Number 64 n April 4, 2013

First Premarital Cohabitation in the United States:

2006–2010 National Survey of Family Growth

by Casey E. Copen, Ph.D.; Kimberly Daniels, Ph.D.; and William D. Mosher, Ph.D., Division of Vital Statistics

Abstract

Objective—This report provides an updated description of trends and

patterns in first premarital cohabitations among women aged 15–44 in the

United States using the National Survey of Family Growth (NSFG). Trends in

pregnancies within first premarital cohabiting unions and differences by Hispanic

origin and race, and education are also presented.

Methods—Data for 2006–2010 were collected through in-person interviews

with 22,682 women and men aged 15–44 in the household population of the

United States. This report is based primarily on the sample of 12,279 women

interviewed in 2006–2010, and is supplemented by data from the 1995 and 2002

NSFGs.

Results—Forty-eight percent of women interviewed in 2006–2010 cohabited

with a partner as a first union, compared with 34% of women in 1995. Between

1995 and 2006–2010, the percentage of women who cohabited as a first union

increased for all Hispanic origin and race groups, except for Asian women. In

2006–2010, 70% of women with less than a high school diploma cohabited as a

first union, compared with 47% of women with a bachelor’s degree or higher.

First premarital cohabitations were longest for foreign-born Hispanic women (33

months) and shortest for white women (19 months). In 2006–2010, 40% of first

premarital cohabitations among women transitioned to marriage by 3 years, 32%

remained intact, and 27% dissolved. Nearly 20% of women experienced a

pregnancy in the first year of their first premarital cohabitation.

Keywords: union stability • marriage • nonmarital births

Introduction Family Growth (NSFG). Estimates from

the 2006–2010 NSFG show that nearly This report presents national one-half (48%) of women aged 15–44 estimates of first premarital had ever cohabited before marriage cohabitations with a male partner for

(Table 1). Similarly, most young couples women aged 15–44 in the United States

live together first before entering using the 2006–2010 National Survey of

marriage (1,2). Cohabitations are

typically short-lived: one-half of

women’s first premarital cohabitations

that began in 1997–2001 became

marriages and another one-third

dissolved within 5 years (2).

Cohabitation has become a more

frequent site for childbearing. A recent

report on fertility using the 2006–2010

NSFG showed that 23% of recent births

among women aged 15–44 occurred

within cohabitation, a significant

increase from 14% in 2002 (3). One-half

of births to cohabiting women in recent

years were unintended (4). Unintended

births are associated with poorer social,

economic, and health outcomes for both

the mother and the child (5).

The Centers for Disease Control

and Prevention’s National Center for

Health Statistics (NCHS) has

conducted the NSFG seven times since

1973. NSFG is jointly planned and

funded by NCHS and several other

programs of the U.S. Department of

Health and Human Services (see

‘‘Acknowledgments’’). NSFG is

designed to provide national data that

complement NCHS vital statistics data

on registered births in the United

States, by collecting data on the

factors that affect birth and pregnancy

rates—including sexual activity,

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 64 n April 4, 2013

marriage, divorce, cohabitation,

contraceptive use, and infertility (6).

Since 1973, NSFG has included fertility

histories that provide data on the factors

that explain fertility in the United States.

In addition to fertility data, the 1995,

2002, and 2006–2010 NSFGs collected

marriage and cohabitation histories for

women.

The current report presents

estimates from the 2006–2010 NSFG on

the first premarital cohabitation

experiences of women aged 15–44 in

the United States and describes trends in

these data since 1995. Estimates of how

long women’s first premarital cohabiting

unions lasted and whether they remained

intact, transitioned to marriage, or

dissolved are presented. A concurrent

aim of this report is to present trends in

the likelihood and timing of pregnancies

within first premarital cohabiting unions,

and to describe differences across

Hispanic origin and race and education

groups for these women.

The Transition From

Cohabitation to Marriage

Given the increase in cohabitation

in the United States over the past

several decades, considerable research

has focused on how long these unions

last and whether they transition to

marriage. Researchers often frame

questions on the meaning of

cohabitation in terms of two

possibilities: whether cohabitation serves

primarily as a step toward marriage,

much like dating and engagement, or as

an alternative to marriage (7–9).

Economic circumstances are related to

the marriage decision-making process

(10–15). Transitions to marriage are

more likely for cohabiting women with

higher levels of education and income

than for cohabiting women of lower

socioeconomic status (10). Economic

barriers to marriage are particularly

significant for cohabiting women with

children (16). Other factors that

influence the progression from

cohabitation to marriage include

relationship commitment and attitudes

toward marriage (17,18).

Source of the Data

This report uses data primarily from

the 12,279 female respondents of the

2006–2010 NSFG. Data were collected

through in-person interviews from a

representative sample of women and

men aged 15–44 in the household

population of the United States from

June 2006 through June 2010. Data on

women from the 1995 and 2002 NSFGs

are presented in some tables to show

trends in premarital cohabitation over

time. The survey year(s) referenced in

the results refer to when female

respondents were interviewed, not when

an event such as a marriage,

cohabitation, or a pregnancy occurred.

The NSFG sample is a nationally

representative, multistage area

probability sample drawn from 110

areas, or primary sampling units, across

the country. To protect the respondent’s

privacy, the sample design of NSFG is

based on independent samples of

women and men, not couples. That is,

only one person was interviewed in each

selected household. The response rate

for the 2006–2010 NSFG was 77%

overall and 78% for women. More

detailed information about the methods

and procedures of NSFG and its sample

design, weighting, imputation, and

variance estimation has been published

(6,19).

Demographic variables

Demographic characteristics of

women presented in this report include:

age at interview, age at first premarital

cohabitation, education, Hispanic origin

and race, and nativity for Hispanic

women, that is, whether she was born in

the United States.

The 2006–2010 NSFG collects

retrospective histories of cohabitations,

marriages, pregnancies, and births of

women aged 15–44. For marriages, the

histories are complete and include data

on premarital cohabitations, if

applicable. For cohabitations with

partners to whom she was never

married, detailed information was

collected for up to four cohabitations.

The variables from the marital and

cohabitation histories used in this report

include dates of when the first

premarital cohabitation began and, if

applicable, dates of when a first

marriage began or the cohabitation

ended.

