NCHS Fact Sheet

November 2012

Uses of NCHS Data

Guiding National Policy

Health Insurance Coverage - NCHS provides the most current and complete national and state-specific (for the largest states) data available to track health insurance coverage, including coverage under both traditional and consumer-directed insurance arrangements. Measures are obtained on persons: currently uninsured; uninsured at any time in the previous year; and uninsured for more than a year. In the first 3 months of 2012, 17.6 percent of the nonelderly population currently lacked health insurance coverage, while 6.7 percent of children under 18 were uninsured. Among adults aged 19-25 - agroup targeted by provisions in the Affordable Care Act - 27.5 percent were uninsured in early 2012, a decrease from the recent high of 35.6 percent in the 3rd quarter of 2010.

Monitoring the Effects of Health Care Legislation - Enhancements to ongoing data collections will track the effects of the Affordable Care Act on health insurance status, access to care, affordability of care, usual source of care, use of emergency care, and use of preventive services, including care to prevent heart disease and stroke. Expanded state-level estimates for some health indicators will be available to support state monitoring activities.

Disparities in Health - NCHS data have long documented disparities in a wide range of health indicators including life expectancy, infant mortality, a variety of risk factors, health insurance coverage, access to care, and use of health care services - leading HHS to identify health disparities as a major public health problem and to develop national goals to eliminate disparities and improve the health of all populations.

Nutrition - Data on Americans' nutritional status and dietary intakes and behaviors contribute to nutrition policy and programs to promote health and prevent disease. NCHS data are used to recommend and evaluate food fortification decisions, develop and revise the Dietary Guidelines for Americans, and help set recommended intake levels for vitamins, minerals, and other nutrients. Data on dietary intake (food and beverages) document no change in total caloric intake among adults in recent years. Data on dietary supplements are available and show use is increasing. Data also show that most American adults consume more sodium than the recommended level.

Immunizations - NCHS data are used to monitor compliance with recommended practices such as recommendations for influenza vaccination and the timing of childhood immunizations. Data collection also includes testing for immunity to vaccine-preventable diseases such as measles, mumps, rubella, tetanus, and diphtheria, and the resulting data contribute to improvements in immunization policies that protect society as a whole and target groups at special risk.

Biomonitoring - NCHS data are used to assess the exposure of the U.S. population to a wide range of environmental chemicals. The data have been used to track exposure to lead and secondhand smoke - both of which continue to decline - for many years. Data are also available on exposure to mercury and some forms of arsenic, environmental phenols such as Bisphenol A (BPA), and pesticides.

Monitoring Health Status and Behaviors

Birth Data - NCHS data provide a wealth of information on health and demographic trends related to childbirth including trends in nonmarital births and births to teens. The 2011 preliminary data show a continuing decline in total births from the all-time high in 2007. The fertility rate declined in 2011 to the lowest rate ever reported for the U.S. The teen birth rate fell 8 percent - also to a record low. The percentage of births to unmarried women declined in 2011 for the 2nd consecutive year to 40.7 percent. Data are also available to monitor higher risk births. In 2011, the preterm birth rate fell for the 5th straight year to 11.7 percent; the low birthweight rate was 8.1 percent, down slightly from 2010.

Teen Pregnancy - NCHS compiles teen pregnancy rates. The latest estimates show a decline of 40 percent from the 1990 peak, to 70 pregnancies per 1,000 teens aged 15-19 in 2008. This reflects reductions in both births and abortions. U.S. teenage pregnancy rates are still among the highest among industrialized nations.

Growth Charts - NCHS data are used to create the pediatric growth charts used by pediatricians and parents to monitor children’s growth. These charts are available in electronic form directly from the CDC website, and are also repackaged by private sector entities and distributed widely to physicians’ offices.

Children’s Behavioral Health - NCHS data are used to monitor children’s emotional and behavioral health. In 2011, about 9 percent of children 4-17 years of age had ADHD and about 5 percent had definite or severe difficulties in emotions, concentration, behavior, or being able to get along with others. Parents reported that 9 percent of school-aged children (6-17 year-olds) were receiving special education services, one-third of whom received these services because of an emotional or behavioral problem. Special NCHS surveys on children with autism document challenges in obtaining care and the impact of this condition on the family.

Obesity - Measured height and weight data illustrate that the percentage of obese Americans - who are at elevated risk of a variety of health problems - has risen dramatically since the 1970s. Between 1980 and 2000 the percent of adults classified as obese doubled - from 15 percent to 31 percent. In 2009-10, 35.7 percent of adults, 18 percent of children aged 6-11, and 18.4 percent of adolescents aged 12-19 were obese.

