Abstract
The National Center for Health Statistics (NCHS), Centers for Disease Control and Prevention, released preliminary data from its National Health Interview Survey for 2016. Quarterly estimates of selected mortality and birth indicators are available for October–December 2015. Monroe Sirken, longtime associate director for research and methodology at NCHS and a leader in the federal statistical community, died on May 20, 2017.
2016 Data on 15 Major Health Indicators
The Early Release Program of the National Health Interview Survey tracks 15 major health indicators quarterly. The data for 2016 are now available from this national survey, which is based on household interviews of a sample of the nation’s civilian noninstitutionalized population. “Early Release of Selected Estimates Based on Data From the 2016 National Health Interview Survey” 1 presents data on 15 health measures: lack of health insurance coverage and type of coverage, having a usual place to go for medical care, obtaining needed medical care, receipt of influenza vaccination, receipt of pneumococcal vaccination, obesity, leisure-time physical activity, current cigarette smoking, alcohol consumption, human immunodeficiency virus (HIV) testing, general health status, personal care needs, serious psychological distress, diagnosed diabetes, and asthma episodes and current asthma.
For each health measure, a figure is presented showing the trend over time from 1997 through 2016 for the total population, followed by figures and tables showing estimates by age group and sex. Estimates (which may be adjusted by age or sex, or both, where appropriate) are also provided for 3 racial/ethnic groups: Hispanic; non-Hispanic white, single race; and non-Hispanic black, single race. For some measures, additional tables or figures are presented.
Selected findings from the report show that for 2016, the percentage of people who were uninsured at the time of interview was 9.0% (28 million people), not significantly different from the 2015 estimate of 9.1% and down from 15.4% (41 million people) in 1997, the first year tracked in this system and included in this report. The percentage of the population with a usual place to go for health care was 88.1% in 2016, a percentage that was not significantly different from the 2015 estimate of 87.8%. People aged ≥65 were the most likely to have a usual place for health care (96.0%), followed by children aged <18 (95.1%). The percentage of adults with a usual place to go for care increased with age: 18-24 (76.0%), 25-44 (79.3%), and 45-64 (90.5%). In all adult age groups, women were more likely than men to have a usual place to go for health care. The percentage of the population that failed to receive needed medical care due to cost peaked in 2009 and 2010 at 6.9% and then generally declined to 4.4% in 2016.
In 2016, 48.2% of adults aged 50-64 received an influenza vaccination, whereas 67.2% of those aged ≥65 received one. Rates of receipt of pneumococcal vaccination also increased with age. In 2016, 62.6% of adults aged 65-74 received a pneumococcal vaccination, whereas 73.3% of those aged ≥75 received one. The percentage of adults who had ever had an HIV test increased from 31.8% in 1997 to 39.5% in 2010. The report also showed that for 2016, 51.7% of US adults aged ≥18 met federal physical activity guidelines for aerobic activity. This percentage was higher than the 2015 estimate (49.0%) and has steadily increased since 2006 (41.4%). The prevalence of current cigarette smoking among US adults declined from 24.7% in 1997 to 15.8% in 2016. For 2016, the percentage of people who had excellent or very good health was 66.4%, which was not significantly different from the 2015 estimate of 66.1%. Men were more likely than women to have excellent health (67.3% vs 65.6%). The prevalence of diagnosed diabetes among adults aged ≥18 was 9.4% in 2016, up from 5.1% in 1997 and 9.2% in 2010, after which it has remained relatively stable. The age–sex-adjusted prevalence of diagnosed diabetes was 11.6% for Hispanic adults, 7.2% for non-Hispanic white adults, and 12.5% for non-Hispanic black adults.
Quarterly Estimates of Birth and Death Indicators
NCHS posts preliminary quarterly estimates of key birth and death indicators on its website. Data for October–December 2016 are now available on interactive dashboards, where users can select topics and variables to create charts. In the release of “Quarterly Provisional Estimates for Selected Birth Indicators, 2015–Quarter 4, 2016,” 2 NCHS presents provisional estimates of selected reproductive indicators from birth data for 2015 through the fourth quarter of 2016. Estimates for 2015 are based on final data, and estimates for 2016 are provisional. Estimates are presented for general fertility rates, age-specific birth rates, total and low-risk cesarean delivery rates, preterm birth rates, and other gestational age categories. These indicators were selected based on their importance for public health surveillance and their feasibility of producing reliable estimates using available provisional data.
The mortality dashboard 3 shows major causes of death and calculates both crude and age-adjusted death rates by quarter in 2016. Provisional estimates are based on a snapshot of all the vital statistics data received and processed by NCHS as of a specified cutoff date. To adjust for the incompleteness of these data, individual records are weighted to independent provisional counts of all the deaths that occurred in each state by month. If the data available to NCHS for a state and month were fewer than 50% of the provisional count, the data for that state and month were imputed. Provisional estimates closely matched final data but are subject to revision in future quarterly releases as additional records for that quarter are received.
Monroe Sirken, 1921-2017
Monroe Sirken, PhD, was a charter member of NCHS. He was on the staff of the National Office of Vital Statistics when it merged with the National Health Survey to form NCHS in 1960. At NCHS, Sirken participated in or led all major efforts in statistical research and methodology for 4 decades.
A sociologist by training, Sirken developed a keen interest in the quantitative aspects of health early in his career and was involved in some of the first national health surveys. His group in the vital statistics program designed and conducted the first follow-back surveys of birth and death records to improve and expand on the information contained in those records. Data from one of those mortality studies on smoking histories appeared in the first surgeon general’s report on smoking and health, Smoking and Health: Report of the Advisory Committee to the Surgeon General of the Public Health Service.
Sirken’s major professional interests were conducting and fostering survey and statistical research that was responsive to the needs of federal statistics. His interest in survey design to collect data on rare and sensitive conditions led to the development of network sampling. His interest in fostering research on the cognitive aspects of survey methods led to the establishment of permanent laboratories for questionnaire design research, first at NCHS and later at other federal statistical agencies in the United States and abroad.
Before becoming a senior research scientist in 1996, Sirken served as the associate director for research and methodology. After retiring in 2011, he continued to serve as an “expert without compensation.” He retired at age 90 with 60 years of federal service.
Sirken was a fellow of the American Statistical Association (and a member for more than 50 years) and the American Association for the Advancement of Science, an elected member of the International Statistical Institute, a charter member of the Federal Committee on Statistical Methodology (from which he received a distinguished service award), and a recipient of the Washington Statistical Society’s Roger Herriot Award for Innovation in Government Statistics. A few days before his death, his senior statistical peers gave him an award for his years of statistical leadership.