Record 83 Million Adults Newly Tested for HIV in 2009

The number of adults tested for HIV reached a record high in 2009, according to an analysis of national survey data released today in a CDC Vital Signs report.

Last year 82.9 million adults between 18 and 64 reported having been tested for HIV. This number represents an increase of 11.4 million people since 2006, when CDC recommended that HIV testing become a routine part of medical care for adults and adolescents, and that people at high risk of infection be tested at least once a year.

Despite this progress, 55 percent of adults—and 28.3 percent of adults with a risk factor for HIV—have not been tested. [Read more…]

Public Awareness of COPD on the Rise

The number of Americans who report being aware of chronic obstructive pulmonary disease, or COPD, increased by 4 percentage points between 2008 and 2010, but many people at risk are still unaware of the disease, according to mailed survey results released today by the National Heart, Lung, and Blood Institute (NHLBI), part of the National Institutes of Health.

Sixty-nine percent of adults said they are aware of COPD. However, up to 30 percent of Americans reported that they were unaware of the condition. Awareness increased steadily among current and former smokers as well as nonsmokers. [Read more…]

Hispanic Life Expectancy Statistics Report Released

CDC’s National Center for Health Statistics has issued “United States Life Tables by Hispanic Origin,” which provides life tables by Hispanic origin based on 2006 death rate data.

Life expectancy at birth for the total population in 2006 was 77.7 years; 80.6 years for the Hispanic population, 78.1 years for the non-Hispanic white population, and 72.9 years for the non-Hispanic black population.

The Hispanic population has a life expectancy advantage at birth of 2.5 years over the non-Hispanic white population and 7.7 years over the non-Hispanic black population. The reasons behind the lower mortality are not known.

Source: CDC (10/13/2010)

20,000+ Annual Foodborne Illnesses Reported, Says CDC

A total of 1,097 foodborne disease outbreaks were reported in 2007 to the Centers for Disease Control and Prevention, according to a CDC analysis. State investigators reported 21,244 illnesses and 18 deaths as a result of these outbreaks. The report also provides the most recent data on how many illnesses were linked to specific types of foods.

“Knowing more about what types of foods and foodborne agents have caused outbreaks can help guide public health and the food industry in developing measures to effectively control and prevent infections and help people stay healthy,” said Chris Braden, acting director of the CDC’s Division of Foodborne, Waterborne and Environmental Diseases.

Despite health officials’ efforts, the cause of an outbreak—either the food or the foodborne agent responsible—often cannot be determined or confirmed. This most commonly is the case when the outbreak is small. Of 1,097 reported outbreaks in 2007, 497 (or 45 percent) confirmed that one foodborne agent was responsible and in an additional 12 outbreaks more than one foodborne agent was responsible. Thus, in more than half of the outbreaks, a foodborne agent was not identified. Norovirus was the most frequently confirmed foodborne agent (39 percent), followed by Salmonella (27 percent).

Foodborne disease outbreaks due to norovirus occur most often when infected food handlers do not wash their hands well after using the toilet; outbreaks due to salmonella occur most often when foods are contaminated with animal feces. Contaminated foods are often of animal origin, such as beef, poultry, milk, or eggs. But any food, including vegetables, may become contaminated. Thorough cooking kills Salmonella.

The report states that in the 235 outbreaks where one food commodity was identified, the largest number of illnesses listed poultry (691 illnesses), beef (667 illnesses), and leafy vegetables (590 illnesses) as the cause. The CDC tracks 17 food commodity categories.

To prevent foodborne illnesses, CDC recommends that consumers and food handlers appropriately clean, separate, cook and chill foods.

Source: CDC, August 12, 2010

U.S. Adult Obesity Rates on the Rise

The number of states with an obesity prevalence of 30 percent or more has tripled in two years to nine states in 2009, according to a CDC Vital Signs report. In 2000, no state had an obesity prevalence of 30 percent or more. The report, “State-Specific Obesity Prevalence Among Adults – United States, 2009,” also finds no state met the nation’s Healthy People 2010 goal to lower obesity prevalence to 15 percent.

The data show a 1.1 percentage point increase—an additional 2.4 million people—in the self-reported prevalence of obesity between 2007 and 2009 among adults aged 18 and over. The report also notes the medical costs associated with obesity are high. In 2008 dollars, medical costs associated with obesity were estimated at $147 billion. People who are obese had medical costs that were $1,429 higher than those of normal weight, the report said.

“Obesity continues to be a major public health problem,” said CDC Director Thomas Frieden, M.D., M.P.H. “We need intensive, comprehensive and ongoing efforts to address obesity. If we don’t more people will get sick and die from obesity-related conditions such as heart disease, stroke, type 2 diabetes and certain types of cancer, some of the leading causes of death.”

