55–64 years. . . . . . . . . . . . . . . . . . . . . . . . 23,961,506
5–14 years . . . . . . . . . . . . . . . . . . . . . . . .
39,976,619 65 years and over. . . . . . . . . . . . . . . . . . . . 34,709,480
15–24 years . . . . . . . . . . . . . . . . . . . . . . .
38,076,743
25–34 years . . . . . . . . . . . . . . . . . . . . . . .
37,233,437 NHANES (Tables 42 and 59)
35–44 years . . . . . . . . . . . . . . . . . . . . . . .
44,659,185 20–44 years . . . . . . . . . . . . . . . . . . . . . . . . . 100,149,847
45–54 years . . . . . . . . . . . . . . . . . . . . . . .
37,030,152 45–64 years . . . . . . . . . . . . . . . . . . . . . . . . . 60,991,658
55–64 years . . . . . . . . . . . . . . . . . . . . . . .
23,961,506 65 years and over . . . . . . . . . . . . . . . . . . . . . 34,709,480
65–74 years . . . . . . . . . . . . . . . . . . . . . . .
18,135,514
75–84 years . . . . . . . . . . . . . . . . . . . . . . . . .
12,314,793 NHANES (Table 62)
85 years and over. . . . . . . . . . . . . . . . . . . . .
4,259,173 20–44 years . . . . . . . . . . . . . . . . . . . . . . . . . 100,149,847
Under 75 years. . . . . . . . . . . . . . . . . . . . . . .
258,059,676 75 years and over . . . . . . . . . . . . . . . . . . . . . 16,573,966
Under 1 year. . . . . . . . . . . . . . . . . . . . . . .
3,794,901
1–14 years . . . . . . . . . . . . . . . . . . . . . . . .
55,168,238 NHANES (Table 85)
15–24 years . . . . . . . . . . . . . . . . . . . . . . .
38,076,743 Under 18 years . . . . . . . . . . . . . . . . . . . . . . . 70,781,454
25–34 years . . . . . . . . . . . . . . . . . . . . . . .
37,233,437 18–44 years . . . . . . . . . . . . . . . . . . . . . . . . . 108,151,050
35–44 years . . . . . . . . . . . . . . . . . . . . . . .
44,659,185 45–64 years . . . . . . . . . . . . . . . . . . . . . . . . . 60,991,658
45–54 years . . . . . . . . . . . . . . . . . . . . . . .
37,030,152 65 years and over . . . . . . . . . . . . . . . . . . . . . 34,709,480
55–64 years . . . . . . . . . . . . . . . . . . . . . . .
23,961,506
65–74 years . . . . . . . . . . . . . . . . . . . . . . .
18,135,514 NOTES: DVS is Division of Vital Statistics.
NHIS, NAMCS, NHAMCS, and NHDS NAMCS is National Ambulatory Medical Care Survey.
All ages . . . . . . . . . . . . . . . . . . . . . . . . . . . .
274,633,642 NHAMCS is National Hospital Ambulatory Medical Care Survey.
Under 18 years . . . . . . . . . . . . . . . . . . . . . . .
70,781,454 http://seer.cancer.gov/stdpopulations.
2–17 years . . . . . . . . . . . . . . . . . . . . . . . .
63,227,991
18–44 years . . . . . . . . . . . . . . . . . . . . . . . . .
108,151,050
18–24 years. . . . . . . . . . . . . . . . . . . . . . . .
26,258,428 Beginning in 1997, the birth rate for the maternal age group
25–34 years. . . . . . . . . . . . . . . . . . . . . . . .
37,233,437
45–49 has included data for mothers aged 50–54 in the
35–44 years. . . . . . . . . . . . . . . . . . . . . . . .
44,659,185
numerator and has been based on the population of women
45–64 years . . . . . . . . . . . . . . . . . . . . . . . . .
60,991,658
45–54 years. . . . . . . . . . . . . . . . . . . . . . . .
37,030,152
aged 45–49 in the denominator. Beginning with 2003 data,
55–64 years. . . . . . . . . . . . . . . . . . . . . . . .
23,961,506 age of mother is imputed for stated ages 8 and under and 65
65–74 years . . . . . . . . . . . . . . . . . . . . . . . . .
18,135,514 and over, for births occurring in states using the 2003
75 years and over . . . . . . . . . . . . . . . . . . . . .
16,573,966 revision of the birth certificate. Starting with 2007 data, age
18–49 years . . . . . . . . . . . . . . . . . . . . . . . . .
127,956,843
of mother is imputed for all births for stated ages 8 and
under and 65 and over, regardless of the birth certificate
40–64 years:
version used. As with data for earlier years, age is imputed
40–49 years. . . . . . . . . . . . . . . . . . . . . . . . 42,285,022
according to the age of mother from the previous record
50–64 years. . . . . . . . . . . . . . . . . . . . . . . . 41,185,865
with the same race and total birth order.
See footnotes at end of table. Age adjustment—Age adjustment is used to compare risks
for two or more populations at one point in time or for one
population at two or more points in time. Age-adjusted rates
are computed by the direct method by applying age-specific
rates in a population of interest to a standardized age
distribution, to eliminate differences in observed rates that
Health, United States, 2014 Appendix II. Definitions and Methods 395
Table II. United States projected year 2000 standard population and proportion distribution, by age, for age-adjusting death
rates prior to 2001
Proportion
distribution Standard
Age Population (weight) million
1
Figure is rounded up instead of down to force total to 1.0.
SOURCE: CDC/NCHS. Anderson RN, Rosenberg HM. Age standardization of death rates: Implementation of the year 2000 standard.
National vital statistics reports; vol 47 no 3. Hyattsville, MD: NCHS; 1998. Available from: http://www.cdc.gov/nchs/data/nvsr/nvsr47/
nvs47_03.pdf.
result from age differences in population composition. mortality ratio for the black to white populations is reduced
Age-adjusted rates should be viewed as relative indexes from 1.6 using the 1940 standard to 1.4 using the 2000
rather than actual measures of risk. standard, reflecting the greater weight the 2000 standard
gives to the older population, in which race differentials in
Age-adjusted rates are calculated by the direct method, as
mortality are smaller.
follows:
Age-adjusted estimates from any data source presented in
n
Health, United States that use the projected year 2000 U.S.
∑ ri × (pi / P) resident population may differ from age-adjusted estimates
i=1
based on the same data presented in other reports if
where different age groups are used in the adjustment procedure.
ri = rate in age group i in the population For more information on implementing the 2000 population
of interest standard for age-adjusting death rates, see: Anderson RN,
pi = standard population in age group i Rosenberg HM. Age standardization of death rates:
n
Implementation of the year 2000 standard. National vital
P = ∑ p i
statistics reports; vol 47 no 3. Hyattsville, MD: NCHS; 1998.
i = 1
Available from: http://www.cdc.gov/nchs/data/nvsr/nvsr47/
n = total number of age groups over the age nvs47_03.pdf. For more information on the derivation of
range of the age-adjusted rate. age-adjustment weights for use with NCHS survey data, see:
Klein RJ, Schoenborn CA. Age adjustment using the 2000
Age adjustment by the direct method requires the use of a projected U.S. population. Healthy People 2010 statistical
standard age distribution. The standard for age-adjusting notes, no 20. Hyattsville, MD: NCHS; 2001. Available from:
death rates and estimates from surveys in Health, United http://www.cdc.gov/nchs/data/statnt/statnt20.pdf. The
States is the projected year 2000 U.S. resident population. projected year 2000 U.S. standard population is available
Starting with Health, United States, 2000, the projected year from the National Cancer Institute's Surveillance,
2000 U.S. standard population replaced the 1970 civilian Epidemiology, and End Results (SEER) Program: http://
noninstitutionalized population for age-adjusting estimates seer.cancer.gov/stdpopulations/stdpop.singleages.html.
from most NCHS surveys; and starting with Health, United
States, 2001, it was used uniformly and replaced the 1940 Mortality data—Death rates are age-adjusted to the
U.S. population for age-adjusting mortality statistics and the projected year 2000 U.S. standard population (Table I).
1980 U.S. resident population, which previously had been Prior to 2001 data, age-adjusted rates were calculated
used for age-adjusting estimates from the National Health using standard million proportions based on rounded
and Nutrition Examination Survey. population numbers (Table II). Starting with 2001 data,
unrounded population numbers are used to age-adjust.
Changing the standard population has implications for racial Adjustment is based on 11 age groups, with two
and ethnic differentials in mortality. For example, the exceptions. First, age-adjusted death rates for black
396 Appendix II. Definitions and Methods Health, United States, 2014
males and black females in 1950 are based on nine age National Health Interview Survey (NHIS)—Starting with
groups, with under 1 and 1–4 combined as one group, the 1997 NHIS, information on alcohol consumption has
and 75–84 and 85 and over combined as one group. been collected in the Sample Adult questionnaire. Adult
Second, age-adjusted rates for years of potential life lost respondents are asked two screening questions about
before age 75 also use the projected year 2000 standard their lifetime alcohol consumption: ‘‘In any 1 year, have
population and are based on eight age groups: under 1, you had at least 12 drinks of any type of alcoholic
1–14, 15–24, and 10-year age groups through 65–74. beverage?’’ and ‘‘In your entire life, have you had at least
12 drinks of any type of alcoholic beverage?’’ Persons
National Health and Nutrition Examination Survey
who report at least 12 drinks in a lifetime are then asked
(NHANES)—Estimates based on the National Health
several questions about alcohol consumption in the past
Examination Survey and NHANES are generally age
year: ‘‘In the past year, how often did you drink any type
adjusted to the projected year 2000 U.S. standard
of alcoholic beverage?’’ and ‘‘In the past year, on those
population by using five age groups: 20–34, 35–44,
days that you drank alcoholic beverages, on the average,
45–54, 55–64, and 65–74 or 65 and over (Table I). Prior to
how many drinks did you have?’’ Adults who had at least
Health, United States, 2001, these estimates were
one drink in the past year were also asked, ‘‘In the past
age-adjusted to the 1980 U.S. resident population.
year, on how many days did you have five or more drinks
National Health Care Surveys—Estimates based on the of any alcoholic beverage?’’
National Hospital Discharge Survey, the National
Levels of alcohol consumption are defined as follows:
Ambulatory Medical Care Survey, and the National
light drinkers, 3 drinks or fewer per week; moderate
Hospital Ambulatory Medical Care Survey are age
drinkers, more than 3 and up to 14 drinks per week for
adjusted to the projected year 2000 U.S. standard
men and more than 3 and up to 7 drinks per week for
population (Table I). Information on the age groups used
women; heavier drinkers, more than 14 drinks per week
in the age-adjustment procedure is contained in the
for men and more than 7 drinks per week for women, on
footnotes to the specific tables.
average.
National Health Interview Survey (NHIS)—Estimates based
National Survey on Drug Use & Health (NSDUH)—Starting
on NHIS are age-adjusted to the projected year 2000 U.S.
in 1999, NSDUH information about the frequency of the
standard population (Table I). Prior to Health, United
consumption of alcoholic beverages in the past 30 days
States, 2000, NHIS estimates were age-adjusted to the
has been obtained for all persons surveyed who are aged
1970 civilian noninstitutionalized population.
12 and over. An extensive list of examples of the kinds of
Information on the age groups used in the age
beverages covered is given to respondents prior to
adjustment procedure is contained in the footnotes to
question administration. A drink is defined as a can or
the specific tables.
bottle of beer, a glass of wine or a wine cooler, a shot of
AIDS—See Appendix II, Acquired immunodeficiency liquor, or a mixed drink with liquor in it. Those times
syndrome (AIDS). when the respondent had only a sip or two from a drink
are not considered consumption. Alcohol use is based on
Alcohol consumption—Alcohol consumption is measured the following questions: ‘‘During the past 30 days, on
differently in the following data systems. (Also see Appendix how many days did you drink one or more drinks of an
II, Binge drinking.) alcoholic beverage?’’, ‘‘On the days that you drank during
the past 30 days, how many drinks did you usually have?’’,
Monitoring the Future (MTF) Study—This school-based and ‘‘During the past 30 days, on how many days did you
survey of secondary school students collects information have five or more drinks on the same occasion?’’
on alcohol use by using self-completed questionnaires.
To determine whether they have tried alcohol in their Any-listed diagnosis—See Appendix II, Diagnosis.
lifetime, students are asked a preliminary alcohol
consumption (defined as beer, wine, liquor, and any Average annual rate of change (percent change)—In
other beverage that contains alcohol) screening Health, United States, average annual rates of change, or
question: ‘‘Have you ever had any alcoholic beverage to growth rates, are calculated as follows:
drink—more than just a few sips?’’ Students who reply in
[(Pn / Po )1/N – 1] × 100
the affirmative are then asked additional questions about
their alcohol consumption over different time frames: where
‘‘On how many occasions (if any) have you had alcohol to Pn = later time period
drink—more than just a few sips... in your lifetime, ...in
Po = earlier time period
the last 12 months, ...in the last 30 days?’’ A subsequent
question asks, ‘‘Think back over the last two weeks. How N = number of years in interval.
many times have you had five or more drinks in a row?’’ A
drink is defined as a bottle of beer, a glass of wine, a shot This geometric rate of change assumes that a variable
glass of liquor, a mixed drink, etc. increases or decreases at the same rate during each year
between the two time periods.
Health, United States, 2014 Appendix II. Definitions and Methods 397
Average length of stay—In the National Hospital Discharge Improvement Evaluation System (QIES) (formerly the Online
Survey, average length of stay is computed by dividing the Survey Certification and Reporting [OSCAR]) database, all
total number of hospital days of care (counting the date of beds in certified facilities are counted on the day of
admission but not the date of discharge) by the number of certification inspection. (Also see Appendix II, Hospital;
patients discharged. The American Hospital Association Occupancy rate.)
computes average length of stay by dividing the number of
inpatient days by the number of admissions. (Also see Binge drinking—Binge drinking is measured in the
Appendix II, Days of care; Discharge; Inpatient.) following data systems. (Also see Appendix II, Alcohol
consumption.)
Basic actions difficulty—Basic actions difficulty captures
Monitoring the Future (MTF) Study—This school-based
limitations or difficulties in movement, emotional, sensory,
survey of secondary school students collects information
or cognitive functioning associated with a health problem.
on alcohol use by using self-completed questionnaires.
Persons with more than one of these difficulties are counted
To determine whether they have tried alcohol, students
only once in the estimates. The full range of functional areas
are asked a preliminary screening question: ‘‘Have you
cannot be assessed on the basis of National Health Interview
ever had any alcoholic beverage to drink—more than
Survey (NHIS) questions; however, the available questions
just a few sips?’’ Students who reply in the affirmative are
can identify difficulty in the following core areas of
then asked additional questions about their alcohol
functioning:
consumption, including one on binge drinking: ‘‘Think
+ Movement (walking, standing, sitting, bending or back over the last two weeks. How many times have you
kneeling, reaching overhead, grasping objects with had five or more drinks in a row?’’ A drink is defined as a
fingers, and lifting). bottle of beer, a glass of wine, a shot glass of liquor, a
+ Selected elements of emotional functioning, in mixed drink, etc. Information on binge drinking is
particular, feelings that interfere with accomplishing obtained for 12th graders (starting in 1975) and for 8th
daily activities. Respondents were classified based on and 10th graders (starting in 1991).
responses to a series of questions that measure National Survey on Drug Use & Health (NSDUH)—In
psychological distress. NSDUH, binge alcohol use is defined as ‘‘Five or more
+ Sensory functioning, based on difficulties seeing or drinks on the same occasion (i.e., at the same time or
hearing. within a couple of hours of each other) at least once in
+ Selected elements in cognitive functioning, specifically the past 30 days.’’ Heavy alcohol use is defined as ‘‘Five or
difficulties with remembering, or experiencing confusion. more drinks on the same occasion (binge drinking) on at
least 5 different days in the past 30 days.’’ (Also see
For many measures of disability, only disabilities resulting Appendix II, Alcohol consumption.)
from an underlying condition that is chronic (based on
nature and duration) are considered. However, whether the Birth cohort—A birth cohort consists of all persons born
underlying conditions related to the core areas of basic within a given period of time, such as a calendar year.
actions difficulty were chronic was not a requirement in
classifying persons. In Health, United States, respondents Birth rate—See Appendix II, Rate: Birth and related rates.
missing responses in a series of questions were classified as
Birthweight—Birthweight is the first weight of the newborn
missing for that component. Respondents reporting that
obtained after birth. Low birthweight is defined as weighing
they ‘‘do not do this activity’’ were classified as missing for
less than 2,500 grams (5 lb 8 oz). Very low birthweight is
that activity. For hearing, respondents reporting that they
defined as weighing less than 1,500 grams (3 lb 4 oz). Prior
were ‘‘deaf’’ or ‘‘had a lot of trouble’’ hearing without the
to 1979, low birthweight was defined as weighing 2,500
use of hearing aids or other listening devices were coded as
grams or less, and very low birthweight as weighing 1,500
having a hearing limitation. For more information on how
grams or less.
this measure was constructed using NHIS data, including the
specific questions asked, see: Altman B, Bernstein A. Blood pressure, high—In Health, United States, a person is
Disability and health in the United States, 2001—2005. considered to have hypertension if they have measured high
Hyattsville, MD: NCHS; 2008. Available from: http:// blood pressure (i.e., average measured systolic blood
www.cdc.gov/nchs/data/misc/disability2001-2005.pdf. pressure of at least 140 mm Hg or diastolic pressure of at
(Also see Appendix II, Complex activity limitation; Hearing least 90 mm Hg) and/or if they report that they are taking a
trouble.) prescription medicine for high blood pressure (respondents
were asked, ‘‘Are you now taking prescribed medicine for
Bed, health facility—The American Hospital Association
your high blood pressure?’’), even if their blood pressure
defines bed count as the number of beds, cribs, and
readings are within the normal range. Uncontrolled high
pediatric bassinets that are set up and staffed for use by
blood pressure is defined as having an average measured
inpatients on the last day of the reporting period. In the
systolic blood pressure of at least 140 mm Hg or diastolic
Center for Medicare & Medicaid Service's Quality
pressure of at least 90 mm Hg, among those with
398 Appendix II. Definitions and Methods Health, United States, 2014
hypertension. Those with uncontrolled high blood pressure calculated from measurements taken at the household
also may be taking prescribed medicine for high blood interview. Both systolic and diastolic measurements were
pressure. These blood pressure standards are consistent with recorded to the nearest even number.
the following: National Heart, Lung, and Blood Institute.
For more information on changes in blood pressure
Seventh report of the Joint National Committee on
measurement in NHANES up to 1991, see: Burt VL, Cutler JA,
Prevention, Detection, Evaluation, and Treatment of High
Higgins M, Horan MJ, Labarthe D, Whelton P, et al. Trends in
Blood Pressure. NIH pub no 04–5230. Bethesda, MD:
the prevalence, awareness, treatment, and control of
National Institutes of Health; 2004. Available from: http://
hypertension in the adult U.S. population: Data from the
www.nhlbi.nih.gov/guidelines/hypertension/jnc7full.pdf;
health examination surveys, 1960 to 1991. Hypertension
and Go AS, Bauman M, King SMC, Fonarow GC, Lawrence W,
1995;26(1):60–9.
Williams KA, et al. AHA/ACC/CDC. An effective approach to
high blood pressure control: A science advisory from the Body mass index (BMI)—BMI is a measure that adjusts
American Heart Association, the American College of body weight for height. It is calculated as weight in
Cardiology, and the Centers for Disease Control and kilograms divided by height in meters squared. Healthy
Prevention. Hypertension 2013. Available from: weight for adults is defined as a BMI of 18.5 to less than 25.0;
http://hyper.ahajournals.org/content/early/2013/11/14/ overweight (including obesity) is greater than or equal to
HYP.0000000000000003.citation. 25.0; and obesity is greater than or equal to 30.0. Within the
Blood pressure data presented in Health, United States are obesity category, Grade 1 obesity is defined as a BMI of 30.0
from the National Health and Nutrition Examination Survey to less than 35.0; Grade 2 is 35.0 to less than 40.0; and Grade
(NHANES). Blood pressure is measured by averaging up to 3 is 40.0 or greater. Prior to assigning a person to a BMI
three blood pressure readings taken for an NHANES category, BMI is rounded to one decimal place. In Health,
participant. Blood pressure readings of 0 mm Hg are United States the NHANES variable, Body Mass Index, is used
assumed to be in error and are not included in the estimates. to assign persons to BMI categories. BMI cut points are
The methods used to measure the blood pressure of defined in the following: U.S. Department of Agriculture and
participants have changed over the different NHANES HHS. Dietary guidelines for Americans, 2010, 7th ed.
survey years. Changes include the following: Washington, DC: U.S. Government Printing Office; 2010.
Available from: http://www.cnpp.usda.gov/DGAs2010
+ Number of blood pressure measurements taken PolicyDocument.htm; National Heart, Lung, and Blood
(increased from one to four). Institute. Clinical guidelines on the identification, evaluation,
+ Equipment maintenance procedures. and treatment of overweight and obesity in adults: The
+ Training of persons taking readings (physician, nurse, or evidence report. NIH pub no 98–4083. Bethesda, MD:
interviewer). National Institutes of Health; 1998. Available from: http://
+ Proportion zero end-digits for systolic and diastolic www.nhlbi.nih.gov/files/docs/guidelines/ob_gdlns.pdf;
readings. Jensen MD, Ryan DH, Apovian CM, Ard JD, Comuzzie AG,
Donato KA, et al. 2013 AHA/ACC/TOS guideline for the
+ Published diastolic definition. management of overweight and obesity in adults: A report
+ Location where the measurements were taken (mobile of the American College of Cardiology/American Heart
examination center [MEC] or home). Association Task Force on Practice Guidelines and the
Obesity Society. Circulation. 2013doi:10.1161/
In 1999 and subsequent years, blood pressure has been 01.cir.0000437739.71477.ee. Available from: http://
measured in the NHANES MEC by one of the MEC physicians. circ.ahajournals.org/content/early/2013/11/11/
For people aged 8 and over, three consecutive blood 01.cir.0000437739.71477.ee.citation; and HHS. Healthy
pressure readings are obtained using the same arm. If a People 2020: Nutrition, physical activity, and obesity; 2012.
blood pressure measurement was interrupted or the Available from: http://www.healthypeople.gov/2020/
measurer was unable to get one or more of the readings, a Leading-Health-Indicators.
fourth attempt may be made. Both systolic and diastolic
measurements are recorded to the nearest even number. Obesity for children and adolescents is defined as a BMI at or
above the sex- and age-specific 95th percentile from the
In NHANES III, three sets of blood pressure measurements 2000 CDC Growth Charts (http://www.cdc.gov/
were taken in the MEC for examinees aged 5 and over. Blood growthcharts/). Starting with Health, United States, 2010, the
pressure measurements were also taken by trained terminology describing excess weight among children
interviewers during the household interview, on sample changed from previous editions. The term obesity now
persons aged 17 and over. Systolic and diastolic average refers to children who were formerly labeled as overweight.
blood pressures were computed as the arithmetic mean of This is a change in terminology only and not a change in
six or fewer measurements obtained at the household measurement. For more information, see: Ogden CL, Flegal
interview (maximum of three) and the MEC examination KM. Changes in terminology for childhood overweight and
(maximum of three). If the examinee did not have blood obesity. National health statistics report; no 25. Hyattsville,
pressure measurements taken in the MEC, this variable was
Health, United States, 2014 Appendix II. Definitions and Methods 399
MD: NCHS; 2010. Available from: http://www.cdc.gov/nchs/ Table III. Revision of the International Classification of
data/nhsr/nhsr025.pdf. Diseases (ICD), by year of conference in which adopted
and years in use in the United States
Cause of death—For the purpose of national mortality
Year of Years in
statistics, every death is attributed to one underlying conference in use in
condition, based on information reported on the death ICD revision which adopted United States
certificate and using the international rules for selecting the
underlying cause of death from the conditions stated on the 1st . . . . . . . . . . . . . . . . . 1900 1900–1909
2nd. . . . . . . . . . . . . . . . . 1909 1910–1920
certificate. The underlying cause is defined by the World
3rd . . . . . . . . . . . . . . . . . 1920 1921–1929
Health Organization (WHO) as ‘‘the disease or injury that
4th . . . . . . . . . . . . . . . . . 1929 1930–1938
initiated the train of events leading directly to death, or the 5th . . . . . . . . . . . . . . . . . 1938 1939–1948
circumstances of the accident or violence that produced the 6th . . . . . . . . . . . . . . . . . 1948 1949–1957
fatal injury.’’ Generally, more medical information is reported 7th . . . . . . . . . . . . . . . . . 1955 1958–1967
on death certificates than is directly reflected in the 8th . . . . . . . . . . . . . . . . . 1965 1968–1978
underlying cause of death. Conditions that are not selected 9th . . . . . . . . . . . . . . . . . 1975 1979–1998
as the underlying cause of death constitute the 10th . . . . . . . . . . . . . . . . 1990 1999–present
nonunderlying causes of death, also known as multiple
SOURCE: CDC/NCHS. Available from: http://www.cdc.gov/nchs/icd.htm.
cause of death.
Cause of death is coded according to the appropriate a rank is skipped. For more information, see: Xu JQ, Murphy
revision of the International Classification of Diseases (ICD) SL, Kochanek KD, et al. Deaths: Final data for 2013. National
(Table III). Effective with deaths occurring in 1999, the United vital statistics reports; vol 64 no 2. Hyattsville, MD: NCHS
States began using the 10th revision of the ICD (ICD–10); [Forthcoming]. Portions available from: http://www.cdc.gov/
during the period 1979–1998, causes of death were coded nchs/data/nvsr/nvsr64/nvsr64_02.pdf. (Also see Appendix II,
and classified according to the 9th revision (ICD–9). Table IV International Classification of Diseases [ICD].)
lists ICD codes for the 6th through 10th revisions for causes
of death shown in Health, United States. Children's Health Insurance Program (CHIP)—Title XXI of
the Social Security Act, often referred to as the Children's
Each ICD revision has produced discontinuities in cause-of
Health Insurance Program (CHIP), is a program originally
death trends. These discontinuities are measured by using
enacted by the Balanced Budget Act of 1997. The Children's
comparability ratios that are essential to the interpretation
Health Insurance Program Reauthorization Act of 2009
of mortality trends. For further discussion, see: http://
(CHIPRA, P.L. 111–3) reauthorized CHIP and appropriated
www.cdc.gov/nchs/nvss/mortality/comparability_icd.htm.
funding for CHIP through FY 2013. The Affordable Care Act
(Also see Appendix II, Comparability ratio; International
of 2010 (ACA, P.L. 111–148) extends CHIP funding through
Classification of Diseases [ICD]; and Appendix I, National Vital
FY 2015. CHIP provides federal funds for states to provide
Statistics System [NVSS]; Multiple Cause-of-Death File.)
health care coverage to eligible low-income, uninsured
Cause-of-death ranking—Selected causes of death of children who do not qualify for Medicaid. Generally CHIP is
public health and medical importance are compiled into only available through age 18. However, a small number of
tabulation lists and are ranked according to the number of adults are covered with CHIP funds under waivers in a few
deaths assigned to these causes. The top-ranking causes states. CHIP gives states broad flexibility in program design
determine the leading causes of death. Certain causes on within a federal framework that includes important
the tabulation lists are not ranked if, for example, the beneficiary protections. Funds from CHIP may be used for a
category title represents a group title (such as ‘‘Major separate child health program or to expand Medicaid.
cardiovascular diseases’’ and ‘‘Symptoms, signs, and Although CHIP is not part of Medicaid, in some instances in
abnormal clinical and laboratory findings, not elsewhere Health, United States, data on CHIP and Medicaid are
classified’’) or the category title begins with the words presented together and those instances are discussed in the
‘‘Other’’ or ‘‘All other.’’ In addition, when one of the titles that footnotes of the respective tables. For more information,
represents a subtotal (such as ‘‘Malignant neoplasms’’) is see: http://www.medicaid.gov/chip/chip-program
ranked, its component parts are not ranked. The tabulation information.html. (Also see Appendix II, Health insurance
lists used for ranking in the 10th revision of the International coverage; Medicaid.)
Classification of Diseases (ICD–10) include the List of 113
Cholesterol—Serum total cholesterol is a combination of
Selected Causes of Death, which replaces the ICD–9 List of
high-density lipoprotein (HDL) cholesterol, low-density
72 Selected Causes, HIV Infection and Alzheimer's Disease;
lipoprotein (LDL) cholesterol, and very low-density
and the ICD–10 List of 130 Selected Causes of Infant Death,
lipoprotein (VLDL) cholesterol and is highly correlated with
which replaces the ICD–9 List of 60 Selected Causes of Infant
LDL cholesterol. High serum total cholesterol is a risk factor
Death and HIV Infection. Causes that are tied receive the
for cardiovascular disease. In its third report on high blood
same rank; the next cause is assigned the rank it would have
cholesterol, the National Cholesterol Education Program
received had the lower-ranked causes not been tied, that is,
Expert Panel on Detection, Evaluation, and Treatment of
400 Appendix II. Definitions and Methods Health, United States, 2014
Table IV. Cause-of-death codes, by applicable revision of the International Classification of Diseases (ICD)
6th and 7th 8th 9th 10th
Cause of death (10th Revision titles) Revisions Revision Revision Revision
Health, United States, 2014 Appendix II. Definitions and Methods 401
Table IV. Cause-of-death codes, by applicable revision of the International Classification of Diseases (ICD)—Con.
6th and 7th 8th 9th 10th
Cause of death (10th Revision titles) Revisions Revision Revision Revision
Occupational diseases:
Angiosarcoma of liver . . . . . . . . . . . . . . . ... ... ... C22.3
Malignant mesothelioma . . . . . . . . . . . . . ... ... 158.8, 158.9, C45
163
Pneumoconiosis . . . . . . . . . . . . . . . . . . ... ... 500–505 J60–J66
Coal workers’ pneumoconiosis . . . . . . . ... ... 500 J60
Asbestosis. . . . . . . . . . . . . . . . . . . . . ... ... 501 J61
Silicosis. . . . . . . . . . . . . . . . . . . . . . . ... ... 502 J62
Other (including unspecified) . . . . . . . . ... ... 503–505 J63–J66
Injuries2 . . . . . . . . . . . . . . . . . . . . . . . . . ... ... E800–E869, *U01–*U03, V01–Y36,
E880–E929, Y85–Y87, Y89
E950–E999
Unintentional injuries3 . . . . . . . . . . . . . . E800–E936, E800–E929, E800–E869, V01–X59, Y85–Y86
E960–E965 E940–E946 E880–E929
Motor vehicle-related injuries3 . . . . . . . E810–E835 E810–E823 E810–E825 V02–V04, V09.0, V09.2,
V12–V14, V19.0–V19.2,
V19.4–V19.6, V20–V79,
V80.3–V80.5, V81.0–
V81.1, V82.0–V82.1,
V83–V86, V87.0–V87.8,
V88.0–V88.8, V89.0,
V89.2
Poisoning . . . . . . . . . . . . . . . . . . . . . E870–E888, E850–E877 E850–E869 X40–X49
E890–E895
Suicide2 . . . . . . . . . . . . . . . . . . . . . . . . E963, E970– E950–E959 E950–E959 *U03, X60–X84, Y87.0
E979
Homicide2 . . . . . . . . . . . . . . . . . . . . . . E964, E980– E960–E969 E960–E969 *U01–*U02, X85–Y09,
E983 Y87.1
Fiream-related injury. . . . . . . . . . . . . . . . ... E922, E955, E922, E955.0– *U01.4, W32–W34,
E965, E970, E955.4, X72–X74, X93–X95,
E985 E965.0–E965.4, Y22–Y24, Y35.0
E970, E985.0–
E985.4
Injury by drug poisoning . . . . . . . . . . . . . ... ... ... X40–X44, X60–X64, X85,
Y10–Y14
Opioid analgesics. . . . . . . . . . . . . . . . . . ... ... ... X40–X44, X60–X64, X85,
Y10–Y14 (underlying
cause) and T40.2–T40.4
(multiple cause)
. . . Cause-of-death codes are not provided for causes not shown in Health, United States.
