Myalgic Encephalomyelitis/Chronic Fatigue Syndrome in Adults: United States, 2021-2022.

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a complex, multisystem illness characterized by activity-limiting fatigue, worsening of symptoms after activity, and other symptoms (1). It affects all age, sex, and racial and ethnic groups and costs the U.S. economy about $18-$51 billion annually (2-5). This report describes the percentage of adults who had ME/CFS at the time of interview by selected demographic and geographic characteristics based on data from the 2021-2022 National Health Interview Survey (NHIS).

Long COVID in Children: United States, 2022.

While most individuals who contract COVID-19 feel better within a few weeks, others have new, returning, or ongoing symptoms that they did not have before COVID-19, which is often referred to as Long COVID (1). This report describes the percentage of children ages 0-17 years who ever had Long COVID or had Long COVID at the time of interview (currently have Long COVID) based on parent-reported data from the 2022 National Health Interview Survey (NHIS). Long COVID was defined as the presence of symptoms for at least 3 months after having COVID-19 among those who received either a positive test or a doctor's diagnosis of COVID-19.

Long COVID in Adults: United States, 2022.

People who have had COVID-19 may continue to have symptoms or develop new symptoms months after being infected with SARS-CoV-2 (1). This can lead to long-term health and economic impacts on those affected and on society (2). This report uses data from the 2022 National Health Interview Survey to describe the percentage of adults who ever had or had Long COVID at the time of interview (currently have Long COVID) by sociodemographic and geographic characteristics. Long COVID was defined as self-reporting the presence of symptoms for at least 3 months after having COVID-19 among those who reported either a positive test or a doctor's diagnosis of COVID-19.

Long COVID and Significant Activity Limitation Among Adults, by Age - United States, June 1-13, 2022, to June 7-19, 2023.

Long COVID is a condition encompassing a wide range of health problems that emerge, persist, or return following COVID-19. CDC analyzed national repeat cross-sectional Household Pulse Survey data to estimate the prevalence of long COVID and significant related activity limitation among U.S. adults aged ≥18 years by age group. Data from surveys completed between June 1-13, 2022, and June 7-19, 2023, indicated that long COVID prevalence decreased from 7.5% (95% CI = 7.1-7.9) to 6.0% (95% CI = 5.7-6.3) among the overall U.S. adult population, irrespective of history of previous COVID-19, and from 18.9% (95% CI = 17.9-19.8) to 11.0% (95% CI = 10.4-11.6) among U.S. adults reporting previous COVID-19. Among both groups, prevalence decreased from June 1-13, 2022, through January 4-16, 2023, before stabilizing. When stratified by age, only adults aged <60 years experienced significant rates of decline (p<0.01). Among adults reporting previous COVID-19, prevalence decreased among those aged 30-79 years through fall or winter and then stabilized. During June 7-19, 2023, 26.4% (95% CI = 24.0-28.9) of adults with long COVID reported significant activity limitation, the prevalence of which did not change over time. These findings help guide the ongoing COVID-19 prevention efforts and planning for long COVID symptom management and future health care service needs.

Health Conditions and Health Care Use Among American Indian and Alaska Native Adults by Tribal Land Residential Status: United States, 2019-2021.

Objective-This report presents estimates for selected health conditions and health care use among American Indian and Alaska Native (AIAN) adults by tribal land residential status.

Anxiety and depression symptoms among children before and during the COVID-19 pandemic.

PURPOSE: The COVID-19 pandemic caused disruptions to children's daily lives due in part to stay-at-home orders and school closures, reducing interactions with both peers and extended family. Yet, few studies with nationally representative data have explored the potential association of the COVID-19 pandemic and children's mental health. METHODS: The current study analyzed data from the 2019 and 2020 National Health Interview Survey (NHIS) to describe changes in the prevalence of symptoms of anxiety and depression before and during the first year of the pandemic among children aged 5-17 years. Changes in prevalence by child- and family-level characteristics were also examined. RESULTS: During the COVID-19 pandemic, nearly one in six children aged 5-17 years had daily or weekly symptoms of anxiety or depression, a significant increase from before the COVID-pandemic (16.7% (95% CI:15.0-18.6) versus 14.4% (95% CI:13.4-15.3)). Males, children 5-11 years, non-Hispanic children, children living in families in large metropolitan areas, incomes at or below the federal poverty level, and whose highest educated parent had more than a HS education, also showed statistically significant increases in anxiety and depression symptoms. CONCLUSIONS: NHIS data may be used to monitor this increase in mental health symptomatology and assist in identifying children at risk.

