Demographic Variation in Health Insurance Coverage:United States, 2022.

Objectives-This report presents national estimates of different types of health insurance coverage and lack of coverage (uninsured). Estimates are presented by selected sociodemographic characteristics, including age, sex, race and Hispanic origin, family income, education level, employment status, and marital status. Methods-Data from the 2022 National Health Interview Survey were used to estimate health insurance coverage. Estimates were categorized by selected sociodemographic characteristics. Additionally, those who were uninsured were categorized by length of time since they had coverage, private coverage was further classified by source of plan, and public coverage was categorized by type of public plan. Results-In 2022, 28.1 million (8.6%) people of all ages were uninsured at the time of the interview. This includes 27.7 million (10.2%) people younger than age 65. Among children, 3.0 million (4.2%) were uninsured, and among working-age adults (ages 18-64), 24.7 million (12.4%) were uninsured. Among people younger than age 65, 64.0% were covered by private health insurance, including 56.0% with employment-based coverage and 6.8% with directly purchased coverage. Moreover, 4.5% were covered by exchange-based coverage, a type of directly purchased coverage. Among people younger than age 65, about two in five children and one in five adults ages 18-64 had public health coverage, mainly Medicaid and the Children's Health Insurance Program. Among adults age 65 and older, the percentage who were covered by private health insurance (with or without Medicare), Medicare Advantage, and traditional Medicare only varied by age, family income, education level, and race and Hispanic origin.

Geographic Variation in Health Insurance Coverage:United States, 2022.

Objectives-This report presents state, regional, and national estimates of the percentage of people who were uninsured, had private health insurance coverage, and had public health insurance coverage at the time of the interview. Methods-Data from the 2022 National Health Interview Survey were used to estimate health insurance coverage. Estimates were categorized by age group, state Medicaid expansion status, urbanization level, expanded region, and state. Estimates by state Medicaid expansion status, urbanization level, and expanded region were based on data from all 50 states and the District of Columbia. State estimates are shown for 32 states and the District of Columbia for people younger than age 65 and adults ages 18-64, and 27 states for children. Results-In 2022, among people younger than age 65, 10.2% were uninsured, 64.0% had private coverage, and 28.2% had public coverage at the time of the interview. Among adults ages 18-64, the percentage who were uninsured ranged from 10.1% for those living in large fringe (suburban) metropolitan counties to 13.9% for both those living in nonmetropolitan counties and large central metropolitan counties. Adults ages 18-64 living in non-Medicaid expansion states were twice as likely to be uninsured (19.6%) compared with those living in Medicaid expansion states (9.1%). A similar pattern was observed among children ages 0-17 years. The percentage of adults ages 18-64 who were uninsured was significantly higher than the national average (12.4%) in Florida (17.9%), Georgia (21.2%), Tennessee (21.6%), and Texas (27.0%), and significantly lower than the national average in Maryland (7.0%), Massachusetts (3.0%), Michigan (6.5%), New York (5.6%), Ohio (8.6%), Pennsylvania (7.2%), Virginia (8.5%), Washington (7.3%), and Wisconsin (7.0%). The percentage of people younger than age 65 who were uninsured was lowest in the New England region (3.5%).

Geographic Variation in Health Insurance Coverage:United States, 2021.

Objective-This report presents state, regional, and national estimates of the percentage of people who were uninsured, had private health insurance coverage, and had public health insurance coverage at the time of the interview.

Anxiety and depression symptoms among children before and during the COVID-19 pandemic.

PURPOSE: The COVID-19 pandemic caused disruptions to children's daily lives due in part to stay-at-home orders and school closures, reducing interactions with both peers and extended family. Yet, few studies with nationally representative data have explored the potential association of the COVID-19 pandemic and children's mental health. METHODS: The current study analyzed data from the 2019 and 2020 National Health Interview Survey (NHIS) to describe changes in the prevalence of symptoms of anxiety and depression before and during the first year of the pandemic among children aged 5-17 years. Changes in prevalence by child- and family-level characteristics were also examined. RESULTS: During the COVID-19 pandemic, nearly one in six children aged 5-17 years had daily or weekly symptoms of anxiety or depression, a significant increase from before the COVID-pandemic (16.7% (95% CI:15.0-18.6) versus 14.4% (95% CI:13.4-15.3)). Males, children 5-11 years, non-Hispanic children, children living in families in large metropolitan areas, incomes at or below the federal poverty level, and whose highest educated parent had more than a HS education, also showed statistically significant increases in anxiety and depression symptoms. CONCLUSIONS: NHIS data may be used to monitor this increase in mental health symptomatology and assist in identifying children at risk.

