Health Statistics on 

OIder Persons 

United States, 1986 

Data from various sources concerning the health 

status and determinants of health of older persons 

are presented. Data on persons aged 55-84 

years are included for comparison purposes. 

Analytical and Epidemiological Studies 

Series 3, No. 25 

DHHS Publication No. (PHS) 87–1 409


U.S. Department of Health and Human Setvices


Public Health Service


National Center for Health Statistics


Hyattsville, Md.


June 1987

XWht Information 

The National Center for Health Statistics has obtained permission from the 

copyright holders to reproduce certain quoted material in this report. Further 

reproduction of this material is prohibited without specific permission of the 

copyright holders, All other material contained in the report is in the public 

domain and may be used and reprinted without special permission: citation as 

to source, however, is appreciated. 

.%ggestetf Citation 

National Center for Health Statistics, R. J. Havlik, B. M. Liu, M, G. Kovar, et al.: 

Health Statistics on Older Persons, United States, 1986, Vita/ and Hea/fh 

Statistics. Series 3, No. 25. DHHS Pub, No. (PHS) 87–1 409, Public Health 

Setvice. Washington. U.S. Government Printing Office, June 1987. 

Library of Congress Catabgiig4n-Pubtin Data 

Health statistics of older persons, United States, 1986. 

(Series 3, AnalytM and epidemiological study ; no. 25) (DHHS publication ; 

(PHS) 87-1409) 

Authors: Richard J, Havlik and others. 

Bibliography: p. 

1. Aged-Health and hygien+llnited Statea-Statistics. 2. Health 

surveys-United States. 3. Medical care surveys-United States. 4. United 

States-Statistics, Medical. 1. Havlik, Richard J. Il. National Center for Health 

Statistics (U. S.) Ill. Series: Vital and health statistics, Series 3, Analytical 

studies ; no. 25. IV. Series: DHHS publication ; (PHS) 87–1409. [DNLM: 1. 

Aged, 2. Health-lJnited States-+tatistics. 3, Health Services for the Agedeconomics—United States. 4. Health Services for the Aged-utilization-United 

States. 5. Health Surveys-United States-Statistics., W2 A N148vc no. 25] 

RA408.A3H43 1987 362.1 ‘0880565 87-600084 

ISBN O-6406-037&3 
National Center for Health Statistics 

Manning Feinleib, M. D., Dr. P. H., Director 

Robert A. Israel, Deputy Director 

Jacob J. Feldman, Ph. D., Associate Director for Analysis and 

Epidemiology 

Gail F. Fisher, Ph. D., Associate Director for Planning and 

Extramural Programs 

Peter L. Hurley, Associate Director for Vital and Health Statistics 

Systems 

Stephen E. Nieberding, Associate Director for Management 

George A. Schnack, Associate Director for Data Processing and 

Services 

Monroe G. Sirken, Ph. D., Associate Director for Research and 

Methodology 

Sandra S. Smith, Information O&icer 

Office of Planning and Extramural Programs 

Gail F. Fisher, Ph. D., Associate Director 

John R. Anderson, Chief, Planning, Evaluation and Legislation 

Staff 

P. Douglas Williams, Chief, State and Academic Research 

Applications Staff 

Thomas S. Vissman, Acting Chief, Program Development Staff 

Alvan O. Zarate, ChieJ International Statistics Staff 

Office of Vial and Health Statistics Systems 

“Peter L. Hurley, Associate Director for Vital and Health Statistics 

Systems 

Mary Grace Kovar, Dr. P. H., Special Assistant for Data Policy 

Office of Analysis and Epidemiology Program 

Jacob J. Feldman, Ph. D., Associate Director 

Joel C. Kleinman, Ph. D., Director, Division of Analysis 

Ronald W. Wilson, Director, Division of Epidemiology and Health 

Promotion 

Division of Health Care Statistics 

Joan F. Van Nostrand, Acting Division Director 

James E. DeLcszier, Chief, Ambulatory Care Statistics Branch 

Mary Moien, Chief, Hospital Care Statistics Branch 

Evelyn S. Mathis, Chiej Long-Term Care Statistics Branch 

Cooperation of the U.S. Bureau of the Census 

Under the legislation establishing the National Health Interview Survey, the 

Public HeAth Service is authorized to use, insofar as ~ssible, tbe sewices or 

facilities of other Federal, State, or private agencies. 