NSFG also contains a pregnancy

and birth history—that is, information

on each pregnancy the woman has ever

had up to the survey date and the

relationship with her partner at the time

of the pregnancy and at the time of the

birth. To examine whether a woman had

a pregnancy within a cohabiting union,

her fertility history was used to

determine if she had any pregnancies

leading to a live birth with her first

cohabiting partner during the

cohabitation. This report measures only

pregnancies ending in a live birth, in

part because it is more difficult to

collect reliable data in the same degree

of detail on pregnancies that end in fetal

loss or abortion. For convenience, a

pregnancy leading to a live birth is

referred to in this report as a

‘‘pregnancy.’’

The definition of Hispanic origin

and race used in this report takes into

account the reporting of more than one

race, in accordance with the 1997

guidelines from the Office of

Management and Budget (20). For

convenience in writing, the term

‘‘black’’ or ‘‘non-Hispanic black’’ is

used instead of the full phrase ‘‘nonHispanic black or African American,

single race.’’ Similarly, the term

‘‘white’’ or ‘‘non-Hispanic white’’ is

used instead of the full phrase ‘‘nonHispanic white, single race.’’ The full

phrases of these categories are shown in

the tables. In selected tables where

sample sizes permit, Asian women are

shown separately. Further technical

details on the variables in this report can

be found in the Technical Notes and in

earlier NSFG reports (1,21,22).

Statistical analysis

Some of the results presented in this

report use life table methodology. The

life table is a tool that demographers use

to study mortality, but it is also applied

to the study of fertility, marriage,

cohabitation, and divorce (1,2,21–25). In

studying mortality, a cohort life table is
National Health Statistics Reports n Number 64 n April 4, 2013	 Page 3

a summary of the mortality history of a

group of people from birth to death. To

apply life table analyses to the study of

cohabitation stability, the cohort of

people is replaced with a cohort of

cohabitations, age is replaced by union

duration, and death is replaced by

marriage or dissolution (22). Life table

analyses account for ‘‘censoring,’’ a

term used in the statistical literature to

denote that the outcome of interest is

unknown at the time of observation

(26). For the analysis of age of entry

into first premarital cohabitation, women

aged 15–44 who had neither cohabited

nor married by the date of interview are

referred to as ‘‘censored’’ because it is

unknown whether they will form a

premarital cohabiting union at a later

time. Previous NSFG reports on

marriage and cohabitation provide more

detail on life table techniques (1,22). In

the description of the results,

probabilities are presented as

percentages, such as the percentage of

first premarital cohabitations that

transitioned to marriage by 3 years.

This report contains estimates from

both single-decrement and multipledecrement life tables. For the singledecrement life table, a woman exits the

table in only one way (e.g., from having

never cohabited to entering a first

premarital cohabitation). The multipledecrement life table operates under

similar conditions as a single-decrement

life table; however, a key difference is

that there are multiple ways an event

can end, and these events are mutually

exclusive (27). In this report, the

multiple-decrement life table presents

estimates that a first premarital

cohabitation remained intact,

transitioned to marriage, or dissolved by

3 years (Table 3). The cohabitation

duration is measured from the start of

cohabitation to the end of cohabitation,

whether it ended by marriage, by

dissolution, or through censoring.

Statistics for this report were

produced using SAS software, Version

9.3 (http://www.sas.com). Probabilities

from single-decrement life tables were

calculated using the Kaplan-Meier

procedure using SUDAAN software

(http://www.rti.org/sudaan). This method

accounts for censored data and NSFG’s

complex survey design. Significant

differences between probabilities were

tested using the PROC SURVIVAL

procedure in SUDAAN.

For frequency tables, significant

differences between groups were

determined by using two-tailed t tests at

the 5% level. No adjustments were

made for multiple comparisons. Terms

such as ‘‘greater than’’ and ‘‘less than’’

indicate that a statistically significant

difference was found. 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 not to be significant. The data

presented in this report are bivariate

associations that may be explained by

other factors not controlled for in the

tables or included in the report.

To make reading easier and to

remind the reader that the results are

based on samples and subject to

sampling error, percentages above 10%

are generally shown rounded to the

nearest whole percentage. When the

percentage being cited is below 10%,

the text cites the percentage to 1

decimal point. In this report, percentages

are not shown if the sample

denominator is less than 100 cases, or if

the numerator is less than 5 cases. The

numerators and denominators are much

larger for most statistics presented in

this report. Results from life table

analyses where the sample sizes were

less than 100 cases are not shown.

When a percentage or other statistic is

not shown for these reasons, the table

contains an asterisk (*) signifying that

the statistic does not meet standards of

reliability or precision.

Results

Marriage or cohabitation as

a first union

One way to describe the increase in

premarital cohabitation for women over

time is to show whether her first union

was a cohabitation or a marriage.

Table 1 presents trends in the type of

first union for all women aged 15–44 in

1995, 2002, and 2006–2010. Trends in

first premarital cohabitation by subgroup

are presented by Hispanic origin and

race and education.

+	 In more recent years, women were

increasingly likely to cohabit with a

partner as a first union rather than to

marry directly: 48% of women

interviewed in 2006–2010 cohabited

as a first union, compared with 43%

in 2002 and 34% in 1995 (Table 1,

Figure 1).

+	 The rise in cohabitation as a first

union over this time period led to a

lower percentage of women aged

15–44 whose first union was a

marriage: 23% in 2006–2010,

compared with 30% in 2002 and 39%

in 1995.

+	 An increase in cohabitation as a first

union for all Hispanic origin and race

groups occurred between 1995 and

2006–2010, except among Asian

women. The percentage of women

who cohabited as a first union

increased 57% for Hispanic women,

43% for white women, and 39% for

black women over this time period.

+	 In 2006–2010, 70% of women with

less than a high school diploma

cohabited as a first union, compared

with 47% of women with a

bachelor’s degree or higher. In 1995,

the difference between these

education groups was smaller but

statistically significant: 46% of

women with less than a high school

diploma cohabited as a first union

compared with 34% of women with a

bachelor’s degree or higher

(Figure 2).

Age at first premarital

cohabitation

The probability of cohabiting by

ages 20, 25, and 30 is shown in Table 2.

By age 18, 9% of women aged 15–44 in

2006–2010 had ever cohabited (data not

shown).

