HEALTH, UNITED STATES, 2011 WITH SPECIAL FEATURE ON SOCIOECONOMIC STATUS AND HEALTH pptx

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National Center for Health Statistics.

Health, United States, 2011: With Special Feature on

Socioeconomic Status and Health. Hyattsville, MD. 2012.

Library of Congress Catalog Number 76–641496

For sale by Superintendent of Documents

U.S. Government Printing Office

Washington, DC 20402

U.S. Department of Health and Human Services

Kathleen Sebelius

Secretary

Centers for Disease Control and Prevention

Thomas R. Frieden, M.D., M.P.H.

Director

National Center for Health Statistics

Edward J. Sondik, Ph.D.

Director

Health, United States, 2011 Preface iii

Preface

Health, United States, 2011 is the 35th report on the

health status of the Nation and is submitted by the

Secretary of the Department of Health and Human

Services to the President and the Congress of the

United States in compliance with Section 308 of the

Public Health Service Act. This report was compiled

by the Centers for Disease Control and Prevention’s

(CDC) National Center for Health Statistics (NCHS).

The National Committee on Vital and Health Statistics

served in a review capacity.

The Health, United States series presents an annual

look at national trends in health statistics. The report

contains a Chartbook that assesses the Nation’s

health by presenting trends and current information

on selected measures of morbidity, mortality, health

care utilization, health risk factors, prevention, health

insurance, and personal health care expenditures.

This year’s Chartbook includes a Special Feature on

Socioeconomic Status and Health. The report also

contains 151 Trend Tables organized around four

major subject areas: health status and determinants,

health care utilization, health care resources, and

health care expenditures. A companion product to

Health, United States—Health, United States: In

Brief—features information extracted from the full

report. The complete report, In Brief, and related data

products are available on the Health, United States

website at: http://www.cdc.gov/nchs/hus.htm.

The 2011 Edition

Health, United States, 2011 includes a summary

‘‘At a Glance’’table that displays selected indicators of

health and their determinants, cross-referenced to

charts and tables in the report. It also contains a

Highlights section, a Chartbook, detailed Trend

Tables, extensive Appendixes, and an Index. Major

sections of the 2011 report are described below.

Chartbook

The 2011 Chartbook contains 41 charts, including 20

(Figures 22–41) on this year’s Special Feature on

Socioeconomic Status and Health (SES). This feature

includes charts on the relationship between SES and

health by using a four-category education variable

and a four-category relative family income variable as

SES measures. Charts on trends in poverty and

differences in relative family income by race and

Hispanic origin for children and adults are presented

to provide context for the other charts. This feature

explores the SES gradient in health measures for

both children and adults and how that gradient

differs across racial and ethnic groups. When

possible, trend data are presented to examine

changes in SES disparities over time. Charts present

information on associations between SES and

morbidity and mortality, prevention and risk factors,

and access to care and health insurance.

Trend Tables

The Chartbook is followed by 151 Trend Tables

organized around four major subject areas: health

status and determinants, health care utilization,

health care resources, and health care expenditures.

The tables present data for selected years, to

highlight major trends in health statistics. Additional

years of data may be available in Excel spreadsheet

files on the Health, United States website. Trend Tables

for which additional data years are available are listed

in Appendix III. Comparability across years in Health,

United States is fostered by including similar Trend

Tables in each volume, and timeliness is maintained

by improving the content of ongoing tables and

adding new tables each year to reflect emerging

topics in public health. A key criterion used in

selecting these tables is the availability of

comparable national data over a period of several

years.

Health, United States, 2011 includes eight new Trend

Tables on the following subjects:

Drug poisoning death rates (Table 36), based on

data from the National Vital Statistics System.

Prevalence of health-related behaviors for

children 6–11 years of age (Table 66), based on data

from the National Survey of Children’s Health.

Prevalence of cigarette smoking (Table 63),

selected disability and health status measures

(Tables 57 and 58), and selected access to medical

care measures (Table 80) by urbanization level, based

on data from the National Health Interview Survey

and the 2006 NCHS Urban–Rural Classification

Scheme for Counties.