In accordance with specifications established by tbe D1visimr of Heallb Inlerview 

Statistics, the Bureau of the Census, under a contractual arrangement, participated 

in planning the survey and collecting the data. 
~ 

I 

Foreword 

This series report was prepared in response to the fundamental need for more analyses and better compilation of 

data concerning older persons. Requests to the National 

Center for Health Statistics (NCHS) for information concerning this important segment of the population come from 

a wide variety of individuals and groups, such as government policy makers, demographers, health care workers, and 

analysts. Some data needs can be met by referral to reports 

in the Vital and Health Statistics series, other publications, 

or special data tabulations from a single survey or data system, Other data are available routinely from Health, United 

States, the yearly departmental publication prepared by 

NCHS staff, In addition, excellent compilations of NCHS 

and other data on older persons are prepared by staff of the 

House of Representatives and Senate as well as by staff of 

the American Association of Retired Persons and other organizations, such as the Office of the Assistant Secretary for 

Planning and Evaluation, Department of Health and Human 

Services, 

Even with these various sources of data, it became apparent that there was a need for a report in which data from 

multiple NCHS data systems were integrated into a single 

source document, with some attempt at analysis of data and 

identification of possible epidemiologic associations. This 

report is the first move in this direction. It was made possible by the efforts of NCHS staff and the financial support of 

the National Institute on Aging through an interagency 

agreement. In the future, the Forum on Aging-Related 

Statistics, a cooperative group including the U.S. Bureau of 

the Census, the National Institute on Aging, and other government agencies interested in the issues of aging, may provide a mechanism for enhancing efforts in the collection and 

dissemination of data concerning older persons in the United 

States. 

Manning Feinleib, M. D., Dr.P.H. 

Director, National Center for Health Statistics 

ill 
Acknowledgments


The authors would like to thank Ms. Margaret Carroll, National Center for Health Statistics; Dr. Kenneth Manton 

Ms. Connie Dresser, Dr. Thomas Drury, Mr. Robinson Ful- of Duke University; and Mr. Ira Rosenwaike of the Univerwood, Ms. Clair Harvey, Dr. Gerry Hendershot, Dr. sity of Pennsylvania for access to, review of, or assistance 

Thomas Hodgson, Mr. Richard Klein, Dr. Diane Makuc, in organizing data for the report. We also wish to recognize 

Ms. Evelyn Mathis, Dr. Marilyn McMillen, Ms. Janeanne the technical assistance of Mr. Alan Cohen and Mr. Daniel 

Mehargue, Ms. Nancy Pearce, Mr. Robert Pokras, Mr. Cohn of Applied Management Systems in preparing some 

Peter Ries, Dr. Harry Rosenberg, Ms. Audrey Shipp, Ms. camera-ready tables and to indicate appreciation to Ms. 

Mabel Smith, and Mr. Ronald Wilson, staff members of the Doris Scherbak for her excellent support services. 

iv 
I Contents


Foreword . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..vii 

Acknowledgments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . viii 

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 

Highlights . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 

Chapterl. Healthstatus+nortalii . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 

Tables 

1. Death rates for all causes among persons 55 years of age andover, by sex, race, and age: United States, 1970and 

1979–84, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 

2, Life expectancy at specified ages, by race and sex: United”States, 1970, 1979, and 1984 . . . . . . . . . . . . . 8 

