Number 20 n March 9, 2010

Health Characteristics of the American Indian
 

or Alaska Native Adult Population:
 

United States, 2004–2008
 by Patricia M. Barnes, M.A.; Patricia F. Adams; and Eve Powell-Griner, Ph.D.

Division of Health Interview Statistics

Abstract

Objective—This report compares national estimates for selected health status

indicators, health behaviors, health care utilization, health conditions,

immunizations, and human immunodeficiency virus (HIV) testing status for

American Indian or Alaska Native (AIAN) adults with those for white, black, Asian,

and Hispanic adults aged 18 years and over.

Methods—The estimates in this report were derived from the Family Core and

the Sample Adult core components of the 2004–2008 National Health Interview

Surveys, conducted by the Centers for Disease Control and Prevention’s National

Center for Health Statistics. Estimates were generated and compared using the

SUDAAN statistical package to account for the complex sample design.

Results—In general, compared with other groups, non-Hispanic AIAN adults

are more likely to have poorer health, unmet medical needs due to cost, diabetes,

trouble hearing, activity limitations, and to have experienced feelings of

psychological distress in the past 30 days. Non-Hispanic AIAN adults are more

likely to be current smokers and current drinkers compared with other adults.

Conclusion—The non-Hispanic AIAN community faces many health challenges

as reflected in their higher rates of risky health behaviors, poorer health status and

health conditions, and lower utilization of health services.

Keywords: c National Health Interview Survey c health behaviors c health care

utilization c conditions.

Introduction

The American Indian or Alaska

Native (AIAN) population are persons

having origins in any of the original

populations of North, Central, or South

America who maintain tribal affiliation

or community attachment. The 2000

U.S. Census showed that 4.3 million

(1.5%) adults in the United States were

AIAN. Approximately 56% (2.4 million)

of AIAN adults are of one race or

ethnicity, whereas the remaining 44%

are AIAN in combination with one or

more other races. The AIAN population

is heterogeneous, with 569 federally

recognized tribes, as well as numerous

other tribes not federally recognized (1).

Although AIAN persons live throughout

the United States, they are more likely

to live in some areas of the country than

others. According to the 2000 census,

43% of AIAN population lived in the

West, 31% lived in the South, 17%

lived in the Midwest, and 9% lived in

the Northeast (2).

AIAN communities face many

health challenges including higher

mortality rates from tuberculosis,

chronic liver disease and cirrhosis,

accidents, diabetes, pneumonia, suicide,

and homicide compared with other

racial and ethnic groups (3). In the

AIAN population, chronic liver disease

and cirrhosis was the sixth leading cause

of death, but was not ranked in the top

10 for the white, black, or Asian or

Pacific Islander populations in 2005 (4).

During that same year, accidents

accounted for more than twice the

percentage of deaths (11.7%) of the

AIAN population compared with other

population groups combined (4), and

their age-adjusted suicide rates were

1.73 times as high as the corresponding

rates for all persons combined (4). The

AIAN population has a life expectancy

at birth that is 2.4 years less than that of

all U.S. populations combined (5), and

they have 1.2 times as many years of

potential life lost at age 75 as that of all

other populations combined (4). The

mortality differentials noted are

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 

Centers for Disease Control and Prevention 

National Center for Health Statistics 
Page 2 National Health Statistics Reports n Number 20 n March 9, 2010

conservative estimates, as studies have

shown that AIAN deaths are often

misidentified on the death certificates so

that death rates are underestimated

(3,6,7).

In addition to disparities in cause of

death, substantial health disparities exist

for many conditions, including heart

disease, tuberculosis, sexually

transmitted diseases, and injuries (8).

The prevalence of diabetes is higher

among the AIAN population (16.5%)

than any other major racial or ethnic

group in the United States, and the

prevalence of diabetes has been

increasing (9,10). These health

disparities may be related to cultural,

genetic, socioeconomic, and behavioral

factors (11) as well as access to and

utilization of health care.

In this report, we examine national

estimates for selected health status

indicators, health behaviors, health care

utilization, health conditions, functional

limitation, immunizations, HIV testing

status, mental health status, and

respondent-assessed health status using

2004–2008 National Health Interview

Survey data (12–16). This report focuses

on the non-Hispanic, single-race AIAN

adult population, and it presents

comparison data for the non-Hispanic,

single-race white; non-Hispanic, singlerace black; non-Hispanic, single-race

Asian; and Hispanic adult populations.

Other subcategories of single-race

persons and multiple-race persons are

not shown due to statistical unreliability.

Methods

Data source

The statistics shown in this report

are based on data from the Family Core

and the Sample Adult Core components

of the 2004–2008 National Health

Interview Surveys (NHIS) (12–16).

NHIS, which is in the field

continuously, is conducted by the

Centers for Disease Control and

Prevention’s National Center for Health

Statistics. It is a survey of a nationally

representative sample of the civilian

noninstitutionalized household

population of the United States. In the

family section of the survey, basic

health and demographic information is

collected on all household members.

Any responsible family member whose

age is equal to or greater than the age of

majority for that state may respond to

questions in the Family Core. In most

states this age is 18 years, but in

Alabama and Nebraska this age is 19,

and in Mississippi it is 21. For children

and adults not available during the

interview, information is provided by a

knowledgeable adult family member

(usually aged 18 years and over; see

above) residing in the household.

Additional information is collected from

one randomly selected adult aged 18

years and over (‘‘the sample adult’’) and

about one randomly selected child aged

0–17 years (‘‘the sample child’’) in each

family. Information on the sample adult

is self-reported except in rare cases

when the sample adult is physically or

mentally incapable of responding, and

information on the sample child is

collected from an adult who is

knowledgeable about the child’s health,

usually a parent.

Statistical Analysis

Five years of data were combined

to increase reliability of estimates for

the smaller population subgroups. Even

with 5 years of data, the standard errors

for some subgroups were quite large. In

tables shown in this report, estimates

with a relative standard error of more

than 30% but less than or equal to 50%

are identified with an asterisk (*),

indicating that they are statistically

unstable due to small sample size.

Readers should exercise caution when

interpreting these statistics. Estimates

with a relative standard error of greater

than 50% are indicated with a dagger

(†) and are not shown.

This report is based on data from

132,203 completed interviews with

sample adults aged 18 years and over,

representing a final sample adult

response rate (which takes into account

household and family nonresponse) for

the combined data years of 68.7%. The

household response rate for the

combined data years was 86.5%.

Procedures used in calculating response

rates for combined NHIS data years are

described in detail in Appendix I of the

Survey Descriptions of the NHIS data

files (17–21).

All estimates and associated

standard errors shown in this report

were generated using SUDAAN, a

software package designed to account

for a complex sample design such as

that of NHIS (22). All estimates for

adults were weighted, using the sample

adult record weight, to represent the

U.S. civilian noninstitutionalized

population aged 18 years and over.

Most estimates presented in this

report were age adjusted using the

projected 2000 U.S. population as the

standard population (23,24). The

SUDAAN procedure PROC DESCRIPT

was used to produce age-adjusted

percentages and their standard errors.

Age adjustment was used to allow

comparison of various sociodemographic

subgroups that have different age

structures. The estimates in this report

were age adjusted using the age groups

18–24 years, 25–44 years, 45–64 years,

and 65 years and over. Estimates for

education, health insurance coverage,

and pneumonia shot were restricted to

certain age groups and were therefore

age adjusted accordingly.

Age-adjusted estimates were

compared using two-tailed significance

tests at the 0.05 level. No adjustments

were made for multiple comparisons. In

this report, terms such as ‘‘greater than’’

and ‘‘less than’’ indicate a statistically

significant difference. Terms such as

‘‘similar’’ or ‘‘no difference’’ indicate

that the statistics being compared were

not significantly different. Lack of

comment regarding the difference

between any two statistics does not

mean that the difference was tested and

found to be not significant.

Most statistics presented in this

report can be replicated using NHIS

public-use data files and accompanying

documentation available for

downloading from the NCHS website at:

http://www.cdc.gov/nchs/nhis.htm. The

variable (STATE) used to create the

Indian Health Service geographic

regions is not included in the public-use

data files to protect respondent

confidentiality. The Indian Health

Service geographic regional estimates
National Health Statistics Reports n Number 20 n March 9, 2010	 Page 3

cannot be replicated using the public-use

data files. Many of the references cited

in this report are also available via the

NCHS website at: http://www.cdc.gov/

nchs.

Selected Results

In the following section, brief,

bulleted summaries of the estimates

shown in Tables 1–7 and Figures 1–4 are

presented for the non-Hispanic AIAN

adult population, the non-Hispanic white

adult population, the non-Hispanic black

adult population, the non-Hispanic Asian

adult population, and the Hispanic adult

population. For conciseness, the

qualifying term ‘‘non-Hispanic’’ will be

omitted when discussing these groups in

the highlights.

Demographic characteristics

(Table 1)

+ Single-race AIAN persons make up

0.6% of the United States adult

population (Figure 1).

+ A smaller percentage of the AIAN

adult population (9.5%) and the

Hispanic adult population (8.2%)

Non-Hispanic all other (1.1%) 

Non-Hispanic Asian 

(4.2%) 

Non-Hispanic white 

(69.5%) 

Hispanic 

(13.3%) 

Non-Hispanic black 

(11.4%) 

NOTES: All non-Hispanic race groups shown are single-race groups, with the exception of the non-Hispanic all other race 

group, which includes all non-Hispanic single-race persons not shown and all non-Hispanic multiple-race persons. 

Persons of Hispanic or Latino origin may be of any race or combination of races. Estimates are age adjusted using the 

projected 2000 U.S. population as the standard population. Estimates are based on household interviews of a sample of the 

civilian, noninstitutionalized population. 

DATA SOURCE: CDC/NCHS, National Health Interview Survey, 2004–2008. 

Non-Hispanic American Indian or
 

Alaska Native 0.6%)
 

Figure 1. Percent distribution of race and ethnicity for adults aged 18 years and over:

United States, 2004–2008

compared with the white adult

population (18.8%), the black adult

population (12.0%), and the Asian

adult population (11.6%) is composed

of persons aged 65 years and over.

+	 AIAN adults (21.1%) and black

adults (21.2%) were more likely than

Asian adults (12.4%) and about twice

as likely as white adults (10.7%) to

have not graduated from high school.

Hispanic adults (43.9%) were most

likely to have not received a high

school diploma compared with other

race/ethnicity groups.

+	 Black adults (18.3%), AIAN adults

(13.6%), and Hispanic adults (12.5%)

were considerably less likely to have

a bachelor’s degree or higher

compared with Asian adults (51.4%)

and white adults (31.8%).

+	 AIAN adults (24.4%), black adults

(21.9%), and Hispanic adults (21.7%)

were about twice as likely as Asian

adults (11.1%) or white adults (8.7%)

to be poor.

+	 Black adults (16.5%) and AIAN

adults (15.6%) were more likely than

Hispanic adults (11.1%), white adults

(10.0%), and about three times as

likely as Asian adults (5.3%) to be

divorced or separated.

+	 AIAN adults (46.4%) were less likely

than Asian adults (64.4%), white

adults (58.7%), or Hispanic adults

(57.5%) to be married. Black adults

(36.9%) were least likely to be

married.

+	 Among adults under age 65 years,

AIAN adults (41.2%) were about two

to four times as likely as black adults

(19.8%), Hispanic adults (14.2%),

Asian adults (9.1%), or white adults

(8.9%) to have public health

insurance coverage.

+	 Among adults under age 65 years,

black adults (22.9%) and AIAN

adults (19.1%) were more likely than

white adults (15.1%) to be uninsured.

Hispanic adults (40.3%) were about

twice as likely as other race/ethnicity

groups to be uninsured.

+	 Fewer than 1 in 10 AIAN adults live

in areas that were not covered by the

Indian Health Service Administration.

Health behaviors (Table 2)

+	 Overall, AIAN adults (32.7%) were

more likely to be current smokers

than white adults (22.5%), black

adults (20.6%), Hispanic adults

(14.4%), or Asian adults (10.4%)

(Figure 2).

+	 White men (31.0%) were more likely

than AIAN (23.8%), Hispanic men

(22.0%), black men (20.6%), or Asian

men (13.4%) to be current moderate

or heavier drinkers.

+	 White women (14.7%) and AIAN

women (11.6%) were more likely

than black women (5.8%), Asian

women (4.5%), or Hispanic women

(4.5%) to be current moderate or

heavier drinkers.

+	 About one-fifth of AIAN adults

(21.8%) were former drinkers

compared with black adults, white

adults, Hispanic adults, and Asian

adults (16.8%, 14.4%, 13.6%, and

8.3%, respectively).

