Lindsey I Black’s research while affiliated with Centers for Disease Control and Prevention and other places

Objective-This report examines the prevalence of developmental disabilities among children in both rural and urban areas as well as service utilization among children with developmental issues in both areas. Methods-Data from the 2015-2018 National Health Interview Survey (NHIS) were used to examine the prevalence of 10 parent- or guardian-reported developmental disability diagnoses (attention-deficit/hyperactivity disorder [ADHD], autism spectrum disorder, blindness, cerebral palsy, moderate to profound hearing loss, learning disability, intellectual disability, seizures, stuttering or stammering, and other developmental delays) and service utilization for their child. Prevalence estimates are presented by urbanicity of residence (urban or rural). Bivariate logistic regressions were used to test for differences by urbanicity. Results-Children living in rural areas were more likely to be diagnosed with a developmental disability than children living in urban areas (19.8% compared with 17.4%). Specifically, children living in rural areas were more likely than those in urban areas to be diagnosed with ADHD (11.4% compared with 9.2%) and cerebral palsy (0.5% compared with 0.2%). However, among children with a developmental disability, children living in rural areas were significantly less likely to have seen a mental health professional, therapist, or had a well-child checkup visit in the past year, compared with children living in urban areas. Children with a developmental disability living in rural areas were also significantly less likely to receive Special Educational or Early Intervention Services compared with those living in urban areas. Conclusion-Findings from this study highlight differences in the prevalence of developmental disabilities and use of services related to developmental disabilities by rural and urban residence.

Objectives: To study the national prevalence of 10 developmental disabilities in US children aged 3 to 17 years and explore changes over time by associated demographic and socioeconomic characteristics, using the National Health Interview Survey. Methods: Data come from the 2009 to 2017 National Health Interview Survey, a nationally representative survey of the civilian noninstitutionalized population. Parents reported physician or other health care professional diagnoses of attention-deficit/hyperactivity disorder; autism spectrum disorder; blindness; cerebral palsy; moderate to profound hearing loss; learning disability; intellectual disability; seizures; stuttering or stammering; and other developmental delays. Weighted percentages for each of the selected developmental disabilities and any developmental disability were calculated and stratified by demographic and socioeconomic characteristics. Results: From 2009 to 2011 and 2015 to 2017, there were overall significant increases in the prevalence of any developmental disability (16.2%-17.8%, P < .001), attention-deficit/hyperactivity disorder (8.5%-9.5%, P < .01), autism spectrum disorder (1.1%-2.5%, P < .001), and intellectual disability (0.9%-1.2%, P < .05), but a significant decrease for any other developmental delay (4.7%-4.1%, P < .05). The prevalence of any developmental disability increased among boys, older children, non-Hispanic white and Hispanic children, children with private insurance only, children with birth weight ≥2500 g, and children living in urban areas and with less-educated mothers. Conclusions: The prevalence of developmental disability among US children aged 3 to 17 years increased between 2009 and 2017. Changes by demographic and socioeconomic subgroups may be related to improvements in awareness and access to health care.

Complementary health is the use of holistic or unconventional medicine with mainstream Western medicine for health and wellness (1,2). Past research has identified yoga, meditation, and seeing a chiropractor as some of the most commonly used approaches (3). This report examines changes over time in the percentage of adults who used yoga, meditation, and chiropractors in the past 12 months, as well as variation by sex, age, and race and Hispanic origin. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

Yoga, meditation, and use of chiropractors are types of complementary health approaches developed outside of mainstream Western medicine (1-2). Although complementary health approaches as a whole are not widely used among children, previous work has established a rise in the use of selected approaches over time (3). This report presents the most recent national estimates of use of the three most prevalent approaches during the past 12 months, among children aged 4-17 years in the United States. Comparable estimates from 2012 are also included to examine changes over time.

In the United States, 14% of all public school students are chronically absent from school, missing 15 or more days per year (1). Chronic school absenteeism has been associated with poor academic performance, poor school engagement, and greater school dropout (2,3). Previous research has also found that children with chronic health conditions are more likely to have suboptimal school achievement, such as an inability to complete high school or obtain a GED, when compared with youth who did not have a chronic health condition (4). Past research has explored associations between school attendance and health conditions; however, studies have been limited in size and were not nationally representative (5,6). Further, many studies focused on chronic physical health conditions and few explored relationships for individual developmental disabilities (DDs) (7). This report examines the association between selected DDs and chronic school absenteeism among children aged 5-17 years using the National Health Interview Survey (NHIS).

