NCHS Dataline

The National Center for Health Statistics (NCHS), Centers for Disease Control and Prevention celebrated its 50th anniversary at the National Conference on Health Statistics held in Washington, D.C., August 16–18, 2010. Presentations at the conference described the accomplishments of NCHS since its formation in 1960, and a new booklet provides a current summary of NCHS programs and activities. NCHS participates in two interagency activities to produce reports profiling the health and economic status of older Americans and the well-being of children in the United States. Both interagency forums have released new reports.

NCHS 50TH ANNIVERSARY

NCHS was formed in 1960, bringing together the Office of Vital Statistics and the National Health Survey, with the mission to monitor the health of the nation. During the past 50 years, NCHS has conducted an expanding set of health surveys and coordinated the nation's vital statistics system. The range of data from NCHS has grown, as have the data resources available to the public through printed and online products. Data systems now cover the population's health from birth to death, by collecting data from vital records, health interviews, and health examinations.

From vital records come the data on births and deaths, including teen births, infant mortality, life expectancy, and leading causes of death. Interviews conducted in the home and standardized health examinations monitor the extent of chronic illness and disability, acute conditions and injuries, health habits and behaviors, and exposure to environmental hazards. Surveys of encounters with providers of health care describe the care received in physicians' offices, hospitals, outpatient and emergency departments, and nursing homes, as well as from home health and hospice agencies and residential care facilities.

Throughout its history, NCHS has conducted research to improve the methods of data collection and the quality of the data. NCHS has developed innovative survey methods and analytical techniques that have advanced its own program and those of other agencies. Through collaborative ventures, NCHS has led the way in standardizing disease classification and measures of health status and disability.

The 50th anniversary was celebrated at the 2010 National Conference on Health Statistics, held in Washington, D.C., August 16–18. At the conference, a series of workshops offered hands-on training and analytical insights for users of the data files from NCHS programs. Leaders in health statistics spoke on the use and impact of NCHS data resources and challenges in the need for and use of data and health statistics. NCHS staff spoke of new developments in NCHS programs. Information from the conference and a new report on current NCHS activities are available on the NCHS website at http://www.cdc.gov/nchs.

NEW REPORTS ON OLDER AMERICANS AND CHILDREN

Two new reports provide a comprehensive profile of the health and economic status of older Americans and the well-being of children in the U.S. The reports were produced by interagency forums, of which NCHS is a member, along with many other federal statistical agencies and key federal programs.

Older Americans

“Older Americans 2010: Key Indicators of Well-Being”¹ is a unique, comprehensive look at aging in the U.S. from the Federal Interagency Forum on Aging-Related Statistics. It is the fifth report prepared by the Forum since 2000 and provides an updated, accessible compendium of indicators, drawn from the most reliable official statistics about the well-being of Americans primarily aged 65 years and older. The Forum—a consortium representing 15 agencies with responsibilities for federal data collection, programs serving older Americans, and research—assembles these data and makes them available to a wide constituency including other agencies, policy makers, researchers, and the public. The indicators are categorized into five broad areas—population, economics, health status, health risks and behaviors, and health care. The 155-page report contains data on 37 key indicators.

Key health indicators show that today's older Americans enjoy longer lives and better health than did previous generations. Life expectancies at both 65 and 85 years of age have increased. Under current mortality conditions, people who survive to 65 years of age can expect to live an average of 18.5 more years, about four years longer than people who were 65 years of age in 1960. The life expectancy of people who survive to 85 years of age today is 6.8 years longer for women and 5.7 years longer for men than in 1960. Yet, life expectancy at age 65 in the U.S. is lower than that of many other industrialized nations. In 2005, women aged 65 in Japan could expect to live on average 3.7 years longer than women in the U.S. Among men, the difference was 1.3 years.

The prevalence of certain chronic conditions differs by sex. Women report higher levels of arthritis than men (55% vs. 42%). Compared with women, men report higher levels of heart disease (38% vs. 27%) and cancer (24% vs. 21%). There are also differences by race/ethnicity in the prevalence of certain chronic conditions. In 2007–2008, among people aged 65 years and older, non-Hispanic black people reported higher levels of hypertension and diabetes than non-Hispanic white people (71% vs. 54% for hypertension and 30% vs. 16% for diabetes). Hispanic people also reported higher levels of diabetes than non-Hispanic white people (27% vs. 16%), but lower levels of arthritis (42% vs. 51%). From 1992 to 2007, the age-adjusted proportion of people aged 65 years and older with a functional limitation declined from 49% to 42%. Women had higher levels of functional limitations than men.

