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1.
Natl Health Stat Report ; (202): 1-19, 2024 04.
Article in English | MEDLINE | ID: mdl-38722687

ABSTRACT

Objectives-Using National Survey of Family Growth data from 2015-2019, this report presents updated national estimates of infertility in U.S. women and men and estimates of impaired fecundity (physical ability to have children) in U.S. women. Detailed demographic breakdowns are also presented, and overall estimates for 2015-2019 are compared with those for 2011-2015. Methods-Data for this report come primarily from the 2015-2019 National Survey of Family Growth, which consisted of 21,441 interviews with men and women ages 15-49, conducted from September 2015 through September 2019. The response rate was 65.9% for women and 62.4% for men. Results-The percentage of women ages 15-44 who had impaired fecundity did not change between 2011-2015 and 2015-2019. The percentage of married women with impaired fecundity also remained stable over this time period. Among all women, 13.4% of women ages 15-49 and 15.4% of women ages 25-49 had impaired fecundity in 2015-2019. The percentage of married women ages 15-44 who were infertile rose from 2011-2015 (6.7%) to 2015-2019 (8.7%). Among married and cohabiting women ages 15-49 in 2015-2019, 7.8% had infertility. Both infertility and impaired fecundity were associated with age for nulliparous (never had a live birth) women after adjusting for other factors. Some form of infertility (either subfertility or nonsurgical sterility) was seen in 11.4% of men ages 15-49 and 12.8% of men ages 25-49 in 2015-2019. . Conclusion-Although these findings are not nationally representative, this report illustrates how linked NHCS-HUD data may provide insight into maternal health outcomes of patients who received housing assistance compared with those who did not.


Subject(s)
Infertility , Humans , United States/epidemiology , Adult , Female , Adolescent , Male , Middle Aged , Young Adult , Infertility/epidemiology , Infertility, Female/epidemiology , Infertility, Male/epidemiology , Fertility
2.
Natl Health Stat Report ; (138): 1-14, 2020 01.
Article in English | MEDLINE | ID: mdl-32510314

ABSTRACT

Objective-This report presents demographic characteristics, health service access and use, and timing of key fertility-related milestones among adults aged 18-44 who had ever been in foster care as compared with those who had never been in foster care in the United States. Methods-The National Survey of Family Growth (NSFG) is a nationally representative survey, with data collected through in-person interviews of the household population of the United States. Analyses used 6 years of NSFG interviews spanning September 2011 through September 2017, and included 11,527 male and 14,439 female respondents aged 18-44. Bivariate analyses examined demographic characteristics and health service access and use by having ever been in foster care, as measured by household roster information and childhood background items. Cumulative probabilities of first sexual intercourse, first marriage, and first birth by age were estimated using Kaplan-Meier procedures. All estimates were stratified by sex. Results-Overall, 2.6% of adults aged 18-44 had ever been in foster care, and the percentage was higher for women (3.0%) than for men (2.3%). Lower percentages of men and women who were ever in foster care had a bachelor's degree or higher (4.8% for men and 9.1% for women) compared with those who had never been in foster care (31.1% and 36.2%, respectively). Receipt of public assistance in the past 12 months was more likely among adults who were ever in foster care compared with those who were never in foster care. Adults ever in foster care were less likely than adults never in foster care to be currently covered by private health insurance and were more likely to be covered by Medicaid. Adults ever in foster care also had higher probabilities of first sexual intercourse and first births at younger ages than those never in foster care.


Subject(s)
Fertility , Foster Home Care , Health Services Accessibility , Adolescent , Adult , Demography , Female , Health Services Accessibility/statistics & numerical data , Humans , Interviews as Topic , Male , Patient Acceptance of Health Care/statistics & numerical data , Qualitative Research , Surveys and Questionnaires , United States , Young Adult
3.
Natl Health Stat Report ; (111): 1-11, 2018 05.
Article in English | MEDLINE | ID: mdl-29874161

