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. 2019 Oct 25;16(3):562–572. doi: 10.1080/21645515.2019.1670036

Table 1.

Characteristics of adolescents aged 13–17 years by metropolitan statistical area (MSA) status – National Immunization Survey–Teen, United States, 2016–2017.

      Metropolitan Statistical Area (MSA)
  Overall
Mostly Urban
Suburban
Mostly Rural
Characteristic Sample Size Weighted % (95% C.I.) Sample Size Weighted % (95% C.I.) Sample Size Weighted % (95% C.I.) Sample Size Weighted % (95% C.I.)
Total 41,424 100.0 (---------) 16,523 40.7 (39.8–41.6) 16,530 46.9 (46.0–47.8) 8,371 12.4 (12.0–12.9)
Survey Year                
2016 20,475 50.0 (49.4–50.6) 7,979 49.3 (48.1–50.6) 8,248 50.0 (48.8–51.1) 4,248 52.3 (50.6–54.1)*
2017 20,949 50.0 (49.4–50.6) 8,544 50.7 (49.4–51.9) 8,282 50.0 (48.9–51.2) 4,123 47.7 (45.9–49.4)*
Age (years)                
13–15 25,502 60.6 (59.7–61.5) 10,218 59.6 (58.1–61.1) 10,171 61.7 (60.4–63.0)* 5,113 59.7 (57.8–61.5)
16–17 15,922 39.4 (38.5–40.3) 6,305 40.4 (38.9–41.9) 6,359 38.3 (37.0–39.6)* 3,258 40.3 (38.5–42.2)
Sex                
Male 21,918 51.0 (50.1–52.0) 8,766 51.6 (50.1–53.1) 8,709 50.4 (49.0–51.7) 4,443 51.7 (49.8–53.6)
Female 19,506 49.0 (48.0–49.9) 7,757 48.4 (46.9–49.9) 7,821 49.6 (48.3–51.0) 3,928 48.3 (46.4–50.2)
Race/ethnicity                
Non-Hispanic White 25,893 52.5 (51.6–53.4) 8,312 41.0 (39.7–42.4) 11,323 58.4 (57.0–59.7)* 6,258 68.2 (66.3–70.0)*
Non-Hispanic Black 3,733 13.8 (13.2–14.4) 2,197 19.0 (17.9–20.3) 1,116 10.3 (9.5–11.2)* 420 9.6 (8.4–10.9)*
Hispanic 7,105 23.4 (22.6–24.3) 4,009 29.0 (27.5–30.5) 2,279 21.5 (20.2–22.9)* 817 12.6 (11.3–14.0)*
American Indian/Alaskan Native 557 0.9 (0.8–1.0) 131 0.5 (0.4–0.7) 129 0.6 (0.5–0.9) 297 3.1 (2.4–3.9)*
Asian 1,680 4.3 (3.9–4.7) 855 5.4 (4.7–6.1) 721 4.2 (3.7–4.9)* 104 1.0 (0.6–1.7)*
Other 2,456 5.1 (4.7–5.4) 1,019 5.1 (4.6–5.7) 962 4.9 (4.4–5.5) 475 5.5 (4.7–6.4)
Immigration status                
Born in U.S. 39,126 93.5 (93.0–94.0) 15,226 90.7 (89.6–91.7) 15,757 94.8 (94.1–95.4)* 8,143 97.9 (97.4–98.4)*
Born outside U.S. 2,045 6.5 (6.0–7.0) 1,203 9.3 (8.3–10.4) 678 5.2 (4.6–5.9)* 164 2.1 (1.6–2.6)*
Region                
Northeast 8,024 16.4 (16.1–16.7) 2,288 12.3 (11.7–13.0) 4,520 22.0 (21.3–22.7)* 1,216 8.7 (7.8–9.7)*
Midwest 8,798 21.4 (21.0–21.8) 3,204 20.1 (19.3–21.0) 3,061 19.2 (18.5–19.9) 2,533 33.9 (32.3–35.5)*
South 15,652 38.3 (37.8–38.9) 7,080 37.9 (36.7–39.1) 6,204 37.5 (36.4–38.5) 2,368 43.1 (41.3–44.9)*
West 8,950 23.9 (23.2–24.5) 3,951 29.7 (28.3–31.1) 2,745 21.4 (20.1–22.7)* 2,254 14.3 (13.2–15.5)*
Mother’s age                
≤34 years 3,285 8.7 (8.2–9.2) 1,496 10.1 (9.3–11.0) 1,038 7.2 (6.5–8.0)* 751 9.4 (8.4–10.5)
35–44 years 16,757 43.4 (42.5–44.3) 6,492 43.2 (41.7–44.7) 6,419 41.7 (40.4–43.1) 3,846 50.5 (48.6–52.3)*
≥45 years 21,382 47.9 (47.0–48.8) 8,535 46.7 (45.2–48.2) 9,073 51.1 (49.7–52.4)* 3,774 40.1 (38.3–41.9)*
Mother’s educational level                
<High School 4,770 13.3 (12.6–14.0) 2,370 16.1 (14.9–17.4) 1,437 10.9 (9.9–12.0)* 963 12.8 (11.6–14.2)*
High School 6,394 22.3 (21.5–23.1) 2,503 22.6 (21.3–24.0) 2,232 20.2 (19.1–21.4)* 1,659 29.0 (27.2–30.9)*
Some college or college graduate 10,535 24.4 (23.6–25.2) 3,846 22.9 (21.7–24.2) 4,108 24.4 (23.2–25.6)* 2,581 29.4 (27.8–31.1)*
> College graduate 19,725 40.0 (39.2–40.9) 7,804 38.4 (37.0–39.8) 8,753 44.5 (43.2–45.8)* 3,168 28.8 (27.2–30.4)*
