chart 1.1: total national health expenditures 1980 – 2005(1) · projections of the population by...

Community Health Indicators

CHAPTER 7

TRENDWATCH CHARTBOOK 2016


Chart 7.1: U.S. Population Trends and Projections by Age, 1980 – 2060(1)

85+ Years

65-84 Years

20-64 Years

0-19 Years

0

50

100

150

200

250

300

350

400

450

500

1980 1990 2000 2010 2015 2020 2025 2030 2035 2040 2045 2050 2055 2060

Mill

ion

s

Source: U.S. Department of Commerce, Bureau of the Census. Projections of the Population by Sex and Age for the United States:

2015-2060. (1) Years 2015 through 2060 are projections.



Chart 7.2: U.S. Population Trends and Projections by Race, 2015 – 2060(1)

All Other(2, 3)

Asian(3)

White, Hispanic

Black(3)

White, Non-Hispanic

0

100

200

300

400

500

2015 2020 2025 2030 2035 2040 2045 2050 2055 2060

Mill

ions

Source: U.S. Department of Commerce, Bureau of the Census. Projections of the Population by Sex, Race, and Hispanic Origin for the

United States: 2015-2060. (1) Years 2015 through 2060 are projections. (2) All Other includes American Indian, Native Alaskan, Native Hawaiian, other Pacific Islander and two or more races. (3) Black, Asian and All Other categories include Hispanic and non-Hispanic individuals.



0

50

100

150

200

250

Diseases of theHeart

MalignantNeoplasms

CerebrovascularDisease

Chronic LowerRespiratoryDiseases

Diabetes Influenza andPneumonia

HIV Infection

De

ath

s p

er

100

,00

0 P

opu

lation

Cause of Death

White

Black

All Persons

Chart 7.3: Age-adjusted Death Rates, Selected Causes, by Race, 2014

Source: National Center for Health Statistics. (2016). Health, United States, 2015. Hyattsville, MD.(1) Racial categories include individuals of both Hispanic and non-Hispanic origin.

(1)

(1)



Chart 7.4: Percent of People with Chronic Conditions by Number and Sex,(1) 2013

42.6%

20.0%

11.8%9.5%

6.7% 9.3%

42.1%

21.7%

12.6%

9.0%6.4%

8.3%

43.2%

18.5%

11.1% 10.0%7.1%

10.2%

0 1 2 3 4 5+

Number of Chronic Conditions

Total

Male

Female

Source: Analysis of 2013 Medical Expenditure Panel Survey data. (1) The analysis was based on the following study: Anderson, G. (2010). Chronic Care: Making the Case for Ongoing Care. Johns Hopkins

University and the Robert Wood Johnson Foundation. There were two distinct differences between this analysis and the study’s

methodologies. First, this analysis used the Chronic Conditions as defined by the Agency for Healthcare Research and Quality Medical

Expenditure Panel Survey (MEPS) documentation. Second, it solely relied on MEPS 2013 data and did not use the two additional data

sources that were referenced in the Anderson 2010 study (i.e., three opinion telephone surveys commissioned by the Partnership for

Solutions and designed by Johns Hopkins and the 1996 Survey of Income and Program Participation data for characteristics of family

caregivers).

Pe

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div

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ls



Chart 7.5: Percent of Fee-for-Service Medicare Beneficiaries with Chronic Conditions, 2014

0.2%3.7%3.8%

5.0%5.9%

7.8%8.0%

10.0%11.0%

13.7%16.2%16.6%

26.7%27.0%

29.4%44.7%

55.1%

0% 10% 20% 30% 40% 50% 60%

Autism DisordersStroke

Schizophrenia and Other Psychotic DisordersAsthma

OsteoporosisCancer

Atrial FibrillationAlzheimer's Disease/Dementia

COPDHeart Failure

DepressionChronic Kidney Disease

DiabetesIschemic Heart Disease

ArthritisHyperlipidemia

Hypertension

Percent of Fee-for-Service Medicare Beneficiaries

Source: Centers for Medicare & Medicaid Services. Medicare Chronic Condition Dashboard. Data released January 7, 2016.

Available at: https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Chronic-

Conditions/CCDashboard.html. (1) Chronic obstructive pulmonary disease.

Previously Percent of People with Chronic Conditions by Type, 2006. Source: Anderson, G. (2010). Chronic Care: Making the

Case for Ongoing Care. Johns Hopkins University and the Robert Wood Johnson Foundation.

(1)



Chart 7.6: Number of Persons with Asthma, 1980 – 2014

5

10

15

20

25

30

35

40

45

1980 1990 2000 2006 2007 2008 2009 2010 2011 2012 2013 2014

Mill

ions o

f P

ers

on

s

Source: Centers for Disease Control and Prevention (2002). Surveillance of Asthma – United States, 1980-1999.

