HEALTH, UNITED STATES, 2011 WITH SPECIAL FEATURE ON SOCIOECONOMIC STATUS AND HEALTH pptx

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Suggested citation
National Center for Health Statistics.
Health, United States, 2011: With Special Feature on
Socioeconomic Status and Health. Hyattsville, MD. 2012.
Library of Congress Catalog Number 76–641496
For sale by Superintendent of Documents
U.S. Government Printing Office
Washington, DC 20402
U.S. Department of Health and Human Services
Kathleen Sebelius
Secretary
Centers for Disease Control and Prevention
Thomas R. Frieden, M.D., M.P.H.
Director
National Center for Health Statistics
Edward J. Sondik, Ph.D.
Director
Health, United States, 2011 Preface iii
Preface
Health, United States, 2011 is the 35th report on the
health status of the Nation and is submitted by the

Secretary of the Department of Health and Human
Services to the President and the Congress of the
United States in compliance with Section 308 of the
Public Health Service Act. This report was compiled
by the Centers for Disease Control and Prevention’s
(CDC) National Center for Health Statistics (NCHS).
The National Committee on Vital and Health Statistics
served in a review capacity.
The Health, United States series presents an annual
look at national trends in health statistics. The report
contains a Chartbook that assesses the Nation’s
health by presenting trends and current information
on selected measures of morbidity, mortality, health
care utilization, health risk factors, prevention, health
insurance, and personal health care expenditures.
This year’s Chartbook includes a Special Feature on
Socioeconomic Status and Health. The report also
contains 151 Trend Tables organized around four
major subject areas: health status and determinants,
health care utilization, health care resources, and
health care expenditures. A companion product to
Health, United States—Health, United States: In
Brief—features information extracted from the full
report. The complete report, In Brief, and related data
products are available on the Health, United States
website at:
The 2011 Edition
Health, United States, 2011 includes a summary
‘‘At a Glance’’ table that displays selected indicators of
health and their determinants, cross-referenced to

charts and tables in the report. It also contains a
Highlights section, a Chartbook, detailed Trend
Tables, extensive Appendixes, and an Index. Major
sections of the 2011 report are described below.
Chartbook
The 2011 Chartbook contains 41 charts, including 20
(Figures 22–41) on this year’s Special Feature on
Socioeconomic Status and Health (SES). This feature
includes charts on the relationship between SES and
health by using a four-category education variable
and a four-category relative family income variable as
SES measures. Charts on trends in poverty and
differences in relative family income by race and
Hispanic origin for children and adults are presented
to provide context for the other charts. This feature
explores the SES gradient in health measures for
both children and adults and how that gradient
differs across racial and ethnic groups. When
possible, trend data are presented to examine
changes in SES disparities over time. Char ts present
information on associations between SES and
morbidity and mortality, prevention and risk factors,
and access to care and health insurance.
Trend Tables
The Chartbook is followed by 151 Trend Tables
organized around four major subject areas: health
status and determinants, health care utilization,
health care resources, and health care expenditures.
The tables present data for selected years, to
highlight major trends in health statistics. Additional

years of data may be available in Excel spreadsheet
files on the Health, United States website. Trend Tables
for which additional data years are available are listed
in Appendix III. Comparability across years in Health,
United States is fostered by including similar Trend
Tables in each volume, and timeliness is maintained
by improving the content of ongoing tables and
adding new tables each year to reflect emerging
topics in public health. A key criterion used in
selecting these tables is the availability of
comparable national data over a period of several
years.
Health, United States, 2011 includes eight new Trend
Tables on the following subjects:
Drug poisoning death rates (Table 36), based on
data from the National Vital Statistics System.
Prevalence of health-related behaviors for
children 6–11 years of age (Table 66), based on data
from the National Survey of Children’s Health.
Prevalence of cigarette smoking (Table 63),
selected disability and health status measures
(Tables 57 and 58), and selected access to medical
care measures (Table 80) by urbanization level, based
on data from the National Health Interview Survey
and the 2006 NCHS Urban–Rural Classification
Scheme for Counties.
Utilization of colorectal tests and procedures
(Table 92), based on data from the National Health
Interview Survey.
Preface Health, United States, 2011 iv

Cost of hospital discharges with common
hospital operating room procedures (Table 132),
based on data from the Healthcare Cost and
Utilization Project.
Appendixes
Appendix I. Data Sources describes each data
source used in Health, United States, 2011 and
provides references for fur ther information about the
sources. Data sources are listed alphabetically within
two broad categories: Government Sources, and
Private and Global Sources.
Appendix II. Definitions and Methods is an
alphabetical listing of terms used in the report. It also
contains information on the methods used in the
report.
Appendix III. Additional Data Years Available lists
tables for which additional years of trend data are
available in Excel spreadsheet files on the Health,
United States website.
Index
The Index to the Trend Tables and figures is a useful
tool for locating data by topic. Tables and figures are
cross-referenced by such topics as child and
adolescent health; older population 65 years of age
and over; women’s health; men’s health; state data;
American Indian and Alask a Native, Asian, black or
African American, and Hispanic-origin populations;
education; injury; disability; and metropolitan and
nonmetropolitan data. Many of the Index topics are
also available as conveniently grouped data

packages on the Health, United States website.
Data Considerations
Racial and Ethnic Data
Many tables in Health, United States present data
according to race and Hispanic origin, consistent
with a Department-wide emphasis on expanding
racial and ethnic detail when presenting health data.
Trend data on race and ethnicity are presented in the
greatest detail possible after taking into account the
quality of the data, the amount of missing data, and
the number of observations. These issues
significantly affect the availability of reportable data
for certain populations, such as the Native Hawaiian
and Other Pacific Islander population and the
American Indian and Alask a Native population.
Standards for the classification of federal data on race
and ethnicity are described in an appendix. (See
Appendix II, Race.)
Education and Income Data
Many tables in Health, United States present data
according to SES, using education and family income
as proxy measures. Education and income data are
generally obtained directly from survey respondents
and are not usually available from records-based data
collection systems. Categories shown for income
data were expanded in Health, United States, 2010.
State vital statistics systems currently report mother’s
education on the birth certificate and (based on an
informant) decedent’s education on the death
certificate. (See Appendix II, Education; Family

income; Poverty.)
Disability Data
Disability can include the presence of physical or
mental impairments that limit a person’s ability to
perform an important activity and affect the use of or
need for supports, accommodations, or interventions
to improve functioning. Information on disability in
the U.S. population is critical to health planning and
policy. Several initiatives are currently under way to
coordinate and standardize the measurement of
disability across federal data systems. Health, United
States, 2009 introduced the first detailed Trend Table
using data from the National Health Interview Survey
to create disability measures consistent with two of
the conceptual components that have been
identified in disability models and legislation: basic
actions difficulty and complex activity limitation.
Basic actions difficulty captures limitations or
difficulties in movement and sensory, emotional, or
mental functioning that are associated with a health
problem. Complex activity limitation describes
limitations or restrictions in a person’s ability to
participate fully in social role activities such as
working or maintaining a household. Health, United
States, 2010 expanded the use of these measures to
many of the tables from the National Health
Interview Survey and this year’s report added two
tables on disability measure by urbanization level
(Tables 57 and 58). Health, United States also includes
the following disability-related information for the

civilian noninstitutionalized population: vision and
hearing limitations for adults (Table 55) and
disability-related information for Medicare enrollees
(Table 145), Medicaid recipients (Table 146), and
veterans with service-connected disabilities
(Table 148). For more information on disability
statistics, see: Altman B, Bernstein A. Disability
and health in the United States, 2001–2005.
Health, United States, 2011 Preface v
Hyattsville, MD: NCHS. 2008. Available from:
/>2005.pdf.
Statistical Significance
All differences between estimates noted in the
Highlights section of Health, United States were
determined to be statistically significant at the 0.05
level using two-sided significance tests (z tests). In
the Chartbook, weighted least squares regression
was performed to test for the presence of a
statistically significant increase or decrease in the
estimates during the time period (see Technical
Notes accompanying the Chartbook). Terms such as
‘‘similar,’’‘‘stable,’’ and‘‘no difference’’ indicate that the
statistics being compared were not significantly
different. Lack of comment regarding the difference
between statistics does not necessarily suggest that
the difference was tested and found to be not
significant. Because statistically significant
differences or trends are partly a function of sample
size (the larger the sample size, the smaller the
change that can be detected), statistically significant