Utilization of colorectal tests and procedures

(Table 92), based on data from the National Health

Interview Survey.

iv Preface Health, United States, 2011

Cost of hospital discharges with common

hospital operating room procedures (Table 132),

based on data from the Healthcare Cost and

Utilization Project.

Appendixes

Appendix I. Data Sources describes each data

source used in Health, United States, 2011 and

provides references for further information about the

sources. Data sources are listed alphabetically within

two broad categories: Government Sources, and

Private and Global Sources.

Appendix II. Definitions and Methods is an

alphabetical listing of terms used in the report. It also

contains information on the methods used in the

report.

Appendix III. Additional Data Years Available lists

tables for which additional years of trend data are

available in Excel spreadsheet files on the Health,

United States website.

Index

The Index to the Trend Tables and figures is a useful

tool for locating data by topic. Tables and figures are

cross-referenced by such topics as child and

adolescent health; older population 65 years of age

and over; women’s health; men’s health; state data;

American Indian and Alaska Native, Asian, black or

African American, and Hispanic-origin populations;

education; injury; disability; and metropolitan and

nonmetropolitan data. Many of the Index topics are

also available as conveniently grouped data

packages on the Health, United States website.

Data Considerations

Racial and Ethnic Data

Many tables in Health, United States present data

according to race and Hispanic origin, consistent

with a Department-wide emphasis on expanding

racial and ethnic detail when presenting health data.

Trend data on race and ethnicity are presented in the

greatest detail possible after taking into account the

quality of the data, the amount of missing data, 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 Islander population and the

American Indian and Alaska Native population.

Standards for the classification of federal data on race

and ethnicity are described in an appendix. (See

Appendix II, Race.)

Education and Income Data

Many tables in Health, United States present data

according to SES, using education and family income

as proxy measures. Education and income data are

generally obtained directly from survey respondents

and are not usually available from records-based data

collection systems. Categories shown for income

data were expanded in Health, United States, 2010.

State vital statistics systems currently report mother’s

education on the birth certificate and (based on an

informant) decedent’s education on the death

certificate. (See Appendix II, Education; Family

income; Poverty.)

Disability Data

Disability can include the presence of physical or

mental impairments that limit a person’s ability to

perform an important activity and affect the use of or

need for supports, accommodations, or interventions

to improve functioning. Information on disability in

the U.S. population is critical to health planning and

policy. Several initiatives are currently under way to

coordinate and standardize the measurement of

disability across federal data systems. Health, United

States, 2009 introduced the first detailed Trend Table

using data from the National Health Interview Survey

to create disability measures consistent with two of

the conceptual components that have been

identified in disability models and legislation: basic

actions difficulty and complex activity limitation.

Basic actions difficulty captures limitations or

difficulties in movement and sensory, emotional, or

mental functioning that are associated with a health

problem. Complex activity limitation describes

limitations or restrictions in a person’s ability to

participate fully in social role activities such as

working or maintaining a household. Health, United

States, 2010 expanded the use of these measures to

many of the tables from the National Health

Interview Survey and this year’s report added two

tables on disability measure by urbanization level

(Tables 57 and 58). Health, United States also includes

the following disability-related information for the

civilian noninstitutionalized population: vision and

hearing limitations for adults (Table 55) and

disability-related information for Medicare enrollees

(Table 145), Medicaid recipients (Table 146), and

veterans with service-connected disabilities

(Table 148). For more information on disability

statistics, see: Altman B, Bernstein A. Disability

and health in the United States, 2001–2005.

Health, United States, 2011 Preface v

Hyattsville, MD: NCHS. 2008. Available from:

http://www.cdc.gov/nchs/data/misc/disability2001­

2005.pdf.