By age 20, 26% of women in

2006–2010 had cohabited, compared

with 23% in 2002 and 19% in 1995. By

age 25, over one-half of women (55%)

in 2006–2010 had cohabited, compared

with 52% in 2002 and 46% in 1995. By
SOURCES: CDC/NCHS, National Survey of Family Growth, 1995, 2002, and 2006–2010, and Table 1 of this report. Percent 

28 

34 

39 

27 

43 

29 30

48 

23 

0 

20 

40 

60 

80 

No union Cohabitation Marriage 

1995 2002 2006–2010 

Figure 1. Type of first unions among women aged 15–44: United States, 1995, 2002, and

2006–2010

Page 4	 National Health Statistics Reports n Number 64 n April 4, 2013

NOTES: Analyses of education is limited to women aged 22–44 years at the time of interview. GED is General Educational 

Development high school equivalency diploma. 

SOURCES: CDC/NCHS, National Survey of Family Growth, 1995 and 2006–2010, and Table 1 of this report. Percent 

1995 2006–2010 

46 

39 39 

34 

70 

62 59 

47 

0 

20 

40 

60 

80 

Less than high 

school 

High school diploma 

or GED 

Some college Bachelor's degree 

or higher 

Figure 2. Percentage of women aged 22–44 whose first union was a cohabitation, by

education: United States, 1995 and 2006–2010

age 30, 74% of women in 2006–2010 25.8 (1), the results for the subgroups

had cohabited, compared with 70% in presented here focus on the probability

2002 and 62% in 1995. of premarital cohabitation by age 25.

Because the median age at first + In 2006–2010, 62% of women aged marriage for women in 2006–2010 was 25–29, 61% of women aged 30–34,

and 47% of women aged 35–44 had

cohabited by age 25. The increase in

cohabitation among younger women

suggests a rising trend in premarital

cohabitation in recent years.

+	 U.S.-born Hispanic women had the

highest probability (65%) of

premarital cohabitation by age 25,

compared with white women (57%),

foreign-born Hispanic women (53%),

and black women (51%). Asian

women had a lower probability of

cohabiting by age 25 (19%),

compared with other race groups.

+	 Women with less than a high school

diploma had the highest probability

of cohabiting by age 25 (76%),

compared with women with a

bachelor’s degree or higher (36%).

Length of first premarital

cohabitation

Since 1995, the length, or median

duration, of first premarital cohabitations

has increased, regardless of whether

these unions remained intact,

transitioned to marriage, or had

dissolved by the time of the interview

(Table A). The length of first premarital

cohabitations for women aged 15–44 in

2006–2010 was 22 months, compared

with 20 months in 2002, and 13 months

in 1995. Cohabitations that transitioned

to marriage also lasted longer in

2006–2010 and 2002 than in 1995—21

months in 2006–2010, 19 months in

2002, and 14 months in 1995. Table B

shows the median length of first

premarital cohabitations for women by

age group, Hispanic origin and race, and

education:

+	 Cohabitations among women under

age 20 were longer (25 months) than

cohabitations among those aged 20

and over (17–20 months).

+	 The length of a first premarital

cohabitation was 33 months for

foreign-born Hispanic women, 27

months for black women, 25 months

for U.S.-born Hispanic women, and

19 months for white women.

+	 First premarital cohabitations were

longer for women aged 22–44 with

less than a high school diploma (30

months) than for women with a
National Health Statistics Reports n Number 64 n April 4, 2013	 Page 5

Table A. Median duration of first premarital cohabitation among women aged 15–44:

United States, 1995, 2002, and 2006–2010

Outcome of cohabitation

Number in

thousands

All premarital

cohabitations Intact Marriage Dissolution

1995 ...........

2002 ...........

2006–2010........

20,317

26,559

29,609

13

20

22

Median duration (in months)

22 14

28 19

32 21

11

15

18

NOTE: Medians were calculated using the Kaplan-Meier procedure, which accounts for censoring.

SOURCE: CDC/NCHS, National Survey of Family Growth, 1995, 2002, and 2006–2010.

bachelor’s degree or higher (17	 NSFG was 22 months, or about 2 years,

months).	 with longer durations for selected race

and education subgroups. The results

Outcome that follow discuss the outcome of these of first premarital cohabitations at the 3-year time point. cohabitation These estimates were obtained using the

Table 3 presents the percent multiple-decrement life table method

distribution of the outcome of first described in the ‘‘Source of the data’’

section. premarital cohabitations for women aged
 

15–44 in 2006–2010: whether the + Forty percent of first premarital
 

cohabitation remained intact, cohabitations among women
 

transitioned to marriage, or dissolved. transitioned to marriage by 3 years,
 

The median duration of premarital 32% remained intact, and 27%
 

cohabitations among women in the dissolved.
 

Table B. Median duration of first premarital cohabitation among women aged 15–44:

United States, 2006–2010

Median

duration

Characteristic (in months)

Total1 ...................................................... 22

Age at first cohabitation

Under 20 years ................................................ 25

20–24 years .................................................. 20

25–29 years .................................................. 17

30–44 years .................................................. 20

Hispanic origin and race

Hispanic or Latina .............................................. 29

U.S. born .................................................. 25

Foreign born ................................................ 33

Not Hispanic or Latina

White, single race ............................................. 19

Black or African American, single race ................................ 27

Education2

No high school diploma or GED ...................................... 30

High school diploma or GED ........................................ 24

Some college, no bachelor’s degree ................................... 22

Bachelor’s degree or higher ........................................ 17

1

Includes women of other or multiple-race and origin groups, and those with missing information on nativity, not shown
 

separately.
 2

Limited to women aged 22–44 years at the time of interview. GED is General Educational Development high school equivalency
 

diploma.
 

NOTE: Medians were calculated using the Kaplan-Meier procedure, which accounts for censoring.
 

SOURCE: CDC/NCHS, National Survey of Family Growth, 2006–2010.
 

+	 A higher percentage of first

premarital cohabitations among white

women (44%) and foreign-born

Hispanic women (42%) transitioned

to marriage by 3 years, compared

with cohabitations for both U.S.-born

Hispanic women and black women

(31% for each).

+	 Almost one-half of the first

premarital cohabitations of foreignborn Hispanic women remained intact

by 3 years (46%), followed by 41%

of both black women and U.S.-born

Hispanic women.

+	 First premarital cohabitations among

women aged 22–44 with higher

education were more likely to

transition to marriage by 3 years.

Over one-half of cohabitations among

women with a bachelor’s degree or

higher had transitioned to marriage

(53%), compared with less than

one-third of cohabitations among

women with less than a high school

diploma (30%) (Figure 3).

