Question

Summarize the status of the 26 indicators as of 2014

Answer 1

Please find the status of 26 Leading Indicators as of 2014:

The Leading Health Indicators (LHIs) are composed of 26 indicators organized under 12 topics. The Healthy People 2020 LHIs are:

1. Access to Health Services.

• Persons with medical insurance (AHS-1.1).
• Persons with a usual primary care provider (AHS-3).

Status:

Access to Health Services

Persons with Health Insurance by Educational Attainment, 2018

For persons aged 25–64 years, the health insurance rate for those with an advanced degree was 43.6% higher than the rate for those without a high school education.
Advanced degree: 96.2%
Less than high school: 67.0%

Data source: National Health Interview Survey (NHIS),

Persons with a Usual Primary Care Provider by Health Insurance Status, 2016

For persons aged less than 65 years, the rate of having a usual primary care provider for those with public insurance was 81.1% higher than the rate for uninsured persons.
Public insurance only: 79.5%
Private insurance: 76.2%
Uninsured: 43.9%

Data source: Medical Expenditure Panel Survey (MEPS), AHRQ.

Persons with Health Insurance

In 2018, 89.0% of persons aged less than 65 years had health insurance.
Healthy People 2020 Target: 100%
12.4% increase needed

Data source: National Health Interview Survey (NHIS), CDC/NCHS.

Persons with a Usual Primary Care Provider

In 2016, 76.4% of people had a usual primary care provider.
Healthy People 2020 Target: 83.9%
9.8% increase needed

Data source: Medical Expenditure Panel Survey (MEPS), AHRQ.

2. Clinical Preventive Services;

• Adults receiving colorectal cancer screening based on the most recent guidelines (C-16).
• Adults with hypertension whose blood pressure is under control (HDS-12).
• Persons with diagnosed diabetes whose A1c value is greater than 9% (D-5.1).
• Children receiving the recommended doses of DTaP, polio, MMR, Hib, HepB, varicella and PCV vaccines by age 19–35 months (IID-8).

Status:

Disparities graphic title: Persons Receiving a Recommended Colorectal Cancer Screening by Insurance Status, 2018

Caption: Among persons aged 50–64 years, the rate for those with private health insurance was more than twice the rate for the uninsured population.

• Private health insurance: 64.3%
• Public health insurance: 61.6%
• Uninsured: 29.7%

Data source: National Health Interview Survey (NHIS), CDC/NCHS.

HEALTHY PEOPLE 2020 TARGETS

Colorectal Cancer Screening

• HP2020 Target: 70.5%
• In 2015, 65.2% of adults aged 50–75 years had received a colorectal cancer screening based on the most recent guidelines (age adjusted).
• 8.1% increase needed.
• Data source: National Health Interview Survey (NHIS), CDC/NCHS.

Blood Pressure Control

• HP2020 Target: 61.2%
• In 2013–16, 47.8% of adults aged 18 years and over with hypertension had it under control (age adjusted).
• 28.0% increase needed.
• Data source: National Health and Nutrition Examination Survey (NHANES), CDC/NCHS.

3. Environmental Quality;

• Air Quality Index >100 (EH-1).
• Children exposed to secondhand smoke (TU-11.1).

STATUS:

Environmental Quality

Title: Exposure to Secondhand Smoke for Children Aged 3–11 Years by Family Income, 2013–2016

Caption: The rate of secondhand smoke exposure for children living in families with incomes below the poverty threshold was more than 4.5 times the rate for children in families with incomes at 500% or more of the poverty threshold.  

Data:  

• <100: 55.1%
• 100–199: 45.2%
• 200–399: 30.9%
• 400–499: 22.4%
• 500+: 11.5%
• X (horizontal)-Axis title: Family Income (Percent Poverty Threshold)
• Y (vertical)-Axis title: Percent  

Data source: National Health and Nutrition Examination Survey (NHANES), CDC/NCHS.

HEALTHY PEOPLE 2020 TARGETS

Title: Air Quality Index (AQI) Exceeding 100 

In 2016–2018, the AQI exceeded 100 for 4.296 billion AQI-weighted people days.

HP2020 Target: 6.843 billion

This objective has exceeded the target.

Data source: Air Quality System (AQS), EPA.

Title: Children Aged 3–11 Years Exposed to Secondhand Smoke 

In 2013–2016, 38.1% of children aged 3–11 years were exposed to secondhand smoke.

HP2020 Target: 47.0%

This objective has exceeded the target.

Data source: National Health and Nutrition Examination Survey (NHANES), CDC/NCHS.

4. Injury and Violence:

• Injury deaths (IVP-1.1).
• Homicides (IVP-29).

Status:

10 Leading Causes of Death, Ages 1–34, 2017

Unintentional injuries, suicide, and homicide are the 3 leading causes of death for Americans aged 1–34, and together comprise 66.6% of all deaths in this age group.

Unintentional injury: 41,955 (41.3% of total deaths)

Suicide: 14,722 (14.5% of total deaths)

Homicide: 11,0281 (10.8% of total deaths)

Cancer: 6,170 (6.1% of total deaths)

Heart disease: 4,900 (4.8% of total deaths)

Congenital anomalies: 1,595 (1.6% of total deaths)

Diabetes: 1,111 (1.1% of total deaths)

Liver disease: 944 (0.9% of total deaths)

Stroke: 911 (0.9% of total deaths)

Influenza and pneumonia: 812 (0.8% of total deaths)

Data source: National Vital Statistics System–Mortality (NVSS–M), CDC/NCHS.

5. Maternal, Infant, and Child Health:

• All Infant deaths (MICH-1.3).
• Total preterm live births (MICH-9.1).