Organized Sports Participation Among Children Aged 6-17 Years: United States, 2020.

Sports team participation has been associated with increased levels of physical activity (1) and improved physical and mental health among children and adolescents (2,3). Disparities in sports participation have been found across age, sex, race, disability, and socioeconomic subgroups (4-6). This report describes national estimates of parent-reported organized sports participation during the past 12 months among children aged 6-17 years. Data from the 2020 National Health Interview Survey (NHIS) are analyzed by sociodemographic characteristics.

Perceived Social and Emotional Support Among Adults: United States, July-December 2020.

Social and emotional support is positively associated with improved wellbeing and a reduced risk of premature mortality (1-4). The frequency by which adults receive the social and emotional support they need can vary by demographics and can be impacted in times of stress (5,6). This report describes the percent distribution of perceived social and emotional support among adults aged 18 and over and how the percentage of adults who always or usually have this support varies by selected sociodemographic characteristics based on data from the National Health Interview Survey (NHIS) collected during July-December 2020.

Symptoms of Anxiety or Depressive Disorder and Use of Mental Health Care Among Adults During the COVID-19 Pandemic - United States, August 2020-February 2021.

The spread of disease and increase in deaths during large outbreaks of transmissible diseases is often associated with fear and grief (1). Social restrictions, limits on operating nonessential businesses, and other measures to reduce pandemic-related mortality and morbidity can lead to isolation and unemployment or underemployment, further increasing the risk for mental health problems (2). To rapidly monitor changes in mental health status and access to care during the COVID-19 pandemic, CDC partnered with the U.S. Census Bureau to conduct the Household Pulse Survey (HPS). This report describes trends in the percentage of adults with symptoms of an anxiety disorder or a depressive disorder and those who sought mental health services. During August 19, 2020-February 1, 2021, the percentage of adults with symptoms of an anxiety or a depressive disorder during the past 7 days increased significantly (from 36.4% to 41.5%), as did the percentage reporting that they needed but did not receive mental health counseling or therapy during the past 4 weeks (from 9.2% to 11.7%). Increases were largest among adults aged 18-29 years and among those with less than a high school education. HPS data can be used in near real time to evaluate the impact of strategies that address mental health status and care of adults during the COVID-19 pandemic and to guide interventions for groups that are disproportionately affected.

Sociodemographic and Geographic Variation in Awareness of Stroke Signs and Symptoms Among Adults - United States, 2017.

Stroke is the fifth leading cause of death in the United States (1). In 2017, on average, a stroke-related death occurred every 3 minutes and 35 seconds in the United States, and stroke is a leading cause of long-term disability (1). To prevent mortality or long-term disability, strokes require rapid recognition and early medical intervention (2,3). Common stroke signs and symptoms include sudden numbness or weakness of the face, arm, or leg, especially on one side; sudden confusion or trouble speaking; sudden trouble seeing in one or both eyes; sudden trouble walking, dizziness, or loss of balance; and a sudden severe headache with no known cause. Recommended action at the first sign of a suspected stroke is to quickly request emergency services (i.e., calling 9-1-1) (2). Public education campaigns have emphasized recognizing stroke signs and symptoms and the importance of calling 9-1-1, and stroke knowledge increased 14.7 percentage points from 2009 to 2014 (4). However, disparities in stroke awareness have been reported (4,5). Knowledge of the five signs and symptoms of stroke and the immediate need to call emergency medical services (9-1-1), collectively referred to as "recommended stroke knowledge," was assessed among 26,076 adults aged ≥20 years as part of the 2017 National Health Interview Survey (NHIS). The prevalence of recommended stroke knowledge among U.S. adults was 67.5%. Stroke knowledge differed significantly by race and Hispanic origin (p<0.001). The prevalence of recommended stroke knowledge was highest among non-Hispanic White adults (71.3%), followed by non-Hispanic Black adults (64.0%) and Hispanic adults (57.8%). Stroke knowledge also differed significantly by sex, age, education, and urbanicity. After multivariable adjustment, these differences remained significant. Increasing awareness of the signs and symptoms of stroke continues to be a national priority. Estimates from this report can inform public health strategies for increasing awareness of stroke signs and symptoms.

Heavy Drinking Among U.S. Adults, 2018.