+	 A higher percentage of first

premarital cohabitations among

women with less than a high school

diploma (43%) had remained intact

by 3 years, compared with 20% of

cohabitations among women with a

bachelor’s degree or higher.

Probability of a pregnancy

during first premarital

cohabitation

The probability of a pregnancy

within the first 2 years of a woman’s

first premarital cohabitation is shown in

Table 4. The results discussed are during

the first year of cohabitation; however,

similar results are seen at the 2-year

time point.

+	 Since 1995, the probability of a

pregnancy within a cohabiting union

among women aged 15–44 has

increased, from 15% in 1995, to 18%

in 2002, and to 19% in 2006–2010.

+	 Nearly one in five women in

2006–2010 (19%) experienced a

pregnancy in the first year of

cohabitation.

+	 One out of four women (25%) who

were under age 20 when they began

cohabiting experienced a pregnancy
Page 6	 National Health Statistics Reports n Number 64 n April 4, 2013 Percent 

43 

36 32 

20 

30 39 

40 

53 

27 26 28 27 Dissolved 

Marriage 

Intact 

100 

80 

60 

40 

20 

0 

Less than high High school diploma Some college Bachelor's degree 

school or GED or higher 

NOTES: Analyses of education is limited to women aged 22–44 years at the time of interview. GED is General Educational
 

Development high school equivalency diploma.
 

SOURCES: CDC/NCHS, National Survey of Family Growth, 2006–2010, and Table 3 of this report.
 

Figure 3. Percentage of first premarital cohabitations that dissolved, transitioned to

marriage, or remained intact by 3 years among women aged 22–44, by education:

United States, 2006–2010

in the first year, compared with about

1 out of 12 women (8%) who were

aged 30–44 when they began

cohabiting.

+ Forty percent of foreign-born

Hispanic women experienced a

pregnancy in the first year of

cohabitation, followed by 24% of

both U.S.-born Hispanic women and

black women, 14% of white women,

and 13% of Asian women (Figure 4).

+ One-third of women with less than a

high school diploma experienced a

pregnancy in the first year of

cohabitation (33%), compared with

5% of women with a bachelor’s

degree or higher.

Probability of marriage

among cohabiting women

with a pregnancy

Table 5 shows the probability of

marriage among the subgroup of women

who became pregnant in their first

premarital cohabitation, shown at 6

months and 1 year. For this analysis, the

duration is measured from the month the

pregnancy began until a marriage

occurred, if applicable. The ‘‘6 months’’

category is a rough indicator of

marriage before the birth of the child.

The results are discussed for 6 months;

however, similar results are seen at the

1-year time point.

+	 By 6 months, the probability of

marriage among women who became

pregnant in their first premarital

cohabitation was higher in the 1995

NSFG (32%) compared with the 2002

and 2006–2010 NSFGs (19% each).

+	 The probability of marriage by 6

months among women who became

pregnant in their first premarital

cohabitation was higher for women

who were in their twenties when they

started cohabiting (23%–26%),

compared with those under age 20

(16%).

+	 The probability of marriage by 6

months among women who became

pregnant in their first premarital

cohabitation was 28% among white

women, compared with 9%–11% for

women in other race groups.

+	 The probability of marriage by 6

months among women who became

pregnant in their first premarital

cohabitation was three times higher

for women with a bachelor’s degree

or higher (45%) than for those with

less than a high school diploma

(15%).

Discussion and

Conclusion

This report presents the latest

estimates for women from the 2006–

2010 NSFG on how long first premarital

cohabitations lasted and whether these

unions transitioned to marriage. Trend

data from the 1995 and 2002 NSFGs

support earlier research showing an

increase in premarital cohabitation in the

United States (2,28,29). The length, or

median duration, of first premarital

cohabitations among women in 2006–

2010 increased over the past decade to

22 months, up from 13 months in 1995.

Estimates from the 2006–2010 NSFG

showed that 40% of women’s first

premarital cohabitations transitioned to

marriage, which is larger than the

percentages of cohabiting unions that

remained intact (32%) or dissolved

(27%) within the first 3 years following

union formation.

There was variation by Hispanic

origin and race in the incidence,

duration, and outcome of women’s first

premarital cohabitations. The percentage

of women who cohabited before

marriage increased for women in all

Hispanic origin and race groups, except

for Asian women. First premarital

cohabitations were longest for foreignborn Hispanic women (33 months) and

shortest for white women (19 months).

A higher percentage of first premarital

cohabitations among white women

(44%) and foreign-born Hispanic

women (42%) transitioned to marriage

by 3 years, compared with cohabitations

for both U.S.-born Hispanic women and

black women (31% each).

Different cohabitation patterns by

education were also seen. Among

women aged 22–44, premarital

cohabitation increased for all levels of

education. However, the increase

between 1995 and 2006–2010 in the

percentage of women who cohabited

before marriage was larger for women

with less than a high school diploma
National Health Statistics Reports n Number 64 n April 4, 2013	 Page 7

SOURCES: CDC/NCHS, National Survey of Family Growth, 2006–2010, and Table 4 of this report. Probability 

0.40 

0.24 0.24 

0.13 

0 

0.1 

0.2 

0.3 

0.4 

0.5 

Foreign born, 

Hispanic 

U.S. born, 

Hispanic 

Black White 

Figure 4. Probability of a pregnancy leading to a live birth in the first year of a first

premarital cohabitation among women aged 15–44, by Hispanic origin and nativity and

race: United States, 2006–2010

(46% in 1995 and 70% in 2006–2010)

than for those with a bachelor’s degree

or higher (34% and 47%, respectively).

Women with less than a high school

diploma had longer cohabitations (30

months) than women with a bachelor’s

degree or higher (17 months). Thirty

percent of first premarital cohabitations

among women with less than a high

school diploma transitioned to marriage

by 3 years, compared with over one-half

of those with a bachelor’s degree or

higher (53%).

This report also describes the

probability of pregnancies within first

premarital cohabiting unions. Nearly one

out of five women experienced a

pregnancy in the first year of a first

premarital cohabitation. Probabilities of

a pregnancy were higher among women

who were under age 20 when they

began cohabiting, among foreign-born

Hispanic women, and among women

with less than a high school diploma.

Alongside the increase in fertility within

cohabiting unions over the past decade

was a decrease in the probability of

marriage among women who became

pregnant in a cohabiting union. These

findings support literature showing an

upward trend in nonmarital childbearing

in the United States (30).