The August Vital Signs report is based on new data from the Behavioral Risk Factor Surveillance System (BRFSS). BRFSS contains state-level public health data and provides a way for states to monitor progress toward Healthy People goals. To assess obesity prevalence, approximately 400,000 phone survey respondents were asked to provide their height and weight, which was used to calculate their body mass index (BMI). An adult is considered obese if he or she has a BMI of 30 or above. For example, a 5-foot-4 woman who weighs 174 pounds or more, or a 5-foot-10 man who weighs 209 pounds or more has a BMI of 30, and so is considered obese.

The BRFSS obesity data are underestimates of true obesity prevalence. Research has found that both men and women often say they are taller than they actually are and women often say they weigh less than they do in telephone surveys. As a result, according to William Dietz, M.D., Ph.D., director of CDC’s Division of Nutrition, Physical Activity and Obesity, the overall BRFSS obesity prevalence estimate of 26.7 percent is 7.2 percentage points lower than the national 2007-2008 estimate of 33.9 percent (nearly 73 million people) from the National Health and Nutrition Examination Survey, for which individuals’ height and weight were measured rather than self-reported.

The BRFSS data highlight how obesity affects some populations more than others. The highest prevalence was found among non-Hispanic blacks overall, whose rate was 36.8 percent, and non-Hispanic black women, whose rate was 41.9 percent. The rate for Hispanics was 30.7 percent. The rate among all non-high school graduates was 32.9 percent. Obesity prevalence was also higher in some regions than others. The South had an obesity prevalence of 28.4 percent while the Midwest had a prevalence of 28.2 percent.

“Obesity is a complex problem that requires both personal and community action,” said Dr. Dietz. “People in all communities should be able to make healthy choices, but in order to make those choices there must be healthy choices to make. We need to change our communities into places where healthy eating and active living are the easiest path.”

90% of U.S. Adults Get Too Much Salt

Less than 10 percent of U.S. adults limit their daily sodium intake to recommended levels, according to a new report, “Sodium Intake in Adults – United States, 2005-2006,” published today in Morbidity and Mortality Weekly Report. The report also finds that most sodium in the American diet comes from processed grains such as pizza and cookies, and meats, including poultry and luncheon meats.

According to the report, U.S. adults consume an average of 3,466 milligrams (mg) of sodium per day, more than twice the current recommended limit for most Americans. Grains provide 36.9 percent of this total, followed by dishes containing meat, poultry, and fish (27.9 percent). These two categories combined account for almost two-thirds of the daily sodium intake for Americans.

An estimated 77 percent of dietary sodium comes from processed and restaurant foods. Many of these foods, such as breads and cookies, may not even taste salty. “Sodium has become so pervasive in our food supply that it’s difficult for the vast majority of Americans to stay within recommended limits,” said Janelle Peralez Gunn, public health analyst with CDC’s Division for Heart Disease and Stroke Prevention and lead author of the report. “Public health professionals, together with food manufacturers, retailers and health care providers, must take action now to help support people’s efforts to reduce their sodium consumption.”

The 2005 Dietary Guidelines for Americans recommends that people consume less than 2,300 mg of sodium per day. Specific groups, including persons with high blood pressure, all middle-aged and older adults and all blacks, should limit intake to 1500 mg per day. These specific groups comprise nearly 70 percent of the U.S. adult population. This study found that only 9.6 percent of all participants met their applicable dietary recommendation, including 5.5 percent of the group limited to 1,500 mg per day and 18.8 percent of the 2,300 mg per day group.

The report examined data for 2005–2006 from the National Health and Nutrition Examination Survey (NHANES), an ongoing study that explores the health and nutritional status of adults and children in the United States. Researchers used information from 24-hour dietary recall and the USDA National Nutrient Database to estimate the daily sodium intake and sources of sodium intake for U.S. adults.

The findings add to a growing body of observational research studies on Americans’ excessive sodium consumption. Overconsumption of sodium can have negative health effects, including increasing average levels of blood pressure. One in three U.S. adults has high blood pressure, and an estimated 90 percent of U.S. adults will develop the disease in their lifetime. Blood pressure is a major risk factor for heart disease and stroke, the first and third leading causes of death among adults in the United States.

Source: CDC, June 24, 2010

Herpes Prevalent in 16 Percent of Americans Aged 14-49

About 1 in 6 Americans (16.2 percent) between the ages of 14 and 49 is infected with herpes simplex virus type 2 (HSV-2), according to a national health survey released today by the Centers for Disease Control and Prevention.  HSV-2 is a lifelong and incurable infection that can cause recurrent and painful genital sores.

The findings, presented at the 2010 National STD Prevention Conference, indicate that herpes remains one of the most common sexually transmitted diseases (STDs) in the United States.

The new estimate, for 2005-2008, comes from CDC’s National Health and Nutrition Examination Survey (NHANES), a nationally representative survey of the U.S. household population that assesses a broad range of health issues.