Statistical Significance

All differences between estimates noted in the

Highlights section of Health, United States were

determined to be statistically significant at the 0.05

level using two-sided significance tests (z tests). In

the Chartbook, weighted least squares regression

was performed to test for the presence of a

statistically significant increase or decrease in the

estimates during the time period (see Technical

Notes accompanying the Chartbook). Terms such as

‘‘similar,’’‘‘stable,’’ and ‘‘no difference’’ indicate that the

statistics being compared were not significantly

different. Lack of comment regarding the difference

between statistics does not necessarily suggest that

the difference was tested and found to be not

significant. Because statistically significant

differences or trends are partly a function of sample

size (the larger the sample size, the smaller the

change that can be detected), statistically significant

differences or trends do not necessarily have public

health significance (1).

Overall estimates generally have relatively small

standard errors, but estimates for certain population

subgroups may be based on small numbers and have

relatively large standard errors. Although numbers of

births and deaths from the Vital Statistics System

represent complete counts (except for births in those

states where data are based on a 50% sample for

selected years) and are not subject to sampling error,

the counts are subject to random variation, which

means that the number of events that actually occur

in a given year may be considered as one of a large

series of possible results that could have arisen under

the same circumstances. When the number of events

is small and the probability of such an event is small,

considerable caution must be observed in

interpreting the conditions described by the figures.

Estimates that are unreliable because of large

standard errors or small numbers of events have

been noted with an asterisk. The criteria used to

designate or suppress unreliable estimates are

indicated in the table footnotes.

For NCHS surveys, point estimates and their

corresponding variances were calculated using the

SUDAAN software package (2), which takes into

consideration the complex survey design. Standard

errors for other surveys or data sets were computed

using the methodology recommended by the

programs providing the data or were provided

directly by those programs. Standard errors are

available for selected tables in the Excel spreadsheet

version on the Health, United States website at:

http://www.cdc.gov/nchs/hus.htm.

Accessto Health, United States

Health, United States can be accessed in its entirety at:

http://www.cdc.gov/nchs/hus.htm. The website is a

user-friendly resource for Health, United States and

related products. In addition to the full report, it

contains the In Brief companion report and data

conveniently grouped by topic. The Chartbook

figures are provided as PowerPoint slides, and the

Trend Tables and Chartbook data tables as Excel

spreadsheet files and individual PDFs. Many Excel

spreadsheet files include additional years of data not

shown in the printed report, along with standard

errors where available. Spreadsheet files for selected

tables will be updated on the website as available.

Visitors to the website can join the Health, United

States electronic mailing list to receive announce￾ments about release dates and notices of updates to

tables. Previous editions of Health, United States, and

their Chartbooks, can also be accessed from the

website.

Printed copies of Health, United States can be

purchased from the Government Printing Office at:

http://bookstore.gpo.gov.

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, Fifth Floor

Hyattsville, MD 20782

Phone: 1–800–232–4636

E-mail: [email protected]

Internet: http://www.cdc.gov/nchs/

References

1. CDC. Youth Risk Behavior Survey (YRBS): Interpretation of YRBS

trend data. 2010. Available from: http://www.cdc.gov/

HealthyYouth/yrbs/pdf/YRBS_trend_interpretation.pdf.

2. SUDAAN, release 10.0.1 [computer software]. Research

Triangle Park, NC: RTI International. 2009.

vi Acknowledgments Health, United States, 2011

Acknowledgments

Overall responsibility for planning and coordinating

the content of this volume rested with the National

Center for Health Statistics’(NCHS) Office of Analysis

and Epidemiology, under the direction of Amy B.

Bernstein, Diane M. Makuc, and Linda T. Bilheimer.

Production of Health, United States, 2011, including

highlights, trend tables, and appendixes, was

managed by Amy B. Bernstein, Sheila J. Franco, and

Virginia M. Freid. Trend tables were prepared by Mary

Ann Bush, Jeanetta E. Churchill, La-Tonya D. Curl,

Anne K. Driscoll, Catherine R. Duran, Sheila J. Franco,

Virginia M. Freid, Tamyra C. Garcia, Nancy Han, Ji-Eun

Kim, Rebecca A. Placek, and Henry Xia, with

assistance from Anita L. Powell and Ilene B. Rosen.