Cohabitation is a common part of

family formation in the United States,

and serves both as a step toward

marriage and as an alternative to

marriage (7–9). Childbearing outside of

marriage continues to increase, and

about one-half of nonmarital births

occur to cohabiting women (3,30). This

report shows differences for women in

how long first premarital cohabitations

lasted, and whether these unions

transitioned to marriage, by Hispanic

origin and race and education. NSFG is

a useful data source that provides

up-to-date descriptions of family

formation and fertility in the United

States.

References

1.	 Copen CE, Daniels K, Vespa J,

Mosher WD. First marriages in the

United States: Data from the

2006–2010 National Survey of

Family Growth. National health

statistics reports; no 49. Hyattsville,

MD: National Center for Health

Statistics. 2012. Available from:

http://www.cdc.gov/nchs/data/nhsr/

nhsr049.pdf.

2.	 Kennedy S, Bumpass L. Cohabitation

and children’s living arrangements:

New estimates from the United

States. Demogr Res 19(47):1663–92.

2008.

3.	 Martinez GM, Daniels K, Chandra A.

Fertility of men and women aged

15–44 years in the United States:

National Survey of Family Growth

2006–2010. National health statistics

reports; no 51. Hyattsville, MD:

National Center for Health Statistics.

2012.

4.	 Mosher WD, Jones J, Abma JC.

Intended and unintended births in the

United States: 1982–2010. National

health statistics reports; no 55.

Hyattsville, MD: National Center for

Health Statistics. 2012.

5.	 Logan C, Holcombe E, Manlove J,

Ryan S. The consequences of

unintended childbearing: A white

paper. The National Campaign to

Prevent Teen and Unplanned

Pregnancy. 2007. Available from:

http://www.thenationalcampaign.org/

resources/pdf/consequences.pdf.

6.	 Groves RM, Mosher WD, Lepkowski

JM, Kirgis NG. Planning and

development of the continuous

National Survey of Family Growth.

National Center for Health Statistics.

Vital Health Stat 1(48). 2009.

Available from: http://www.cdc.gov/

nchs/data/series/sr_01/sr01_048.pdf.

7.	 Seltzer JA. Families formed outside

of marriage. J Marriage Fam

62(4):1247–68. 2000.

8.	 Smock PJ. Cohabitation in the

United States: An appraisal of

research themes, findings, and

implications. Annu Rev Sociol

26:1–20. 2000.

9.	 Heuveline P, Timberlake JM. The

role of cohabitation in family

formation: The United States in

comparative perspective. J Marriage

Fam 66(5):1214–30. 2004.

10. Lichter DT, Qian Z, Mellott LM.

Marriage or dissolution? Union

transitions among poor cohabiting

women. Demography 43(2):223–40.

2006.

11. Oppenheimer VK. Cohabitation and

marriage during young men’s

career-development process.

Demography 40(1):127–49. 2003.
Page 8 National Health Statistics Reports n Number 64 n April 4, 2013

12. Schwartz CR, Mare RM. Trends in

educational assortative marriage from

1940 to 2003. Demography

42(4):621–46. 2005.

13. Smock PJ, Manning WD, Porter M.

‘‘Everything’s there except money:’’

How money shapes decisions to

marry among cohabitors. J Marriage

Fam 67(3):680–96. 2005.

14. Harknett K, Kuperberg A. Education,

labor markets, and the retreat from

marriage. Soc Forces 90(1):41–64.

2011.

15. Schneider D. Wealth and the marital

divide. AJS 117(2):627–67. 2011.

16. Lichter DT. Childbearing among

cohabiting women: Race, pregnancy,

and union transitions. In: Booth A,

Brown SL, Landale NS, et al., eds.

Early Adulthood in a Family

Context. New York: Springer

Publishing Company. 209–19. 2012.

17. Stanley SM, Rhoades GK, Markman

HJ. Sliding versus deciding: Inertia

and the premarital cohabitation

effect. Family Relations 55:499–509.

2006.

18. Sassler S, Miller AJ. Class

differences in cohabitation processes.

Family Relations 60(2):163–77.

2011.

19. Lepkowski JM, Mosher WD, Davis

KE, et al. The 2006–2010 National

Survey of Family Growth: Sample

design and analysis of a continuous

survey. National Center for Health

Statistics. Vital Health Stat 2(150).

2010. Available from: http://www.

cdc.gov/nchs/data/series/sr_02/

sr02_150.pdf.

20. Office of Management and Budget.

Revisions to the standards for the

classification of federal data on race

and ethnicity. Fed Regist

62FR58781–58790. Statistical Policy

Directive 15. 1997.

21. Goodwin PY, Mosher WD, Chandra

A. Marriage and cohabitation in the

United States: A statistical portrait

based on Cycle 6 (2002) of the

National Survey of Family Growth.

National Center for Health Statistics.

Vital Health Stat 23(28). 2010.

Available from: http://www.cdc.gov/

nchs/data/series/sr_23/sr23_028.pdf.

22. Bramlett MD, Mosher WD.

Cohabitation, marriage, divorce, and

remarriage in the United States.

National Center for Health Statistics.

Vital Health Stat 23(22). 2002.

Available from: http://www.cdc.gov/

nchs/data/series/sr_23/sr23_022.pdf.

23. Reinhold S. Reassessing the link

between premarital cohabitation and

marital instability. Demography

47(3):719–33. 2010.

24. Manlove J, Wildsmith E, Ikramullah

E, Ryan S, Holcombe E, Scott M,

Peterson K. Union transitions

following the birth of a child to

cohabiting parents. Popul Res Policy

Rev 31(3):361–86. 2012.

25. Manning WD, Smock PJ, Majumdar

D. The relative stability of cohabiting

and marital unions for children.

Popul Res Policy Rev 23:135–59.

2004.

26. Allison PD. Survival analysis using

SAS: A practical guide. Cary, NC:

SAS Institute Inc. 1995.

27. Schoen R. Modeling multigroup

populations. New York: Plenum

Press. 1988.

28. Bumpass L, Lu HH. Trends in

cohabitation and implications for

children’s family contexts in the

United States. Pop Studies 4(1):29–

41. 2000.

29. Lichter DT, Turner RN, Sassler S.

National estimates of the rise in

serial cohabitation. Social Science

Research 39(5):754–65. 2010.