Heavy drinking is defined as the average consumption of more than 7 drinks per week for women and more than 14 drinks per week for men in the past year (1). Heavy drinking is associated with an increased risk of alcohol use disorders, suicide, interpersonal violence, traffic injuries, liver disease, certain cancers and infectious diseases, and adverse birth outcomes in pregnant women (1,2). This report describes adult alcohol use in the United States and presents the prevalence of heavy drinking by demographic characteristics, select mental health indicators, and select measures of health care access and utilization.

Electronic Cigarette Use Among U.S. Adults, 2018.

In 2018, an estimated 8.1 million U.S. adults were current electronic cigarette (e-cigarette) users (1). E-cigarette use is a public health concern (2), and it has been linked to a recent outbreak of lung injury and deaths among adults (3). Although the potential long-term health risks of e-cigarettes are not yet as well-known as they are with cigarettes, e-cigarettes usually contain nicotine, and nicotine is highly addictive (2). Moreover, the most common tobacco product combination among adults is e-cigarettes and cigarettes (4). This report examines e-cigarette use among U.S. adults aged 18 and over by selected sociodemographic characteristics and in relation to cigarette smoking status.

Eye Disorders and Vision Loss Among U.S. Adults Aged 45 and Over With Diagnosed Diabetes, 2016-2017.

Diabetes increases with age. In 2017, the prevalence of diagnosed diabetes increased from 13.2% among adults aged 45-64 to 20.1% among those aged 65-74 and 19.8% among those aged 75 and over (1). Compared with adults without diabetes, adults with diabetes are more likely to develop eye disorders and vision loss from eye disorders (2,3). Moreover, duration of diabetes is a risk factor for the progression of visual problems (3,4). This report compares the age-adjusted percentages of adults aged 45 and over with diagnosed diabetes who were told by a doctor or other health professional that they had cataracts, diabetic retinopathy, glaucoma, or macular degeneration and vision loss due to these disorders, by years since their diabetes diagnosis.

Strategies Used by Adults Aged 18-64 to Reduce Their Prescription Drug Costs, 2017.

In 2017, nearly 60% of U.S. adults aged 18-64 reported being prescribed medication in the past 12 months (1). Approximately 70% of prescription medications carry out-of-pocket costs, with generics costing on average $6 and brand names costing on average $30 (2). Strategies to reduce prescription drug costs at the individual level may include asking one's doctor for a lower-cost medication, not taking medication as prescribed, or using alternative therapies (3). This report examines changes over time in the percentage of adults aged 18-64 who were prescribed medication and reported using these selected strategies to reduce their prescription drug costs in the past 12 months.

Effect of prenatal EPA and DHA on maternal and umbilical cord blood cytokines.

BACKGROUND: Investigators have hypothesized that omega-3 fatty acid supplementation may modulate the immune response. However, available evidence is conflicting. We performed this study to investigate the effect of prenatal eicosapentaenoic acid (EPA)- and docosahexaenoic acid (DHA)-rich fish oil supplementation on maternal and fetal cytokine production. METHODS: This study is a secondary analysis of a randomized controlled trial designed to assess whether prenatal EPA- or DHA-rich fish oil supplementation would prevent perinatal depressive symptoms among women at risk. Enrolled participants received EPA-rich fish oil (1060 mg EPA plus 274 mg DHA), DHA-rich fish oil (900 mg DHA plus 180 mg EPA) or soy oil placebo. Maternal venous blood was collected at enrollment (12-20 weeks gestation) and after supplementation (34-36 weeks gestation). Umbilical cord blood was collected at delivery. We analyzed stored plasma specimens for 16 human cytokines using multiplex immunoassays. Maternal and cord blood cytokine levels were compared among the treatment groups. Associations of serum DHA and EPA with maternal and cord blood cytokines were explored via regression analysis. RESULTS: We enrolled 126 women, of whom 118 completed the trial. Prenatal supplementation with EPA-rich fish oil significantly lowered maternal IL6, IL15, and TNFα concentrations. However, supplementation with DHA-rich fish oil had no significant effect on maternal cytokine profiles. Maternal serum DHA fraction was significantly associated with IL1α, and maternal serum DHA and EPA fractions were significantly associated with IL 10 concentrations after supplementation. Compared with placebo, supplementation with EPA- or DHA-rich fish oils had no significant effect on cord blood cytokine concentrations. CONCLUSIONS: Prenatal supplementation with EPA-rich fish oil significantly reduced levels of several inflammatory cytokines in maternal plasma, while prenatal DHA-rich fish oil had no significant effect on cytokine concentrations. Supplementation with EPA- and DHA- rich fish oil had no significant effect on umbilical cord blood cytokine concentrations. TRIAL REGISTRATION: Clinical Trial Registration: registration number NCT00711971 7/7/2008.

