Abstract
New reports from the National Center for Health Statistics (NCHS), Centers for Disease Control and Prevention (CDC), present the latest national data on (1) births, (2) the sleeping patterns of women by menopausal status, (3) drug overdose deaths among teenagers, and (4) estimates of insurance coverage from NCHS and the US Census Bureau.
Final 2016 Birth Statistics Released
The latest national data on birth statistics have been released in a report, “Births in the United States, 2016,” 1 that summarizes key findings on the fertility and health characteristics of mothers and infants. The report compares findings from 2016 with findings from 2015 and notes the most recent high or low rate. Data are based on birth certificates filed in state vital statistics offices and reported to NCHS through the National Vital Statistics System.
The report shows that the fertility rate per 1000 females aged 15-44 declined from 62.5 in 2015 to 62.0 in 2016. The fertility rate has decreased by 11% since 2007, when it was 69.3 births per 1000 females aged 15-44, the most recent high. The birth rate per 1000 teenagers aged 15-19 declined by 9%, from 22.3 in 2015 to 20.3 in 2016. The teenage birth rate has declined 51% since 2007, when the rate was 41.5 per 1000 females aged 15-19. Birth rates for women in their twenties declined from 2015 to 2016: a 4% decline for women aged 20-24 (from 76.8 in 2015 to 73.8 in 2016) and a 2% decline for women aged 25-29 (from 104.3 in 2015 to 102.1 in 2016). However, birth rates for women in their thirties and early forties rose from 2015 to 2016. The birth rate per 1000 women aged 30-34 was up 1% (from 101.5 in 2015 to 102.7 in 2016); for women aged 35-39, it was up 2% (from 51.8 in 2015 to 52.7 in 2016); and for women aged 40-44, it was up 4.0% (from 11.0 in 2015 to 11.4 in 2016). Since 2007, the birth rate has risen 19% for women in their early forties, 11% for women in their late thirties, and 2% for women in their early thirties.
The percentage of cesarean deliveries declined about 1%, from 32.0% in 2015 to 31.9% in 2016, and was down 3% from a peak of 32.9% in 2009. Compared with the 2009 peak, cesarean deliveries in 2016 were down 13.0% for women aged ≤20 (from 32.9% to 20.2%), 6% for women aged 20-29 (from 30.2% to 28.5%), 5% for women aged 30-39 (from 38.4% to 36.3%), and 3% for women aged ≥40 (from 49.5% to 47.9%). The preterm birth rate (ie, the number of infants delivered at <37 weeks completed gestation per 100 births) rose for the second straight year in 2016, up 2% (from 9.6% in 2014 and 2015 to 9.9% in 2016). Most of the increase from 2014 to 2016 was among infants born late preterm (ie, the number of infants delivered before 34 weeks completed gestation per 100 births), up 4.0% from 6.8% in 2014 to 7.1% in 2016. The early preterm birth rate (ie, the number of infants delivered before 34 weeks completed gestation per 100 births) was essentially unchanged (2.8% in 2016).
Triplet and higher-order multiple births declined in 2016. The 2016 rate of triplet and higher-order multiple births was 101.4 per 100 000 total births, a nonsignificant decline from 103.6 in 2015. The 2016 rate declined to nearly one-half of the 1998 peak, which was 193.5 per 100 000 total births. Declines in triplet and higher-order multiple birth rates were seen for all women aged ≥20 from 1998 to 2016; the largest declines were among women aged 30-39, down 64% (from 376.3 to 135.3 per 100 000 births) and women aged ≥ 40, down 55% (from 517.6 to 232.4 per 100 000 births).
Sleep Patterns
A new NCHS report, “Sleep Duration and Quality Among Women Aged 40-59, by Menopausal Status,” 2 describes sleep duration and sleep quality among nonpregnant women aged 40-59 by menopausal status. The age range selected for this analysis reflects the focus on midlife sleep health. In this analysis of data from the National Health Interview Survey, 74.2% of women were premenopausal, 3.7% perimenopausal, and 22.1% postmenopausal in 2015. Women were postmenopausal if they had gone without a menstrual cycle for >1 year or were in surgical menopause after the removal of their ovaries. Women were perimenopausal if they no longer had a menstrual cycle and their last menstrual cycle was ≤1 year ago. Premenopausal women still had a menstrual cycle. The National Health Interview Survey is a large-scale general-purpose health survey with a nationally representative sample of the civilian, noninstitutionalized population.
The survey found that among women aged 40-59, perimenopausal women (56.0%) were more likely than postmenopausal (40.5%) and premenopausal (32.5%) women to sleep <7 hours, on average, during a 24-hour period. Postmenopausal women aged 40-59 were more likely than premenopausal women aged 40-59 to have trouble falling asleep (27.1% vs 16.8%) and staying asleep (35.9% vs 23.7%) ≥4 times during the past week. Postmenopausal women aged 40-59 (55.1%) were more likely than premenopausal women aged 40-59 (47.0%) to not wake up feeling well rested ≥4 days during the past week.
Drug Overdose Deaths
A new NCHS report, “Drug Overdose Deaths Among Adolescents Aged 15-19 in the United States: 1999-2015,” 3 presents the latest data and tracks trends in drug overdose deaths among adolescents aged 15-19, with data from death records filed in state vital statistics offices and reported to NCHS through the National Vital Statistics System. Population data and data on mortality were from multiple cause-of-death mortality files (1999-2015), which code the underlying and contributing causes of death. The report shows that the death rate per 100 000 population for drug overdose among adolescents aged 15-19 more than doubled from 1999 (1.6) to 2007 (4.2), declined by 26% from 2007 to 2014 (3.1), and then increased in 2015 (3.7). The drug overdose death rate rose from 1999 to 2007 for teenaged males and females, and the rate declined only for teenaged males from 2007 to 2014.
The report also shows the percentage distributions of drug overdose deaths for 2015 by intent (eg, unintentional, suicide, homicide) and presents trends in drug overdose death rates by type of drug involved. For male and female adolescents, most drug overdose deaths in 2015 were unintentional. Death rates for drug overdoses among those aged 15-19 in 2015 were highest for opioids, specifically heroin.
Comparison of Insurance Estimates
Two major sources of health insurance coverage estimates for the US population are NCHS and the US Census Bureau. The estimates from these 2 agencies tend to show similar patterns; however, they have documented substantial differences arising from the various methods used to collect and process the data. In recent years, NCHS’s National Health Interview Survey and the US Census Bureau’s Current Population Survey were modified to measure similar concepts, but differences in data collection methods and periods, sampling error, nonresponse, and data processing resulted in minor differences in estimates. A fact sheet, “Comparison of the Prevalence of Uninsured Persons From the National Health Interview Survey and the Current Population Survey, 2016 and 2017,” 4 details the latest data on the percentage of the population that lacks health insurance coverage, by age and race/ethnicity, from both sources. The latest quarterly estimates for January through March 2017 from NCHS show that 8.8% of the nation’s civilian, noninstitutionalized population lacked health insurance. The comparable figure from the US Census Bureau shows that 9.6% of the US population had no health insurance for February through April 2017.
The Fact Sheet includes estimates of lack of insurance coverage for the Hispanic and non-Hispanic white and black populations, which show a similar pattern for data from NCHS and the US Census Bureau. The estimate of Hispanic adults aged 18-64 who lacked health insurance was 24.5% per NCHS, as compared with 23.0% according to the US Census Bureau. The estimate for non-Hispanic white adults without health insurance was 8.4% per NCHS, as compared with 9.8% according to the US Census Bureau. The estimate for non-Hispanic black adults was 13.0% per NCHS and 15.5% according to the US Census Bureau.