The findings suggest relatively stable HSV-2 prevalence since CDC’s last national estimate (17 percent for 1999-2004), because the slight decline in prevalence between the two time periods is not statistically significant.

The study finds that women and blacks were most likely to be infected.  HSV-2 prevalence was nearly twice as high among women (20.9 percent) than men (11.5 percent), and was more than three times higher among blacks (39.2 percent) than whites (12.3 percent).  The most affected group was black women, with a prevalence rate of 48 percent.

As with other STDs, biological factors may make women more susceptible to HSV-2 infection. Additionally, racial disparities in HSV-2 infection are likely perpetuated because of the higher prevalence of infection within African-American communities, placing African-Americans at greater risk of being exposed to herpes with any given sexual encounter.

“This study serves as a stark reminder that herpes remains a common and serious health threat in the United States.  Everyone should be aware of the symptoms, risk factors, and steps that can be taken to prevent the spread of this lifelong and incurable infection,” said Kevin Fenton, M.D., director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention.  “We are particularly concerned about persistent high rates of herpes among African-Americans, which is likely contributing to disproportionate rates of HIV in the black community.”

Research shows that people with herpes are two to three times more likely to acquire HIV, and that herpes can also make HIV-infected individuals more likely to transmit HIV to others.  CDC estimates that over 80 percent of those with HSV-2 are unaware of their infection.  Symptoms may be absent, mild, or mistaken for another condition.  And people with HSV-2 can transmit the virus even when they have no visible sores or other symptoms.

“Many individuals are transmitting herpes to others without even knowing it,” said John M. Douglas, Jr., M.D., director of CDC’s Division of STD Prevention.  “We can’t afford to be complacent about this disease.  It is important that persons with symptoms suggestive of herpes—especially recurrent sores in the genital area—seek clinical care to determine if these symptoms may be due to herpes and might benefit from treatment.”

Combination of Prevention Approaches Needed to Reduce National Herpes Rates
Although HSV-2 infection is not curable, there are effective medications available to treat symptoms and prevent outbreaks.  Those with known herpes infection should avoid sex when herpes symptoms or sores are present and understand that HSV-2 can still be transmitted when sores are not present. Effective strategies to reduce the risk of HSV-2 infection include abstaining from sexual contact, using condoms consistently and correctly, and limiting the number of sex partners.

CDC does not recommend HSV-2 screening for the general population.   However, such testing may be useful for individuals who are unsure of their status and at high risk for the disease, including those with multiple sex partners, those who are HIV-positive, and gay and bisexual men.


Source: Centers for Disease Control (CDC), March 9, 2010

Heart Disease Hospitalization Rates in the U.S.

Heart disease hospitalization rates among Americans aged 65 years and older vary substantially depending on where they live, according to a report released today by the Centers for Disease Control and Prevention.

The “Atlas of Heart Disease Hospitalizations Among Medicare Beneficiaries” shows that the highest hospitalization rates occur among blacks compared to other racial and ethnic groups.  Hospitalization rates were also highest in counties located primarily in Appalachia, the Mississippi Delta, Texas and Oklahoma. A significant number of Medicare beneficiaries live in counties without hospitals capable of providing specialized heart disease treatment.

The atlas provides for the first time statistics about heart disease hospitalizations at the county level.  Data came from the Medicare records of more than 28 million people each year between 2000 and 2006 in the 50 states, Washington, D.C., Puerto Rico and the U.S. Virgin Islands. The report documented an average of 2.1 million hospitalizations for heart disease each year.

“These data bring into sharp focus the differences in heart disease hospitalization rates that exist across this country,” said Michele Casper, Ph.D., epidemiologist in CDC’s Division for Heart Disease and Stroke Prevention.  “Importantly, with county–level information, health professionals at the local, state and national levels will be able to tailor heart disease prevention programs and polices to the needs of people living in communities with high rates of heart disease.”

Heart disease is the nation’s leading cause of death. In 2010, it is estimated to cost the United States $316.4 billion in health care services, medications and lost productivity.

In states with the highest heart disease hospitalization rate, the burden is generally two times higher than states with the lowest rates.  For instance, in Louisiana there were 95.2 hospitalizations for every 1,000 Medicare beneficiaries, compared with 44.8 in Hawaii over the same six–year period.

The atlas also brings to light significant racial and ethnic disparities. The heart disease hospitalization rate is much higher among blacks (85.3 hospitalizations per 1,000 beneficiaries) than for whites (74.4 per 1,000) or Hispanics (73.6 per 1,000).  While these rates declined slowly between 2000 and 2006 for Hispanic and white Americans aged 65 years and older, they remained steady among older black Americans.