Appendix II tables and the index were assembled by

Anita L. Powell. Production planning and

coordination of trend tables were managed by

Rebecca A. Placek. Review and clearance books were

assembled by Ilene B. Rosen. Administrative and

word processing assistance was provided by Lillie C.

Featherstone and Danielle Wood.

Production of the Chartbook was managed by

Virginia M. Freid and Sheila J. Franco. Data and

analysis for specific charts were provided by Amy B.

Bernstein, Anne K. Driscoll, Sheila J. Franco,

Virginia M. Freid, Tamyra C. Garcia, Ji-Eun Kim,

Kimberly Lochner, and Elsie Pamuk. Charts were

drafted by La-Tonya D. Curl, and data tables were

prepared by Rebecca A. Placek. Technical assistance

and programming were provided by Mary Ann Bush,

La-Tonya D. Curl, Catherine R. Duran, Nancy Han,

Xiang Liu, and Henry Xia.

Publication production was performed by

CDC/OSELS/NCHS/OD/Office of Information

Services, Information Design and Publishing Staff.

Project management and editorial review were

provided by Barbara J. Wassell. The designer was

Sarah M. Hinkle. The cover was designed by Megan

Griner. Layout and production were done by Zung T.

Le and Jacqueline M. Davis. Design and production

for Health, United States, 2011: In Brief were provided

by Kyung M. Park. Oversight review for publications

and electronic products was provided by Christine J.

Brown, Tommy C. Seibert, Jr., and Tammy Stewart￾Prather. Printing was managed by Patricia L. Wilson,

CDC/OCOO/MASO.

Electronic access through the NCHS Internet site

was provided by Christine J. Brown, La-Tonya D. Curl,

Jacqueline M. Davis, Zung T. Le, Anthony Lipphardt,

Anita L. Powell, Sharon L. Ramirez, Ilene B. Rosen, and

Barbara J. Wassell.

Data and technical assistance were provided by

staff of the following NCHS organizations: Division of

Health Care Statistics: Vladislav Beresovsky, Frederic H.

Decker, Carol J. DeFrances, Lisa L. Dwyer, Marni J. Hall,

Lauren Harris-Kojetin, Maria F. Owings, and Susan M.

Schappert; Division of Health and Nutrition

Examination Surveys: Debra J. Brody, Margaret D.

Carroll, Bruce A. Dye, Mark Eberhardt, Jaime J.

Gahche, Quiping Gu, Xianfen Li, Cynthia L. Ogden,

Ryne Paulose, Sung Sug (Sarah) Yoon, and Chia-Yih

Wang; Division of Health Interview Statistics: Patricia F.

Adams, Veronica E. Benson, Barbara Bloom, Robin A.

Cohen, Susan S. Jack, Whitney Kirzinger, Jacqueline

Lucas, Michael Martinez, Kathleen S. O’Connor,

Jennifer Peregoy, Jeannine Schiller, Charlotte A.

Schoenborn, and Brian W. Ward; Division of Vital

Statistics: Joyce C. Abma, Robert N. Anderson,

Elizabeth Arias, Anjani Chandra, Brady Hamilton,

Donna L. Hoyert, Kenneth D. Kochanek, Marian

MacDorman, Joyce A. Martin, T. J. Mathews,

Ari Minin˜o, Sherry L. Murphy, Michelle Osterman, and

Stephanie J. Ventura; Office of Analysis and

Epidemiology: Lara Akinbami, Li-Hui Chen,

Deborah D. Ingram, Susan Lukacs, Patricia Pastor,

Laura A. Pratt, Kenneth Schoendorf, Cynthia A.

Reuben, Cheryl V. Rose, Rashmi Tandon, Margaret

Warner, and Julie Dawson Weeks; Office of the Center

Director: Juan Albertorio and Francis C. Notzon; and

Office of Research and Methodology: Meena Khare.