National Center for Health Statistics. National Health Interview Survey 2001, 2006, 2007, 2008, 2009, 2010,

2011, 2012, 2013 and 2014.



Chart 7.7: Percent of Adults with Hypertension by Sex,(1) 1988 – 1994 and 2011 – 2014

26.4%24.4%

31.0%29.7%

Male Female

Pe

rce

nt o

f A

dults A

ge

s 2

0+

1988-1994

2011-2014

Source: National Center for Health Statistics. (2016). Health, United States, 2015. Hyattsville, MD.(1) Data are age-adjusted to 2000 standard population.



Chart 7.8: Percent of Adults Who Are Overweight and Obese,(1)

1960 – 2014

Overweight

Obese

0%

10%

20%

30%

40%

50%

60%

70%

80%

1960-1962 1976-1980 1988-1994 1999-2002 2003-2006 2009-2012 2011-2014

Pe

rce

nt o

f A

dults A

ge

s 2

0-7

4

(2)

Source: National Center for Health Statistics. (2016). Health, United States, 2015. Hyattsville, MD.(1) Data are age-adjusted to 2000 standard population.(2) Overweight includes obese.



Chart 7.9: Percent of Expenses Used by People with Chronic Conditions by Service Type,(1) 2013

94% 93%

84% 83%

Home Health Care Visits Prescription Drugs Inpatient Hospital Stays Physician Visits

Pe

rce

nt o

f S

pen

din

g

Type of Service







caregivers).



Chart 7.10: Percent of Spending for Individuals with Chronic Conditions by Insurance Status,(1) 2013

99%

99%

100%

71%

79%

84%

0% 20% 40% 60% 80% 100%

Percent of Spending







caregivers).

Uninsured

Privately Insured

Medicaid Beneficiaries

Ages 65+ with Medicare

Only

Ages 65+ with Medicare and

Supplemental Insurance

Ages 65+ with Medicare and

Medicaid



Chart 7.11: Percent of Medicare Fee-for-Service Beneficiaries vs. Percent of Medicare Spending, by Number of Chronic Conditions,(1) 2014

Source: Centers for Medicare & Medicaid Services. Medicare Chronic Condition Dashboard. Data released January 7, 2016. Available

at: https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Chronic-Conditions/CCDashboard.html. (1) Includes 15 CMS identified chronic conditions.(2) Percentages were rounded, so they do not add to 100 percent.

Previously Percent of Population vs. Percent of Spending, by Number of Chronic Conditions, 2006. Source: Anderson, G. (2010).

Chronic Care: Making the Case for Ongoing Care. Johns Hopkins University and the Robert Wood Johnson Foundation.

0 to 1 Chronic Condition, 35%

0 to 1 Chronic Condition, 7%

2 to 3 Chronic Conditions, 30%




6+ Chronic Conditions, 15%

6+ Chronic Conditions, 49%

Percent of Medicare SpendingPercent of Beneficiaries(2) (2)



$20.0B

Chart 7.12: Percent of Medicare Fee-for-Service Spending on Chronic Conditions, by Type of Service,(1) 2010

Source: Centers for Medicare & Medicaid Services. Chronic Conditions Among Medicare Beneficiaries Chartbook 2012.

Available at: http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Chronic-

Conditions/Downloads/2012Chartbook.pdf. (1) Includes 15 CMS identified chronic conditions.(2) PAC = Post-Acute Care.(3) E&M = Evaluation & Management.(4) DME = Durable Medical Equipment.

Chart added in Chartbook 2013. Replaced: Working Age Adults with Activity Limitations Due to Chronic

Conditions, by Condition and Age, 2006-2007. Source: National Center for Health Statistics. (2010).

Health, United States, 2009. Hyattsville, MD.

41%

34%

26%

19%

24%

16%

10%

5%

2%

3%

5%

7%

10%

15%

19%

21%

8%

10%

11%

12%

4%

7%

10%

13%

4%

6%

8%

9%

7%

9%

11%

14%

0% 100%

6+ ChronicConditions

4 to 5Chronic

Conditions

2 to 3Chronic

Conditions

0 to 1Chronic

Conditions

Inpatient PAC Hospice Outpatient E&M Procedures Imaging and Testing DME & All Other Part B

$141.8B

(3) (4)

$86.0B

$57.2B

(2)



Source: National Center for Health Statistics. (2016). Health, United States, 2015. Hyattsville, MD.(1) Includes individuals of non-Hispanic origin only.(2) Includes individuals of Hispanic and non-Hispanic origin.