ABSTRACT

This report provides a profile of sexually experienced, cohabiting adults aged 18-44 in the United States based on 2011-2015 data from the National Survey of Family Growth (NSFG). Additionally, this report compares these cohabiting adults with those sexually experienced adults who are currently married and those who are unmarried and not currently cohabiting. Data are shown by selected demographic characteristics, attitudes, and family formation behaviors. NSFG data used in this report were collected through in-person interviews from September 2011 through September 2015 with nationally representative samples of 6,674 men and 8,292 women aged 18-44 who were sexually experienced. The overall response rate for the 2011-2015 NSFG was 71%: 72% for women and 70% for men.Overall, 17.1% of women and 15.9% of men aged 18-44 who were sexually experienced were cohabiting at the time of interview. Compared with those who were married or unmarried and not cohabiting, cohabiting women and men were more likely to have no high school diploma or GED. Both cohabiters and unmarried, noncohabiting individuals reported lower household incomes than married persons. Cohabiting women and men were more supportive of premarital cohabitation, the idea that living together before marriage may help prevent divorce, and of raising children in cohabiting unions, compared with married and unmarried, noncohabiting adults. Cohabiting individuals were more likely to report having had their first sexual intercourse before the age of 18 and having cohabited two or more times in the pastthan both married and unmarried, noncohabiting individuals. They were also more likely than married men and women to have had an unintended birth.


Subject(s)
Attitude , Demography , Family Characteristics , Marital Status , Adolescent , Adult , Female , Fertility , Humans , Male , Sexual Behavior , Surveys and Questionnaires , United States , Young Adult
4.
Am J Public Health ; 108(3): 361-367, 2018 03.
Article in English | MEDLINE | ID: mdl-29345997

ABSTRACT

OBJECTIVES: To describe long-term national trends in health insurance coverage among US veterans from 2000 to 2016 in the context of recent health care reform. METHODS: We used 2000 to 2016 National Health Interview Survey data on veterans aged 18 to 64 years to examine trends in insurance coverage and uninsurance by year, income, and state Medicaid expansion status. We also explored the current proportions of veterans with each type of insurance by age group. RESULTS: The percentage of veterans with private insurance decreased from 70.8% in 2000 to 56.9% in 2011, whereas between 2000 and 2016 Department of Veterans Affairs (VA) health care coverage (only) almost tripled, Medicaid (without concurrent TRICARE or private coverage) doubled, and TRICARE coverage of any type tripled. After 2011, the percentage of veterans who were uninsured decreased. In 2016, low-income veterans in Medicaid expansion states had double the Medicaid coverage (41.1%) of low-income veterans in nonexpansion states (20.1%). CONCLUSIONS: Our estimates, which are nationally representative of noninstitutionalized veterans, show marked increases in military-related coverage through TRICARE and VA health care. In 2016, only 7.2% of veterans aged 18 to 64 years and 3.7% of all veterans (aged 18 years or older) remained uninsured.


Subject(s)
Insurance Coverage/statistics & numerical data , Insurance Coverage/trends , Insurance, Health/statistics & numerical data , Insurance, Health/trends , Veterans/statistics & numerical data , Adult , Health Care Reform , Health Surveys , Humans , Insurance, Health/classification , Medicaid/statistics & numerical data , Medically Uninsured/statistics & numerical data , Middle Aged , United States , United States Department of Veterans Affairs/statistics & numerical data
5.
Public Health Rep ; 132(2): 149-156, 2017.
Article in English | MEDLINE | ID: mdl-28135423

ABSTRACT

OBJECTIVES: This study, measuring the prevalence of chronic obstructive pulmonary disease (COPD), examined (1) whether a single survey question asking explicitly about diagnosed COPD is sufficient to identify US adults with COPD and (2) how this measure compares with estimating COPD prevalence using survey questions on diagnosed emphysema and/or chronic bronchitis and all 3 survey questions together. METHODS: We used data from the 2012-2014 National Health Interview Survey to examine different measures of prevalence among 7211 US adults who reported a diagnosed respiratory condition (ie, emphysema, chronic bronchitis, and/or COPD). RESULTS: We estimated a significantly higher prevalence of COPD by using a measure accounting for all 3 diagnoses (6.1%; 95% CI, 5.9%-6.3%) than by using a measure of COPD diagnosis only (3.0%; 95% CI, 2.8%-3.1%) or a measure of emphysema and/or chronic bronchitis diagnoses (4.7%; 95% CI, 4.6%-4.9%). This pattern was significant among all subgroups examined except for non-Hispanic Asian adults. The percentage difference between measures of COPD was larger among certain subgroups (adults aged 18-39, Hispanic adults, and never smokers); additional analyses showed that this difference resulted from a large proportion of adults in these subgroups reporting a diagnosis of chronic bronchitis only. CONCLUSIONS: With the use of self- or patient-reported health survey data such as the National Health Interview Survey, it is recommended that a measure asking respondents only about COPD diagnosis is not adequate for estimating the prevalence of COPD. Instead, a measure accounting for diagnoses of emphysema, chronic bronchitis, and/or COPD may be a better measure. Additional analyses should explore the reliability and validation of survey questions related to COPD, with special attention toward questions on chronic bronchitis.