1
Categories for coding human immunodeficiency virus (HIV) infection were introduced in 1987. The asterisk (*) indicates codes that are not part of
ICD–9.
2
Starting with 2001 data, NCHS introduced categories *U01–*U03 for classifying and coding deaths due to acts of terrorism. The asterisk (*)
indicates codes that are not part of ICD–10. Starting with 2007 data, NCHS introduced the category J09 for coding avian influenza virus. In 2009,
the title for the ICD–10 code J09 was changed from Influenza due to identified avian Influenza virus to Influenza due to certain identified influenza
virus. This change was made to accommodate deaths from influenza A (H1N1) virus in the ICD–10 code J09 for data years 2009 and beyond.
3
In the public health community, the term unintentional injuries is preferred to accidents, and the term motor vehicle-related injuries is preferred to
SOURCE: CDC/NCHS. Advance report: Final mortality statistics, 1974. Monthly vital statistics report; vol 24 no 11 suppl. Hyattsville, MD: NCHS;
Hoyert DL, Kochanek KD, Murphy SL. Deaths: Final data for 1997. National vital statistics reports; vol 47 no 19. Hyattsville, MD: NCHS; 1999.
Hoyert DL, Heron MP, Murphy SL, Kung H-C. Deaths: Final data for 2003. National vital statistics reports; vol 54 no 13. Hyattsville, MD: NCHS;
Murphy SL, Xu JQ, Kochanek KD. Deaths: Final data for 2010. National vital statistics reports; vol 61 no 4. Hyattsville, MD: NCHS; 2013. Available
from:http://www.cdc.gov/nchs/data/nvsr/nvsr61/nvsr61_04.pdf.
Xu JQ, Murphy SL, Kochanek KD, et al. Deaths: Final data for 2013. National vital statistics reports; vol 64 no 2. Hyattsville, MD: NCHS; 2015.
Available from:http://www.cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_02.pdf.
402 Appendix II. Definitions and Methods Health, United States, 2014
High Blood Cholesterol in Adults (Adult Treatment Panel III, measurements are standardized according to the criteria of
or ATP III) continued to classify a serum total cholesterol the CDC—and later the CDC–National Heart, Lung, and
value greater than or equal to 240 mg/dL (6.20 mmol/L) as Blood Institute Cholesterol Standardization Program—to
high and a value of at least 200 mg/dL but less than 240 ensure comparable and accurate measurements. For more
mg/dL as borderline-high. ATP III focused on LDL cholesterol information, see: Myers GL, Cooper GR, Winn CL, Smith SJ.
as the primary target of cholesterol-lowering therapy and The Centers for Disease Control–National Heart, Lung, and
used other cardiovascular disease risk factors (such as Blood Institute Lipid Standardization Program: An approach
cigarette smoking, low HDL cholesterol, hypertension, family to accurate and precise lipid measurements. Clin Lab Med
history, and age) to evaluate an individual's risk for 1989;9(1):105–35. A detailed summary of the procedures
cardiovascular disease. A more recent set of guidelines—the used for measurement of total cholesterol in the earlier
result of a collaboration among the National Heart, Lung, NHANES survey years has been published in: Johnson CL,
and Blood Institute; the American College of Cardiology; and Rifkind BM, Sempos CT, Carroll MD, Bachorik PS, Briefel RR, et
the American Heart Association—focused on which groups al. Declining serum total cholesterol levels among U.S.
of people could benefit from statin use, based on their risk adults: The National Health and Nutrition Examination
factors. Because Health, United States focuses on providing Surveys. JAMA 1993;269(23):3002–8. A description of the
population-level prevalence data rather than individual-level laboratory procedures for the total cholesterol measurement
estimates, three broad indicators of cholesterol are for different NHANES survey years is published by NCHS and
presented. For more information on high cholesterol is available from: http://www.cdc.gov/nchs/nhanes.htm.
guidelines, see: National Cholesterol Education Program
(NCEP). Third report of the NCEP Expert Panel on Detection, Cigarette smoking—Cigarette smoking and related
Evaluation, and Treatment of High Blood Cholesterol in tobacco use are measured in the following data systems.
Adults (Adult Treatment Panel III): Final report. NIH pub no Monitoring the Future (MTF) Study—Information on
02–5215. Bethesda, MD: National Institutes of Health, current cigarette smoking was obtained for 12th graders
National Heart, Lung, and Blood Institute; 2002. Available (starting in 1975) and for 8th and 10th graders (starting
from: http://www.nhlbi.nih.gov/guidelines/cholesterol/ in 1991), based on the following question: ‘‘How
atp3full.pdf; Stone NJ, Robinson JG, Lichtenstein AH, Merz frequently have you smoked cigarettes during the past
CNB, Blum CB, Eckel RH, et al. 2013 ACC/AHA guideline on 30 days?’’
the treatment of blood cholesterol to reduce atherosclerotic
cardiovascular risk in adults: A report of the American National Health Interview Survey (NHIS)—Information
College of Cardiology/American Heart Association Task about cigarette smoking is obtained for adults aged 18
Force on Practice Guidelines. Circulation. 2014;129:S1–45. and over. Starting in 1993, current smokers are identified
Available from: http://circ.ahajournals.org/content/129/ by asking the following two questions: ‘‘Have you
25_suppl_2/S1.full. smoked at least 100 cigarettes in your entire life?’’ and
‘‘Do you now smoke cigarettes every day, some days, or
In Health, United States, three measures of total cholesterol not at all?’’ Persons who smoked 100 cigarettes and who
are presented: hypercholesterolemia, high serum total now smoke every day or some days were defined as
cholesterol, and mean serum total cholesterol. current smokers. Before 1992, current smokers were
Hypercholesterolemia is based on both laboratory testing identified based on positive responses to the following
and self-reported medication use. It is defined as measured two questions: ‘‘Have you smoked 100 cigarettes in your
serum total cholesterol greater than or equal to 240 mg/dL entire life?’’ and ‘‘Do you smoke now?’’ (traditional
or reporting taking cholesterol-lowering medications. definition). In 1992, the definition of current smoker in
Respondents who were told by a doctor or health NHIS was modified to specifically include persons who
professional that their cholesterol was high, and were told smoked on some days (revised definition). In 1992,
by a doctor to take cholesterol-lowering medication and cigarette smoking data were collected for a half-sample,
answered ‘‘yes’’ to the question, ‘‘Are you now following this with one-half the respondents (one-quarter sample)
advice?’’ were classified as taking cholesterol-lowering answering the traditional smoking questions and the
medication. High serum total cholesterol is defined as other one-half of respondents (one-quarter sample)
measured serum total cholesterol greater than or equal to answering the revised smoking question, ‘‘Do you smoke
240 mg/dL (6.20 mmol/L). Both high serum cholesterol and every day, some days, or not at all?’’ An unpublished
mean serum total cholesterol are based on serum samples analysis of the 1992 traditional smoking measure
collected during the National Health and Nutrition revealed that the crude percentage of current smokers
Examination Survey (NHANES) examination. aged 18 and over remained the same as for 1991. The
Venous blood serum samples collected from NHANES estimates for 1992 shown in Health, United States
participants at mobile examination centers were frozen and combine data collected using both the traditional and
shipped on dry ice to the laboratory conducting the lipid revised questions.
analyses. Serum total cholesterol was measured on all In 1993–1995, estimates of cigarette smoking prevalence
examined adults regardless of whether they had fasted, and were based on a half-sample. Smoking data were not
data were analyzed regardless of fasting status. Cholesterol collected in 1996. Starting in 1997, smoking data were
Health, United States, 2014 Appendix II. Definitions and Methods 403
collected in the Sample Adult questionnaire. For more not more than 10 years ago, or over 10 years ago). In 2010
information on survey methodology and sample sizes only, additional questions on the use of virtual or CT
pertaining to NHIS cigarette smoking data, see the colonoscopy were included in the questionnaire, but these
NHIS Adult Tobacco Use Information website at: questions were not used to determine whether respondents
http://www.cdc.gov/nchs/nhis/tobacco.htm. had a colorectal test or procedure.
National Survey on Drug Use & Health (NSDUH)— Colorectal screening tests and procedures may be used
Information on current cigarette smoking is obtained for for diagnostic or screening purposes. Recommendations
all persons surveyed who are aged 12 and over, based on for screening tests and time between screening vary
the following question: ‘‘During the past 30 days, have based on individual risks and the particular colorectal
you smoked part or all of a cigarette?’’ tests. The current recommendation, made by the U.S.
Preventive Services Task Force in 2008, is the use of fecal
Civilian noninstitutionalized population; Civilian occult blood testing, sigmoidoscopy, or colonoscopy in
population—See Appendix II, Population. adults aged 50 to 75. For a summary of current colorectal
screening recommendations, and updated
Colorectal tests or procedures—Colorectal tests or recommendations when available, see the U.S. Preventive
procedures are used to detect polyps, abnormal cell growth, Services Task Force summary of recommendations on
lesions, and other gastrointestinal conditions, including screening for colorectal cancer, available from:
colon cancer. These tests often include home fecal occult http://www.uspreventiveservicestaskforce.org/uspstf/
blood tests, sigmoidoscopy, or colonoscopy. The time uspscolo.htm.
interval varies depending on the test and individual risk
factors. In Health, United States, estimates of colorectal tests are
presented for adults aged 50–75 who had any colorectal test
In the National Health Interview Survey (NHIS), questions or procedure (defined as reporting a home fecal occult
about colorectal tests or procedures were asked of blood test [FOBT] in the past year, a sigmoidoscopy
respondents aged 40 and over on an intermittent schedule, procedure in the past 5 years with FOBT in the past 3 years,
and the questions varied over time. or a colonoscopy in the past 10 years) or a colonoscopy in
In 2000, 2003, 2005, and 2008, respondents were asked, the past 10 years.
‘‘Have you ever had a sigmoidoscopy, colonoscopy, or
proctoscopy?’’ In 2010 and 2013, respondents were asked Community hospital—See Appendix II, Hospital.
two separate questions: ‘‘Have you ever had a
Comparability ratio—About every 10 to 20 years, the
colonoscopy?’’ and ‘‘Have you ever had a sigmoidoscopy?’’
International Classification of Diseases (ICD) is revised to stay
An additional question about colorectal testing, ‘‘Have you
abreast of advances in medical science and changes in
ever had a blood stool test using a home testing kit?’’ was
medical terminology. Each of these revisions produces
asked in all of these survey years.
breaks in the continuity of cause-of-death statistics because
Respondents who replied that they had a colorectal test or of changes in classification and in the rules for selecting an
procedure were asked subsequent questions about the underlying cause of death. Classification and rule changes
month, year, and time since their most recent test or affect cause-of-death trend data by shifting deaths away
procedure. In 2000 and 2003, if respondents did not provide from some cause-of-death categories and into others.
the year of, or the time since, their most recent colorectal Comparability ratios measure the effect of changes in
exam, they were asked about the time frame of their most classification and coding rules. For the causes shown in
recent exam (i.e., whether they had the exam a year ago or Table V, comparability ratios range between 0.6974 and
less, more than 1 year ago but not more than 2 years ago, 1.5812. Influenza and pneumonia had the lowest
more than 2 years ago but not more than 3 years ago, more comparability ratio (0.6974), indicating that this cause is
than 3 years ago but not more than 5 years ago, more than 5 about 30% less likely to be selected as the underlying cause
years ago but not more than 10 years ago, or over 10 years of death under ICD–10 than under ICD–9. Alzheimer's
ago). For adults who provided the year, but not the month, disease had the highest comparability ratio (1.5812),
of their most recent exam, the exam date was coded as indicating that Alzheimer's disease is 58% more likely to be
July 15 of the provided year. selected as the underlying cause when ICD–10 coding is
used.
In 2005, 2008, 2010, and 2013, the questionnaire skip
pattern was modified so that respondents giving an For selected causes of death, the ICD–9 codes used to
incomplete or partial date (missing month or year) of their calculate death rates for 1980–1998 differ from the ICD–9
most recent colorectal exam were asked a follow-up codes most nearly comparable with the corresponding
question about the time since their most recent exam (i.e., ICD–10 cause-of-death category, which also affects the
whether they had the exam a year ago or less, more than 1 ability to compare death rates across ICD revisions.
year ago but not more than 2 years ago, more than 2 years Examples of these causes are Ischemic heart disease;
ago but not more than 3 years ago, more than 3 years ago Cerebrovascular diseases; Trachea, bronchus, and lung
but not more than 5 years ago, more than 5 years ago but cancer; Unintentional injuries; and Homicide. To address this
404 Appendix II. Definitions and Methods Health, United States, 2014
Table V. Comparability of selected causes of death adjust mortality statistics for causes of death classified by
between the 9th and 10th revisions of the International the 9th revision to be comparable with cause-specific
Classification of Diseases (ICD) mortality statistics classified by the 10th revision.
Final The application of comparability ratios to mortality statistics
comparability helps make the analysis of change between 1998 and 1999
1
Cause of death ratio2
more accurate and complete. The 1998 comparability
Human immunodeficiency virus (HIV) modified death rate is calculated by multiplying the
disease . . . . . . . . . . . . . . . . . . . . . . . . . 1.0821 comparability ratio by the 1998 death rate. Comparability
Malignant neoplasms . . . . . . . . . . . . . . . . 1.0093 modified rates should be used to estimate mortality change
Colon, rectum, and anus . . . . . . . . . . . . 0.9988
between 1998 and 1999.
Trachea, bronchus, and lung . . . . . . . . . 0.9844
Breast . . . . . . . . . . . . . . . . . . . . . . . . . 1.0073 Caution should be used when applying the comparability
Prostate . . . . . . . . . . . . . . . . . . . . . . . . 1.0144 ratios presented in Table V to age-, race-, and sex-specific
Diabetes mellitus . . . . . . . . . . . . . . . . . . . 1.0193 mortality data. Demographic subgroups may sometimes
Alzheimer’s disease . . . . . . . . . . . . . . . . . 1.5812 differ with regard to their cause-of-death distribution, and
Diseases of heart. . . . . . . . . . . . . . . . . . . 0.9852
this would result in demographic variation in cause-specific
Ischemic heart diseases . . . . . . . . . . . . 1.0006
comparability ratios.
Essential (primary) hypertension and
hypertensive renal disease . . . . . . . . . . . 1.1162 For more information, see: Anderson RN, Miniño AM,
Cerebrovascular diseases . . . . . . . . . . . . . 1.0502
Hoyert DL, Rosenberg HM. Comparability of cause of death
Influenza and pneumonia . . . . . . . . . . . . . 0.6974
between ICD–9 and ICD–10: Preliminary estimates. National
Chronic lower respiratory diseases . . . . . . 1.0411
Chronic liver disease and cirrhosis. . . . . . . 1.0321
vital statistics reports; vol 49 no 2. Hyattsville, MD: NCHS;
Nephritis, nephrotic syndrome, and 2001, available from: http://www.cdc.gov/nchs/data/nvsr/
nephrosis. . . . . . . . . . . . . . . . . . . . . . . . 1.2555 nvsr49/nvsr49_02.pdf; Kochanek KD, Smith BL, Anderson RN.
Pregnancy, childbirth, and the puerperium. . . 1.1404 Deaths: Preliminary data for 1999. National vital statistics
Unintentional injuries . . . . . . . . . . . . . . . . . 1.0251 reports; vol 49 no 3. Hyattsville, MD: NCHS; 2001, available
Motor vehicle-related injuries . . . . . . . . . . 0.9527 from: http://www.cdc.gov/nchs/data/nvsr/nvsr49/
Poisoning . . . . . . . . . . . . . . . . . . . . . . . 1.0365 nvsr49_03.pdf; Final ratios for 113 selected causes of death,
Suicide . . . . . . . . . . . . . . . . . . . . . . . . . . 1.0022
available from: ftp://ftp.cdc.gov/pub/Health_Statistics/
Homicide . . . . . . . . . . . . . . . . . . . . . . . . . 1.0020
NCHS/Datasets/Comparability/icd9_icd10/; and the ICD
Firearm-related injury. . . . . . . . . . . . . . . . . 1.0012
Chronic and noncommunicable diseases . . . 1.0100
comparability ratio website at: http://www.cdc.gov/nchs/
Injuries . . . . . . . . . . . . . . . . . . . . . . . . . . 1.0159 nvss/mortality/comparability_icd.htm. (Also see Appendix II,
Cause of death; International Classification of Diseases [ICD].)
1
See Table IV for ICD–9 and ICD–10 cause-of-death codes.
2
Ratio of number of deaths classified by ICD–10 to number of deaths Compensation—See Appendix II, Employer costs for
classified by ICD–9. employee compensation.
SOURCE: CDC/NCHS. Final comparability ratios for 113 selected
causes of death. Available from: ftp://ftp.cdc.gov/pub/Health_Statistics/ Complex activity limitation—Complex activity limitation is
NCHS/Datasets/Comparability/icd9_icd10/Comparability_Ratio_ a construct used to measure disability as defined by the
tables.xls. inability to function successfully in certain social roles.
Miniño M, Anderson RN, Fingerhut LA, Boudreault MA, Warner M. Complex activities consist of the tasks and organized activity
Deaths: Injuries, 2002. National vital statistics reports; vol 54 no 10.
Hyattsville, MD: NCHS; 2006. Available from: http://www.cdc.gov/nchs/
that make up numerous social roles such as working,
data/nvsr/nvsr54/nvsr54_10.pdf. maintaining a household, living independently, or
participating in community activities. Complex activity
source of discontinuity, mortality trends for 1980–1998 were performance requires the execution of a combination of
recalculated using ICD–9 codes that are more comparable core areas of functioning. Complex activities include the
with codes for corresponding ICD–10 categories. Table IV following:
shows the ICD–9 codes used for these causes. This + Maintaining independence, including self-care and the
modification may lessen the discontinuity between the 9th ability to carry out activities associated with maintaining
and 10th revisions, but the effect on the discontinuity a household, such as shopping, cooking, and taking care
between the 8th and 9th revisions is not measured. of bills (measures are based on questions commonly
Comparability ratios shown in Table V are based on a known as activities of daily living [ADLs] and
comparability study in which the same deaths were coded instrumental activities of daily living [IADLs]). Limitations
using both the 9th and 10th revisions. The comparability in these activities usually reflect severe restrictions and
ratio was calculated by dividing the number of deaths are associated with limitations in other complex
classified by ICD–10 by the number of deaths classified by activities.
ICD–9. The resulting ratios represent the net effect of the + Difficulties experienced with social and leisure
10th revision on cause-of-death statistics and can be used to activities—represented in this measure by using
Health, United States, 2014 Appendix II. Definitions and Methods 405
questions about attending movies or sporting events, douche, Today sponge, suppository or insert, jelly or cream,
visiting with friends, or pursuing hobbies or relaxation or other method; and for 1982, foam, douche, suppository or
activities. insert, or other method.
+ Perceived limitation in the ability to work (a core aspect
of social participation for the majority of the U.S. Cost-charge ratio—The Agency for Healthcare Research
population)—represented by the respondent's self and Quality's Healthcare Cost and Utilization Project (HCUP)
defined limitation in the kind or amount of work they can contains data on total charges per discharge as reported on
do or their inability to work at a job or business. the hospital discharge record. This charge information
represents the amount the hospital billed for services but
For many measures of disability, only disabilities resulting does not reflect how much hospital services actually cost or
from an underlying condition that is chronic (based on the specific amounts that hospitals received in payment.
nature and duration) are considered. However, whether the Data on costs may be of more interest to some users. The
underlying conditions related to the complex activities were HCUP Cost-to-Charge ratio files convert charges to costs.
chronic was not a requirement in classifying persons as Each file contains hospital-specific cost-to-charge ratios
having a complex activity limitation. In Health, United States, based on all-payer inpatient cost for nearly every hospital in
respondents missing responses in a series of questions were HCUP. Cost information was obtained from hospital cost
classified as missing for that component. Respondents reports collected by the Centers for Medicare & Medicaid
reporting that they ‘‘do not do this activity’’ were classified Services. Some imputations for missing values were
as missing for that activity. For more information on how this necessary. These files are unique by year.
measure was constructed using data from the National
Health Interview Survey, including the specific questions Critical access hospital—See Appendix II, Hospital.
asked, see: Altman B, Bernstein A. Disability and health in the
Crude birth rate; Crude death rate—See Appendix II, Rate:
United States, 2001–2005. Hyattsville, MD: NCHS; 2008.
Birth and related rates; Rate: Death and related rates.
Available from: http://www.cdc.gov/nchs/data/misc/
disability2001-2005.pdf. (Appendix II, Activities of daily living Days of care—Days of care is defined similarly in several
[ADL]; Basic actions difficulty; Instrumental activities of daily data systems, as discussed below. (Also see Appendix II,
living [IADL].) Admission; Average length of stay; Discharge; Hospital;
Hospital utilization; Inpatient.)
Consumer Price Index (CPI)—The CPI, prepared by the U.S.
Bureau of Labor Statistics, is a monthly measure of the American Hospital Association—Days, hospital days, or
average change in prices of goods and services purchased inpatient days are the number of adult and pediatric days
by urban households. The medical care component of the of care rendered during the entire reporting period. Days
CPI shows trends in medical care prices based on specific of care for newborns are excluded.
indicators of hospital, medical, and drug prices. A revised
National Hospital Discharge Survey (NHDS)—Days of care
definition of the CPI has been in use since January 1988.
refers to the total number of patient days accumulated
(Also see Appendix II, Gross domestic product [GDP]; and
by inpatients at the time of discharge from nonfederal
Health expenditures, national.)
short-stay hospitals during a reporting period. All days
Contraception—The National Survey of Family Growth from and including the date of admission, but not
collects information on contraceptive use as reported by including the date of discharge, are counted.
women aged 15–44. To determine current contraceptive use,
Death rate—See Appendix II, Rate: Death and related rates.
women were asked to identify up to 4, out of 21,
contraceptive methods they had used during the month of Dental caries—Dental caries is evidence of decay on the
interview. Contraceptive methods listed as ‘‘other methods’’ crown or enamel surface of a tooth (i.e., coronal caries) and
in 2011–2013 included emergency contraception, includes treated and untreated caries. Untreated dental
contraceptive ring, female condom/vaginal pouch, foam, caries refers to decay on the crown or enamel surface of a
cervical cap, Today-brand sponge, suppository or insert, jelly tooth (i.e., coronal caries) that has not been treated or filled.
or cream (without diaphragm), and other methods. Decay in the root (i.e., root caries) was not included.
Previously, contraceptive methods listed as ‘‘other methods’’
included the following: for 2006–2010, the contraceptive In Health, United States, estimates on the presence of caries
ring, female condom/vaginal pouch, foam, cervical cap, are based on evaluation of primary and permanent teeth for
Today-brand sponge, suppository or insert, jelly or cream persons aged 5 and older. The third molars were not
(without diaphragm), and other methods; for 2002, the included. Persons without at least one natural tooth
female condom, foam, cervical cap, Today sponge, (primary or permanent) were classified as edentulous
suppository or insert, jelly or cream (without diaphragm), or (without any teeth) and were excluded. The majority of
other method; for 1995, the female condom or vaginal edentulous persons are aged 65 and over. Estimates of
pouch, foam, cervical cap, Today sponge, suppository or edentulism among persons aged 65 and over are 33% in
insert, jelly or cream, or other method; for 1988, foam, 1988–1994, 23% in 2005–2008, and 19% in 2011–2012.
406 Appendix II. Definitions and Methods Health, United States, 2014
Dental caries was identified by an oral examination as part Only respondents who were not classified as having
of the National Health and Nutrition Examination Survey physician-diagnosed diabetes were evaluated to determine
(NHANES). Over time, there have been changes in the if they had undiagnosed diabetes. Undiagnosed diabetes
NHANES oral health examination process, ages examined, was based on the results of laboratory testing of whole
and methodology. During 1988–1994, a full-mouth blood and blood plasma samples collected from NHANES
complete oral health exam was conducted by a trained participants at mobile examination centers. Undiagnosed
dentist on those aged 1 and over. During 1999–2004, a diabetes was defined as a fasting plasma glucose (FPG) of at
full-mouth complete oral health exam was conducted by a least 126 mg/dL or a hemoglobin A1c of at least 6.5% and no
trained dentist on those aged 2 and over. During 2005–2008, reported physician diagnosis. Respondents had fasted for at
data were collected for those aged 5 and over by a trained least 8 hours and less than 24 hours at the time of the blood
health technologist using the Basic Screening Examination draw. Fasting is not necessary to measure hemoglobin A1c.
(BSE), a simplified screening process to collect information However, to be consistent with the subsample of fasting
on untreated caries, dental restorations, and dental sealants. respondents used for FPG, assessment of undiagnosed
During 2009–2010, the BSE was conducted by a trained diabetes in Health, United States is limited to the fasting
dental hygienist on those aged 3–19. No data were collected subsample. Total diabetes includes those who were
on adults. During 2005–2008 and 2009–2010, due to use of classified as having either physician-diagnosed or
the BSE, it cannot be determined whether untreated decay undiagnosed diabetes. Fasting weights were used to obtain
was found in permanent teeth or primary teeth. For prevalence estimates, and pregnant women were excluded.
2011–2012, a full-mouth complete oral health exam was
Starting with Health, United States, 2010, an elevated
conducted by a trained dentist on those aged 1 and over.
hemoglobin A1c (greater than or equal to 6.5%) was
For more information, see: Dye BA, Barker LK, Li X, Lewis BG, included as a component of the definition of undiagnosed
Beltrán-Aguilar ED. Overview and quality assurance for the diabetes, along with FPG. Previous editions of Health, United
oral health component of the National Health and Nutrition States did not evaluate hemoglobin A1c to classify
Examination Survey (NHANES), 2005–08. J Public Health respondents as having undiagnosed diabetes; undiagnosed
Dent 2011;71(1):54–61; and see the following NHANES diabetes was based solely on elevated FPG (greater than or
resources: http://www.cdc.gov/nchs/nhanes/nhanes2005 equal to 126 mg/dL) among those without physician
2006/OHX_D.htm, http://www.cdc.gov/nchs/nhanes/ diagnosed diabetes. The revised definition of undiagnosed
nhanes2007-2008/OHX_E.htm, http://www.cdc.gov/nchs/ diabetes was based on recommendations from the
nhanes/nhanes2009-2010/OHXDEN_F.htm, and http:// American Diabetes Association (ADA). Hemoglobin A1c was
wwwn.cdc.gov/nchs/nhanes/2011-2012/OHXDEN_G.htm. recommended as a component in diagnosing diabetes
because recent improvements in assay standardization
Dental visit—Starting in 1997, National Health Interview make A1c results more reliable. In addition, research has
Survey respondents were asked, ‘‘About how long has it provided evidence linking elevated A1c levels with diabetic
been since you last saw or talked to a dentist? Include all complications, thus allowing for a threshold to be set above
types of dentists, such as orthodontists, oral surgeons, and which patients would be diagnosed as having diabetes.
all other dental specialists as well as hygienists.’’ Starting in Although the ADA recommends using hemoglobin A1c
2001, the question was modified slightly to ask respondents greater than or equal to 6.5% as an indicator of undiagnosed
how long it had been since they last saw a dentist. Questions diabetes, it cautions that A1c may be misleading in
about dental visits were not asked for children under age 2 individuals with certain blood disorders (including sickle cell
for years 1997–1999 and under age 1 for years 2000 and trait), which may have specific ethnic or geographic
beyond. Starting with 1997 data, estimates are presented for distributions. Therefore, clinicians may use other criteria and
people with a dental visit in the past year. tests to diagnose a specific patient. For more information,
see: Diagnosis and classification of diabetes mellitus.
Diabetes—Diabetes is a group of conditions in which Diabetes Care 2013;36(suppl 1):S67–S74; Standards of
insulin is not adequately secreted or utilized. Diabetes is a medical care in diabetes—2010. Diabetes Care
leading cause of disease and death in the United States. 2010;33(suppl 1):S11–S61; and International expert
Using data from the National Health and Nutrition committee report on the role of the A1c assay in the
Examination Survey (NHANES), three measures of diabetes diagnosis of diabetes. Diabetes Care 2009;32(7):1327–34. To
are presented in Health, United States: physician-diagnosed ensure data comparability over time, the revised definition
diabetes, undiagnosed diabetes, and total diabetes. of undiagnosed diabetes was applied to all estimates shown
Physician-diagnosed diabetes data were obtained by in Health, United States. As expected, this revised definition
self-report. Respondents who answered ‘‘yes’’ to the increased the percentage of respondents classified as
question, ‘‘Other than during pregnancy, have you ever having undiagnosed diabetes.
been told by a doctor or health professional that you have
diabetes or sugar diabetes?’’ were classified as having Periodically, NHANES laboratory testing is performed at
physician-diagnosed diabetes. different laboratories and using different instruments than
testing in earlier years. In those instances, NHANES conducts
crossover studies to evaluate the impact of these changes
Health, United States, 2014 Appendix II. Definitions and Methods 407
on laboratory measurements, and thus their impact on the discharge is a completed inpatient hospitalization. A
evaluation of data over time. Crossover studies have been hospitalization may be completed by death or by release of
conducted to evaluate the impact of laboratory changes on the patient to the customary place of residence, a nursing
both FPG and A1c. The recommended adjustments to FPG to home, another hospital, or other locations. (Also see
account for laboratory changes from 2005–2006 to present Appendix II, Admission; Average length of stay; Days of care;
have been incorporated in estimates presented in Health, Hospital utilization; Inpatient.)
United States so that these estimates are compatible with
those from earlier years. NHANES does not recommend any Domiciliary care home—See Appendix II, Long-term care
adjustments to the A1c data. facility; Nursing home.