30. Ventura SJ. Changing patterns of

nonmarital childbearing in the United

States. NCHS data brief, no 18.

Hyattsville, MD: National Center for

Health Statistics. 2009.
National Health Statistics Reports n Number 64 n April 4, 2013 Page 9

Table 1. Type of first unions among women aged 15–44, by Hispanic origin and race and education: United States, 1995, 2002, and

2006–2010

Type of first union

Number in

Characteristic thousands Total No union Cohabitation Marriage

Percent distribution (standard error)

Total, 1995................................ 60,201 100.0 27.5 (0.6) 33.7 (0.6) 38.7 (0.6)

Total, 2002................................ 61,561 100.0 26.7 (0.8) 43.1 (0.9) 30.2 (0.9)

Total, 2006–20101 ........................... 61,755 100.0 29.1 (0.9) 47.9 (1.2) 23.0 (0.9)

Hispanic origin and race

Hispanic or Latina

1995................................. 6,702 100.0 28.2 (1.2) 29.6 (1.3) 42.2 (1.6)

2006–2010 ............................. 10,474 100.0 27.0 (1.1) 46.6 (1.4) 26.4 (1.3)

U.S. born

1995................................. 4,166 100.0 34.8 (1.7) 31.9 (1.6) 33.3 (1.8)

2006–2010 ............................. 5,369 100.0 37.6 (1.6) 47.2 (1.8) 15.2 (1.6)

Foreign born

1995................................. 2,527 100.0 17.4 (1.9) 25.9 (1.7) 56.7 (2.1)

2006–2010 ............................. 5,104 100.0 15.8 (1.5) 46.1 (1.9) 38.1 (1.8)

Not Hispanic or Latina

White, single race

1995................................. 42,154 100.0 24.7 (0.6) 34.5 (0.8) 40.9 (0.8)

2006–2010 ............................. 37,384 100.0 27.1 (1.2) 49.4 (1.7) 23.6 (1.3)

Black or African American, single race

1995................................. 8,060 100.0 39.4 (1.2) 35.4 (1.1) 25.2 (1.1)

2006–2010 ............................. 8,451 100.0 38.4 (1.5) 49.2 (1.5) 12.5 (1.2)

Asian, single race

1995................................. 2,090 100.0 35.3 (5.6) 21.6 (2.1) 43.1 (5.3)

2006–2010 ............................. 2,456 100.0 32.8 (3.6) 21.9 (3.0) 45.3 (3.4)

Education2

No high school diploma or GED

1995 .................................. 5,396 100.0 8.5 (0.9) 45.5 (1.7) 46.0 (1.7)

2006–2010 .............................. 6,844 100.0 7.1 (0.8) 70.3 (1.9) 22.6 (2.0)

High school diploma or GED

1995 .................................. 18,177 100.0 8.7 (0.6) 39.4 (1.2) 51.9 (1.2)

2006–2010 .............................. 11,578 100.0 9.4 (0.9) 61.8 (1.4) 28.8 (1.5)

Some college, no bachelor’s degree

1995 .................................. 12,362 100.0 16.9 (1.1) 38.8 (1.1) 44.3 (1.1)

2006–2010 .............................. 13,702 100.0 13.9 (1.0) 58.9 (1.9) 27.1 (1.7)

Bachelor’s degree or higher

1995 .................................. 11,741 100.0 20.2 (0.9) 34.3 (1.2) 45.5 (1.2)

2006–2010 .............................. 15,083 100.0 18.8 (1.2) 46.6 (2.0) 34.6 (1.9)

1

Includes women of other or multiple-race and origin groups, and those with missing information on nativity, not shown separately.
 2

Limited to women aged 22–44 years at the time of interview. GED is General Educational Development high school equivalency diploma.
 

NOTE: Percentages may not add to 100 due to rounding.
 

SOURCE: CDC/NCHS, National Survey of Family Growth, 1995, 2002, and 2006–2010.
 
Page 10 National Health Statistics Reports n Number 64 n April 4, 2013

Table 2. Probability of a first premarital cohabitation by ages 20, 25, and 30 among women aged 15–44: United States, 1995, 2002, and

2006–2010

Probability of first premarital cohabitation

Number in Age Standard Age Standard Age Standard

Characteristic thousands 20 error 25 error 30 error

Total 1995 ................................ 60,201 0.19 0.005 0.46 0.008 0.62 0.010

Total 2002 ................................ 61,561 0.23 0.008 0.52 0.011 0.70 0.012

Total 2006–20101 ........................... 61,755 0.26 0.011 0.55 0.013 0.74 0.012

Age at interview

Under 20 years ............................. 10,478 . . . . . . . . . . . . . . . . . .

20–24 years ............................... 10,365 0.30 0.020 . . . . . . . . . . . .

25–44 years ............................... 40,912 0.25 0.011 0.54 0.013 0.73 0.012

25–29 years ............................. 10,535 0.30 0.017 0.62 0.020 . . . . . .

30–34 years ............................. 9,188 0.28 0.018 0.61 0.020 0.79 0.014

35–44 years ............................. 21,190 0.20 0.011 0.47 0.015 0.68 0.017

Hispanic origin and race

Hispanic or Latina ........................... 10,474 0.30 0.015 0.59 0.017 0.76 0.016

U.S. born ............................... 5,369 0.34 0.021 0.65 0.019 0.80 0.026

Foreign born ............................. 5,104 0.27 0.016 0.53 0.025 0.72 0.024

Not Hispanic or Latina

White, single race .......................... 37,384 0.26 0.014 0.57 0.018 0.76 0.016

Black or African American, single race ............. 8,451 0.21 0.014 0.51 0.017 0.69 0.021

Asian, single race .......................... 2,456 0.07 0.018 0.19 0.035 0.38 0.060

Education2

No high school diploma or GED................... 6,844 0.51 0.022 0.76 0.020 0.88 0.014

High school diploma or GED..................... 11,578 0.35 0.018 0.64 0.019 0.79 0.017

Some college, no bachelor’s degree ................ 13,702 0.24 0.015 0.59 0.017 0.77 0.015

Bachelor’s degree or higher ..................... 15,083 0.08 0.010 0.36 0.019 0.61 0.022

. . . Category not applicable.
 1

Includes women of other or multiple-race and origin groups, and those with missing information on nativity, not shown separately.
 2

Limited to women aged 22–44 years at the time of interview. GED is General Educational Development high school equivalency diploma.
 