+	 About 59% of Asian adults and 39%

of white adults were of a healthy

weight compared with about 31% of

Hispanic adults, 29% of AIAN adults,

and 29% of black adults (Figure 3).
Percent 

American Indian White Black Asian Hispanic or Alaska Native 

80 

70 

60 

50 

40 

30 

20 

10 

0 

NOTE: Estimates are age adjusted using the projected 2000 U.S. population as the standard population.
 

Estimates are based on household interviews of a sample of the civilian, noninstitutionalized population. 


DATA SOURCE: CDC/NCHS, National Health Interview Survey, 2004–2008.
 

Never Former Current
 

Smoking status
 

Page 4	 National Health Statistics Reports n Number 20 n March 9, 2010

+	 AIAN adults (43.8%) were more

likely than white adults (34.6%) to

never engage in any leisure-time

physical activity.

Health care utilization

(Table 3)

+ Of adults with a usual place of health

care, 39% of AIAN adults compared

with 81% of white adults, 78% of

Asian adults, 75% of black adults,

and 65% of Hispanic adults

considered a doctor’s office or Health

Maintenance organization (HMO)

their usual place of care.

+	 Of adults with a usual place of health

care, AIAN adults (50.7%) were more

likely than Hispanic adults (28.1%)

and about three times as likely as

Asian adults (17.9%), black adults

(17.4%), or white adults (15.5%) to

consider a clinic or health center as

their usual place of care.

+	 AIAN men (66.4%), white men

(63.2%), and black men (59.5%) were

more likely than Asian men (54.6%)

or Hispanic men (48.4%) to have

seen or talked to a health professional

within the past 6 months.

+	 White women (76.9%), black women

(74.4%), and AIAN women (73.1%)

were more likely than Hispanic

women (66.2%) or Asian women

(64.5%) to have seen or talked to a

Figure 2. Percent distribution of cigarette smoking status for adults aged 18 years and

over, by race, and ethnicity: United States, 2004–2008

*Estimate does not meet standards of reliability or precision and should be used with caution. 

NOTE: Estimates are age adjusted using the projected 2000 U.S. population as the standard population. 

Estimates are based on household interviews of a sample of the civilian, noninstitutionalized population. 

DATA SOURCE: CDC/NCHS, National Health Interview Survey, 2004–2008. 

American Indian 

or Alaska Native White Black Asian Hispanic 

0 

10 

20 

30 

40 

50 

60 

70 

Underweight Healthy weight Overweight 

(not obese) 

Obese 

Body weight status 

* 

Percent 

Figure 3. Percent distribution of body weight status for adults aged 18 years and over, by

race and ethnicity: United States, 2004–2008

+ Black women (39.8%) and AIAN white women (23.0%) and nearly six

women (39.7%) were more likely times as likely as Asian women

than Hispanic women (29.9%) and (7.0%) to be obese.

health professional within the past 6

months.

+	 AIAN adults (17.6%), Hispanic adults

(16.5%), and black adults (15.5%),

were more likely than white adults

(11.3%) or Asian adults (9.2%) to

have last seen a dentist more than 5

years ago.

+ AIAN adults (10.3%), black adults

(9.6%), and Hispanic adults (9.0%),

were more likely than white adults

(7.3%) and nearly three times as

likely as Asian adults (3.4%) not to

have received needed medical care

due to cost of care.

Conditions (Table 4)

+	 AIAN adults (14.7%) were more

likely than black adults (10.0%) and

Hispanic adults (8.3%), and more

than twice as likely as Asian adults
National Health Statistics Reports n Number 20 n March 9, 2010	 Page 5 Percent 

American Indian White Black Asian Hispanic 

or Alaska Native 20
 

18
 

16
 

14
 

12
 

10
 

8
 

6
 

4
 

2
 

0
 

NOTE: Estimates are age adjusted using the projected 2000 U.S. population as the standard population. 

Estimates are based on household interviews of a sample of the civilian, noninstitutionalized population. 

DATA SOURCE: CDC/NCHS, National Health Interview Survey, 2004–2008. 

Diabetes	 Heart disease 

Figure 4. Percentage of adults aged 18 years and over who have ever been diagnosed

with diabetes, and percentage of adults aged 18 years and over who have ever been

diagnosed with heart disease, by race and ethnicity: United States, 2004–2008

(6.1%) to have ever been told they

had heart disease (Figure 4).

+ More than one-third of black adults

(36.2%) and AIAN adults (34.5%)

compared with about one-fourth of

white adults (25.7%), Hispanic adults

(24.1%), and Asian adults (22.2%)

had ever been told they had

hypertension.

+ AIAN adults (17.5%) were more

likely than black adults (11.8%) and

Hispanic adults (10.6%) and more

than twice as likely as Asian adults

(8.0%) or white adults (6.6%) to have

ever been told they had diabetes.

(Figure 4).

+ AIAN adults (18.5%) were more

likely than Hispanic adults (13.8%),

black adults (13.6%), or Asian adults

(9.3%) to experience a migraine or

severe headache during the last 3

months.

+ Overall, AIAN adults (5.5%) were

more likely than white adults (3.2%)

and more than twice as likely as

Hispanic adults (1.9%), Asian adults

(1.5%), or black adults (1.2%) to

have a lot of trouble hearing or to be

deaf.

+	 AIAN adults (41.1%) were about

twice as likely as Asian adults

(19.0%) and were also more likely

than white adults (31.6%), black

adults (31.0%), and Hispanic adults

(25.7%), to have a functional

limitation caused by at least one

chronic condition.

Selected immunizations

(Table 5)

+	 About 3 in 10 AIAN adults (31.7%),

white adults (29.9%), and Asian

adults (28.8%) compared with about

2 in 10 black adults (22.8%) and

Hispanic adults (21.2%) had received

an influenza vaccination during the

past 12 months.

+	 Among adults aged 65 years and

over, about one-half of AIAN adults

(52.9%) compared with about

one-third of Hispanic adults (33.2%)

had ever received the pneumonia

shot. White adults (62.0%) were more

likely to receive the pneumonia shot

compared with black, Asian, or

Hispanic adults.

+	 AIAN adults (29.6%) were more

likely than Hispanic adults (21.9%) to

have ever received a hepatitis B
 

vaccine.
 

+	 AIAN adults (43.0%) were more

likely than Hispanic adults (38.0%),

white adults (34.3%), or Asian adults

(30.6%) to have ever been tested for

the HIV virus. Black adults (51.5%)

were most likely to have ever been

tested for the HIV virus.

Mental health status

(Table 6)

+	 Hispanic adults (3.5%), AIAN adults

(3.4%), black adults (3.4%), and

white adults (2.9%) were about twice

as likely as Asian adults (1.4%) to

have experienced serious

psychological distress within the past

30 days.

+	 Overall, Hispanic women (4.9%)

were most likely to have experienced

serious psychological distress within

the past 30 days compared with black

women (3.9%), white women (3.4%),

AIAN women (3.1%), and Asian

women (1.6%).

+	 AIAN adults (3.0%) and Hispanic

adults (2.9%) were nearly three times

as likely as Asian adults (1.1%) to

have felt hopeless most or all of the

time within the past 30 days.

+	 AIAN adults (3.2%) and Hispanic

adults (2.2%) were more likely than

white adults (1.7%) and two to three

times as likely as Asian adults (1.0%)

to have felt worthless most or all of

the time within the past 30 days.

Respondent-assessed health

status (Table 7)

+	 AIAN adults, black adults, and

Hispanic adults were less likely than

white and Asian adults to be in

excellent or very good health.

+	 Black adults (14.7%), AIAN adults

(14.1%), and Hispanic adults (13.2%)

were more likely than white adults

(8.2%) or Asian adults (6.9%) to be

in fair health.

+	 About 6% of AIAN adults, 5% of

black adults, and 4% of Hispanic

adults were in poor health compared

with 3% of white adults and 2% of

Asian adults.
Page 6	 National Health Statistics Reports n Number 20 n March 9, 2010

Discussion

This analysis highlights the

disparities between AIAN adults and

adults of other racial/ethnic groups. As

shown in this report, in general

compared with other groups, AIAN

adults are more likely to have poorer

health, unmet medical needs due to cost,

diabetes, trouble hearing, activity

limitations, and to have experienced

feelings of psychological distress in the

past 30 days. The AIAN adults are more

likely to be current smokers and current

drinkers compared with other adults.

The finding of poorer health status

of the AIAN population compared with

other adults is consistent with previous

research (3–7). Some of the variation in

health status indicators of AIAN adults

compared with other adults may be

associated with the heterogeneity of

their demographic characteristics. Age, a

characteristic associated with health

status, was statistically controlled for in

this study through age adjustment.

However, controlling for other sociodemographic factors was beyond the

scope of this report. Other factors that

may be associated with health outcomes,

including tribal affiliation, were not

examined in this report due to

limitations on sample sizes and available

information. As with other populations,

it is likely that there is heterogeneity

within the AIAN population in terms of

demographic characteristics as well as

health outcomes. Grouping all AIAN

adults into a single category may mask

the differences among AIAN subgroups.

Notwithstanding the limitations of

the study, NHIS provides an opportunity

to merge data across years and thus

increase the precision of the estimates

for the AIAN population. In addition,

the data are nationally representative,

allowing generalization of these findings

to the U.S. population as well as the

AIAN population.

References

1.Ogunwole SU. We The People:

American Indians and Alaska Natives

in the United States. U.S.

Department of Commerce. U.S.

Census Bureau. Census 2000 Brief.

February 2006.

2.Office of Minority Health and Health

Disparities. American Indian and

Alaska Native Populations. Centers

for Disease Control and Prevention.

Available from: www.cdc.gov/omhd/

Populations/AIAN/AIAN.htm.

3.Anderson RN, Smith BL. Deaths:

Leading causes for 2001. National

vital statistics reports; vol 52 no 9.

Hyattsville, MD: National Center for

Health Statistics. 2003.

4.National Center for Health Statistics,

Health, United States, 2008 with

Special Feature on the Health of

Young Adults. Hyattsville, MD:

2009.

5.Indian Health Service. Facts on

Indian Health Disparities. January

2006.

6.Rosenberg HM, Maurer JD, Sorlie

PD, Johnson NJ, et al. Quality of

death rates by race and Hispanic

origin: A summary of current

research, 1999. National Center for

Health Statistics. Vital Health Stat

2(128). 1999.

7.Sorlie PD, Rogot E, Johnson NJ.

Validity of demographic

characteristics on the death

certificate. Epidemiology 3(2):181–4.

1992.

8.Forquera R. Urban Indian Health.

Issue Brief. The Henry J. Kaiser

Family Foundation. November 2001.

9.CDC. National Center for Chronic

Disease Prevention and Health

Promotion. Preventing diabetes and

its complications. Factsheet, 2009.

Available from: www.cdc.gov/

chronicdisease/resources/

publications/fact_sheets/diabetes.htm.

10. CDC. Diabetes prevalence among

American Indians and Alaska Natives

and the overall population: United

States, 1994–2002. MMWR 2003:52

no 30: 702–4.

11. Denny CH, Taylor TL. American

Indian and Alaska Native health

behavior: findings from the

behavioral risk factor surveillance

system, 1992–1995. Ethn Dis. 1999

Autumn;9(3):403–9.

12. National Center for Health Statistics.

National Health Interview Survey:

2004 data release [online]. Available

from: http://www.cdc.gov/nchs/nhis/

nhis_2004_data_release.htm.

13. National Center for Health Statistics.

National Health Interview Survey:

2005 data release [online]. Available

from: http://www.cdc.gov/nchs/nhis/

nhis_2005_data_release.htm.

14. National Center for Health Statistics.

National Health Interview Survey:

2006 data release [online]. Available

from: http://www.cdc.gov/nchs/nhis/

nhis_2006_data_release.htm.

15. National Center for Health Statistics.

National Health Interview Survey:

2007 data release [online]. Available

from: http://www.cdc.gov/nchs/nhis/

nhis_2007_data_release.htm.

16. National Center for Health Statistics.

National Health Interview Survey:

2008 data release [online]. Available

from: http://www.cdc.gov/nchs/nhis/

nhis_2008_data_release.htm.

17. National Center for Health Statistics.

National Health Interview Survey

(NHIS): 2004 Public-use data

release. NHIS survey description

[online]. Available from: http://

www.cdc.gov/nchs/data/nhis/

srvydesc.pdf.

18. National Center for Health Statistics.

National Health Interview Survey

(NHIS): 2005 Public-use data

release. NHIS survey description

[online]. Available from: ftp://

ftp.cdc.gov/pub/Health_Statistics/

NCHS/Dataset_Documentation/NHIS/

2005/srvydesc.pdf.

19. National Center for Health Statistics.

National Health Interview Survey

(NHIS): 2006 Public-use data

release. NHIS survey description

[online]. Available from: ftp://

ftp.cdc.gov/pub/Health_Statistics/

NCHS/Dataset_ Documentation/

NHIS/2006/srvydesc.pdf.