Receipt of Selected Preventive Health Services for Women and Men of Reproductive Age - United States, 2011-2013.

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.

Sleep Duration and Quality Among Women Aged 40-59, by Menopausal Status.

Data from the National Health Interview Survey, 2015. Among those aged 40-59, perimenopausal women (56.0%) were more likely than postmenopausal (40.5%) and premenopausal (32.5%) women to sleep less than 7 hours, on average, in a 24-hour period. Postmenopausal women aged 40-59 were more likely than premenopausal women aged 40-59 to have trouble falling asleep (27.1% compared with 16.8%, respectively), and staying asleep (35.9% compared with 23.7%), four times or more in the past week. Postmenopausal women aged 40-59 (55.1%) were more likely than premenopausal women aged 40-59 (47.0%) to not wake up feeling well rested 4 days or more in the past week.

Vaccination Coverage Among Adults Aged 65 and Over: United States, 2015.

KEY FINDINGS: Data from the National Health Interview Survey ? Among adults aged 65 and over, more than two-thirds had an influenza vaccine in the past 12 months (69.0%). ? More than one in two adults aged 65 and over had a tetanus vaccine in the past 10 years (56.9%). ? More than 6 of 10 adults aged 65 and over had ever had a pneumococcal vaccine (63.6%), while a little more than one-third had ever had a shingles vaccine (34.2%). ? Among adults aged 65 and over, vaccination coverage was highest for non-Hispanic white adults compared with non- Hispanic black and Hispanic adults. ? Vaccination coverage was lowest among poor adults aged 65 and over.

Utilization of Clinical Preventive Services for Cancer and Heart Disease Among Insured Adults: United States, 2015.

KEY FINDINGS: Data from the National Health Interview Survey •Two-thirds of insured adults aged 50-75 were screened for colorectal cancer within the recommended intervals. •Insured women aged 30-39 (90.5%) were more likely than their older peers to be screened for cervical cancer within the recommended intervals. •Seventy-three percent of insured women aged 50-74 had a mammogram in the past 2 years. •The percentage of insured adults who had a cardiovascular risk screening (blood pressure, blood sugar) within the recommended intervals significantly increased with advancing age for both men and women. Recent improvements in health insurance coverage (1) have been associated with improved access to health care (2-4) and increased utilization of preventive services (5). Most insurance plans are now required to cover specific clinical preventive services without copayment from the insured adult (6). This report presents the proportion of insured adults who received selected services that are recommended for the prevention or early detection of cancer and heart disease. Sex- and age-specific differences are examined. The age groups included in each chart vary because the selected preventive services are recommended for different age groups.

Measuring the Prevalence of Diagnosed Chronic Obstructive Pulmonary Disease in the United States Using Data From the 2012-2014 National Health Interview Survey.

OBJECTIVES: This study, measuring the prevalence of chronic obstructive pulmonary disease (COPD), examined (1) whether a single survey question asking explicitly about diagnosed COPD is sufficient to identify US adults with COPD and (2) how this measure compares with estimating COPD prevalence using survey questions on diagnosed emphysema and/or chronic bronchitis and all 3 survey questions together. METHODS: We used data from the 2012-2014 National Health Interview Survey to examine different measures of prevalence among 7211 US adults who reported a diagnosed respiratory condition (ie, emphysema, chronic bronchitis, and/or COPD). RESULTS: We estimated a significantly higher prevalence of COPD by using a measure accounting for all 3 diagnoses (6.1%; 95% CI, 5.9%-6.3%) than by using a measure of COPD diagnosis only (3.0%; 95% CI, 2.8%-3.1%) or a measure of emphysema and/or chronic bronchitis diagnoses (4.7%; 95% CI, 4.6%-4.9%). This pattern was significant among all subgroups examined except for non-Hispanic Asian adults. The percentage difference between measures of COPD was larger among certain subgroups (adults aged 18-39, Hispanic adults, and never smokers); additional analyses showed that this difference resulted from a large proportion of adults in these subgroups reporting a diagnosis of chronic bronchitis only. CONCLUSIONS: With the use of self- or patient-reported health survey data such as the National Health Interview Survey, it is recommended that a measure asking respondents only about COPD diagnosis is not adequate for estimating the prevalence of COPD. Instead, a measure accounting for diagnoses of emphysema, chronic bronchitis, and/or COPD may be a better measure. Additional analyses should explore the reliability and validation of survey questions related to COPD, with special attention toward questions on chronic bronchitis.