Dental Care Among Adults Age 65 and Older: United States, 2022.

Oral health is associated with overall health, especially in older adults (age 65 and older). Chronic conditions in older adults may affect oral health, and poor oral health may increase the risk of certain chronic conditions (1-3). Poor oral health has also been associated with increased cardiovascular disease risk (4). Several factors, including chronic conditions, health status, race, and income have been associated with reduced dental care use among older adults (5-9). This report describes the percentage of older adults who had a dental visit in the past 12 months by selected sociodemographic characteristics and chronic conditions using the 2022 National Health Interview Survey (NHIS). .

Demographic Variation in Health Insurance Coverage:United States, 2022.

Objectives-This report presents national estimates of different types of health insurance coverage and lack of coverage (uninsured). Estimates are presented by selected sociodemographic characteristics, including age, sex, race and Hispanic origin, family income, education level, employment status, and marital status. Methods-Data from the 2022 National Health Interview Survey were used to estimate health insurance coverage. Estimates were categorized by selected sociodemographic characteristics. Additionally, those who were uninsured were categorized by length of time since they had coverage, private coverage was further classified by source of plan, and public coverage was categorized by type of public plan. Results-In 2022, 28.1 million (8.6%) people of all ages were uninsured at the time of the interview. This includes 27.7 million (10.2%) people younger than age 65. Among children, 3.0 million (4.2%) were uninsured, and among working-age adults (ages 18-64), 24.7 million (12.4%) were uninsured. Among people younger than age 65, 64.0% were covered by private health insurance, including 56.0% with employment-based coverage and 6.8% with directly purchased coverage. Moreover, 4.5% were covered by exchange-based coverage, a type of directly purchased coverage. Among people younger than age 65, about two in five children and one in five adults ages 18-64 had public health coverage, mainly Medicaid and the Children's Health Insurance Program. Among adults age 65 and older, the percentage who were covered by private health insurance (with or without Medicare), Medicare Advantage, and traditional Medicare only varied by age, family income, education level, and race and Hispanic origin.

Geographic Variation in Health Insurance Coverage:United States, 2022.

Objectives-This report presents state, regional, and national estimates of the percentage of people who were uninsured, had private health insurance coverage, and had public health insurance coverage at the time of the interview. Methods-Data from the 2022 National Health Interview Survey were used to estimate health insurance coverage. Estimates were categorized by age group, state Medicaid expansion status, urbanization level, expanded region, and state. Estimates by state Medicaid expansion status, urbanization level, and expanded region were based on data from all 50 states and the District of Columbia. State estimates are shown for 32 states and the District of Columbia for people younger than age 65 and adults ages 18-64, and 27 states for children. Results-In 2022, among people younger than age 65, 10.2% were uninsured, 64.0% had private coverage, and 28.2% had public coverage at the time of the interview. Among adults ages 18-64, the percentage who were uninsured ranged from 10.1% for those living in large fringe (suburban) metropolitan counties to 13.9% for both those living in nonmetropolitan counties and large central metropolitan counties. Adults ages 18-64 living in non-Medicaid expansion states were twice as likely to be uninsured (19.6%) compared with those living in Medicaid expansion states (9.1%). A similar pattern was observed among children ages 0-17 years. The percentage of adults ages 18-64 who were uninsured was significantly higher than the national average (12.4%) in Florida (17.9%), Georgia (21.2%), Tennessee (21.6%), and Texas (27.0%), and significantly lower than the national average in Maryland (7.0%), Massachusetts (3.0%), Michigan (6.5%), New York (5.6%), Ohio (8.6%), Pennsylvania (7.2%), Virginia (8.5%), Washington (7.3%), and Wisconsin (7.0%). The percentage of people younger than age 65 who were uninsured was lowest in the New England region (3.5%).

Characteristics of Adults Aged 18-64 Who Did Not Take Medication as Prescribed to Reduce Costs: United States, 2021.

About 60% of adults aged 18 and over reported taking at least one prescription medication in 2021, with 36% reporting taking three or more (1). Out-ofpocket costs on retail drugs rose 4.8% to $63 billion in 2021 (2). High costs may limit individuals' access to medications and lead to people not taking medication as prescribed (3,4); this may result in more serious illness and require additional treatment (5). This report examines the characteristics of adults aged 18-64 who took prescription medication in the past 12 months and did not take medication as prescribed due to cost. Cost-saving measures included skipping doses, taking less medication than prescribed, or delaying filling a prescription.

Financial Burden of Medical Care Among Veterans Aged 25-64, by Health Insurance Coverage:United States, 2019-2021.

Objective-In addition to health insurance coverage options available to the general population, veterans may have access to Tricare, a healthcare program for uniformed services members and retirees, and U.S. Department of Veterans Affairs (VA) health care. This report measures the financial burden of medical care among veterans aged 25-64 and examines how that burden may vary by health insurance coverage.

Problems Paying Medical Bills: United States, 2021.

