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CDC annual report: Prescription drug use, obesity rates increase

Life expectancy is up and tobacco use is down, but there are still several concerning health indicators in the CDC’s 40th annual report on long-term trends in health and health care delivery of the nation between 1975 and 2015 which was delivered from the Secretary of HHS to President Donald Trump and Congress.

The report, Health, United States, 2016, describes birth rates and infant mortality, life expectancy and leading causes of death, health risk behaviors, health care utilization and insurance coverage and health expenditures. Highlights from the report include declines in cigarette smoking, increases in prescription drug use and changes in expenditures for hospitals and home health care. The CDC also investigated population changes that have affected patterns of disease and health care access and utilization since 1975.

CDC investigators found that life expectancy increased between 1975 and 2015 from 68.8 years to 76.3 years for males, from 76.6 years to 81.2 years for females and from 72.6 years to 78.8 years for the total population, but declined between 2014 and 2015 from 76.5 years to 76.3 years for males, from 81.3 years to 81.2 years for females and from 78.9 years to 78.8 years for the total population. There was a 63% decline in the infant mortality rate, from 16.07 to 5.9 deaths per 1,000 live births.

The age-adjusted heart disease and cancer death rates both decreased over the past 40 years by 61% and 21%, respectively. However, heart disease and cancer are still the top two causes of death in the nation.

Among individuals aged 25 years and older, there was a decline from 36.9% to 15.6% for the age-adjusted prevalence of current cigarette smoking. Obesity increased progressively from 22.9% between 1988 and 1994 to 37.8% between 2013 and 2014 among adults aged 20 years and older.

All age groups demonstrated an increase in prescription drug use from 1988 to 1994 and 2013 to 2014. During the same period, use of five or more prescription drugs in the past 40 days increased among adults aged 65 years and older from 13.8% to 42.2%.

The percentage of males and females aged younger than 75 years with an overnight hospital stay was lower in 2015 than 1975, but was not significantly different for those aged 75 years and older. The number of community hospital beds per 1,000 resident population declined by nearly 50%, while the average length-of-stay per hospital stay declined by nearly one-third and occupancy rates decreased by approximately 16% between 1975 and 2014.

Furthermore, the CDC reported that the share of personal health care expenditures paid for hospital care (45.3% to 38.1%), nursing care facilities and continuing care retirement communities (7.1% to 5.8%) and dental services (7.1% to 4.3%) decreased, while physician and clinical services remained the same (22.4% to 23.4%) and home health care (0.5% to 3.3%), prescription drugs (7.1% to 11.9%) and other types of care (10.6% to 13.2%) increased.

Preliminary data indicated that the percentage of uninsured children under age 18 years declined from 12.0% to 5%, the percentage with Medicaid coverage increased from 11.3% to 39.2% and the percentage with private coverage decreased from 75.1% to 53.5% between 1978 and September 2016.

“These trends in health and health care have occurred alongside changes in the demographic characteristics of the U.S. population,” the CDC wrote in a press release.

The United States population grew older and became more diverse, with the number of Americans aged 65 years and older rising from 22.6 million (1975) to 47.8 million (2015) and the percentage of the population identifying as racial or ethnic minorities rising from 20.1% (1980) to 38.4% (2015). The percentage of children aged younger than 18 years living in poverty fluctuated from 1975 and 2015, reaching a high in 1993 (22.7%), declining to 16.2 in 2000, increasing to 22 in 2010 and declining to 19.7% in 2015. In addition, the shift in the population from rural areas to suburban areas increased. – by Alaina Tedesco

Disclosure: Healio Internal Medicine was unable to confirm relevant financial disclosures at the time of population.