differences or trends do not necessarily have public
health significance (1).
Overall estimates generally have relatively small
standard errors, but estimates for certain population
subgroups may be based on small numbers and have
relatively large standard errors. Although numbers of
births and deaths from the Vital Statistics System
represent complete counts (except for births in those
states where data are based on a 50% sample for
selected years) and are not subject to sampling error,
the counts are subject to random variation, which
means that the number of events that actually occur
in a given year may be considered as one of a large
series of possible results that could have arisen under
the same circumstances. When the number of events
is small and the probability of such an event is small,
considerable caution must be observed in
interpreting the conditions described by the figures.
Estimates that are unreliable because of large
standard errors or small numbers of events have
been noted with an asterisk. The criteria used to
designate or suppress unreliable estimates are
indicated in the table footnotes.
For NCHS surveys, point estimates and their
corresponding variances were calculated using the
SUDAAN software package (2), which takes into
consideration the complex survey design. Standard
errors for other surveys or data sets were computed
using the methodology recommended by the
programs providing the data or were provided

directly by those programs. Standard errors are
available for selected tables in the Excel spreadsheet
version on the Health, United States website at:

Access to Health, United States
Health, United States can be accessed in its entirety at:
The website is a
user-friendly resource for Health, United States and
related products. In addition to the full report, it
contains the In Brief companion report and data
conveniently grouped by topic. The Chartbook
figures are provided as PowerPoint slides, and the
Trend Tables and Chartbook data tables as Excel
spreadsheet files and individual PDFs. Many Excel
spreadsheet files include additional years of data not
shown in the printed report, along with standard
errors where available. Spreadsheet files for selected
tables will be updated on the website as available.
Visitors to the website can join the Health, United
States electronic mailing list to receive announce-
ments about release dates and notices of updates to
tables. Previous editions of Health, United States, and
their Chartbooks, can also be accessed from the
website.
Printed copies of Health, United States can be
purchased from the Government Printing Office at:
.
Questions?
If you have questions about Health, United States or
related data products, please contact:

Office of Information Services
Information Dissemination Staff
National Center for Health Statistics
Centers for Disease Control and Prevention
3311 Toledo Road, Fifth Floor
Hyattsville, MD 20782
Phone: 1–800–232–4636
E-mail:
Internet:
References
1. CDC. Youth Risk Behavior Survey (YRBS): Interpretation of YRBS
trend data. 2010. Available from:
HealthyYouth/yrbs/pdf/YRBS_trend_interpretation.pdf.
2. SUDAAN, release 10.0.1 [computer software]. Research
Triangle Park, NC: RTI International. 2009.
Acknowledgments Health, United States, 2011 vi
Acknowledgments
Overall responsibility for planning and coordinating
the content of this volume rested with the National
Center for Health Statistics’ (NCHS) Office of Analysis
and Epidemiology, under the direction of Amy B.
Bernstein, Diane M. Makuc, and Linda T. Bilheimer.
Production of Health, United States, 2011, including
highlights, trend tables, and appendixes, was
managed by Amy B. Bernstein, Sheila J. Franco, and
Virginia M. Freid. Trend tables were prepared by Mary
Ann Bush, Jeanetta E. Churchill, La-Tonya D. Curl,
Anne K. Driscoll, Catherine R. Duran, Sheila J. Franco,
Virginia M. Freid, Tamyra C. Garcia, Nancy Han, Ji-Eun
Kim, Rebecca A. Placek, and Henry Xia, with

assistance from Anita L. Powell and Ilene B. Rosen.
Appendix II tables and the index were assembled by
Anita L. Powell. Production planning and
coordination of trend tables were managed by
Rebecca A. Placek. Review and clearance books were
assembled by Ilene B. Rosen. Administrative and
word processing assistance was provided by Lillie C.
Featherstone and Danielle Wood.
Production of the Chartbook was managed by
Virginia M. Freid and Sheila J. Franco. Data and
analysis for specific charts were provided by Amy B.
Bernstein, Anne K. Driscoll, Sheila J. Franco,
Virginia M. Freid, Tamyra C. Garcia, Ji-Eun Kim,
Kimberly Lochner, and Elsie Pamuk. Charts were
drafted by La-Tonya D. Curl, and data tables were
prepared by Rebecca A. Placek. Technical assistance
and programming were provided by Mary Ann Bush,
La-Tonya D. Curl, Catherine R. Duran, Nancy Han,
Xiang Liu, and Henry Xia.
Publication production was performed by
CDC/OSELS/NCHS/OD/Office of Information
Services, Information Design and Publishing Staff.
Project management and editorial review were
provided by Barbara J. Wassell. The designer was
Sarah M. Hink le. The cover was designed by Megan
Griner. Layout and production were done by Zung T.
Le and Jacqueline M. Davis. Design and production
for Health, United States, 2011: In Brief were provided
by Kyung M. Park. Oversight review for publications
and electronic products was provided by Christine J.

Brown, Tommy C. Seiber t, Jr., and Tammy Stewart-
Prather. Printing was managed by Patricia L. Wilson,
CDC/OCOO/MASO.
Electronic access through the NCHS Internet site
was provided by Christine J. Brown, La-Tonya D. Curl,
Jacqueline M. Davis, Zung T. Le, Anthony Lipphardt,
Anita L. Powell, Sharon L. Ramirez, Ilene B. Rosen, and
Barbara J. Wassell.
Data and technical assistance were provided by
staff of the following NCHS organizations: Division of
Health Care Statistics: Vladislav Beresovsky, Frederic H.
Decker, Carol J. DeFrances, Lisa L. Dwyer, Marni J. Hall,
Lauren Harris-Kojetin, Maria F. Owings, and Susan M.
Schappert; Division of Health and Nutrition
Examination Surveys: Debra J. Brody, Margaret D.
Carroll, Bruce A. Dye, Mark Eberhardt, Jaime J.
Gahche, Quiping Gu, Xianfen Li, Cynthia L. Ogden,
Ryne Paulose, Sung Sug (Sarah) Yoon, and Chia-Yih
Wang; Division of Health Interview Statistics:Patricia F.
Adams, Veronica E. Benson, Barbara Bloom, Robin A.
Cohen, Susan S. Jack, Whitney Kirzinger, Jacqueline
Lucas, Michael Martinez, Kathleen S. O’Connor,
Jennifer Peregoy, Jeannine Schiller, Charlotte A.
Schoenborn, and Brian W. Ward; Division of Vital
Statistics: Joyce C. Abma, Robert N. Anderson,
Elizabeth Arias, Anjani Chandra, Brady Hamilton,
Donna L. Hoyert, Kenneth D. Kochanek, Marian
MacDorman, Joyce A. Martin, T. J. Mathews,
Ari Minin˜o, Sherry L. Murphy, Michelle Osterman, and
Stephanie J. Ventura; Office of Analysis and

