Special Feature on Emergency Care

In 2011, 20% of persons reported at least one emergency department visit in the past year, and 7% reported two or more visits (Figure 20).

During 2001 through 2011, both children under age 18 and adults aged 18–64 with Medicaid coverage were more likely to have at least one emergency department visit in the past year, compared with the uninsured and those with private coverage (Figure 21).

In 2008–2010, falls were the most common reason for an injury-related visit to an emergency department (Figure 24).

Between 2000 and 2010, 35% of emergency department visits included an x-ray, while the use of advanced imaging (CT or MRI) scans increased from 5% to 17% of emergency department visits (Figure 26).

In 2009–2010, 81% of emergency department visits were discharged for follow-up care as needed, 16% ended with the patient being admitted to the hospital, 2% ended with the patient leaving without completing the visit, and less than 1% ended in the patient’s death (Figure 27).

Life Expectancy and Mortality

Between 2000 and 2010, life expectancy at birth increased 2.1 years for males and 1.7 years for females. The gap in life expectancy between males and females narrowed from 5.2 years in 2000 to 4.8 years in 2010, with females having the longer life expectancy (Table 18).

Between 2000 and 2010, life expectancy at birth increased more for the black than for the white population, thereby narrowing the gap in life expectancy between these two racial groups. In 2000, life expectancy at birth for the white population was 5.5 years longer than for the black population; by 2010, the difference had narrowed to 3.8 years (Table 18).

Between 2000 and 2010, the infant mortality rate decreased 11% from 6.91 to 6.15 deaths per 1,000 live births. In 2000, the infant mortality rate for white mothers was 5.7 compared to 14.1 for black mothers; by 2010 the infant mortality rate declined to 5.2 among white mothers and 11.6 among black mothers (Table 13).

Between 2000 and 2010, the age-adjusted heart disease death rate decreased 30%, from 257.6 to 179.1 deaths per 100,000 population. In 2010, 24% of all deaths were from heart disease (Tables 22 and 26).

Between 2000 and 2010, the age-adjusted cancer death rate decreased 13%, from 199.6 to 172.8 deaths per 100,000 population. In 2010, 23% of all deaths were from cancer (Tables 22 and 28).

Fertility and Natality

Between 2009 and 2010, the birth rate among teenagers aged 15–19 fell 10%, from 37.9 to 34.2 live births per 1,000 females—a record low for the United States (Table 3).

Low birthweight is associated with elevated risk of death and disability in infants. The percentage of low-birthweight births [infants weighing less than 2,500 grams (5.5 pounds) at birth] was 8.15% in 2010 and has declined slowly since 2006, when it was 8.26% (Table 6).

Health Risk Factors

Between 1988–1994 and 1999–2000, the prevalence of obesity among children aged 2–5 increased from 7% to 10% and then did not increase significantly through 2009–2010 (Table 63 and Figure 10).

The prevalence of obesity among children aged 6–11 and adolescents aged 12–19 increased from 11% to 15% between 1988–1994 and 1999–2000 and then did not increase significantly through 2009–2010 (Table 63 and Figure 10).

In 2011, 48% of adults aged 18 and over did not meet the 2008 federal physical activity guidelines. This percentage increased with age, rising from 36% of adults aged 18–24 to 68% of adults aged 75 and over (Table 67).

Between 1988–1994 and 2007–2010, the percentage of adults aged 20 and over with grade 1 obesity [a body mass index (BMI) of 30.0–34.9] increased from 14% to 20%. Those with grade 2 obesity (BMI of 35.0–39.9) rose from 5% to 9%, and those with grade 3 or higher obesity (BMI of 40 or higher) doubled, from 3% to 6% (Table 68).

In 2011, 19% of U.S. adults were current cigarette smokers, unchanged from the 2010 level. Men (22%) were more likely than women (17%) to be current cigarette smokers (Table 54).

Between 2001 and 2011, the percentage of students in grades 9–12 who reported riding with a driver who had been drinking alcohol declined from 31% to 24% (Table 61).

In 2011, 22% of adults aged 18 and over reported drinking five or more drinks in 1 day in the past year, decreasing from 32% of adults aged 18–44 to 18% of those aged 45–64, and 6% of those aged 65 and over (Table 62).