The report also tracks changes in health risks and behaviors, many of which have shown long-term improvements, even though recent estimates indicate no significant changes. There was no significant change in the percentage of people aged 65 years and older reporting physical activity from 1997 to 2008. As with other age groups, the percentage of people aged 65 years and older who are obese has increased since 1988–1994. In 2007–2008, 32% of people aged 65 years and older were obese, compared with 22% in 1988–1994. However, during the past several years, this trend has leveled off, with no statistically significant change in obesity for older men or women from 1999–2000 to 2007–2008.

The percentage of people aged 65 years and older living in counties that experienced poor air quality for any air pollutant decreased from 52% in 2000 to 36% in 2008. The proportion of leisure time that older Americans spent socializing and communicating (e.g., visiting friends or attending or hosting social events) declined with age. For Americans aged 55–64 years, 13% of leisure time was spent socializing and communicating compared with 8% for those aged 75 years and older.

The report examined changes in health care and health-care costs. Overall, health-care costs have risen dramatically for older Americans. In addition, from 1992 to 2006, the percentage of health-care costs going to prescription drugs almost doubled—from 8% to 16%—with prescription drugs accounting for a large percentage of out-of-pocket health-care spending. Sources of payment for health care vary by income. Lower-income individuals rely heavily on Medicaid, while those with higher incomes rely more on private insurance. Lower-income individuals pay a lower percentage of out-of-pocket health-care costs but have a higher average cost for services than individuals with higher incomes.

In a previous report, “Older Americans 2008: Key Indicators of Well-Being,”² the Forum identified six areas where better data were needed to support research and policy efforts. In the 2010 report, the Forum updates those six areas, identifying new data sources when available, and provides information on one additional topic area. The Forum has identified the following topics as priority areas for data-collection efforts related to older Americans: caregiving, elder abuse, functioning and disability, mental health and cognitive functioning, pension measures, residential care, and end-of-life issues. For data on residential care, the Forum reported that the 2010 National Survey of Residential Care Facilities (NSRCF), fielded by NCHS as the first-ever national survey of residential care providers, will contribute significantly to the data needed in this area of health care. Residential care facilities include places such as assisted living residences; board and care homes; and personal care homes that are licensed, registered, listed, certified, or otherwise regulated by a state. The NSRCF is designed to produce estimates of these places and their residents. It will allow for the identification of varied levels of supportive care and assistance by housing arrangement.

“Older Americans 2010: Key Indicators of Well-Being” is available online at http://www.AgingStats.gov and in limited quantities in print. Supporting data for each indicator, including complete tables, PowerPoint slides, and source descriptions, can be found on the Forum's website. Single printed copies of the report are available at no charge through NCHS while supplies last. Requests may be made by sending an e-mail to nchsquery@cdc.gov. For multiple print copies, send an e-mail request to agingforum@cdc.gov.

Children

“America's Children in Brief: Key National Indicators of Well-Being, 2010”² was compiled by the Federal Interagency Forum on Child and Family Statistics, a working group of 22 federal agencies, including NCHS, that collects, analyzes, and reports data on issues related to children and families. This summary report groups the most recently available major federal statistics on children and young people under several domains: family and social environment, economic circumstances, health care, physical environment and safety, behavior, education, and health. The purpose of the report is to provide statistical information on children and families in a nontechnical, easy-to-use format to stimulate discussion among data providers, policy makers, and members of the public. A more detailed report alternates every other year with this condensed version that highlights selected indicators.

Highlights of the report show the following:

• A drop in the proportion of infants born earlier than 37 weeks, from 12.7% to 12.3%

• A drop in births to adolescent girls aged 15–17 years, from 22.2 per 1,000 population to 21.7 per 1,000 population

• A rise in the rate of children from birth to 17 years of age covered by health insurance at some time during the year, from 89% to 90%

• A rise in the proportion of related children from birth to 17 years of age living in poverty, from 18% to 19%

• A drop in the percentage of children from birth to 17 years of age living with at least one parent employed year-round full-time, from 77% to 75%

• A rise in the percentage of children from birth to 17 years of age living in food-insecure homes, from 17% to 22%, the highest prevalence since monitoring began. The report defines food security as access at all times to enough food for active, healthy lives for all family members.

Printed copies of the report are also available from the Health Resources and Services Administration Information Center, P.O. Box 2910, Merrifield, VA 22116, or by e-mailing ask@hrsa.gov. The report, data updates, and detailed statistical information accompanying this year's report are available online at the Forum's website at http://www.childstats.gov.