Mental Health Treatment Among Adults Aged 18-44: United States, 2019-2021.

In 2020, the percentage of adults who had received any mental health treatment in the past 12 months was significantly higher than in 2019 (1,2). Previous research has found that symptoms of an anxiety disorder or a depressive disorder increased from 2020 through the beginning of 2021, especially among younger adults (3). This report describes trends in the percentage of adults aged 18-44 who had received any mental health treatment, defined as having either taken medication for mental health, received counseling or therapy, or both in the past 12 months by selected characteristics based on data from the 2019-2021 National Health Interview Survey (NHIS). Estimates for adults aged 45-64 and 65 and over are presented for comparison.

Organized Sports Participation Among Children Aged 6-17 Years: United States, 2020.

Sports team participation has been associated with increased levels of physical activity (1) and improved physical and mental health among children and adolescents (2,3). Disparities in sports participation have been found across age, sex, race, disability, and socioeconomic subgroups (4-6). This report describes national estimates of parent-reported organized sports participation during the past 12 months among children aged 6-17 years. Data from the 2020 National Health Interview Survey (NHIS) are analyzed by sociodemographic characteristics.

Assessing Anxiety and Depression: A Comparison of National Health Interview Survey Measures.

Objective-This report examines differences across two different sets of measures used to assess anxiety and depression in the National Health Interview Survey (NHIS).

Geographic Variation in Health Insurance Coverage: United States, 2020.

Objective-This report presents state, regional, and national estimates of the percentage of people who were uninsured, had private health insurance coverage, and had public health insurance coverage at the time of the interview.

Mental Health Treatment Among Adults: United States, 2020.

In 2019, 19.2% of adults had received any mental health treatment in the past 12 months, including 15.8% who had taken prescription medication for their mental health and 9.5% who received counseling or therapy from a mental health professional (1). A recent study showed that symptoms of anxiety and depression among adults increased during 2020 (2). This report describes the percentage of U.S. adults who have taken prescription medication for their mental health or have received counseling or therapy from a mental health professional in the past 12 months by select characteristics, based on data from the 2020 National Health Interview Survey (NHIS). Estimates are also presented for any mental health treatment, defined as having taken medication for mental health, received counseling or therapy, or both in the past 12 months.

Demographic Variation in Health Insurance Coverage: United States, 2019.

Objectives-This report presents national estimates of different types of health insurance coverage and lack of coverage (uninsured). Estimates are presented by selected sociodemographic characteristics, including age, sex, race and Hispanic origin, poverty status, education level, employment status, and marital status.

Symptoms of Anxiety or Depressive Disorder and Use of Mental Health Care Among Adults During the COVID-19 Pandemic - United States, August 2020-February 2021.

The spread of disease and increase in deaths during large outbreaks of transmissible diseases is often associated with fear and grief (1). Social restrictions, limits on operating nonessential businesses, and other measures to reduce pandemic-related mortality and morbidity can lead to isolation and unemployment or underemployment, further increasing the risk for mental health problems (2). To rapidly monitor changes in mental health status and access to care during the COVID-19 pandemic, CDC partnered with the U.S. Census Bureau to conduct the Household Pulse Survey (HPS). This report describes trends in the percentage of adults with symptoms of an anxiety disorder or a depressive disorder and those who sought mental health services. During August 19, 2020-February 1, 2021, the percentage of adults with symptoms of an anxiety or a depressive disorder during the past 7 days increased significantly (from 36.4% to 41.5%), as did the percentage reporting that they needed but did not receive mental health counseling or therapy during the past 4 weeks (from 9.2% to 11.7%). Increases were largest among adults aged 18-29 years and among those with less than a high school education. HPS data can be used in near real time to evaluate the impact of strategies that address mental health status and care of adults during the COVID-19 pandemic and to guide interventions for groups that are disproportionately affected.

