During the past 20 years, this report has tracked our nation`s 20.1 percent improvement in overall health (see graph). This national success stems from improvements in the reduction of infant mortality, infectious disease, prevalence of smoking, cardiovascular deaths, violent crime and children in poverty, and an increase in immunization coverage. However, success has eluded us in two very significant measures -- the rapid increases in both the prevalence of obesity and the rate of uninsured population. In addition, the high school graduation rate remains relatively stagnant with less than three of four incoming freshmen graduating within four years. Improvements Since 1990
 Table 8
National Measures of Successes and Challenges: Long Term
|
MEASURE |
EDITION TO EDITION CHANGES |
|
Successes |
|
|
|
|
Infectious Disease |
53 percent decrease in the incidence of infectious disease from 40.7 cases in 1990 to 19.1 cases per 100,000 population in 2009. |
|
Infant Mortality |
33 percent decrease in the infant mortality rate from 10.2 deaths in 1990 to 6.8 deaths per 1,000 live births in 2009. |
|
Prevalence of Smoking |
38 percent decline in the prevalence of smoking from 29.5 percent in 1990 to 18.3 percent of the population in 2009. |
|
Violent Crime |
25 percent decline in the violent crime rate from 609 offenses in 1990 to 455 offenses per 100,000 population in 2009. |
|
Cardiovascular Deaths |
29 percent decline in the rate of deaths from cardiovascular disease from 405.1 deaths in 1990 to 287.9 deaths per 100,000 population in 2009. |
|
Children in Poverty |
8 percent decline in the percentage of children in poverty from 20.6 percent in 1990 to 19.0 percent of persons under age 18 in 2009. |
|
Immunization Coverage |
42 percent increase in immunization coverage from 55.1 percent in 1999 to 78.2 percent of children ages 19 to 35 months receiving complete immunizations in 2009. |
|
Premature Death |
14 percent decline from 8,716 years of potential life lost before age 75 per 100,000 population in 1990 to 7,511 years of potential life lost before age 75 per 100,000 population in 2009. |
|
Air Pollution |
The average amount of fine particulate in the air continues to decline from 13.2 micrograms in 2003 to 11.7 micrograms per cubic meter in 2009. |
|
Challenges |
|
Prevalence of Obesity |
129 percent increase in the prevalence of obesity from 11.6 percent in 1990 to 26.6 percent of the population in 2009. |
|
Lack of Health Insurance |
14 percent increase in the rate of uninsured population from 13.4 percent in 1990 to 15.3 percent in 2009. |
|
High School Graduation Rate |
The high school graduation rate continues to remain around 73 percent of incoming freshman that graduate within four years. |
|
Poor Mental Health Days |
In the last eight years, the number of poor mental health days per month has stagnated at 3.4 days in the previous 30 days. |
|
Poor Physical Health Days |
In the last six years, the number of poor physical health days per month has stagnated at 3.6 days in the previous 30 days. |
|
Prenatal Care |
Adequate prenatal care is available to only about 70 percent of pregnant women. |
The graph (Improvement since 1990) shows that the rate of improvement experienced in the health of the United States` population occurred in two phases. During the 1990s, annual improvement in health was 1.5 percent per year on average. During this decade, the annual improvement in health has been 0.4 percent per year. Special concern surrounds the decline in health determinants, as those measures point to the future health of the population.
|
Prevalence of Smoking Since 1990 |
|
The United States has the potential to return to the rates of improvement typical in the 1990s. However, to do so, it must address the drivers of declining health more directly while focusing on reducing important risk factors. For example, the prevalence of smoking has been stagnant for many years and only just recently started to show improvement, declining from 19.8 percent in 2008 to 18.3 percent in 2009, the lowest level in 20 years. |
 |
| Prevalence of Obesity Since 1990 |
|
 |
Unprecedented and unchecked growth in the prevalence of obesity has also dramatically affected the overall health of the United States. The prevalence of obesity has increased 129 percent from 11.6 percent of the population in 1990 to 26.6 percent of the population in 2009. Now, more than one in four people in the U.S. is considered obese - a category that the Centers for Disease Control and Prevention reserves for those who are significantly over the suggested body weight given their height. This alarming rate of increase shows little evidence of slowing or abating (see graph). These very high obesity rates are gathered from the Behavioral Risk Factor Surveillance System, the nation`s largest phone survey about health, and rely on self-reported height and weight. Actual obesity rates, as measured by health professionals, may be almost 10 percent higher, meaning that over one-third of the population is now obese. |
|
Lack of Health Insurance Since 2001 |
|
Lack of health insurance coverage increased from 13.9 percent in 2001 to 15.3 percent of the population in 2009 (see graph). Lack of health insurance not only inhibits people from getting the proper care when needed but also reduces access to necessary preventive care to curtail or minimize future illnesses.
High school graduation, poor mental health days and poor physical health days have had minimal improvement improved in the last decade and restrict more significant improvements in health.
While there have been improvements since 1990, these worsening influences have caused and will continue to cause slower rates of improvement than experienced in the 1990s. |
 |
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Yun, S, et.al. A comparison of national estimates of obesity prevalence from the behavioral risk factor surveillance system and the national health and nutrition examination survey, International Journal of Obesity (2006) 30, 164-170 |