Objective-This report presents national estimates of people living in families having problems paying medical bills by selected sociodemographic and geographic characteristics, including sex, race and Hispanic origin, family income, health insurance coverage status, education level, urbanization level, region, and state Medicaid expansion status.

Influenza and Pneumococcal Vaccination Among Male Veterans and Nonveterans, 2016-2018.

OBJECTIVES: The Advisory Committee on Immunization Practices recommends persons aged ≥6 months receive an influenza vaccination annually, and certain adults aged ≥19 years receive the 23-valent pneumococcal polysaccharide vaccine alone or in series with the 13-valent pneumococcal conjugate vaccine, depending on age, chronic conditions, and smoking status. This study examines the prevalence of influenza and pneumococcal vaccination relative to Healthy People 2020 goals to understand how vaccination receipt differs by veteran status and sociodemographic subgroups. METHODS: We analyzed pooled data from the 2016-2018 National Health Interview Survey (N = 35 094) in 2021 to estimate the prevalence of influenza and pneumococcal vaccination for men aged 25-64 years and for men aged ≥65 years by veteran status and selected sociodemographic subgroups. We used 2-tailed t tests with an α = .05 to identify significant differences. RESULTS: Among men, 44.7% of veterans and 33.5% of nonveterans aged 25-64 years and 71.0% of veterans and 64.9% of nonveterans aged ≥65 years received an influenza vaccine in the past year. Among men aged 25-64 years at high risk for pneumococcal disease, 35.9% of veterans and 20.8% of nonveterans had ever received ≥1 dose of any pneumococcal vaccination. Disparities in the prevalence of vaccination within examined sociodemographic characteristics were often smaller in magnitude among veterans than among nonveterans for both vaccinations. CONCLUSIONS: Vaccination rates were below Healthy People 2020 targets for both groups, except influenza vaccination among veterans aged ≥65 years. Understanding differences in vaccine uptake may inform efforts to improve vaccination rates by identifying subgroups who are at high risk of disease and have low vaccination rates.

Geographic Variation in Health Insurance Coverage:United States, 2021.

Objective-This report presents state, regional, and national estimates of the percentage of people who were uninsured, had private health insurance coverage, and had public health insurance coverage at the time of the interview.

Demographic Variation in Health Insurance Coverage:United States, 2021.

Objective-This report presents national estimates of different types of health insurance coverage and lack of coverage (uninsured).Estimates are presented by selected sociodemographic characteristics, including age, sex, race and Hispanic origin, family income, education level, employment status, and marital status.

Physical, Speech, Rehabilitative, or Occupational Therapy Use Among Adults Aged 25-64, by Veteran Status: United States, 2019-2020.

The aim of physical, speech, rehabilitative, and occupational therapy is to restore health, independence, and quality of life by addressing a range of health-related conditions that limit people's abilities to perform functional activities in their daily lives (1). Because functional ability is closely related to participation in society, it is an important dimension of health (2). Veterans have greater prevalence of disability and chronic pain than nonveterans (2,3), which may limit functional abilities. This report describes the use of physical, speech, rehabilitative, or occupational therapy in the past 12 months by veteran status and selected sociodemographic characteristics among adults aged 25-64.

Dental Care Utilization Among Adults Aged 18-64: United States, 2019 and 2020.

Oral health is an essential component of overall health and well-being (1,2). Along with good oral hygiene, an important factor of oral health is regular dental care (3). However, about 35% of adults aged 18 and over did not have a dental visit in 2019 (4), and predictors such as age, race, sex, and socioeconomic status were associated with delayed dental care among adults in the United States (5). In 2020, many dental practices limited their hours and services in response to the COVID-19 pandemic (6,7). This report uses data from the 2019 and 2020 National Health Interview Survey (NHIS) to describe recent changes in the prevalence of dental visits among adults aged 18-64.

Demographic Variation in Health Insurance Coverage:United States, 2020.

Objective-This report presents national estimates of different types of health insurance coverage and lack of coverage (uninsured). Estimates are presented by selected sociodemographic characteristics, including age, sex, race and Hispanic origin, family income, education level, employment status, and marital status.

Geographic Variation in Health Insurance Coverage: United States, 2020.

Objective-This report presents state, regional, and national estimates of the percentage of people who were uninsured, had private health insurance coverage, and had public health insurance coverage at the time of the interview.

Urban-rural Differences in Dental Care Use Among Adults Aged 18-64.

Regular dental care can lower the risk for oral diseases, and studies have shown a connection between oral health and general health (1,2). However, in 2019 about 35% of adults aged 18 and over did not have a dental examination or cleaning (3). It has been shown that disparities exist in access and use of dental care, especially between rural and urban areas (4,5). In this report, urban-rural differences in dental care use, defined as a dental visit in the past 12 months, were examined among adults aged 18-64 by demographic characteristics.

Demographic Variation in Health Insurance Coverage: United States, 2019.