Health Care Utilization Among U.S. Adults With Inflammatory Bowel Disease, 2015-2016.

Objective-To measure health care utilization among adults with inflammatory bowel disease (IBD) and compare with adults without IBD. Methods-Adults aged 18 and over with IBD (1.2%) and without IBD were identified from the 2015 and 2016 National Health Interview Survey (n = 66,610). This study presents age-adjusted percentages and model-adjusted prevalence ratios (APRs) of selected health service use to identify differences by IBD status. IBD status and use of health care services are based on self-reports. Results-Compared with adults without IBD, adults with IBD were more likely to have visited any doctor or mental health provider in the past 12 months. IBD was also associated with higher prevalence of being prescribed medication, and having received acute care services, such as emergency room visits, overnight hospitalizations, or surgeries. Differences by IBD status were greatest for visiting a specialist (APR: 1.98; 95% confidence interval [CI]: 1.82-2.14) and home visits (APR: 1.80; 95% CI: 1.25-2.59) in the past 12 months. Conclusions-Adults with IBD had higher health service use than adults without IBD. Future studies may assess patient characteristics and outcomes associated with increased utilization among IBD patients.

Mental Health Treatment Among Children Aged 5-17 Years: United States, 2019.

About 16.5% of school-aged children had been diagnosed with a mental health disorder in the United States in 2016 (1). The most common mental health disorders among children include attention-deficit/hyperactivity disorder, anxiety, and behavioral disorders (2). This report describes the percentage of U.S. children aged 5-17 years who have taken prescription medication for mental health or have received counseling or therapy from a mental health professional in the past 12 months by select characteristics, based on data from the 2019 National Health Interview Survey (NHIS). Estimates are also presented for any mental health treatment, defined as having taken medication for mental health, received counseling or therapy, or both in the past 12 months.

Symptoms of Depression Among Adults: United States, 2019.

Depression is characterized by the presence of feelings of sadness, emptiness, or irritability, accompanied by bodily and cognitive changes lasting at least 2 weeks that significantly affect the individual's capacity to function (1). The eight-item Patient Health Questionnaire (PHQ-8) is a validated diagnostic and severity measure of symptoms of depressive disorders (2,3). Adults with scores of 0-4 are considered to have no or minimal symptoms of depression, while those with scores of 5-9, 10-14, or 15-24 are considered to have mild, moderate, or severe symptoms, respectively (2,3). This report examines the percentage of adults aged 18 and over with symptoms of depression in the past 2 weeks in 2019, by symptom severity and select demographic characteristics, using the PHQ-8 scale.

Mental Health Treatment Among Adults: United States, 2019.

In 2018, about 19% of adults experienced any mental illness in the past year, defined as having any mental, behavioral, or emotional disorder in the past year that met criteria of the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, or DSM-IV, excluding developmental or substance use disorders (1,2). This report describes the percentage of U.S. adults who have taken prescription medication for their mental health or have received counseling or therapy from a mental health professional in the past 12 months by select characteristics, based on data from the 2019 National Health Interview Survey (NHIS). Estimates are also presented for any mental health treatment, defined as having taken medication for mental health, received counseling or therapy, or both in the past 12 months.

Symptoms of Generalized Anxiety Disorder Among Adults: United States, 2019.

Generalized anxiety disorder (GAD) is characterized by excessive worry that is difficult to control accompanied by physical symptoms including restlessness, being easily fatigued, difficulty concentrating, irritability, muscle tension, or sleep disturbance (1). The GAD-7 scale is a validated brief selfreport measure to screen for GAD and assess the severity of symptoms (2). Adults with GAD-7 scores of 0-4 are considered to have no or minimal symptoms of GAD, while those with scores of 5-9, 10-14, or 15-21 are considered to have mild, moderate, or severe symptoms, respectively (2). This report examines the percentage of adults aged 18 and over who experienced symptoms of anxiety in the past 2 weeks, by severity of symptoms and select demographic characteristics, using the GAD-7 scale.

Shingles Vaccination Among Adults Aged 60 and Over: United States, 2018.