Estimates presented in Health, United States may differ from Drug—Drugs are pharmaceutical agents, by any route of
other estimates based on the same data and presented administration, for the prevention, diagnosis, or treatment of
elsewhere if different weights, age-adjustment groups, medical conditions or diseases. Data on specific drug use are
definitions, or trend adjustments are used. collected in several NCHS surveys. (Also see Appendix II,
For more information, see: http://wwwn.cdc.gov/nchs/ Multum Lexicon Plus therapeutic class.)
nhanes/2011-2012/GHB_G.htm and http://wwwn.cdc.gov/ National Health and Nutrition Examination Survey
nchs/nhanes/2011-2012/GLU_G.htm. (NHANES)—Drug information from NHANES III and from
NHANES for 1999 and subsequent years was collected
Diagnosis—Diagnosis is the act or process of identifying or during in-person interviews conducted in participants'
determining the nature and cause of a disease or injury homes. Starting with 2001 data, participants were asked
through evaluation of patient history, examination, and whether they had taken a medication in the past 30 days
review of laboratory data. Diagnoses in the National Hospital for which they needed a prescription. For 1999–2000 and
Discharge Survey, the National Ambulatory Medical Care 1988–1994 data, the question wording differed slightly;
Survey, and the National Hospital Ambulatory Medical Care participants were asked whether they had taken a
Survey are abstracted from medical records and coded to prescription medication in the past month. For all survey
the International Classification of Diseases, 9th Revision, years, those who answered ‘‘yes’’ were asked to provide
Clinical Modification (ICD–9–CM). the prescription medication containers for the
For a given medical care encounter, the first-listed diagnosis interviewer. For each medication reported, the
can be used to categorize the visit, or if more than one interviewer entered the product's complete name from
diagnosis is recorded on the medical record, the visit can be the container. If no container was available, the
categorized based on all diagnoses recorded. Analyzing interviewer asked the participant to verbally report the
first-listed diagnoses avoids double-counting events such as name of the medication. In addition, participants were
visits or hospitalizations; the first-listed diagnosis is often, asked how long they had been taking the medication
but not always, considered the most important or dominant and the main reason for use.
condition among all comorbid conditions. However, the All reported medication names were converted to their
choice of the first-listed diagnosis by the medical facility may standard generic ingredient name. For multi-ingredient
be influenced by reimbursement or other factors. A hospital products, the ingredients were listed in alphabetical
discharge would be considered a first-listed stroke discharge order and counted as one drug (e.g., Tylenol #3 was listed
if the diagnosis code for stroke was recorded in the first as acetaminophen; codeine). No trade or proprietary
diagnosis field on the hospital record. An any-listed stroke names were provided on the data file.
discharge would classify all diagnoses of stroke recorded on
the hospital face sheet, regardless of the order in which they Drug data from NHANES provide a snapshot of all
are listed. Any-listed diagnoses double-count events such as prescribed drugs reported by a sample of the civilian
visits or hospitalizations with more than one recorded noninstitutionalized population for a 30-day period (or
diagnosis but provide information on the burden a specific past month, for earlier survey years). Drugs taken on an
diagnosis presents to the health care system. (Also see irregular basis, such as every other day, once per week, or
Appendix II, External cause of injury; Injury; Injury-related for a 10-day period, were captured in the 30-day recall
visit.) period. Data shown in Health, United States for the
percentage of the population reporting multiple
Diagnostic and other nonsurgical procedure—See prescription drugs during the past 30 days include a
Appendix II, Procedure. range of drug utilization patterns; for example, persons
who took three or more drugs daily during the past 30
Discharge—The National Health Interview Survey defines a days or persons who took a different drug three separate
hospital discharge as the completion of any continuous times would be classified as taking three or more drugs
period of stay of one night or more in a hospital as an in the past 30 days, as long as at least three different
inpatient. According to the National Hospital Discharge drugs were taken at some time during the past 30 days.
Survey and the Healthcare Cost and Utilization
Project—National (Nationwide) Inpatient Sample, a
408 Appendix II. Definitions and Methods Health, United States, 2014
For more information on prescription drug data
have/(person) has] completed or the highest degree [you
collection and coding in NHANES, see: http://
have/(person) has] received?’’ For data on children,
www.cdc.gov/nchs/nhanes/nhanes1999-2000/
education is based on the level of education completed
RXQ_DRUG.htm.
by the head of the household. The question asked is,
‘‘What is the highest grade or level of school [you
For more information on NHANES III prescription drug
have/(person) has] completed or the highest degree [you
data collection and coding, see: ftp://ftp.cdc.gov/pub/
have/(person) has] received?’’
Health_Statistics/NCHS/nhanes/nhanes3/2A/
pupremed.pdf. (Also see Appendix I, National Health and Emergency department—According to the National
Nutrition Examination Survey [NHANES].) Hospital Ambulatory Medical Care Survey, an emergency
department is a hospital facility that is staffed 24 hours a day
Drug abuse—See Appendix II, Illicit drug use.
and provides unscheduled outpatient services to patients
Education—Several approaches to defining educational whose condition requires immediate care. Emergency
categories are used in Health, United States. services provided under the ‘‘hospital as landlord’’
arrangement were also eligible. An emergency department
National Health Interview Survey (NHIS)—Starting in 1997, was in scope if it was staffed 24 hours a day. If an in-scope
the NHIS questionnaire was changed to ask, ‘‘What is the emergency department had an emergency service area that
highest level of school [person] has completed or the was open less than 24 hours a day, then that area was
highest degree received?’’ Responses were used to included under the emergency department. If a hospital had
categorize adults according to educational credentials an emergency department that was staffed less than 24
(i.e., no high school diploma or general educational hours a day, that department was considered an outpatient
development high school equivalency diploma [GED]; clinic. (Also see Appendix II, Emergency department or
high school diploma or GED; some college, no bachelor's emergency room visit; Outpatient department.)
degree; bachelor's degree or higher).
Emergency department or emergency room visit—
Prior to 1997, the education variable in NHIS was
Starting with the 1997 National Health Interview Survey,
measured by asking, ‘‘What is the highest grade or year
respondents to the Sample Adult questionnaire and the
of regular school [person] has ever attended?’’ and ‘‘Did
Sample Child questionnaire (generally a parent) were asked
[person] finish the grade/year?’’ Responses were used to
about the number of visits to hospital emergency rooms
categorize adults according to years of education
during the past 12 months, including visits that resulted in
completed (i.e., less than 12, 12, 13–15, or 16 years or
hospitalization. In the National Hospital Ambulatory Medical
more).
Care Survey, an emergency department visit is a direct
Data from the 1996 and 1997 NHIS were used to personal exchange between a patient and a physician or
compare distributions of educational attainment for other health care provider working under the physician's
adults aged 25 and over, using categories based on supervision, for the purpose of seeking care and receiving
educational credentials (1997) and categories based on personal health services. (Also see Appendix II, Emergency
years of education completed (1996). A larger department; Injury-related visit.)
percentage of persons reported some college than
13–15 years of education, and a correspondingly smaller Employer costs for employee compensation—Employer
percentage reported high school diploma or GED than costs for employee compensation is a measure of the
12 years of education. In 1997, 19% of adults reported no average cost, per employee hour worked, to employers for
high school diploma, 31% a high school diploma or GED, wages, salaries, and benefits. Wages and salaries are defined
26% some college, and 24% a bachelor's degree or as the hourly straight-time wage rate or, for workers not paid
higher. In 1996, 18% of adults reported less than 12 years on an hourly basis, straight-time earnings divided by the
of education, 37% reported 12 years, 20% reported corresponding hours. Straight-time wage and salary rates
13–15 years, and 25% reported 16 or more years of are total earnings before payroll deductions, excluding
education. premium pay for work in addition to the regular work
schedule (e.g., overtime, weekends, and holidays), shift
National Health and Nutrition Examination Survey differentials, and nonproduction bonuses such as
(NHANES)—In 1988–1994 (NHANES III) the questionnaire discretionary holiday bonuses and lump-sum payments
asked, ‘‘What is the highest grade or year of regular provided in lieu of wage increases. Production bonuses,
school [person] has completed?’’ Responses were used incentive earnings, commission payments, and cost-of-living
to categorize adults according to educational credentials adjustments are included in straight-time wage and salary
(i.e., no high school diploma or general educational rates. Benefits covered are paid leave (paid vacations,
development high school equivalency diploma [GED]; holidays, sick leave, and other leave), supplemental pay
high school diploma or GED; some college, no bachelor's (premium pay for overtime, weekends, or holidays), shift
degree; bachelor's degree or higher). Starting with differentials, nonproduction bonuses, insurance benefits
1999–2000 data, the questionnaire was changed to ask, (life, health, and short- and long-term disability), retirement
‘‘What is the highest grade or level of school [you
Health, United States, 2014 Appendix II. Definitions and Methods 409
and savings benefits (pension and other retirement plans NCHS website at: http://www.cdc.gov/nchs/injury/
and savings and thrift plans), and legally required benefits injury_tools.htm; and see: Bergen G, Chen LH, Warner M,
(Social Security, Medicare, federal and state unemployment Fingerhut LA. Injury in the United States: 2007 chartbook.
insurance, and workers' compensation). (Also see Appendix Hyattsville, MD: NCHS; 2008. Available from: http://
I, National Compensation Survey [NCS].) www.cdc.gov/nchs/data/misc/injury2007.pdf.
End-stage renal disease (ESRD)—ESRD is a complete or Family income—For the National Health Interview Survey
near-complete failure of the kidneys to function to excrete and the National Health and Nutrition Examination Survey,
wastes, concentrate urine, and regulate electrolytes. ESRD all people within a household who are related to each other
occurs when the kidneys are no longer able to function at by blood, marriage, or adoption constitute a family. Each
the level necessary for day-to-day life. It usually occurs as member of a family is classified according to the total
chronic renal failure worsens to the point where kidney income of the family. Unrelated individuals are classified
function is less than 10% of normal. At that point, kidney according to their own income.
function is so low that without dialysis or kidney
National Health Interview Survey (NHIS)—Prior to 1997,
transplantation, complications are multiple and severe, and
family income was the total income received by
death will occur from accumulation of fluids and waste
members of a family (or by an unrelated individual) in the
products in the body. Without treatment, the loss of kidney
12 months before interview. Family income included
function in ESRD is usually irreversible and permanent, and
wages, salaries, rents from property, interest, dividends,
death follows.
profits and fees from their own businesses, pensions, and
Although the Medicare program covers the majority of help from relatives. Starting in 1997, NHIS collected
ESRD-certified patients, not all individuals with ESRD are family income data for the calendar year prior to
eligible for Medicare. In addition to being medically interview (e.g., 2013 family income data were based on
determined to have ESRD, filing an application, and meeting calendar year 2012 information). The 1997–2006
any applicable waiting period, an individual must meet one instrument allowed the respondent to supply a specific
of the following criteria: dollar amount (up to $999,995). Any family income
responses greater than $999,995 were entered as
+ The individual has earned the required work credits
$999,996. Respondents who did not know or refused to
under Social Security, Railroad Retirement, or as a
give a dollar amount in response to this question were
government employee.
asked if their total combined family income for the
+ The individual is receiving Social Security or Railroad previous year was $20,000 or more, or less than $20,000.
Retirement benefits. If the respondent answered this question, he or she was
+ The individual is the spouse or dependent child of a then given one of two flash cards and asked to indicate
person who has earned the required work credits or is which income group listed on the card best represented
receiving Social Security or Railroad Retirement benefit. the family's combined income during the previous
calendar year. One flash card listed incomes that were
The United States Renal Data System has tracked both $20,000 or more, and the other flash card listed incomes
Medicare-eligible and -ineligible ESRD patients since May that were less than $20,000. Starting with the 2007 NHIS,
1995. For more information, see Appendix I, United States the income amount follow-up questions that had been in
Renal Data System (USRDS). place since 1997 were replaced with a series of unfolding
bracket questions. The unfolding bracket method asked
Ethnicity—See Appendix II, Hispanic origin. a series of closed-ended income range questions (e.g., ‘‘Is
it less than $50,000?’’) if the respondent did not provide
Exercise—See Appendix II, Physical activity, leisure-time.
an answer to the exact income amount question. The
Expenditures—See Appendix II, Health expenditures, closed-ended income range questions were constructed
national. (Also see Appendix I, National Health Expenditure so that each successive question establishes a smaller
Accounts [NHEA].) range for the amount of the family's income. In 2011,
several new unfolding-bracket income questions were
External cause of injury—The external cause of injury is added to NHIS to improve the assignment of poverty
used for classifying the circumstances in which injuries status. Additional questions focused on assessing
occur. The International Classification of Diseases, 9th Revision whether a family's income was less than 200% of the
(ICD–9), External Cause of Injury Matrix, is a two-dimensional poverty threshold or 200% or more of the poverty
array describing both the mechanism or external cause of threshold. The question received depended on family
the injury (e.g., fall, motor-vehicle traffic) and the manner or size. In addition, a question was added for respondents
intent of the injury (e.g., unintentional, self-inflicted, or who answered that their family's income was $100,000 or
assault). Although this matrix was originally developed for more as to whether their family's income was less than
mortality, it has been adapted for use with the ICD–9 Clinical $150,000, or $150,000 or more. For more information on
Modification (ICD–9–CM). For more information, see the this series of family income questions, see: 2013 NHIS
410 Appendix II. Definitions and Methods Health, United States, 2014
public-use data release. NCHS. 2014. Available from: families with no reported income information in any of
http://www.cdc.gov/nchs/nhis/2013imputedincome.htm. the NHANES survey years. (Also see Appendix II, Poverty.)
Also see: Pleis JR, Cohen RA. Impact of income bracketing National Immunization Survey (NIS)—Prior to 1998, family
on poverty measures used in the National Health income was the total income received by all family
Interview Survey's Early Release Program: Preliminary members in the past 12 months at the time of interview.
data from the 2007 NHIS. Hyattsville, MD: NCHS. 2007. Following the changes in the NHIS income questions, NIS
Available from: http://www.cdc.gov/nchs/data/nhis/ changed the reference period for 1998 onward and
income.pdf. collected income received by all family members for the
calendar year prior to the interview year for households
For NHIS respondents, family income data are used in the
with age-eligible children (e.g., 2013 NIS family income
computation of a poverty measure. Starting with Health,
data are based on calendar year 2012 income). Family
United States, 2004, a new methodology for imputing
income is the combined total income received by all
family income data for NHIS was implemented for data
members of a family before taxes. For the family income
years 1997 and beyond. Multiple imputations were
questions, the household respondent is asked to include
performed for survey years 1997 and beyond, with five
income received from jobs, social security, retirement
sets of imputed values created to allow for the
income, unemployment payments, public assistance,
assessment of variability caused by imputation. A
interest, dividends, net income from business, farm, rent,
detailed description of the multiple imputation
or any other sources. Respondents who answered ‘‘don't
procedure, and data files for 1997 and beyond, are
know’’ or refused to give a dollar amount for the total
available from: http://www.cdc.gov/nchs/nhis/
family income were asked a cascading sequence of
quest_data_related_1997_forward.htm, through the
income questions (a total of 15 cascading questions that
Data Release or the Imputed Income Files link under that
attempt to place the family income into one of 15
year. For data years 1990–1996, about 16%–18% of
income intervals ranging from less than or equal to
persons had missing data for family income. In those
$7,500 to greater than or equal to $75,000). The initial
years, missing values were imputed for family income by
question asks if the family income for the prior year was
using a sequential hot deck within matrix cells
more or less than $20,000. Subsequent sets of income
imputation approach. A detailed description of the
range questions are asked so that each successive
imputation procedure and data files, with imputed
question establishes a smaller income range. The
annual family income for 1990–1996, is available from:
midpoint of the income range is used as the total family
ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/Datasets/
income value for respondents who answered ‘‘don't
NHIS/1990-96_Family_Income/. (Also see Appendix II,
know’’ or refused to give a dollar amount. A family
Poverty; Table VI.)
income variable is constructed from the total family
National Health and Nutrition Examination Survey income question and the cascading income questions. If
(NHANES)—In NHANES 1999 and onward, family income an exact income is given, family income is set to this
is asked in a series of questions about possible sources of amount; otherwise it is set to the midpoint of the tightest
income, including wages, salaries, interest and dividends, bounds established by the cascading income questions.
federal programs, child support, rents, royalties, and The values of total family income are used to calculate a
other possible sources. After the information about poverty measure. For NIS, this ratio is calculated only for
sources of income was obtained in the family interview households with age-eligible children, using the actual
income section of the questionnaire, the respondent was family income value or the midpoint of the interval from
asked to report total combined family income for him- or the series of cascading questions in the numerator and
herself and the other members of their family, in dollars. the poverty threshold provided by the Census Bureau for
If the respondent did not provide an answer or did not the size of the family and the number of related children
know the total combined family income, he or she was in the household in the denominator. Details of the
asked if the total family income was less than $20,000 or income questions and computation of the income-to
$20,000 or more. If the respondent answered, a follow-up poverty ratio for each data collection year can be found
question asked the respondent to select an income in the NIS data documentation (Data User's Guide and
range from a list on a printed flash card. The midpoint of Household Interview Questionnaire) provided on the NIS
the income range was then used as the total family website at: http://www.cdc.gov/nchs/nis/datasets.htm.
income value. Family income values are used to calculate
For more information, see: Battaglia MP, Hoaglin DC,
a poverty measure. NHANES II (1976–1980) included
Izrael D, Khare M, Mokdad A. Improving income
questions on components of income; NHANES III
imputation by using partial income information and
(1988–1994) did not ask the detailed components-of
ecological variables. Presented at the American Statistical
income questions but asked respondents to identify their
Association–Joint Statistical Meeting; 2002 Aug 11–15,
income based on a set of ranges provided on a flash card.
New York, NY. Available from: http://www.cdc.gov/nchs/
Family income was not imputed for individuals or
data/nis/estimation_weighting/Battaglia2002.pdf.
Health, United States, 2014 Appendix II. Definitions and Methods 411
Table VI. Imputed family income percentages in the National Health Interview Survey, by selected characteristics:
United States, 1990–2013
Females Females
All Under 18 years 18–64 Under 1–64 65 years 18 years 40 years 2 years 45 years
Year ages 18 years and over years 65 years years and over and over and over and over and over
Percent
1990 . . . . . . . . . . . 16 14 18 16 15 15 24 18 21 17 22
1991 . . . . . . . . . . . 18 15 19 17 17 17 26 19 23 18 23
1992 . . . . . . . . . . . 18 16 19 18 17 17 27 20 23 18 23
1993 . . . . . . . . . . . 16 14 17 16 15 15 23 17 19 16 20
1994 . . . . . . . . . . . 17 15 18 17 16 16 25 18 21 17 21
1995 . . . . . . . . . . . 16 14 16 15 15 15 22 17 19 16 19
1996 . . . . . . . . . . . 17 14 17 16 16 16 24 18 20 17 20
1997 . . . . . . . . . . . 24 21 26 24 23 23 34 26 30 25 30
1998 . . . . . . . . . . . 29 25 30 28 27 27 39 30 34 29 34
1999 . . . . . . . . . . . 31 27 32 30 29 29 43 33 37 31 37
2000 . . . . . . . . . . . 32 28 33 31 30 31 45 34 38 32 38
2001 . . . . . . . . . . . 32 27 33 31 30 30 44 34 37 32 38
2002 . . . . . . . . . . . 32 28 33 31 30 30 44 33 37 32 37
2003 . . . . . . . . . . . 33 30 35 33 32 32 44 35 38 34 38
2004 . . . . . . . . . . . 33 29 34 32 31 31 41 34 36 33 37
2005 . . . . . . . . . . . 33 29 34 32 31 31 44 35 37 33 38
2006 . . . . . . . . . . . 34 31 35 33 33 33 45 36 39 34 39
2007 . . . . . . . . . . . 33 29 34 32 31 31 43 35 38 33 37
2008 . . . . . . . . . . . 30 27 31 29 29 29 40 32 34 30 34
2009 . . . . . . . . . . . 25 21 26 24 23 23 34 26 29 25 29
2010 . . . . . . . . . . . 25 20 26 24 23 23 36 27 30 25 30
2011 . . . . . . . . . . . 22 19 23 22 21 21 31 24 26 23 26
2012 . . . . . . . . . . . 23 19 24 22 21 21 32 24 27 23 27
2013 . . . . . . . . . . . 23 19 24 23 22 22 31 25 27 23 27
Federal hospital—See Appendix II, Hospital. termination of pregnancy. Data on gestational age are
subject to error for several reasons, including imperfect
Fee-for-service health insurance—Fee-for-service health maternal recall or misidentification of the last menstrual
insurance is private (commercial) health insurance that period because of postconception bleeding, delayed
reimburses health care providers on the basis of a fee for ovulation, or intervening early miscarriage.
each health service provided to the insured person. It is also
known as indemnity health insurance. In addition, ‘‘fee-for Gross domestic product (GDP)—The GDP is the market
service’’ is a term often applied to original Medicare, before value of the goods and services produced by labor and
Medicare managed-care plans or other new payment property located in the United States. As long as the labor
systems were introduced. (Also see Appendix II, Health and property are located in the United States, the suppliers
insurance coverage; Managed care; Medicare.) (i.e., the workers and, for property, the owners) may be U.S.
residents or residents of other countries. (Also see Appendix
Fertility rate—See Appendix II, Rate: Birth and related rates. II, Consumer Price Index [CPI]; Health expenditures,
national.)
General hospital—See Appendix II, Hospital.
Health care contact—Starting in 1997, the National Health
Geographic region—The U.S. Census Bureau groups the 50 Interview Survey has collected information on health care
states and D.C., for statistical purposes, into four geographic contacts with doctors and other health care professionals by
regions (Northeast, Midwest, South, and West) and nine using the following series of questions: ‘‘During the past 12
divisions based on geographic proximity. (See Figure I.) months, how many times have you gone to a hospital
emergency room about your own health?’’ , ‘‘During the past
Gestation—For the National Vital Statistics System and
12 months, did you receive care at home from a nurse or
CDC's Abortion Surveillance System, the period of gestation
other health care professional? What was the total number
is defined as beginning with the first day of the last normal
of home visits received?’’, and ‘‘During the past 12 months,
menstrual period and ending with the day of birth or day of
how many times have you seen a doctor or other health care
412 Appendix II. Definitions and Methods Health, United States, 2014
Figure I. U.S. Census Bureau: Four geographic regions and nine divisions of the United States
West Northeast
WA Midwest ME
New
MT ND England
OR MN
WI NY
ID SD
MI Middle
WY
West North Atlantic RI
Pacific Central East North
IA NJ
Central
Mountain NE OH
NV IN DE
UT MD
CO WV
CA VA
KS DC
MO
KY
South
OK East Atlantic
AZ
NM AR
A South
West South Central
GA
Central AL
TX LA
FL
AK
South
HI
professional about your own health at a doctor’s office, a care contacts was included in the 1–3 visits category, and a
clinic, or some other place? Do not include times you were respondent with 9.5 health care contacts was included in
hospitalized overnight, visits to hospital emergency rooms, the 4–9 visits category. Respondents were included in this
home visits, or telephone calls.’’ Starting with 2000 data, this analysis only if they were known on all three visit variables.
question was amended to specifically exclude dental visits.
Analyses of the percentage of children without a health care
For 1997–1999, for each question, respondents were shown visit are based on the following question: ‘‘During the past
a flash card with response categories of 0, 1, 2–3, 4–9, 10–12, 12 months, how many times has [person] seen a doctor or
or 13 or more visits. For tabulation of the 1997–1999 data, other health care professional about [his/her] health at a
responses of 2–3 were recoded to 2, responses of 4–9 were doctor's office, a clinic, or some other place? Do not include
recoded to 6, responses of 10–12 were recoded to 11, and 13 times [person] was hospitalized overnight, visits to hospital
or more visits were recoded to 13. The recoded values for the emergency rooms, home visits, or telephone calls.’’ (Also see
three types of visits were then added to yield an estimate of Appendix II, Emergency department or emergency room
total health care contacts. Starting with 2000 data, response visit; Home visit.)
categories were expanded to 0, 1, 2–3, 4–5, 6–7, 8–9, 10–12,
13–15, or 16 or more. For 2000 and more recent data, these Health expenditures, national—National health
response categories were recoded to the midpoint of the expenditures are estimated by the Centers for Medicare &
range. The category of 16 or more was recoded to 16. The Medicaid Services (CMS) and measure calendar year
recoded values for the three types of visits were then added spending for health care in the United States by type of
to yield an estimate of the summary measure of health care service delivered (e.g., hospital care, physician services,
contacts (including doctor's visits, hospital emergency room nursing home care) and source of funding for those services
visits, and home visits). After summing the three component (e.g., private health insurance, Medicare, Medicaid, out-of
visit variables, respondents with values on the edge of the pocket spending). CMS produces both historical and
categories presented in Health, United States were rounded projected estimates of health expenditures by category.
down to provide a more conservative estimate of the (Also see Appendix II, Gross domestic product [GDP].) Types
number of visits. For example, a respondent with 3.5 health of national health expenditures include:
Health, United States, 2014 Appendix II. Definitions and Methods 413
Health consumption expenditures are outlays for goods government coverage. People with Indian Health Service
and services relating directly to patient care, plus coverage only were considered uninsured in ACS.
expenses for administering health insurance programs
National Health Interview Survey (NHIS)—For point-in
and public health activities. This category is equivalent to
time health insurance estimates, NHIS respondents were
total national health expenditures minus expenditures
asked about their coverage at the time of interview. For
for investment in noncommercial research and structures
1993–1996, respondents were asked about their
and equipment.
coverage in the previous month. Questions on health
Personal health care expenditures are outlays for goods insurance coverage were expanded starting in 1993,
and services relating directly to patient care. These compared with previous years. In 1997, the entire
expenditures are total national health expenditures questionnaire was redesigned and data were collected
minus expenditures for investment, health insurance using a computer-assisted personal interview (CAPI). In
program administration and the net cost of insurance, 2007, questions on health insurance coverage were
and public health activities. expanded again to include three new questions on
high-deductible health plans, health savings accounts,
Business, household, and other private expenditures are
and flexible spending accounts.
outlays for services paid for by nongovernmental
sources, such as consumers, private industry, and Respondents were considered to be covered by private
philanthropic and other non-patient-care sources. health insurance if they indicated private health
insurance or, prior to 1997, if they were covered by a
Government expenditures are outlays for services paid for
single-service hospital plan. Private health insurance
by federal, state, and local government agencies or
includes managed care such as health maintenance
expenditures required by governmental mandate (such
organizations (HMOs).
as workers' compensation insurance payments).
Private insurance obtained through the workplace was
Health insurance coverage—Health insurance is broadly defined as any private insurance that was originally
defined to include both public and private payers who cover obtained through a present or former employer or union,
medical expenditures incurred by a defined population in a or, starting in 1997, through the workplace, self-
variety of settings. Estimates of health insurance are employment, or a professional association. Starting in
available from several different government surveys. 2011, respondents were also asked whether health
Because of differences in methodology, question wording, insurance coverage was obtained through parents or
and recall period, estimates from different sources may vary another relative. Coverage obtained through parents or
and are not directly comparable. For more information, see: another relative was not included as workplace coverage.
Health insurance measurement: Differences by data source.
Available from: http://www.census.gov/content/dam/ Until 1996, persons were defined as having Medicaid or
Census/library/infographics/health_insurance_ other public assistance coverage if they indicated that
measurement.pdf. they had either Medicaid or other public assistance or if
they reported receiving Aid to Families with Dependent
American Community Survey (ACS)—For point-in-time Children (AFDC) or Supplemental Security Income (SSI).
health insurance estimates, ACS respondents were asked After welfare reform in late 1996, Medicaid was delinked
about their coverage at the time of interview. from AFDC and SSI. Starting in 1997, persons were
Respondents were asked: ‘‘Is this person CURRENTLY considered to be covered by Medicaid if they reported
covered by any of the following types of health insurance Medicaid or a state-sponsored health program. Starting
or health coverage plans? Mark yes or no for each type of in 1999, persons were considered covered by Medicaid if
coverage: Insurance through a current or former they reported coverage by the Children's Health
employer or union [of this person or another family Insurance Program (CHIP). Medicare or military health
member]; Insurance purchased directly from an plan coverage was also determined in the interview, and
insurance company [by this person or another family starting in 1997 other government-sponsored program
member]; Medicare, for people 65 and older, or people coverage was determined as well.
with certain disabilities; Medicaid, Medical Assistance, or
any kind of government-assistance plan for those with If respondents did not report coverage under one of the
low incomes or a disability; TRICARE or other military above types of plans and they had unknown coverage
health care; VA (including those who have ever used or under either private health insurance or Medicaid, they
enrolled for VA health care); Indian Health Service; Any were considered to have unknown coverage.
other type of health insurance or health coverage plan The remaining respondents without any indicated
[specify plan].’’ In ACS, persons were considered coverage were considered uninsured. The uninsured
uninsured if they were not covered by private health were persons who did not have coverage under private
insurance, Medicare, Medicaid, Medical Assistance, health insurance, Medicare, Medicaid, public assistance, a
TRICARE or other military health care, veteran's coverage state-sponsored health plan, other government
through the Veteran's Administration, or other sponsored programs, or a military health plan. Persons
414 Appendix II. Definitions and Methods Health, United States, 2014
with only Indian Health Service (IHS) coverage were exhaustive categories: (a) people with health insurance
considered uninsured. Although NHIS respondents who continuously for the full 12 months prior to interview,
report IHS coverage as their only source of coverage are (b) those who had a period of up to 12 months prior to
currently recoded to being uninsured, IHS provides a interview without coverage, and (c) those who were
comprehensive health service delivery system for uninsured for more than 12 months prior to interview.
approximately 2.2 million American Indian and Alaska This stub variable has been added to selected tables. Two
Native persons. See: http://www.ihs.gov/newsroom/ additional NHIS questions were used to determine the
factsheets/ihsyear2015profile/. Estimates of the appropriate category for the survey respondents: (a) all
percentage of persons who were uninsured based on persons without a known comprehensive health
NHIS may differ slightly from those based on other insurance plan were asked, ‘‘About how long has it been
sources because of differences in survey questions, recall since [person] last had health care coverage?’’; and (b) all
period, and other aspects of survey methodology. persons with known health insurance coverage were
asked, ‘‘In the past 12 months, was there any time when
In NHIS, on average less than 2% of people aged 65 and
[person] did NOT have ANY health insurance coverage?’’
over reported no current health insurance coverage, but
the small sample size precludes the presentation of (Also see Appendix II, Children's Health Insurance Program
separate estimates for this population. Therefore, the [CHIP]; Fee-for-service health insurance; Health maintenance
term ‘‘uninsured’’ refers only to the population under organization [HMO]; Managed care; Medicaid; Medicare;
age 65. Uninsured.)
Two additional questions were added to the health
insurance section of NHIS beginning with the third Health maintenance organization (HMO)—An HMO is a
quarter of 2004 (Table VII). One question was asked of health care system that assumes or shares both the financial
persons aged 65 and over who had not indicated that risks and the delivery risks associated with providing
they had Medicare: ‘‘People covered by Medicare have a comprehensive medical services to a voluntarily enrolled
card which looks like this. [Are/Is] [person] covered by population in a particular geographic area, usually in return
Medicare?’’ The other question was asked of persons for a fixed, prepaid fee. Pure HMO enrollees use only the
under age 65 who had not indicated any type of prepaid, capitated health services of the HMO panel of
coverage: ‘‘There is a program called Medicaid that pays medical care providers. Open-ended HMO enrollees use the
for health care for persons in need. In this state it is also prepaid HMO health services but may also receive medical
called [state name]. [Are/Is] [person] covered by care from providers who are not part of the HMO panel.