Mother’s marital status                
Married 29,234 67.8 (66.9–68.7) 11,061 63.5 (62.0–65.0) 12,359 72.2 (70.9–73.5)* 5,814 64.6 (62.6–66.5)
Widowed/divorced/separated 6,951 23.1 (22.2–23.9) 2,856 24.2 (22.8–25.6) 2,548 21.0 (19.9–22.2)* 1,547 27.3 (25.5–29.1)*
Never married 2,541 9.2 (8.6–9.8) 1,433 12.3 (11.3–13.4) 694 6.7 (6.0–7.6)* 414 8.1 (7.0–9.5)*
Parent aware of VFC program                
Yes 15,877 37.6 (36.7–38.5) 6,192 36.6 (35.2–38.1) 6,187 37.4 (36.1–38.7) 3,498 41.3 (39.4–43.1)*
No 25,547 62.4 (61.5–63.3) 10,331 63.4 (61.9–64.8) 10,343 62.6 (61.3–63.9) 4,873 58.7 (56.9–60.6)*
Family income to poverty ratio                
<133% 10,380 31.5 (30.6–32.4) 4,988 38.9 (37.4–40.4) 2,997 23.3 (22.1–24.5)* 2,395 38.5 (36.7–40.4)
133%–<322% 11,256 27.9 (27.1–28.8) 4,055 25.6 (24.3–26.9) 4,219 28.0 (26.8–29.3)* 2,982 35.5 (33.7–37.3)*
322%–<503% 8,281 17.4 (16.8–18.1) 2,903 14.2 (13.3–15.1) 3,782 20.9 (19.9–22.0)* 1,596 14.8 (13.6–16.1)
>503% 11,507 23.1 (22.4–23.9) 4,577 21.4 (20.3–22.6) 5,532 27.8 (26.7–29.0)* 1,398 11.2 (10.1–12.3)*
Medical insurance                
Private only 24,016 51.4 (50.5–52.3) 8,951 45.7 (44.2–47.2) 10,804 59.0 (57.7–60.4)* 4,261 41.0 (39.3–42.8)*
Any Medicaid 12,707 37.3 (36.4–38.3) 5,585 43.0 (41.4–44.5) 3,998 29.9 (28.6–31.2)* 3,124 47.2 (45.3–49.1)*
Other 3,181 7.0 (6.6–7.5) 1,289 6.5 (6.0–7.2) 1,235 7.4 (6.8–8.1)* 657 7.1 (6.3–8.1)
Uninsured 1,520 4.2 (3.9–4.6) 698 4.8 (4.1–5.5) 493 3.6 (3.1–4.2)* 329 4.7 (3.9–5.6)
Well child visit at age 11–12 years                
Yes 20,223 47.0 (46.1–47.9) 7,952 45.2 (43.8–46.7) 8,969 51.0 (49.6–52.3)* 3,302 37.6 (35.8–39.4)*
No 9,518 22.2 (21.4–22.9) 3,316 21.2 (20.0–22.4) 3,147 19.3 (18.3–20.4)* 3,055 36.2 (34.4–38.0)*
Don’t know 11,683 30.8 (30.0–31.7) 5,255 33.6 (32.1–35.0) 4,414 29.7 (28.5–31.0)* 2,014 26.3 (24.6–28.0)*
Parental report of provider recommendation for vaccine                
Yes 28,639 73.4 (72.5–74.3) 11,497 74.0 (72.5–75.4) 11,764 74.2 (72.9–75.5) 5,378 68.3 (66.4–70.1)*
No 9,202 26.6 (25.7–27.5) 3,497 26.0 (24.6–27.5) 3,481 25.8 (24.5–27.1) 2,224 31.7 (29.9–33.6)*
Vaccination facility type                
All private facilities 20,483 52.8 (51.9–53.7) 8,629 52.8 (51.3–54.3) 9,730 59.4 (58.1–60.7)* 2,124 27.6 (25.9–29.3)*
All public facilities 6,048 15.4 (14.7–16.1) 2,016 15.1 (14.0–16.3) 1,537 11.4 (10.4–12.4)* 2,495 31.7 (29.9–33.5)*
All hospital facilities 4,911 10.0 (9.5–10.5) 2,218 11.6 (10.7–12.5) 1,698 8.8 (8.1–9.6)* 995 9.3 (8.3–10.5)*
All STD/school/teen clinics or other facilities 705 2.1 (1.8–2.5) 319 2.1 (1.7–2.6) 252 2.2 (1.7–2.8) 134 1.9 (1.3–2.6)
Mixed** 8,382 18.4 (17.8–19.1) 2,915 17.0 (15.9–18.1) 2,973 16.9 (15.9–17.9) 2,494 29.0 (27.4–30.7)*
Other†† 599 1.3 (1.1–1.4) 294 1.4 (1.1–1.7) 249 1.3 (1.1–1.6) 56 0.6 (0.4–0.9)*

Abbreviation: VFC = Vaccines for Children; STD = sexually transmitted disease.

*Statistically different compared with adolescents living in mostly urban areas (p < .05).

Insurance categories are mutually exclusive.

Includes Indian Health Service, military, Children’s Health Insurance Program, and some private.

Status of health-care visit at age 11–12 years based on provider-reported data.

**Mixed indicates that the facility is identified to be in more than one of the facility categories, such as private, public, hospital, and STD/school/teen clinics.

††Includes military, WIC clinics, and pharmacies.