SOURCE: CDC/NCHS, National Survey of Family Growth, 1995, 2002, and 2006–2010.
 
National Health Statistics Reports

n Number 64n April 4, 2013 Page 11

premarital cohabitations that remained intact, transitioned to marriage, or dissolved among women aged 15–44, by cohabitation duration:

Cohabitation duration

1 year 3 years

Number in

housands Total Intact Marriage Dissolution Total Intact Marriage Dissolution

Percent distribution (standard error)

29,609 100.0 67.0 (0.001) 19.4 (0.001) 13.6 (0.001) 100.0 32.2 (0.001) 40.3 (0.001) 27.4 (0.001)

13,393 100.0 70.2 (0.001) 15.1 (0.001) 14.7 (0.001) 100.0 37.7 (0.001) 30.7 (0.001) 31.5 (0.001)

11,131 100.0 65.2 (0.001) 20.4 (0.001) 14.3 (0.001) 100.0 28.5 (0.001) 44.0 (0.001) 27.5 (0.001)

3,829 100.0 61.5 (0.003) 29.5 (0.002) 8.9 (0.001) 100.0 22.9 (0.002) 58.4 (0.002) 18.7 (0.002)

1,255 100.0 65.1 (0.004) 29.2 (0.003) 5.7 (0.001) 100.0 32.2 (0.004) 49.6 (0.004) 18.2 (0.003)

4,884 100.0 70.8 (0.002) 17.5 (0.001) 11.7 (0.001) 100.0 43.5 (0.002) 36.3 (0.002) 20.2 (0.002)2,533 100.0 71.0 (0.002) 13.2 (0.002) 15.8 (0.002) 100.0 40.6 (0.003) 31.2 (0.003) 28.2 (0.003)

2,351 100.0 70.7 (0.003) 22.0 (0.002) 7.4 (0.002) 100.0 46.2 (0.002) 41.5 (0.002) 12.3 (0.002)

18,451 100.0 64.4 (0.001) 21.2 (0.001) 14.5 (0.001) 100.0 26.7 (0.001) 43.9 (0.001) 29.4 (0.001)

4,154 100.0 71.6 (0.002) 15.3 (0.002) 13.1 (0.001) 100.0 41.1 (0.002) 30.8 (0.002) 28.0 (0.001)

4,810 100.0 73.1 (0.002) 15.3 (0.001) 11.5 (0.001) 100.0 43.2 (0.002) 30.0 (0.002) 26.8 (0.002)7,149 100.0 69.8 (0.002) 19.4 (0.001) 10.8 (0.001) 100.0 35.8 (0.002) 38.6 (0.002) 25.7 (0.001)

8,076 100.0 65.8 (0.001) 19.7 (0.001) 14.5 (0.001) 100.0 31.5 (0.001) 40.0 (0.001) 28.4 (0.002)

7,034 100.0 62.3 (0.002) 24.9 (0.002) 12.8 (0.001) 100.0 20.3 (0.002) 53.2 (0.002) 26.6 (0.002)

groups, and those with missing information on nativity, not shown separately.

nterview. GED is General Educational Development high school equivalency diploma.

bution; percentages may not add to 100 due to rounding.

owth, 2006–2010.
Page 12 National Health Statistics Reports n Number 64 n April 4, 2013

Table 4. Probability of a pregnancy within 2 years of a first premarital cohabitation among women aged 15–44: United States, 1995, 2002,

and 2006–2010

Cohabitation duration

1 year 2 years

Characteristic

Number in

thousands Probability

Standard

error Probability

Standard

error

Total 1995 ................................

Total 2002 ................................

Total 2006–20101 ...........................

Age at first premarital cohabitation

Under 20 years .............................

20–24 years ...............................

25–29 years ...............................

30–44 years ...............................

Hispanic origin and race

Hispanic or Latina ...........................

U.S. born ...............................

Foreign born .............................

Not Hispanic or Latina

White, single race ..........................

Black or African American, single race .............

Asian, single race ..........................

Education2

No high school diploma or GED...................

High school diploma or GED.....................

Some college, no bachelor’s degree ................

Bachelor’s degree or higher .....................

20,317

26,559

29,609

13,393

11,131

3,829

1,255

4,884

2,533

2,351

18,451

4,154

538

4,810

7,149

8,076

7,034

0.15

0.18

0.19

0.25

0.15

0.13

0.08

0.32

0.24

0.40

0.14

0.24

0.13

0.33

0.24

0.18

0.05

0.007

0.009

0.009

0.015

0.013

0.018

0.022

0.020

0.029

0.030

0.011

0.018

0.039

0.021

0.020

0.014

0.009

0.26

0.29

0.31

0.41

0.25

0.20

0.13

0.50

0.41

0.59

0.23

0.40

0.24

0.53

0.38

0.27

0.10

0.011

0.013

0.013

0.019

0.016

0.031

0.030

0.029

0.044

0.030

0.014

0.026

0.088

0.027

0.024

0.021

0.015

1

Includes women of other or multiple-race and origin groups, and those with missing information on nativity, not shown separately.
 2

Limited to women aged 22–44 years at the time of interview. GED is General Educational Development high school equivalency diploma.
 

NOTE: This table includes only pregnancies ending in a live birth.
 

SOURCE: CDC/NCHS, National Survey of Family Growth, 1995, 2002, and 2006–2010.
 
National Health Statistics Reports n Number 64 n April 4, 2013 Page 13

Table 5. Probability of marriage within 1 year of a pregnancy in a first premarital cohabitation among women aged 15–44, by

cohabitation duration since pregnancy: United States, 2006–2010

Cohabitation duration (since pregnancy)

6 months 1 year

Characteristic

Number in

thousands Probability

Standard

error Probability

Standard

error

Total 1995 ................................

Total 2002 ................................

Total 2006–20101 ...........................

Age at first premarital cohabitation

Under 20 years .............................

20–24 years ...............................

25–29 years ...............................

Hispanic origin and race

Hispanic or Latina ...........................

U.S. born ...............................

Foreign born .............................

Not Hispanic or Latina

White, single race ..........................

Black or African American, single race .............

Education2

No high school diploma or GED...................

High school diploma or GED.....................

Some college, no bachelor’s degree ................

Bachelor’s degree or higher .....................