Diabetes - Diabetes - both diagnosed and undiagnosed - affects many Americans and is a leading chronic disease among adults in our country. In 2005-08, about 11 percent of adults aged 20 and older had diabetes; approximately one in four people with diabetes are unaware they have the disease.

Cholesterol - Data are used to monitor blood cholesterol, documenting declines in the population with high cholesterol from the 1960s through 2009-10 when about 13 percent of adults had high cholesterol. Data also show a decrease in the prevalence of children and adolescents aged 6-19 years with high cholesterol – from 11.3 percent in 1988-94 to 8.1 percent in 2007-10.

Hypertension - NCHS data called attention to hypertension decades ago, leading to prevention efforts. But it remains common. In 2009-10, almost 29 percent of adults aged 18 and over had hypertension – a level that has not changed significantly in the last decade. The data show increases since 1999-2000, however, in high blood pressure awareness, treatment, and control. In 2009-10, more than half of adults with hypertension had their condition under control.

Smoking - NCHS has chronicled cigarette smoking levels since 1964 - the year the first Surgeon General's report on smoking was released. The data show steady declines from 1965, when over 40 percent of adults smoked cigarettes, until 1990 when about 25 percent of adults smoked. Smoking rates remained near that level through much of the 1990s, but have dropped further since then. In 2011, 19 percent of adults smoked cigarettes.

Oral Health - Oral health has improved significantly for most Americans since the 1990s. The prevalence of tooth decay in permanent teeth is down for all ages. There’s more use of protective dental sealants and less gum disease, and more seniors are retaining their natural teeth. But disparities persist. In 2009-10, about 1 in 4 children aged 3-9 living in poverty had untreated dental caries compared to less than 1 in 7 children living above the federal poverty level. And the prevalence of complete tooth loss was much higher for adults aged 65-74 living at or below the poverty level (34 percent) than for those living above it (13 percent).

Asthma - Tracking different aspects of asthma - prevalence, health care utilization, and mortality - reveals the challenges of addressing this disease and can lead to better targeting of interventions. In 2010, 9.3 percent of children and 8.2 percent of adults had asthma. NCHS data illustrate the disparate impact of asthma, with blacks experiencing more ED visits, hospitalizations, and deaths due to asthma than whites.

Injuries - Injuries inflict a heavy toll on Americans. NCHS data document that unintentional injuries were the leading cause of death in 2010 for those 1-44 years of age and the 5th leading cause of death for all ages. In 2010, 67 percent of injury deaths were unintentional, while 21 percent were suicides and 9 percent were homicides. Poisoning caused the most injury deaths, followed by motor vehicles, firearms, falls, and suffocation. In the past decade, poisonings have increased at a greater pace than other causes of injury death - and drug poisonings account for about 90 percent of poisoning deaths.

Disabilities and Functional Status - International efforts are underway to improve our understanding of disabilities and the impact of activity limitations on participation in society. NCHS obtains data to assess basic actions functioning (for example, functioning in movement, sensory, or cognitive functioning) and complex activity functioning (limits in self-care, social activities, or work). In 2010, 33 percent of adults reported at least one basic actions difficulty or complex activity limitation.

Children’s Emotional Health - NCHS data are used to monitor children’s emotional and behavioral health. In 2010, about 9 percent of children 4-17 years of age had ADHD and about 6 percent had definite or severe difficulties in emotions, concentration, behavior, or being able to get along with others. Parents reported that 8 percent of school-aged children (6-17 year-olds) were receiving special education services; about 37 percent of these children received special education services because of an emotional or behavioral problem.

Assessing the Health Care System

Health Care Delivery System - Our health care delivery system is changing. Key changes in recent years include: increased use of prescription medications, declining rates of inpatient hospitalization for heart disease and stroke, increased inpatient hospitalizations for knee replacements, increased crowding in emergency departments, decreased length of service among the oldest-old home health care patients, and increased use of hospice care by persons with primary diagnoses other than cancer.

Health Information Technology - NCHS data track changes in the use of electronic health records, which have the potential to enhance the efficiency and safety of health care encounters. Data show use of electronic health records increasing among office-based physicians, with 57 percent of physicians reporting use of a system in 2011. About three quarters of these systems met federal “meaningful use” criteria. Technology is also changing the way we communicate about health issues, with increasing numbers of adults using the internet to fill prescriptions, schedule appointments, and communicate with providers.