Additional data and technical assistance were

provided by the following organizations of the

Centers for Disease Control and Prevention (CDC):

Epidemiology Program Office: Samuel L. Groseclose

and Michael Wodajo; National Center for Chronic

Disease Prevention and Health Promotion: Sonya

Gamble, Steve Kinchen, and Karen Pazol; National

Center for HIV/AIDS, Viral Hepatitis, STD, and TB

Prevention: Stacy Cohen, Irene Hall, Alexis Kaigler,

Rachel S. Wynn, and Jill Wasserman; National Center

for Immunization and Respiratory Diseases: Christina

Dorell and James A. Singleton; National Institute for

Occupational Safety and Health: John Myers, Kara

Perritt, Roger Rosa, and John Sestito; by the following

organizations within the Department of Health and

Human Services: Agency for Healthcare Research

and Quality: Roxanne Andrews, David Kashihara,

and Steven R. Machlin; Centers for Medicare &

Medicaid Services: Joseph Benson, M. Kent Clemens,

Cathy A. Cowan, Christine Cox, Maria Diacogiannis,

Health, United States, 2011 Acknowledgments vii

Micah Hartman, Stephanie L. Hunt, Christopher

Kessler, Deborah W. Kidd, Barbara S. Klees, John

Klemm, Kimberly Lochner, Maggie S. Murgolo,

Jason G. Petroski, Joseph F. Regan, Thomas W. Reilly,

Loan Swisher, John A. Wandishin, Benjamin E.

Washington, Lekha Whittle, and Lirong Zhao;

National Institutes of Health: Nancy Breen, Kathy

Cronin, Brenda Edwards, Paul W. Eggars, and

Marsha Lopez; Substance Abuse and Mental Health

Services Administration: Jeffrey Buck, James Colliver,

Joe Gfroerer, Beth Han, Laura Milazzo-Sayre, and

Rita Vandivort-Warren; and by the following

governmental and nongovernmental organizations:

U.S. Census Bureau: Bernadette D. Proctor; Bureau of

Labor Statistics: Daniel Ginsburg, Jeffrey Schildkraut,

Stephen Pegula, Elizabeth Rogers, and Audrey

Watson; Department of Veterans Affairs: Pheakdey Lim

and Dat Tran; American Association of Colleges of

Pharmacy: Jennifer M. Patton, Danielle Taylor, and

Maureen Thielemans; American Association of

Colleges of Osteopathic Medicine: Wendy Fernando

and Tom Levitan; American Association of Colleges of

Podiatric Medicine: Moraith G. North; American

Osteopathic Association: Margaret Harrison; American

Dental Education Association: Jon D. Ruesch;

Association of American Medical Colleges: Franc Slapar

and Amber Sterling; Association of Schools and

Colleges of Optometry: Paige Pence and Joanne

Zuckerman; Association of Schools of Public Health:

Kristin Dolinski; Cowles Research Group: C. McKeen

Cowles; NOVA Research Company: Shilpa Bengeri;

and Thomson Reuters: Rosanna Coffey and

Katharine Levit.

SPECIAL ACKNOWLEDGMENTS

Dr. Diane Makuc

and

Ms. Rebecca Placek

All those associated with Health, United States would like to give special thanks to Dr. Diane Makuc

and Ms. Rebecca Placek, who recently retired from the National Center for Health Statistics.

Dr. Makuc contributed to Health, United States for more than 30 years, providing direction and

insightful guidance for the report. Her strong grasp of public health issues, knowledge of NCHS

data systems, and expertise in statistical methodology were key to ensuring the high quality and

continued relevance of this annual report to Congress on the health of the Nation.

For 32 years, Ms. Placek was the anchor of the Health, United States production team—keeping this

large and complex project well organized and of the highest quality. She managed the entire trend

table production process with a wonderful combination of meticulousness and good spirits, and

was instrumental in designing systems to track the overall production status of the report.

The Health, United States team is truly grateful to both Diane and Becky for their vital and tireless

contributions to the report over their many years of association. We miss them dearly and wish

them the very best in their retirement!

