CDC Releases 40th Annual Report on Nation's Health Trends

Each year, the CDC prepares a report on health statistics that is submitted to the president and Congress by the secretary of HHS. This year’s edition, the 40th annual Health, United States report, focuses on the long-term health trends witnessed over the past decades.

The CDC’s comprehensive report on 2016 health statistics features a 27-figure Chartbook, 114 detailed Trend Tables, and 2 Appendices, as well as an At a Glance table and key highlights. These highlights discuss the report’s 4 major focuses: health status and determinants; utilization of health resources; healthcare resources; and healthcare expenditures and payers. Generally, many of the trends are indicative of the nation’s public health successes, but they also reveal some new and persistent challenges.

The section on health status and determinants describes how the average life expectancy has increased by more than 6 years from 1975 to 2015 and infant mortality has decreased by 63%. Racial and ethnic disparities in life expectancy have narrowed significantly, although gaps still persist. In this 40-year period, the age-adjusted death rates of heart disease and cancer have declined, while age-adjusted opioid death rates have increased sharply since 1999. The prevalence of cigarette smoking among adults has been more than halved since 1974, but e-cigarettes have become more popular among youth in recent years.

Data on healthcare utilization indicate that the percentage of those who had no healthcare visits in the past year decreased from 1997 to 2015; in this same time, rates of those having a dental visit in the past year increased. In 2015, the rates of Americans receiving preventive care services, like colorectal cancer screening and vaccinations for the flu or human papillomavirus, continued to rise.

As for trends in healthcare resources, occupancy rates declined in community hospitals from 1975 to 2015 and in nursing homes from 1995 to 2015. The average length of a community hospital stay decreased by 2.2 days from 1975 to 2014. Over 15 years, the number of dentists increased, although by 2015 there were still geographic disparities in the concentration of dentists per 100,000 population.

Finally, the report outlined trends in health expenditures and insurance. Health expenditures as a percent of gross domestic product increased from 7.9% in 1975 to 17.8% in 2015, potentially driven by rising costs of hospitalizations for procedures like coronary artery bypass. Over these 4 decades, the share of health expenditures paid by private insurance, Medicare, or Medicaid increased, while the out-of-pocket costs to consumers decreased. The uninsurance rate was close to 12% in both 1978 and 2016, although it had risen to over 18% in the mid-1990s and peaked at higher than 20% in the early 2010s.

In a summary of takeaways, the report noted that the nation’s health has improved substantially in many areas thanks to public health achievements like smoking cessation efforts and advances in medical technology and treatment options. However, new problems have arisen, from new infectious diseases to the opioid epidemic. Furthermore, health improvements are not always observed equally for Americans of varying income levels, races, locations, and educational attainment.

These challenges, the report argues, are precisely why the Health, United States report series endeavors to present a long-term view of the nation’s health, in order to identify patterns and variations over the past 4 decades. “Monitoring the health of the American people is an essential step in making sound health policy and setting research and program priorities,” it concluded.