Objective: Agreement between administrative and survey data has been shown to vary by the condition of interest and there is limited research dedicated to parental report of asthma among children. The current study assesses the concordance between parent-reported asthma from the National Health Interview Survey (NHIS) with Medicaid administrative claims data among linkage eligible children from the NHIS. Methods: Medicaid Analytic eXtract (MAX) files from the Centers for Medicare & Medicaid Services (CMS) (years 2000-2005) were linked to participants of the NHIS (years 2001-2005). Concordance measures were calculated to assess overall agreement between a claims-based asthma diagnosis and a survey-based asthma diagnosis. Structural equation modeling was used to assess the association between demographic, service utilization, and co-occurring conditions factors and agreement. Results: Percent agreement between the two data sources was high (90%) with a prevalence-adjusted bias-adjusted kappa of 0.80 and Cohen's kappa of 0.55. Agreement varied by demographic characteristics, service utilization characteristics, and the presence of allergies and other health conditions. Structural equation modeling results found the presence of a series of co-occurring conditions, namely allergies, resulted in significantly lower agreement after controlling for demographics and service utilization. Conclusions: There was general agreement between asthma diagnoses reported in the NHIS when compared to medical claims. Discordance was greatest among children with co-occurring conditions.

In recent years, there has been increased awareness and prevention efforts toward reducing concussion incidence. Previous research has most often estimated the prevalence of concussions among youth using medical claims data (1–4). In the 2016 National Health Interview Survey (NHIS), parents or guardians answered questions about whether their children have ever had a significant head injury or concussion. This report presents estimates of parent-reported lifetime significant head injuries among children aged 3–17 years, providing information about head injuries beyond those that were medically attended.

Developmental disabilities are a set of heterogeneous disorders characterized by difficulties in one or more domains, including but not limited to, learning, behavior, and self-care. This report provides the latest prevalence estimates for diagnosed autism spectrum disorder, intellectual disability, and other developmental delay among children aged 3–17 years from the 2014–2016 National Health Interview Survey (NHIS). Estimates are also presented for any developmental disability, defined as having had one or more of these three diagnoses. Prevalence estimates are based on parent or guardian report of ever receiving a diagnosis of each developmental disability from a doctor or other health care professional.