Contents

Health, United States, 2011 Contents xi

Contents

Preface ................................. iii

Acknowledgments........................ vi

List of Chartbook Figures................... xiii

List of Trend Tables........................ xv

At a Glance Table and Highlights

At a Glance Table ......................... 2

Highlights............................... 4

Special Feature on Socioeconomic Status and

Health .............................. 4

Life Expectancy and Mortality ............. 5

Fertility and Natality..................... 5

Health Risk Factors...................... 5

Measures of Health and Disease Prevalence . . . 6

Health Care Utilization................... 6

Urbanization Level: Health Status, Risk Factors,

and Access to Care ..................... 7

Unmet Need for Medical Care, Prescription

Drugs, and Dental Care Due to Cost ....... 7

Health Care Resources................... 7

Health Care Expenditures and Payers ....... 8

Health Insurance Coverage ............... 8

ChartbookWith Special Feature on

Socioeconomic Status and Health

Mortality................................ 10

Life Expectancy at Birth .................. 10

Infant Mortality ........................ 10

Selected Causes of Death ................ 11

Motor Vehicle-related Death Rates......... 11

Natality ................................. 12

Teenage Birth Rates..................... 12

Morbidity ............................... 12

Heart Disease Prevalence ................ 12

Disability Measures ....................... 13

Basic Actions Difficulty or Complex Activity

Limitation............................ 13

Health Risk Factors........................ 13

Current Cigarette Smoking ............... 13

Uncontrolled High Blood Pressure ......... 14

Obesity Among Children................. 14

Overweight and Obesity Among Adults..... 15

Prevention .............................. 15

Influenza and Pneumococcal Vaccination . . . 15

Mammography Use ..................... 16

Health Insurance ......................... 16

Coverage Among Children ............... 16

Coverage Among Adults 18–64 Years

of Age .............................. 17

Utilization and Access ..................... 17

Prescription Drug Use ................... 17

Emergency Department Visits............. 18

Delay or Nonreceipt of Needed Medical Care

or Prescription Drugs due to Cost......... 18

Health Care Resources..................... 19

Patient Care Physicians per Population...... 19

Personal Health Care Expenditures........... 19

Source of Funds ........................ 19

Type of Expenditure..................... 20

Special Feature on Socioeconomic Status and

Health................................. 24

Introduction ............................. 24

Children

Background ............................. 27

Child Poverty .......................... 27

Morbidity ............................... 28

Current Asthma Among Children .......... 28

Attention Deficit Hyperactivity Disorder

Among Children....................... 29

Health Risk Factors........................ 30

Child Obesity .......................... 30

Children’s Screen Time................... 31

Prevention .............................. 32

Babies Who Were Breastfed for 3 Months or

More ............................... 32

Adolescent Vaccinations ................. 33

Health Insurance ......................... 34

Uninsured Children ..................... 34

Utilization and Access ..................... 35

Dental Visits Among Children ............. 35

xii Contents Health, United States, 2011

Adults

Background ............................. 36

Adult Poverty .......................... 36

Mortality................................ 37

Life Expectancy at Age 25 ................ 37

Morbidity ............................... 38