Epidemiology: Lara Akinbami, Li-Hui Chen,
Deborah D. Ingram, Susan Lukacs, Patricia Pastor,
Laura A. Pratt, Kenneth Schoendorf, Cynthia A.
Reuben, Cheryl V. Rose, Rashmi Tandon, Margaret
Warner, and Julie Dawson Weeks; Office of the Center
Director: Juan Albertorio and Francis C. Notzon; and
Office of Research and Methodology: Meena Khare.
Additional data and technical assistance were
provided by the following organizations of the
Centers for Disease Control and Prevention (CDC):
Epidemiology Program Office: Samuel L. Groseclose
and Michael Wodajo; National Center for Chronic
Disease Prevention and Health Promotion:Sonya
Gamble, Steve Kinchen, and Karen Pazol; National
Center for HIV/AIDS, Viral Hepatitis, STD, and TB
Prevention: Stacy Cohen, Irene Hall, Alexis Kaigler,
Rachel S. Wynn, and Jill Wasserman; National Center
for Immunization and Respiratory Diseases: Christina
Dorell and James A. Singleton; National Institute for
Occupational Safety and Health: John Myers, Kara
Perritt, Roger Rosa, and John Sestito; by the following
organizations within the Department of Health and
Human Services: Agency for Healthcare Research
and Quality: Roxanne Andrews, David Kashihara,
and Steven R. Machlin; Centers for Medicare &
Medicaid Services: Joseph Benson, M. Kent Clemens,
Cathy A. Cowan, Christine Cox, Maria Diacogiannis,
Health, United States, 2011 Acknowledgments vii
Micah Hartman, Stephanie L. Hunt, Christopher
Kessler, Deborah W. Kidd, Barbara S. Klees, John

Klemm, Kimberly Lochner, Maggie S. Murgolo,
Jason G. Petroski, Joseph F. Regan, Thomas W. Reilly,
Loan Swisher, John A. Wandishin, Benjamin E.
Washington, Lekha Whittle, and Lirong Zhao;
National Institutes of Health: Nancy Breen, Kathy
Cronin, Brenda Edwards, Paul W. Eggars, and
Marsha Lopez; Substance Abuse and Mental Health
Services Administration: Jeffrey Buck, James Colliver,
Joe Gfroerer, Beth Han, Laura Milazzo-Sayre, and
Rita Vandivort-Warren; and by the following
governmental and nongovernmental organizations:
U.S. Census Bureau: Bernadette D. Proctor; Bureau of
Labor Statistics: Daniel Ginsburg, Jeffrey S childkraut,
Stephen Pegula, Elizabeth Rogers, and Audrey
Watson; Department of Veterans Affairs: Pheakdey Lim
and Dat Tran; American Association of Colleges of
Pharmacy: Jennifer M. Patton, Danielle Taylor, and
Maureen Thielemans; A merican Association of
Colleges of Osteopathic Medicine: Wendy Fernando
and Tom Levitan; American Association of Colleges of
Podiatric Medicine: Moraith G. North; American
Osteopathic Association: Margaret Harrison; American
Dental Education Association: Jon D. Ruesch;
Association of American Medical Colleges: Franc Slapar
and Amber Sterling; Association of Schools and
Colleges of Optometry: Paige Pence and Joanne
Zuckerman; Association of Schools of Public Health:
Kristin Dolinski; Cowles Research Group: C. McKeen
Cowles; NOVA Research Company: Shilpa Bengeri;
and Thomson Reuters: Rosanna Coffey and

Katharine Levit.
SPECIAL ACKNOWLEDGMENTS
Dr. Diane Makuc
and
Ms. Rebecca Placek
All those associated with Health, United States would like to give special thanks to Dr. Diane Makuc
and Ms. Rebecca Placek, who recently retired from the National Center for Health Statistics.
Dr. Makuc contributed to Health, United States for more than 30 years, providing direction and
insightful guidance for the report. Her strong grasp of public health issues, knowledge of NCHS
data systems, and expertise in statistical methodology were key to ensuring the high quality and
continued relevance of this annual repor t to Congress on the health of the Nation.
For 32 years, Ms. Placek was the anchor of the Health, United States production team—keeping this
large and complex project well organized and of the highest quality. She managed the entire trend
table production process with a wonderful combination of meticulousness and good spirits, and
was instrumental in designing systems to track the overall production status of the report.
The Health, United States team is truly grateful to both Diane and Becky for their vital and tireless
contributions to the report over their many years of association. We miss them dearly and wish
them the very best in their retirement!
C ontents
Health, United States, 2011 Contents xi
Contents
Preface iii
Acknowledgments vi
List of Chartbook Figures xiii
ListofTrendTables xv
At a Glance Table and Highlights
AtaGlanceTable 2
Highlights 4
Special Feature on Socioeconomic Status and
Health 4

Life Expectancy and Mortality 5
Fertility and Natality 5
HealthRiskFactors 5
Measures of Health and Disease Prevalence . . . 6
Health Care Utilization 6
Urbanization Level: Health Status, Risk Factors,
andAccesstoCare 7
Unmet Need for Medical Care, Prescription
Drugs,andDentalCareDuetoCost 7
Health Care Resources 7
Health Care Expenditures and Payers 8
Health Insurance Coverage 8
Chartbook W ith Special F eatur e on
Socioeconomic Status and Health
Mortality 10
Life Expectancy at Birth 10
InfantMortality 10
Selected Causes of Death 11
MotorVehicle-relatedDeathRates 11
Natality 12
Teenage Birth Rates 12
Morbidity 12
Heart Disease Prevalence 12
Disability Measures 13
Basic Actions Difficulty or Complex Activity
Limitation 13
HealthRiskFactors 13
Current Cigarette Smoking 13
Uncontrolled High Blood Pressure 14
Obesity Among Children 14

Overweight and Obesity Among Adults 15
Prevention 15
Influenza and Pneumococcal Vaccination . . . 15
Mammography Use 16
HealthInsurance 16
Coverage Among Children 16
Coverage Among Adults 18–64 Years
ofAge 17
Utilization and Access 17
PrescriptionDrugUse 17
Emergency Department Visits 18
Delay or Nonreceipt of Needed Medical Care
or Prescription Drugs due to Cost 18
Health Care Resources 19
Patient Care Physicians per Population 19
Personal Health Care Expenditures 19
Source of Funds 19
Type of Expenditure 20
Special Feature on Socioeconomic Status and
Health 24
Introduction 24
Children
Background 27
ChildPoverty 27
Morbidity 28
Current Asthma Among Children 28
Attention Deficit Hyperactivity Disorder
Among Children 29
HealthRiskFactors 30
ChildObesity 30

Children’sScreenTime 31
Prevention 32
Babies Who Were Breastfed for 3 Months or
More 32
AdolescentVaccinations 33
HealthInsurance 34
UninsuredChildren 34
Utilization and Access 35
Dental Visits Among Children 35
xii Contents Health, United States, 2011
Adults
Background 36
AdultPoverty 36
Mortality 37
Life Expectancy at Age 25 37
Morbidity 38
Depression 38
Edentulism (Lack of Natural Teeth) 39
Two or More Selected Chronic Health
Conditions 40
Disability Measures 41
Basic Actions Difficulty or Complex
ActivityLimitation 41
HealthRiskFactors 42
Adult Obesity 42
Current Cigarette Smoking 43
Prevention 44
Colorectal Tests or Procedures 44
Health Insurance 45
Uninsured Adults 45

AccesstoCare 46
Delay or Nonreceipt of Medical Care in
thePast12MonthsDuetoCost 46
Technical Notes 47
Data Tables f or Special F eatur e: Figures 22–41 . . . 49
Trend Tables
HealthStatusandDeterminants 71
Population 71
Fertility and Natality 76
Mortality 98
Determinants and Measures of Health 170
Utilization of Health Resources 268
Ambulatory Care 268
InpatientCare 328
Health Care Resources 349
Personnel 349
Facilities 357
Health Care Expenditures and Payers 368
National Health Expenditures 368
Health Care Coverage and Major Federal
Programs 395
State Health Expenditures and Health
Insurance 419
Appendixes
Appendix Contents 425
Appendix I. Data Sources 429
Appendix II. Definitions and Methods 485
Appendix III. Additional Data Years Available. . . 550
Index
Index 555