Problem/condition: Receipt of key preventive health services among women and men of reproductive age (i.e., 15-44 years) can help them achieve their desired number and spacing of healthy children and improve their overall health. The 2014 publication Providing Quality Family Planning Services: Recommendations of CDC and the U.S. Office of Population Affairs (QFP) establishes standards for providing a core set of preventive services to promote these goals. These services include contraceptive care for persons seeking to prevent or delay pregnancy, pregnancy testing and counseling, basic infertility services for those seeking to achieve pregnancy, sexually transmitted disease (STD) services, and other preconception care and related preventive health services. QFP describes how to provide these services and recommends using family planning and other primary care visits to screen for and offer the full range of these services. This report presents baseline estimates of the use of these preventive services before the publication of QFP that can be used to monitor progress toward improving the quality of preventive care received by women and men of reproductive age. Period covered: 2011-2013. Description of the system: Three surveillance systems were used to document receipt of preventive health services among women and men of reproductive age as recommended in QFP. The National Survey of Family Growth (NSFG) collects data on factors that influence reproductive health in the United States since 1973, with a focus on fertility, sexual activity, contraceptive use, reproductive health care, family formation, child care, and related topics. NSFG uses a stratified, multistage probability sample to produce nationally representative estimates for the U.S. household population of women and men aged 15-44 years. This report uses data from the 2011-2013 NSFG. The Pregnancy Risk Assessment Monitoring System (PRAMS) is an ongoing, state- and population-based surveillance system designed to monitor selected maternal behaviors and experiences that occur before, during, and shortly after pregnancy among women who deliver live-born infants in the United States. Annual PRAMS data sets are created and used to produce statewide estimates of preconception and perinatal health behaviors and experiences. This report uses PRAMS data for 2011-2012 from 11 states (Hawaii, Maine, Maryland, Michigan, Minnesota, Nebraska, New Jersey, Tennessee, Utah, Vermont, and West Virginia). The National Health Interview Survey (NHIS) is a nationally representative survey of noninstitutionalized civilians in the United States. NHIS collects data on a broad range of health topics, including the prevalence, distribution, and effects of illness and disability and the services rendered for or because of such conditions. Households are identified through a multistage probability household sampling design, and estimates are produced using weights that account for the sampling design, nonresponse, and poststratification adjustments. This report uses data from the 2013 NHIS for women aged 18-44 years. Results: Many preventive health services recommended in QFP were not received by all women and men of reproductive age. For contraceptive services, including contraceptive counseling and advice, 46.5% of women aged 15-44 years at risk for unintended pregnancy received services in the past year, and 4.5% of men who had vaginal intercourse in the past year received services in that year. For sexually transmitted disease (STD) services, among all women aged 15-24 years who had oral, anal, or vaginal sex with an opposite sex partner in the past year, 37.5% were tested for chlamydia in that year. Among persons aged 15-44 years who were at risk because they were not in a mutually monogamous relationship during the past year, 45.3% of women were tested for chlamydia and 32.5% of men were tested for any STD in that year. For preconception care and related preventive health services, data from selected states indicated that 33.2% of women with a recent live birth (i.e., 2-9 months postpartum) talked with a health care professional about improving their health before their most recent pregnancy; of selected preconception counseling topics, the most frequently discussed was taking vitamins with folic acid before pregnancy (81.2%), followed by achieving a healthy weight before pregnancy (62.9%) and how drinking alcohol (60.3%) or smoking (58.2%) during pregnancy can affect a baby. Nationally, among women aged 18-44 years irrespective of pregnancy status, 80.9% had their blood pressure checked by a health care professional and 31.7% received an influenza vaccine in the past year; 54.5% of those with high blood pressure were tested for diabetes, 44.9% of those with obesity had a health care professional talk with them about their diet, and 55.2% of those who were current smokers had a health professional talk with them about their smoking in the past year. Among all women aged 21-44 years, 81.6% received a Papanicolaou (Pap) test in the past 3 years. Receipt of certain preventive services varied by age and race/ethnicity. Among women with a recent live birth, the percentage of those who talked with a health care professional about improving their health before their most recent pregnancy increased with age (range: 25.9% and 25.2% for women aged ≤19 and 20-24 years, respectively, to 35.9% and 37.8% for women aged 25-34 and ≥35 years, respectively). Among women with a recent live birth, the percentage of those who talked with a health care professional about improving their health before their most recent pregnancy was higher for non-Hispanic white (white) (35.2%) compared with non-Hispanic black (black) (30.0%) and Hispanic (26.0%) women. Conversely, across most STD screening services evaluated, testing was highest among black women and men and lowest among their white counterparts. Receipt of many preventive services recommended in QFP increased consistently across categories of family income and continuity of health insurance coverage. Prevalence of service receipt was highest among women in the highest family income category (>400% of federal poverty level [FPL]) and among women with insurance coverage for each of the following: contraceptive services among women at risk for unintended pregnancy; medical services beyond advice to help achieve pregnancy; vaccinations (hepatitis B and human papillomavirus [HPV], ever; tetanus, past 10 years; influenza, past year); discussions with a health care professional about improving health before pregnancy and taking vitamins with folic acid; blood pressure and diabetes screening; discussions with a health care professional in the past year about diet, among those with obesity; discussions with a health care professional in the past year about smoking, among current smokers; Pap tests within the past 3 years; and mammograms within the past 2 years. Interpretation: Before 2014, many women and men of reproductive age were not receiving several of the preventive services recommended for them in QFP. Although differences existed by age and race/ethnicity, across the range of recommended services, receipt was consistently lower among women and men with lower family income and greater instability in health insurance coverage. Public health action: Information in this report on baseline receipt during 2011-2013 of preventive services for women and men of reproductive age can be used to target improvements in the use of recommended services through the development ofresearch priorities, information for decision makers, and public health practice. Health care administrators and practitioners can use the information to identify subpopulations with the greatest need for preventive services and make informed decisions on resource allocation. Public health researchers can use the information to guide research on the determinants of service use and factors that might increase use of preventive services. Policymakers can use this information to evaluate the impact of policy changes and assess resource needs for effective programs, research, and surveillance on the use of preventive health services for women and men of reproductive age.

Key findings: Data from the National Health Interview Survey •The percentages of adolescents aged 10-17 who did not have a usual place for preventive care, did not receive a well-child checkup in the past 12 months, or did not have a dental visit in the past 12 months decreased from 2008 to 2014. •In 2014, 2% of adolescents aged 10-17 did not have a usual place for preventive care, 21% did not receive a well-child checkup, and 12% did not have a dental visit in the past 12 months. •In 2014, the percentages of adolescents not having a usual place for preventive care, not receiving a well-child checkup, and not having a dental visit were higher for those aged 16-17 compared with those in younger age groups. These percentages also varied by race and ethnicity, poverty status, and insurance status.