Between 2003 and 2007, the percentage of children aged 6–11 who did not get daily vigorous physical activity decreased from 69% to 62%; the percentage who had more than 2 hours of screen time on an average weekday (watched TV or videos, played video games, or used a computer recreationally) increased from 36% to 40%; and the percentage who did not get enough sleep nightly increased from 25% to 28% (Table 60).

Measures of Health and Disease Prevalence

In 2009–2011, 6% of children under age 18 had an asthma attack in the past year, and 5% had a food allergy. Ten percent of children under age 5 had three or more ear infections in the past year. Among school-age children aged 5–17, 10% had attention deficit hyperactivity disorder and 6% had serious emotional or behavioral difficulties (Table 41).

In 2011, the percentage of noninstitutionalized adults who reported their health as fair or poor ranged from 7% of those aged 18–44 to 29% of those aged 75 and over (Table 50).

In 2011, 27% of noninstitutionalized adults aged 18–64 reported a disability (defined as any basic actions difficulty or complex activity limitation), compared with 62% of those aged 65 and over (Table 48).

In 2010–2011, 45% of men and 31% of women aged 75 and over had ever been told by a physician or other health professional that they had heart disease (Table 44).

In 2010–2011, 26% of men and 19% of women aged 75 and over had ever been told by a physician or other health professional that they had cancer (excluding squamous and basal cell skin cancers) (Table 44).

Between 1988–1994 and 2007–2010, the prevalence of uncontrolled high blood pressure among adults aged 20 and over with hypertension decreased from 74% to 49% (Table 64).

Between 1988–1994 and 2007–2010, the percentage of adults aged 20 and over with a high serum total cholesterol level (defined as greater than or equal to 240 mg/dL) declined from 20% to 14% (Table 65).

Health Care Utilization

Unmet Need for Medical Care, Prescription Drugs, and Dental Care Due to Cost

Between 2001 and 2011, among adults aged 18–64, the percentage who reported not receiving, or delaying, needed medical care due to cost in the past 12 months increased from 10% to 14%. The percentage not receiving needed prescription drugs due to cost increased from 7% to 11%, and the percentage not receiving needed dental care due to cost grew from 10% to 16% (Table 73).

In 2011, 35% of adults aged 18–64 who were uninsured did not get, or delayed, needed medical care due to cost in the past 12 months, compared with 7% of adults with private coverage and 13% of adults with Medicaid (Table 73 and Figure 18).

In 2011, 24% of adults aged 18–64 who were uninsured did not get needed prescription drugs due to cost in the past 12 months, compared with 5% of those with private coverage and 14% of those with Medicaid (Table 73 and Figure 18).

Health Care Resources

Between 2000 and 2010, the number of physicians in patient care in the United States ranged from 23 to 24 per 10,000 population. In 2010, the number of patient care physicians per 10,000 population ranged from 18 in Idaho and Mississippi to 40 in Massachusetts and 69 in the District of Columbia (Table 100).

Between 2000 and 2010, the United States had about 5,000 community hospitals and 800,000 community hospital beds (Table 106).

In 2011, there were about 1.7 million nursing home beds in 16,000 certified nursing homes. Between 2000 and 2011, nursing home bed occupancy for the United States was stable at 82% (Table 109).

Health Care Expenditures and Payers

Health Insurance Coverage

Between 2001 and 2011, the percentage of the population under age 65 with private health insurance obtained through the workplace declined from 67% to 56% (Table 122).

In 2011, 7% of children under age 18 and 21% of adults aged 18–64 had no health insurance coverage (public or private) at the time of interview (Table 124).

Between 2001 and 2011, among children in families with income just above the poverty level (100%–199% of poverty), the percentage of uninsured children under age 18 dropped from 19% to 11%, while the percentage with coverage through Medicaid or the Children’s Health Insurance Program (CHIP) increased from 33% to 58% (Tables 123 and 124).

Between 2010 and 2011, the percentage of adults aged 19–25 who were uninsured decreased from 34% to 28% (Table 124 and Figure 15).