Objectives-This report presents national estimates of different types of health insurance coverage and lack of coverage (uninsured). Estimates are presented by selected sociodemographic characteristics, including age, sex, race and Hispanic origin, poverty status, education level, employment status, and marital status.

Multiple Chronic Conditions Among Veterans and Nonveterans: United States, 2015-2018.

Objectives-This report describes the prevalence of multiple (two or more) chronic conditions (MCC) among veterans and nonveterans and examines whether differences by veteran status may be explained by differences in sociodemographic composition, smoking behavior, and weight status based on body mass index. Methods-Data from the 2015-2018 National Health Interview Survey were used to estimate the prevalence of MCC among adults aged 25 and over by veteran status and sex. Estimates (age-stratified and age-adjusted) were also presented by race and Hispanic origin, educational attainment, poverty status, smoking status, and weight status. Multivariate logistic regression models examined the odds of MCC by veteran status after age stratification (65 and over or under 65) and further adjustment for age and other covariates. Results-Among adults aged 25 and over, age-adjusted prevalence of MCC was higher among veterans compared with nonveterans for both men and women (22.2% compared with 17.0% for men aged 25-64, 66.9% compared with 61.9% for men aged 65 and over, 25.4% compared with 19.6% among women aged 25-64, and 74.1% compared with 61.8% among women aged 65 and over). Following stratification by age and adjustment for selected sociodemographic characteristics, the prevalence of MCC remained higher among veterans compared with nonveterans for both men and women. After further adjustment for smoking status and weight status, differences in the prevalence of MCC by veteran status were reduced but remained statistically significant, with the exception of men aged 65 and over.

Reasons for Being Uninsured Among Adults Aged 18-64 in the United States, 2019.

Previously published data from the National Health Interview Survey (NHIS) reported that the percentage of uninsured adults aged 18-64 significantly decreased from 20.4% in 2013 to 13.3% in 2018 (1). Lack of health insurance has been associated with not receiving preventive services or screenings and may, in turn, lead to delays in disease diagnosis and poorer health outcomes (2). The 2019 NHIS included six questions for uninsured adults to better understand their reasons for currently being uninsured. This report describes the characteristics of uninsured adults aged 18-64 in 2019 and the percentage who identified with each of the six reasons for being uninsured. For the three most prevalent reasons, the percentage who identified with each reason is presented by selected demographic characteristics, and health status.

Selected Financial Burdens of Health Care Among Families With Older Adults, by Family Composition: United States, 2017-2018.

Objective-This report describes how problems paying medical bills and forgone medical care vary by family composition among families with at least one older adult (aged 65 and over). Methods-Data from families in the 2017-2018 National Health Interview Survey that included at least one older adult were analyzed (n = 19,471). Bivariate and multivariate analyses, adjusted for selected family characteristics that may put families at financial risk, were conducted for both outcome measures and shown by family composition. The family compositions examined were one older adult living alone, two older adults, one younger (aged 18-64) and one older adult, three or more adults (where at least one was an older adult), and two or more adults (where at least one was an older adult) and at least one child (under age 18 years). Results-About 8.6% of families with older adults experienced problems paying medical bills, and 8.9% had forgone medical care. The most common composition for older-adult families was one older adult living alone (39.7%). Older-adult families consisting of only two older adults were the least likely to have experienced problems paying medical bills (4.0%) and to have forgone medical care (3.8%) compared with other family compositions. Older-adult families with at least one child were the most likely to experience problems paying medical bills (21.3%) and to have forgone medical care (18.4%). After adjusting for selected family characteristics in multivariate analyses, the odds of experiencing problems paying medical bills and forgone medical care weakened for all family compositions but remained significantly lower for families with two older adults. Conclusion-Among families with older adults, financial burdens of medical care vary based on family composition.

Problems Paying Medical Bills, 2018.

Previously published data from the National Health Interview Survey (NHIS) found that in 2017 one in seven persons under age 65 was in a family having problems paying medical bills (1). Significant expenses for one family member may adversely affect the whole family (2). People who are in families with problems paying medical bills may experience serious financial consequences, such as having problems with paying for food, clothing, or housing, and filing for bankruptcy (3). Health insurance coverage status (i.e., uninsured, public coverage, or private coverage) may also impact the ability to afford health care costs (4). This report examines characteristics of persons who live in families that have problems paying medical bills.

Strategies Used by Adults With Diagnosed Diabetes to Reduce Their Prescription Drug Costs, 2017-2018.

In 2018, 10.1% of adults aged 18 and over had diagnosed diabetes (1). The majority of those with diabetes take medication for this condition (2). Compared with those without diabetes, adults with diagnosed diabetes experience higher out-of-pocket costs for prescription medications (3) and cost-related, medication nonadherence behaviors (4). Adults have used several strategies to reduce the costs of prescription drugs, including not taking medication as prescribed and asking their doctor for a lower-cost medication (5). This report examines the percentage of adults aged 18 and over with diagnosed diabetes who used these selected strategies to reduce their prescription drug costs.