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)

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

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)

One Quarter of All Americans Experience Daily Pain

More than a quarter of the entire population in the United States experiences some form of pain every day. Americans spent between $2 and $6 billion on non prescription painkillers in 2007, while the cost of productivity loss attributable to pain-related conditions is estimated at $60 billion a year.

"Although much is known about the pain experienced by those with chronic illnesses, until now relatively little was known about pain in the entire U.S. population," says Arthur A. Stone, Ph.D., a Professor in the Department of Psychiatry and Behavioral Science at Stony Brook University.

"Our assessment approach allowed us to get accurate information about pain at several carefully selected times from the previous day," explains Dr. Stone, which enabled the researchers to address several new questions about pain, daily activities, and respondents’ personal characteristics.

Ten thousand people were contacted via random-digit dialing, and a total of 3,982 people were actually interviewed. To make the study results representative of the U.S. population, the data were adjusted with sample weights developed by the Gallup Organization. 29% of men and 27% of women said they experienced pain at sampled times.

The researchers also found a correlation between pain and lower income and less education: "Those with lower income or less education spent a higher proportion of time in pain and reported higher average pain than did those with higher income or more education," they wrote.

Additionally, the report found that the average pain rating increased with age, although it reached a plateau between ages of about 45 years and 75 years, with little difference between men and women.

According to Dr. Stone, "The study results expand our understanding of pain in the United States and supplement more traditional assessment approaches with a very detailed perspective on the pain people experience on a daily basis. This suggests new avenues of research that may ultimately lead to improved treatment of pain."

Study authors: Arthur A. Stone, Ph.D., Distinguished Professor and Vice Chair, Department of Psychiatry and Behavioral Science at Stony Brook University, and Alan Krueger, Ph.D., Professor, Department of Economics and the Woodrow Wilson School at Princeton University

Source: The Lancet, May 3, 2008