Morbidity in the USA

Main Category: Cancer / Oncology
Article Date: 28 Feb 2004 - 0:00 PDT

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National Center for Health Statistics

Limitation of activity due to chronic health conditions, limitations in activities of daily living, and self-assessed (or family member-assessed) health status are summary measures of morbidity presented in this report.

Additional measures of morbidity that are presented include the incidence of specific diseases, injury-related emergency department use, and suicide attempts.

Limitation of activity due to chronic health conditions among children was more common among boys than among girls and was more than twice as high among school-age children (5-11 and 12-17 years of age) as among preschoolers (under 5 years of age) during the period 1999-2001.

More than 9 percent of school-age and adolescent boys had an activity limitation compared with about 5 percent of girls, with the majority classified as having a limitation based on participation in special education. Between 1997 and 2001 levels of activity limitation among children remained about the same.

Limitations in handling personal care needs such as bathing (activities of daily living or ADLs) and routine needs such as shopping (instrumental activities of daily living or IADLs) increase sharply with age among the noninstitutionalized population.

In 2001, about 14 percent of all Medicare beneficiaries 65 years of age and over were limited in at least one of six ADLs. Among noninstitutionalized persons age 65 years and over, about 10 percent had difficulty and received help or supervision with at least one ADL .

Mental illness is a significant cause of activity limitation among working-age adults living in the community. In 1999-2001 mental illness was the second most frequently mentioned causal condition for activity limitation among adults 18-44 years of age and third among adults 45-54 years.

In 2001 the percent of persons reporting fair or poor health was more than three times as high for persons living below the poverty level as for those with family income more than twice the poverty level (21 percent and 6 percent, age adjusted.

New pediatric AIDS cases have been declining steadily since 1994 when U.S. Public Health Service guidelines recommended testing and treatment of pregnant women and neonates to reduce perinatal HIV transmission. The vast majority of pediatric AIDS cases occur through perinatal exposure.

In 2001 fewer than 200 new AIDS cases were reported among children under the age of 13 years, compared with 745 in 1995. In 2001 tuberculosis incidence declined for the 9th consecutive year to 5.7 cases per 100,000 population, but the rate of decline slowed in 2001 compared with the previous 5 years.

Untreated chlamydial infections can lead to pelvic inflammatory disease (PID) with potentially serious complications including infertility, chronic pelvic pain, and life-threatening tubal pregnancy.

In 2001 the reported rate for chlamydial infection was 278 cases per 100,000 persons. Rates of reported chlamydial infection have been increasing annually since the late 1980s when public programs for screening and treatment of women were first established to avert pelvic inflammatory disease and related complications. Incidence rates for all cancers combined declined in the 1990s for males.

Between 1990 and 1999 age-adjusted cancer incidence rates declined on average nearly 2 percent per year for Hispanic males, non-Hispanic white males, and black males.

Although there was no significant change in cancer incidence for females overall, among Hispanic females rates decreased on average 1 percent per year, and among Asian or Pacific Islander females rates increased 1 percent per year.

The most frequently diagnosed cancer sites in males are prostate, followed by lung and bronchus, and colon and rectum.

Cancer incidence at these sites is higher for black males than for males of other racial and ethnic groups. In 1999 age-adjusted cancer incidence rates for black males exceeded those for white males by 58 percent for prostate, 48 percent for lung and bronchus, and 10 percent for colon and rectum. Breast cancer is the most frequently diagnosed cancer among females.

Breast cancer incidence is higher for non-Hispanic white females than for females in other racial and ethnic groups. In 1999 age-adjusted breast cancer incidence rates for non-Hispanic white females exceeded those for black females by 24 percent, for Asian or Pacific Islander females by 48 percent, and for Hispanic females by 80 percent.

Injuries accounted for 37 percent of all visits to emergency departments (ED) in 1999-2000. The proportion of ED visits that were injury-related declined with age from 41 percent for children and adults under 45 years of age to 33 percent for persons 45-64 years and 26 percent for those 65 years and over. In 1999-2000 falls was the most often cited reason for injury-related ED visits among persons 45 years of age and older.

Between 1993 and 2001, the percent of high school students who reported attempting suicide (8-9 percent) and whose suicide attempts required medical attention (about 3 percent) remained fairly constant.

Girls were more likely than boys to consider or attempt suicide and were also more likely to make an attempt that required medical attention. However in 2000 adolescent boys (15-19 years of age) were nearly five times as likely to die from suicide as were adolescent girls, in part reflecting their choice of more lethal methods, such as firearms.