STATUS:

Maternal, Infant, and Child Health

Infant Mortality Rate by Race and Ethnicity of Mother, 2017

The infant mortality rate experienced by infants born to non-Hispanic black mothers was more than 2.5 times the rate experienced by infants born to Asian or Pacific Islander mothers (10.9 versus 4.2 deaths under 1 year of age per 1,000 live births, respectively).

Black, not Hispanic: 10.9 infant deaths per 1,000 live births
American Indian or Alaska Native: 8.3 infant deaths per 1,000 live births
Hispanic: 5.1 infant deaths per 1,000 live births
White, not Hispanic: 4.7 infant deaths per 1,000 live births
Asian or Pacific Islander: 4.2 infant deaths per 1,000 live births

Data source: Linked Birth/Infant Death Data Set, CDC/NCHS.

6. Mental Health:

• Suicide (MHMD-1).
• Adolescents with a major depressive episode in the past 12 months (MHMD-4.1).

Status:

Suicide Rate by Sex, 2017

In 2017, females had a lower suicide rate than males. The rate for males was more than 3.5 times the rate for females.

Males: 22.4 per 100,000 population (age adjusted)
Females: 6.1 per 100,000 population (age adjusted)

Data source: National Vital Statistics System–Mortality (NVSS–M), CDC/NCHS; Bridged-race Population Estimates, CDC/NCHS and Census.

7. Nutrition, Physical Activity, and Obesity:

• Adults meeting aerobic physical activity and muscle-strengthening objectives (PA-2.4).
• Obesity among adults (NWS-9).
• Obesity among children and adolescents (NWS-10.4).
• Mean daily intake of total vegetables (NWS-15.1).

STATUS:

Nutrition, Physical Activity, and Obesity

Physical Activity by Education: Adults Aged 25 Years and Over, 2018

The proportion (age adjusted) of adults aged 25 years and over who met the guidelines for aerobic physical activity and for muscle-strengthening activity in 2018 increased as education level increased.
Less than high school: 9.8%
High school: 14.6%
Some college: 20.8%
Associate's degree: 22.9%
4-year college degree: 30.1%
Advanced degree: 35.0%.

8. Oral Health:

• Children, adolescents, and adults who visited the dentist in the past year (OH-7).

STATUS:

Persons with a Dental Visit by Family Income, 2016

The rate of having had a dental visit in the past 12 months for persons aged 2 years and over with family incomes 400% of the poverty threshold or above was 90% higher than that for persons with family incomes below the poverty threshold (age adjusted).

400% or more: 55.8%
200–399%: 39.3%
100–199%: 30.2%
Less than 100%: 29.4%

Data source: Medical Expenditure Panel Survey (MEPS), AHRQ.

9. Reproductive and Sexual Health:

• Sexually active females receiving reproductive health services (FP-7.1).
• Knowledge of serostatus among HIV-positive persons (HIV-13).

Status:

Reproductive and Sexual Health

Reproductive Health Services

In 2015–17, 84.2% of sexually active females aged 20–44 years with a 4-year college degree received reproductive health services in the past 12 months, compared to 68.3% of females with less than a high school education.

Data source: National Survey of Family Growth (NSFG), CDC/NCHS.

Awareness of HIV Infection

In 2016, 68.2% more persons aged 55 years and over living with HIV were aware of their HIV infection compared to persons aged 13–24 years.

Persons aged 13–24 years: 56.0%
Persons aged 55 years and over 94.2%

Data source: National HIV Surveillance System, CDC/NCHHSTP.

10. Social Determinants:

• Students graduating from high school within 4 years of starting 9th grade (AH-5.1).

Status: On-Time High School Graduation Rates by Race/Ethnicity, 2016–17 School Year

On-time high school graduation rates, defined as the percentage of students awarded a high school diploma within 4 years of starting 9th grade, varied among racial and ethnic groups in the 2016–17 school year.

• Asian or Pacific Islander, not Hispanic: 91%
• White, not Hispanic: 89%
• Hispanic: 80%
• Black, not Hispanic: 78%
• American Indian or Alaska Native, not Hispanic: 72%

Data source: Common Core of Data (CCD), ED/NCES.

On-Time High School Graduation Rate

• In the 2016–17 school year, 85% of students attending public schools graduated with a regular diploma within 4 years of starting 9th grade.
• Healthy People 2020 Target: 87%
• 2.4% increase needed.

Data source: Common Core of Data (CCD), ED/NCES.

11. Substance Abuse:

• Adolescents using alcohol or illicit drugs in past 30 days (SA-13.1).
• Binge drinking in past month—Adults (SA-14.3).

Status:

Adolescent Alcohol or Illicit Drug Use in Past 30 Days by Age, 2017

Rates of alcohol or illicit drug use in the past 30 days among adolescents aged 12-17 years increase with age. The rate for adolescents aged 16-17 years was more than 7.5 times the rate of adolescents aged 12-13 years.

12-13 years: 3.2%
14-15 years: 11.6%
16-17 years: 25.6%

Data sources: National Survey on Drug Use and Health (NSDUH), SAMHSA.

12. Tobacco:

• Adult cigarette smoking (TU-1.1).
• Adolescent cigarette smoking in past 30 days (TU-2.2).

Status:

Current Cigarette Smoking Among Adults by Metropolitan Status, 2017

Among adults aged 18 years and over, age-adjusted rates of current cigarette smoking were higher among adults living in non-metropolitan areas.

• Metropolitan: 12.9%
• Non-metropolitan: 22.7%

Data source: National Health Interview Survey (NHIS), CDC/NCHS.