Subject(s)
Pulmonary Disease, Chronic Obstructive/epidemiology , Adolescent , Adult , Aged , Female , Health Surveys , Humans , Male , Middle Aged , Prevalence , United States/epidemiology , Young Adult
6.
NCHS Data Brief ; (297): 1-8, 2017 01.
Article in English | MEDLINE | ID: mdl-29319474

ABSTRACT

In 2010, one-fifth of the U.S. population lived in rural areas (1). There is known variation in social, demographic, and health characteristics across urban and rural residence (1­3). Recent National Center for Health Statistics (NCHS) reports show higher teen birth and infant mortality rates in rural counties than in urban counties (4,5). Less is known about urban and rural variation in fertility-related behavior, such as sexual activity and contraceptive use. Using National Survey of Family Growth (NSFG) data from 2011 through 2015 for women aged 18­44, this report describes urban-rural differences in first sexual intercourse, marital and cohabitation status, number of births, and contraceptive use based on residence at the time of interview.


Subject(s)
Contraception Behavior/statistics & numerical data , Marriage/statistics & numerical data , Rural Population/statistics & numerical data , Sexual Behavior/statistics & numerical data , Urban Population/statistics & numerical data , Adolescent , Adult , Family Characteristics , Female , Humans , Parity , Residence Characteristics , Socioeconomic Factors , United States/epidemiology , Young Adult
7.
Diabetes Ther ; 7(3): 497-509, 2016 Sep.
Article in English | MEDLINE | ID: mdl-27350546

ABSTRACT

INTRODUCTION: Family time caring for children with diabetes is an overlooked component of the overall burden of the condition. We document and analyze risk factors for time family members spend providing health care at home and arranging/coordinating health care for children with diabetes. METHODS: Data for 755 diabetic children and 16,161 non-diabetic children whose chronic conditions required only prescription (Rx) medication were from the 2009-2010 United States National Survey of Children with Special Health Care Needs (NS-CSHCN). We used generalized ordered logistic regressions to estimate adjusted odds ratios (AORs) of time burden by diabetes, insulin use, and stability of the child's health care needs, controlling for health and socioeconomic status. RESULTS: Nearly one-quarter of diabetic children had family members who spent 11+ h/week providing health care at home, and 8% spent 11+ h/week arranging/coordinating care, compared with 3.3% and 1.9%, respectively, of non-diabetic Rx-only children. Time providing care at home for insulin-using children was concentrated in the higher time categories: AORs for insulin-using diabetic compared to non-diabetic Rx-only children were 4.4 for 1+ h/week compared with <1 h/week, 9.7 for 6+ vs. <6 h, and 12.4 for 11+ vs. <11 h (all P < 0.05); the pattern was less pronounced for non-insulin-using children. AORs for arranging/coordinating care did not vary by time contrast: AOR = 4.2 for insulin-using, 3.0 for non-insulin-using children. CONCLUSION: Health care providers, school personnel, and policymakers need to work with family members to improve care coordination and identify other ways to reduce family time burdens caring for children with diabetes.