20. National Center for Health Statistics.

National Health Interview Survey

(NHIS): 2007 Public-use data

release. NHIS survey description

[online]. Available from: ftp://

ftp.cdc.gov/pub/Health_Statistics/

NCHS/Dataset_Documentation/NHIS/

2007/srvydesc.pdf.

21. National Center for Health Statistics.

National Health Interview Survey

(NHIS): 2008 Public-use data

release. NHIS survey description

[online]. Available from: ftp://

ftp.cdc.gov/pub/Health_Statistics/

NCHS/Dataset_Documentation/NHIS/

2008/srvydesc.pdf.

22. Research Triangle Institute.

SUDAAN (Release 9.0.1) [Computer

Software]. Research Triangle Park,

NC: Research Triangle Institute.

2005.

23. Day JC. Population projections of the

United States by age, sex, race, and

Hispanic origin: 1995 to 2050, U.S.

Bureau of the Census, Current
National Health Statistics Reports

n Number 20n March 9, 2010 Page7

Population Reports, P25–1130.

Washington. U.S. Government

Printing Office. Available from:

http://www.census.gov/prod/1/pop/

p25-1130

. 1996.

24. Klein RJ, Schoenborn CA. Age

adjustment using the 2000 projected

U.S. population. Healthy People

Statistical Notes, no 20. Hyattsville,

Md: National Center for Health

Statistics. 2001.

25. Office of Management and Budget.

Revisions to the Standards for the

Classification of Federal Data on

Race and Ethnicity. Federal Register

62(210):58782–90. 1997.

26. Kessler RC, Barker PR, Colpe LJ, et

al. Screening for serious mental

illness in the general population.

Archives of General Psychiatry.

60:184–9. 2003.
Page 8 National Health Statistics Reports n Number 20 n March 9, 2010

Table 1. Age-adjusted percent distributions (with standard errors) of selected demographic characteristics for adults aged 18 years and

over, by race and ethnicity: United States, 2004–2008

Race1 and ethnicity

Not Hispanic or Latino2

American Black or

Indian or African

Selected characteristic Alaska Native White American Asian Hispanic2

Percent distributions3 (standard error)

Total. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.00 100.00 100.00 100.00 100.00

Sex

Male ................................... 50.4 (2.11) 48.3 (0.22) 44.3 (0.46) 48.2 (0.80) 50.2 (0.45)

Female .................................. 49.6 (2.11) 51.7 (0.22) 55.7 (0.46) 51.8 (0.80) 49.8 (0.45)

Age4

18–24 years ............................... 18.0 (1.98) 11.5 (0.23) 15.6 (0.46) 13.0 (0.64) 17.4 (0.36)

25–44 years ............................... 39.8 (2.38) 33.8 (0.24) 40.6 (0.50) 44.3 (0.85) 50.0 (0.49)

45–64 years ............................... 32.8 (2.10) 35.8 (0.22) 31.8 (0.44) 31.0 (0.81) 24.4 (0.39)

65 years and over ........................... 9.5 (1.06) 18.8 (0.22) 12.0 (0.31) 11.6 (0.52) 8.2 (0.27)

Education5

Less than a high school diploma .................. 21.1 (2.34) 10.7 (0.19) 21.2 (0.47) 12.4 (0.63) 43.9 (0.59)

High school diploma or GED6 .................... 39.4 (2.88) 29.2 (0.26) 31.3 (0.49) 17.4 (0.67) 24.4 (0.43)

Some college .............................. 25.9 (2.17) 28.3 (0.23) 29.2 (0.47) 18.8 (0.75) 19.3 (0.40)

Bachelor’s degree or higher ..................... 13.6 (2.07) 31.8 (0.34) 18.3 (0.43) 51.4 (1.13) 12.5 (0.39)

Poverty status7

Poor ................................... 24.4 (3.72) 8.7 (0.20) 21.9 (0.48) 11.1 (0.58) 21.7 (0.42)

Near poor ................................ 24.1 (2.01) 15.7 (0.18) 24.0 (0.41) 17.5 (0.74) 29.3 (0.43)

Not poor ................................. 51.6 (3.71) 75.5 (0.29) 54.1 (0.61) 71.5 (0.87) 48.9 (0.56)

Marital status

Never married.............................. 20.4 (1.86) 18.8 (0.17) 31.7 (0.37) 21.6 (0.54) 18.6 (0.27)

Married .................................. 46.4 (3.11) 58.7 (0.26) 36.9 (0.48) 64.4 (0.68) 57.5 (0.42)

Cohabiting ................................ 10.2 (1.47) 6.4 (0.13) 6.5 (0.25) 3.2 (0.31) 6.8 (0.21)

Divorced or separated......................... 15.6 (1.52) 10.0 (0.12) 16.5 (0.29) 5.3 (0.29) 11.1 (0.24)

Widowed ................................. 7.4 (1.13) 6.1 (0.08) 8.3 (0.21) 5.5 (0.33) 6.0 (0.21)

Health insurance coverage (under 65 years)8

Private .................................. 39.7 (3.70) 76.1 (0.30) 57.3 (0.57) 74.1 (0.84) 45.5 (0.57)

Public ................................... 41.2 (4.11) 8.9 (0.18) 19.8 (0.45) 9.1 (0.53) 14.2 (0.36)

Uninsured ................................ 19.1 (2.01) 15.1 (0.21) 22.9 (0.44) 16.8 (0.72) 40.3 (0.56)

Indian Health Service (IHS) geographic regions9

Alaska .................................. *1.8 (0.65) 0.2 (0.04) † 0.2 (0.02) *0.1 (0.03)

East .................................... 37.9 (5.19) 39.1 (0.52) 50.4 (0.93) 25.0 (0.97) 43.9 (0.85)

Northern plains ............................. 15.3 (3.48) 16.4 (0.47) 8.2 (0.44) 6.1 (0.61) 3.2 (0.28)

Pacific coast............................... 13.3 (2.12) 11.2 (0.29) 6.1 (0.28) 36.2 (1.09) 30.2 (0.78)

Southwest ................................ *21.7 (7.27) 5.8 (0.26) 1.4 (0.13) 4.9 (0.45) 9.8 (0.54)

Not IHS region ............................. 9.9 (2.71) 27.3 (0.52) 33.8 (0.94) 27.6 (1.06) 12.8 (0.50)

* Estimates preceded by an asterisk have a relative standard error of greater than 30% and less than or equal to 50% and should be used with caution as they do not meet the standards of

reliability or precision.

† Estimates with a relative standard error greater than 50% are indicated with a dagger, but are not shown. 1

The category race refers to persons who indicated only a single race group. Persons who indicated a single race other than the groups shown are not shown separately due to small sample
 

sizes. Persons who indicated not Hispanic or Latino and multiple races are excluded from the table.
 2

Persons of Hispanic or Latino origin may be of any race or combination of races. The category not Hispanic or Latino refers to all persons who are not of Hispanic or Latino origin, regardless of
 

race.
 3

Unknowns for education, poverty status, marital status, and health insurance coverage were not included in the denominators when calculating percentages.
 4

Estimates for age groups are not age-adjusted.
 5

Education is shown only for persons aged 25 years and over.
 6

GED is General Educational Development high school equivalency diploma.
 7

Poverty status is based on family income and family size using the U.S. Census Bureau’s poverty thresholds for 2003, 2004, 2005, 2006, and 2007. Poor persons are defined as below the
 

poverty threshold. Near poor persons have incomes of 100% to less than 200% of the poverty threshold. Not poor persons have incomes that are 200% of the poverty threshold or greater.
 

Because of the different income questions used in 2007 and beyond, income estimates may not be comparable with those from earlier years.
 8

Classification of health insurance coverage is based on a hierarchy of mutually exclusive categories. Persons with more than one type of health insurance were assigned to the first appropriate
 

category in the hierarchy. Persons under age 65 years and those aged 65 years and over were classified separately because of the prominence of Medicare coverage in the older population.
 

Persons with Indian Health Service (IHS) were included in the category public. See Definition of terms for more details.
 9

These five regions contain 36 states that are typically covered by Indian Health Service (IHS) administrative areas. The category Not IHS region contains the remaining 14 states and the District
 

of Columbia. See Definition of terms for the states included in each region.
 

NOTE: Unless otherwise specified, estimates are age adjusted using the projected 2000 U.S. population as the standard population and using four age groups: 18–24 years, 25–44 years, 45–64

years, and 65 years and over. Estimates for education (for those aged 25 years and over) are age adjusted using the projected 2000 U.S. population as the standard population and using three

age groups: 25–44 years, 45–64 years, 65 years and over. Estimates for health insurance coverage (for those under 65 years of age) are age adjusted using the projected 2000 U.S. population as

the standard population and using three age groups: 18–24 years, 25–44 years, and 45–64 years. Estimates are based on household interviews of a sample of the civilian, noninstitutionalized

population.

DATA SOURCE: CDC/NCHS, National Health Interview Survey, 2004–2008.
National Health Statistics Reports n Number 20 n March 9, 2010 Page 9

Table 2. Age-adjusted percent distributions (with standard errors) of selected health behaviors for adults 18 years of age and over, by

race and ethnicity: United States, 2004–2008

Race1 and ethnicity

Not Hispanic or Latino2

American Black or

Indian or African

Selected characteristic Alaska Native White American Asian Hispanic2

Both sexes Percent distributions3 (standard error)

Total. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.00 100.00 100.00 100.00 100.00

Cigarette smoking status4

Never smoker ............................ 44.6 (4.48) 54.0 (0.26) 64.8 (0.44) 77.9 (0.66) 69.6 (0.45)

Former smoker............................ 22.8 (3.02) 23.5 (0.18) 14.6 (0.32) 11.7 (0.50) 16.0 (0.35)

Current smoker ........................... 32.7 (2.87) 22.5 (0.22) 20.6 (0.39) 10.4 (0.50) 14.4 (0.32)

Alcohol drinking status5 ........................

Lifetime abstainer 24.3 (3.25) 18.4 (0.29) 35.2 (0.59) 47.7 (0.84) 35.1 (0.50)

Former drinker ............................ 21.8 (1.80) 14.4 (0.19) 16.8 (0.35) 8.3 (0.45) 13.6 (0.32)

Current light or infrequent drinker ................ 36.1 (2.17) 44.5 (0.26) 35.6 (0.50) 35.2 (0.79) 38.0 (0.46)

Current moderate or heavier drinker............... 17.9 (2.22) 22.6 (0.23) 12.3 (0.31) 8.8 (0.44) 13.3 (0.31)

Body weight status6

Underweight ............................. *1.3 (0.49) 2.0 (0.07) 1.4 (0.11) 5.1 (0.40) 1.1 (0.09)

Healthy weight ............................ 29.2 (2.18) 39.2 (0.22) 29.1 (0.42) 58.7 (0.81) 30.7 (0.43)

Overweight (but not obese) .................... 30.2 (2.08) 34.5 (0.21) 34.5 (0.42) 28.4 (0.74) 39.9 (0.45)

Obese ................................. 39.4 (2.38) 24.3 (0.21) 35.1 (0.46) 7.8 (0.46) 28.4 (0.43)

Leisure-time physical activity7

Inactive ................................ 43.8 (2.81) 34.6 (0.40) 50.2 (0.64) 38.1 (0.88) 52.1 (0.55)

Engaged in some activity but less than regular ........ 30.7 (2.21) 31.4 (0.27) 26.3 (0.46) 32.7 (0.78) 25.0 (0.42)

Engaged in regular activity .................... 25.5 (2.12) 34.0 (0.29) 23.5 (0.44) 29.1 (0.79) 23.0 (0.43)

Male

Total. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.00 100.00 100.00 100.00 100.00

Cigarette smoking status4

Never smoker ............................ 36.4 (4.90) 49.0 (0.35) 56.2 (0.69) 65.0 (1.11) 58.9 (0.69)

Former smoker............................ 25.0 (3.28) 26.9 (0.26) 18.7 (0.51) 18.6 (0.87) 22.5 (0.58)

Current smoker ........................... 38.6 (4.08) 24.1 (0.31) 25.1 (0.64) 16.4 (0.87) 18.6 (0.52)

Alcohol drinking status5

Lifetime abstainer .......................... 16.6 (3.12) 13.8 (0.32) 25.4 (0.73) 33.3 (1.14) 21.0 (0.59)

Former drinker ............................ 26.7 (2.81) 14.7 (0.24) 17.0 (0.51) 10.5 (0.74) 15.0 (0.48)

Current light or infrequent drinker ................ 32.9 (2.82) 40.5 (0.33) 37.0 (0.77) 42.8 (1.24) 42.0 (0.66)

Current moderate or heavier drinker............... 23.8 (3.46) 31.0 (0.34) 20.6 (0.59) 13.4 (0.82) 22.0 (0.54)