Health, United States, 2011 Contents xiii
List of Chartbook Figures
Mortality
Figure 1. Life expectancy at birth, by race and sex
and Hispanic origin: United States , 1980–2008 . . . 10
Figure 2. Infant, neonatal, and postneonatal
mortality rates: United States, 1998–2008 10
Figure 3. Death rates for selected causes of death
for all ages , by sex: Unit ed States , 1998–2008 11
Figure 4. Motor vehicle-related death rates
among persons 15–24 years of age, by sex and age:
United States, 1998–2008 11
Natality
Figure 5. Teenage childbearing, by maternal
age and race and Hispanic origin: United States,
1998–2008 12
Morbidity
Figure 6. Respondent-reported lifetime heart
disease prevalence among adults 18 years of age
and over, by sex and age: United States, 1999–2000
through 2009–2010 12
Disability Measures
F igure 7. Basic actions difficulty or complex activity
limitation among adults 18 years of age and over,
by sex and age: United States, 2000–2010 13
Health Risk Fac tors
Figure 8. Current cigarette smoking among high
school seniors and adults 18 years of age and over,
by sex and age: United States, 2000–2010 13
Figure 9. Uncontrolled high blood pressure

among adults 20 years of age and over for persons
with hypertension, by sex and age: United States,
1988–1994, 1999–2002, and 2007–2010 14
Figure 10. Obesity among children, by age:
United States , 1988–1994 through 2009–2010 . . . 14
Figure 11. Overweight and obesity among adults
20 years of age and over, by sex: United States,
1988–1994, 1999–2002, and 2007–2010 15
Prevention
Figure 12. Influenza and pneumococcal
vaccination among adults, by type of vaccination
and age: United States, 2000–2010 15
Figure 13. Mammography use in the past 2 years
among women 40 years of age and over, by age:
United States, 2000–2010 16
Health Insurance
Figure 14. Health insurance coverage among
children under 18 years of age, by type of
coverage: United States, 2000–2010 16
Figure 15. Health insurance coverage among
adults 18–64 years of age, by age and type of
coverage: United States, 2000–2010 17
Utilization and Access
Figure 16. Use of three or more prescription drugs
in the past 30 days, by sex and age: United States,
1988–1994, 1999–2002, and 2005–2008 17
Figure 17. Any emergency department visit
within the past 12 months, by age and type of
coverage: United States, 2000–2010 18
Figure 18. Delay or nonreceipt of needed medical

care or prescription drugs in the past 12 months
due to cost among adults 18–64 years of age, by
type of coverage: United States, 2000–2010 . . . 18
Health Care Resources
Figure 19. Patient care physicians per 10,000
population, by state: United States, 2009 Personal
Health Care Expenditures 19
Personal Health Care Expenditures
Figure 20. Personal health care expenditures,by
source of funds: United States, 1999–2009 19
Figure 21. Personal health care expenditures,by
type of expenditure: United States , 1999–2009. . . 20
Special Feature on Socioeconomic
Status and Health
Children
Figure 22. Children under 18 years of age, by
percent of poverty level and race and Hispanic
origin: United States, 1990–2010 27
Figure 23. Current asthma among children under
18 years of age, by race and Hispanic origin and
percent of poverty level: United States,
2009–2010 28
Figure 24. Attention deficit hyperactivity
disorder among children 5–17 years of age, by
race and Hispanic origin and percent of poverty
level: United States, 2009–2010 29
Figure 25. Obesity among children 2–19 years of
age, by sex of child and education level of head
of household: United States, 1988–1994 and
2007–2010 30

Figure 26. Children 6–11 years of age who engaged
in more than 2 hours of screen time daily, by sex
and percent of poverty level: United States,
average annual, 2003 and 2007 31
xiv Contents Health, United States, 2011
Figure 27. Babies breastfed 3 months or more
among mothers 22–44 years of age, by mother’s
education level: United States, 1992–1994 through
2002–2004 32
Figure 28. Vaccinations among adolescents
13–17 years of age, by type of vaccine and percent
of poverty level: United States, 2009 33
Figure 29. No health insurance coverage among
children under 18 years of age, by percent of poverty
level and race and Hispanic origin: United States,
2000–2010 34
Figure 30. Dental visits in the past year among
children 2–17 years of age, by percent of poverty
level and race and Hispanic origin: United States,
2000–2010 35
Adults
Figure 31. Adults 18 years of age and over, by
percent of poverty level and race and Hispanic
origin: United States, 1990–2010 36
Figure 32. Life expectancy at age 25,bysex
and education level: United States, 1996 and
2006 37
Figure 33. Depression among adults 20 years of
age and over, by age and percent of poverty level:
United States, 2005–2010 38

Figure 34. Edentulism (lack of natural teeth)
among adults 45 years of age and over, by age
and percent of poverty level: United States,
2000–2010 39
Figure 35. Two or more selected chronic health
conditions among adults 45–64 years of age, by
percent of poverty level: United States, 1999–2000
and 2009–2010 40
Figure 36. Basic actions difficulty or complex
activity limitation among adults 18 years of age
and over, by age and percent of poverty level:
United States, 2000–2010 41
Figure 37. Obesity among adults 25 years of age
and over, by sex and education level: United States,
1988–1994 and 2007–2010 42
Figure 38. Current cigarette smoking among
adults 25 years of age and over, by age and
education level: United States, 2000–2010 43
Figure 39. Colorectal tests or procedures among
adults 50–75 years of age, by education level:
United States, 2000–2010 44
Figure 40. No health insurance coverage among
adults 18–64 years of age, by percent of poverty
level and race and Hispanic origin: United States,
2000–2010 45
Figure 41. Delay or nonreceipt of needed medical
care in the past 12 months due to cost among
adults 18–64 years of age, by percent of poverty
level and race and Hispanic origin: United States,
2000–2010 46

Summar y List of Trend Tables by Topic
Tables 1–151
Population (Tables 1 and 2)
Resident population
Persons in poverty
Fertility and Natality (Tables 3–14)
Births
Low birthweight
Breastfeeding
and more . . .
Mortality (Tables 15–42)
Infant mortality
Life expectancy
Death rates, by cause
and more . . .
Determinants and Measures of Health
(Tables 43–76)
Health status
Cigarette smoking
Alcohol consumption
High blood pressure
Overweight and obesity
and more . . .
Ambulatory Care (Tables 77–101)
Visits: health care, dentists, emergency departments
and more . . .
Prevention: mammograms, pap smears, vaccinations
Inpatient Care (Tables 102–108)
Hospital stays and procedures
Nursing homes

and more . . .
Personnel (Tables 109–115)
Physicians
Dentists
Nurses
Health professions school enrollment
and more . . .
Facilities (Tables 116–123)
Hospitals
Nursing homes
and more . . .
National Health Expenditures
(Tables 124–137)
Personal health expenditures
Out-of-pocket costs
Prescription drug expenditures
Nursing home costs
and more . . .
Health Care Coverage and Major Federal
Programs (Tables 138–148)
Insurance coverage:
Medicare
Medicaid
Private coverage
Uninsured
HMOs
and more . . .
State Health Expenditures and Health
Insurance (Tables 149–151)
Medicare, Medicaid, HMO expenditures and enrollees

Uninsured persons
Health, United States, 2011 Contents xv
List of Trend Tables
Health Status and Determinants
Population
Table 1. Resident population, by age, sex, race,
and Hispanic origin: United States, selected
years 1950–2009 71
Table 2. Persons below poverty level, by
selected characteristics, race, and Hispanic origin:
United States, selected years 1973–2009 74
Fertility and Natality
Table 3. Crude birth rates, fertility rates, and birth
rates, by age, race, and Hispanic origin of mother:
United States, selected years 1950–2008 76
Table 4. Live births, by plurality and detailed
race and Hispanic origin of mother: United States,
selected years 1970–2008 79
Table 5. Prenatal care for live births, by detailed
race and Hispanic origin of mother: United States,
selected reporting areas 2007 and 2008 80
Table 6. Teenage childbearing, by age and
detailed race and Hispanic origin of mother:
United States, selected years 1970–2008 81
Table 7. Nonmarital childbearing, by detailed
race and Hispanic origin of mother, and maternal
age: United States , selected years 1970–2008 83
Table 8. Mothers who smoked cigarettes during
pregnancy, by selected characteristics: United States,
selected reporting areas 2007 and 2008 84