3.	 Death rates for the 10 leading causes ofdeath for persons 55 years of age andover in rank order, by age: United 

States, 1984 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 

4,	 Death rates for diseases of heart among persons 55 years of age and over, by sex, race, and age: United States, 

1979-84 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 

5.	 Death rates for ischemic heart disease among persons 55 years of age and over, by sex, race, and age: United 

States, 1979-84, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 

6.	 Death rates for cerebrovascular diseases among persons 55 years of age and over, by sex, race, and age: United 

States, 1979–84 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 

7. Death rates for malignant neoplasms, including neoplasms of lymphatic and hematopoietic tissues, among persons 

55 years of age and over, bysex, race, and age: United States, 1979–84 . . . . . . . . . . . . . . . . . . . . . 12 

8, Death rates for malignant neoplasms of the respiratory and intrathoracic organs among persons 55 years of age and 

over, bysex, race, andage:United States, 1979–84 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 

9,	 Death rates for suicide among persons 55 years of age and over, by sex, race, and age: United States, 

1979-84 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 

10.	 Number and percent distributions of resident population by age, according to race and sex: United States, 

1979–85 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 

Chapterll .lnternationalcomparisons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...16 

Tables 

11. Life expectancy for males at specified ages: Selected countries, latest available year . . . . . . . . . . . . . . . . 17 

12. Life expectancy for females at specified ages: Selected countries, latest available year . . . . . . . . . . . . . . . 18 

13. Percent of the population aged 65years and ove~Selected countties, 1950-2025 . . . . . . . . . . . . . . . . . 18 

Chapter llLMeasures of health among older persons liingin the community . . . . . . . . . . . . . . . . . . . . 19 

Tables 

14.	Average annual percent distributions of persons 55 years of age and over by respondent-assessed health status 

and degree of activity limitation due to chronic conditions, according to race, sex, and age: United States, 

1983-84 ., . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 

15.	Average annual rate of acute conditions for persons 55 years of age and over, by type of acute condition, race, sex, 

andage: UnitedStates, 1982–84 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 

16.	Average annual rate of selected reported impairments for persons 55 yearsof age and over, by type ofimpairment, 

race, sex, andage: United States, 1982–84 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 

v 
17.	Average annual rate of selected reported chronic conditions for persons 55 years of age and over, by type of


chronic condition, race, sex, and age: United States, 1982–84 . . . . . . . . . . . . . . . . . . . . . . . . . . .


18.	Rate of selected reported chronic conditions for persons 55 years of age and over, by type of chronic condition,


sex, andage: UnitedStates, selected years 1972-84 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


Chapter lV. Heahhstatus anddeterminant%arnage, tivingalone, andnskof insttiutionatization . . . . . . . . . .


Figures


1. Marriages and marriage rates of women 65 years of age and over: United States, 1970-84 . . . . . . . . . . . . .


2. Marriages and marriage rates of men 65 years of age and over: United States, 1970-84 . . . . , , , . . . . , , .


3.	 Percent of the noninstitutionalized population 65 years of age and over using community services, by type of


service and whether living alone or with others: United States, 1984 . . . . . . . . . . . . . . . . . . . . . . . .


Tables 

19.	Number in sample, population in thousands, and percent distributions of persons 65 years of age and over by


selected characteristics, according to whether living alone or with others: United States, 1984 . . . . . . . . . . .


20. Number in sample, population in thousands, and number of persons ages 55–75 years and over who had mental 

or sensory impairments, by activities of daily living functional ability, impairment, sex, and age: United


States, 1984 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


21.	 Number in sample, population in thousands, and percent distribution of persons ages 55–75 years and over who


had mental or sensory impairments, by activities of daily living functional ability, according to impairment, sex,


andage: United States, 1984.., . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


22.	 Number in sample, population in thousands, and number of persons ages 55–75 years and over who had mental or


sensory impairments, by instrumental activities of daily living functional ability, impairment, sex, and age: United


States, 1984 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


23.	 Number in sample, population in thousands, and percent distribution of persons ages 55–75 years and over who


had mental or sensory impairments, by instrumental activities of daily living functional ability, acccrding to


impairment, sex, andage: United States, 1984 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


24.	 Number in sample, population in thousands, and number of persons ages 55–75 years and over who had mental or


sensory impairments, by cardiovascular functional ability, impairment, sex, and age: United States, 1984 . . . . .