Shingles is a painful rash caused by the varicella zoster virus (1). Persons of all ages are at risk for shingles. However, this risk and the risk of complications increase with age (1,2). Vaccines have been developed to prevent shingles, and beginning in 2017, the Advisory Committee on Immunization Practices (ACIP) recommended that all adults aged 50 and over be vaccinated (3). Prior to this change, ACIP had recommended that only adults aged 60 and over receive a shingles vaccine (3). This report describes trends in shingles vaccination as well as variation by demographic, socioeconomic, and geographic characteristics among adults aged 60 and over.

Reported Importance and Access to Health Care Providers Who Understand or Share Cultural Characteristics With Their Patients Among Adults, by Race and Ethnicity.

Objective-This report examines racial and ethnic differences in the reported importance and frequency of seeing culturally competent health care providers among U.S. adults. Methods-Using the 2017 National Health Interview Survey, estimates of the importance and frequency of seeing health care providers who shared or understood respondents' culture were examined by race and Hispanic ethnicity, and stratified by other demographic characteristics. Results-Among adults who had seen a health care professional in the past 12 months, the percentage of non-Hispanic white adults who thought it was very important to have a health care provider who shared or understood their culture was significantly lower than that among all other race and Hispanic-ethnicity groups. Among those who thought it was at least slightly important to have a health care provider who shared or understood their culture, minority groups were generally more likely to report never being able to see a culturally similar health care provider compared with non-Hispanic white adults, and this pattern persisted regardless of sex, age group, or urbanicity.

Receipt of Preventive Care Services Among US Adults with Inflammatory Bowel Disease, 2015-2016.

BACKGROUND: Previous reports suggest that adults with inflammatory bowel disease (IBD) receive suboptimal preventive care. AIMS: The population-based study compared the receipt of these services by US adults with and without IBD. METHODS: Adults aged ≥ 18 years with IBD (1.2%) and without IBD were identified from the 2015 and 2016 National Health Interview Survey (n = 66,610). Age-standardized prevalence of doctor visits, receipt of medical advice, and selected preventive care was calculated for adults with and without IBD. The model-adjusted prevalence ratios were estimated for receipt of preventive care associated with IBD. RESULTS: The prevalence of a doctor visit in the past 12 months was significantly higher among adults with IBD than those without. IBD was also associated with significantly higher prevalence of receiving medical advice about smoking cessation (83.9% vs. 66.4%) and diet (42.9% vs. 32.1%), having colon cancer screening in the past 12 months (44.0% vs. 26.7%), having ever had an HIV test (51.5% vs. 45.4%) or pneumococcal vaccine (75.3% vs. 64.0%), having received a tetanus vaccine in the past 10 years (72.0% vs. 61.8%), and having received a flu vaccine in the past 12 months (48.4% vs. 41.0%), but was not significantly associated with receiving cervical cancer screening and hepatitis A and B vaccines. CONCLUSIONS: Adults with IBD were more likely to receive many types of preventive care than adults without IBD. The findings can inform healthcare policy makers to make strategic decisions that enhance multidisciplinary coordination from various medical specialties to ensure optimal preventive care for IBD patients.

Differences in Select Measures of Health Care Access, Utilization, and Financial Burden by Urbanicity, 2017.

Objective-This report examines select measures of health care access, utilization, and financial burden by metropolitan statistical area (MSA) status among adults aged 18-64. Methods-Data from the 2017 National Health Interview Survey were used to examine how a usual place to go for care, visits to a doctor or emergency room in the past year, unmet medical need due to cost, inability to afford prescription medications, and problems paying medical bills differed by MSA status among adults aged 18-64. Estimates are presented for adults living in a large MSA (population of 1 million or more), living in a small MSA (less than 1 million in population), and not living in an MSA. Results-In 2017, adults not living in an MSA generally had reduced access to or use of health care, and a higher financial burden associated with their care, compared with those in more populous areas. However, after controlling for selected sociodemographic and health characteristics, it was found that for the measures examined, adults not living in MSAs were more likely to have a usual place to go for care but less likely to have financial burden associated with their care compared with those in small or large MSAs. Conclusion-The unadjusted results show that adults not living in an MSA are more likely to have financial burden associated with their health care and reduced access to or use of health care services compared with those in large MSAs. However, the differences in the measures examined may be due to differential distributions of poverty levels, insurance coverage status, or other sociodemographic or health characteristics between the MSA status categories rather than MSA status itself.