The atlas also points out geographical differences in access to hospitals with the capability to treat heart disease patients. In 2005, 21 percent of all counties in the United States had no hospital, and 31 percent lacked a hospital with an emergency room.  Specialized cardiac services are even more limited, with 63 percent of U.S. counties lacking a cardiologist outside the Veterans Affairs system.

“Heart disease is largely preventable, and reducing the toll of this disease on society is a national priority,” said Darwin Labarthe, M.D., Ph.D., director of CDC’s Division for Heart Disease and Stroke Prevention. “With targeted public health efforts, such as prevention and early identification of risk factors, and increased access to appropriate medical care, the burden of heart disease can be reduced.”

Source: CDC (March 1, 2010)

Twenty Percent of American Teens Have Abnormal Lipid Levels

Twenty percent of young people aged 12-19 years in the United States have at least one abnormal lipid level, according to a study from the Centers for Disease Control and Prevention.  Abnormal lipid levels are major risk factors for heart disease, the leading cause of death among adults in the United States.

The report, “Prevalence of Abnormal Lipid Levels among Youths —United States, 1999–2006,” was published today in CDC’s Morbidity and Mortality Weekly Report (MMWR).

The report examined data for 1999–2006 from the National Health and Nutrition Examination Survey (NHANES), an ongoing study that explores the health and nutritional status of about 6,000 participants every year.  Researchers analyzed measurements of low-density lipoprotein, or “bad,” cholesterol (LDL-C); high-density lipoprotein, or “good,” cholesterol (HDL-C); and triglycerides.

The researchers found that young people who were overweight or obese were more likely to have one or more abnormal lipid levels compared to normal weight youth.  Fourteen percent of normal weight, 22 percent of overweight, and 43 percent of obese youth had one or more abnormal lipid levels.

The study also found that 32 percent of these young people would be candidates for lipid screening based on American Academy of Pediatrics (AAP) guidelines.  The AAP recommends lipid screening for young people with a family history of high blood cholesterol or premature cardiovascular disease, or the presence of at least one major risk factor for heart disease, such as smoking, high blood pressure, diabetes, or overweight/obesity.

Reviewing health indicators for 3,125 youths, researchers found that differences in lipid levels were associated with sex, age, and race/ethnicity. Specifically:

  • More boys (24 percent) than girls (16 percent) had at least one abnormal lipid level.
  • Fourteen- and 15-year-olds (9 percent) and 18- and 19-year-olds (10 percent) were more likely to have low HDL cholesterol levels than 12- and 13-year-olds (5 percent).
  • Non-Hispanic white youths were more likely to have low levels of HDL cholesterol (8 percent) and high triglycerides (12 percent), compared to non-Hispanic black youths (5 percent and 4 percent, respectively).

Typically, heart disease develops in adulthood. But its risk factors, such as abnormal lipid levels and overweight/obesity often emerge during childhood and adolescence.

“Overweight and obese young people are at far greater risk of having abnormal lipid levels than are youths with normal weights,” said Ashleigh May, Ph.D.,  Epidemic Intelligence Service Officer in CDC’s Division for Heart Disease and Stroke Prevention, and lead author of the report.  “The current epidemic of childhood obesity makes this a matter of significant and urgent concern.”

In the past three decades, obesity among American youths has increased from 5 percent to more than 17 percent.  In light of this, the study’s authors suggested that clinicians should be aware of guidelines for lipid screening and treatment among youths.

Source: Centers for Disease Control (Jan. 21, 2010)

40% of Emergency Room Visits Billed to Public Insurance, Says Report

More than 40 percent of the 120 million visits that Americans made to hospital emergency departments in 2006 were billed to public insurance, according to the latest News and Numbers from the Agency for Healthcare Research and Quality.

According to the analysis by the federal agency, about 50 million emergency department visits were billed to Medicaid and Medicare. The uninsured accounted for another 18 percent of visits for emergency care, while 34 percent of the visits were billed to private insurance companies and the rest were billed to workers compensation, military health plan administrator Tricare and other payers.

The agency’s study of hospital emergency department use in 2006 also found that:

  • About 38 percent of the 24.2 million visits billed to Medicare ended with the patients being admitted, compared with 11 percent of the 41.5 million visits billed to private insurers, 9.5 percent of the 26 million visits billed to Medicaid and 7 percent of the 21.2 million visits by the uninsured.
  • The uninsured were the most frequent users of hospital emergency departments. Their rate was 1.2 times greater than that of people with public or private insurance – 452 visits per 1,000 population vs. 367 visits per 1,000 population, respectively.
  • The uninsured were also the most likely to be treated and released – a possible indication of their use of hospital emergency departments as their usual source of care. Their "treat-and-release" rate was 421 visits per 1,000 population vs. 301 per 1,000 population for the insured.

Source: Agency for Healthcare Research and Quality (AHRQ)