25.	 Number in sample, population in thousands, and percent distribution of persons ages 55–75 years and over who


had mental or sensory impairments, by cardiovascular functional ability, according to impairment, sex, and age:


United States, 1984 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


26.	 Number in sample, population in thousands, and number of persons ages 55–75 years and over who had mental or


sensory impairments, by arthritic or rheumatic functional ability, impairment, sex, and age: United States, 1984 . .


27.	 Number in sample, population in thousands, and percent distribution of persons ages 55–75 years and over who


had mental or sensory impairments, by arthritic or rheumatic functional ability, according to impairment, sex, and


age: United States, 1984.... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


Chapter V. Determinants of health-cardiovascular tisk factors . . . . . . . . . . . . . . . . . . . . . . . . . . . ,


Tables


28.	 Percent of persons 55–74 years of age with selected cardiovascular risk factors, by race, sex, and age: United


States, 1971–74and 197G80 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


29.	 Percent of Mexican-American persons 55–74 years of age with selected cardiovascular risk factors, by sex and


age: United States, 1982–83 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


30.	 Intake of fat components and cholesterol for persons 55–74 years of age, by race, sex, and age: United States,


1971–74and 1976-80 .,, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


31. Percent of persons 55 years of age and over, by smoking status, sex, and age: United States, 1979 and 1985 . . .


Chapter V1. Determinants of heatt~xercise and activities of daily Iiiing . . . . . . . . . . . . . . . . . , . . . .


Figures


4.	 Percent of the noninstitutionalized population 65 years of age and over who have difficulty with activities of daily


living, bytypeofactivity : United States, 1984 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


5,	 Percent of the noninstitutionalized population 65 years of age and over who have difficulty with instrumental activi­


ties of daily living, by type of activity: United States,.1984 . . . . . . . . . . . . . . . . . . . . . . . . . . . .


24 

24 

25 

25 

26 

27 

28 

29 

30 

31 

32 

33 

34 

35 

36 

37 

39 

39 

40 

40 

41 

42 

42 

vi 
I


Tables 

32. Number in sample, population in thousands, and percent distribution of persons ages 55–85 years and over by 

I 

33.


I


34. 

I 

35, 

36. 

37. 

38. 

39. 

40. 

41. 

42. 

43. 

44. 

whether they had regular exercise, according to sex and age: United States, 1984 . . . . . . . . . . . . . . . . .


Number in sample, ‘ppulation in thousand;, and percent distribution of persons ages 55–85 years and over by fre­


quency of walking one mile per week, according to sex and age: United States, 1984 . . . . . . . . . . . . . . .


Number in sample, population in thousands, and percent distribution of persons ages 55–85 years and over by


whether they had difficult y in walking up 10 steps or one quarter of a mile, according to sex and age: United


States, 1984 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


Number in sample, population in thousands, and percent distribution of persons ages 55–85 years and over by


whether they had difficulty in lifting 10 or 25 pounds, according to sex and age: United States, 1984 . . . . . . .


Number in sample, population in thousands, and percent distribution of persons ages 55–85 years and over by com­


parison of their activity levels with others, according to sex and age: United States, 1984 . . . . . . . . . . . . .


Number in sample, population in thousands, and percent distribution of persons ages 55–85 years and over


by comparison of their activity levels to I year ago, according to sex and age: United States, 1984 . . . . . . . .