8.
NCHS Data Brief ; (246): 1-8, 2016 May.
Article in English | MEDLINE | ID: mdl-27227570

ABSTRACT

KEY FINDINGS: Data from the National Health Interview Survey •The percentages of adolescents aged 10-17 who did not have a usual place for preventive care, did not receive a well-child checkup in the past 12 months, or did not have a dental visit in the past 12 months decreased from 2008 to 2014. •In 2014, 2% of adolescents aged 10-17 did not have a usual place for preventive care, 21% did not receive a well-child checkup, and 12% did not have a dental visit in the past 12 months. •In 2014, the percentages of adolescents not having a usual place for preventive care, not receiving a well-child checkup, and not having a dental visit were higher for those aged 16-17 compared with those in younger age groups. These percentages also varied by race and ethnicity, poverty status, and insurance status.


Subject(s)
Dental Care/statistics & numerical data , Patient-Centered Care/statistics & numerical data , Preventive Health Services/statistics & numerical data , Adolescent , Adolescent Health Services/statistics & numerical data , Child , Ethnicity/statistics & numerical data , Female , Health Services Accessibility/statistics & numerical data , Humans , Insurance Coverage/statistics & numerical data , Insurance, Health/statistics & numerical data , Male , Poverty/statistics & numerical data , Racial Groups/statistics & numerical data , United States
9.
NCHS Data Brief ; (230): 1-8, 2016 Jan.
Article in English | MEDLINE | ID: mdl-26766187

ABSTRACT

KEY FINDINGS: Data from the National Health Interview Survey, 2013-2014. Single parents, especially women, were more likely than adults in other types of families to have short sleep duration, frequently have trouble falling asleep and staying asleep, and frequently wake up feeling not well-rested. Within family types, women were more likely than men to frequently have trouble falling asleep and staying asleep, and to frequently wake up feeling not well-rested. Overall, adults in two-parent families were less likely than adults in other types of families to have taken sleep medication four times or more in the past week.


Subject(s)
Single Parent/statistics & numerical data , Sleep Initiation and Maintenance Disorders/embryology , Adolescent , Adult , Age Distribution , Family Characteristics , Female , Humans , Male , Middle Aged , Risk Factors , Sex Distribution , Sleep Stages , Sleep Wake Disorders , United States , Young Adult
10.
Soc Sci Res ; 52: 602-14, 2015 Jul.
Article in English | MEDLINE | ID: mdl-26004483

ABSTRACT

We identify need, enabling, and predisposing factors for high family time burdens associated with the health care of chronically-ill children, using data from the U.S. 2009-2010 National Survey of Children with Special Health Care Needs (NS-CSHCN), a population-based survey of 40,242 children with special health care needs (CSHCN). We estimate generalized ordered logistic multivariable regressions of time spent (1) providing health care for the child at home, (2) arranging/coordinating health care, and (3) combined time. Factors associated with higher time burdens included child's functional limitations, severe or unstable health conditions, public health insurance, lack of a medical home, low family income, low adult education, and non-white race. Nonproportional odds models revealed associations between risk factors and time burden that were obscured by binary and standard ordered logistic models. Clinicians and policymakers can use this information to design interventions to alleviate this important family stressor.


Subject(s)
Child Health , Chronic Disease , Cost of Illness , Delivery of Health Care , Family , Adolescent , Adult , Child , Child, Preschool , Female , Health Services Accessibility , Home Care Services , Humans , Infant , Insurance Coverage , Insurance, Health , Logistic Models , Male , Racial Groups , Risk Factors , Severity of Illness Index , Socioeconomic Factors , United States
11.
Health Serv Res ; 50(2): 440-61, 2015 Apr.
Article in English | MEDLINE | ID: mdl-25100200

ABSTRACT

OBJECTIVES: To examine which components of medical homes affect time families spend arranging/coordinating health care for their children with special health care needs (CSHCNs) and providing health care at home. DATA SOURCES: 2009-2010 National Survey of Children with Special Health Care Needs (NS-CSHCN), a population-based survey of 40,242 CSHCNs. STUDY DESIGN: NS-CSHCN is a cross-sectional, observational study. We used generalized ordered logistic regression, testing for nonproportional odds in the associations between each of five medical home components and time burden, controlling for insurance, child health, and sociodemographics. DATA COLLECTION/EXTRACTION METHODS: Medical home components were collected using Child and Adolescent Health Measurement Initiative definitions. PRINCIPAL FINDINGS: Family-centered care, care coordination, and obtaining needed referrals were associated with 15-32 percent lower odds of time burdens arranging/coordinating and 16-19 percent lower odds providing health care. All five components together were associated with lower odds of time burdens, with greater reductions for higher burdens providing care. CONCLUSIONS: Three of the five medical home components were associated with lower family time burdens arranging/coordinating and providing health care for children with chronic conditions. If the 55 percent of CSHCNs lacking medical homes had one, the share of families with time burdens arranging care could be reduced by 13 percent.