Body weight status6

Underweight ............................. † 1.0 (0.08) 1.2 (0.17) 2.8 (0.44) 0.6 (0.09)

Healthy weight ............................ 30.0 (3.38) 30.9 (0.29) 29.8 (0.68) 51.8 (1.22) 26.5 (0.60)

Overweight (but not obese) .................... 30.4 (3.40) 42.6 (0.31) 39.9 (0.70) 36.8 (1.15) 46.0 (0.68)

Obese ................................. 38.7 (3.88) 25.5 (0.29) 29.2 (0.65) 8.7 (0.64) 26.8 (0.58)

Leisure-time physical activity7

Inactive ................................ 43.9 (4.08) 33.6 (0.48) 45.3 (0.83) 35.1 (1.17) 50.2 (0.74)

Engaged in some activity but less than regular ........ 30.0 (3.12) 31.0 (0.37) 25.9 (0.66) 33.4 (1.11) 25.5 (0.62)

Engaged in regular activity .................... 26.1 (3.36) 35.4 (0.37) 28.8 (0.71) 31.5 (1.12) 24.4 (0.61)

Female

Total. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.00 100.00 100.00 100.00 100.00

Cigarette smoking status4

Never smoker ............................ 51.2 (4.30) 58.2 (0.33) 71.3 (0.51) 89.6 (0.63) 79.9 (0.46)

Former smoker............................ 21.2 (3.41) 20.8 (0.24) 11.6 (0.35) 5.7 (0.47) 10.2 (0.35)

Current smoker ........................... 27.6 (2.80) 21.0 (0.27) 17.1 (0.43) 4.7 (0.43) 10.0 (0.33)

Alcohol drinking status5

Lifetime abstainer .......................... 31.4 (3.98) 22.4 (0.35) 42.7 (0.71) 60.6 (1.11) 48.8 (0.66)

Former drinker ............................ 17.7 (1.94) 14.3 (0.23) 16.7 (0.44) 6.5 (0.50) 12.6 (0.39)

Current light or infrequent drinker ................ 39.3 (3.60) 48.5 (0.34) 34.8 (0.59) 28.4 (1.01) 34.1 (0.59)

Current moderate or heavier drinker............... 11.6 (1.90) 14.7 (0.23) 5.8 (0.25) 4.5 (0.49) 4.5 (0.24)

See footnotes at end of table.
Page 10 National Health Statistics Reports n Number 20 n March 9, 2010

Table 2. Age-adjusted percent distributions (with standard errors) of selected health behaviors for adults 18 years of age and over, by

race and ethnicity: United States, 2004–2008—Con.

Race1 and ethnicity

Not Hispanic or Latino2

Selected characteristic

American

Indian or

Alaska Native White

Black or

African

American Asian Hispanic2

Body weight status6

Underweight .............................

Healthy weight ............................

Overweight (but not obese) ....................

Obese .................................

Leisure-time physical activity7

Inactive ................................

Engaged in some activity but less than regular ........

Engaged in regular activity ....................

*1.6 (0.80)

29.1 (2.80)

29.6 (2.94)

39.7 (3.34)

43.1 (3.16)

32.1 (2.74)

24.8 (2.44)

Percent distributions3 (standard error)

2.9 (0.11) 1.5 (0.16) 7.3 (0.64)

47.5 (0.32) 28.6 (0.52) 65.4 (1.11)

26.6 (0.26) 30.0 (0.50) 20.4 (0.96)

23.0 (0.27) 39.8 (0.59) 7.0 (0.61)

35.4 (0.42) 54.2 (0.72) 41.0 (1.18)

31.8 (0.31) 26.6 (0.58) 32.0 (1.07)

32.8 (0.35) 19.1 (0.47) 27.0 (1.05)

1.6 (0.15)

35.1 (0.56)

33.4 (0.55)

29.9 (0.58)

53.9 (0.65)

24.4 (0.51)

21.6 (0.52)

* Estimates preceded by an asterisk have a relative standard error of greater than 30% and less than or equal to 50% and should be used with caution as they do not meet the standards of

reliability or precision.

†Estimates with a relative standard error greater than 50% are indicated with a dagger, but are not shown. 1

The category race refers to persons who indicated only a single race group. Persons who indicated a single race other than the groups shown are not shown separately due to small sample
 

sizes. Persons who indicated not Hispanic or Latino and multiple races are excluded from the table.
 2

Persons of Hispanic or Latino origin may be of any race or combination of races. The category not Hispanic or Latino refers to all persons who are not of Hispanic or Latino origin, regardless of
 

race.
 3

Denominator for each percent distribution excludes persons with unknown health behavior characteristic.
 4

Cigarette smoking status: Never smoker - never smoked at all or smoked less than 100 cigarettes in lifetime; Former smoker - smoked at least 100 cigarettes in lifetime but not currently smoking;
 

and Current smoker - smoked at least 100 cigarettes in lifetime and currently smoked every day or some days.
 5

Alcohol drinking status: Lifetime abstainer is less than 12 drinks in lifetime; Former drinker is at least 12 drinks in lifetime, but none in the past year; Current light drinker is at least 12 drinks in
 

lifetime, at least 12 drinks in past year, and 3 drinks or fewer per week on average, infrequent drinker is at least 12 drinks in lifetime and 1–11 drinks in past year; Current moderate or heavier
 

drinker is at least 12 drinks in lifetime, at least 12 drinks in past year, and drank more than 3 drinks per week, on average.
 6

Body weight status is based on Body Mass Index (BMI), calculated as kilograms/meters2 using self-reported weight and height. Underweight is a BMI of less than 18.5; Healthy weight is a BMI of
 

greater than or equal to 18.5 and less than 25; Overweight (but not obese) is a BMI of greater than or equal to 25 and less than 30; and Obese is a BMI of greater than or equal to 30. 7

Questions related to leisure-time physical activity were phrased in terms of current behavior and lack a specific reference period. Inactive - no light-moderate or vigorous leisure-time physical

activity lasting at least 10 minutes; Engaged in some activity but less than regular - some light-moderate or vigorous leisure-time physical activity lasting at least 10 minutes but the activity did not

meet the definition for regular leisure-time physical activity; Engaged in regular activity - vigorous leisure-time physical activity at least three times per week lasting at least 20 minutes each time

OR light-moderate leisure-time physical activity at least five times per week lasting at least 30 minutes each time OR both.

NOTE: Estimates are age-adjusted using the projected 2000 U.S. population as the standard population and using four age groups: 18–24 years, 25–44 years, 45–64 years, and 65 years and

over. Estimates are based on household interviews of a sample of the civilian, noninstitutionalized population.

DATA SOURCE: CDC/NCHS, National Health Interview Survey, 2004–2008.
National Health Statistics Reports n Number 20 n March 9, 2010 Page 11

Table 3. Age-adjusted percent distributions (with standard errors) and age-adjusted percents (with standard errors) of selected health

care access and utilization measures for adults 18 years of age and over, by race and ethnicity: United States, 2004–2008

Race1 and ethnicity

Not Hispanic or Latino2

Selected characteristic

American

Indian or

Alaska Native White

Black or

African

American Asian Hispanic2

Both sexes Percent distributions3 (standard error)

Total. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.00 100.00 100.00 100.00 100.00
 

Usual place for health care

Has usual place ........................... 84.0 (2.41) 85.9 (0.21) 84.5 (0.37) 83.7 (0.64) 72.0 (0.46)

No usual place ............................ 15.0 (2.34) 13.0 (0.20) 14.3 (0.36) 15.3 (0.62) 26.7 (0.44)

Has more than one place ..................... † 1.1 (0.06) 1.2 (0.10) 1.0 (0.16) 1.3 (0.11)

Type of place for health care4

Doctor’s office or HMO5 ...................... 38.6 (5.16) 81.2 (0.32) 75.3 (0.50) 77.9 (0.86) 65.0 (0.67)

Clinic or health center ....................... 50.7 (5.71) 15.5 (0.31) 17.4 (0.44) 17.9 (0.79) 28.1 (0.64)

Hospital emergency room or outpatient department ..... *7.4 (2.53) 1.5 (0.06) 5.8 (0.24) 2.2 (0.27) 4.5 (0.23)

Some other place . . . . . . . . . . . . . . . . . . . . . . . . . . *1.8 (0.77) 0.9 (0.05) 0.6 (0.08) 0.9 (0.15) 0.7 (0.08)

Doesn’t go to one place most often ............... † 0.9 (0.05) 0.9 (0.10) 1.2 (0.19) 1.6 (0.14)

Time since last saw or talked to health professional

Never ................................. † 0.7 (0.05) 1.5 (0.17) 2.2 (0.26) 4.2 (0.20)

6 months or less. . . . . . . . . . . . . . . . . . . . . . . . . . . 69.6 (2.44) 70.2 (0.23) 67.7 (0.44) 59.6 (0.82) 57.0 (0.44)

More than 6 months, but not more than 1 year ago ..... 12.1 (1.47) 14.4 (0.17) 15.6 (0.33) 18.5 (0.68) 14.4 (0.33)

More than 1 year, but not more than 2 years ago ...... 7.6 (1.14) 7.7 (0.12) 8.6 (0.27) 10.0 (0.59) 10.7 (0.27)

More than 2 years, but not more than 5 years ago...... 5.3 (1.17) 4.7 (0.10) 4.6 (0.19) 6.4 (0.38) 8.2 (0.24)

More than 5 years ago ....................... 4.2 (1.18) 2.3 (0.07) 2.1 (0.13) 3.3 (0.29) 5.5 (0.20)

Time since last saw a dentist

Never ................................. *2.0 (0.83) 0.4 (0.04) 1.3 (0.13) 2.5 (0.28) 4.0 (0.19)

6 months or less. . . . . . . . . . . . . . . . . . . . . . . . . . . 35.3 (1.80) 48.2 (0.28) 32.1 (0.51) 43.9 (0.90) 30.1 (0.43)

More than 6 months, but not more than 1 year ago ..... 17.3 (1.75) 17.4 (0.17) 20.5 (0.38) 19.7 (0.69) 17.9 (0.35)

More than 1 year, but not more than 2 years ago ...... 13.5 (1.63) 12.1 (0.15) 15.9 (0.35) 13.5 (0.55) 15.8 (0.34)

More than 2 years, but not more than 5 years ago...... 14.3 (1.49) 10.6 (0.15) 14.7 (0.34) 11.3 (0.55) 15.6 (0.33)

More than 5 years ago ....................... 17.6 (2.54) 11.3 (0.17) 15.5 (0.35) 9.2 (0.51) 16.5 (0.33)

Percent3 (standard error)

Measures of health care access6

Delayed medical care due to cost ................ 11.6 (1.64) 10.4 (0.15) 10.5 (0.26) 4.8 (0.35) 10.7 (0.28)

Did not receive medical care due to cost............ 10.3 (1.59) 7.3 (0.13) 9.6 (0.25) 3.4 (0.29) 9.0 (0.26)

Male Percent distributions3 (standard error)

Total. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.00 100.00 100.00 100.00 100.00
 

Usual place for health care

Has usual place ........................... 77.3 (3.76) 81.7 (0.31) 79.5 (0.61) 81.2 (0.92) 65.3 (0.64)

No usual place ............................ 21.4 (3.71) 17.1 (0.30) 19.1 (0.58) 17.9 (0.92) 33.3 (0.63)

Has more than one place ..................... † 1.2 (0.08) 1.3 (0.17) 0.9 (0.18) 1.4 (0.15)

Type of place for health care4

Doctor’s office or HMO5 ...................... 31.4 (5.47) 79.4 (0.43) 74.3 (0.78) 77.6 (1.25) 66.5 (0.87)

Clinic or health center ....................... 56.9 (6.24) 16.2 (0.40) 15.9 (0.64) 17.6 (1.18) 25.5 (0.81)

Hospital emergency room or outpatient department ..... *8.0 (2.47) 2.0 (0.10) 7.5 (0.44) 2.4 (0.38) 4.8 (0.34)

Some other place . . . . . . . . . . . . . . . . . . . . . . . . . . *3.4 (1.61) 1.1 (0.07) 1.0 (0.16) 0.9 (0.21) 0.8 (0.12)

Doesn’t go to one place most often ............... † 1.3 (0.09) 1.3 (0.19) 1.5 (0.28) 2.4 (0.25)

Time since last saw or talked to health professional

Never ................................. † 0.9 (0.07) 2.1 (0.24) 2.6 (0.42) 5.4 (0.29)

6 months or less. . . . . . . . . . . . . . . . . . . . . . . . . . . 66.4 (4.00) 63.2 (0.32) 59.5 (0.66) 54.6 (1.17) 48.4 (0.64)

More than 6 months, but not more than 1 year ago ..... 10.6 (1.91) 15.2 (0.25) 16.4 (0.55) 18.6 (0.96) 14.5 (0.47)

