Medical Expenditure Panel Survey Agency for Healthcare 

Research and Quality

STATISTICAL BRIEF #187 

October 2007

Cholesterol Screening among the U.S. 

Noninstitutionalized Adult Population 

Age 20 and Older, 2005 

Anita Soni, PhD 

Introduction 

High blood cholesterol has been associated with hardening of the 

arteries, heart disease, and a raised risk of death from heart attack. 

Cholesterol testing is recommended as a screening test to be done 

on all adults age 20 and older at least once every five years. It is 

frequently done in conjunction with a routine physical exam. 

 

The U.S. Preventive Services Task Force (USPSTF) strongly 

recommends that clinicians routinely screen men age 35 years and 

older and women age 45 years and older for lipid disorders and treat 

abnormal lipids in people who are at increased risk of coronary heart 

disease. 

This Statistical Brief estimates cholesterol testing among the U.S. 

civilian noninstitutionalized population age 20 and older. The 

estimates presented are derived from data collected in the 

questionnaire used in the Household Component of the Medical 

Expenditure Panel Survey (MEPS-HC). All differences discussed in

the text are statistically significant at the 0.05 level or better. 

Findings 

In 2005, almost 36 million or about 17 (16.8) percent of the U.S. 

civilian noninstitutionalized population age 20 and older reported that 

they have never had their blood cholesterol checked by a health 

professional (figure 1). 

Age 

Getting a blood cholesterol check was found to be strongly related to 

age. A higher percentage of those in the younger age group (20 to 34) reported never having had their 

blood cholesterol checked compared with those in the older age groups (35 to 44, 45 to 64, and 65 and 

older) at 38.7 percent versus 16.7 percent, 6.3 percent, and 2.3 percent, respectively (figure 1). 

Highlights 

 Almost 17 percent (16.8 

percent) of the U.S. civilian 

noninstitutionalized population age 20 and older 

population reported that 

they have never had their 

blood cholesterol checked 

by a health professional. 

 One-fourth of Hispanic 

adults age 20 and older 

reported that they have 

never had their blood 

cholesterol checked by a 

health professional. 

 One-fifth of adult males

age 20 and older reported 

they have never have had 

their blood cholesterol 

checked.

 More than one-third of 

uninsured adults between 

the age of 20 and 64 

reported that they have 

never had their blood 

cholesterol checked. 

 More than one-fifth (21.2 

percent) of those with less 

than a high school education reported they have 

never had their blood 

cholesterol checked by a 

health professional. 

Sex 

A higher percentage of adult males age 20 and older reported never having had their blood cholesterol 

checked compared with females in the same age group (19.6 percent versus 14.2 percent) (figure 2). 
Race/ethnicity 

One-fourth (24.8 percent) of Hispanic adults age 20 and older reported that they have never had their 

blood cholesterol checked by a health professional. This percentage was much higher than that for nonHispanic whites, non-Hispanic blacks, and non-Hispanic Asians (24.8 percent versus 15.4 percent, 15.6 

percent, and 16.0 percent, respectively) (figure 3). 

Educational level 

Adults age 20 and older with at least some college education were less likely to have reported that they 

have never had their blood cholesterol checked by a health professional than those who had only a high 

school education or less than a high school education (14.5 percent versus 18.0 percent and 21.2 

percent, respectively) (figure 4). 

Metropolitan areas 

A higher percentage of adults age 20 and older who lived in non-metropolitan areas reported that they 

have never had their blood cholesterol checked by a health professional compared with those who lived 

in metropolitan areas (21.5 percent versus 15.8 percent) (figure 5). 

Insurance status 

Among adults age 20 to 64, those who were uninsured were much more likely to have never had their 

blood cholesterol checked by a health professional than those who had either private or public insurance 

(34.6 percent versus 16.1 percent and 21.9 percent, respectively) (figure 6). 

Data Source 

The estimates in this Statistical Brief were derived from the MEPS 2005 Full Year Population 

Characteristics data file (HC-090). 

Definitions 

The question on having cholesterol checks was asked in the Preventive Care section of the MEPS-HC 

questionnaire. 