Medicaid?’’ Respondents who originally classified There is usually a substantial deductible, copayment, or
themselves as uninsured, but whose classification was coinsurance associated with use of nonpanel providers.
changed to Medicare or Medicaid on the basis of a ‘‘yes’’ HMO model types are as follows:
response to either question, subsequently received Group model HMO is an HMO that contracts with a single
appropriate follow-up questions concerning periods of multispecialty medical group to provide care to the
noncoverage for insured respondents. Of the 892 people HMO's membership. The group practice may work
(unweighted) who were eligible to receive the Medicare exclusively with the HMO, or it may provide services to
probe question in the third and fourth quarters of 2004, non-HMO patients as well. The HMO pays the medical
55% indicated that they were covered by Medicare. Of group a negotiated per capita rate, which the group
the 9,146 people (unweighted) who were eligible to distributes among its physicians, usually on a salaried
receive the Medicaid probe question in the third and basis.
fourth quarters of 2004, 3% indicated that they were
covered by Medicaid. Estimates in Health, United States Staff model HMO is a closed-panel HMO (where patients
were calculated using the responses to the two can receive services only through a limited number of
additional probe questions. For a complete discussion of providers) in which physicians are HMO employees. The
the effect of the addition of these two probe questions providers see members in the HMO's own facilities.
on the estimates for insurance coverage, see: Cohen RA, Network model HMO is an HMO that contracts with
Martinez ME. Impact of Medicare and Medicaid probe multiple physician groups to provide services to HMO
questions on health insurance estimates from the members. It may include single or multispecialty groups.
National Health Interview Survey, 2004. Health E-Stats.
NCHS; 2005. Available from: http://www.cdc.gov/nchs/ Individual practice association (IPA) is a health care
data/hestat/impact04/impact04.htm. provider organization composed of a group of
independent practicing physicians who maintain their
Survey respondents may be covered by health insurance own offices and band together for the purpose of
at the time of interview but may have experienced one contracting their services to HMOs, preferred provider
or more lapses in coverage during the 12 months prior to organizations, and insurance companies. An IPA may
interview. Starting with Health, United States, 2006, NHIS contract with and provide services to both HMO and
estimates have been presented for the following three non-HMO plan participants.
Health, United States, 2014 Appendix II. Definitions and Methods 415
Mixed model HMO is an HMO that combines features of Hispanic origin—Hispanic or Latino origin includes persons
more than one HMO model. of Mexican, Puerto Rican, Cuban, Central and South
American, and other or unknown Latin American or Spanish
(Also see Appendix II, Managed care; Preferred provider origin. Persons of Hispanic origin may be of any race.
organization [PPO].)
Birth file—The reporting area for an Hispanic-origin item
Health services and supplies expenditures—See on the birth certificate expanded between 1980 and
Appendix II, Health expenditures, national. 1993 (when the Hispanic item was included on the birth
certificate in all states and D.C.). Trend data on births of
Health status, respondent-assessed—Health status was Hispanic and non-Hispanic parentage in Health, United
measured in the National Health Interview Survey by asking States are affected by expansion of the reporting areas,
the family respondent about his or her health or the health which affects numbers of events, composition of the
of a family member: ‘‘Would you say [person's] health in Hispanic population, and maternal and infant health
general is excellent, very good, good, fair, or poor?’’ characteristics.
Hearing trouble—In the National Health Interview Survey, In 1980 and 1981, information on births of Hispanic
information about hearing trouble is obtained by asking parentage was reported on the birth certificate by the
respondents how well they hear without the use of hearing following 22 states: Arizona, Arkansas, California,
aids. Prior to 2007 data, respondents were asked, ‘‘Which Colorado, Florida, Georgia, Hawaii, Illinois, Indiana,
statement best describes your hearing without a hearing Kansas, Maine, Mississippi, Nebraska, Nevada, New
aid: good, a little trouble, a lot of trouble, or deaf?’’ In the Jersey, New Mexico, New York, North Dakota, Ohio, Texas,
2007 data, the question was revised to expand the response Utah, and Wyoming. In 1982 Tennessee, and in 1983 D.C.,
categories. Respondents were asked, ‘‘These next questions began reporting this information. Between 1983 and
are about your hearing WITHOUT the use of hearing aids or 1987, information on births of Hispanic parentage was
other listening devices. Is your hearing excellent, good, [do available for 23 states and D.C. In 1988, this information
you have] a little trouble hearing, moderate trouble, a lot of became available for Alabama, Connecticut, Kentucky,
trouble, or are you deaf?’’ Starting with 2008 data, Massachusetts, Montana, North Carolina, and
respondents were asked, ‘‘WITHOUT the use of hearing aids Washington state, increasing the number of states
or other listening devices, is your hearing excellent, good, reporting information on births of Hispanic parentage to
[do you have] a little trouble hearing, moderate trouble, a lot 30 states and D.C. In 1989, this information became
of trouble, or are you deaf?’’ Because of the expanded available from an additional 17 states, increasing the
response categories, 2007 and subsequent data are not number of Hispanic-reporting states to 47 and D.C. In
strictly comparable with earlier years and caution is urged 1989, only Louisiana, New Hampshire, and Oklahoma did
when interpreting trends. For example, in 2006, 3.5% of not report Hispanic parentage on the birth certificate.
adults (aged 18 and over) were classified as having hearing With the inclusion of Louisiana in 1989 and Oklahoma in
difficulty (response categories: a lot of trouble or deaf ). In 1990 as Hispanic-reporting states, 99% of birth records
2007, 2.3% of adults (aged 18 and over) were classified as included information on mother's origin. Hispanic origin
having hearing difficulty (response categories: a lot of of the mother was reported on the birth certificates of 49
trouble or deaf ). This more than 30% decline from 2006 to states and D.C. in 1991 and 1992; only New Hampshire
2007 in the estimate of those with hearing trouble is likely did not provide this information. Starting in 1993,
attributable to the addition of the moderate trouble Hispanic origin of mother was reported by all 50 states
response category, rather than changes in the prevalence of and D.C.
hearing trouble. Although all age groups saw a decline in Starting with 2003 data, some states began using the
the percentage reporting hearing trouble between 2006 and 2003 revision of the U.S. Standard Certificate of Live Birth.
2007, the amount of the decline varied. There was a 50% Hispanic origin and race are collected separately on the
decline in reported hearing trouble among adults aged birth certificate. The Hispanic origin question on the
18–44 (from 0.8% in 2006 to 0.4% in 2007). Among adults 2003 revision of the birth certificate asks respondents to
aged 45–64, the percentage that reported hearing trouble select only one response. Occasionally, more than one
declined 43%, from 3.5% in 2006 to 2.0% in 2007. Among Hispanic origin response is given; that is, a specified
adults aged 65 and over, reported hearing trouble declined Hispanic origin group (Mexican, Puerto Rican, Cuban, or
24%, from 11.4% in 2006 to 8.7% in 2007. Central and South American) in combination with one or
For more information, see: Pleis JR, Lucas JW. Summary more other specified Hispanic origin groups. From 2003
health statistics for U.S. adults: National Health Interview through 2012, respondents who selected more than one
Survey, 2007. NCHS. Vital Health Stat 2009;10(240). Available Hispanic origin on the birth certificate were classified as
from: http://www.cdc.gov/nchs/data/series/sr_10/ other Hispanic. In 2012, 0.4% of births in the revised
sr10_240.pdf. (Also see Appendix II, Basic actions difficulty.) state reporting area, plus Massachusetts (unrevised state
that also reported more than one Hispanic origin
response), were to women reporting more than one
416 Appendix II. Definitions and Methods Health, United States, 2014
Table VII. Percentage of persons under age 65 with Medicaid or who are uninsured, by selected demographic
characteristics, using Method 1 and Method 2 estimation procedures: United States, 2004
Medicaid 1 Uninsured 2
1
Includes persons who do not have private coverage but who have Medicaid or other state-sponsored health plans, including the Children’s Health
2
Includes persons who have not indicated that they are covered at the time of interview under private health insurance, Medicare, Medicaid, CHIP,
a state-sponsored health plan, other government programs, or military health plan (includes VA, TRICARE, and CHAMP–VA). This category
includes persons who are only covered by Indian Health Service or only have a plan that pays for one type of service, such as accidents or dental
care.
3
Starting with the third quarter of 2004, two additional questions were added to the National Health Interview Survey (NHIS) insurance section to
reduce potential errors in reporting of Medicare and Medicaid status. Persons aged 65 and over not reporting Medicare coverage were asked
explicitly about Medicare coverage, and persons under age 65 with no reported coverage were asked explicitly about Medicaid coverage.
Estimates calculated without using the additional information from these questions are noted as Method 1. Estimates calculated using the
4
Based on family income and family size and composition, using the U.S. Census Bureau’s poverty thresholds. The percentage of respondents
with unknown poverty level was 28.2% in 2004. See the NHIS Survey Description for 2004. Available from: http://www.cdc.gov/nchs/data/nhis/
srvydesc.pdf.
5
Persons of Hispanic origin may be of any race or combination of races. Similarly, the category Not Hispanic or Latino refers to all persons who
SOURCE: CDC/NCHS, National Health Interview Survey, 2004, Family Core Component. Data are based on household interviews of a sample of
the civilian noninstitutionalized population. Available from: http://www.cdc.gov/nchs/data/hestat/impact04/impact04.htm. See Appendix I, National Health
Health, United States, 2014 Appendix II. Definitions and Methods 417
Hispanic origin. Beginning with 2013 data, respondents Hispanic population. In 1990, more than 96% of death
who select more than one Hispanic origin are randomly records included information on Hispanic origin of the
assigned to a single Hispanic origin. The Hispanic origin decedent.
question on the 1989 revision of the birth certificate also
Starting with 2003 data, some states began using the
offers the opportunity to report more than one origin;
2003 revision of the U.S. Standard Certificate of Death,
however, NCHS processing guidelines for unrevised data
which allows the reporting of more than one race
allow for coding only the first Hispanic origin listed.
(multiple races) and includes some revisions in the item
Linked birth/Infant death file—The linked birth/infant reporting Hispanic origin. The effect of the 2003 revision
death file is particularly useful for computing accurate of the Hispanic origin item on the reporting of Hispanic
infant mortality rates by race and Hispanic origin origin on death certificates is presumed to be minor. For
because the race and Hispanic origin of the mother from more information, see Appendix II, Race. Also see the
the birth certificate are used in both the numerator and Technical Notes section of the annual series of ‘‘Deaths:
denominator of the linked birth/infant death infant Final Data’’ reports, available from: http://www.cdc.gov/
mortality rate. In contrast, infant mortality rates based on nchs/products/nvsr.htm; and NCHS procedures for
the vital statistics mortality file use for the numerator multiple-race and Hispanic origin data: Collection,
race and Hispanic origin as reported on the death coding, editing, and transmitting. Hyattsville, MD: NCHS;
certificate and for the denominator the race and Hispanic 2004. Available from: http://www.cdc.gov/nchs/data/
origin of the mother as reported on the birth certificate. dvs/Multiple_race_docu_5-10-04.pdf.
Race and Hispanic origin information from the birth
National Health Interview Survey (NHIS) and National
certificate, which is reported by the mother, is considered
Health and Nutrition Examination Survey (NHANES)—
more reliable than race and Hispanic origin information
Questions on Hispanic origin are self-reported in
from the death certificate, which is reported by the
NHANES III and subsequent years, and since 1976 in
funeral director based on information provided by an
NHIS, and precede questions on race. For 1999–2006
informant or by observation. See Appendix II, Hispanic
data, the NHANES sample was designed to provide
origin; sections for Birth file, Mortality file.
estimates specifically for persons of Mexican origin and
Mortality file—The reporting area for an Hispanic-origin not for all Hispanic-origin persons in the United States.
item on the death certificate expanded between 1985 Persons of Hispanic origin other than Mexican were
and 1997. In 1985, mortality data by Hispanic origin of entered into the sample with different selection
decedent were based on deaths of residents of the probabilities that are not nationally representative of the
following 17 states and D.C. whose data on the death total U.S. Hispanic population. Starting with 2007–2008
certificate were at least 90% complete on a place-of data collection, all Hispanic persons were oversampled,
occurrence basis and of comparable format: Arizona, not just persons of Mexican origin. In addition to
Arkansas, California, Colorado, Georgia, Hawaii, Illinois, allowing estimates for the total group of Hispanic
Indiana, Kansas, Mississippi, Nebraska, New York, North persons, the sample size for Hispanic persons of Mexican
Dakota, Ohio, Texas, Utah, and Wyoming. In 1986, New origin is sufficient to continue to produce reliable
Jersey began reporting Hispanic origin of decedent, estimates for this group. However, the methodology for
increasing the number of reporting states to 18 and D.C. the oversampling of Hispanic persons did not provide
in 1986 and 1987. In 1988, Alabama, Kentucky, Maine, sufficient sample sizes for calculating estimates for other
Montana, North Carolina, Oregon, Rhode Island, and Hispanic subgroups besides Mexican origin. For more
Washington state were added to the reporting area, information on the NHANES sampling methodology
increasing the number of states to 26 and D.C. In 1989, changes, see http://www.cdc.gov/nchs/nhanes/
an additional 18 states were added, increasing the nhanes2007-2008/sampling_0708.htm; and the
Hispanic reporting area to 44 states and D.C.; only series of NHANES analytic guidelines available from:
Connecticut, Louisiana, Maryland, New Hampshire, http://www.cdc.gov/nchs/nhanes/analytic_
Oklahoma, and Virginia were not included in the guidelines.htm. For more information on race and
reporting area. Starting with 1990 data in Health, United Hispanic origin in NHIS, see the NHIS Race and Hispanic
States, the criterion was changed to include states whose Origin Information home page. Available from:
data were at least 80% complete. In 1990, Maryland, http://www.cdc.gov/nchs/nhis/rhoi.htm.
Virginia, and Connecticut; in 1991 Louisiana; and in 1993
Surveillance, Epidemiology, and End Results (SEER)
New Hampshire were added, increasing the reporting
Program—SEER data are available from the National
area for Hispanic origin of decedent to 47 states and D.C.
Institutes of Health, National Cancer Institute. SEER
in 1990; 48 states and D.C. in 1991 and 1992; and 49
Hispanic data used in Health, United States tables exclude
states and D.C. in 1993–1996. Only Oklahoma did not
data from Alaska. The North American Association of
provide this information in 1993–1996. Starting in 1997,
Central Cancer Registries, Inc. (NAACCR) Hispanic
Hispanic origin of decedent was reported by all 50 states
Identification Algorithm was used on a combination of
and D.C. Based on data from the U.S. Census Bureau, the
variables to classify incidence cases as Hispanic for
1990 reporting area encompassed 99.6% of the U.S.
418 Appendix II. Definitions and Methods Health, United States, 2014
analytic purposes. See: NAACCR guideline for enhancing and can provide active medical and nursing care. Hospitals
Hispanic–Latino identification. Bethesda, MD: may be classified by type of service, ownership, size in terms
National Cancer Institute; 2003. Available from: of number of beds, and length of stay. In the National
http://seer.cancer.gov/seerstat/variables/seer/
Hospital Ambulatory Medical Care Survey, hospitals include
yr1973_2004/race_ethnicity/.
all those with an average length of stay for all patients of less
than 30 days (short-stay) or hospitals whose specialty is
Youth Risk Behavior Survey (YRBS)—Prior to 1999, a single
general (medical or surgical) or children's general. Federal
question was asked about race and Hispanic origin, with
hospitals and hospital units of institutions and hospitals with
the option of selecting one of the following categories:
fewer than six beds staffed for patient use are excluded.
white not Hispanic, black not Hispanic, Hispanic or
(Also see Appendix II, Average length of stay; Bed, health
Latino, Asian or Other Pacific Islander, American Indian or
facility; Days of care; Emergency department; Inpatient;
Alaska Native, or other. Between 1999 and 2003,
Outpatient department.)
respondents were asked a single question about race
and Hispanic origin with the option of choosing one or Community hospital—Community hospitals, based on
more of the following categories: white, black or African the AHA definition, include all nonfederal, short-term
American, Hispanic or Latino, Asian, Native Hawaiian or general and special hospitals whose facilities and
Other Pacific Islander, or American Indian or Alaska services are available to the public. Special hospitals
Native. Beginning in 2005, respondents were asked a include obstetrics and gynecology; eye, ear, nose, and
question about Hispanic origin (‘‘Are you Hispanic or throat; rehabilitation; orthopedic; and other specialty
Latino?’’ ) and a second separate question about race that services. Short-term general and special children's
included the option of selecting one or more of the hospitals are also considered to be community hospitals.
following categories: American Indian or Alaska Native, A hospital may include a nursing-home-type unit and
Asian, black or African American, Native Hawaiian or still be classified as short-term, provided the majority of
Other Pacific Islander, or white. Because of the its patients are admitted to units where the average
differences between questions, the data about race and length of stay is less than 30 days. Hospital units of
Hispanic ethnicity for the years prior to 1999 are not institutions such as prisons and college infirmaries that
strictly comparable with estimates for the subsequent are not open to the public and are contained within a
years. However, analyses of data collected between 1991 nonhospital facility are not included in the category of
and 2003 have indicated that the data are comparable community hospitals. Traditionally, the definition
across years and can be used to study trends. See included all nonfederal short-stay hospitals except
Appendix II, Race; and see: Brener ND, Kann L, McManus facilities for persons with intellectual disabilities
T. A comparison of two survey questions on race and (formerly called mentally retarded). In a revised
ethnicity among high school students. Public Opin Q definition, the following additional sites were excluded:
2003;67(2):227–36. hospital units of institutions, and alcoholism and
chemical dependency facilities.
HIV—See Appendix II, Human immunodeficiency virus (HIV)
disease. Federal hospital—Federal hospitals are those operated by
the federal government.
Home visit—Starting in 1997, the National Health Interview For-profit hospital—For-profit hospitals are operated for
Survey has been collecting information on home visits profit by individuals, partnerships, or corporations.
received during the 12 months prior to interview.
Respondents are asked, ‘‘During the past 12 months, did you General hospital—General hospitals provide diagnostic,
receive care at home from a nurse or other health care treatment, and surgical services for patients with a
professional? What was the total number of home visits variety of medical conditions. According to WHO, these
received?’’ These data are combined with data on visits to hospitals provide medical and nursing care for more than
doctors' offices, clinics, and emergency departments to one category of medical discipline (e.g., general
provide a summary measure of health care visits. (Also see medicine, specialized medicine, general surgery,
Appendix II, Emergency department or emergency room specialized surgery, and obstetrics). Excluded are
visit; Health care contact.) hospitals, usually in rural areas, that provide a more
limited range of care.
Hospital—According to the American Hospital Association
Nonprofit hospital—Nonprofit hospitals are those
(AHA), hospitals are licensed institutions with at least six
controlled by nonprofit organizations, such as religious
beds whose primary function is to provide diagnostic and
organizations and fraternal societies.
therapeutic patient services for medical conditions; they
have an organized physician staff and provide continuous Registered hospital—Registered hospitals are those
nursing services under the supervision of registered nurses. registered with AHA. About 98% of U.S. hospitals are
The World Health Organization (WHO) considers an registered.
establishment to be a hospital if it is permanently staffed by
at least one physician, can offer inpatient accommodation,
Health, United States, 2014 Appendix II. Definitions and Methods 419
Short-stay hospital—In the National Hospital Discharge on a screening test for HIV antibody, followed by a positive
Survey, short-stay hospitals are those in which the result on a confirmatory test, or a positive result or
average length of stay is less than 30 days. The National detectable quantity on an HIV virologic test (see MMWR
Health Interview Survey defines short-stay hospitals as 2008;57(RR–10):1–8).
any hospital or hospital department in which the type of
Since 1985, many states and U.S. dependent areas have
service provided is general; maternity; eye, ear, nose, and
implemented HIV case reporting as part of their
throat; children's; or osteopathic.
comprehensive HIV and AIDS surveillance programs. As of
Special hospital—Special hospitals are those, such as April 2008, all reporting areas (50 states, D.C., and the six U.S.
psychiatric, tuberculosis, chronic disease, rehabilitation, dependent areas of American Samoa, Guam, the Northern
maternity, and alcoholic or narcotic dependency Mariana Islands, Puerto Rico, the Republic of Palau, and the
facilities, that provide a particular type of service to the U.S. Virgin Islands) had implemented HIV case surveillance
majority of their patients. using a confidential system for name-based case reporting
for both HIV infection and AIDS. To better capture and
Hospital-based physician—See Appendix II, Physician. characterize populations in which HIV infection has been
newly diagnosed, including persons with evidence of recent
Hospital day—See Appendix II, Days of care. HIV infection, many states report the prevalence of those
living with a diagnosis of HIV infection, including those
Hospital utilization—Estimates of hospital utilization (such
living with AIDS.
as hospital discharge rate, days of care rate, average length
of stay, and percentage of the population with a In 2008, changes were made to the case definition for HIV
hospitalization) presented in Health, United States are based infection. The new case definition combined the two
on data from four sources: Healthcare Cost and Utilization previous case definitions for HIV and AIDS and established a
Project, National (Nationwide) Inpatient Sample (HCUP–NIS); new disease staging classification. The term HIV/AIDS was
National Health Interview Survey (NHIS); National Hospital replaced with the term ‘‘diagnosis of HIV infection,’’ which is
Discharge Survey (NHDS); and American Hospital defined as diagnosis of HIV infection regardless of the stage
Association (AHA). Beginning with the 2012 data year, of disease (stage 1, 2, 3 [AIDS], or unknown) and refers to all
HCUP–NIS is a 20% sample of discharges (alive or deceased) persons with a diagnosis of HIV infection (see MMWR
from all community hospitals participating in HCUP, 2008;57(RR–10):1–8). Mortality and morbidity coding for HIV
excluding rehabilitation and long-term acute care hospitals disease are similar and have evolved over time.
(a total of nearly 4,440 hospitals). For prior years, HCUP–NIS
From 2008 to the present, a revised HIV case definition was
estimates are based on hospital stays for persons discharged
used to classify HIV infection among adults, adolescents, and
alive or deceased from about 1,000 hospitals sampled to
children. The revised definition incorporates the following
approximate a 20% stratified sample of U.S. community
HIV infection classification staging system:
hospitals, excluding rehabilitation hospitals and long-term
acute care hospitals. NHIS hospital utilization data are based + HIV infection, stage 1: No AIDS-defining condition and
on household interviews with a sample of the civilian either a CD4 count of 500 cells/μL or more or a
noninstitutionalized population. Respondents were asked CD4 percentage of total lymphocytes of 29% or more.
whether they had any hospital stays in the past year. NHDS + HIV infection, stage 2: No AIDS-defining condition and
data are based on hospital discharge records of persons who either a CD4 count of 200–499 cells/μL or a
had an inpatient stay in a nonfederal, short-stay hospital. CD4 percentage of total lymphocytes of 14%–28%.
NHDS includes hospital discharge records for persons
+ HIV infection, stage 3 (AIDS): Documentation of an
discharged alive or deceased and for institutionalized
AIDS-defining condition or either a CD4 count of less
persons. The NHDS tables shown in Health, United States
than 200 cells/μL or a CD4 percentage of total
exclude data for newborns. AHA data are from information
lymphocytes of less than 14%. Documentation of an
reported by a census of hospitals. Estimates for average
AIDS-defining condition supersedes a CD4 count or
length of stay presented in Health, United States from NHDS
percentage that would not by itself be the basis for a
and AHA data differ because of different methods for
stage 3 (AIDS) classification.
counting days of care. (Also see Appendix II, Average length
of stay; Days of care; Discharge; and Appendix I, Healthcare + HIV infection, stage unknown: No reported information on
Cost and Utilization Project [HCUP], National [Nationwide] AIDS-defining conditions and no information available on
Inpatient Sample; National Health Interview Survey [NHIS]; CD4 count or percentage (see MMWR 2008;57(RR–10):1–8).
National Hospital Discharge Survey [NHDS].) Mortality coding—Starting with 1999 data and the
introduction of the 10th revision of the International
Human immunodeficiency virus (HIV) disease—HIV
Classification of Diseases (ICD–10), the title for this cause
disease is caused by infection with a cytopathic retrovirus,
of death was changed from HIV infection to HIV disease,
which in turn leads to destruction of parts of the immune
and the ICD codes were changed to B20–B24. Starting
system. A surveillance case for HIV requires laboratory
with 1987 data, NCHS introduced category numbers
confirmed evidence of infection, including a positive result
*042–*044 for classifying and coding HIV infection as a
420 Appendix II. Definitions and Methods Health, United States, 2014
cause of death in ICD–9. The asterisks before the National Survey on Drug Use & Health (NSDUH)—
category numbers indicate that these codes were not Information on illicit drug use is collected for survey
part of the original ICD–9. HIV infection was formerly participants aged 12 and over. Information on any illicit
referred to as human T-cell lymphotropic virus-III/ drug use includes any use of marijuana or hashish,
lymphadenopathy-associated virus (HTLV–III/LAV) cocaine, heroin, hallucinogens, or inhalants, as well as
infection. Before 1987, deaths involving HIV infection nonmedical use of prescription psychotherapeutic drugs.
were classified to Deficiency of cell-mediated immunity Current use (within the past month) is based on the
(ICD–9 code 279.1) contained in the category All other question: ‘‘How long has it been since you last used
diseases; to Pneumocystosis (ICD–9 code 136.3) [drug name]?’’ (Also see Appendix II, Substance use.)
contained in the category All other infectious and
parasitic diseases; to Malignant neoplasms, including Immunization—See Appendix II, Vaccination.
neoplasms of lymphatic and hematopoietic tissues; and
to a number of other causes. Because of these coding Incidence—Incidence is the number of cases of disease
changes, death statistics for HIV infection before 1987 are having their onset during a prescribed period of time. It is
not strictly comparable with data for 1987 and often expressed as a rate (e.g., the incidence of measles per
subsequent years and therefore are not shown in Health, 1,000 children aged 5–15 during a specified year). Measuring
United States. incidence may be complicated because the population at
risk for the disease may change during the period of interest,
Morbidity coding—The National Hospital Discharge due to births, deaths, or migration, for example. In addition,
Survey codes diagnosis data using the International determining whether a case is new—that is, whether its
Classification of Diseases, 9th Revision, Clinical Modification onset occurred during the prescribed period of time—may
(ICD–9–CM). During 1984 and 1985, only data for AIDS be difficult. Because of these difficulties in measuring
(ICD–9–CM code 279.19) were included. In 1986–1994, incidence, many health statistics are instead measured in
discharges with the following diagnoses were included: terms of prevalence. (Also see Appendix II, Prevalence.)
AIDS, HIV infection and associated conditions, and
positive serological or viral culture findings for HIV Income—See Appendix II, Family income.
(ICD–9–CM codes 042–044, 279.19, and 795.8).
Beginning in 1995, discharges with the following Individual practice association (IPA)—See Appendix II,
diagnoses were included: HIV disease and asymptomatic Health maintenance organization (HMO).
HIV infection status (ICD–9–CM codes 042 and V08).
Industry of employment—For the presentation of data in
(Also see Appendix II, Acquired immunodeficiency Health, United States, industries are classified according to
syndrome [AIDS]; Cause of death; International Classification the North American Industry Classification System (NAICS).
of Diseases [ICD]; International Classification of Diseases, 9th NAICS groups establishments into industries based on their
Revision, Clinical Modification [ICD–9–CM]; Tables IV and X.) production or supply function. Establishments using similar
raw material inputs, capital equipment, and labor are
Hypercholesterolemia—See Appendix II, Cholesterol. classified in the same industry. This approach creates
homogeneous categories well suited for economic analysis.
Hypertension—See Appendix II, Blood pressure, high. NAICS uses a two- through six-digit hierarchical coding
system to classify all economic activity. The first two digits of
ICD; ICD codes—See Appendix II, Cause of death; the six-digit code designate the highest level of aggregation,
International Classification of Diseases (ICD). into the government and 20 private industry sectors
(Table VIII). Agriculture, forestry, fishing and hunting; mining;
Illicit drug use—Illicit drug use refers to the use and misuse
construction; and manufacturing are primarily goods
of illegal and controlled drugs.
producing sectors, and the remaining 16 sectors are entirely
Monitoring the Future (MTF) Study—In this school-based service providing. NAICS allows for the classification of more
survey of secondary school students, information on than 1,000 industries. For more information on NAICS, see:
illicit drug use is collected using self-completed http://www.census.gov/eos/www/naics.
questionnaires. The information is based on the
Starting in 1997, NAICS replaced the Standard Industrial
following questions: ‘‘On how many occasions (if any)
Classification (SIC) system, which was last updated in 1997.
have you used marijuana in the last 30 days?’’ and ‘‘On
The SIC system focused on the manufacturing sector of the
how many occasions (if any) have you used hashish in
economy and provided significantly less detail for the
the last 30 days?’’ Questions on cocaine use include the
now-dominant service sector, including newly developed
following: ‘‘On how many occasions (if any) have you
industries in information services, health care delivery, and
taken crack (cocaine in chunk or rock form) during the
high-technology manufacturing. Although some titles in SIC
last 30 days?’’ and ‘‘On how many occasions (if any) have
and NAICS are similar, there is little comparability between
you taken cocaine in any other form during the last 30
the two systems because industry groupings are defined
days?’’
Health, United States, 2014 Appendix II. Definitions and Methods 421
differently. Estimates classified by NAICS should not be Table VIII. Codes for industries, based on the North
compared with estimates that used SIC. American Industry Classification System (NAICS)
Industry Code
Infant death—An infant death is the death of a live-born
child before his or her first birthday. Age at death may be Agriculture, forestry, fishing and hunting. . . . . . . . 11
further classified as neonatal or postneonatal. Neonatal Mining, quarrying, and oil and gas extraction . . . . 21
deaths are those that occur before the 28th day of life; Utilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
postneonatal deaths are those that occur within 28 days to Construction . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
under 1 year of age. (Also see Appendix II, Rate: Death and Manufacturing . . . . . . . . . . . . . . . . . . . . . . . . . . 31–33
related rates.) Wholesale trade . . . . . . . . . . . . . . . . . . . . . . . . 42
Retail trade . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44–45
Injury—The International Classification of External Causes Transportation and warehousing . . . . . . . . . . . . . 48–49
of Injuries (ICECI) Coordination and Maintenance Group Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
Finance and insurance . . . . . . . . . . . . . . . . . . . . 52
defines injury as a (suspected) bodily lesion resulting from
Real estate and rental and leasing . . . . . . . . . . . 53
acute overexposure to energy (this can be mechanical,
Professional, scientific, and technical services . . . 54
thermal, electrical, chemical, or radiant) interacting with the Management of companies and enterprises . . . . . 55
body in amounts or rates that exceed the threshold of Administrative and support and waste
physiological tolerance. The time between exposure to the management and remediation services . . . . . . . 56
energy and the appearance of an injury is short. In some Educational services . . . . . . . . . . . . . . . . . . . . . 61
cases, an injury results from an insufficiency of any of the Health care and social assistance . . . . . . . . . . . . 62
vital elements (i.e., air, water, or warmth), as in strangulation, Arts, entertainment, and recreation . . . . . . . . . . . 71
drowning, or freezing. Acute poisonings and toxic effects, Accommodation and food services . . . . . . . . . . . 72
Other services, except public administration . . . . . 81
including overdoses of substances and wrong substances
Public administration . . . . . . . . . . . . . . . . . . . . . 92
given or taken in error are included, as are adverse effects
and complications of therapeutic, surgical, and medical care. SOURCE: Bureau of Labor Statistics. Available from:
Psychological harm is excluded. Injuries can be intentional http://www.census.gov/eos/www/naics/.
or unintentional (i.e., accidental). In NCHS data systems,
external causes of nonfatal injuries are coded to the
International Classification of Diseases, 9th Revision, and subsequent data years, the patient record form had a
Clinical Modification, Supplementary Classification of specific question on whether the episode of care was an
External Causes of Injury and Poisoning, and the codes are initial visit for the problem. In the 2005 and 2006 surveys,
often referred to as E codes. See Table IX for a list of external this variable was not included, and in its place an imputed
causes of injury categories and E codes used in Health, variable was constructed that indicated whether the visit
United States. Also see the NCHS injury website at: was or was not the initial visit for the problem. For an
http://www.cdc.gov/nchs/injury.htm; and see: ICECI explanation of the methodology used to create the imputed
Coordination and Maintenance Group. International initial visit variable, see: http://www.cdc.gov/nchs/data/
Classification of External Causes of Injuries (ICECI), ver 1.2. ahcd/initialvisit.pdf. For more information, see the
Amsterdam, The Netherlands: Consumer Safety Institute; CDC/NCHS Injury Data and resources website at:
and Adelaide, Australia: Australian Institute of Health and http://www.cdc.gov/nchs/injury.htm; and Fingerhut LA.