More than 1 year, but not more than 2 years ago ...... 7.0 (1.42) 10.2 (0.20) 11.4 (0.45) 11.7 (0.81) 12.2 (0.41)

More than 2 years, but not more than 5 years ago...... 8.0 (2.14) 6.9 (0.18) 7.2 (0.36) 8.2 (0.63) 10.9 (0.37)

More than 5 years ago ....................... *6.0 (1.88) 3.5 (0.12) 3.4 (0.24) 4.3 (0.48) 8.6 (0.34)

Time since last saw a dentist

Never ................................. † 0.6 (0.06) 1.5 (0.17) 2.7 (0.41) 4.8 (0.25)

6 months or less. . . . . . . . . . . . . . . . . . . . . . . . . . . 33.7 (2.87) 44.8 (0.37) 29.5 (0.72) 40.9 (1.21) 27.0 (0.61)

More than 6 months, but not more than 1 year ago ..... 16.0 (2.50) 17.4 (0.24) 19.5 (0.58) 18.5 (0.92) 16.7 (0.49)

More than 1 year, but not more than 2 years ago ...... 11.8 (2.02) 12.8 (0.22) 16.8 (0.59) 13.8 (0.81) 16.1 (0.48)

More than 2 years, but not more than 5 years ago...... 15.7 (2.59) 11.5 (0.21) 15.7 (0.55) 13.0 (0.86) 16.5 (0.50)

More than 5 years ago ....................... 20.4 (3.47) 12.9 (0.24) 17.0 (0.54) 11.1 (0.88) 19.0 (0.52)

See footnotes at end of table.
Page 12 National Health Statistics Reports n Number 20 n March 9, 2010

Table 3. Age-adjusted percent distributions (with standard errors) and age-adjusted percents (with standard errors) of selected health

care access and utilization measures for adults 18 years of age and over, by race and ethnicity: United States, 2004–2008—Con.

Race1 and ethnicity

Not Hispanic or Latino2

Selected characteristic

American

Indian or

Alaska Native White

Black or

African

American Asian Hispanic2

Percent3 (standard error)

Measures of health care access6

Delayed medical care due to cost ................ 12.8 (2.45) 9.2 (0.19) 8.9 (0.39) 4.3 (0.44) 9.6 (0.39)

Did not receive medical care due to cost............ 12.0 (2.53) 6.4 (0.16) 8.1 (0.36) 3.3 (0.40) 8.2 (0.35)

Female Percent distributions3 (standard error)

Total. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.00 100.00 100.00 100.00 100.00

Usual place for health care

Has usual place ........................... 90.4 (2.11) 90.0 (0.21) 88.6 (0.41) 86.1 (0.79) 79.2 (0.52) 
 

No usual place ............................ 8.8 (1.98) 9.1 (0.20) 10.4 (0.40) 12.7 (0.76) 19.6 (0.49) 
 

Has more than one place ..................... † 0.9 (0.08) 1.0 (0.10) 1.1 (0.25) 1.1 (0.13) 
 

Type of place for health care4

Doctor’s office or HMO5 ...................... 45.3 (5.67) 82.7 (0.32) 76.0 (0.57) 78.1 (1.16) 63.7 (0.76)

Clinic or health center ....................... 45.1 (5.97) 14.9 (0.31) 18.4 (0.52) 18.1 (1.08) 30.3 (0.74)

Hospital emergency room or outpatient department ..... *6.8 (2.93) 1.1 (0.07) 4.6 (0.25) 2.0 (0.36) 4.3 (0.30)

Some other place . . . . . . . . . . . . . . . . . . . . . . . . . . † 0.8 (0.07) 0.4 (0.09) 0.8 (0.21) 0.7 (0.11)

Doesn’t go to one place most often ............... † 0.5 (0.04) 0.6 (0.11) 0.9 (0.25) 1.0 (0.14)

Time since last saw or talked to health professional

Never ................................. † 0.5 (0.05) 1.1 (0.17) 1.9 (0.29) 3.0 (0.22)

6 months or less. . . . . . . . . . . . . . . . . . . . . . . . . . . 73.1 (3.01) 76.9 (0.27) 74.4 (0.52) 64.5 (1.09) 66.2 (0.56)

More than 6 months, but not more than 1 year ago ..... 13.5 (2.40) 13.6 (0.22) 14.9 (0.40) 18.3 (0.89) 14.3 (0.40)

More than 1 year, but not more than 2 years ago ...... 8.3 (1.67) 5.3 (0.13) 6.2 (0.28) 8.3 (0.76) 9.0 (0.36)

More than 2 years, but not more than 5 years ago...... 2.6 (0.79) 2.6 (0.10) 2.5 (0.17) 4.7 (0.44) 5.2 (0.27)

More than 5 years ago ....................... *2.4 (1.09) 1.1 (0.06) 1.0 (0.11) 2.4 (0.33) 2.2 (0.16)

Time since last saw a dentist

Never ................................. † 0.3 (0.03) 1.2 (0.16) 2.4 (0.34) 3.2 (0.23)

6 months or less. . . . . . . . . . . . . . . . . . . . . . . . . . . 37.0 (2.91) 51.6 (0.34) 34.2 (0.61) 46.8 (1.17) 33.4 (0.56)

More than 6 months, but not more than 1 year ago ..... 17.8 (2.53) 17.3 (0.23) 21.4 (0.47) 20.9 (0.94) 19.2 (0.45)

More than 1 year, but not more than 2 years ago ...... 15.5 (2.65) 11.3 (0.18) 15.2 (0.42) 13.0 (0.76) 15.6 (0.45)

More than 2 years, but not more than 5 years ago...... 13.0 (1.94) 9.7 (0.19) 13.9 (0.40) 9.6 (0.70) 14.7 (0.41)

More than 5 years ago ....................... 15.1 (2.68) 9.8 (0.19) 14.2 (0.40) 7.4 (0.62) 13.9 (0.41)

Percent3 (standard error)

Measures of health care access6

Delayed medical care due to cost ................ 10.4 (1.94) 11.5 (0.20) 11.7 (0.34) 5.3 (0.52) 11.8 (0.41)

Did not receive medical care due to cost............ 8.4 (1.88) 8.1 (0.17) 10.8 (0.35) 3.6 (0.43) 9.9 (0.35)

* Estimates preceded by an asterisk have a relative standard error of greater than 30% and less than or equal to 50% and should be used with caution as they do not meet the standards of

reliability or precision.

† Estimates with a relative standard error greater than 50% are indicated with a dagger, but are not shown. 1

The category race refers to persons who indicated only a single race group. Persons who indicated a single race other than the groups shown are not shown separately due to small sample

sizes. Persons who indicated not Hispanic or Latino multiple race are excluded from the table. 2

Persons of Hispanic or Latino origin may be of any race or combination of races. The category not Hispanic or Latino refers to all persons who are not of Hispanic or Latino origin, regardless of

race.
 3

Denominator for each percent distribution and percent excludes persons with unknown characteristic.
 4

Only persons who reported one or more usual places to go for health care were asked about the type of place.
 5

HMO is health maintenance organization.
 6

When asked about delaying or not receiving medical care due to cost, respondents were instructed to exclude dental care.
 

NOTE: Estimates are age adjusted using the projected 2000 U.S. population as the standard population and using four age groups: 18–24 years, 25–44 years, 45–64 years, and 65 years and

over. Estimates are based on household interviews of a sample of the civilian, noninstitutionalized population.

DATA SOURCE: CDC/NCHS, National Health Interview Survey, 2004–2008.
National Health Statistics Reports n Number 20 n March 9, 2010 Page 13

Table 4. Age-adjusted percentages (with standard errors) of adults 18 years of age and over with selected conditions, sensory problems,

and functional limitation status, by race and ethnicity: United States, 2004–2008

Race1 and ethnicity

Not Hispanic or Latino2

American Black or

Indian or African

Selected characteristic Alaska Native White American Asian Hispanic2

Both sexes Percent3 (standard error)

Selected circulatory conditions4 .....................

Heart disease5 .............................. 14.7 (1.93) 12.2 (0.13) 10.0 (0.25) 6.1 (0.37) 8.3 (0.24)

Hypertension ............................... 34.5 (2.48) 25.7 (0.18) 36.2 (0.40) 22.2 (0.61) 24.1 (0.36)

Stroke ................................... 4.7 (1.27) 2.4 (0.05) 3.7 (0.16) 2.0 (0.23) 2.3 (0.15)

Selected respiratory conditions4

Emphysema ................................ *3.0 (0.92) 1.9 (0.05) 0.9 (0.08) 0.5 (0.11) 0.9 (0.10)

Asthma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14.2 (1.66) 11.6 (0.15) 11.6 (0.28) 8.2 (0.46) 8.6 (0.26)

Hayfever .................................. 9.6 (1.42) 8.8 (0.14) 6.5 (0.22) 7.2 (0.44) 6.1 (0.21)

Sinusitis .................................. 13.9 (1.63) 14.7 (0.17) 13.5 (0.33) 6.1 (0.37) 8.4 (0.26)

Chronic bronchitis ............................ 4.9 (0.87) 4.4 (0.09) 3.9 (0.16) 1.5 (0.20) 2.5 (0.14)

Other selected conditions

Cancer4 .................................. 7.0 (1.30) 8.4 (0.11) 4.2 (0.17) 3.2 (0.31) 3.7 (0.19)

Diabetes4,6 ................................ 17.5 (1.97) 6.6 (0.10) 11.8 (0.27) 8.0 (0.44) 10.6 (0.28)

Ulcer4.................................... 11.4 (1.71) 7.6 (0.12) 6.0 (0.20) 3.9 (0.31) 5.6 (0.20)

Migraine or severe headache ..................... 18.5 (1.94) 14.9 (0.17) 13.6 (0.33) 9.3 (0.47) 13.8 (0.31)

Pain in neck ................................ 15.4 (1.78) 15.2 (0.17) 10.7 (0.29) 8.9 (0.44) 13.6 (0.30)

Pain in lower back ............................ 31.1 (2.14) 28.6 (0.23) 23.9 (0.42) 17.9 (0.65) 25.1 (0.41)

Pain down leg below knees ...................... 43.0 (4.33) 30.9 (0.40) 35.4 (0.83) 25.8 (1.51) 37.5 (0.83)

Selected sensory problems

A lot of trouble hearing or deaf .................... 5.5 (1.16) 3.2 (0.07) 1.2 (0.09) 1.5 (0.19) 1.9 (0.15)

Absence of all natural teeth ...................... 13.9 (1.50) 8.0 (0.12) 9.4 (0.25) 5.8 (0.40) 6.8 (0.24)

Functional limitation status7

Limited8 .................................. 42.9 (2.53) 33.0 (0.24) 32.6 (0.43) 20.6 (0.61) 27.4 (0.39)

Limited; caused by at least 1 chronic condition9 .......... 41.1 (2.37) 31.6 (0.24) 31.0 (0.42) 19.0 (0.58) 25.7 (0.39)

Male

Selected circulatory conditions4

Heart disease5 .............................. 15.5 (2.63) 13.5 (0.19) 9.1 (0.38) 6.8 (0.55) 8.6 (0.38)

Hypertension ............................... 38.7 (3.27) 26.7 (0.25) 33.4 (0.61) 23.2 (0.89) 22.1 (0.53)

Stroke ................................... 6.9 (2.06) 2.5 (0.09) 3.5 (0.27) 2.0 (0.37) 2.4 (0.22)

Selected respiratory conditions4

Emphysema ................................ *2.7 (1.16) 2.3 (0.09) 1.1 (0.14) 0.6 (0.18) 0.9 (0.16)

Asthma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.1 (2.01) 10.1 (0.21) 9.6 (0.40) 7.6 (0.61) 6.5 (0.34)

Hayfever .................................. 7.5 (1.95) 7.8 (0.17) 5.4 (0.31) 7.3 (0.63) 4.9 (0.28)

Sinusitis .................................. 9.0 (1.86) 10.7 (0.21) 8.5 (0.42) 5.5 (0.50) 6.4 (0.32)

Chronic bronchitis ............................ 4.9 (1.46) 3.0 (0.10) 2.3 (0.19) 1.6 (0.31) 1.5 (0.17)

Other selected conditions

Cancer4 .................................. 7.1 (2.10) 7.7 (0.15) 4.2 (0.27) 2.3 (0.39) 3.1 (0.27)

Diabetes4,6 ................................ 18.2 (2.67) 7.2 (0.15) 11.3 (0.42) 8.9 (0.67) 10.6 (0.43)

Ulcer4.................................... 12.8 (2.95) 7.6 (0.17) 5.7 (0.32) 3.9 (0.44) 4.9 (0.28)

Migraine or severe headache ..................... 11.4 (2.18) 9.3 (0.19) 8.7 (0.41) 5.3 (0.55) 8.3 (0.36)

Pain in neck ................................ 14.9 (2.69) 12.7 (0.21) 8.7 (0.39) 7.1 (0.58) 10.9 (0.43)

Pain in lower back ............................ 31.2 (3.14) 27.0 (0.32) 20.4 (0.58) 15.6 (0.80) 22.5 (0.56)

Pain down leg below knees ...................... 45.2 (5.69) 28.8 (0.56) 33.7 (1.36) 23.6 (2.20) 35.0 (1.32)

Selected sensory problems

A lot of trouble hearing or deaf .................... 9.3 (2.13) 4.2 (0.11) 1.2 (0.14) 1.4 (0.26) 2.1 (0.26)

Absence of all natural teeth ...................... 14.8 (2.25) 8.0 (0.16) 8.3 (0.36) 5.2 (0.48) 6.2 (0.36)

Functional limitation status7

Limited8 .................................. 42.4 (3.20) 29.4 (0.31) 26.6 (0.61) 16.8 (0.85) 22.2 (0.53)

Limited; caused by at least 1 chronic condition9 .......... 40.4 (3.14) 28.3 (0.31) 25.5 (0.60) 15.8 (0.81) 20.9 (0.52)

See footnotes at end of table.
Page 14 National Health Statistics Reports n Number 20 n March 9, 2010

Table 4. Age-adjusted percentages (with standard errors) of adults 18 years of age and over with selected conditions, sensory problems,

and functional limitation status, by race and ethnicity: United States, 2004–2008—Con.