Heart disease indicators 

The indicators for heart disease were drawn from variables indicating the presence of heart disease 

(coronary heart disease, angina, heart attack, stroke, or any other heart-related disease). For each of the 

conditions listed, the following question was asked: “(Have/Has) PERSON ever been told by a doctor or 

other health professional that PERSON had [condition].” 

Racial and ethnic classifications 

Classification by race and ethnicity was based on information reported for each family member. 

Respondents were asked if each family member was Hispanic or Latino. Respondents were also asked 

which race or races best described each family member. Race categories included white, black/African 

American, American Indian or Alaska Native, Asian, Native Hawaiian or other Pacific Islander, and other. 

Based on these questions, sample persons were classified into the following race/ethnicity categories: 

Hispanic, white non-Hispanic single race, black non-Hispanic single race, Asian non-Hispanic single race, 

and other (Hawaiian/Pacific Islander non-Hispanic, American Indian/Alaska Native non-Hispanic, and 

multiple races non-Hispanic). 

Educational level 

Respondents were asked to report the highest grade of schooling ever completed by each family member 

as of the date of the interview: not a high school graduate, high school graduate, or some college. 

Health insurance status 

Individuals under age 65 were classified into the following three insurance categories based on 

household responses to the health insurance status questions: 

- Any private health insurance: Individuals who, at any time during the year, had insurance that provided 

coverage for hospital and physician care (other than Medicare, Medicaid, or other public 

hospital/physician coverage) were classified as having private insurance. Coverage by TRICARE 
(Armed Forces–related coverage) was also included as private health insurance. Insurance that 

provided coverage for a single service only, such as dental or vision coverage, was not included. 

- Public coverage only: Individuals were considered to have public coverage only if they met both of the 

following criteria: 1) they were not covered by private insurance at any time during the year, and 2) they 

were covered by one of the following public programs at some point during the year: Medicare, 

Medicaid, or other public hospital/physician coverage. 

- Uninsured: The uninsured were defined as people not covered by private hospital/physician insurance, 

Medicare, TRICARE, Medicaid, or other public hospital/physician programs at any time during the entire 

year or their period of eligibility for the survey. 

Individuals 65 and older were classified into the following three insurance categories: 

- Medicare only: Individuals who, at any time during the year, were covered by Medicare only. 

- Medicare plus private: Individuals who at any time during the year, were covered by a combination of 

Medicare, TRICARE or private insurance. 

- Medicare plus other public coverage: Individuals who, at any time during the year, were covered by 

Medicare and some other type of public insurance, but had no private coverage. 

Metropolitan areas 

Metropolitan areas are metropolitan statistical areas (MSAs) designated by the U.S. Office of 

Management and Budget that are composed of a large population nucleus combined with adjacent 

communities that have a high degree of economic and social integration with the nucleus. An MSA has 

one or more central counties containing the area’s main population concentration. 

About MEPS-HC 

MEPS-HC is a nationally representative longitudinal survey that collects detailed information on health 

care utilization and expenditures, health insurance, and health status, as well as a wide variety of social, 

demographic, and economic characteristics for the civilian noninstitutionalized population. It is cosponsored by the Agency for Healthcare Research and Quality and the National Center for Health Statistics. 

For more information about MEPS, call the MEPS information coordinator at AHRQ (301-427-1406) or 

visit the MEPS Web site at http://www.meps.ahrq.gov/. 

References 

For a detailed description of the MEPS survey design, sample design, and methods used to minimize 

sources of nonsampling error, see the following publications: 

Cohen, J. Design and Methods of the Medical Expenditure Panel Survey Household Component. MEPS 

Methodology Report No. 1. AHCPR Pub. No. 97-0026. Rockville, Md.: Agency for Health Care Policy and 

Research, 1997. 

Cohen, S. Sample Design of the 1996 Medical Expenditure Panel Survey Household Component. MEPS 

Methodology Report No. 2. AHCPR Pub. No. 97-0027. Rockville, Md.: Agency for Health Care Policy and 

Research, 1997. 

Cohen, S. Design Strategies and Innovations in the Medical Expenditure Panel Survey. Medical Care,

July 2003: 41(7) Supplement: III-5–III-12. 

