Health Statistics and Health Policy
Linda T. Bilheimer, Ph.D.
Office of Analysis & Epidemiology
National Center for Health Statistics
June 28, 2009
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Disease Control and Prevention
National Center for Health Statistics
Uninsured population under age 65, by age,
January-September, 2008
30.0
25.0
20.0
24.1
19.6
percent
18-64
Under 18
14.4
15.0
12.9
10.0
8.5
5.2
5.0
0.0
At time of interview
Part of the year
Source: CDC/NCHS, Early release of estimates from the National Health Interview Survey
More than a year
Insurance status, adults age 18-64, by poverty status,
January-September, 2008
100
90
82.4
80
70
<100% FPL
percent
60
100%-199% FPL
>=200% FPL
50
38.5
40
40.8
37.4
39.5
30
23.4
22.6
20
11.9
10
7.1
0
Private
Public
Source: CDC/NCHS, Early release of estimates from the National Health Interview Survey
Uninsured
Trends in private coverage for adults age 18-64,
by poverty status, 1997 to 2008*
100.0
90.0
>= 200% poverty
80.0
70.0
percent
60.0
50.0
100%-199% poverty
40.0
30.0
< 100% poverty
20.0
10.0
0.0
1997
1998
1999
2000
2001
2002
2003
2004
2005
*Data for January-September, 2008
Source: CDC/NCHS, Early releases of estimates from the National Health Interview Survey
2006
2007
2008
Insurance status of adults age 18-64, by state, 2007
100
90
79.0
80
77.5
70.4
70
66.6
65.8
61.6
percent
60
Uninsured
50
Public
Private
40
30
29.6
23.7
22.2
20
10
14.8 15.7
9.8
12.0
11.8
14.9
13.5
8.1
8.2
0
Texas
Florida
California
New York
Source: CDC/NCHS, Early release of estimates from the National Health Interview Survey
New Jersey
Massachusetts
Insured adults, ages 18-64, reporting delaying
or not receiving medical care due to cost, 2004-2008*
20
18
16
14.4
13.6
14
13.7
13.6
13.6
percent
12
All
Private
10
Public
8.3
8
6.9
7.3
6.8
6.2
6
5.9
7.3
7.2
6.3
6.3
2006
2007
4
2
0
2004
2005
* Data for January-June, 2008
Source: CDC/NCHS, Early releases of estimates from the National Health Interview Survey
2008
Usual source of care for adults age 18-64,
by insurance status, 2007
Adults with a usual source
100.0
90.0
85.5
80.0
70.0
All adults
61.8
percent
60.0
50.0
Uninsured
57.0
Medicaid
Private
48.3
40.0
33.0 33.4
30.0
20.0
12.8
10.0
9.6 9.9
8.7
4.1
1.1
0.0
No usual source
Dr's office or HMO
Clinic or health center Hospital ED or OP dept.
Source: CDC/NCHS, National Health Interview Survey, in Vital and Health Statistics Reports, Series 10, No. 240
Emergency department visits,
by expected source of payment, 2006
100
90
86.5
80
per 100 population
70
60
53.3
50
47.4
40
30
24.9
20
10
0
Uninsured
Medicaid
Medicare
Source: CDC/NCHS, National Hospital Ambulatory Medical Care Survey, in National Health Statistics Reports, No. 8.
Private
Distribution of body mass index, adults age 20-74,
1976-1980 and 2005-2006
Source: CDC/NCHS, National Health and Nutrition Examination Survey (NHANES), from NCHS Data Brief, No. 1.
Hypertension and diabetes prevalence,
adults age 20 and over,1988-1994 to 2003-2006
40
35
31.3
30.0
30
age-adjusted percent
25.5
25
Hypertension
Diabetes
20
15
10
9.4
10.2
8.3
5
0
1988-1994
Source: CDC/NCHS, National Health and Nutrition Examination Survey
1999-2002
2003-2006
Growth in incidence and prevalence of
end-stage renal disease, 1980 to 2005
1800
1585
1600
1400
1351
per 100,000 population
1200
1000
New patients
Living patients
800
726
600
400
326
351
255
199
200
76
0
1980
1990
Source: Centers for Medicare and Medicaid Services, Renal Beneficiary and Utilization System
2000
2005
Trends in stroke mortality, adults age 18 and over,
by race and ethnicity, 1981 to 2005
Note: Age-adjusted rates per 100, 000 population
Source: CDC/NCHS, National Vital Statistics System—Mortality. Chart created in Health Data Interactive.
Stroke deaths,
by health service area, 2002-2004
2010 Target: 50
Age-adjusted rate per 100,000
Note: Stroke deaths are defined by ICD-10 codes I60-I69. Data are age-adjusted to the 2000 standard population. The 5 legend
categories represent the following percentage of Health Service Areas (from lowest to highest): 10%, 20%, 40%, 20%, 10%.