Race1 and ethnicity

Not Hispanic or Latino2

American Black or

Indian or African

Selected characteristic Alaska Native White American Asian Hispanic2

Female Percent3 (standard error)

Selected circulatory conditions4

Heart disease5 .............................. 15.0 (2.30) 11.3 (0.16) 10.7 (0.33) 5.6 (0.49) 8.1 (0.32)

Hypertension ............................... 30.2 (3.03) 24.7 (0.22) 38.3 (0.50) 21.1 (0.79) 25.8 (0.47)

Stroke ................................... *2.5 (0.90) 2.4 (0.07) 3.8 (0.21) 2.0 (0.32) 2.4 (0.19)

Selected respiratory conditions4

Emphysema ................................ *3.2 (1.28) 1.6 (0.06) 0.8 (0.10) 0.5 (0.14) 0.9 (0.12)

Asthma ................................... 18.2 (2.19) 13.0 (0.20) 13.2 (0.37) 8.7 (0.67) 10.7 (0.36)

Hayfever .................................. 11.7 (1.94) 9.8 (0.19) 7.3 (0.30) 7.1 (0.62) 7.1 (0.31)

Sinusitis .................................. 18.8 (2.25) 18.4 (0.24) 17.3 (0.45) 6.7 (0.54) 10.4 (0.37)

Chronic bronchitis ............................ 5.2 (1.19) 5.8 (0.14) 5.2 (0.23) 1.5 (0.25) 3.4 (0.21)

Other selected conditions

Cancer4 .................................. 7.5 (1.64) 9.2 (0.15) 4.2 (0.21) 4.0 (0.45) 4.5 (0.26)

Diabetes4,6 ................................ 16.2 (2.27) 6.2 (0.13) 12.1 (0.34) 7.1 (0.57) 10.7 (0.37)

Ulcer4.................................... 10.8 (2.01) 7.7 (0.15) 6.2 (0.27) 4.0 (0.44) 6.2 (0.29)

Migraine or severe headache ..................... 25.3 (2.61) 20.4 (0.26) 17.7 (0.44) 13.1 (0.77) 19.5 (0.45)

Pain in neck ................................ 16.1 (1.93) 17.6 (0.24) 12.3 (0.38) 10.6 (0.64) 16.3 (0.43)

Pain in lower back ............................ 30.8 (2.89) 30.1 (0.30) 26.7 (0.53) 20.0 (0.99) 27.7 (0.55)

Pain down leg below knees ...................... 41.6 (5.81) 32.6 (0.52) 36.5 (1.01) 27.3 (2.07) 39.5 (1.04)

Selected sensory problems

A lot of trouble hearing or deaf .................... 2.7 (0.75) 2.3 (0.07) 1.1 (0.11) 1.6 (0.27) 1.7 (0.17)

Absence of all natural teeth ...................... 13.1 (1.71) 8.0 (0.16) 10.1 (0.33) 6.3 (0.58) 7.2 (0.33)

Functional limitation status7

Limited8 .................................. 43.0 (3.20) 36.3 (0.31) 37.2 (0.53) 24.0 (0.89) 32.5 (0.53)

Limited; caused by at least 1 chronic condition9 .......... 41.6 (3.28) 34.6 (0.30) 35.4 (0.53) 22.0 (0.86) 30.3 (0.52)

* Estimates preceded by an asterisk have a relative standard error of greater than 30% and less than or equal to 50% and should be used with caution as they do not meet the standards of
 

reliability or precision.
 1

The category race refers to persons who indicated only a single race group. Persons who indicated a single race other than the groups shown are not shown separately due to small sample
 

sizes. Persons who indicated not Hispanic or Latino and multiple races are excluded from the table.
 2

Persons of Hispanic or Latino origin may be of any race or combination of races. The category not Hispanic or Latino refers to all persons who are not of Hispanic or Latino origin, regardless of
 

race.
 3

Denominator for each percent excludes persons with unknown characteristic.
 4

Respondents were asked if they had ever been told by a doctor or other health professional that they had these conditions.
 5

Heart disease includes coronary heart disease, angina pectoris, heart attack, or any other heart condition or disease.
 6

Female respondents were instructed to exclude pregnancy-related diabetes. Responses from persons who said they had borderline diabetes were treated as unknown with respect to diabetes.
 7

Functional limitation status is based on any degree of difficulty the respondent had in performing specific physical tasks (e.g., walking a quarter of a mile, walking up 10 steps, standing for two
 

hours, carrying a 10-pound object) and engaging in social activities and recreation without the assistance of another person or using special equipment.
 8

Limited includes limitation caused by at least one chronic condition, limitation not caused by chronic condition, and unknown if condition causing limitation activity is chronic.
 9

The category limited; caused by at least one chronic condition is a subset of the category limited. Conditions lasting more than 3 months are classified as chronic; selected conditions (e.g.,
 

arthritis, diabetes, cancer, heart conditions) are considered chronic regardless of duration.

NOTES: Estimates are age adjusted using the projected 2000 U.S. population as the standard population and using four age groups: 18–24 years, 25–44 years, 45–64 years, and 65 years and

over. See Technical Notes for information regarding time frame for questions asking about conditions. Estimates are based on household interviews of a sample of the civilian, noninstitutionalized

population.

DATA SOURCE: CDC/NCHS, National Health Interview Survey, 2004–2008.
National Health Statistics Reports n Number 20 n March 9, 2010 Page 15

Table 5. Age-adjusted percentages (with standard errors) of adults 18 years of age and over who received selected immunizations and

HIV tests, by race and ethnicity: United States, 2004–2008

Race1 and ethnicity

Not Hispanic or Latino2

American Black or

Indian or African

Selected characteristic Alaska Native White American Asian Hispanic2

Both sexes Percent3 (standard error)

Received an influenza vaccination past 12 months4 ...... 31.7 (2.85) 29.9 (0.22) 22.8 (0.38) 28.8 (0.71) 21.2 (0.36)

Ever received pneumonia shot5 ................... 52.9 (6.98) 62.0 (0.45) 41.5 (1.08) 39.0 (2.02) 33.2 (1.24)

Ever received hepatitis B vaccine.................. 29.6 (2.70) 29.4 (0.23) 29.3 (0.47) 32.9 (0.79) 21.9 (0.40)

Ever tested for HIV6 .......................... 43.0 (2.39) 34.3 (0.23) 51.5 (0.51) 30.6 (0.78) 38.0 (0.45)

Male

Received an influenza vaccination past 12 months4 ...... 28.7 (2.80) 27.3 (0.27) 22.1 (0.56) 27.9 (1.00) 19.5 (0.51)

Ever received pneumonia shot5 ................... 58.0 (9.65) 59.6 (0.68) 38.5 (1.79) 37.8 (3.26) 31.5 (2.03)

Ever received hepatitis B vaccine.................. 22.2 (3.28) 25.7 (0.31) 24.3 (0.66) 31.9 (1.18) 19.6 (0.56)

Ever tested for HIV6 .......................... 40.3 (4.48) 31.6 (0.30) 50.6 (0.75) 28.7 (1.06) 33.7 (0.66)

Female

Received an influenza vaccination past 12 months4 ...... 34.9 (3.81) 32.3 (0.29) 23.4 (0.47) 29.6 (0.98) 23.1 (0.49)

Ever received pneumonia shot5 ................... 54.2 (7.16) 64.1 (0.56) 43.7 (1.33) 39.1 (2.73) 34.8 (1.62)

Ever received hepatitis B vaccine.................. 37.8 (2.92) 33.1 (0.30) 33.4 (0.57) 34.0 (1.06) 24.6 (0.52)

Ever tested for HIV6 .......................... 46.8 (3.17) 37.0 (0.30) 52.6 (0.59) 32.5 (1.08) 43.2 (0.56)

1

The category race refers to persons who indicated only a single race group. Persons who indicated a single race other than the groups shown are not shown separately due to small sample
 

sizes. Persons who indicated not Hispanic or Latino and multiple races are excluded from the table.
 2

Persons of Hispanic or Latino origin may be of any race or combination of races. The category not Hispanic or Latino refers to all persons who are not of Hispanic or Latino origin, regardless of
 

race.
 3

Denominator for each percent excludes persons with unknown characteristic.
 4

Recieved an influenza vaccination past 12 months includes persons who received a flu shot in the past 12 months or had flu vaccine (FluMistY) sprayed in their nose in the past 12 months.
 5

Ever received a pneumonia shot is only shown for persons 65 years of age and over. Estimates are age adjusted using the projected 2000 U.S. population as the standard population and using
 

two age groups: 65–74 years and 75 years and over.
 6

HIV is human immunodeficiency virus.
 

NOTE: Estimates are age adjusted using the projected 2000 U.S. population as the standard population using four age groups: 18–24 years, 25–44 years, 45–64 years, and 65 years and over.
 

Estimates are based on household interviews of a sample of the civilian, noninstitutionalized population.
 

DATA SOURCE: CDC/NCHS, National Health Interview Survey, 2004–2008.
 
Page 16 National Health Statistics Reports n Number 20 n March 9, 2010

Table 6. Age-adjusted percentages (with standard errors) of adults 18 years of age and over with feelings of psychological distress, by

race and ethnicity: United States, 2004–2008

Race1 and ethnicity

Not Hispanic or Latino2

American Black or

Indian or African

Selected characteristic Alaska Native White American Asian Hispanic2

Both sexes Percent3 (standard error)

Serious psychological distress4 ................... 3.4 (0.78) 2.9 (0.08) 3.4 (0.16) 1.4 (0.16) 3.5 (0.16)

Feel sad

Most or all of the time ....................... 4.9 (1.03) 2.7 (0.07) 4.3 (0.19) 2.1 (0.23) 4.3 (0.17)

Some of the time .......................... 11.3 (1.63) 7.4 (0.12) 9.9 (0.26) 7.6 (0.46) 9.5 (0.27)

Feel nervous

Most or all of the time ....................... 4.1 (0.94) 4.1 (0.10) 3.6 (0.17) 1.8 (0.21) 4.5 (0.17)

Some of the time .......................... 10.6 (1.37) 12.1 (0.16) 9.9 (0.27) 8.6 (0.47) 9.6 (0.27)

Feel restless

Most or all of the time ....................... 7.0 (1.12) 5.9 (0.11) 5.1 (0.18) 2.4 (0.26) 4.9 (0.18)

Some of the time .......................... 11.9 (1.50) 12.4 (0.17) 11.4 (0.33) 7.2 (0.42) 9.1 (0.28)

Feel hopeless

Most or all of the time ....................... 3.0 (0.77) 1.9 (0.06) 2.3 (0.13) 1.1 (0.14) 2.9 (0.14)

Some of the time .......................... 7.1 (1.27) 3.8 (0.08) 4.6 (0.18) 3.5 (0.28) 4.9 (0.20)

Feel like everything is an effort

Most or all of the time ....................... 6.3 (1.02) 4.9 (0.10) 7.6 (0.27) 3.5 (0.29) 5.4 (0.20)

Some of the time .......................... 10.0 (1.48) 8.3 (0.13) 9.5 (0.28) 6.1 (0.41) 7.1 (0.23)

Feel worthless

Most or all of the time ....................... 3.2 (0.76) 1.7 (0.06) 1.7 (0.11) 1.0 (0.15) 2.2 (0.13)