Chart 7.13: Percent Uninsured by Race, 1984 – 2014

White(1)

Black(1)

Asian(2)

Hispanic

All

0%

10%

20%

30%

40%

1984 1989 1995 2000 2009 2010 2011 2012 2013 2014

Pe

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nt o

f P

opu

lation

Und

er

Ag

e 6

5



Chart 7.14: Percent of Adults with No Usual Source of Care by Race, 1997 – 2014

White(1)

Black(1)

Asian(2)

10%

15%

20%

25%

30%

35%

40%

1997-1998

1999-2000

2001-2002

2003-2004

2005-2006

2006-2007

2007-2008

2008-2009

2009-2010

2010-2011

2011-2012

2012-2013

2013-2014

Hispanic

Source: National Center for Health Statistics. (2016). Health, United States, 2015. Hyattsville, MD.(1) Includes individuals of non-Hispanic origin only.(2) Includes individuals of Hispanic and non-Hispanic origin.

Pe

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nt o

f A

dults A

ge

s 1

8-6

4



Chart 7.15: Percent of Adults with No Usual Source of Care by Insurance Status, 1997 – 2014

11% 11% 9% 9% 10% 10% 10% 10% 11% 10% 11% 11% 11%

47%49% 49% 50%

53% 53% 52%54% 56% 54% 54% 54% 53%

1997-1998

1999-2000

2001-2002

2003-2004

2005-2006

2006-2007

2007-2008

2008-2009

2009-2010

2010-2011

2011-2012

2012-2013

2013-2014

Insured Uninsured

Source: National Center for Health Statistics. (2016). Health, United States, 2015. Hyattsville, MD.

Pe

rce

nt o

f A

dults A

ge

s 1

8-6

4



White(2)

Black(2)

Asian(1)

Hispanic

0%

5%

10%

15%

1997-1998

1999-2000

2001-2002

2003-2004

2005-2006

2006-2007

2008-2009

2009-2010

2010-2011

2011-2012

2012-2013

2013-2014

Pe

rce

nt o

f C

hild

ren

Un

de

r 1

8 Y

ea

rsChart 7.16: Percent of Children with No Usual Source of Care by Race, 1997 – 2014

Source: National Center for Health Statistics. (2016). Health, United States, 2015. Hyattsville, MD.(1) Includes individuals of Hispanic and non-Hispanic origin. (2) Includes individuals of non-Hispanic origin only.



Chart 7.17: Percent of Children with No Usual Source of Care by Insurance Status, 1997 – 2014

4% 4% 3%3% 3% 3% 3% 3% 3%

2% 3% 2%

28%29% 29% 29%

31% 31%30% 29% 28% 28%

27%26%

1997-1998

1999-2000

2001-2002

2003-2004

2005-2006

2006-2007

2008-2009

2009-2010

2010-2011

2011-2012

2012-2013

2013-2014

Insured Uninsured

Source: National Center for Health Statistics. (2016). Health, United States, 2015. Hyattsville, MD.

Pe

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f C

hild

ren

Un

de

r 1

8 Y

ears



Chart 7.18: Percent of Individuals with No Health Care Visits by Race, Insurance Status, 1997 and 2014

15%17%

23%25%

14%

34%

13%15%

17%

22%

13%

39%

White Black Asian Hispanic Insured Uninsured

1997 2014

Source: National Center for Health Statistics. (2016). Health, United States, 2015. Hyattsville, MD.(1) Includes individuals of non-Hispanic origin only. (2) Includes individuals of Hispanic and non-Hispanic origin.

Race Insurance Status

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div

idua

ls

(1) (1) (2)



Chart 7.19: Percent of Children with No Health Care Visits by Race, Insurance Status, 1998 and 2014

11%

15%16%

19%

10% 10% 10%

29%

7%9% 9%

12%

8% 7%8%

27%

White Black Asian Hispanic AnyInsurance

PrivateInsurance

Medicaid Uninsured

Pe

rce

nt o

f C

hild

ren

Un

de

r 1

8 Y

ears 1998 2014

Race

Source: National Center for Health Statistics. (2016). Health, United States, 2015. Hyattsville, MD.(1) Includes individuals of non-Hispanic origin only. (2) Includes individuals of Hispanic and non-Hispanic origin.

Insurance Status

(1) (1) (2)



Chart 7.20: Percent of Children with No Dental Visits by Race, Poverty Status, 1997 and 2014

Source: National Center for Health Statistics. (2016). Health, United States, 2015. Hyattsville, MD.(1) Includes individuals of non-Hispanic origin only. (2) Includes individuals of Hispanic and non-Hispanic origin.(3) FPL = federal poverty level.