For information on heart disease, lipid disorders, and cholesterol testing and treatment, see the following: 

ABCs of Preventing Heart Disease, Stroke and Heart Attack, American Heart Association, Feb. 2007, 

Cholesterol: www.Americanheart.org 

Know Your Numbers: It’s National Cholesterol Education Month: Centers for Disease Control and 

Prevention, Atlanta, Ga., September 2007. http://www.cdc.gov/Features/Cholesterol/ 

Screening for Lipid Disorders in Adults: http://www.ahrq.gov/clinic/uspstf/uspschol.htm 
Cholesterol: http://www.labtestsonline.org/understanding/analytes/cholesterol/test.html 

Detection, Evaluation, and Treatment of the High Blood Cholesterol in Adults (Adult Treatment Panel III): 

http://www.nhlbi.nih.gov/guidelines/cholesterol/atp_iii.htm 

Suggested Citation 

Soni, A. Cholesterol Screening among the U.S. Noninstitutionalized Adult Population Age 20 and Older, 

2005. Statistical Brief #187. October 2007. Agency for Healthcare Research and Quality, Rockville, Md. 

http://www.meps.ahrq.gov/mepsweb/data_files/publications/st187/stat187.pdf 

∗ ∗ ∗

AHRQ welcomes questions and comments from readers of this publication who are interested in 

obtaining more information about access, cost, use, financing, and quality of health care in the United 

States. We also invite you to tell us how you are using this Statistical Brief and other MEPS data and 

tools and to share suggestions on how MEPS products might be enhanced to further meet your needs. 

Please e-mail us at mepsprojectdirector@ahrq.hhs.gov or send a letter to the address below: 

Steven B. Cohen, PhD, Director 

Center for Financing, Access, and Cost Trends 

Agency for Healthcare Research and Quality 

540 Gaither Road 

Rockville, MD 20850 
Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey 2005

16.8

38.7

16.7

2.3

6.3

0

10

20

30

40

50

Total population 20-34 35-44 45-64 65+

Percent

Figure 1. Percentage of adults age 20 and older, who never

had their blood cholesterol checked, by age, 2005

Never had blood cholesterol checked

Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey 2005 Percent

Figure 2. Percentage of adults age 20 and older, who never

had their blood cholesterol checked, by sex, 2005

19.6

14.2

0

10

20

30

40

Male Female

Never had blood cholesterol checked

Statistical Brief #187: Cholesterol Screening among the U.S. Noninstitutionalized Adult Population Age 20 and Older, 2005 
Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey 2005

24.8

15.4 15.6

20.0

16.0

0

10

20

30

40

50

Hispanic White nonHispanic Black nonHispanic Asian nonHispanic Other nonHispanic

Percent

Figure 3. Percentage of adults age 20 and older, who never

had their blood cholesterol checked, by race/ethnicity, 2005

Never had blood cholesterol checked

Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey 2005

21.2

18.0

14.5

0

10

20

30

Less than high school Completed high school At least some college

Percent

Figure 4. Percentage of adults age 20 and older, who never

had blood cholesterol checked, by education, 2005

Never had blood cholesterol checked

Statistical Brief #187: Cholesterol Screening among the U.S. Noninstitutionalized Adult Population Age 20 and Older, 2005 
Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey 2005

15.8

21.5

0

10

20

30

40

Metropolitan area Non-metropolitan area

Percent

Figure 5. Percentage of adults age 20 and older, who never

had blood cholesterol checked, by metropolitan areas, 2005

Never had blood cholesterol checked

Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey 2005 Percent

Figure 6. Percentage of adults ages 20 and older, who never

had blood cholesterol checked, by age and insurance status, 2005

20-64

16.1

21.9

34.6

0

10

20

30

40

Private Public only Uninsured

65+

3.3

1.8 2.7

0

5

10

15

20

Medicare only Medicare+Private Medicare+Public

Never had blood cholesterol checked

Statistical Brief #187: Cholesterol Screening among the U.S. Noninstitutionalized Adult Population Age 20 and Older, 2005