Welfare National Injury Surveillance Unit. Flinders University; Recommended definition of initial injury visits to emergency
2004. Available from: http://www.who.int/classifications/icd/ departments for use with the NHAMCS–ED data. NCHS.
adaptations/iceci/en/index.html. (Also see Appendix II, Health E-Stats; 2006. Available from: http://www.cdc.gov/
Diagnosis; Injury-related visit.) nchs/data/hestat/injury/injury.htm. (Also see Appendix II,
Emergency department or emergency room visit; External
Injury-related visit—In the National Hospital Ambulatory cause of injury; Injury.)
Medical Care Survey (NHAMCS), an emergency department
visit was considered injury-related if the physician diagnosis Inpatient—An inpatient is a person who is formally
was injury-related or an external cause-of-injury code (E admitted to the inpatient service of a hospital for
code) was present (Tables IX and X). Starting with Health, observation, care, diagnosis, or treatment. (Also see
United States, 2008, an injury-related visit was redefined as Appendix II, Admission; Average length of stay; Days of care;
an initial injury visit. In the 2001–2010 NHAMCS, an initial Discharge; Hospital.)
injury visit was the first visit to an emergency department
for an injury that was characterized by either the first-listed Inpatient care—See Appendix II, Hospital utilization.
diagnosis being a valid injury diagnosis or by a valid
first-listed E code, regardless of the diagnosis code. Visits for Inpatient day—See Appendix II, Days of care.
which the first-listed diagnosis or the first-listed E code was
Instrumental activities of daily living (IADL)—IADLs are
for a complication of medical care or for an adverse event
activities related to independent living and include
were not counted as injury visits. For 2001–2004 and 2007
preparing meals, managing money, shopping for groceries
422 Appendix II. Definitions and Methods Health, United States, 2014
Table IX. Codes for external causes of injury, from the International Classification of Diseases, 9th Revision, Clinical
Modification
External cause of injury category E code
SOURCE: Recommended framework of E code groupings for presenting injury morbidity data. Available from: http://www.cdc.gov/injury/wisqars/
ecode_matrix.html, and the International Classification of Diseases, 9th Revision, Clinical Modification. Available from: http://www.cdc.gov/nchs/icd/
icd9cm.htm.
or personal items, performing light or heavy housework, and International Classification of Diseases, 9th Revision,
using a telephone. In the National Health Interview Survey, Clinical Modification (ICD–9–CM)—ICD–9–CM is based on,
respondents are asked whether they or family members and is compatible with, the World Health Organization's
aged 18 and over need the help of another person for ICD–9. The United States currently uses ICD–9–CM to code
handling routine IADL needs because of a physical, mental, morbidity diagnoses and inpatient procedures. ICD–9–CM
or emotional problem. consists of three volumes. Volumes 1 and 2 contain the
diagnosis tabular list and index; Volume 3 contains the
In the Medicare Current Beneficiary Survey, if a sample
procedure classification (tabular list and index combined).
person had any difficulty performing an activity by him- or
herself and without special equipment, or did not perform ICD–9–CM is divided into 17 chapters and two supplemental
the activity at all because of health problems, the person classifications. The chapters are arranged primarily by body
was categorized as having a limitation in that activity. The system. In addition, there are chapters for Infectious and
limitation may have been temporary or chronic at the time parasitic diseases; Neoplasms; Endocrine, nutritional, and
of interview. Sample persons in the community answered metabolic diseases; Mental disorders; Complications of
health status and functioning questions themselves, if able pregnancy, childbirth, and puerperium; Certain conditions
to do so. For sample persons in a long-term care facility, a originating in the perinatal period; Congenital anomalies;
proxy such as a nurse answered questions about the sample and Symptoms, signs, and ill-defined conditions. The two
person's health status and functioning. (Also see Appendix II, supplemental classifications are for factors influencing
Activities of daily living [ADL]; Complex activity limitation; health status and contact with health services (V codes), and
Limitation of activity.) for external causes of injury and poisoning (E codes).
Insurance—See Appendix II, Health insurance coverage. In Health, United States, morbidity data are currently
classified using ICD–9–CM. Diagnostic categories and codes
Intermediate care facility—See Appendix II, Nursing home. for ICD–9–CM are shown in Table X; ICD–9–CM procedure
categories and codes are shown in Tables XI and XII. For
International Classification of Diseases (ICD)—The ICD is more information about ICD–9–CM, see the NCHS
used to code and classify cause-of-death data. The ICD is Classification of Diseases, Functioning, and Disability
developed collaboratively by the World Health Organization website at: http://www.cdc.gov/nchs/icd.htm. (Also see
and 10 international centers, one of which is housed at Appendix II, International Classification of Diseases [ICD].)
NCHS. The purpose of the ICD is to promote international
comparability in the collection, classification, processing, International Classification of Diseases, 10th Revision,
and presentation of health statistics. Since 1900, the ICD has Clinical Modification/Procedure Coding System (ICD–10–
been modified about once every 10 years, except for the CM/PCS)—Use of ICD–10–CM/PCS to report medical
20-year interval between the 9th and 10th revisions (ICD–9 diagnoses and inpatient procedures will be implemented
and ICD–10) (Table III). The purpose of the revisions is to stay October 1, 2015. The transition to ICD–10 is required for
abreast of advances in medical science. New revisions everyone covered by the Health Insurance Portability and
usually introduce major disruptions in time series of Accountability Act (HIPAA). This change to ICD–10 does not
mortality statistics (Tables IV and V). For more information, affect Current Procedural Terminology (CPT) coding for
see the NCHS ICD–10 website at: http://www.cdc.gov/nchs/ outpatient procedures and physician services. ICD–10–CM/
icd/icd10.htm. (Also see Appendix II, Cause of death; PCS consists of two parts: ICD–10–CM for diagnosis coding,
Comparability ratio; International Classification of Diseases, and ICD–10–PCS for inpatient procedure coding. For more
9th Revision, Clinical Modification [ICD–9–CM].) information about ICD–10–CM/PCS, see the NCHS
Health, United States, 2014 Appendix II. Definitions and Methods 423
Table X. Codes for diagnostic categories, from the International Classification of Diseases, 9th Revision, Clinical Modification
Diagnostic category Code
Childbirth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . V27
Septicemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 038
Diabetes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 250
Dehydration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 276.5
Schizophrenia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 295
Arrhythmias . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 427
Hypertension. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 401
Stroke . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 430–438
Asthma. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 493
Appendicitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 540–543
Gallstones . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 574
Fracture. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 800–829
Complications of care and adverse effects . . . . . . . . . . . . . . . . . . 996–999, 909.3, 909.5, 995.0–995.4, 995.6–995.7,
995.86, 995.89
Classification of Diseases, Functioning, and Disability Length of stay—See Appendix II, Average length of stay.
website at: http://www.cdc.gov/nchs/icd.htm and the
Centers for Medicare & Medicaid Services ICD–10 transition Life expectancy—Life expectancy is the average number of
website at: http://www.cms.gov/Medicare/Coding/ICD10/ years of life remaining to a person at a particular age and is
index.html. based on a given set of age-specific death rates—generally
the mortality conditions existing in the period mentioned.
Late fetal death rate—See Appendix II, Rate: Death and Life expectancy may be determined by sex, race and
related rates. Hispanic origin, or other characteristics by using age-specific
death rates for the population with that characteristic. (Also
Leading causes of death—See Appendix II, Cause-of-death see Appendix II, Rate: Death and related rates.)
ranking.
424 Appendix II. Definitions and Methods Health, United States, 2014
U.S. life tables by Hispanic origin were available starting with considered limited if one or more of these conditions is
2006 data. Life expectancy data for the Hispanic population chronic. Children under age 18 who receive special
was not available before 2006 for three major reasons: education or early intervention services are considered to
(a) coverage of the Hispanic population in the U.S. mortality have a limitation of activity. (Also see Appendix II, Activities
statistics system was incomplete, (b) misclassification of of daily living [ADL]; Instrumental activities of daily living
Hispanic persons on death certificate data underestimated [IADL].)
deaths in the Hispanic population, and (c) misstatement of
age at the oldest ages in the Hispanic population led to an Long-term care facility—A long-term care facility is a
underestimation of mortality at the oldest ages. residence that provides a specific level of personal or
medical care or supervision to residents. In the Medicare
Hispanic origin was added to the U.S. standard death Current Beneficiary Survey, a residence is considered a
certificate in 1989, but it was not adopted by every state long-term care facility if it has three or more long-term care
until 1997. By 1997, all states had reporting at rates over beds and answers affirmatively to at least one of three
99%. Research on race and Hispanic origin reporting on U.S. questions: ‘‘Does this facility (a) provide personal care
death certificates found that misclassification of race and services to residents, (b) provide continuous supervision of
Hispanic origin accounts for a net underestimate of 5% for residents, (c) provide any long-term care?’’ Types of long
total Hispanic deaths and 1% for total non-Hispanic black term care facilities include licensed nursing homes, skilled
deaths, and a net overestimate of 0.5% for non-Hispanic nursing homes, intermediate care facilities, retirement
white deaths. To address the effects of age misstatement at homes (that provide services), domiciliary or personal care
the oldest ages, the probability of death for Hispanic facilities, distinct long-term care units in a hospital complex,
persons over age 80 is estimated as a function of non mental health facilities and centers, assisted and foster care
Hispanic white mortality with the use of the Brass relational homes, and institutions for persons with intellectual
logit model. For more information, see: Arias E. United States disabilities (formerly called mentally retarded) and the
life tables by Hispanic origin. NCHS. Vital Health Stat developmentally disabled. (Also see Appendix II, Nursing
2010;2(152). Available from: http://www.cdc.gov/nchs/data/ home.)
series/sr_02/sr02_152.pdf.
In 2000, the life table methodology was revised. The revised Low birthweight—See Appendix II, Birthweight.
methodology is similar to that developed for the 1999–2001
Mammography—A mammogram is an x-ray image of the
decennial life tables. In 2008, the life table methodology was
breast used to detect irregularities in breast tissue. In the
refined in two important ways. First, a logistic rather than a
National Health Interview Survey, questions concerning use
nonlinear least squares model was used to smooth and
of mammography are asked on an intermittent schedule,
extrapolate the Vital and Medicare blended death rates at
and question content differed across years. For 2013, women
the older ages. Second, the age at which smoothing is
were asked when they had their most recent mammogram,
begun was raised from 66 to 85 years or so, depending on
and use of mammography was defined as ‘‘percent of
the population. Values for 2001 and subsequent data years
women having a mammogram within the past two years.’’
are based on the latest revision of the life table
Survey questions have changed over time as follows.
methodology. As a result, data post-2000 may differ from
figures published previously. For a full description of the In 1987 and 1990, women were asked to report when they
new life table methodology, see: Arias E. United States life had their last mammogram. In 1991, women were asked
tables, 2008. National vital statistics reports; vol 61 no 3. whether they had a mammogram in the past 2 years. In 1993
Hyattsville, MD: NCHS; 2012. Available from: http:// and 1994, women were asked whether they had a
www.cdc.gov/nchs/data/nvsr/nvsr61/nvsr61_03.pdf. mammogram within the past year, between 1 and 2 years
ago, or over 2 years ago. In 1998, women were asked
Limitation of activity—Limitation of activity may be whether they had a mammogram a year ago or less, more
defined in different ways, depending on the conceptual than 1 year but not more than 2 years, or more than 2 years
framework. In the National Health Interview Survey, ago.
limitation of activity refers to a long-term reduction in a
person's capacity to perform the usual kind or amount of In 1999, women were asked when they had their most
activities associated with his or her age group as a result of a recent mammogram, in days, weeks, months, or years.
chronic condition. Limitation of activity is assessed by asking Estimates for 1999 may be slightly overestimated in
persons a series of questions about limitations in their or a comparison with previous years due to the inclusion of
family member's ability to perform activities usual for their women who responded ‘‘2 years ago’’ (10% of women),
age group because of a physical, mental, or emotional which could have included more than 2 years but less than 3
problem. Persons are asked about limitations in activities of years.
daily living, instrumental activities of daily living, play, In 2000 and 2003, women were asked when they had their
school, work, difficulty walking or remembering, and any most recent mammogram (asked to give month and year).
other activity limitations. For reported limitations, the causal Women who did not respond were given a follow-up
health conditions are determined, and persons are question that used the 1999 wording, and women who did
Health, United States, 2014 Appendix II. Definitions and Methods 425
Table XI. Codes for procedure categories for National Hospital Discharge Survey data, from the International Classification
of Diseases, 9th Revision, Clinical Modification
Procedure category Code
Pacemaker . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37.7–37.8
Hysterectomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68.3–68.5
Mastectomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85.4
not respond to the 1999 wording were asked a second the mammography questions were identical to those asked
follow-up question that used the 1998 wording. Estimates in 2005.
for 2000 and 2003 may be slightly overestimated compared
Mammography screening recommendations have changed
with estimates prior to 1999 due to the inclusion of women
over time and vary in the recommended age to begin
who responded ‘‘2 years ago’’ (2% of women), which could
screening and the interval for screening. The current
have included more than 2 years but less than 3 years.
recommendation, made by the U.S. Preventive Services Task
In 2005, women were asked the same series of Force in 2009, is the use of screening mammography for
mammography questions as in the 2000 and 2003 surveys, breast cancer every 2 years in women aged 50–74.
but the questionnaire skip pattern was modified so that
For additional details and a summary of current and historic
more women were asked the follow-up question using the
recommendations, see: U.S. Preventive Services Task Force.
1998 wording. Thus, estimates for 2005 and subsequent
Screening for breast cancer. Rockville, MD: Agency for
years are more precise than estimates for 1999, 2000, and
Healthcare Research and Quality; 2009. Available from:
2003. SAS code to categorize mammography data for 2000
http://www.uspreventiveservicestaskforce.org/uspstf/
and beyond is available from: http://www.cdc.gov/nchs/
uspsbrca.htm; and U.S. Preventive Services Task Force. Guide
nhis/nhis_2005_data_release.htm. In 2008, 2010, and 2013,
to clinical preventive services, 2014. Rockville, MD: Agency
426 Appendix II. Definitions and Methods Health, United States, 2014
for Healthcare Research and Quality; 2014. Available from: specialized services to certain categories of Medicaid
http://www.ahrq.gov/professionals/clinicians-providers/ beneficiaries. For more information on state Medicaid
guidelines-recommendations/guide/index.html. managed care plans, see http://www.medicaid.gov/.
Managed care—‘‘Managed care’’ is a term originally used to (Also see Appendix II, Health maintenance organization
refer to prepaid health plans (generally, health maintenance [HMO]; Medicare; Medicaid; Preferred provider organization
organizations, or HMOs) that furnish care through a network [PPO].)
of providers under a fixed budget and ‘‘manage’’ costs.
Marital status—Marital status is classified through self
Increasingly, the term is also used to include preferred
reporting into the categories married and unmarried. The
provider organizations (PPOs) and even forms of indemnity
term ‘‘married’’ encompasses all married people, including
insurance coverage (i.e., ‘‘fee-for-service’’ insurance).
those separated from their spouses. ‘‘Unmarried’’ includes
Medicare managed care includes a combination of risk- and those who are single (never married), divorced, or widowed.
cost-based plans. Risk-based plans receive a fixed
Birth file—In 1970, 39 states and D.C., and in 1975, 38
prepayment per beneficiary per month to help pay for the
states and D.C., included a direct question about
cost of all covered services that a beneficiary may use. Each
mother's marital status on the birth certificate. Since
year, the Centers for Medicare & Medicaid Services (CMS)
1980, national estimates of births to unmarried women
announces a ‘‘benchmark’’ amount for each county for
have been based on two methods for determining
coverage of Medicare Part A and Part B services. A managed
marital status: a direct question in the birth registration
care plan contracting with Medicare then submits a ‘‘bid,’’
process and inferential procedures. In 1980–1996, marital
which represents the revenue it needs to cover these
status was reported on the birth certificates of 41–45
services. If the bid is above the benchmark, the difference
states and D.C.; with the addition of California in 1997, 46
must be charged in a premium to the enrollees of the plan. If
states and D.C.; and in 1998–2001, 48 states and D.C. In
the bid is below the benchmark, then a portion of the
1997, all but four states (Connecticut, Michigan, Nevada,
difference must be used to provide additional benefits to
and New York), and in 1998, all but two states (Michigan
enrollees, with the Medicare trust funds receiving the
and New York) included a direct question about mother's
remaining share.
marital status on their birth certificates. In 1998–2007,
Cost-based plans are offered by an HMO or a competitive marital status was imputed as married on birth records
medical plan and are paid for their ‘‘reasonable costs’’ in with missing information in the 48 states and D.C. where
providing Medicare services to enrollees, based on annual this information was obtained by a direct question. In
cost reports filed with CMS. For current definitions of the 2008–2013 for 49 states and D.C., marital status is
various Medicare managed care plans, see the CMS reported in the birth registration process.
Medicare managed care manual. Ch 1, section 30, ‘‘Types of
For states lacking a direct question, marital status was
MA plans,’’ Baltimore, MD: CMS; 2011. Available from:
inferred. Before 1980, the incidence of births to
http://www.cms.gov/manuals/downloads/mc86c01.pdf.
unmarried women in states with no direct question on
Medicare enrollees can choose to enroll in a managed care marital status was assumed to be the same as the
program (if available) or to receive services on a fee-for incidence in reporting states in the same geographic
service basis. division. Starting in 1980, for states without a direct
question, marital status was inferred by comparing the
The two major Medicaid managed care categories are
parents' and child's surnames. For 1994–1996, birth
risk-based plans (managed care organizations, or MCOs) and
certificates in 45 states and the D.C. included a question
primary care case management (PCCM) arrangements.
about the mother's marital status. Beginning in 1997, the
Risk-based plans (MCOs) are paid a fixed monthly fee per
marital status of women giving birth in California and
enrollee. MCOs assume some or all of the financial risk for
Nevada has been determined by a direct question in the
providing the services covered under the contract. PCCM
birth registration process. Beginning June 15, 1998,
providers are usually physicians, physician group practices,
Connecticut discontinued inferring the mother's marital
or entities employing or having other arrangements with
status and added a direct question regarding mother's
such physicians, but they can also include nurse
marital status to the state's birth certificate.
practitioners, nurse midwives, or physician assistants. These
providers (also called gatekeepers) contract directly with the In 2005, Michigan added a direct question to the birth
state to locate, coordinate, and monitor covered primary registration process but uses inferential procedures to
care (and sometimes additional services). PCCM providers update information collected using the direct question.
are paid a per-patient case management fee and usually do In both Michigan and New York, a birth is inferred as
not assume financial risk for the provision of services. Some nonmarital if either of these factors, listed in priority-of
states allow Medicaid enrollees to voluntarily enroll in use order, is present: (a) a paternity acknowledgment
managed care plans; most states require that at least certain was received or (b) the father's name is missing. For
categories of Medicaid beneficiaries join such plans. Both 2006–2008 data, inferential procedures were used to
MCOs and PCCM arrangements include plans that provide compile birth statistics by marital status, in full or in part,
Health, United States, 2014 Appendix II. Definitions and Methods 427
for New York and Michigan, respectively. For 2009–2013, In general, children in families with incomes up to
mother's marital status is inferred for New York. $44,700 per year (for a family of four in 2011) are likely to
be eligible for Medicaid or CHIP coverage. In many states,
National Health Interview Survey (NHIS)—In NHIS, marital
families with higher incomes can still qualify for coverage
status is asked of, or about, all persons aged 14 and over.
for their children. This includes children in mandatory
Respondents are asked, ‘‘Are you now married, widowed,
Medicaid eligibility groups, which states must cover in
divorced, separated, never married, or living with a
order to participate in Medicaid, as well as children in
partner?’’
optional eligibility groups that a state may elect to cover.
Maternal age—See Appendix II, Age. All children from birth to age 6 years with family incomes
up to 133% of poverty ($29,700 for a family of four in
Medicaid—Medicaid was authorized in 1965 and became 2011) and children ages 6–18 with family incomes up to
Title XIX of the Social Security Act. Medicaid is a jointly 100% of poverty ($22,350 for a family of four in 2011) are
funded cooperative venture between the federal and state eligible for Medicaid. Other eligible children include
governments to assist states in the provision of adequate infants born to women covered by Medicaid (known as
medical care to eligible persons. Within broad federal ‘‘deemed newborns’’ ), certain children in foster care or an
guidelines, each state establishes its own eligibility adoption assistance program, and certain children with
standards; determines the type, amount, duration, and disabilities.
scope of services; sets the rate of payment for services; and Nondisabled Adults—Medicaid provides health coverage
administers its own program. to 11 million nonelderly low-income parents, other
Medicaid is the largest program providing medical and caretaker relatives, pregnant women, and other
health-related services to America's poorest people. nondisabled adults. States provide coverage to parents
Medicaid eligibility criteria have changed over time. and caretaker relatives who are in mandatory eligibility
Currently, Medicaid provides health coverage to children, groups and optional eligibility groups.
pregnant women, parents, seniors, and individuals with Eligibility levels for parents and caretaker relatives vary
disabilities. In order to participate in Medicaid, federal law across the country, and there is currently no federal
requires states to cover certain population groups requirement that states provide coverage to
(mandatory eligibility groups) and gives them the flexibility nonpregnant adults without dependent children. ACA
to cover other population groups (optional eligibility creates a national minimum eligibility standard of 133%
groups). States set individual eligibility criteria within federal of poverty, beginning in 2014, which will include
minimum standards. States can apply to the Centers for coverage of most adults under age 65 at this income
Medicare & Medicaid Services for a waiver of federal law to level.
expand health coverage beyond these groups. In order to be
eligible for Medicaid, individuals need to satisfy federal and Parents and Caretaker Relatives—Parents and caretaker
state requirements regarding residency, immigration status, relatives in low-income families with dependent children
and documentation of U.S. citizenship. are eligible for coverage if their income meets minimum
eligibility levels established for financial and medical
Many states have expanded coverage, particularly for assistance in 1996, which averages 41% of poverty. (1996
children, above the federal minimums. For many eligibility was the year of enactment for welfare reform, which held
groups, income is calculated in relation to HHS poverty in place guaranteed Medicaid eligibility for those
guidelines, which are updated annually. For other groups, receiving AFDC benefits at that time.) Parents are also
income standards are based on income or other eligible for Medicaid if they are medically needy, or
nonfinancial criteria standards for other programs, such as through Transitional Medical Assistance (TMA). States
the Supplemental Security Income (SSI) program. have the option to cover parents with incomes above the
The Affordable Care Act (ACA) creates a national Medicaid 1996 minimum levels, and many states do so as
minimum eligibility level of 133% of poverty ($29,700 for a mandatory or optional Medicaid state plan coverage or
family of four in 2011) for nearly all Americans under age 65. as part of a 1115 waiver program.
This Medicaid eligibility expansion went into effect January Adults Without Dependent Children—There is currently no
1, 2014, but states could have chosen to expand coverage federal requirement that states provide health coverage
with federal support before this date. The major eligibility to adults without dependent children. These adults
groups covered by most states include: qualify for Medicaid coverage only if they have a
+ Major Eligibility Group disability or are age 65 or over. However, about one-half
of states provide some coverage through federal waivers
Children—Most states have elected to provide Medicaid or state-funded programs for nondisabled adults who
to children in families with family incomes above the have limited incomes but do not otherwise qualify for
minimum of 100% of poverty, and all states have Medicaid.
expanded coverage to children with higher incomes
through the Children's Health Insurance Program (CHIP).
428 Appendix II. Definitions and Methods Health, United States, 2014
Affordable Care Act Provides Eligibility for Most Low-income eligible for Medicaid based on the traditional eligibility
Adults—In 2014, individuals under age 65 (including categories.
parents and adults without dependent children) with
incomes below 133% of poverty ($14,500 for an Medicaid operates as a vendor payment program.
individual in 2011) became eligible for Medicaid in every States may pay health care providers directly on a fee
state. This change ends the longstanding coverage gap for-service basis, or states may pay for Medicaid services
for low-income adults. States could have chosen to through various prepayment arrangements, such as through
expand eligibility for adults prior to 2014, and several health maintenance organizations or other forms of
states did so. managed care. Within federally imposed upper limits and
specific restrictions, each state for the most part has broad
+ Other Eligibility Groups discretion in determining the payment methodology and
Medically Needy—Many states have what are called payment rate for services. Thus, the Medicaid program
‘‘medically needy programs,’’ which are optional for varies considerably from state to state, as well as within
states. Individuals with significant health needs whose each state over time. For more information, see:
income is too high to otherwise qualify for Medicaid http://www.medicaid.gov/.
under other eligibility groups can still become eligible by (Also see Appendix II, Health expenditures, national; Health
‘‘spending down’’ the amount of income that is above a insurance coverage; Health maintenance organization
particular state's medically needy income standard. [HMO]; Managed care; and Appendix I, Medicaid Statistical
Individuals spend down by incurring expenses for Information System [MSIS].)
medical and remedial care. If once those incurred
expenses are subtracted from the person's annual Medicaid payments—Under the Medicaid program,
income and the person's income is at or below the state's medical vendor payments are payments (expenditures) to
medically needy income standard, the person can be medical vendors from the state through a fiscal agent, or to
eligible for Medicaid. The Medicaid program then pays a health insurance plan. Adjustments are made for Indian
the cost of services that exceed what the individual had Health Service payments to Medicaid, cost settlements,
to incur in the way of expenses in order to become third-party recoupments, refunds, voided checks, and other
eligible. financial settlements that cannot be related to specific
In addition to states with medically needy programs, provided claims. Excluded are payments made for medical
states that determine Medicaid eligibility of the aged, care under the emergency assistance provisions; payments
blind, and disabled using more restrictive eligibility made from state medical assistance funds that are not
criteria than are used by the Supplemental Security federally matchable; disproportionate-share hospital
Income (SSI) program (known as 209(b) states) also allow payments, cost sharing, or enrollment fees collected from
individuals to spend down their excess income to the recipients or a third party; and administration and training
state's categorically needy income standard. 209(b) costs. Medicaid payment data presented in Health, United
states must allow a spenddown to their categorically States are from the Medical Statistical Information System
needy income standard even if the state also has a (MSIS), which obtains payment data from electronic
medically needy program. Medicaid data submitted to the Centers for Medicare &
Medicaid Services by each state. Payment data are based on
Thirty-six states and D.C. use spenddown programs, adjudicated claims for medical services reimbursed with
either as medically needy programs or as 209(b) states. Title XIX funds.
Breast and Cervical Cancer Prevention and Treatment
Medical specialty—See Appendix II, Physician specialty.
Program—States can choose to provide Medicaid
coverage to certain groups of women who are in need of Medicare—Medicare is a nationwide program providing
treatment for breast and cervical cancer. Women are health insurance coverage to selected groups, regardless of
screened through CDC's National Breast and Cervical income. The covered groups are (a) most people aged 65
Cancer Early Detection Program (NBCCEDP). For a and over; (b) people entitled to Social Security or Railroad
woman to be eligible for Medicaid under this option, she Retirement disability benefits for at least 24 months (with
must have been screened for and found to have breast or the waiting period waived or reduced in certain situations);
cervical cancer, including precancerous conditions, (c) government employees or spouses with Medicare-only
through the NBCCEDP; need treatment for breast or coverage who have been disabled for more than 29 months
cervical cancer; be under age 65; and be uninsured and (with the waiting period waived or reduced in certain
otherwise not eligible for Medicaid. situations); (d) most people with end-stage renal disease;
Tuberculosis (TB)—States can choose to provide Medicaid and (e) certain people in the Libby, Montana, vicinity who
financing for coverage of TB-related services to low are diagnosed with asbestos-related conditions. The
income individuals who are infected with TB. This program was enacted on July 30, 1965, as Title XVIII of the
eligibility group serves individuals who are not otherwise Social Security Act, ‘‘Health Insurance for the Aged and
Disabled,’’ and became effective on July 1, 1966.
Health, United States, 2014 Appendix II. Definitions and Methods 429
From its inception, Medicare has included two separate but areas based on the 2010 standards (available from:
coordinated programs: Hospital Insurance (Part A) and http://www.whitehouse.gov/sites/default/files/omb/
Supplementary Medical Insurance (Part B). Part C (Medicare bulletins/2013/b13-01.pdf ). New MSA delineations are
Advantage, previously known as Medicare+Choice) was incorporated into individual data systems at different times.
established by the Balanced Budget Act of 1997 as an In the 2000 and 2010 standards, an MSA is a county, or
expanded set of options for the delivery of health care under group of contiguous counties, that contains at least one
Medicare. Although all Medicare beneficiaries can receive urbanized area with a population of 50,000 or more.
their benefits through the original fee-for-service program, In addition to the county or counties that contain all or
most beneficiaries enrolled in both Part A and Part B have part of the urbanized area, an MSA may contain other
the option to participate in a Medicare Advantage plan counties if there are strong social and economic ties with
instead. the central county or counties, as measured by commuting.