Depression ............................ 38

Edentulism (Lack of Natural Teeth) ......... 39

Two or More Selected Chronic Health

Conditions ........................... 40

Disability Measures ....................... 41

Basic Actions Difficulty or Complex

Activity Limitation ..................... 41

Health Risk Factors........................ 42

Adult Obesity ......................... 42

Current Cigarette Smoking ............... 43

Prevention .............................. 44

Colorectal Tests or Procedures ............ 44

Health Insurance ......................... 45

Uninsured Adults....................... 45

Access to Care ........................... 46

Delay or Nonreceipt of Medical Care in

the Past 12 Months Due to Cost .......... 46

Technical Notes .......................... 47

Data Tables for Special Feature: Figures 22–41 . . . 49

Trend Tables

Health Status and Determinants............. 71

Population ............................ 71

Fertility and Natality .................... 76

Mortality.............................. 98

Determinants and Measures of Health...... 170

Utilization of Health Resources.............. 268

Ambulatory Care ....................... 268

Inpatient Care ......................... 328

Health Care Resources..................... 349

Personnel ............................. 349

Facilities .............................. 357

Health Care Expenditures and Payers......... 368

National Health Expenditures............. 368

Health Care Coverage and Major Federal

Programs ............................ 395

State Health Expenditures and Health

Insurance ............................ 419

Appendixes

Appendix Contents ....................... 425

Appendix I. Data Sources .................. 429

Appendix II. Definitions and Methods ........ 485

Appendix III. Additional Data Years Available. . . 550

Index

Index .................................. 555

Health, United States, 2011 Contents xiii

List of Chartbook Figures

Mortality

Figure 1. Life expectancy at birth, by race and sex

and Hispanic origin: United States, 1980–2008 . . . 10

Figure 2. Infant, neonatal, and postneonatal

mortality rates: United States, 1998–2008 .... 10

Figure 3. Death rates for selected causes of death

for all ages, by sex: United States, 1998–2008 .... 11

Figure 4. Motor vehicle-related death rates

among persons 15–24 years of age, by sex and age:

United States, 1998–2008 .................. 11

Natality

Figure 5. Teenage childbearing, by maternal

age and race and Hispanic origin: United States,

1998–2008 .............................. 12

Morbidity

Figure 6. Respondent-reported lifetime heart

disease prevalence among adults 18 years of age

and over, by sex and age: United States, 1999–2000

through 2009–2010 ....................... 12

Disability Measures

Figure 7. Basic actions difficulty or complex activity

limitation among adults 18 years of age and over,

by sex and age: United States, 2000–2010 ..... 13

Health Risk Factors

Figure 8. Current cigarette smoking among high

school seniors and adults 18 years of age and over,

by sex and age: United States, 2000–2010 ..... 13

Figure 9. Uncontrolled high blood pressure

among adults 20 years of age and over for persons

with hypertension, by sex and age: United States,

1988–1994, 1999–2002, and 2007–2010 ...... 14

Figure 10. Obesity among children, by age:

United States, 1988–1994 through 2009–2010 . . . 14

Figure 11. Overweight and obesity among adults

20 years of age and over, by sex: United States,

1988–1994, 1999–2002, and 2007–2010 ...... 15

Prevention

Figure 12. Influenza and pneumococcal

vaccination among adults, by type of vaccination

and age: United States, 2000–2010........... 15

Figure 13. Mammography use in the past 2 years

among women 40 years of age and over, by age:

United States, 2000–2010 .................. 16

Health Insurance

Figure 14. Health insurance coverage among

children under 18 years of age, by type of

coverage: United States, 2000–2010.......... 16

Figure 15. Health insurance coverage among

adults 18–64 years of age, by age and type of

coverage: United States, 2000–2010.......... 17

Utilization and Access

Figure 16. Use of three or more prescription drugs

in the past 30 days, by sex and age: United States,

1988–1994, 1999–2002, and 2005–2008 ...... 17

Figure 17. Any emergency department visit

within the past 12 months, by age and type of

coverage: United States, 2000–2010.......... 18

Figure 18. Delay or nonreceipt of needed medical

care or prescription drugs in the past 12 months

due to cost among adults 18–64 years of age, by

type of coverage: United States, 2000–2010 . . . 18

Health Care Resources

Figure 19. Patient care physicians per 10,000

population, by state: United States, 2009 Personal

Health Care Expenditures .................. 19

Personal Health Care Expenditures

Figure 20. Personal health care expenditures, by

source of funds: United States, 1999–2009..... 19

Figure 21. Personal health care expenditures, by

type of expenditure: United States, 1999–2009. . . 20

Special Feature on Socioeconomic

Status and Health

Children

Figure 22. Children under 18 years of age, by

percent of poverty level and race and Hispanic

origin: United States, 1990–2010 ............ 27

Figure 23. Current asthma among children under

18 years of age, by race and Hispanic origin and

percent of poverty level: United States,

2009–2010 .............................. 28

Figure 24. Attention deficit hyperactivity

disorder among children 5–17 years of age, by

race and Hispanic origin and percent of poverty

level: United States, 2009–2010 ............. 29

Figure 25. Obesity among children 2–19 years of

age, by sex of child and education level of head

of household: United States, 1988–1994 and

2007–2010 .............................. 30

Figure 26. Children 6–11 years of age who engaged

in more than 2 hours of screen time daily, by sex

and percent of poverty level: United States,

average annual, 2003 and 2007 ............. 31

xiv Contents Health, United States, 2011

Figure 27. Babies breastfed

3 months or more

among mothers 22–44 years of age, by mother’s

education level: United States, 1992–1994 through

2002–2004 .............................. 32

Figure 28. Vaccinations among adolescents

13–17 years of age, by type of vaccine and percent

of poverty level: United States, 2009 ......... 33

Figure 29. No health insurance coverage among

children under 18 years of age, by percent of poverty

level and race and Hispanic origin: United States,

2000–2010 .............................. 34

Figure 30. Dental visits in the past year among

children 2–17 years of age, by percent of poverty

level and race and Hispanic origin: United States,

2000–2010 .............................. 35

Adults

Figure 31. Adults 18 years of age and over, by

percent of poverty level and race and Hispanic

origin: United States, 1990–2010 ............ 36

Figure 32. Life expectancy at age 25, by sex

and education level: United States, 1996 and

2006 ................................... 37

Figure 33. Depression among adults 20 years of

age and over, by age and percent of poverty level:

United States, 2005–2010 .................. 38

Figure 34. Edentulism (lack of natural teeth)

among adults 45 years of age and over, by age

and percent of poverty level: United States,

2000–2010 .............................. 39

Figure 35. Two or more selected chronic health

conditions among adults 45–64 years of age, by

percent of poverty level: United States, 1999–2000

and 2009–2010 .......................... 40

Figure 36. Basic actions difficulty or complex

activity limitation among adults 18 years of age

and over, by age and percent of poverty level:

United States, 2000–2010 .................. 41

Figure 37. Obesity among adults 25 years of age

and over, by sex and education level: United States,

1988–1994 and 2007–2010 ................. 42

Figure 38. Current cigarette smoking among

adults 25 years of age and over, by age and

education level: United States, 2000–2010..... 43

Figure 39. Colorectal tests or procedures among

adults 50–75 years of age, by education level:

United States, 2000–2010 .................. 44

Figure 40. No health insurance coverage among

adults 18–64 years of age, by percent of poverty

level and race and Hispanic origin: United States,

2000–2010 .............................. 45

Figure 41. Delay or nonreceipt of needed medical

care in the past 12 months due to cost among

adults 18–64 years of age, by percent of poverty

level and race and Hispanic origin: United States,

2000–2010 .............................. 46

Summary List of Trend Tables by Topic

Tables 1–151

Population (Tables 1 and 2)

Resident population

Persons in poverty

Fertility and Natality (Tables 3–14)

Births

Low birthweight

Breastfeeding

and more . . .

Mortality (Tables 15–42)

Infant mortality

Life expectancy

Death rates, by cause

and more . . .

Determinants and Measures of Health

(Tables 43–76)

Health status

Cigarette smoking

Alcohol consumption

High blood pressure

Overweight and obesity

and more . . .

Ambulatory Care (Tables 77–101)

Visits: health care, dentists, emergency departments

and more . . .

Prevention: mammograms, pap smears, vaccinations

Inpatient Care (Tables 102–108)

Hospital stays and procedures

Nursing homes

and more . . .

Personnel (Tables 109–115)

Physicians

Dentists

Nurses

Health professions school enrollment

and more . . .

Facilities (Tables 116–123)

Hospitals

Nursing homes

and more . . .

National Health Expenditures

(Tables 124–137)

Personal health expenditures

Out-of-pocket costs

Prescription drug expenditures

Nursing home costs

and more . . .

Health Care Coverage and Major Federal

Programs (Tables 138–148)

Insurance coverage:

Medicare

Medicaid

Private coverage

Uninsured

HMOs

and more . . .

State Health Expenditures and Health

Insurance (Tables 149–151)

Medicare, Medicaid, HMO expenditures and enrollees

Uninsured persons