Race Poverty Status

24%

31% 30%

39% 38% 38%

24%

14%16%17%

21%19%

22% 22%

16%

10%

White Black Asian Hispanic <100%FPL

100-199%FPL

200-399%FPL

≥ 400%FPL

Pe

rce

nt o

f C

hild

ren

2-1

7 Y

ears

1997 2014

(3)

(1) (1) (2)


45%

40% 39%

46%

41%

46%

73%

65%

70%

74%

66%

75%

White Black Asian Hispanic Below FPL At or Above FPL

Pe

rce

nt o

f C

hild

ren

19

-35

Mo

nth

s o

f A

ge

2009 2014


Chart 7.21: Percent of Children Vaccinated(1) by Race, Poverty Status, 2009(2) and 2014

Source: National Center for Health Statistics. (2016). Health, United States, 2015. Hyattsville, MD.(1) Vaccinations include DTP, Polio, MMR, Hib, Hepatitis B, Varicella and PCV.(2) Classification methodology changed for the Influenza Type B vaccine—before January 2009, NIS did not distinguish

between Hib vaccine product types, so children who received three doses of the vaccine that required four doses were

misclassified as fully vaccinated.(3) Includes individuals of non-Hispanic origin only. (4) FPL = federal poverty level.

Race Poverty Status

(4)(3) (3) (3)



Chart 7.22: Percent of Women(1) Receiving Mammography(2) byRace, Poverty Status, 1994 and 2013

61%64%

56%

52%

44%

49%

65%

74%

68% 67% 67%

61%

50%

57%

66%

77%

White Black Asian Hispanic <100%FPL

100-199%FPL

200-399%FPL

≥400% FPL

Pe

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nt o

f W

om

en O

ve

r A

ge

40

1994 2013

Source: National Center for Health Statistics. (2016). Health, United States, 2015. Hyattsville, MD.(1) Women over 40 years of age.(2) Indicates use of mammography in two years prior to 1994 and 2013.(3) Includes individuals of non-Hispanic origin only. (4) Includes individuals of Hispanic and non-Hispanic origin.(5) FPL = federal poverty level.

Poverty StatusRace

(5)

(3) (3) (4)



Chart 7.23: Percent of Adults(1) with Chronic Conditions by Insurance Type, 2012

52.5%

27.6%

49.1%

65.9%

25.3%

24.2%

26.8%

20.4%

13.1%

21.4%

13.2%

8.7%9.4%

26.9%

10.8%4.9%

0%

20%

40%

60%

80%

100%

Private Public Other Uninsured

No Chronic Conditions 1 Chronic Condition 2 Chronic Conditions 3+ Chronic Conditions

Source: Centers for Disease Control and Prevention. Multiple Chronic Conditions Among US Adults: A 2012 Update. Available at:

http://www.cdc.gov/pcd/issues/2014/13_0389.htm. (1) Includes individuals 18 years of age and above.(2) Public health insurance includes Medicaid, Children’s Health Insurance Program and Medicare.(3) Other health insurance includes state-sponsored health plans, other government programs and military health plans.

Chart added in Chartbook 2016.

(2) (3)



Chart 7.24: Total Expenses on Top 10 Most Costly Conditions Among Adults(1) by Sex, 2013

Source: Agency for Healthcare Research and Quality. Center for Financing, Access, and Cost Trends. Household Component of the Medical

Expenditure Panel Survey, 2013. Available at: https://meps.ahrq.gov/mepsweb/. (1) Only includes adults ages 18 and older. (2) Normal birth/live born and systemic lupus and connective tissues disorders are not included among the top ten most costly

conditions for males.(3) Back Problems and Hyperlipidemia are not included among the top ten most costly conditions for females.


$46$45

$43 $41$40 $39

$30

$40

$23

$16

$44

$28

$50

$31

$24

$31

$21

$10

Bill

ions o

f D

olla

rs

Female

Male

Heart

Conditions

Trauma-

related

Disorders

Diabetes Hyper-

tension

Hyperlip-

idemia(3)

COPD,

AsthmaMental

Disorders

Osteo-

arthritisCancer Back

Problems(3)

Normal

birth/Live

born(2)

Systemic

lupus and

connective

tissues

disorders(2)

$29$26 $26

$18 $18



Chart 7.25: 30-Day Readmission Rate for Medicare Fee-for-Service Beneficiaries by Number of Chronic Conditions,(1) 2014

7.7%9.1%

12.0%

23.1%

0 - 1 2 - 3 4 - 5 6+

Source: Centers for Medicare & Medicaid Services. Medicare Chronic Condition Dashboard. Data released January 7, 2016.

Available at: https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Chronic-

Conditions/CCDashboard.html. (1) Includes 15 CMS identified chronic conditions.


chart 1.1: total national health expenditures 1980 – 2005(1) · projections of the population by...

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