Counties that are not within an MSA are considered to be
Organizations that seek to contract as Medicare Advantage
nonmetropolitan. For more information, see:
plans must meet specific organizational, financial, and other
http://www.census.gov/population/metro/ and
requirements. Although most Medicare Advantage enrollees
http://www.whitehouse.gov/omb/bulletins_fy05_b05-02.
are in coordinated care plans, such as health maintenance
Most data by MSA currently in Health, United States are
organizations and preferred provider organizations,
based on the June 2003 OMB definitions (2000 OMB
Medicare Advantage plans also include private fee-for
standards applied to 2000 census data). (Also see Appendix
service plans, provider-sponsored organizations, special
II, Urbanization.)
needs plans, and medical savings account plans (MSA plans,
which provide benefits after a single high deductible is met). National Health Interview Survey (NHIS)—For respondents
Medicare Advantage plans are generally paid on a capitation to NHIS, designation of place of residence as
basis—that is, plans are paid a predetermined amount per metropolitan or nonmetropolitan is based on the
member per month, which is adjusted according to the following MSA definitions: for 2006 and beyond, on the
health status of the plans' members—and are required to June 2003 OMB definitions (2000 OMB standards applied
provide at least those services covered by Parts A and B, to 2000 census data); for 1995–2005, on the June 1993
except hospice services. Plans may (and in certain situations OMB definitions (1990 OMB standards applied to 1990
must) provide extra benefits (such as vision or hearing census data); and for 1985–1994, on the June 1983 OMB
coverage) or reduce cost sharing or premiums. definitions (1980 OMB standards applied to 1980 census
data). For estimates based on 2006 NHIS data combined
The Medicare Prescription Drug, Improvement, and
with earlier years of NHIS, metropolitan status of
Modernization Act (also called the Medicare Modernization
residence for all years involved is based on the June 2003
Act, or MMA) was passed on December 8, 2003. The MMA (P.
definitions. Introduction of each set of standards may
L. 108–173) established a voluntary prescription drug
create a discontinuity in trends.
benefit for Medicare beneficiaries and created a new
Medicare Part D. People eligible for Medicare could begin to National Immunization Survey (NIS)—Designation of
enroll in Part D beginning in January 2006. For more place of residence as metropolitan or nonmetropolitan
information, see: http://www.medicare.gov/publications/ for respondents to NIS is based on 2000 census data and
pubs/pdf/10050.pdf and http://www.cms.gov/Research the MSAs delineated in 2003, as well as the following
Statistics-Data-and-Systems/Statistics-Trends-and-Reports/ versions and revisions of MSA definitions: for 2011 and
MedicareMedicaidStatSupp/2013.html. (Also see Appendix 2012, on the December 2009 definitions; for 2010, on the
II, Fee-for-service health insurance; Health insurance November 2008 definitions, for New England, the
coverage; Health maintenance organization [HMO]; county-based areas were used; for 2009, on the
Managed care; and Appendix I, Medicare Administrative November 2007 definitions, for New England, the
Data.) county-based areas were used; for 2008, on the
December 2006 definitions, for New England, the
Metropolitan statistical area (MSA)—The Office of county-based areas were used; for quarter 4 of 2007, on
Management and Budget (OMB) defines MSAs according to the December 2006 definitions; for quarters 1–3 of 2007,
published standards that are applied to U.S. Census Bureau on the December 2005 definitions, for New England, the
data. The standards are revised periodically, generally prior county-based areas were used in 2007; for 2006, on the
to the decennial census, and are applied to the census data November 2004 definitions, for New England, the
to delineate the statistical areas. Revisions to the areas are county-based areas were used; for 2005, on the
implemented between censuses by using updated December 2003 definitions, for New England, the
population estimates. The most recent standards were county-based areas were used; for quarters 3 and 4 of
released in June 2010 (available from: http:// 2004, on the December 2003 definitions; and for quarters
www.whitehouse.gov/sites/default/files/omb/assets/ 1 and 2 of 2004 and quarter 4 of 2003, on the June 2003
fedreg_2010/06282010_metro_standards-Complete.pdf ). definitions. For 2003–2004 for New England, the
In February 2013, OMB released a new delineation of county-based areas were used. For more information,
the nation's metropolitan and micropolitan statistical see: http://www.census.gov/population/metro/.
430 Appendix II. Definitions and Methods Health, United States, 2014
Micropolitan statistical area—The Office of Management Data presented in the Health, United States Trend Table on
and Budget (OMB) defines micropolitan statistical areas prescription drug use by drug class are based on the second
based on published standards that are applied to U.S. level of the Lexicon Plus nested category system (e.g.,
Census Bureau data. The standards are revised periodically, calcium channel blocking agents). A drug may have up to
generally prior to the decennial census, and are applied to four drug therapeutic categories; drugs classified into more
the census data to delineate statistical areas. Revisions to the than one class were counted in each class. For example, if a
areas are implemented between censuses using updated person reported taking lorazepam, that respondent was
population estimates. The most recent standards were classified as taking an anticonvulsant, an antiemetic/
released in June 2010 (available from: http:// antivertigo agent, and an anxiolytic, sedative, hypnotic drug.
www.whitehouse.gov/sites/default/files/omb/assets/
The drug information file is updated along with each cycle
fedreg_2010/06282010_metro_standards-Complete.pdf ).
of prescription medication data release. Some new
OMB released a new delineation of the nation's
therapeutic categories could be added, and a few assigned
metropolitan and micropolitan statistical areas based on
classification levels might be changed (e.g., alendronate
the 2010 standards in February 2013 (available from:
now has three classification levels: metabolic agents [level
http://www.whitehouse.gov/sites/default/files/omb/
1], bone resorption inhibitors [level 2], and bisphosphonates
bulletins/2013/b13-01.pdf ). Data for micropolitan statistical
[level 3]); under the prior drug information file, alendronate
areas currently in Health, United States are based on the
had two classification levels: hormones (level 1) and
2003-based delineation. The micropolitan statistical area
bisphosphonates (level 2)). Data presented in Health,
data will be updated when the new delineation is
United States used the most recent drug information file for
incorporated into individual data systems.
all data years.
A micropolitan statistical area is a nonmetropolitan county,
For more information, see: http://wwwn.cdc.gov/nchs/
or group of contiguous nonmetropolitan counties, that
nhanes/1999-2000/RXQ_DRUG.htm.
contains an urban cluster of 10,000–49,999 persons. A
micropolitan statistical area may include surrounding Neonatal mortality rate—See Appendix II, Rate: Death and
counties that have strong social and economic ties with the related rates.
central county or counties as measured by commuting.
Nonmetropolitan counties that are not classified as part of a Nonprofit hospital—See Appendix II, Hospital.
micropolitan statistical area are considered noncore. For
more information about micropolitan statistical areas, see North American Industry Classification System
http://www.census.gov/population/www/metroareas/ (NAICS)—See Appendix II, Industry of employment.
metroarea.html. (Also see Appendix II, Metropolitan
statistical area [MSA]; Urbanization.) Notifiable disease—A notifiable disease is one that, when
diagnosed, health providers are required (usually by law) to
Multum Lexicon Plus therapeutic class—Starting with report to state or local public health officials. Notifiable
2003 data, NCHS used Lexicon Plus (Cerner Multum, Inc., diseases are of public interest by reason of their
Denver, CO), a proprietary database, to assist with data contagiousness, severity, or frequency. For more
editing and classification of human drugs. Starting with information, see: http://www.cdc.gov/osels/ph_surveillance/
2005 data, Lexicon Plus has also been used to assist with nndss/nndsshis.htm.
data collection. Data collected before 2003 were updated by
adding a generic drug code from Lexicon Plus. Nursing home—In the Quality Improvement Evaluation
System (QIES) (formerly the Online Survey Certification and
Lexicon Plus is a comprehensive database of all prescription Reporting [OSCAR]) database, a nursing home is a facility
and some nonprescription drug products available in the that is certified and meets the Centers for Medicare &
U.S. drug market. It uses a three-level nested category Medicaid Services' long-term care requirements for
system to assign a therapeutic classification to each drug Medicare and Medicaid eligibility.
(e.g., for atenolol: cardiovascular agents [level 1]; beta
adrenergic blocking agents [level 2]; cardioselective beta After October 1, 1990, long-term care facilities that met the
blockers [level 3]). Not all drugs have three classification Omnibus Budget Reconciliation Act of 1987, P. L. 100–203,
levels; some may only have two (e.g., for diltiazem: 101 Stat. 1330 nursing home reform requirements and were
cardiovascular agents [level 1]; calcium channel blocking formerly certified under Medicaid as skilled nursing, nursing
agents [level 2]). Other drugs may have only one home, or intermediate care facilities were reclassified as
classification level. All drugs in NCHS surveys were assigned nursing facilities. Medicare continues to certify skilled
into a Lexicon Plus drug category, even those drugs not nursing facilities but not intermediate care facilities. State
found in the Lexicon Plus drug database. ‘‘Unspecified’’ Medicaid programs can certify intermediate care facilities for
drugs were assigned to their respective therapeutic persons with intellectual disabilities (formerly called
category (e.g., hormones/hormone modifiers– unspecified: mentally retarded) or the developmentally disabled. To be
category ID = 97, category name = hormones/hormone certified for participation in Medicaid, nursing facilities must
modifiers). also be certified to participate in Medicare (except those
Health, United States, 2014 Appendix II. Definitions and Methods 431
facilities that have obtained waivers). Thus, most nursing surgery suites, or procedure rooms within an outpatient care
home care is now provided in skilled care facilities. facility. A surgical operation involving more than one
surgical procedure is considered one surgical operation.
(Also see Appendix II, Long-term care facility; Nursing home;
(Also see Appendix II, Procedure.)
Resident, health facility.)
Outpatient visit—The American Hospital Association
Nursing home expenditures—See Appendix II, Health
defines outpatient visits as visits for receipt of medical,
expenditures, national.
dental, or other services at a hospital by patients who are
Obesity—See Appendix II, Body mass index (BMI). not lodged in the hospital. Each appearance by an
outpatient to each unit of the hospital is counted
Occupancy rate—In American Hospital Association individually as an outpatient visit, including all clinic visits,
statistics, hospital occupancy rate is calculated as the referred visits, observation services, outpatient surgeries,
average daily census divided by the number of hospital and emergency department visits. In the National Hospital
beds, cribs, and pediatric bassinets set up and staffed on the Ambulatory Medical Care Survey, an outpatient department
last day of the reporting period, expressed as a percentage. visit is a direct personal exchange between a patient and a
Average daily census is calculated by dividing the total physician or other health care provider working under the
annual number of inpatients, excluding newborns, by 365 physician's supervision for the purpose of seeking care and
days to derive the number of inpatients receiving care on an receiving personal health services. (Also see Appendix II,
average day during the annual reporting period. The Emergency department or emergency room visit;
occupancy rate for facilities other than hospitals is Outpatient department.)
calculated as the number of residents at the facility reported
on the day of interview, divided by the number of reported Overweight—See Appendix II, Body mass index (BMI).
beds. In the Quality Improvement Evaluation System (QIES)
Pap smear—A Pap smear (also known as a Papanicolaou
(formerly the Online Survey Certification and Reporting
smear or Pap test) is a microscopic examination of cells
[OSCAR]) database, occupancy is determined as of the day of
scraped from the cervix that is used to detect cancerous or
certification inspection as the total number of residents on
precancerous conditions of the cervix or other medical
that day divided by the total number of beds on that day.
conditions.
Office-based physician—See Appendix II, Physician. In the National Health Interview Survey (NHIS), questions
concerning Pap smear use are asked on an intermittent
Office visit—In the National Ambulatory Medical Care schedule, and the question content has differed slightly
Survey, a physician's ambulatory practice (office) can be in across years. For 2013, women were asked when they had
any location other than in a hospital, nursing home, other their most recent Pap smear, and use of Pap smears was
extended care facility, patient's home, industrial clinic, defined as ‘‘percent of women having a Pap smear within
college clinic, or family planning clinic. Offices in health the past three years.’’ Survey questions have changed over
maintenance organizations and private offices in hospitals time.
are included. An office visit is any direct personal exchange
between an ambulatory patient and a physician or members In 1987, women were asked to report when they had their
of his or her staff for the purpose of seeking care and most recent Pap smear, in days, weeks, months, or years.
rendering health services. (Also see Appendix II, Outpatient Women who did not respond were asked a follow-up
visit.) question, ‘‘Was it 3 years ago or less, between 3 and 5 years,
or 5 years or more ago?’’ In 1990 and 1991, Pap smear data
Operation—See Appendix II, Procedure. in the past 3 years were not available. In 1993 and 1994,
women were asked whether they had a Pap smear within
Outpatient department—According to the National the past year, between 1 and 3 years ago, or more than 3
Hospital Ambulatory Medical Care Survey (NHAMCS), an years ago. In 1998, women were asked whether they had a
outpatient department (OPD) is a hospital facility where Pap smear 1 year ago or less, more than 1 year but not more
nonurgent ambulatory medical care is provided. The than 2 years ago, more than 2 years but not more than 3
following types of OPDs are excluded from NHAMCS: years ago, more than 3 years but not more than 5 years ago,
ambulatory surgical centers, chemotherapy, employee or more than 5 years ago.
health services, renal dialysis, methadone maintenance, and
radiology. (Also see Appendix II, Emergency department; In 1999, women were asked when they had their most
Outpatient visit.) recent Pap smear, in days, weeks, months, or years. Estimates
for 1999 may be slightly overestimated in comparison with
Outpatient surgery—According to the American Hospital estimates for previous years due to the inclusion of women
Association, outpatient surgery is a surgical operation, who responded ‘‘3 years ago’’ (4% of women), which could
whether major or minor, performed on a patient who does have included more than 3 years but less than 4 years.
not remain in the hospital overnight. Outpatient surgery
may be performed in inpatient operating suites, outpatient
432 Appendix II. Definitions and Methods Health, United States, 2014
In 2000 and 2003, women were asked when they had their a hysterectomy. Women were asked, ‘‘Have you had a
most recent Pap smear (give month and year). Women who hysterectomy?’’ In addition, women who reported that they
did not respond were given a follow-up question that used had not had a recent Pap smear were asked the most
the 1999 wording, and women who did not respond to the important reason they had not had a Pap smear; one reason
follow-up question were asked a second follow-up question women could select was because they had had a
that used the 1998 wording. Estimates for 2000 and 2003 hysterectomy. Women indicating in either of these questions
may be slightly overestimated in comparison with years that they had had a hysterectomy were excluded from the
prior to 1999 due to the inclusion of women who responded Pap smear screening estimates.
‘‘3 years ago’’ (less than 1% of women), which could have
Pap smear screening recommendations have changed
included more than 3 years but less than 4 years.
over time and vary in the recommended age to begin
In 2005, women were asked the same series of questions and end screening and the interval for screening. For a
about Pap smear use as in the 2000 and 2003 surveys, but summary of current and historic recommendations, see:
the questionnaire skip pattern was modified so that more U.S. Preventive Services Task Force. Cervical cancer:
women were asked the follow-up question using the 1998 Screening [Recommendation summary]. Release date,
wording, and these women were not uniformly coded as March 2012. Rockville, MD: Agency for Healthcare
having had a Pap smear within the past 3 years. Thus, Research and Quality; 2013. Available from:
estimates for 2005 are more precise than estimates for 1999, http://www.uspreventiveservicestaskforce.org/uspstf/
2000, and 2003. SAS code to categorize Pap smear data for uspscerv.htm.
2000 and beyond is available from: http://www.cdc.gov/
nchs/nhis/nhis_2005_data_release.htm. Patient—See Appendix II, Inpatient; Office visit; Outpatient
visit.
In 2008, 2010, and 2013, Pap smear questions were similar to
those asked in 2005. Percent change/percentage change—See Appendix II,
All women aged 18 and over are asked the Pap smear Average annual rate of change (percent change).
question(s). Women who reported having had a
Perinatal mortality rate; ratio—See Appendix II, Rate:
hysterectomy (removal of the uterus, with or without
Death and related rates.
removal of the ovaries and cervix) were still asked the Pap
smear questions because a woman who has had a Personal care home with or without nursing—See
hysterectomy may still have Pap smear testing. Appendix II, Nursing home.
The current recommendation, made by the U.S. Preventive
Services Task Force in 2012, is the use of Pap smears for cervical Personal health care expenditures—See Appendix II,
cancer every 3 years in women aged 21–65. In Health, United Health expenditures, national.
States, 2014, additional age groups (18–20, 21–24, and 21–44)
Physical activity, leisure-time—Starting with Health,
were added to account for the new recommendation. For more
United States, 2010, estimates on leisure-time physical
information on the change in recommendations, see:
activity changed to reflect the federal 2008 Physical
http://www.uspreventiveservicestaskforce.org/Page/
Activity Guidelines for Americans (available from:
Document/RecommendationStatementFinal/cervical-cancer
http://www.health.gov/PAGuidelines/guidelines/
screening#update-of-previous-uspstf-recommendation.
default.aspx). Adults who met the 2008 guidelines reported
The U.S. Preventive Services Task Force recommends against at least 150 minutes per week of moderate-intensity or
routine Pap smear screening in women who have had a total 75 minutes per week of vigorous-intensity aerobic physical
hysterectomy for benign disease. Therefore, two measures of activity (or an equivalent combination of moderate- and
Pap smear screening are presented in Health, United States: vigorous-intensity aerobic activity) and muscle
one among all women and one among women who did not strengthening activities at least twice a week. The estimates
report having a hysterectomy, although it is not known from for the percentage of Americans who met the 2008
NHIS data whether the hysterectomy was for benign disease. guidelines for aerobic and muscle strengthening are not
Questions about whether the respondent had a comparable with estimates in previous editions of Health,
hysterectomy were not asked in 2003. For other survey United States that showed the percentage of Americans with
years, questions about hysterectomy in NHIS differed regular leisure-time physical activity. For more information,
slightly, as follows. see: Carlson SA, Fulton JE, Schoenborn CA, Loustalot F. Trend
and prevalence estimates based on the 2008 Physical
In 1987, women who reported that they had not had a
Activity Guidelines for Americans. Am J Prev Med
recent Pap smear were asked the most important reason
2010;39(4)305–13.
they had not had a Pap smear; one reason women could
select was because they had had a hysterectomy. In 1993, Starting with 1998 data, leisure-time physical activity has
1994, 1998, 1999, and 2013 women were asked, ‘‘Have you been assessed in the National Health Interview Survey
had a hysterectomy?’’ In 2000, 2005, 2008, and 2010, two (NHIS) by asking adults a series of questions about how
questions were used to determine whether women had had often they do vigorous or light/moderate physical activity of
Health, United States, 2014 Appendix II. Definitions and Methods 433
at least 10 minutes duration and about how long these Primary care generalist—These physicians practice in the
sessions generally last. All questions related to leisure-time general fields of family medicine, general practice,
physical activity were phrased in terms of current behavior internal medicine, obstetrics and gynecology, and
and lack a specific reference period. Vigorous physical pediatrics. Specifically excluded are primary care
activity is described as causing heavy sweating or a large specialists associated with these generalist fields.
increase in breathing or heart rate, and light/moderate as
Primary care specialist—These specialists practice in the
causing light sweating or a slight to moderate increase in
primary care subspecialties of family medicine, internal
breathing or heart rate. Adults were also asked about how
medicine, obstetrics and gynecology, and pediatrics.
often they did leisure-time physical activities specifically
Family medicine subspecialties include geriatric
designed to strengthen their muscles, such as lifting weights
medicine and sports medicine. Internal medicine
or doing calisthenics. For more information, see the
subspecialties include adolescent medicine, critical care
NHIS Adult Physical Activity Information website at:
medicine, diabetes, endocrinology, diabetes and
http://www.cdc.gov/nchs/nhis/physical_activity.htm.
metabolism, hematology, hepatology, hematology/
Physician—Data on physician characteristics are obtained oncology, cardiac electrophysiology, infectious diseases,
through physician self-report from the American Medical clinical and laboratory immunology, geriatric medicine,
Association's (AMA) Physician Masterfile. Although the AMA sports medicine, nephrology, nutrition, medical
collects data for both doctors of medicine (MDs) and doctors oncology, pulmonary critical care medicine, and
of osteopathy (DOs), in Health, United States data for DOs rheumatology. Obstetrics and gynecology subspecialties
come from the American Osteopathic Association. include hospice and palliative medicine (obstetrics and
gynecology), maternal and fetal medicine, critical care
Active (or professionally active) physician—These medicine (obstetrics and gynecology), and reproductive
physicians are currently engaged in patient care or other endocrinology. Pediatric subspecialties include
professional activity for a minimum of 20 hours per week. adolescent medicine, pediatric critical care medicine,
Other professional activity includes administration, pediatrics/internal medicine, neonatal–perinatal
medical teaching, research, and other activities such as medicine, pediatric allergy, pediatric cardiology, pediatric
employment with insurance carriers, pharmaceutical endocrinology, pediatric infectious disease, pediatric
companies, corporations, voluntary organizations, and pulmonology, medical toxicology (pediatrics), pediatric
medical societies. Physicians who are retired, semiretired, emergency medicine, pediatric gastroenterology,
working part-time, or not practicing are classified as pediatric hematology/oncology, clinical and laboratory
inactive and are excluded. Also excluded are physicians immunology (pediatrics), pediatric nephrology, pediatric
with unknown address and physicians who did not rheumatology, and sports medicine (pediatrics).
provide information on type of practice or present
employment (not classified). Specialty care physician—These physicians are sometimes
called specialists and include primary care specialists
Hospital-based physician—These physicians are listed above in addition to all other physicians not
employed under contract with hospitals to provide direct included in the generalist definition. Specialty fields
patient care and include physicians in residency training include allergy and immunology, aerospace medicine,
(including clinical fellows) and full-time members of the anesthesiology, cardiovascular diseases, child and
hospital staff. adolescent psychiatry, colon and rectal surgery,
Office-based physician—These physicians are engaged in dermatology, diagnostic radiology, forensic pathology,
seeing patients in solo practice, group practice, two gastroenterology, general surgery, medical genetics,
physician practice, other patient care employment, or in neurology, nuclear medicine, neurological surgery,
providing inpatient services such as those offered by occupational medicine, ophthalmology, orthopedic
pathologists and radiologists. surgery, otolaryngology, psychiatry, public health and
general preventive medicine, physical medicine and
Data for physicians are presented by type of education rehabilitation, plastic surgery, anatomic and clinical
(doctor of medicine or doctor of osteopathy); place of pathology, pulmonary diseases, radiation oncology,
education (U.S. medical graduates and international thoracic surgery, urology, addiction medicine, critical
medical graduates); activity status (professionally active care medicine, legal medicine, and clinical
and inactive); area of specialty; and geographic area. pharmacology.
(Also see Appendix II, Physician specialty.)
(Also see Appendix II, Physician.)
Physician specialty—A physician specialty is any specific
branch of medicine in which a physician may concentrate. Population—The U.S. Census Bureau collects and publishes
Data are based on physician self-reports of their primary data on populations in the United States according to
area of specialty. Physician data are broadly categorized into several different definitions. Various statistical systems then
two areas of practice: those who provide primary care and use the appropriate population for calculating rates. (Also
those who provide specialty care.
434 Appendix II. Definitions and Methods Health, United States, 2014
see Appendix I, Population Census and Population and are often used to determine eligibility in certain federal
Estimates.) programs. The HHS poverty guidelines take into account
family size and state (coterminous, Alaska, Hawaii), but not
Resident population includes persons whose usual place
family composition. For more information, see HHS. Office of
of residence (i.e., the place where one usually lives and
the Assistant Secretary for Planning and Evaluation. Poverty
sleeps) is in one of the 50 states or D.C. It includes
Guidelines, Research, and Measurement website at:
members of the Armed Forces stationed in the United
http://aspe.hhs.gov/poverty/index.cfm.
States and their families. It excludes members of the
Armed Forces stationed outside the United States and National Health Interview Survey (NHIS)—For data years
civilian U.S. citizens whose usual place of residence is prior to 1997, a ratio of family income to U.S. Census
outside the United States. The resident population is the Bureau poverty threshold is computed taking into
denominator used to calculate birth and death rates and account family income and family size. Starting with
incidence of disease. 1997 data, the poverty ratio was based on family income,
family size, and family composition (number of children
Civilian population is the resident population excluding
in the family, and for families with two or fewer adults
members of the Armed Forces, although families of
the age of the adults in the family). (Also see Appendix II,
members of the Armed Forces are included. The civilian
Consumer Price Index [CPI]; Family income; and
population is the denominator for rates calculated for the
Appendix I, Current Population Survey [CPS]; National
National Hospital Discharge Survey and for emergency
Health Interview Survey [NHIS].)
department visit rates using the National Hospital
Ambulatory Medical Care Survey—Emergency National Health and Nutrition Examination Survey
Department Component. (NHANES)—NHANES uses the U.S. Census Bureau's
Current Population Survey (CPS) definition of family to
Civilian noninstitutionalized population is the civilian
group household members into a family unit. A poverty
population excluding persons residing in institutions
ratio is computed by dividing family income by the HHS
(such as nursing homes, prisons, jails, mental hospitals,
poverty guidelines specific to family size, as well as the
and juvenile correctional facilities). U.S. Census Bureau
appropriate guideline year, and state. See: Johnson CL,
estimates of the civilian noninstitutionalized population
Paulose-Ram R, Ogden CL, et al. National Health and
are used to calculate sample weights for the National
Nutrition Examination Survey: Analytic guidelines,
Health Interview Survey, the National Health and
1999–2010. NCHS. Vital Health Stat 2(161). 2013.
Nutrition Examination Survey, and the National Survey of
Available from: http://www.cdc.gov/nchs/data/series/
Family Growth, and as denominators for rates calculated
sr_02/sr02_161.pdf.
for the National Ambulatory Medical Care Survey and the
National Hospital Ambulatory Medical Care Preferred provider organization (PPO)—A PPO is a type of
Survey—Outpatient Department Component. medical plan in which coverage is provided to participants
through a network of selected health care providers, such as
Postneonatal mortality rate—See Appendix II, Rate: Death
hospitals and physicians. Enrollees may seek care outside
and related rates.
the network but pay a greater percentage of the cost of
Poverty—Two related versions of federal poverty measures coverage than within the network. (Also see Appendix II,
are shown in Health, United States. The first measure—a ratio Health maintenance organization [HMO]; Managed care.)
of family income to federal poverty threshold—is
Prevalence—Prevalence is the number of cases of a disease,
constructed using poverty thresholds from the U.S. Census
number of infected persons, or number of persons with
Bureau. Poverty thresholds are updated annually for
some other attribute present during a particular interval of
inflation by the Census Bureau using the Consumer Price
time. It is often expressed as a rate (e.g., the prevalence of
Index for all urban consumers (CPI–U). Poverty thresholds
diabetes per 1,000 persons during a year). (Also see
include a set of money income thresholds that vary by
Appendix II, Incidence.)
family size and composition but do not vary geographically.
Families or individuals with income below the appropriate Primary care specialty—See Appendix II, Physician
threshold are classified as below poverty. For example, the specialty.
average poverty threshold for a family of four was $23,834 in
2013, $22,314 in 2010, $17,603 in 2000, and $13,359 in 1990. Private expenditures—See Appendix II, Health
For more information, see the U.S. Census Bureau's poverty expenditures, national.
threshold website at: http://www.census.gov/hhes/www/
poverty/poverty.html. Procedure—Procedures can include surgical procedures
(such as appendectomies), diagnostic procedures (such as
The second poverty measure used in Health, United States is
spinal taps), and therapeutic treatments (such as infusion of
a ratio of family income to the HHS poverty guidelines.
a cancer chemotherapeutic substance) reported on a
Poverty guidelines are derived from the U. S. Census
patient's medical record. In Health, United States, procedures
Bureau's poverty thresholds, are issued annually by HHS,
are currently coded according to the International
Health, United States, 2014 Appendix II. Definitions and Methods 435
Classification of Diseases, 9th Revision, Clinical Modification Purchasing power parities (PPPs)—PPPs are calculated
(ICD–9–CM). rates of currency conversion that equalize the purchasing
power of different currencies by eliminating the differences
National Hospital Discharge Survey (NHDS)—In NHDS, up
in price levels between countries. PPPs show the ratio of
to four different procedures are coded per hospital stay;
prices in national currencies for the same good or service in
in 2010 data, up to eight different procedures are coded.
different countries. PPPs can be used to make intercountry
Common procedures were identified by procedure code
comparisons of the gross domestic product (GDP) and its
or, where appropriate, by groups of procedure codes
component expenditures. (Also see Appendix II, Gross
(Table XI). Procedures per hospital stay can be counted in
domestic product [GDP].)
different ways depending on the type of data of interest.
Counting any-listed procedures means that if one or Race—In 1977, the Office of Management and Budget
more of the same procedure occurs during the hospital (OMB) issued ‘‘Race and Ethnic Standards for Federal
stay, it is only counted once, so any-listed counts will Statistics and Administrative Reporting’’ (Statistical Policy
generally be equivalent to the number of hospital stays Directive 15) to promote comparability of data among
during which a procedure was performed. Counting federal data systems. The 1977 Standards called for the
all-listed procedures means that if the same procedure federal government's data systems to classify individuals
occurs multiple times during a hospital stay it is counted into the following four racial groups: American Indian or
each time it occurs, up to the maximum of four available Alaska Native, Asian or Pacific Islander, black, and white.
codes, to maintain consistency across all of the data years Depending on the data source, the classification by race was
shown in Health, United States; thus, all-listed procedure based on self-classification or on observation by an
counts can be greater than the number of hospital stays interviewer or other person filling out the questionnaire.
with a procedure. In Health, United States, NHDS
procedure data are presented for any-listed procedures. In 1997, revisions were announced for classification of
individuals by race within the federal government's data
Healthcare Cost and Utilization Project, National systems. (See: Revisions to the Standards for the
(Nationwide) Inpatient Sample (HCUP–NIS)—Up to 15 Classification of Federal Data on Race and Ethnicity. Fed
procedures are coded per hospital stay in the HCUP–NIS Regist 1997 October 30;62(210):58781–90.) The 1997
database. For each record, a principal procedure is Standards specify five racial groups: American Indian or
identified as the first procedure listed. HCUP–NIS Alaska Native, Asian, black or African American, Native
procedure data presented in Health, United States are Hawaiian or Other Pacific Islander, and white. These five
limited to operating room procedures that are principal categories are the minimum set for data on race in federal
procedures (first-listed). Valid operating room procedures statistics. The 1997 Standards also offer an opportunity for
were identified according to diagnosis-related groups respondents to select more than one of the five groups,
(DRGs) software. For DRG development, physician panels leading to many possible multiple-race categories. As with
classify all ICD–9–CM procedure codes based on whether the single-race groups, data for the multiple-race groups are
the procedure would be performed in operating rooms to be reported when estimates meet agency requirements
in most hospitals. Clinical Classifications Software (CCS) for reliability and confidentiality. The 1997 Standards allow
was used to categorize ICD–9–CM principal operating for observer or proxy identification of race but clearly state a
room procedure codes into one of 231 clinically preference for self-classification. The federal government
meaningful categories. CCS was developed at the considers race and Hispanic origin to be two separate and
Agency for Healthcare Research and Quality as a tool for distinct concepts. Thus, Hispanic persons may be of any race.
clustering patient procedures into a manageable number Federal data systems were required to comply with the 1997
of clinically meaningful categories. For more information Standards by 2003.
on CCS, see: http://www.hcup-us.ahrq.gov/
toolssoftware/ccs/AppendixBSinglePR.txt. T h e t o p National Health Interview Survey (NHIS)—Starting with
ranking operating room procedure categories by age Health, United States, 2002, race-specific estimates based
group, based on the number of discharges and total on NHIS were tabulated using the 1997 Standards for
national costs, are presented in Health, United States data year 1999 and beyond and are not strictly
(Table XII). CCS categories labeled ‘‘other’’ are not comparable with estimates for earlier years. The 1997
presented because these comprise miscellaneous Standards specify five single-race categories plus
procedures that do not form a homogenous group. multiple-race categories. Estimates for specific race
groups are shown when they meet requirements for
(Also see Appendix II, Outpatient surgery.) statistical reliability and confidentiality. The race
categories white only, black or African American only,
Proprietary hospital—See Appendix II, Hospital. American Indian or Alaska Native only, Asian only, and
Native Hawaiian or Other Pacific Islander only include
Public expenditures—See Appendix II, Health persons who reported only one racial group; the
expenditures, national. category 2 or more races includes persons who reported
more than one of the five racial groups in the 1997
436 Appendix II. Definitions and Methods Health, United States, 2014
Table XII. Codes for procedure categories for Healthcare Cost and Utilization Project data, from the International
Classification of Diseases, 9th Revision, Clinical Modification
Procedure category Code
NOTES: Procedures were classified by Clinical Classifications Software (CCS). For more information, see: http://www.hcup-us.ahrq.gov/
toolssoftware/ccs/AppendixBSinglePR.txt.