4,110

6,810

8,848

5,437

2,543

700

2,346

1,020

1,326

4,083

1,647

2,616

2,702

2,271

616

0.32

0.19

0.19

0.16

0.23

0.26

0.10

0.09

0.10

0.28

0.11

0.15

0.17

0.20

0.45

0.019

0.025

0.014

0.018

0.030

0.056

0.017

0.022

0.024

0.024

0.027

0.027

0.026

0.024

0.060

0.44

0.28

0.26

0.24

0.30

0.30

0.16

0.16

0.16

0.37

0.16

0.19

0.30

0.27

0.53

0.021

0.028

0.016

0.021

0.033

0.056

0.022

0.025

0.033

0.027

0.030

0.027

0.034

0.027

0.049

1

Includes women of other or multiple-race and origin groups, and those with missing information on nativity, not shown separately.
 2

Limited to persons aged 22–44 years at the time of interview. GED is General Educational Development high school equivalency diploma.
 

NOTES: The subgroup of women aged 30–44 who became pregnant in their first premarital cohabitation was to small to show separately. This tables includes only pregnancies ending in a live
 

birth.
 

SOURCE: CDC/NCHS, National Survey of Family Growth, 1995, 2002, and 2006–2010.
 
Page 14 National Health Statistics Reports n Number 64 n April 4, 2013
National Health Statistics Reports

n Number 64n April 4, 2013 Page 15

Technical Notes

Definition of terms

Further details on the variables used

in this report are provided in previous

National Survey of Family Growth

reports (e.g., reference 1).

Age at first premarital cohabitation—

Calculated as the number of months

between the date of birth (computed

variable CMBIRTH) and the date of first

premarital cohabitation (recode variable

COHAB1) divided by 12. In the analysis

of entry intoa first premarital cohabitation,

women are ‘‘at risk’’ of enteringa first

premarital cohabitation untila marriage

occurred or the date of the interview (i.e.,

they are censored).

Cohabitation dissolution—When the

woman and her first premarital

cohabiting partner stopped living

together for the last time.

Cohabitation status relative to first

marriage—Whether the respondent had

ever cohabited, and if so, whether the

first cohabitation was before or after

first marriage (recode variable

COHSTAT).

First premarital cohabitation

duration—Calculated as the number of

months elapsed from the beginning of

the first premarital cohabitation to the

end, either by marriage, by dissolution,

or through censoring at the time of the

interview for intact cohabiting unions

(recode variable COH1DUR).

Multiple-decrement life table—

Describes transitions out of first

premarital cohabiting unions. First

premarital cohabiting unions could

remain intact, transition to marriage, or

dissolve. Percent distributions derived

from the life table survivor function are

presented in Table3. These percentages

represent the distribution of women in

each state at the specified time point. An

SAS macro was used to calculate the

multiple-decrement life table estimates

(27). Further information about this

procedure is available at http://

www.cdc.gov/nchs/data_access/

space.htm.

Outcome of first premarital

cohabitation—Indicates the outcome of

the first premarital cohabitation at the

time of interview: whether the

cohabitation was intact, had transitioned

toa marriage, or had dissolved without

marriage (recode variable COHOUT).

Pregnancies with first premarital

cohabiting partner—Pregnancies thata

respondent has had with her first

premarital cohabiting partner were

determined by comparing the date when

her pregnancy began (recode variable

DATCON) for pregnancies ending in

live births (recode variable OUTCOM)

with the date of her first premarital

cohabitation (recode variables COHAB1

and COHSTAT respectively), to

determine if she had any pregnancies

with this partner during the cohabitation.

Union—Refers to two different

types of co-residential relationships:a

marriage or cohabitation.
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National Health Statistics Reports n Number 64 n April 4, 2013

Acknowledgments

The 2006–2010 National Survey of Family Growth (NSFG) was conducted by the Centers for Disease Control and Prevention’s (CDC) National

Center for Health Statistics (NCHS) with the support and assistance of a number of other organizations and individuals. Interviewing and other

tasks were performed by the University of Michigan’s Survey Research Center, Institute for Social Research, under a contract with NCHS. The

2006–2010 NSFG was jointly planned and funded by the following programs and agencies of the U.S. Department of Health and Human

Services:

• Eunice Kennedy Shriver National Institute for Child Health and Human Development • Office of Population Affairs • National Center for Health Statistics, CDC

• Division of HIV/AIDS Prevention, CDC

• Division of Sexually Transmitted Disease Prevention, CDC

• Division of Reproductive Health, CDC

• Division of Birth Defects and Developmental Disabilities, CDC • Division of Cancer Prevention and Control, CDC

• Children’s Bureau of the Administration for Children and Families (ACF) • Office of Planning, Research, and Evaluation, ACF

• Office of the Assistant Secretary for Planning and Evaluation

NCHS gratefully acknowledges the contributions of these programs and agencies, and all others who assisted in designing and implementing

the 2006–2010 NSFG.

This report was prepared under the general direction of Charles J. Rothwell, Acting Director of the National Center for Health Statistics, and

Stephanie J. Ventura, Chief of the Reproductive Statistics Branch of NCHS’ Division of Vital Statistics (DVS). The authors are also grateful for

the valuable comments on earlier drafts provided by Stephanie Ventura; Robert Anderson, DVS Acting co-Associate Director for Science;

Jennifer Madans, NCHS Associate Director for Science; Van Parsons, statistician with NCHS’ Office of Research and Methodology; and Daniel

Lichter, Professor of Policy Analysis and Management and Sociology and Director of the Cornell Population Center at Cornell University.

The authors would also like to thank Veena Billioux, Isaedmarie Febo-Vázquez, and Yashodhara Patel for their helpful contributions in the

preparation of this report. The report was produced by CDC/OSELS/NCHS/OD/Office of Information Services, Information Design and

Publishing Staff: Danielle Woods edited the report; typesetting was done by Annette Holman; and graphics were produced by Sarah Hinkle.

Suggested citation

Copen CE, Daniels K, Mosher WD. First

premarital cohabitation in the United States:

2006–2010 National Survey of Family Growth.

National health statistics reports; no 64.

Hyattsville, MD: National Center for Health

Statistics. 2013.

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

Charles J. Rothwell, M.S., Acting Director

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

for Science

Division of Vital Statistics

Delton Atkinson, M.P.H., M.P.H., P.M.P.,

Acting Director

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DHHS Publication No. (PHS) 2013–1250 • CS238269