Some of the time .......................... 3.7 (0.82) 3.1 (0.08) 3.5 (0.18) 2.5 (0.25) 3.5 (0.18)

Male

Serious psychological distress4 ................... *3.6 (1.25) 2.3 (0.09) 2.8 (0.25) 1.2 (0.22) 2.2 (0.18)

Feel sad

Most or all of the time ....................... *4.6 (1.50) 2.2 (0.09) 3.6 (0.29) 1.8 (0.32) 2.9 (0.22)

Some of the time .......................... 10.8 (2.50) 5.9 (0.15) 8.4 (0.39) 5.6 (0.54) 7.4 (0.38)

Feel nervous

Most or all of the time ....................... *4.0 (1.33) 3.2 (0.11) 3.0 (0.26) 1.3 (0.24) 2.7 (0.20)

Some of the time .......................... 8.7 (1.98) 10.2 (0.21) 8.2 (0.38) 6.7 (0.56) 7.5 (0.37)

Feel restless

Most or all of the time ....................... 8.6 (1.79) 5.7 (0.15) 4.3 (0.29) 2.1 (0.34) 3.6 (0.24)

Some of the time .......................... 9.6 (2.18) 11.8 (0.23) 9.8 (0.43) 5.9 (0.53) 7.5 (0.36)

Feel hopeless

Most or all of the time ....................... *3.5 (1.18) 1.5 (0.08) 2.0 (0.22) 0.9 (0.19) 1.9 (0.17)

Some of the time .......................... 9.3 (2.46) 3.2 (0.11) 3.8 (0.27) 2.8 (0.36) 3.7 (0.27)

Feel like everything is an effort

Most or all of the time ....................... 4.8 (1.35) 4.4 (0.13) 6.7 (0.37) 3.3 (0.39) 4.1 (0.24)

Some of the time .......................... 11.6 (2.26) 7.2 (0.18) 8.5 (0.41) 4.2 (0.45) 5.8 (0.32)

Feel worthless

Most or all of the time ....................... *3.8 (1.18) 1.4 (0.07) 1.4 (0.16) 0.7 (0.18) 1.5 (0.16)

Some of the time .......................... *4.2 (1.39) 2.6 (0.10) 3.1 (0.27) 2.1 (0.31) 2.8 (0.27)

Female

Serious psychological distress4 ................... 3.1 (0.86) 3.4 (0.11) 3.9 (0.21) 1.6 (0.22) 4.9 (0.26)

Feel sad

Most or all of the time ....................... 4.9 (1.07) 3.2 (0.10) 5.0 (0.23) 2.3 (0.31) 5.7 (0.26)

Some of the time .......................... 11.8 (1.83) 8.7 (0.16) 11.0 (0.35) 9.4 (0.68) 11.5 (0.37)

Feel nervous

Most or all of the time ....................... 4.0 (1.12) 5.0 (0.14) 4.1 (0.21) 2.4 (0.35) 6.2 (0.27)

Some of the time .......................... 12.4 (1.77) 13.8 (0.21) 11.3 (0.37) 10.5 (0.72) 11.7 (0.39)

See footnotes at end of table.
National Health Statistics Reports n Number 20 n March 9, 2010 Page 17

Table 6. Age-adjusted percentages (with standard errors) of adults 18 years of age and over with feelings of psychological distress, by

race and ethnicity: United States, 2004–2008—Con.

Race1 and ethnicity

Not Hispanic or Latino2

Selected characteristic

American

Indian or

Alaska Native White

Black or

African

American Asian Hispanic2

Feel restless

Percent3 (standard error)

Most or all of the time .......................

Some of the time ..........................

Feel hopeless

Most or all of the time .......................

Some of the time ..........................

Feel like everything is an effort

Most or all of the time .......................

Some of the time ..........................

Feel worthless

5.2 (1.44)

14.3 (2.05)

*2.5 (0.84)

5.0 (1.17)

7.5 (1.38)

8.4 (1.62)

6.1 (0.15)

12.9 (0.21)

2.2 (0.09)

4.4 (0.12)

5.4 (0.13)

9.3 (0.18)

5.7 (0.24)

12.6 (0.42)

2.6 (0.17)

5.2 (0.24)

8.4 (0.33)

10.3 (0.36)

2.6 (0.41)

8.4 (0.62)

1.2 (0.19)

4.2 (0.42)

3.7 (0.41)

8.0 (0.65)

6.1 (0.28)

10.8 (0.40)

3.9 (0.23)

6.2 (0.29)

6.6 (0.30)

8.4 (0.31)

Most or all of the time .......................

Some of the time ..........................

*2.4 (0.78)

*3.1 (1.02)

2.0 (0.09)

3.6 (0.11)

1.9 (0.14)

3.8 (0.22)

1.2 (0.25)

3.0 (0.39)

2.9 (0.20)

4.3 (0.24)

* Estimates preceded by an asterisk have a relative standard error of greater than 30% and less than or equal to 50% and should be used with caution as they do not meet the standards of

reliability or precision.
 1

The category race refers to persons who indicated only a single race group. Persons who indicated a single race other than the groups shown are not shown separately due to small sample
 

sizes. Persons who indicated not Hispanic or Latino and multiple races are excluded from the table.
 2

Persons of Hispanic or Latino origin may be of any race or combination of races. The category not Hispanic or Latino refers to all persons who are not of Hispanic or Latino origin, regardless of
 

race.
 3

Denominator for each percent excludes persons with unknown characteristic.
 4

Serious psychological distress: Six psychological distress questions are included in the sample adult component. These questions ask how often a respondent experienced certain symptoms of

psychological distress during the past 30 days. The response codes (0–4) of the six items for each person are summed to yield a scale with a 0 to 24 range. A value of 13 or more for this scale is

used here to define serious psychological distress.

NOTE: Estimates are age adjusted using the projected 2000 U.S. population as the standard population and using four age groups: 18–24 years, 25–44 years, 45–64 years, and 65 years and

over. Estimates are based on household interviews of a sample of the civilian, noninstitutionalized population.

DATA SOURCE: CDC/NCHS, National Health Interview Survey, 2004–2008.
Page 18 National Health Statistics Reports n Number 20 n March 9, 2010

Table 7. Age-adjusted percent distributions (with standard errors) of respondent-assessed health status for adults 18 years of age and

over, by race and ethnicity: United States, 2004–2008

Race1 and ethnicity

Not Hispanic or Latino2

American Black or

Indian or African

Selected characteristic Alaska Native White American Asian Hispanic2

Both sexes Percent distribution3 (standard error)

Total. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.00 100.00 100.00 100.00 100.00

Excellent ............................... 22.6 (1.98) 31.1 (0.25) 24.0 (0.42) 31.6 (0.77) 25.3 (0.40)

Very good ............................... 23.6 (2.19) 33.6 (0.22) 27.4 (0.41) 31.6 (0.76) 27.3 (0.40)

Good.................................. 33.6 (2.00) 24.3 (0.20) 29.3 (0.40) 27.7 (0.73) 30.1 (0.41)

Fair................................... 14.1 (1.44) 8.2 (0.12) 14.7 (0.31) 6.9 (0.44) 13.2 (0.30)

Poor .................................. 6.1 (1.08) 2.8 (0.07) 4.6 (0.18) 2.2 (0.23) 4.0 (0.18)

Male

Total. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.00 100.00 100.00 100.00 100.00

Excellent ............................... 21.3 (2.59) 31.7 (0.33) 26.5 (0.66) 32.1 (1.04) 27.3 (0.57)

Very good ............................... 22.9 (2.74) 33.6 (0.31) 27.3 (0.63) 32.2 (1.08) 28.7 (0.59)

Good.................................. 34.2 (2.80) 24.0 (0.27) 28.5 (0.63) 27.4 (0.99) 28.8 (0.59)

Fair................................... 15.0 (2.13) 7.9 (0.17) 13.4 (0.45) 6.4 (0.58) 11.5 (0.43)

Poor .................................. 6.6 (1.78) 2.8 (0.10) 4.3 (0.29) 1.9 (0.33) 3.7 (0.27)

Female

Total. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.00 100.00 100.00 100.00 100.00

Excellent ............................... 23.7 (2.79) 30.6 (0.30) 21.9 (0.49) 31.2 (1.04) 23.2 (0.49)

Very good ............................... 24.7 (2.77) 33.6 (0.30) 27.6 (0.51) 31.1 (1.04) 26.1 (0.52)

Good.................................. 32.8 (2.63) 24.5 (0.25) 30.0 (0.50) 28.0 (1.05) 31.5 (0.55)

Fair................................... 13.4 (1.73) 8.5 (0.15) 15.8 (0.41) 7.4 (0.61) 14.9 (0.40)

Poor .................................. 5.3 (1.33) 2.9 (0.09) 4.8 (0.23) 2.4 (0.34) 4.3 (0.23)

1

The category race refers to persons who indicated only a single race group. Persons who indicated a single race other than the groups shown are not shown separately due to small sample
 

sizes. Persons who indicated not Hispanic or Latino and multiple races are excluded from the table.
 2

Persons of Hispanic or Latino origin may be of any race or combination of races. The category not Hispanic or Latino refers to all persons who are not of Hispanic or Latino origin, regardless of
 

race.
 3

Denominator for each percent distribution excludes persons with unknown respondent-assessed health status.
 

NOTE: Estimates are age adjusted using the projected 2000 U.S. population as the standard population and using four age groups: 18–24 years, 25–44 years, 45–64 years, and 65 years and
 

over. Estimates are based on household interviews of a sample of the civilian, noninstitutionalized population.
 

DATA SOURCE: CDC/NCHS, National Health Interview Survey, 2004–2008.
 
National Health Statistics Reports n Number 20 n March 9, 2010 Page 19

Technical Notes

Sample design

The National Health Interview

Survey (NHIS) is a cross-sectional

household interview survey of the U.S.

civilian noninstitutionalized population.

Data are collected continuously

throughout the year in all 50 states and

the District of Columbia. NHIS uses a

multistage, clustered sample design to

collect data on a variety of health

indicators. Information on basic health

topics is collected for all household

members, if necessary by proxy from

one adult family member. Additional

information is collected from one

randomly selected adult and about one

randomly selected child in each family.

Self-response is required for the Sample

Adult questionnaire except in rare cases

where sample adults are physically or

mentally incapable of responding for

themselves. Interviews are conducted in

the home using a computer-assisted

personal interview, or CAPI, with

telephone interviewing permitted for

followup, if necessary.

Starting in 2006, the NHIS sample

design included Asian persons in the

NHIS oversampling of minority

populations; previously, only households

with black and Hispanic persons were

oversampled. The sample adult selection

process was also revised in 2006 so that

when black, Hispanic, or Asian persons

aged 65 years and over were present,

they had an increased chance of being

selected as the sample adult.

Response rates

Combining the years 2004–2008,

NHIS interviews were completed in

162,348 households and 165,954

families with 132,203 adults aged 18

years and over completing the Sample

Adult questionnaire. The final response

rate (which takes into account household

and family nonresponse) for the

2004–2008 combined sample adult files

was 68.7%. The household response rate

for the combined years was 86.5%.

Procedures used in calculating response

rates for combined data years are

described in detail in Appendix I of the

Survey Descriptions of the NHIS data

files (17–21). The number of completed

household, family, and sample adult

interviews by year and household and

sample adult response rates by year are

found in Table I.

Item nonresponse

Item nonresponse for each of the

sociodemographic indicators shown in

this report was about 1% or less for

years 2004–2008, with the exception of

poverty status, which is based on

detailed family income asked for in the

family component of the questionnaire.

Item nonresponse for the poverty

indicator was about 20% for years

2004–2008. To minimize the possible

bias that could be introduced from a

relatively large amount of missing

income data, the NHIS Multiple

Imputed Family Income data were used.

The NHIS Imputed Family Income data

were produced by multiple imputation, a

technique that allows the extra variation

due to imputation to be accounted for in

the data analysis. Item nonresponse for

the health behavior, health care,

conditions, immunizations, and other

health related items ranged from 0.1%

to 5.7%. The denominators for statistics

shown in Tables 2–7 exclude persons

with unknown health related

characteristics for a given table. Results

for persons with unknown

sociodemographic characteristics are not

shown separately, but are included in the

total of Table 1.

Age adjustment

Data shown in this report were age

adjusted using the projected 2000 U.S.

population provided by the U.S. Census

Bureau as the standard population

(23,24). Age adjustment was used to

allow comparison among various

population subgroups that have different

age structures. This is particularly

important for demographic

characteristics such as race and

ethnicity, education, and marital status.

It is also helpful for other

characteristics. The following age

groups were used for age adjustment:

18–24 years, 25–44 years, 45–64 years,

and 65 years and over (Table II).