Table 9. Low birthweight live births, by detailed
race, Hispanic origin, and smoking status of mother:
United States, selected years 1970–2008 85
Table 10. Low birthweight live births among
mothers 20 years of age and over, by detailed
race, Hispanic origin, and education of mother:
United States, selected reporting areas 2007
and 2008 86
Table 11. Low birthweight live births, by race and
Hispanic origin of mother, and state: United States,
2000–2002, 2003–2005, and 2006–2008 88
Table 12. Legal abortions and legal abortion
ratios, by selected patient characteristics:
United States, selected years 1973–2007 90
Table 13. Contraceptive use in the past month
among women 15–44 years of age, by age, race
and Hispanic origin, and method of contraception:
United States, selected years 1982–2008 92
Table 14. Breastfeeding among mothers 15–44
years of age, by year of baby's birth and selected
characteristics of mother: United States, average
annual 1986–1988 through 2002–2004 97
Mortality
Table 15. Infant, neonatal, and postneonatal
mortality rates, by detailed race and Hispanic
origin of mother: United States, selected years
1983–2007 98
Table 16. Infant mortality rates, by birthweight:
United States, selected years 1983–2007 99
Table 17. Infant mortality rates, fetal mortality

rates, and perinatal mortality rates, by race:
United States, selected years 1950–2008 100
Table 18. Infant mortality rates,byraceand
Hispanic origin of mother, and state: United States,
average annual 1989–1991, 2002–2004, and
2005–2007 101
Table 19. Neonatal mortality rates,byraceand
Hispanic origin of mother, and state: United States,
average annual 1989–1991, 2002–2004, and
2005–2007 103
Table 20. Infant mortality rates and international
rankings: Organisation for Economic Co-operation
and Development (OECD) countries, selected
years 1960–2008 105
Table 21. Life expectancy at birth and at 65 years
of age, by sex: Organisation for Economic Co-
operation and Development (OECD) countries,
selected years 1980–2009 106
Table 22. Life expectancy at birth, at 65 years
of age, and at 75 years of age, by sex, race, and
Hispanic origin: United States, selected years
1900–2009 108
Table 23. Age-adjusted death rates,byrace,
Hispanic origin, and state: United States,
average annual 1979–1981, 1989–1991, and
2006–2008 110
Table 24. Age-adjusted death rates for selected
causes of death, by sex, race, and Hispanic origin:
United States, selected years 1950–2008 112
Table 25. Years of potential life lost before age

75 for selected causes of death, by sex, race, and
Hispanic origin: United States, selected years
1980–2008 116
Table 26. Leading causes of death and numbers
of deaths, by sex, race, and Hispanic origin:
United States, 1980 and 2008 120
Table 27. Leading causes of death and numbers
of deaths, by age: United States, 1980 and
2008 124
Table 28. Age-adjusted death rates,byrace,
sex, region, and urbanization level: United States,
average annual, selected years 1996–1998
through 2006–2008 126
Table 29. Death rates for all causes, by sex, race,
Hispanic origin, and age: United States, selected
years 1950–2008 129
xvi Contents Health, United States, 2011
Table 30. Death rates for diseases of heart, by sex,
race, Hispanic origin, and age: United States,
selected years 1950–2008 133
Table 31. Death rates for cerebrovascular diseases,
by sex, race, Hispanic origin, and age: United States,
selected years 1950–2008 136
Table 32. Death rates for malignant neoplasms,by
sex, race, Hispanic origin, and age: United States,
selected years 1950–2008 139
Table 33. Death rates for malignant neoplasms
of trachea, bronchus, and lung, by sex, race,
Hispanic origin, and age: United States, selected
years 1950–2008 143

Table 34. Death rates for malignant neoplasm of
breast among females, by race, Hispanic origin,
and age: United States, selected years
1950–2008 146
Table 35. Death rates for human immunodeficiency
virus (HIV) disease, b y sex, race , Hispanic origin, and
age: United States , select ed years 1987–2008 148
Table 36. Death rates for drug poisoning and
drug poisoning involving opioid analgesics,by
sex, age, race, and Hispanic origin: United States,
selected years 1999–2008 150
Table 37. Death rates for motor vehicle-related
injuries, by sex, race, Hispanic origin, and age:
United States, selected years 1950–2008 153
Table 38. Death rates for homicide, by sex, race,
Hispanic origin, and age: United States, selected
years 1950–2008 157
Table 39. Death rates for suicide, by sex, race,
Hispanic origin, and age: United States, selected
years 1950–2008 161
Table 40. Death rates for firearm-related injuries,
by sex, race, Hispanic origin, and age: United States,
selected years 1970–2008 164
Table 41. Deaths from selected occupational
diseases among persons 15 years of age and over:
United States, selected years 1980–2008 167
Table 42. Occupational fatal injuries and rates,
by industry, sex, age, race, and Hispanic origin:
United States, selected years 1995–2009 168
Determinants and Measures of Health

Table 43. Nonfatal occupational injuries and
illnesses with days away from work , job transfer,
or restriction, by industry: United States, selected
years 2003–2009 170
Table 44. Selected notifiable disease rates and
number of new cases: United States, selected
years 1950–2009 171
Table 45. Acquired immunodeficiency syndrome
(AIDS) diagnoses, by year of diagnosis and selected
characteristics: United States, 2006–2009 173
Table 46. Health conditions among children
under 18 years of age, by selected characteristics:
United States, average annual, selected years
1997–1999 through 2008–2010 176
Table 47. Age-adjusted cancer incidence rates for
selected cancer sites, by sex, race, and Hispanic
origin: United States, selected geographic areas,
selected years 1990–2008 181
Table 48. Five-year relative cancer survival rates
for selected cancer sites, by race and sex:
United States, selected geographic areas, selected
years 1975–1977 through 2001–2007 184
Table 49. Respondent-reported prevalence of
heart disease, cancer, and stroke among adults
18 years of age and over, by selected characteristics:
United States, average annual, selected years
1997–1998 through 2009–2010 185
Table 50. Diabetes prevalence and glycemic
control among adults 20 years of age and over,
by sex, age, and race and Hispanic origin:

United States, selected years 1988–1994 through
2003–2006 188
Table 51. End-stage renal disease patients,by
selected characteristics: United States, selected
years 1980–2008 190
Table 52. Severe headache or migraine,
low back pain, and neck pain among adults
18 years of age and over, by selected characteristics:
United States, selected years 1997–2010 192
Table 53. Joint pain among adults 18 years of age
and over, by selected characteristics: United States,
selected years 2002–2010 195
Table 54. Basic actions difficulty and complex
activity limitation among adults 18 years of age
and over, by selected characteristics: United States,
selected years 1997–2010 200
Table 55. Vision and hearing limitations among
adults 18 years of age and over, by selected
characteristics: United States, selected years
1997–2010 202
Table 56. Respondent-assessed health status,
by selected characteristics: United States,
selected years 1991–2010 205
Table 57. Selected measures of disability and
health status among adults 18–64 years of age,
by urbanization level and selected characteristics:
United States, average annual, 2002–2004 through
2008–2010 207
Table 58. Selected measures of disability and
health status among adults 65 years of age and

over, by urbanization level and selected
characteristics: United States, average annual,
2002–2004 through 2008–2010 212
Health, United States, 2011 Contents xvii
Table 59. Serious psychological distress in the
past 30 days among adults 18 years of age and
over, by selected characteristics: United States,
average annual, selected years 1997–1998
through 2009–2010 217
Table 60. Current cigarette smoking among adults
18 years of age and over, by sex, race, and age:
United States, selected years 1965–2010 219
Table 61. Age-adjusted prevalence of current
cigarette smoking among adults 25 years of age
and over, by sex, race, and education level:
United States, selected years 1974–2010 221
Table 62. Current cigarette smoking among adults,
by sex, race, Hispanic origin, age, and education
level: United States, average annual, selected years
1990–1992 through 2008–2010 222
Table 63. Current cigarette smoking among adults
18–64 years of age, by urbanization level and
selected characteristics: United States, average
annual, 2002–2004 through 2008–2010 225
Table 64. Use of selected substances in the past
month among persons 12 years of age and over, by
age, sex, race, and Hispanic origin: United States,
selected years 2002–2009 230
Table 65. Use of selected substances among
high school seniors, 10th graders, and 8th graders,