Standards or one of the five racial groups and ‘‘some exclusive because each race category includes all
other race.’’ Prior to data year 1999, data were tabulated persons who mention that race; and (c) Hispanic origin
according to the 1977 Standards, with four racial groups, and race: detailed race and Hispanic origin with a
and the Asian only category included Native Hawaiian or multiple-race total category. Where applicable,
Other Pacific Islander. Estimates for single-race comparison tabulations by race and Hispanic origin are
categories prior to 1999 included persons who reported shown based on the 1977 Standards. Because there are
one race or, if they reported more than one race, more race groups with the 1997 Standards, the sample
identified one race as best representing their race. size of each race group under the 1997 Standards is
Differences between estimates tabulated using the two slightly smaller than the sample size under the 1977
standards for data year 1999 are discussed in the Standards. Only those few multiple-race groups with
footnotes for each NHIS table in Health, United States sufficient numbers of observations to meet standards of
2002, 2003, and 2004 editions. Available from: http:// statistical reliability are shown. These tables also illustrate
www.cdc.gov/nchs/hus/previous.htm#editions. changes in labels and group categories resulting from
the 1997 Standards. The race designation black was
Tables XIII and XIV illustrate NHIS data tabulated by race
changed to black or African American, and the ethnicity
and Hispanic origin according to the 1997 and 1977
designation Hispanic was changed to Hispanic or Latino.
Standards for two health statistics (cigarette smoking
and private health insurance coverage). In these Survey data included in Health, United States, other than
examples, three separate tabulations using the 1997 NHIS, the National Survey of Drug Use & Health (NSDUH),
Standards are shown: (a) Race: mutually exclusive race and the National Health and Nutrition Examination
groups, including several multiple-race combinations; Survey (NHANES), generally do not permit tabulation of
(b) Race, any mention: race groups that are not mutually estimates for the detailed race and ethnicity categories
Health, United States, 2014 Appendix II. Definitions and Methods 437
Table XIIl. Current cigarette smoking among adults aged 18 and over, by race and Hispanic origin under the 1997 and 1977
Standards for federal data on race and ethnicity: United States, average annual 1993–1995
Sample Standard Sample Standard
1997 Standards size Percent error 1977 Standards size Percent error
White only. . . . . . . . . . . . . . ... 46,228 25.2 0.26 White . . . . . . . . . . . . . . ..... 46,664 25.3 0.26
Black or African American only ... 7,208 26.6 0.64 Black . . . . . . . . . . . . . . . ..... 7,334 26.5 0.63
American Indian or Alaska American Indian or Alaska
Native only. . . . . . . . . . . . . ... 416 32.9 2.53 Native . . . . . . . . . . . . . ..... 480 33.9 2.38
Asian only . . . . . . . . . . . . . . ... 1,370 15.0 1.19 Asian or Pacific Islander . . ..... 1,411 15.5 1.22
2 or more races total . . . . . . . ... 786 34.5 2.00
Black or African American;
white . . . . . . . . . . . . . . . ... 83 *21.7 6.05
American Indian or Alaska
Native; white . . . . . . . . . . ... 461 40.0 2.58
* Estimates are considered unreliable. Data preceded by an asterisk have a relative standard error of 20%–30%.
NOTES: The Office of Management and Budget’s (OMB) 1997 Revisions to the Standards for the Classification of Federal Data on Race and
Ethnicity specifies five race groups (white, black or African American, American Indian or Alaska Native, Asian, and Native Hawaiian or Other
Pacific Islander) and allows respondents to report one or more race groups. Estimates for single-race and multiple-race groups not shown above
do not meet standards for statistical reliability or confidentiality (relative standard error greater than 30%). Race groups under the 1997 Standards
were based on the question, ‘‘What is the group or groups which represents [person’s] race?’’ For persons who selected multiple groups, race
groups under the OMB’s 1977 Race and Ethnic Standards for Federal Statistics and Administrative Reporting were based on the additional
question, ‘‘Which of those groups would you say best represents [person’s] race?’’ Race-specific estimates in this table were calculated after
excluding respondents of other and unknown race. Other published race-specific estimates are based on files in which such responses have been
edited. Estimates are age-adjusted to the year 2000 standard population using five age groups: 18–24, 25–34, 35–44, 45–64, and 65 and over.
SOURCE: CDC/NCHS, National Health Interview Survey. See Appendix I, National Health Interview Survey (NHIS).
shown in Tables XIII and XIV, either because race data were imputed. Prior to the 2000 NHIS, a crude imputation
based on the 1997 Standards categories are not yet method that assigned a race to persons with missing
available or because there are insufficient numbers of values for the variable MAINRACE (the respondent's
observations in certain subpopulation groups to meet classification of the race he or she most identified with)
statistical reliability or confidentiality requirements. was used. Under these procedures, if an observed race
was recorded by the interviewer, it was used to code a
To improve the quality of data on ethnicity and race in
race value. If there was no observed race value, all
NHIS, hot-deck imputation of selected race and ethnicity
persons who had a missing value for MAINRACE and
variables was done for the first time in the 2000 NHIS and
were identified as Hispanic on the Hispanic origin
continued to be used for subsequent data years. Starting
question were coded as white. In all other cases,
with 2003 data, records for persons for whom ‘‘other
non-Hispanic persons were coded as ‘‘other race.’’
race’’ was the only race response were treated as having
Additional information on the NHIS methodology for
missing data on race and were added to the pool of
imputing race and ethnicity is available from the survey
records for which selected race and ethnicity variables
438 Appendix II. Definitions and Methods Health, United States, 2014
Table XIV. Private health care coverage among persons under age 65, by race and Hispanic origin under the 1997 and 1977
Standards for federal data on race and ethnicity: United States, average annual 1993–1995
Sample Standard Sample Standard
1997 Standards size Percent error 1977 Standards size Percent error
White only. . . . . . . . . . . . . . . . . 168,256 76.1 0.28 White . . . . . . . . . . . . . . ..... 170,472 75.9 0.28
Black or African American only . . . 30,048 53.5 0.63 Black . . . . . . . . . . . . . . . ..... 30,690 53.6 0.63
American Indian or Alaska American Indian or Alaska
Native only. . . . . . . . . . . . . . . . 2,003 44.2 1.97 Native . . . . . . . . . . . . . ..... 2,316 43.5 1.85
Asian only . . . . . . . . . . . . . . . . . 6,896 68.0 1.39 Asian and Pacific Islander. ..... 7,146 68.2 1.34
Native Hawaiian or Other Pacific
Islander only . . . . . . . . . . . . . . 173 75.0 7.43
2 or more races total . . . . . . . . . . 4,203 60.9 1.17
Black or African American;
white . . . . . . . . . . . . . . . . . . 686 59.5 3.21
American Indian or Alaska
Native; white . . . . . . . . . . . . . 2,022 60.0 1.71
Asian; white . . . . . . . . . . . . . . 590 71.9 3.39
Native Hawaiian or Other
Pacific Islander; white . . . . . . 56 59.2 10.65
NOTES: The Office of Management and Budget’s (OMB) 1997 Revisions to the Standards for the Classification of Federal Data on Race and
Ethnicity specifies five race groups (white, black or African American, American Indian or Alaska Native, Asian, and Native Hawaiian or Other
Pacific Islander) and allows respondents to report one or more race groups. Estimates for single-race and multiple-race groups not shown above
do not meet standards for statistical reliability or confidentiality (relative standard error greater than 30%). Race groups under the 1997 Standards
were based on the question, ‘‘What is the group or groups which represents [person’s] race?’’ For persons who selected multiple groups, race
groups under the OMB’s 1977 Race and Ethnic Standards for Federal Statistics and Administrative Reporting were based on the additional
question, ‘‘Which of those groups would you say best represents [person’s] race?’’ Race-specific estimates in this table were calculated after
excluding respondents of other and unknown race. Other published race-specific estimates are based on files in which such responses have been
edited. Estimates are age-adjusted to the year 2000 standard population using three age groups: under 18, 18–44, and 45–64. See Appendix II,
Age adjustment.
SOURCE: CDC/NCHS, National Health Interview Survey. See Appendix I, National Health Interview Survey (NHIS).
documentation at: http://www.cdc.gov/nchs/nhis/ beyond. Prior to data year 1999, the 1977 Standards were
quest_data_related_1997_forward.htm and from used. Because of the differences between the two
the NHIS race and Hispanic origin home page at: standards, the race-specific estimates shown in Trend
http://www.cdc.gov/nchs/nhis/rhoi.htm. Tables based on NHANES for 1999–2004 are not strictly
comparable with estimates for earlier years. Race in
National Health and Nutrition Examination Survey
NHANES I and II was determined primarily by interviewer
(NHANES)—Starting with Health, United States, 2003,
observation; starting with NHANES III, race was self
race-specific estimates based on NHANES were tabulated
reported by survey participants.
using the 1997 Standards for data years 1999 and
Health, United States, 2014 Appendix II. Definitions and Methods 439
The NHANES sample for data years 1999–2006 was as white. Starting in 1964, unknown race was classified
designed to provide estimates specifically for persons of according to information on the birth record. Starting
Mexican origin and not for all Hispanic-origin persons in with the 2000 census, the race and ethnicity data used
the United States. Persons of Hispanic origin other than for denominators (population) to calculate birth and
Mexican origin were entered into the sample with fertility rates have been collected in accordance with the
different selection probabilities that are not nationally 1997 revised OMB standards for race and ethnicity.
representative of the total U.S. Hispanic population. However, the numerators (births) will not be compatible
Starting with 2007–2008 data, all Hispanic persons were with the denominators until all the states revise their
oversampled, not just persons of Mexican origin. birth certificates to reflect the new standards. To
Oversampling of the black population was continued. compute rates, it is currently necessary to bridge
The current sample design also oversamples the Asian population data for multiple-race persons to single-race
population. In Health, United States estimates are shown categories. (Also see Appendix I, Population Census and
for non-Hispanic white, non-Hispanic black, and Population Estimates, Bridged-race Population
Mexican-origin persons. Although data were collected Estimates.)
according to the 1997 Standards, there are insufficient
Starting with 2003 data, some states began using the
numbers of observations during this period to meet
2003 revision of the U.S. Standard Certificate of Live Birth,
statistical reliability or confidentiality requirements for
which allows the reporting of more than one race
reporting estimates for additional race categories.
(multiple races). For 2013 data, 44 states, D.C., Guam, and
National Survey on Drug Use & Health (NSDUH)—Race Northern Marianas allowed the reporting of multiple
specific estimates based on NSDUH are tabulated using race data. The 44 states and D.C. represented 91% of all
the 1997 Standards. Estimates in the NSDUH Trend Table U.S. resident births. In 2013, multiple race was reported
begin with data year 2002. Estimates for specific race for slightly more than 2% of mothers in the states that
groups are shown when they meet requirements for permitted reporting of more than one race. In 2013, data
statistical reliability and confidentiality. The race from the vital records of the remaining six states, and two
categories white only, black or African American only, territories, followed the 1977 OMB Standards and
American Indian or Alaska Native only, Asian only, and reported the minimum set of four race categories,
Native Hawaiian or Other Pacific Islander only include compared with the minimum of five race categories for
persons who reported only one racial group; the the 1997 Standards. To provide uniformity and
category two or more races includes persons who comparability of the data during the transition to the
reported more than one of the five racial groups in the 2003 revision, before multiple-race data are available for
1997 Standards or one of the five racial groups and all reporting areas, the responses of those who reported
‘‘some other race.’’ more than one race are bridged to a single race. For more
information on the adoption of the 2003 revision of the
National Vital Statistics System (NVSS)—Some of the states
U.S. Standard Certificate of Live Birth, see the Technical
in the Vital Statistics Cooperative Program are still
Notes section of the annual series of ‘‘Births: Final Data’’
revising their birth and death records to conform to the
reports, available from: http://www.cdc.gov/nchs/
1997 Standards on race and ethnicity. During the
products/nvsr.htm.
transition to full implementation of the 1997 Standards,
vital statistics data will continue to be presented for four Although the bridging procedure imputes multiple race
major race groups (white, black or African American, of mothers to one of the four minimum races stipulated
American Indian or Alaska Native, and Asian or Pacific in the 1977 Standards, mothers of a specified Asian or
Islander) in accordance with the 1977 Standards. Pacific Islander (API) subgroup (Chinese, Japanese,
Hawaiian, or Filipino) in combination with another race
Birth file—Information about the race and Hispanic origin
(American Indian or Alaska Native, black, and/or white) or
of the mother and father are provided by the mother at
another API subgroup cannot be imputed to a single API
the time of birth and are recorded on the birth certificate
subgroup. Data for the API subgroups are available in the
or fetal death record. Since 1980, birth rates, birth
2013 Natality public-use data file at: http://www.cdc.gov/
characteristics, and death rates for live-born infants and
nchs/births.htm.
fetal deaths are presented in Health, United States
according to race of the mother. Before 1980, data were Mortality file—Information about the race and Hispanic
tabulated by race of the newborn and fetus, taking into origin of a decedent is reported by the funeral director as
account the race of both parents. If the parents were of provided by an informant (often the surviving next of
different races and one parent was white, the child was kin), or in the absence of an informant, on the basis of
classified according to the race of the other parent. When observation. Death rates by race and Hispanic origin are
neither parent was white, the child was classified based on information from death certificates
according to father's race, with one exception: if either (numerators of the rates) and on population estimates
parent was Hawaiian, the child was classified Hawaiian. from the Census Bureau (denominators). Race and
Before 1964, if race was unknown, the birth was classified ethnicity information from the census is by self-report. To
440 Appendix II. Definitions and Methods Health, United States, 2014
the extent that race and Hispanic origin are inconsistent American Indian and Alaska Native persons who reside
between these two data sources, death rates will be on or near reservations. Because of misclassification of
biased. Studies have shown that persons self-reported as American Indian or Alaska Native persons on death
American Indian, Asian, or Hispanic on census and survey certificates American Indian or Alaska Native national
records may sometimes be reported as white or non and state-specific mortality estimates published in
Hispanic on the death certificate, resulting in an Health, United States should be interpreted with caution.
underestimation of deaths and death rates for the
Interpretation of trends for the Asian population in the
American Indian, Asian, and Hispanic groups. Bias also
United States should take into account that this
results from undercounts of some population groups in
population more than doubled between 1980 and 1990,
the census—particularly young black males, young white
primarily because of immigration. Between 1990 and
males, and elderly persons—resulting in an
2000, the increase in the Asian population was 48% for
overestimation of death rates. Race and ethnicity
persons reporting that they were Asian alone and 72%
reporting on the death certificate continues to be
for persons who reported they were either Asian alone or
excellent for the white and black populations. It remains
Asian in combination with another race.
poor for the American Indian or Alaska Native population
but is reasonably good for the Hispanic and Asian or For more information on coding race by using vital
Pacific Islander populations. Decedent characteristics statistics, see: NCHS. Vital statistics of the United States,
such as place of residence and nativity have an vol I, Natality, and vol II, Mortality, part A, Technical
important effect on the quality of reporting on the death appendix. Hyattsville, MD; published annually. Available
certificate. The effects of misclassification on mortality from: http://www.cdc.gov/nchs/nvss.htm.
estimates were most pronounced for the American
Starting with 2003 data, some states began using the
Indian or Alaska Native population, where correcting for
2003 revision of the U.S. Standard Certificate of Death,
misclassification reverses a large American Indian or
which allows the reporting of more than one race
Alaska Native-over-white mortality advantage to a large
(multiple races). This change was implemented to reflect
disadvantage. Among the Hispanic and Asian or Pacific
the increasing diversity of the U.S. population and to be
Islander populations, adjustment for death certificate
consistent with the decennial census. For more
misclassification did not significantly affect minority
information on states reporting of multiple-race data, see
majority mortality. For more information, see: Arias E,
the annual series of ‘‘Deaths: Final Data’’ reports,
Schauman WS, Eschbach K, et al. The validity of race and
available from: http://www.cdc.gov/nchs/products/
Hispanic origin reporting on death certificates in the
nvsr.htm.
United States. NCHS. Vital Health Stat 2008;2(148).
Available from: http://www.cdc.gov/nchs/data/series/ To provide uniformity and comparability of data until all
sr_02/sr02_148.pdf. states are reporting multiple-race data, it has been
necessary to bridge the responses of those for whom
Denominators for infant mortality rates are based on the
more than one race is reported (multiple race) to one
number of live births, rather than on population
single race. For more information, see: NCHS procedures
estimates. Race information for the denominator is
for multiple-race and Hispanic origin data: Collection,
supplied from the birth certificate. Before 1980, race of
coding, editing, and transmitting. Hyattsville, MD: NCHS;
child for the denominator took into account the races of
2004. Available from: http://www.cdc.gov/nchs/data/
both parents. Starting in 1980, race information for the
dvs/Multiple_race_docu_5-10-04.pdf; and NCHS. Vital
denominator has been based solely on the race of the
statistics of the United States, vol I, Natality, and vol II,
mother. Race information for the numerator is supplied
Mortality, part A, Technical appendix. Hyattsville, MD;
from the death certificate. For the infant mortality rate,
published annually. Available from: http://www.cdc.gov/
race information for the numerator is race of the
nchs/nvss.htm.
deceased child.
Youth Risk Behavior Survey (YRBS)—Prior to 1999, the
Issues affecting the interpretation of vital event rates for
1977 OMB Standards were used. Respondents could
the American Indian or Alaska Native population include
select only one of the following categories: white (not
(a) changes in the classification or self-identification of
Hispanic), black (not Hispanic), Hispanic or Latino, Asian
persons of American Indian or Alaska Native heritage
or Pacific Islander, American Indian or Alaska Native, or
over time, and (b) misclassification of American Indian or
other. Beginning in 1999, the 1997 OMB Standards were
Alaska Native persons on death certificates by the funeral
used for race-specific estimates, and respondents were
director or informant. Vital event rates for the American
given the option of selecting more than one category to
Indian or Alaska Native population shown in Health,
describe their race and ethnicity. Between 1999 and
United States are based on the total U.S. resident
2003, students were asked a single question about race
American Indian and Alaska Native population, as
and Hispanic origin, with the option of choosing more
enumerated by the U.S. Census Bureau. In contrast, the
than one of the following responses: white, black or
Indian Health Service calculates vital event rates for this
African American, Hispanic or Latino, Asian, Native
population based on U.S. Census Bureau county data for
Health, United States, 2014 Appendix II. Definitions and Methods 441
Hawaiian or Other Pacific Islander, or American Indian or Fertility rate is the total number of live births, regardless
Alaska Native. In 2005, students were asked a question of the age of the mother, per 1,000 women of
about Hispanic origin (‘‘Are you Hispanic or Latino?’’) and reproductive age (15–44 years). Beginning in 1997, the
a second separate question about race that included the birth rate for the maternal age group 45–49 includes
option of selecting more than one of the following data for mothers aged 50–54 in the numerator and is
categories: American Indian or Alaska Native, Asian, black based on the population of women aged 45–49 in the
or African American, Native Hawaiian or Other Pacific denominator.
Islander, or white. Because of the differences between
+ Death and related rates
questions, data about race and Hispanic ethnicity for the
years prior to 1999 are not strictly comparable with Death rate is calculated by dividing the number of deaths
estimates for the later years. However, analyses of data in a population in a year by the midyear resident
collected between 1991 and 2003 have indicated that population. For census years, rates are based on
the data are comparable across years and can be used to unrounded census counts of the resident population as
study trends. See: Brener ND, Kann L, McManus T. A of April 1. For the noncensus years 1981–1989, rates are
comparison of two survey questions on race and based on national estimates of the resident population
ethnicity among high school students. Public Opin Q as of July 1, rounded to thousands. Rounded population
2003;67(2):227–36. estimates for 10-year age groups are calculated by
summing unrounded population estimates before
(Also see Appendix II, Hispanic origin; and Appendix I, rounding to thousands. Starting in 1991, rates are based
Population Census and Population Estimates.) on unrounded national population estimates. Rates for
the Hispanic and non-Hispanic white populations in each
Rate—A rate is a measure of some event, disease, or year are based on unrounded state population estimates
condition in relation to a unit of population, along with for states in the Hispanic reporting area. Death rates are
some specification of time. (Also see Appendix II, Age expressed as the number of deaths per 100,000 resident
adjustment; Population.) population. The rate may be restricted to deaths in
+ Birth and related rates specific age, race, sex, or geographic groups or from
specific causes of death (specific rate), or it may be
Birth rate is calculated by dividing the number of live related to the entire population (crude rate). (Also see
births in a population in a year by the resident Appendix I, Population Census and Population
population. For census years, rates are based on Estimates.)
unrounded census counts of the resident population as
of April 1. For the noncensus years 1981–1989, rates are Birth cohort infant mortality rates are based on the birth
based on national estimates of the resident population cohort linked birth and infant death files and are
as of July 1, rounded to thousands. Rounded population computed as the number of deaths under age 1 year to
estimates for 5-year age groups are calculated by members of the birth cohort, divided by the number of
summing unrounded population estimates before live births, times 1,000. (Also see Appendix II, Birth
rounding to thousands. Starting in 1991, rates are based cohort.)
on unrounded national population estimates. Birth rates Fetal mortality rate is the number of fetal deaths with
for 1991–1999 were revised based on the April 1, 2000, stated or presumed gestation of 20 weeks or more,
census. Birth rates for 1991–1999 were revised based on divided by the sum of live births plus fetal deaths, times
the 1990 and 2000 censuses. The rates for 1990, 2000, 1,000.
and 2010 are based on populations from the censuses in
those years as of April 1. Birth rates for 2001–2009 were Infant mortality rate is based on period files and is
revised based on the 2000 and 2010 censuses. Birth rates calculated by dividing the number of infant deaths
for 2011 and subsequent years were computed using during a calendar year by the number of live births
2010-based postcensal estimates. The population reported in the same year. It is expressed as the number
estimates have been provided by the U.S. Census Bureau of infant deaths per 1,000 live births. Neonatal mortality
and have been modified to be consistent with OMB racial rate is the number of deaths among infants under age 28
categories as of 1977 and historical categories for birth days per 1,000 live births. Postneonatal mortality rate is
data. Beginning in 1997, the birth rate for the maternal the number of infant deaths that occur between 28 days
age group 45–49 includes data for mothers aged 50–54 to under 1 year after birth, per 1,000 live births. (Also see
in the numerator and is based on the population of Appendix II, Infant death.)
women aged 45–49 in the denominator. Birth rates are Late fetal mortality rate is the number of fetal deaths with
expressed as the number of live births per 1,000 stated or presumed gestation of 28 weeks or more,
population. The rate may be restricted to births to divided by the sum of live births plus late fetal deaths,
women of specific age, race, marital status, or geographic times 1,000. (Also see Appendix II, Gestation.)
location (specific rate), or it may be related to the entire
population (crude rate).
442 Appendix II. Definitions and Methods Health, United States, 2014
Perinatal mortality rates and ratios relate to the period Relative standard error (RSE)—RSE is a measure of an
surrounding the birth event. Rates and ratios are based estimate's reliability. The RSE of an estimate is obtained by
on events reported in a calendar year. Although several dividing the standard error of the estimate, SE(r), by the
different perinatal mortality definitions exist, the estimate itself, r. This quantity is expressed as a percentage
perinatal definition used in Health, United States (and of the estimate and is calculated as follows:
used most commonly for international comparisons) is
the sum of late fetal deaths at 28 weeks of gestation or RSE = 100 × [SE(r)/(r)]
more plus infant deaths within 7 days of birth, divided by
Estimates with large RSEs are considered unreliable. In
the sum of live births plus late fetal deaths, times 1,000.
Health, United States, most statistics with large RSEs are
Perinatal mortality ratio is the sum of late fetal deaths
preceded by an asterisk or are not presented. The criteria for
plus infant deaths within 7 days of birth, divided by the
evaluating RSEs is discussed in the footnotes accompanying
number of live births, times 1,000.
each table.
+ Visit rate
Relative survival rate—The relative survival rate is the ratio
Visit rate is a basic measure of service utilization for of the observed survival rate for the patient group to the
event-based data. Examples of events include physician expected survival rate for persons in the general population
office visits with drugs provided, or hospital discharges. similar to the patient group with respect to age, sex, race,
In the visit rate calculation, the numerator is the number and calendar year of observation. The 5-year relative survival
of estimated events, and the denominator is the rate estimates the proportion of cancer patients who have
corresponding U.S. population estimate for those who survived their cancer 5 years after diagnosis. Because more
possibly could have had events during a given period of than one-half of all cancers occur in persons aged 65 and
time. The interpretation is that for every person in the over, many of these individuals die of other causes with no
population there were, on average, x events. It does not evidence of recurrence of their cancer. However, by
mean that x persons in the population had events, adjusting observed survival for the normal life expectancy of
because some persons in the population had no events the general population of the same age, the relative survival
while others had multiple events. The only exception is rate gives a more specific estimate of the chance of surviving
when an event can occur just once for a person (e.g., if an the effects of cancer alone.
appendectomy is performed during a hospital stay). The
visit rate is best used to compare utilization across Reporting area—In the National Vital Statistics System,
various subgroups of interest, such as age or race groups the reporting area for such basic items on the birth and
or geographic regions. death certificates as age, race, and sex is based on data from
residents of all 50 states in the United States, D.C., and
Region—See Appendix II, Geographic region. New York City. The term ‘‘reporting area’’ may be used
interchangeably with the term ‘‘registration area.’’
Registered hospital—See Appendix II, Hospital.
(Also see Appendix II, Registration area; and Appendix I,
Registration area—The United States has separate National Vital Statistics System [NVSS].)
registration areas for birth, death, marriage, and divorce
Resident, health facility—In the Quality Improvement
statistics. In general, registration areas correspond to states
Evaluation System (QIES) (formerly the Online Survey
and include two separate registration areas for D.C. and New
Certification and Reporting [OSCAR]) database, all residents
York City. The term ‘‘reporting area’’ may be used
in certified facilities are counted on the day of certification
interchangeably with the term ‘‘registration area.’’ All
inspection.
registration areas have adopted laws that require
registration of births and deaths and the reporting of fetal Resident population—See Appendix II, Population.
deaths. It is believed that more than 99% of births and
deaths occurring in this country are registered. Rural—See Appendix II, Urbanization.
The death registration area was established in 1900 with 10
Self-assessment of health—See Appendix II, Health status,
states and D.C., and the birth registration area was
respondent-assessed.
established in 1915, also with 10 states and D.C. Beginning
in 1933, all states were included in the birth and death Serious psychological distress—The K6 mental health
registration areas. The specific states added year by year are screening instrument is a measure of psychological distress
shown in: Hetzel AM. History and organization of the vital associated with unspecified but potentially diagnosable
statistics system. Hyattsville, MD: NCHS; 1997. Available mental illness that may result in a higher risk for disability
from: http://www.cdc.gov/nchs/data/misc/usvss.pdf. and higher utilization of health services. In the National
Currently, Puerto Rico, the U.S. Virgin Islands, and Guam each Health Interview Survey (NHIS), the K6 questions were asked
constitute a separate registration area, although their data of adults aged 18 and over. The K6 is designed to identify
are not included in statistical tabulations of U.S. resident persons with serious psychological distress, using as few
data. (Also see Appendix II, Reporting area.) questions as possible. The six items included in the K6 are:
Health, United States, 2014 Appendix II. Definitions and Methods 443
During the past 30 days, how often did you feel: past year, and past month. However, only estimates of
use in the past month are presented in Health, United
+ So sad that nothing could cheer you up?
States. For illicit drug use, respondents in NSDUH are
+ Nervous? asked about use of marijuana/hashish, cocaine (including
+ Restless or fidgety? crack), inhalants, hallucinogens, heroin, and prescription
+ Hopeless? type psychotherapeutic drugs (pain relievers,
tranquilizers, stimulants, and sedatives) used
+ That everything was an effort?
nonmedically. A series of questions is asked about each
+ Worthless? substance: ‘‘Have you ever, even once, used
[substance]?’’, and ‘‘How long has it been since you last
Possible answers are ‘‘All of the time’’ (4 points), ‘‘Most of the
used [substance]?’’ Numerous probes and checks are
time’’ (3 points), ‘‘Some of the time’’ (2 points), ‘‘A little of the
included in the computer-assisted interview system.
time’’ (1 point), and ‘‘None of the time’’ (0 points).
Nonprescription medications and legitimate use of
To score the K6, the points are added together, yielding a prescription drugs under a doctor's supervision are not
possible total of 0–24 points. A threshold of 13 points or included in the survey. Summary measures, such as
more is used to define serious psychological distress. current illicit drug use, are produced. (Also see Appendix
Persons answering ‘‘Some of the time’’ to all six questions II, Alcohol consumption; Cigarette smoking; Illicit drug
would not reach the threshold for serious psychological use; and Appendix I, National Survey on Drug Use &
distress because to achieve a score of 13 they would need to Health [NSDUH].)
answer ‘‘Most of the time’’ to at least one item. The version
of the K6 used in NHIS provides 1-month prevalence rates Suicidal ideation—Suicidal ideation means having
because the reference period is the past 30 days. For more thoughts of suicide or of taking action to end one's own life.
information, see: Kessler RC, Barker PR, Colpe LJ, Epstein JF, Suicidal ideation includes all thoughts of suicide, both when
Gfroerer JC, Hiripi E, et al. Screening for serious mental illness the thoughts include a plan to commit suicide and when
in the general population. Arch Gen Psychiatry they do not include a plan. Suicidal ideation is measured in
2003;60(2):184–9. (Also see Appendix II, Basic actions the Youth Risk Behavior Survey by the following three
difficulty.) questions: ‘‘During the past 12 months, did you ever
seriously consider attempting suicide?’’ , ‘‘During the past 12
Short-stay hospital—See Appendix II, Hospital. months, how many times did you actually attempt suicide?’’,
and ‘‘If you attempted suicide during the past 12 months,
Skilled nursing facility—See Appendix II, Nursing home. did any attempt result in an injury, poisoning, or overdose
that had to be treated by a doctor or nurse?’’ For more
Smoker—See Appendix II, Cigarette smoking. information, see: http://www.cdc.gov/HealthyYouth/yrbs/
index.htm.
Special hospital—See Appendix II, Hospital.
Surgery—See Appendix II, Outpatient surgery; Procedure.
Substance use—Substance use refers to the use of selected
substances, including alcohol, tobacco products, drugs, Surgical specialty—See Appendix II, Physician specialty.
inhalants, and other substances that can be consumed,
inhaled, injected, or otherwise absorbed into the body with Tobacco use—See Appendix II, Cigarette smoking.
possible dependence and other detrimental effects. (Also
see Appendix II, Illicit drug use.) Uninsured—Broadly, persons are considered uninsured if
they do not have coverage under private health insurance,
Monitoring the Future (MTF) Study—MTF collects
Medicare, Medicaid, public assistance, a state-sponsored or
information on the use of selected substances by using
other government-sponsored plan or program, or a military
self-completed questionnaires in a school-based survey
health plan. Because of differences in methodology,
of secondary school students. MTF has tracked 12th
question wording, and recall period, estimates from
graders' illicit drug use and attitudes toward drugs since
different sources may vary and are not directly comparable.