Subject(s)
Continuity of Patient Care/statistics & numerical data , Disabled Children/statistics & numerical data , Health Services Accessibility/statistics & numerical data , Patient-Centered Care/statistics & numerical data , Adolescent , Child , Child, Preschool , Cross-Sectional Studies , Female , Humans , Male , Referral and Consultation/statistics & numerical data , Residence Characteristics , Socioeconomic Factors , Time Factors
12.
Soc Sci Med ; 116: 22-31, 2014 Sep.
Article in English | MEDLINE | ID: mdl-24973571

ABSTRACT

After several decades of decline, U.S. suicide rates have risen since 2005, a trend driven largely by increases among those aged 45-64 that began in 1999. A prominent explanation for this pattern relates to deteriorating economic conditions, especially the sharp rise in unemployment associated with the Great Recession of 2007-2009. We pool data from 1997 to 2010 on the 50 U.S. states to examine the role of economic factors in producing the recent rise in suicide rates. Unlike prior studies, we examine trends in the total suicide rate and in the rate disaggregated by sex, age group and time period and include a number of important confounding factors in a multivariate analysis. We find a strong positive association between unemployment rates and total suicide rates over time within states. The association appears stronger in states that had higher female labor force participation rates over the period, suggesting that the Great Recession may generate greater levels of anomie in this context. Once we consider contextual factors such as female labor force participation, we find that rising unemployment had a similar adverse effect on male and female suicide rates. A positive effect of unemployment on temporal variation in middle-aged suicide exists but not for other age groups. Other economic characteristics, such as percent of manufacturing jobs and per capita income, are not associated with temporal variation in suicide rates within states but are associated with variation between states in suicide rates. The findings suggest that the following may be important components of effective prevention strategies: 1) specifically targeting employers and workplaces as important stakeholders in the prevention of suicide, 2) disseminating information about health risks tied to un/employment, and 3) linking the unemployed to mental health resources.


Subject(s)
Economic Recession/statistics & numerical data , Suicide/statistics & numerical data , Unemployment/statistics & numerical data , Adolescent , Adult , Age Factors , Aged , Female , Humans , Male , Middle Aged , Sex Factors , Socioeconomic Factors , Time Factors , United States , Young Adult
13.
PLoS One ; 8(12): e82570, 2013.
Article in English | MEDLINE | ID: mdl-24340042

ABSTRACT

OBJECTIVES: Medical homes, an important component of U.S. health reform, were first developed to help families of children with special health care needs (CSHCN) find and coordinate services, and reduce their children's unmet need for health services. We hypothesize that CSHCN lacking medical homes are more likely than those with medical homes to report health system delivery or coverage problems as the specific reasons for unmet need. METHODS: Data are from the 2005-2006 National Survey of Children with Special Health Care Needs (NS-CSHCN), a national, population-based survey of 40,723 CSHCN. We studied whether lacking a medical home was associated with 9 specific reasons for unmet need for 11 types of medical services, controlling for health insurance, child's health, and sociodemographic characteristics. RESULTS: Weighted to the national population, 17% of CSHCN reported at least one unmet health service need in the previous year. CSHCN without medical homes were 2 to 3 times as likely to report unmet need for child or family health services, and more likely to report no referral (OR= 3.3), dissatisfaction with provider (OR=2.5), service not available in area (OR= 2.1), can't find provider who accepts insurance (OR=1.8), and health plan problems (OR=1.4) as reasons for unmet need (all p<0.05). CONCLUSIONS: CSHCN without medical homes were more likely than those with medical homes to report health system delivery or coverage reasons for unmet child health service needs. Attributable risk estimates suggest that if the 50% of CSHCN who lacked medical homes had one, overall unmet need for child health services could be reduced by as much as 35% and unmet need for family health services by 40%.