Estimates for education, health insurance

coverage, and pneumonia shot are

restricted to certain age groups and are

therefore age adjusted accordingly.

Estimates were calculated using

software for statistical analysis of

correlated data (SUDAAN) (22). The

SUDAAN procedure PROC DESCRIPT

was used to produce age-adjusted

percentages and their standard errors.

Tests of significance

Statistical tests performed to assess

significance of differences between the

estimates were two-tailed with no

adjustments for multiple comparisons.

The test statistic used to determine

statistical significance of differences

between two percentages was

|Xa–Xb|

Z = , 2

√S 2

a b + S

Table I. Completed interviews and response rates, by year: National Health Interview

Survey, 2004–2008

Interviews and rates 2004 2005

Year

2006 2007 2008

Completed interviews Number

Household ........................... 36,579 38,509 29,204 29,266 28,790

Family. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37,466 39,284 29,868 29,915 29,421

Sample adult ......................... 31,326 31,428 24,275 23,393 21,781

Response rate Percent

Household ........................... 86.9 86.5 87.3 87.1 84.9

Sample adult (Final) ..................... 72.5 69.0 70.8 67.8 62.6
Page 20 National Health Statistics Reports n Number 20 n March 9, 2010

Table II. Age distributions used in ageadjusting estimates shown in Tables 1–7

and Figures 1–4

Projected 2000

U.S. standard

population

Age (in thousands)

18 years and over .......... 203,851

18–24 years............. 26,258

25–44 years............. 81,892

45–64 years............. 60,991

65 years and over ......... 34,710

Education

25 years and over .......... 177,593

25–44 years............. 81,892

45–64 years............. 60,991

65 years and over ......... 34,710

Health insurance

18–64 years .............. 169,141

18–24 years............. 26,258

25–44 years............. 81,892

45–64 years............. 60,991

Pneumonia shot

65 years and over .......... 34,710

65–74 years............. 18,136

75 years and over ......... 16,574

where Xa and Xb are the two

percentages being compared, and Sa and

Sb are the standard errors of those

percentages. The critical value used for

two-sided tests at the 0.05 level of

significance was 1.96.

Relative standard error

Estimates with a relative standard

error of more than 30% but less than or

equal to 50% are identified with an

asterisk (*). Estimates with a relative

standard error of greater than 50% are

indicated with a dagger (†) and are not

shown. The relative standard errors are

calculated as follows:

Relative standard error (as a percentage)

= (SE/Est) 100,

where SE is the standard error of the

estimate, and Est is the estimate.

Demographic terms

Age—The age recorded for each

person is the age at the last birthday.

Education—The categories of

education are based on the years of

school completed or highest degree

obtained for persons aged 25 and over.

Only years completed in a school that

advances a person toward an elementary

or high school diploma, General

Educational Development high school

equivalency diploma (GED), college,

university, or professional degree are

included. Education in other schools or

home schooling is counted only if the

credits are accepted in a regular school

system.

Health insurance coverage—NHIS

respondents were asked about their

health insurance coverage at the time of

the interview. Respondents reported

whether they were covered by private

insurance (obtained from their employer

or workplace, purchased directly, or

through a local or community program),

Medicare, Medigap, (supplemental

Medicare coverage), Medicaid,

Children’s Health Insurance Program

(CHIP), Indian Health Service (IHS),

military coverage (including VA,

TRICARE, or CHAMP-VA), a statesponsored health plan, another

government program or single service

plans. This information was used to

form a health insurance hierarchy that

consisted of three mutually exclusive

categories. Persons with more than one

type of health insurance were assigned

to the first appropriate category in the

following hierarchy: private coverage,

public coverage (includes persons with

Medicare, Medigap, Medicaid, CHIP,

military coverage, a state-sponsored

health plan, IHS, or another government

program), and uninsured (also includes

persons who only have a plan that pays

for one type of service, such as

accidents or dental care).

Hispanic or Latino origin—

Hispanic or Latino origin includes

persons of Mexican, Puerto Rican,

Cuban, Central or South American, or

Spanish origins. Persons of Hispanic or

Latino origin may be of any race.

Indian Health Service (IHS)

geographic regions—Consists of five

regions that contain 36 states that are

typically covered by the IHS

administrative areas. An additional

category of ‘‘Not IHS region’’ was

included so that all 50 states and the

District of Columbia would be

accounted for. The five regions and the

additional category are as follows:

Alaska = Alaska; East = Alabama,

Connecticut, Florida, Kansas, Louisiana,

Maine, Massachusetts, Mississippi, New

York, North Carolina, Oklahoma,

Pennsylvania, Rhode Island, South

Carolina, Tennessee, and Texas;

Northern Plains = Indiana, Iowa,

Michigan, Minnesota, Montana,

Nebraska, North Dakota, South Dakota,

Wisconsin, and Wyoming; Pacific Coast

= California, Idaho, Oregon, and

Washington; Southwest = Arizona,

Colorado, Nevada, New Mexico, and

Utah; Not IHS region = Arkansas,

Delaware, District of Columbia,

Georgia, Hawaii, Illinois, Kentucky,

Maryland, Missouri, New Hampshire,

New Jersey, Ohio, Vermont, Virginia,

and West Virginia.

Marital status—Respondents were

asked to choose a marital status

category. Adults could select the

category they felt most appropriate for

their marital situation. In some cases,

persons reporting their marital status as

‘‘married’’ may have been living in

common-law marital unions.

Alternatively, these individuals could

have identified their marital status as

‘‘living with partner.’’ Adults who were

living with a partner were considered to

be members of the same family (as if

married) and are categorized as

‘‘cohabiting.’’ The distinction between

‘‘married’’ and ‘‘living with partner’’

was made by the respondent.

Poverty status—Poverty categories

are based on the ratio of the family’s

income in the previous calendar year to

the appropriate poverty threshold (given

the family’s size and number of

children) defined by the U.S. Census

Bureau for that year. ‘‘Poor’’ persons are

defined as persons whose family

incomes are below the poverty

threshold. ‘‘Near poor’’ persons have

family incomes of 100% to less than

200% of the poverty threshold, and

‘‘Not poor’’ persons have family

incomes that are 200% of the poverty

threshold or greater.

Race—The 1997 Office of

Management and Budget (OMB) federal

guidelines (25) for reporting race require

that persons of ‘‘single race’’ be

distinguished from persons of ‘‘multiple

race.’’ ‘‘Single race’’ refers to persons
National Health Statistics Reports n Number 20 n March 9, 2010 Page 21

who indicated only a single-race group.

Estimates for the smaller subcategories

of single-race persons and multiple-race

combinations can only be reported to

the extent that the estimates meet the

requirements for confidentiality and

statistical reliability. In this report, four

categories are shown for single-race

individuals (AIAN, white, black or

African American, and Asian). Other

subcategories of single- race persons

and multiple-race persons are not shown

due to statistical unreliability as

measured by the relative standard errors

of the estimates.

Health behavior terms

Lifetime alcohol drinking status

Lifetime abstainer—Had fewer than

12 drinks in lifetime.

Former drinker—Had 12 drinks or

more in lifetime, but no drinks in the

past year.

Current infrequent or light

drinker—Current infrequent drinker had

at least 12 drinks in lifetime and 1 to 11

drinks in the past year; and light drinker

had at least 12 drinks in lifetime and 3

drinks or less per week on average.

Current moderate or heavier

drinker—Had at least 12 drinks in

lifetime and more than 3 drinks per

week, on average.

Body weight status—Body weight

status is based on body mass index

(BMI), which is calculated from

self-reported height and weight without

shoes. BMI is calculated as weight

divided by height2 using metric units

(i.e., kilograms/meter2).

Underweight—Is a BMI of less than

18.5.

Healthy weight—Is a BMI of

greater than or equal to 18.5 and less

than 25.

Overweight but not obese—Is a

BMI of greater than or equal to 25 and

less than 30.

Obese—Is a BMI of greater than or

equal to 30.

Leisure-time physical activity

Inactive—Includes persons who

engaged in no light, moderate, or

vigorous leisure-time physical activity

lasting 10 minutes or longer. Persons

classified as physically inactive includes

persons who volunteered that they were

unable to engage in the activity.

‘‘Inactive’’ may include individuals who

engaged in only strengthening activities.

Some activity, less than regular

activity—Is any light, moderate or

vigorous leisure-time physical activity

lasting at least 10 minutes that did not

meet the criteria for ‘‘regular.’’

Regular activity—Is vigorous

leisure-time physical activity at least

three times per week lasting at least 20

minutes each time or light-moderate

leisure-time physical activity at least

five times per week lasting at least 30

minutes each time or both. It does not

include other combinations of activity

levels (e.g., vigorous activity twice a

week combined with light or moderate

activity three times a week). The

number of individuals with such

combinations of activity is small.

Smoking status

Never—Never smoked a cigarette or

smoked fewer than 100 cigarettes in

lifetime.

Former—Smoked at least 100

cigarettes in lifetime, but currently do

not smoke.

Current—Smoked at least 100

cigarettes in lifetime and currently

smoked cigarettes every day or some

days.

Health care utilization terms

Doctor or other health care

professional—Refers to medical doctors

(MDs) and osteopathic physicians

(DOs), including general practitioners as

well as specialists, dermatologists,

psychiatrists, ophthalmologists,

psychologists, nurses, physical

therapists, and chiropractors.

Usual place for health care—Usual

place of health care was based on a

question that asked whether respondents

had a place that they usually went to

when they were sick or needed advice

about their health. These places include

a walk-in clinic, doctor’s office, clinic,

health center, health maintenance

organization, hospital emergency room

or outpatient clinic, or a military or VA

health care facility.

Time since last physician contact or

other health professional contact—This

is the length of time, prior to the week

of interview, since the respondent last

consulted a physician or other health

care professional in person or by

telephone for health treatment or advice

of any type. This may include a contact

while a patient is in the hospital as well

as a contact from a home visit.

Time since last dental contact—This

is the length of time since the

respondent last saw or talked to a

dentist, including dental specialists as

well as dental hygienists, prior to the

week of interview.

Chronic condition—A condition is

considered chronic if its onset was more

than 3 months before the date of

interview, or it is a type of condition

that ordinarily lasts more than 3 months.

Examples of conditions considered

chronic regardless of onset are diabetes,

emphysema, and arthritis.

Functional limitation—Is based on

any degree of difficulty the respondent

had in performing specific tasks (e.g.,

walking a quarter of a mile, walking up

10 steps, standing for 2 hours, carrying

a 10-pound object, etc.) and engaging in

social activities and recreation without

the assistance of another person or using

special equipment because of a physical,

mental, or emotional problem.

Influenza vaccination—Respondents

were asked in separate questions if they

had received a flu shot during the past

12 months and if they had received a flu

vaccine sprayed in their nose during the

past 12 months.

Pneumonia shot—This variable is

based on a question that asked whether

the respondent has ever had a

pneumonia shot.

Human immunodeficiency virus

(HIV) testing status—This variable is

based on a question that asked whether

the respondent has ever had his or her

blood tested for HIV.

Serious psychological distress—Is

based on a series of six questions asking

about symptoms of psychological

distress experienced in the past 30 days.

The symptoms include feeling: so sad
Page 22 National Health Statistics Reports n Number 20 n March 9, 2010

that nothing could cheer you up,

nervous, restless or fidgety, hopeless,

that everything was an effort, and

worthless. The response options ranged

from ‘‘never’’ (score=0) to ‘‘all of the

time’’ (score=4). Items with missing

data were assigned a score of zero for

that item. A summary score for these six

items was calculated and a total score of

13 or higher was classified as ‘‘serious

psychological distress,’’ consistent with

a scoring algorithm developed by

Kessler, et al. (26).

Respondent-assessed health

status—Respondent-assessed health

status was based on the question,

‘‘Would you say your health, in general,

was excellent, very good, good, fair, or

poor?’’ Information was obtained from

all respondents with proxy responses

allowed for adults not taking part in the

interview and all children 17 years of

age and under.
Page 24 National Health Statistics Reports n Number 20 n March 9, 2010

Suggested citation

Barnes PM, Adams PF, Powell-Griner E.

Health characteristics of the American Indian

or Alaska Native adult population: United

States, 2004–2008 National health statistics

reports; no 20. Hyattsville, MD: National

Center for Health Statistics. 2010.

Copyright information

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.

National Center for Health Statistics

Edward J. Sondik, Ph.D., Director
 

Jennifer H. Madans, Ph.D., Associate Director
 

for Science
 

Division of Health Interview Statistics

Jane F. Gentleman, Ph.D., Director

U.S. DEPARTMENT OF

HEALTH & HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics

3311 Toledo Road

Hyattsville, MD 20782

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PENALTY FOR PRIVATE USE, $300

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DHHS Publication No. (PHS) 2010–1250

CS208319

T35798 (02/2010)