by sex and race: United States, selected years
1980–2010 232
Table 66. Health-related behaviors of children
6–11 years of age, by selected characteristics:
United States, 2003 and 2007 235
Table 67. Health risk behaviors among students
in grades 9–12, by sex, grade level, race, and
Hispanic origin: United States, selected years
1991–2009 237
Table 68. Heavier drinking and drinking five or
more drinks in a day among adults 18 years of age
and over, by selected characteristics: United States,
selected years 1997–2010 239
Table 69. Selected health conditions and risk
factors: United States, selected years 1988–1994
through 2009–2010 242
Table 70. Hypertension among persons 20 years
of age and over, by selected characteristics:
United States, selected years 1988–1994
through 2007–2010 244
Table 71. Cholesterol among persons 20 years
of age and over, by selected characteristics:
United States, selected years 1988–1994 through
2007–2010 246
Table 72. Mean energy and macronutrient intake
among persons 20 years of age and over, by sex and
age: United States, selected years 1971–1974
through 2005–2008 250
Table 73. Participation in leisure-time aerobic and
muscle-strengthening activities that meet the

2008 federal Physical Activity Guidelines for adults
18 years of age and over, by selected characteristics:
United States, selected years 1998–2010 252
Table 74. Healthy weight, overweight, and
obesity among persons 20 years of age and over,
by selected characteristics: United States, selected
years 1960–1962 through 2007–2010 257
Table 75. Obesity among children and
adolescents 2–19 years of age, by selected
characteristics: United States, selected years
1963–1965 through 2007–2010 264
Table 76. Untreated dental caries, by selected
characteristics: United States, selected years
1971–1974 through 2005–2008 266
Utilization of Health Resources
Ambulatory Care
Table 77. No usual source of health care
among children under 18 years of age, by
selected characteristics: United States, average
annual, selected years 1993–1994 through
2009–2010 268
Table 78. No usual source of health care among
adults 18–64 years of age, by selected characteristics:
United States, average annual, selected years
1993–1994 through 2009–2010 270
Table 79. Reduced access to medical care, dental
care, and prescription drugs during the past
12 months due to cost, by selected characteristics:
United States, selected years 1997–2010 272
Table 80. Selected measures of access to medical

care among adults 18–64 years of age, by
urbanization level and selected characteristics:
United States, average annual, 2002–2004
through 2008–2010 275
Table 81. Reduced access to medical care during
the past 12 months due to cost, by state: 25 largest
states and United States, average annual, selected
years 1997–1998 through 2009–2010 278
Table 82. No health care visits to an office or
clinic within the past 12 months among children
under 18 years of age, by selected characteristics:
United States, average annual, selected years
1997–1998 through 2009–2010 279
Table 83. Health care visits to doctor offices,
emergency departments, and home visits within
the past 12 months, by selected characteristics:
United States, selected years 1997–2010 281
Table 84. Influenza vaccination among adults
65 years of age and over: Selected Organisation for
Economic Co-operation and Development (OECD)
countries, 1998–2009 284
xviii Contents Health, United States, 2011
Table 85. Vaccination coverage among children
19–35 months of age for selected diseases, by race,
Hispanic origin, poverty level, and location of
residence in metropolitan statistical area:
United States, selected years 1995–2009 285
Table 86. Vaccination coverage among children
19–35 months of age, by state and selected urban
area: United Stat es, selected y ears 2002–2009 . . . 288

Table 87. Vaccination coverage among adolescents
13–17 years of age for selected diseases, by selected
characteristics: United States, 2006–2009 290
Table 88. Influenza vaccination among adults 18
years of age and over, by selected characteristics:
United States, selected years 1989–2010 291
Table 89. Pneumococcal vaccination among adults
18 years of age and over, by selected characteristics:
United States, selected years 1989–2010 293
Table 90. Use of mammography among women
40 years of age and over, by selected characteristics:
United States, selected years 1987–2010 295
Table 91. Use of Pap smears among women 18 years
of age and over, by selected characteristics:
United States, selected years 1987–2010 298
Table 92. Use of colorectal tests or procedures
among adults 50–75 years of age, by selected
characteristics: United States, selected years
2000–2010 303
Table 93. Emergency department visits within
the past 12 months among children under 18 years
of age, by selected characteristics: United States,
selected years 1997–2010 305
Table 94. Emergency department visits within
the past 12 months among adults 18 years of age
and over, by selected characteristics: United States,
selected years 1997–2010 309
Table 95. Initial injury-related visits to hospital
emergency departments, by sex, age, and intent and
mechanism of injury: United States, average annual,

selected years 2005–2006 and 2008–2009 312
Table 96. Visits to physician offices, hospital
outpatient departments, and hospital emergency
departments, by age, sex, and race: United States,
selected years 1995–2009 314
Table 97. Visits to primary care generalist and
specialist physicians, by selected characteristics
and type of physician: United States, selected
years 1980–2009 317
Table 98. Dental visits in the past year, by selected
characteristics: United States, selected years
1997–2010 319
Table 99. Prescription drug use in the past 30 days,
by sex, age, race and Hispanic origin: United States,
selected years 1988–1994 through 2005–2008. . . 321
Table 100. Selected prescription drug classes used
in the past 30 days, by sex and age: United States,
selected years 1988–1994 through 2005–2008. . . 323
Table 101. Dietary supplement use among persons
20 years of age and over, by selected characteristics:
United States, selected years 1988–1994 through
2005–2008 326
Inpatient Care
Table 102. Persons with hospital stays in the past
year, by selected characteristics: United States,
selected years 1997–2010 328
Table 103. Discharges, days of care, and average
length of stay in nonfederal short-stay hospitals,
by selected characteristics: United States, selected
years 1980 through 2008–2009 332

Table 104. Discharges in nonfederal short-stay
hospitals, by sex, age, and selected first-listed
diagnosis: United States, selected years 1990
through 2008–2009 335
Table 105. Discharge rate in nonfederal short-stay
hospitals, by sex, age, and selected first-listed
diagnosis: United States, selected years 1990
through 2008–2009 338
Table 106. Average length of stay in nonfederal
short-stay hospitals, by sex, age, and selected
first-listed diagnosis: United States, selected years
1990 through 2008–2009 341
Table 107. Discharges with at least one procedure
in nonfederal short-stay hospitals, by sex, age, and
selected procedures: United States, selected years
1990 through 2008–2009 344
Table 108. Hospital admissions, average length of
stay, outpatient visits, and outpatient surgery, by
type of ownership and size of hospital: United States,
selected years 1975–2009 348
Health Care Resources
Personnel
Table 109. Active physicians and physicians in
patient care, by state: United States, selected
years 1975–2009 349
Table 110. Doctors of medicine, by place of medical
education and activity: United States and outlying
U.S. areas, selected years 1975–2009 350
Table 111. Doctors of medicine in primary care,
by specialty : United States and outlying U.S. areas,

selected years 1949–2009 351
Table 112. Active dentists, by state: United States,
selected years 1993–2008 352
Table 113. Health care employment and wages,
by selected occupations: United States, selected
years 2001–2010 353
Health, United States, 2011 Contents xix
Table 114. First-year enrollment and graduates
of health professions schools, and number of
schools, by selected profession: United States,
selected academic years 1980–1981 through
2008–2009 354
Table 115. Total enrollment in schools for selected
health occupations, by race and Hispanic origin:
United States, selected academic years 1980–1981
through 2008–2009 355
Facilities
Table 116. Hospitals, beds, and occupancy rates, by
type of ownership and size of hospital: United States,
selected years 1975–2009 357
Table 117. Mental health organizations and beds
for 24-hour hospital and residential treatment, by
type of organization: United States, selected years
1986–2008 358
Table 118. Community hospital beds and average
annual percent change, by state: United States,
selected years 1960–2009 359
Table 119. Occupancy rates in community hospitals
and average annual percent change, by state:
United States, selected years 1960–2009 360