Quality and Patient Safety - NCHS data systems offer a wealth of opportunities to examine quality and patient safety issues, including over-, under-, or misuse of procedures, complications of care, preventable hospitalizations, pain management, and deaths due to medical error. Concern about antimicrobial resistance and over-prescribing of antibiotics to children led to educational efforts regarding appropriate use of antibiotics in the mid-1990s. For children under 15 years of age, there was a 31 percent decline in the rate of antibiotics prescribed per physician office visit between 1997 and 2009, suggesting that physicians have responded to these initiatives.

Emergency Care - NCHS data are used to monitor the emergency care system, including assessing the Nation’s ability both to provide basic emergency care and to respond to natural disasters and other public health emergencies. Demand for emergency care is increasing - ED visits increased from about 108 million in 2000 to 130 million in 2010. During the same period the number of hospital EDs decreased. In 2011, about 19 percent of children and 20 percent of adults visited the emergency room at least once in the previous 12 months.

Complementary and Alternative Medicine - NCHS data represent the most comprehensive and reliable data on complementary and alternative medicine use in the U.S., revealing that 38 percent of adults and about 12 percent of children under 18 used some form of alternative medicine in 2007.

Shaping Research Priorities

Older Americans - The aging of the population, particularly increases in those 85 and older, will lead to an increase in the number of people who need health care. NCHS data show that older adults use a disproportionate share of both hospital and ambulatory care; data also document increased demand for home health and hospice care between 2000 and 2007. Data on residential care communities was collected in 2010, further adding to our understanding of the long term care needs of the elderly. NCHS provides data to examine resource use such as staffing and charges, care management, and use of technology, all increasingly important research, policy, and provider issues.

Women’s Health - NCHS data are used to monitor the health of American women in all stages of their lives, with a particular focus on the childbearing years. Data are obtained to monitor access to contraception including drugs and procedures, and their possible side effects - important components of reproductive health. Data on cesareans are also monitored, revealing that almost one-third of all U.S. births were cesareans in 2011. Data on preventive services such as mammograms show that in 2010 about 72 percent of women aged 50-74 years reported having had a mammogram in the last two years.

Infant and Fetal Mortality - After decades of decline, the U.S. infant mortality rate did not decrease from 2000 to 2005, but it has declined since then. In 2011, the preliminary U.S. infantmortality rate was 6.05 infant deaths per 1,000 live births - a decline of 12 percent since 2005. Preterm birth and low birthweight are both important risk factors linked to infant mortality. In addition to monitoring trends, NCHS data are used to describe differentials in rates. For example, infants born to black mothers are at much higher risk of infant mortality. NCHS also publishes data on fetal deaths (stillbirths).

Life Expectancy and Causes of Death - Drawing on data from state vital records, NCHS monitors trends in life expectancy, death rates, and causes of death, documenting the dramatic improvements in life expectancy in the past century. Americans experienced the longest life expectancy in U.S. history - 78.7 years (76.3 years for men and 81.1 years for women) in 2011. The 5 leading causes of death accounted for about 62 percent of deaths in the U.S. in 2011. Heart disease, cancer, chronic lower respiratory diseases, stroke, and accidents were the leading causes of death, although this general profile differs markedly based on age.

Who Uses NCHS Data?

Congress and other policymakers - to track major policy initiatives including implementation of the Affordable Care Act, set priorities for prevention and research programs, and evaluate outcomes.

Epidemiologists, biomedical and health services researchers - to understand trends in multiple aspects of health and health care, the relationship of observed risk factors to health outcomes, and the use of health services.

Businesses - to support health-related activities of pharmaceutical and food manufacturers, market research firms, consulting firms, and trade associations.

Public health professionals - to track preventable illnesses and functional limitations and evaluate the impact of intervention programs

Media and advocacy groups - to obtain background information and raise awareness of issues such as heart disease, cancer, diabetes, child nutrition, Alzheimer’s disease, and health disparities.

Individual physicians - to evaluate health and risk factors of their patients (for example, reference standards and norms for conditions such as cholesterol, body weight, and blood pressure, and reference growth charts for children).

Actuaries - to gauge the health of the Social Security and Medicare trust funds and set premiums for health and life insurance.

Access to NCHS Data

Published reports - in print and on website.
Public use data files for analysis by researchers.
Website-only data releases of timely information on important health issues.
FastStats A-Z - quick access to key health data.
Pre-tabulated tables with state-level data on issues of special interest, such as births and deaths.
Interactive data warehouses where pre-tabulated tables can be customized and used to produce charts, including “VitalStats” and “Health Data Interactive,” containing national and state data on a wide variety of health topics.
Web-based tutorials to assist data users.
Research Data Centers - secure access to detailed data.

For further information on NCHS and its programs, visit the NCHS website or call the Office of Planning, Budget and Legislation at 301-458-4100.