Subject(s)
Child Health Services , Delivery of Health Care , Family Health , Health Care Reform , Patient-Centered Care , Child , Child, Preschool , Female , Humans , Male , Risk Factors , United States
14.
Arch Suicide Res ; 17(4): 360-72, 2013.
Article in English | MEDLINE | ID: mdl-24224670

ABSTRACT

This study examines the association between antidepressant use and suicide rates, by sex, age, and method of suicide, between 1998 and 2007 in the United States. Overall suicide rates for the young and elderly declined but rates for the middle-aged increased. All age groups experienced increases in antidepressant use. The elderly exhibited the largest increase in antidepressant usage and biggest declines in suicide rates. Firearm suicides for men and women declined but suicide by drug poisoning rose, particularly for women. For young males and elderly males and females, better treatment of severe depression may have contributed to declining suicide rates. However, rising rates of prescription drug use are associated with higher levels of suicide by drug poisoning.


Subject(s)
Antidepressive Agents/therapeutic use , Depressive Disorder/drug therapy , Suicide/trends , Adolescent , Adult , Age Distribution , Aged , Aged, 80 and over , Child , Female , Humans , Male , Middle Aged , Sex Distribution , United States/epidemiology , Young Adult
15.
Am J Public Health ; 101(2): 274-7, 2011 Feb.
Article in English | MEDLINE | ID: mdl-21164085

ABSTRACT

We examined eligibility and enrollment among parents of children in New Jersey's State Children's Health Insurance Program following expansion of parental eligibility for NJ FamilyCare coverage. Data were from the 2003 NJ FamilyCare Family Health Survey (n = 416 families). Parental eligibility was higher in households without a full-time employed parent (odds ratio [OR] = 5.50; 95% confidence interval [CI] = 2.72, 11.14) and lower among single parents (OR = 0.38; 95% CI = 0.23, 0.61). Enrollment was higher among single parents (OR = 2.24; 95% CI = 1.17, 4.31). Roughly one third of eligible parents did not enroll, suggesting the need to increase awareness of parental eligibility and reduce barriers to enrollment.


Subject(s)
Eligibility Determination/statistics & numerical data , Family , Insurance, Health/statistics & numerical data , State Health Plans/statistics & numerical data , Humans , New Jersey , Socioeconomic Factors
16.
Public Health Rep ; 125(5): 680-8, 2010.
Article in English | MEDLINE | ID: mdl-20873284

ABSTRACT

OBJECTIVE: We examined trends in suicide rates for U.S. residents aged 40 to 59 years from 1979 to 2005 and explored alternative explanations for the notable increase in such deaths from 1999 to 2005. METHODS: We obtained information on suicide deaths from the National Center for Health Statistics and population data from the U.S. Census Bureau. Age- and gender-specific suicide rates were computed and trends therein analyzed using linear regression techniques. RESULTS: Following a period of stability or decline, suicide rates have climbed since 1988 for males aged 40-49 years, and since 1999 for females aged 40-59 years and males aged 50-59 years. A crossover in rates for 40- to 49-year-old vs. 50- to 59-year-old males and females occurred in the early 1990s, and the younger groups now have higher suicide rates. The post-1999 increase has been particularly dramatic for those who are unmarried and those without a college degree. CONCLUSIONS: The timing of the post-1999 increase coincides with the complete replacement of the U.S. population's middle-age strata by the postwar baby boom cohorts, whose youngest members turned 40 years of age by 2005. These cohorts, born between 1945 and 1964, also had notably high suicide rates during their adolescent years. Cohort replacement may explain the crossover in rates among the younger and older middle-aged groups. However, there is evidence for a period effect operating between 1999 and 2005, one that was apparently specific to less-protected members of the baby boom cohort.


Subject(s)
Suicide/trends , Adult , Age Distribution , Cohort Effect , Cohort Studies , Effect Modifier, Epidemiologic , Female , Humans , Linear Models , Male , Middle Aged , Risk Factors , Sex Distribution , Socioeconomic Factors , Suicide/statistics & numerical data , United States/epidemiology , Suicide Prevention
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