Table 120. Nursing homes, beds, residents, and
occupancy rates, by state: United States, selected
years 1995–2010 361
Table 121. Certified intermediate care facilities
and specialty hospitals, number of facilities and
beds, by state: United States, selected years
1995–2010 363
Table 122. Medicare-certified providers and
suppliers: United States, selected years
1975–2009 365
Table 123. Number of magnetic resonance imaging
(MRI) units and computed tomography (CT)
scanners: Selected countries, selected years
1990–2009 366
Health Care Expenditures and Payers
National Health Expenditures
Table 124. Total health expenditures as a
percentage of gross domestic product and per
capita health expenditures in dollars, by selected
countries: Selected years 1960–2009 368
Table 125. Gross domestic product, national
health expenditures, per capita amounts, percent
distribution, and average annual percent change:
United States, selected years 1960–2009 370
Table 126. Consumer Price Index and average
annual percent change for all items, selected items,
and medical care components: United States,
selected years 1960–2010 371
Table 127. Growth in personal health care
expenditures and percent distribution of factors

affecting growth: United States, 1960–2009 . . . 373
Table 128. National health expenditures, average
annual percent change, and percent distribution,
by type of expenditure: United States, selected
years 1960–2009 374
Table 129. Personal health care expenditures,
by source of funds and type of expenditure:
United States, selected years 1960–2009 376
Table 130. National health expenditures for
mental health services, average annual percent
change and percent distribution, by type of
expenditure: United States, selected years
1986–2005 379
Table 131. National health expenditures for
substance abuse treatment, average annual
percent change and percent distribution, by type
of expenditure: United States, selected years
1986–2005 380
Table 132. Cost of hospital discharges with
common hospital operating room procedures
in nonfederal community hospitals, by age and
selected principal procedure: United States,
selected years 2000–2009 381
Table 133. Expenses for health care and
prescribed medicine, by selected population
characteristics: United States, selected years
1987–2008 384
Table 134. Sources of payment for health care,by
selected population characteristics: United States,
selected years 1987–2008 387

Table 135. Out-of-pocket health care expenses
among persons with medical expenses, by age:
United States, selected years 1987–2008 390
Table 136. Expenditures for health services and
supplies and percent distribution, by sponsor:
United States, selected years 1987–2009 391
Table 137. Employers’ costs per employee-hour
worked for total compensation, wages and salaries,
and health insurance, by selected characteristics:
United States, selected years 1991–2011 393
Health Care Coverage and Major Federal
Programs
Table 138. Private health insurance coverage
among persons under 65 years of age, by selected
characteristics: United States, selected years
1984–2010 395
Table 139. Private health insurance coverage
obtained through the workplace among persons
under 65 years of age, by selected characteristics:
United States, selected years 1984–2010 398
Table 140. Medicaid coverage among persons
under 65 years of age, by selected characteristics:
United States, selected years 1984–2010 401
Contents Health, United States, 2011 xx
Table 141. No health insurance coverage among
persons under 65 years of age, by selected
characteristics: United States, selected years
1984–2010 404
Table 142. Health insurance coverage of
Medicare beneficiaries 65 years of age and over, by

type of coverage and selected characteristics:
United States, selected years 1992–2008 407
Table 143. Medicare enrollees and expenditures
and percent distribution, by Medicare program
and type of service: United States and other areas,
selected years 1970–2010 409
Table 144. Medicare enrollees and program
payments among fee-for-service Medicare
beneficiaries, by sex and age: United States and
other areas, selected years 1994–2009 411
Table 145. Medicare beneficiaries, by race,
Hispanic origin, and selected characteristics:
United States, selected years 1992–2007 412
Table 146. Medicaid beneficiaries and payments,
by basis of eligibility, and race and Hispanic
origin: United States, selected fiscal years
1999–2009 414
Table 147. Medicaid beneficiaries and payments,
by type of ser vice: United States, selected fiscal
years 1999–2009 416
Table 148. Department of Veterans Affairs
health care expenditures and use, and persons
treated, by selected characteristics: United States,
selected fiscal years 1970–2010 417
State Health Expenditures and Health
Insurance
Table 149. Medicare enrollees, enrollees in
managed care, payment per enrollee, and short-
stay hospital utilization, by state: United States,
selected years 1994–2009 419

Table 150. Medicaid beneficiaries, beneficiaries
in managed care, payments per beneficiary,
and beneficiaries per 100 persons below the
poverty level, by state: United States, selected
fiscal years 1999–2009 421
Table 151. Persons without health insurance
coverage, by state: United States, average
annual, selected years 1995–1997 through
2007–2009 422
At a Glance Table and Highlights




     
Health, United States, 2011: At a Glance
Health, United States, 2011
Value (year) Figure/Table no.
Life Expectancy and Mortality
Life Expectancy in years Figure 1/Table 22
At birth 76.8 (2000) 77.9 (2007) 78.5 (2009)
At 65 years 17.6 (2000) 18.6 (2007) 19.2 (2009)
Infant deaths per 1,000 live births Figure 2/Table 17
All infants 6.91 (2000) 6.75 (2007) 6.61 (2008)
Deaths per 100,000 population, age-adjusted Table 24
All causes 869.0 (2000) 760.2 (2007) 758.3 (2008)
Heart disease 257.6 (2000) 190.9 (2007) 186.5 (2008)
Cancer 199.6 (2000) 178.4 (2007) 175.3 (2008)
Stroke 60.9 (2000) 42.2 (2007) 40.7 (2008)
Chronic lower respiratory diseases 44.2 (2000) 40.8 (2007) 44.0 (2008)

Unintentional injuries 34.9 (2000) 40.0 (2007) 38.8 (2008)
Motor-vehicle 15.4 (2000) 14.4 (2007) 12.9 (2008)
Diabetes 25.0 (2000) 22.5 (2007) 21.8 (2008)
Morbidity and Risk Factors
Fair or poor health, percent Table 56
All ages 8.9 (2000) 9.9 (2009) 10.1 (2010)
65 years and over 26.9 (2000) 24.0 (2009) 24.4 (2010)
Heart disease, percent Table 49
18 years and over 10.9 (1999–2000) 11.6 (2007–2008) 11.8 (2009–2010)
65 years and over 29.6 (1999–2000) 31.8 (2007–2008) 30.4 (2009–2010)
Cancer (ever had), percent Table 49
18 years and over 4.9 (1999–2000) 5.8 (2007–2008) 6.3 (2009–2010)
65 years and over 15.2 (1999–2000) 17.0 (2007–2008) 18.1 (2009–2010)
Hypertension,
1
percent Table 69
20 years and over 28.9 (1999–2000) 32.6 (2007–2008) 31.9 (2009–2010)
High serum total cholesterol,
2
percent Table 69
20 years and over 17.7 (1999–2000) 14.6 (2007–2008) 13.6 (2009–2010)
Obese, percent Figures 10 and 11/Table 69
Obese,
3
20 years and over 30.3 (1999–2000) 33.9 (2007–2008) 35.9 (2009–2010)
Obese (BMI at or above sex- and
age-specic 95th percentile):
2–5 years 10.3 (1999–2000) 10.1 (2007–2008) 12.1 (2009–2010)
6–11 years 15.1 (1999–2000) 19.6 (2007–2008) 18.0 (2009–2010)
12–19 years 14.8 (1999–2000) 18.1 (2007–2008) 18.4 (2009–2010)