Number in sample, population in thousands, and percent distribution of persons ages 55–85 years and over with


difficulty in activities of daily living by whether they had difficulty in walking and getting outside, according to


sexandage: United States, 1984 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


Number in sample, population in thousands, and percent distribution of persons ages 55–85 years and over with


difficulty in activities of daily living by whether they had difficulty getting in or out of bed or chair and bathing


or showering, according to sex and age: United States, 1984 . . . . . . . . . . . . . . . . . . . . . . . . . . .


Number in sample, population in thousands, and percent distribution of persons ages 55–85 years and over with


difficulty in activities of daily living by whether they had difficulty eating or dressing, according to sex and age:


United States, 1984 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


Number in sample, population in thousands, and percent distribution of persons ages 55–85 years and over with


difficulty in activities of daily living by whether they had difficulty using toilet or controlling urination, according


tosexand age: United States, 1984. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


Number in sample, population in thousands, and percent distribution of persons ages 55–85 years and over with


difficulty in activities of daily living by whether they had difficulty preparing own meals or using telephone,


accordhg tosexandage: United States, 1984 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


Number in sample, population in thousands, and percent distribution of persons ages 55–85 years and over with


difficulty in activities of daily living by whether they had difficulty in shopping or managing money, according


tosexand age: United States, 1984. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


Number in sample, population in thousands, and percent distribution of persons ages 55–85 years and over with


difficulty in activities of daily living by whether they had difficulty in doing light or heavy housework, according


tosexand age: United States, 1984 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...55


43 

44 

45 

46 

47 

48 

49 

50 

51 

52 

53 

54 

56 

58


59


60


61 

64


65


66


Chapter V1l. Useofheatth carc+ambulatory med~l care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Tables 

45.	 Percent distributions of persons 55 years of age and over by level of hospital, ambulatory care, and prescription 

druguse, according tosexandage: United States, 1980 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

46.	 Average annual number of physician contacts per person, by race, sex, respondent-assessed health status, and


age: United States, 1982–83 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...59


47.	 Number of mentions of most frequent all-listed diagnoses for ambulatory patients 55 years of age and over and 

rank bysexand age: United States, 1980and 1981 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

48.	 Number of mentions of selected drugs frequently ordered or provided for ambulatory patients 55 years of age and 

over, byage:United States, 1980 and 1981 . . . . . . . . . . . . . . . . . . ..~._ . . . ..~. . ..~. . . 

Chapter Vlll. Useofheatth care-eare inshort-stay hospitals . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Tables 

49.	 Number of patients discharged, rate of discharges, days of care, and average length of stay for males 55 years of 

age and over, by age and selected first-listed diagnoses: United States, 1979 and 1984 . . . . . . . . . . . . . . . 

50.	 Number of patients discharged, rate of discharges, days of care, and average length of stay for females 55 years of 

age and over, by age and selected first-listed diagnoses: United States, 1979 and 1984 . . . . . . . . . . . . . . . 

51.	 Number of patients discharged, rate of discharges, and average length of stay for persons 55 years of age and over 

with a diagnosis of acute myoeardialinfarction, by sex and age: United States, 1979, 1982, and 1984 , . . . . , . 

vii 
� 

52.	 Rate of patients discharged with a diagnosis of fractures, all sites, and hip fracture (fracture of neck of femur) 

for persons 55 years of age and over, by sex and age: United States, 1979 and 1984. . . . . . . . . . . . . . . . 

53.	 Number and rate of surgical procedures for males 55 years of age and over discharged from short-stay hospitals, 

by age and selected procedures: United States, 1979 and 1984. . . . . . . . . . . . . . . . . . . . . . . . . . . 

54.	 Number and rate of surgical procedures for females 55 years of age and over discharged from short-stay hospitals, 

by age and selected procedures: United States, 1979 and 1984. . . . . . . . . . . . . . . . . . . . . . . . . . . 