1975. In 1991, 8th and 10th graders were added to the
For more information, see: Health insurance measurement:
study. The survey includes questions on abuse of
Differences by data source. Available from:
substances including (but not limited to) marijuana,
http://www.census.gov/content/dam/Census/library/
inhalants, other illegal drugs, alcohol, cigarettes, and
infographics/health_insurance_measurement.pdf.
other tobacco products. (Also see Appendix I, Monitoring
the Future [MTF] Study.) American Community Survey (ACS)—In ACS, persons are
considered uninsured if they do not have coverage
National Survey on Drug Use & Health (NSDUH)—NSDUH
through private health insurance, Medicare, Medicaid,
conducts in-person, computer-assisted interviews of a
Children's Health Insurance Program, military/TRICARE or
sample of individuals aged 12 and over at their place of
veterans coverage, another government program, or
residence. For illicit drug use, alcohol use, and tobacco
other insurance. Persons with only Indian Health Service
use, information is collected about use in the lifetime,
444 Appendix II. Definitions and Methods Health, United States, 2014
coverage are considered uninsured. The questions on and nonmetropolitan noncore. Recently, NCHS updated the
health insurance are administered throughout the year Urban–Rural Classification scheme. The 2013 NCHS Scheme
and ask about current health insurance coverage as of is based on the February 2013 OMB delineation of MSAs and
the day of the interview. micropolitan statistical areas, 2012 postcensal estimates of
county and place population, and county-level data on
National Health Interview Survey (NHIS)—In NHIS, the
selected settlement density, socioeconomic, and
uninsured are persons who do not have coverage under
demographic variables from Census 2010. Comparison of
private health insurance, Medicare, Medicaid, public
the 2013 and 2006 schemes showed that 9% of counties had
assistance, a state-sponsored health plan, other
different category assignments in the two schemes, with
government-sponsored programs, or a military health
most of the counties moving to a more urban category. For
plan. Persons with only Indian Health Service coverage
more information on the 2006 and 2013 classification
are considered uninsured. Estimates for the uninsured
schemes, see: http://www.cdc.gov/nchs/data_access/
are shown only for the population under age 65.
urban_rural.htm.
Estimates of the percentage of persons who are
uninsured based on NHIS may differ slightly from those Usual source of care—Usual source of care was measured
based on the March Current Population Survey or the in the National Health Interview Survey (NHIS) in 1993 and
American Community Survey because of differences in 1994 by asking the respondent, ‘‘Is there a particular person
survey questions, recall period, and other aspects of or place that [person] usually goes to when [person] is sick
survey methodology. or needs advice about [person's] health?’’ In the 1995 and
Survey respondents may be covered by health insurance 1996 NHIS, the respondent was asked, ‘‘Is there one doctor,
at the time of interview but may have experienced one person, or place that [person] usually goes to when [person]
or more lapses in coverage during the year prior to is sick or needs advice about health?’’ Starting in 1997, the
interview. Starting with Health, United States, 2006, NHIS respondent was asked, ‘‘Is there a place that [person] usually
estimates for people with health insurance coverage for goes when he/she is sick or you need advice about [his/her]
all 12 months prior to interview, for those who were health?’’ Persons who report the emergency department as
uninsured for any period up to 12 months, and for those their usual source of care are defined in Health, United States
who were uninsured for more than 12 months were as having no usual source of care.
added as stub variables to selected tables. (Also see
Appendix II, Health insurance coverage.) Vaccination—Vaccinations, or immunizations, work by
stimulating the immune system—the natural disease
Urbanization—Urbanization is the degree of urban fighting system of the body. A healthy immune system is
(city-like) character of a particular geographic area. able to recognize invading bacteria and viruses and produce
Urbanization can be measured in a variety of ways. In Health, substances (antibodies) to destroy or disable these invaders.
United States, the two measures currently used to categorize Vaccinations prepare the immune system to ward off a
counties by urbanization level are the Office of Management disease. In addition to the initial immunization process, the
and Budget's (OMB) metropolitan and micropolitan effectiveness of some immunizations can be improved by
statistical area classification and the 2006 NCHS Urban–Rural periodic repeat injections or ‘‘boosters.’’ Vaccines are among
Classification Scheme for Counties. For more information on the most successful and cost-effective public health tools
the OMB classification of counties, see Appendix II, available for reducing morbidity and mortality from
Metropolitan statistical area (MSA); Micropolitan statistical vaccine-preventable diseases. For a comprehensive list of
area. vaccine-preventable diseases, see: http://www.cdc.gov/
vaccines/vpd-vac/vpd-list.htm and http://www.cdc.gov/
The 2006 NCHS Urban–Rural Classification Scheme for vaccines/spec-grps/default.htm.
Counties is a six-level classification scheme to assign the
3,141 U.S. counties and county equivalents to four The currently recommended childhood vaccination
metropolitan (or urban) categories and two non schedule includes vaccines that prevent infectious diseases
metropolitan (or rural) categories. The county classifications including hepatitis A and B, diphtheria, tetanus toxoids,
are based on the following information: (a) the December acellular pertussis (whooping cough), measles, mumps,
2005 OMB delineation of metropolitan and micropolitan rubella (German measles), polio, varicella (chicken pox), and
statistical areas; (b) 2004 postcensal county and place some forms of meningitis (HIB), influenza, and pneumonia.
population estimates; and (c) county-level data on selected In February 2006, a rotavirus vaccine (RotaTeq) was licensed
settlement density, socioeconomic, and demographic for use in U.S. infants.
variables from Census 2000. The six categories of the 2006 A vaccine that protects against the four types of human
NCHS Scheme are large central metro (inner-city counties of papillomavirus (HPV) that cause most cervical cancers and
MSAs of 1 million or more population), large fringe metro genital warts began to be marketed in 2006 and is now
(suburban counties of MSAs of 1 million or more available for both females and males. The vaccine was
population), medium metro (counties of MSAs of 250,000– recommended for 11- and 12 year-old girls and for girls and
999,999 population), small metro (counties of MSAs with less women aged 13–26 who have not yet been vaccinated or
than 250,000 population), nonmetropolitan micropolitan,
Health, United States, 2014 Appendix II. Definitions and Methods 445
completed the vaccine series. In October 2011, HPV Wages and salaries—See Appendix II, Employer costs for
vaccination was recommended for males aged 11 and 12. employee compensation.
Available from: http://www.cdc.gov/mmwr/preview/
mmwrhtml/mm6050a3.htm. Years of potential life lost (YPLL)—YPLL is a measure of
premature mortality. Starting with Health, United States,
Boosters (revaccination) of vaccinations received during 1996, YPLL has been presented for persons under age 75
childhood or adulthood are necessary for some vaccines. In because the average life expectancy in the United States is
addition to keeping current with the vaccines listed above, over 75 years. YPLL–75 is calculated using the following
and annual influenza vaccination, some additional eight age groups: under 1, 1–14, 15–24, 25–34, 35–44,
vaccinations are recommended for older adults, persons 45–54, 55–64, and 65–74. The number of deaths for each age
with specific health conditions, or health care workers who group is multiplied by years of life lost, calculated as the
are likely to be exposed to infectious persons. Herpes zoster difference between age 75 years and the midpoint of the
vaccination is recommended one time for adults aged 60 age group. For the eight age groups, the midpoints are 0.5,
and over, and pneumococcal vaccination is recommended 7.5, 19.5, 29.5, 39.5, 49.5, 59.5, and 69.5 years, respectively.
one time for adults aged 65 and over. For example, the death of a person aged 15–24 counts as
For a full discussion of recommended vaccination schedules 55.5 years of life lost. Years of potential life lost is derived by
by age and population, see CDC's vaccination and summing years of life lost over all age groups. In Health,
immunization website at: http://www.cdc.gov/vaccines/ United States, 1995 and earlier editions, YPLL was presented
schedules/index.html. for persons under age 65. For more information, see: CDC.
Premature mortality in the United States: Public health
Influenza vaccination—In the National Health Interview issues in the use of years of potential life lost. MMWR
Survey, questions concerning influenza vaccination were 1986;35(SS–02):1S–11S. Available from: http://www.cdc.gov/
slightly different across the survey years. Respondents mmwr/preview/mmwrhtml/00001773.htm.
were asked, ‘‘During the past 12 months, have you had a
flu shot? A flu shot is usually given in the fall and protects
against influenza for the flu season.’’ Beginning in
September 2003, respondents were asked about
influenza vaccination by nasal spray (sometimes called
by the brand name FluMist) during the past 12 months,
in addition to the question regarding the flu shot.
Starting with 2005 data, receipt of nasal spray or a flu
shot was included in the calculation of influenza
vaccination estimates. In 2010, additional questions were
asked about the receipt of the H1N1 flu shot and spray,
including month and year received. These H1N1
questions, and the original seasonal flu questions, were
asked only in quarters 1 and 2 and the first several weeks
of quarter 3. Beginning August 11, 2010, revised flu
vaccination questions replaced all flu vaccination
questions fielded earlier in 2010 and were used in 2011
and beyond. The revised questions reflect the
introduction of a new combined flu vaccination that
protects against both the seasonal and H1N1 strains. For
more information regarding 2010 influenza questions,
see: ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/
Dataset_Documentation/NHIS/2010/srvydesc.pdf.
The prevalence of influenza vaccination during the
past 12 months may differ from season-specific
coverage, and estimates from different data sources
may differ (additional estimates are available from:
http://www.cdc.gov/flu/fluvaxview/).
446 Appendix II. Definitions and Methods Health, United States, 2014
Index
Index
(Numbers are table and figure numbers)
A A—Con.
Table/Figure (F) Table/Figure (F)
Abortion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
American Indian or Alaska Native population—Con.
Access to care (see also Dental visits; Emergency department visits; Infant mortality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11, 13
Marijuana use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
Neck pain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46
Stroke, respondent-reported . . . . . . . . . . . . . . . . . . . . . . . . . 42
Allergy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Teenage childbearing . . . . . . . . . . . . . . . . . . . . . . . . . . 3, 4, F5
Unmarried mothers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Unmet need . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
AIDS cases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
Vision trouble . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
Allergy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Asthma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Attention-deficit/hyperactivity disorder . . . . . . . . . . . . . . . . . . 39
AIDS cases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
Allergy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Birth rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3, 5, F5
Asthma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Births, number . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Attention-deficit/hyperactivity disorder . . . . . . . . . . . . . . . . . . 39
Birthweight, low . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6, 7
Birth rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3, 5
Cancer, respondent-reported . . . . . . . . . . . . . . . . . . . . . . . . 42
Births, number . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Birthweight, low . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6, 7
Cancer, respondent-reported . . . . . . . . . . . . . . . . . . . . . . . . 42
Death rates, selected causes . . . . . . . 18, 24, 25, 26, 27, 28, 29,
Dental visits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84
Death rates, all causes . . . . . . . . . . . . . . . . . . . . . . . 17, 18, 23
Drug poisoning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
Death rates, selected causes . . . . . . . 18, 24, 25, 26, 27, 28, 29,
Ear infection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Dental visits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84
Drug poisoning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
Ear infection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Hearing trouble . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
A—Con. B—Con.
Table/Figure (F) Table/Figure (F)
Asian or Pacific Islander population—Con.
Black or African American population—Con.
Hearing trouble . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
Birthweight, low . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6, 7
Mammography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76
Cancer survival, 5-year relative . . . . . . . . . . . . . . . . . . . . . . . 41
Marijuana use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
Cholesterol . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
Neck pain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46
Cigarette smoking . . . . . . . . . . . . . . . . . 52, 53, 54, 55, 56, F23
Pap smear . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77
Complex activity limitation . . . . . . . . . . . . . . . . . . . . . . . . . . 47
Physical activity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63
Contraception . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Population, resident . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Death rates, all causes . . . . . . . . . . . . . . . . . . . . 17, 18, 22, 23
Poverty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Death rates, selected causes . . . . . . . 18, 24, 25, 26, 27, 28, 29,
Stroke, respondent-reported . . . . . . . . . . . . . . . . . . . . . . . . . 42
Death rates, state and U.S. territory . . . . . . . . . . . . . . . . . . . 17
Teenage childbearing . . . . . . . . . . . . . . . . . . . . . . . . . . 3, 4, F5
Death rates, urbanization . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
Unmarried mothers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Deaths, leading causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Unmet need . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
Dental caries (cavities), untreated . . . . . . . . . . . . . . . . . . . . . 66
Vision trouble . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
Diabetes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44
Asthma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39, 89
Drug poisoning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
Atherosclerosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20, 21
Drugs, prescription, use in past 28 days . . . . . . . . . . . . . . . . 85
Attention-deficit/hyperactivity disorder . . . . . . . . . . . . . . . . . . . . 39
Ear infection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
B
Expenses, health care . . . . . . . . . . . . . . . . . . . . . . . . . 106, 107
Basic actions difficulty . . . . . . . . . . . . . . 46, 47, 50, 54, 58, 63, 68,
Glycemic control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44
Births
Healthy weight . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64
Age of mother . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3, 5
Hearing trouble . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
Birth rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3, 5
Births, number . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4, 5
Birthweight, low . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6, 7
Fertility rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Hypertension . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60
Hospital discharges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89
State . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Teenage childbearing . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4, F5
Inhalants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56
Unmarried mothers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Mammography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76
AIDS cases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
Allergy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Asthma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Attention-deficit/hyperactivity disorder . . . . . . . . . . . . . . . . . . 39
Neck pain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46
Birth rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3, 4, 5
B—Con. C—Con.
Table/Figure (F) Table/Figure (F)
Black or African American population—Con.
Child and adolescent health—Con.
Pap smear . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77
30, 31, 32, 33, 34, 36
Population, resident . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Dental caries (cavities), untreated . . . . . . . . . . . . . . . . . . 59, 66
Poverty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Dental visits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84
Seatbelt use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
Doctor visits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83
Stroke, respondent-reported . . . . . . . . . . . . . . . . . . . . . . . . . 42
Drugs, prescription, use in 28 days . . . . . . . . . . . . . . . . . 85, 86
Suicidal ideation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
Ear infection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Teenage childbearing . . . . . . . . . . . . . . . . . . . . . . . . . . 3, 4, F5
Emergency department visits . . . . . . . . . . . . . . . 79, 81, 82, F17
Unmarried mothers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Emotional or behavioral difficulties . . . . . . . . . . . . . . . . . . . . 39
Unmet need . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
End-stage renal disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
Violence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
Health insurance . . . . . . . . . . . . . . . . . . . . . . 111, 112, 113, 114
Vision trouble . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
Health status, respondent-assessed . . . . . . . . . . . . . . . . . . . 50
Breastfeeding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Illicit drug use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55, 56
Inhalants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56
Injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81
C
Marijuana use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55, 56
Deaths and death rates . . . . . . . . 18, 20, 21, 26, 27, 28, F3, F20
Physical activity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
Hospital discharges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89
Population, resident . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Incidence rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
Poverty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Prevalence, respondent-reported . . . . . . . . . . . . . . . . . . . . . . 42
Seatbelt use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
subgroups.
Violence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
Deaths and death rates . . . . . . . . . . . . . 18, 20, 21, 25, F3, F20
Cholesterol . . . . . . . . . . . . . . . . . . . . . . . . . . 59, 61, 86, F21, F28
Hospital discharges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89
Chronic conditions, selected . . . . . . . . . . . . . . . . . . . . . . . 43, F21
Prevalence, respondent-reported . . . . . . . . . . . . . . . . . . . . . . 42
Chronic liver disease and cirrhosis . . . . . . . . . . 18, 19, 20, 21, F20
Abortion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Colorectal tests or procedures . . . . . . . . . . . . . . . . . . 78, F14, F27
AIDS cases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
71, 74, 75, 76, 77, 80, 84, 87,
Allergy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Congenital anomalies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20, 21
Asthma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Contraception . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Attention-deficit/hyperactivity disorder . . . . . . . . . . . . . . . . . . 39
Cost, see Employers’ costs for health insurance.
Birthweight, low . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6, 7
Cuban population, see Hispanic origin subgroups.
Breastfeeding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Cocaine use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56
D E—Con.
Table/Figure (F) Table/Figure (F)
Deaths, death rates (see also Cancer [malignant neoplasms];
Education—Con.
Mammography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76
All causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
Pap smear . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77
State . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Stroke, respondent-reported . . . . . . . . . . . . . . . . . . . . . . . . . . 42
Urbanization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
Suicidal ideation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
Dentists . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95, 97
Elderly population, see Older population aged 65 and over.
Schools and students . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97
Emergency department visits . . . . . . . . . . . . . . . 79, 80, 81, F17, F26
State . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95
Emotional or behavioral difficulties . . . . . . . . . . . . . . . . . . . . . . . . 39
Hospital discharges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89
Energy and macronutrient intake . . . . . . . . . . . . . . . . . . . . . . . . . 62
Diphtheria, see Diseases, notifiable; Vaccinations. Hospital care expenditures; Medicaid; Medicare; Nursing homes
Disability
expenditures; Physician services expenditures; Prescription drug
Basic actions difficulty . . . . . . . . . . . 46, 47, 50, 54, 58, 63, 68, 69,
Complex activity limitation . . . . . . . . 46, 47, 50, 54, 58, 63, 68, 69,
Source of funds . . . . . . . . . . . . . . . . . . . . . . . . . . 102, 104, F17
Diseases, notifiable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
F
Doctors of Medicine, see Physicians.
Drug poisoning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
Fertility rates, see Births.
Drug use, illicit, see Alcohol consumption; Cigarette smoking; Fetal mortality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Cocaine use; Illicit drug use; Inhalants; Marijuana use. Firearm-related injuries, death rates . . . . . . . . . . . . . . . . . . . . . . . 34
G
E
Geographic region
Ear infection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Access to care . . . . . . . . . . . . . . . . . . . . . . . . . 67, 68, 69, 70, 71
Education
Back pain, low . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46
Access to care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
Breastfeeding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Breastfeeding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Colorectal tests or procedures . . . . . . . . . . . . . . . . . . . . . . . . 78
Cancer, respondent-reported . . . . . . . . . . . . . . . . . . . . . . . . . 42
Death rates, urbanization . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
Cocaine use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56
Emergency department visits . . . . . . . . . . . . . . . . . . . . . . . 79, 80
Hearing trouble . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
Health insurance . . . . . . . . . . . . . . . . . . . . . . . 111, 112, 113, 114
G—Con. H—Con.
Table/Figure (F) Table/Figure (F)
Geographic region—Con.
Hispanic or Latino population—Con.
Vaccinations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74, 75
Breastfeeding . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . 10
Cigarette smoking . . . . . . . . . . . . . . . .
. . . . . . . . . . 54, 55, F23
Contraception . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . 9
Haemophilus influenzae, invasive, see Diseases, notifiable. Death rates, all causes . . . . . . . . . . . .
. . . . . . . . . . . 17, 18, 23
Hawaiian population, see Native Hawaiian or Other Pacific Islander Death rates, selected causes . . . . . . .
18, 24, 25, 26, 27, 28, 29,
Health care expenses, see Expenses, health care. Deaths, leading causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Health care utilization . . . . . . . 70, 71, 72, 73, 74, 75, 76, 77, 78, 79,
Dental caries (cavities), untreated . . . . . . . . . . . . . . . . . . . . . 66
80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, F26
Public . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . F25
Fetal mortality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Health professionals visits, see Visits to health professionals. Health status, respondent-assessed . . . . . . . . . . . . . . . . . . . 50
Healthy weight . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64
Hearing trouble . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
Hearing trouble . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
Heart disease, respondent-reported . . . . . . . . . . . . . . . . . . . . 42
Heart disease
Hospital utilization, inpatient . . . . . . . . . . . . . . . . . . . . . . 87, 117
Deaths and death rates . . . . . . . . . . . . . 18, 20, 21, 24, F3, F20
Hospital utilization, outpatient department . . . . . . . . . . . . . . 117
Prevalence, respondent-reported . . . . . . . . . . . . . . . . . . . . . . 42
Life expectancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16, F1
pacemaker) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90
Marijuana use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
AIDS cases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
Nursing home expenditures . . . . . . . . . . . . . . . . . . . . . . . . 117
Allergy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Occupational injury deaths . . . . . . . . . . . . . . . . . . . . . . . . . . 36
Asthma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Out-of-pocket health care expenditures . . . . . . . . . . . . . 106, 107
H—Con. I
Table/Figure (F) Table/Figure (F)
Hispanic or Latino population—Con.
Illicit drug use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55, 56
Pap smear . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77
Incidence (Cancer) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
Population, resident . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Infant mortality (see also Fetal mortality)
Poverty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Age at death . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11, 12, F2
Seatbelt use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
Birth cohort data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Stroke, respondent-reported . . . . . . . . . . . . . . . . . . . . . . . . . 42
International . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Suicidal ideation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
Race and Hispanic origin . . . . . . . . . . . . . . . . . . . . . . 11, 12, 13
Teenage childbearing . . . . . . . . . . . . . . . . . . . . . . . . . . 3, 4, F5
State . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Unmarried mothers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Infectious disease
Unmet need . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
Deaths . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18, 19, 20, 21, 29
Violence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
Notifiable diseases . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37, 38
Vision trouble . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
Vaccinations . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72, 73, 74, 75
Chronic conditions, selected . . . . . . . . . . . . . . . . . . . . . . . . . 43 Inpatient care, see Hospital utilization; Mental health; Nursing homes,
utilization.
Health insurance . . . . . . . . . . . . . . . . . . . . . . 111, 112, 113, 114
Instrumental activities of daily living (IADL), see Limitation of activity.
Infant mortality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Insurance, see Health insurance.
Teenage childbearing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
International health (see also Expenditures, national health;
Unmarried mothers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Infant mortality; Life expectancy) . . . . . . . . . . . . . . . . . . . . 14, 15
HIV/AIDS
Hospital discharges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89
K
Home health care expenditures . . . . . . . . . . . . . . . . . . . . . . . 103
Admissions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91
Days of care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88
State . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 122
Marijuana use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
Coverage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115
Physical activity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63, F24
State . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121
Years of potential life lost (YPLL) . . . . . . . . . . . . . . . . . . . . . 19
Men’s health
Emotional or behavioral difficulties, children . . . . . . . . . . . . . . 39
AIDS cases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
Hospital discharges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89
Cancer, respondent-reported . . . . . . . . . . . . . . . . . . . . . . . . 42
Access to care . . . . . . . . . . . . . . . . . . . . . . . 67, 68, 69, 70, 71
Cholesterol . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
Basic actions difficulty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
Contraception . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Death rates, urbanization . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
Death rates, selected causes . . . . . . . . . . 18, 24, 25, 26, 27, 29,
Emergency department visits . . . . . . . . . . . . . . . . . . . . . 79, 80
30, 31, 32, 33, 34, 36, 38, F3, F4, F20
Headache, severe or migraine . . . . . . . . . . . . . . . . . . . . . . . 46
Dental visits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84
Hearing trouble . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
Diabetes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44
Heart disease, respondent-reported . . . . . . . . . . . . . . . . . . . . 42
Doctor visits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83
Hospital utilization, inpatient . . . . . . . . . . . . . . . . . . . . . . . . . 87
Drug poisoning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
Medicaid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113
M—Con. N—Con.
Table/Figure (F) Table/Figure (F)
Metropolitan/nonmetropolitan data—Con.
Nephritis, nephrotic syndrome and nephrosis . . . . . . . 18, 19, 20, 21
Stroke, respondent-reported . . . . . . . . . . . . . . . . . . . . . . . . . 42
Nurses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 96
Unmet need . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
Nursing homes
Vision trouble . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
Expenditures . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103, 104, 117
Births, rate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Obesity . . . . . . . . . . . . . . . . . . . . . . . . . . 59, 64, 65, F10, F11, F21
Cancer, respondent-reported . . . . . . . . . . . . . . . . . . . . . . . . 42
Occupational diseases, deaths . . . . . . . . . ............ . . . . 35
Cholesterol . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
Occupational injury deaths . . . . . . . . . . . . ............ . . . . 36
Cigarette smoking . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54
Occupational therapists . . . . . . . . . . . . . . ............ . . . . 96
Diabetes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44
Access to care . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . 69, 71
Glycemic control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44
Back pain, low . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . 46
Healthy weight . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64
Cigarette smoking . . . . . . . . . . . . . . . .
. . . . . . . . . . . 52, 54, F8
Hearing trouble . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
Complex activity limitation . . . . . . . . . .
. . . . . . . . . . . . . 47, F7
Hypertension . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60
Death rates, selected causes . . . . . . .
24, 25, 26, 27, 28, 29, 30,
Infant mortality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
31, 32, 33, 34, 36
Medicaid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113
Deaths, leading causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Neck pain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46
Dental caries (cavities), untreated . . . . . . . . . . . . . . . . . . . . . 66
Physical activity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63
Doctor visits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83
Poverty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Drug poisoning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
Stroke, respondent-reported . . . . . . . . . . . . . . . . . . . . . . . . . 42
Emergency department visits . . . . . . . . . . . . . . . . . . . 80, 81, 82
Teenage childbearing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
End-stage renal disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
Unmarried mother . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Energy and macronutrient intake . . . . . . . . . . . . . . . . . . . . . . 62
Unmet need . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
Expenses, health care . . . . . . . . . . . . . . . . . 105, 106, 107, 108
Vaccinations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74, 75
Glycemic control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44
Vision trouble . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
Headache, severe or migraine . . . . . . . . . . . . . . . . . . . . . . . 46
MMR (measles, mumps, rubella), see Vaccinations. Health insurance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115, 117
Hearing trouble . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
117, 121
National health expenditures, see Expenditures, national health. Hospital utilization, outpatient department . . . . . . . . . . . . 82, 117
AIDS cases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
Injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81
Alcohol consumption . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
Life expectancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15, 16
Cigarette smoking . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
Limitation of activity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117
Illicit drugs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
Mammography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76
Vaccinations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72
Medicare . . . . . . . . . . . . . . . . . . . . . . . 107, 115, 116, 117, 121
Neck pain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46
Neck pain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46
O—Con. P—Con.
Table/Figure (F) Table/Figure (F)
Older population aged 65 and over—Con.
Poverty—Con.
Pap smear . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77
Dental caries (cavities), untreated . . . . . . . . . . . . . . . . . . . . . 66
Physical activity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63
Dental visits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84
Pneumonia discharges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89
Diabetes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44
Population, resident . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Ear infection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Stroke, respondent-reported . . . . . . . . . . . . . . . . . . . . . . . . . 42
Emotional or behavioral difficulties . . . . . . . . . . . . . . . . . . . . 39
Suicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . F4
Glycemic control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44
Unmet need . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
Headache, severe or migraine . . . . . . . . . . . . . . . . . . . . . . . 46
Vaccinations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74, 75
Health care visits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
Vision trouble . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
Health insurance . . . . . . . . . . . . . . . 111, 112, 113, 114, 115, F25
Opioid poisoning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
Health status, respondent-assessed . . . . . . . . . . . . . . . . . . . 50
Optometry students . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97
Healthy weight . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64
Osteoarthritis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89
Hearing trouble . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
P Medicare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115
Pacemakers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90
Neck pain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46
Vision trouble . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
Physicians
State . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92
Public Health, schools of; students . . . . . . . . . . . . . . . . . . . . . . 97
Podiatry students . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97
Birthweight, low . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Population, resident . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Health insurance . . . . . . . . . . . . . . . . . . . . . . 111, 112, 113, 114
Poverty
Poverty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Alcohol consumption . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58
R
Allergy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Race, see specific race groups.
Asthma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Rocky Mountain spotted fever, see Diseases, notifiable.
Attention-deficit/hyperactivity disorder . . . . . . . . . . . . . . . . . . 39
Rubella (German measles), see Diseases, notifiable; Vaccinations.
Cancer, respondent-reported . . . . . . . . . . . . . . . . . . . . . . . . 42
S W
Table/Figure (F) Table/Figure (F)
Salmonellosis, see Diseases, notifiable.
Wages and salaries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 96, 110
Septicemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20, 21
White population
Special Feature, Adults aged 55–64 . . . . . F20, F21, F22, F23, F24,
Asthma . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . 39
Attention-deficit/hyperactivity disorder . .
. . . . . . . . . . . . . . . . 39
Birthweight, low . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Death rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Birth rates . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . 3, 4, 5
Dentists . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95
Births, number . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . 4
Birthweight, low . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . 6, 7
Hospital beds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99
Breast cancer . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . 28, 40
Breastfeeding . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . 10
Infant mortality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Medicaid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 122
Cancer, respondent-reported . . . . . . . .
. . . . . . . . . . . . . . . . 42
Medicare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121
Cholesterol . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . 61
Physicians . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92
Cigarette smoking . . . . . . . . . . . . . . . .
. 52, 53, 54, 55, 56, F23
Cocaine use . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . 56
Suicidal ideation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
Contraception . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . 9
Doctor visits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83
Drug poisoning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
Unmet need for medical care, dental care, prescription drugs . . . 69,
Emotional or behavioral difficulties . . . . . . . . . . . . . . . . . . . . 39
F18, F29
End-stage renal disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
V
Health insurance . . . . . . . . . . . . . . . . . . 111, 112, 113, 114, 115
Vision trouble . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
Heart disease, respondent-reported . . . . . . . . . . . . . . . . . . . . 42
Hypertension . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60
W—Con. W—Con.
Table/Figure (F) Table/Figure (F)
White population—Con.
Women’s health—Con.
Inhalants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56
29, 30, 31, 32, 33, 34, 36, F3, F4, F20
Mammography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76
Dental caries (cavities), untreated . . . . . . . . . . . . . . . . . . . . . 66
Neck pain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46
Drugs, prescription, use in past 28 days . . . . . . . . . . . . . 85, 86
Pap smear . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77
Headache, severe or migraine . . . . . . . . . . . . . . . . . . . . . . . 46
Population, resident . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Health status, respondent-assessed . . . . . . . . . . . . . . . . . . . 50
Poverty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Healthy weight . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64
Seatbelt use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
Hearing trouble . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
Stroke, respondent-reported . . . . . . . . . . . . . . . . . . . . . . . . . 42
Hospital utilization, inpatient . . . . . . . . . . . . . . . . . 87, 88, 89, 90
Suicidal ideation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
Hospital utilization, outpatient department . . . . . . . . . . . . . . . 82
Teenage childbearing . . . . . . . . . . . . . . . . . . . . . . . . . . 3, 4, F5
Hypertension . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60, F9
Unmarried mothers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Illicit drug use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
Unmet need . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
Injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81, F4
Violence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
Mammography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76, F27
Vision trouble . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
Marijuana use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
Women’s health
Neck pain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46
Abortion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Overweight and obesity . . . . . . . . . . . . . . . . . . . . . . . . . 64, F11
AIDS cases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
Pap smear . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77, F27
Births, number . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Stroke, respondent-reported . . . . . . . . . . . . . . . . . . . . . . . . . 42
Breastfeeding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Unmarried mothers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Cancer, respondent-reported . . . . . . . . . . . . . . . . . . . . . . . . 42
Vaccinations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74, 75
Cesarean section . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90
Years of potential life lost (YPLL) . . . . . . . . . . . . . . . . . . . . . 19
Cholesterol . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
Working-age adults (aged 18–64) . . . . . . 43, 47, 68, 69, 75, 77, 80,
84, 87, 111, 112, 113, 114, F7, F15, F17, F18