Healthy People 2010 Obj. 12-7
Source: National Vital Statistics System—Mortality (NVSS-M), NCHS, CDC.
Stroke deaths among selected populations
“Stroke Belt” states and New York, 2004
“Stroke Belt” States
New York
Total
63
33
American
Indian
Asian
*
Hispanic
Black
White
Female
Male
100
80
60
40
20
0
0
20
40
60
80
100
Age-adjusted rate per 100,000 population
* = Data are statistically unreliable.
Note: Stroke deaths are defined by ICD-10 codes I60-I69. Data are age adjusted to the 2000 standard population. “Stroke Belt” States are Alabama, Arkansas,
Georgia, Mississippi, North Carolina, South Carolina, and Tennessee. Asian includes Pacific Islander. The black and white categories exclude persons of Hispanic
origin. Persons of Hispanic origin may be of any race. Source: CDC/NCHS National Vital Statistics System—Mortality
Trends in diabetes mortality, adults age 18 and over,
by race and ethnicity,1981 to 2005
Note: Age-adjusted rates per 100, 000 population
Source: National Vital Statistics System—Mortality. Chart created in Health Data Interactive.
Trends in diabetes-related deaths among persons
with diabetes, by race and ethnicity, 1999 to 2005
12
age-adjusted per 1,000 standard population
10
non-Hispanic black
8
non-Hispanic white
6
Hispanic
4
2
0
1999
2000
2001
2002
2003
2004
Sources: CDC/NCHS, National Vital Statistics System-Mortality and National Health Interview Survey, from DATA2010.
2005
Number of drugs for chronic conditions recorded in visits to
physician offices and hospital outpatient departments,
1995-1996 and 2004-2005
40
35
32.1
30.8
per 100 population
30
24.0
25
20.0
19.9
20
19.5
1995-1996
2004-2005
15
9.6
9.5
10
10.2
6.0
5.9
5.4
5
0
Hyperlipidemia
drugs
Blood
glucose/sugar
regulators
Beta blockers
ACE inhibitors
Diuretics
Other hypertension
drugs
Sources: CDC/NCHS, National Ambulatory Medical Care Survey and National Hospital Ambulatory Care Survey.
Access to care problems for adults age 18-64
with one or more chronic conditions1, by insurance status, 2007
60
50.0
50
39.0
percent
40
Unmet medical care need due to cost
Unmet prescription drug need due to cost
30
21.7
18.5
20
10
6.5
7.7
0
Uninsured
1Diabetes,
Medicaid
Private
cardiovascular disease, chronic obstructive pulmonary disease, asthma, cancer, arthritis
Source: CDC/NCHS, National Health Interview Survey
Women age 40-64 having a mammogram in the past 2 years,
by insurance status, 2000 and 2005
100
90
80
77.1
74.5
70
61.7
percent
60
55.6
2000
2005
50
40.7
38.1
40
30
20
10
0
Private
Source: CDC/NCHS, National Health Interview Survey
Medicaid
Uninsured
Any use of electronic medical records
by office-based physicians, 2001-2008
45
40
percent of physicians
35
30
25
20
15
10
5
0
2001
2002
2003
* Preliminary estimate
Sources: CDC/NCHS, National Ambulatory Medical Care Survey
2004
2005
2006
2008*
Privately insured adults age 18-64 enrolled in high-deductible
and consumer-directed health plans, January-September 2008
25
20.0
20
15.8
15
High-deductible plan
13.9
percent
Consumer-directed plan
10
5.7
5
2.8
1.6
0
Less than high school
High school
Source: CDC/NCHS, Early release of estimates from the National Health Interview Survey
More than high school
Where did these data come from?
Uninsured and access
to care rates in the
Population
National
Health
Interview
Survey
Prevalence of chronic
conditions and risk
factors in the
population
National Health
And Nutrition
Examination
Survey
Where did these data come from?
Information from health
care providers on use of
services and EMR
National
Health
Care
Survey
Mortality
National
Vital
Statistics
System
Selected information in NCHS data systems
•
Vital statistics
–
–
•
births
deaths
symptoms
diagnoses
self-reported health status
injuries
functioning/disabilities
body measurement
family growth
• sexual practices
• family planning
•
exercise
diet
environmental exposures
smoking/alcohol/drugs
knowledge, attitudes, beliefs
sleep habits
–
–
•
specialty
size of practice or institution
ownership
sources of revenue
location
electronic medical records
Health care management
–
Risk factors
–
–
–
–
–
–
Providers and organizations
–
–
–
–
–
–
Health status
–
–
–
–
–
–
–
•
•
use of services:
• acute
• preventive
• long term
service location
expected sources of payment
Individual/family characteristics
–
–
–
–
–
–
–
age/sex
race/ethnicity
education
insurance status
income
employment status
urban/rural
For more information
Visit the NCHS website: www.cdc.gov/nchs
Contact Linda Bilheimer: lbilheimer@cdc.gov