Cigarette smoking, percent Figure 8/Table 60
18 years and over 23.2 (2000) 20.6 (2009) 19.3 (2010)
Aerobic activity and muscle strengthening,
4
percent Table 73
18 years and over 15.1 (2000) 18.8 (2009) 20.4 (2010)
Health Care Utilization
No health care visit in past 12 months, percent Table 83
Under 18 years 12.3 (2000) 9.1 (2009) 8.1 (2010)
18–44 years 23.4 (2000) 22.6 (2009) 24.2 (2010)
45–64 years 14.9 (2000) 15.3 (2009) 14.8 (2010)
65 years and over 7.4 (2000) 4.7 (2009) 5.3 (2010)
2 At a Glance Health, United States, 2011
Health, United States, 2011 At a Glance 3



Health, United States, 2011: At a Glance
Health, United States, 2011
Value (year) Figure/Table no.
Emergency room visit in past 12 months, percent Tables 93 and 94
Under 18 years 20.3 (2000) 20.8 (2009) 22.1 (2010)
18–44 years 20.5 (2000) 22.0 (2009) 22.0 (2010)
45–64 years 17.6 (2000) 18.4 (2009) 19.2 (2010)
65 years and over 23.7 (2000) 24.9 (2009) 23.7 (2010)
Dental visit in past year, percent Table 98
2–17 years 74.1 (2000) 78.4 (2009) 78.9 (2010)
18–64 years 65.1 (2000) 62.0 (2009) 61.1 (2010)
65 years and over 56.6 (2000) 59.6 (2009) 57.7 (2010)
Prescription drug in past 30 days, percent Table 99

Under 18 years 23.9 (2001–2004) 25.3 (2005–2008)
18–44 years 37.7 (2001–2004) 37.8 (2005–2008)
45–64 years 66.2 (2001–2004) 64.8 (2005–2008)
65 years and over 87.3 (2001–2004) 90.1 (2005–2008)
Hospitalization in past year, percent Table 102
18–44 years 7.0 (2000) 6.7 (2009) 6.3 (2010)
45–64 years 8.4 (2000) 8.5 (2009) 8.3 (2010)
65 years and over 18.2 (2000) 17.1 (2009) 16.1 (2010)
Health Insurance and Access to Care
Uninsured, percent Figures 14 and 15/Table 141
Under 65 years 17.0 (2000) 17.5 (2009) 18.2 (2010)
Under 18 years 12.6 (2000) 8.2 (2009) 7.8 (2010)
18–44 years 22.4 (2000) 25.9 (2009) 27.1 (2010)
45–64 years 12.6 (2000) 14.6 (2009) 15.7 (2010)
Delayed or did not receive needed medical care in past 12 months due to cost, percent Figure 18/Table 79
Under 18 years 4.6 (2000) 5.2 (2009) 4.4 (2010)
18–44 years 9.5 (2000) 15.1 (2009) 14.5 (2010)
45–64 years 8.8 (2000) 15.1 (2009) 14.9 (2010)
65 years and over 4.5 (2000) 5.1 (2009) 5.0 (2010)
Health Care Resources
Patient care physicians per 10,000 population
Figure 19/Table 109
United States 22.7 (2000) 25.7 (2008) 25.4 (2009)
Highest state 34.4 (MA) (2000) 39.7 (MA) (2008) 39.6 (MA) (2009)
Lowest state 14.4 ( I D) (2000) 17.0 ( I D) (2008) 17.3 (MS) (2009)
Community hospital beds per 1,000 population Table 118
United States 2.9 (2000) 2.6 (2009)
Highest state 6.0 (ND) (2000) 5.2 (ND) (2009)
Lowest state 1.9 (NM,NV,OR,UT, 1.7 (OR,WA) (2009)
WA) (2000)

Expenditures
Personal health care expenditures, dollars Figure 21/Table 129
Total in trillions $1.2 (2000) $2.0 (2008) $2.1 (2009)
Per capita $4,122 (2000) $6,552 (2008) $6,797 (2009)
––– Data not available.
1
Having measured high blood pressure (systolic pressure of at least 140 mm Hg or diastolic pressure of at least 90 mm Hg) and/or taking antihypertensive
medication.
2
Having high serum total cholesterol of 240 mg/dl or greater.
3
Obesity is a body mass index (BMI) greater than or equal to 30. Height and weight are measured.
4
Meeting 2008 federal guidelines for aerobic activity and muscle strengthening.
NOTES: Some estimates are from the Excel spreadsheet version of the cited table and are not shown in the PDF version or in the printed version. For more information, data sources,
notes, and the Excel version of the spreadsheet, see the complete report, Health, United States, 2011, available from:
Highlights Health, United States, 2011 4
Highlights
Special Feature on Socioeconomic
Status and Health
Children
In 2007–2010, obesity among boys and girls 2–19
years of age decreased with increasing education of
the head of household. In households where the
head had less than a high school education, 24% of
boys and 22% of girls were obese, compared with
households where the head had a Bachelor’s degree
or higher education in which 11% of boys and 7% of
girls were obese (Figure 25).
On average in 2003 and 2007, children 6–11 years of

age living below 400% of the poverty level were
more likely to have more than 2 hours of screen time
on an average weekday (watching TV or videos,
playing video games, or using a computer
recreationally) (38%–43%) than children living at
400% or more of the poverty level (31%) (Figure 26).
In 2002–2004, babies of mothers who had less than
a Bachelor’s degree were less likely to be breastfed
foratleast3months (43%–46%) than babies of
mothers who had a Bachelor ’s degree or higher
education (75%) (Figure 27).
Between 2000 and 2010, the percentage of children
with a family income below 200% of the poverty
level who were uninsured decreased from 22% to
11%–13%, while the percentage with a family
income at 200%–399% of poverty who were
uninsured decreased from 9% to 7%, and children
with a family income at 400% or more of the poverty
level who were uninsured decreased from 3% to 2%
(Figure 29).
In 2009–2010, children 5–17 years of age living below
200% of the pover ty level were more likely to have
been told by a doctor or other health professional
that they had attention deficit hyperactivity
disorder (11%–13%) than children living at 200% or
more of the poverty level (8%) (Figure 24).
In 2010, the percentage of children 2–17 years of age
who had a dental visit within the past year rose with
relative family income, from 73% of those living
below 200% of the poverty level to 88% of those at

400% or more of the poverty level (Figure 30).
Adults
Between 1996 and 2006, the gap in life expectancy
at age 25 between those with less than a high school
education and those with a Bachelor’s degree or
higher education increased by 1.9 years for men and
2.8 years for women. On average in 2006, 25-year-old
men without a high school diploma had a life
expectancy 9.3 years less than those with a
Bachelor’s degree or higher; women without a high
school diploma had a life expectancy 8.6 years less
than those with a Bachelor ’s degree or higher
(Figure 32).
In 2005–2010, the prevalence of depression among
adults 45–64 years of age was 5 times as high for
those below poverty (24%), 3 times as high for those
with family income between 100%–199% of poverty
(15%), and more than 1.5 times as high for those with
family income between 200%–399% (7%), compared
with those at 400% or more of the poverty level
(5%) (Figure 33).
In 2010, the percentage of noninstitutionalized
adults 18–64 years of age with a disability (defined
as a basic actions difficulty or complex activity
limitation) was inversely associated with relative
family income and was twice as high among those
living below the poverty level (40%) compared with
those with family income at 400% or more of poverty
(20%) (Figure 36).
In 2010, edentulism (lack of natural teeth) was five

times as high for adults 45–64 years of age with a
family income below 200% of the poverty level
(15%) and nearly three times as high for those with
family income between 200%–399% of poverty (8%),
compared with those at 400% or more of the poverty
level (3%) (Figure 34).
In 2007–2010, women 25 years of age and over with
less than a Bachelor ’s degree were more likely to be
obese (39%–43%) than those with a Bachelor’s
degree or higher education (25%); obesity among
men did not vary consistently by educational
attainment (Figure 37).
In 2010, 31% of adults 25–64 years of age with a high
school diploma or less education were current
smokers, compared with 24% of adults with some
college and 9% of adults with a Bachelor’s degree or
higher (Figure 38).