55.	 Number and rate of diagnostic and other nonsurgical procedures for male hospital discharges 55 years of age and 

over, by age and selected procedures: United States, 1979 and 1984 . . . . . . . . . . . . . . . . . . . . . . . . 

56.	 Number and rate of diagnostic and other nonsurgical procedures for female hospital discharges 55 years of age and 

over, by age and selected procedures: United States, 1979 and 1984 . . . . . . . . . . . . . . . . . . . . . . . . 

Chapter lX. Useofhealth car=ursing homeeare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Tables 

57.	 Number and rate of nursing home residents 55 years of age and over, by sex, race, and age: United States, 

1973–74, 1977, and 1985 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

58.	 Percent distributions and median length of stay since admission of nursing home residents, live discharges, and 

dead discharges, by age, sex, and marital status: United States, selected years 1976-85 . . . . . . . . . . . . . . 

59.	 Percent distributions of nursing home residents 55 years of age and over by functional status, according to age and 

sex: United States, 1985..... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Chapter X. Costofhealth care... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Tables 

60.	 Per capita personal health care expenditures for persons 65 years of age and over, by type of service and source of 

funds: United States, 1984 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

61.	 Total charges for health services and percent distribution for persons 45 years of age and over by selected diagnostic categories, according to age: United States, 1980 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Appendix. Datasystems with statistics on aging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Symbols 

-.. Data not available 

. . . Category not applicable 

Quantity zero 

0.0	 Quantity more than zero but less than 

0.05 

z	 Quantity more than zero but less than 

500 where numbers are rounded to 

thousands 

Figure does not meet standard of 

reliability or precision (more than 

30-percent relative standard error in 

numerator of percent or rate) 

66 

67 

68 

69 

70 

71 

73 

74 

75 

76 

77 

77 

78 

81 

# Figure suppressed to comply with 

confidentiality requirements 

VIM 
Health Statistics on OIder 

Persons 

by Richard J. Havlik, M. D., National Center for Health 

Statistics; Barbara Marzetta Liu, Northwest Institute; Mary 

Grace Kovar, Dr.P. H., National Center for Health Statistics; 

Richard Suzman, Ph. D., National Institute on Aging; Jacob J. 

Feldman, Ph. D., Tamara Harris, M. D., and Joan Van 

Nostrand, National Center for Health Statistics 

Introduction 

The National Center for Health Statistics (NCHS) collects 

data on the health of older persons through numerous data 

systems. The Vital Statistics Program and the National Health 

and Nutrition Examination Survey (NHANES) are examples. 

This report contains statistics from the data systems covering 

four general areas—mortality, other measures of health status 

and determinants of health, use of health care, and health 

costs . 

The structure of this report is patterned after the annual 

publication Health, United States, with detailed tables and 

accompanying text. Where data permit, the tables contain 

age, sex, and race categorizations including the age group 

85 years and over as well as aggregated data for persons 

aged 65 years and over and 75 years and over. For comparison 

purposes, the tables also include data concerning the transition 

age group 55-64 years of age. 

NCHS compiles the most detailed information available 

on U.S. death rates. In particular, the distribution and trend 

in major causes of mortality in older persons, such as ischemic 

heart disease, cancer, and stroke, can be addressed. In addition, 

trends in lung cancer and suicide in older persons, a matter 

of some recent interest, are addressed. The year 1979 is used 

for most trend comparisons because it began the period covered 

by the current revision of the International Classification of 

Diseases.’ Because life expectancy has been increasing in 

the United States, comparison with data from other countries 

provides interesting contrasts. 

An indication of the frequencies of disease and impairments in persons of different age groups can be gained by 

combining data from multiple years of the continuous National 

Health Interview Survey (NHIS). For example, a combination 

of these comparably collected data allows consideration of 

the small but very important subgroup 85 years of age and 

over. Even with this strategy, however, some of the less 

common conditions cannot be reliably estimated for black 

men and women. The Supplement on Aging of the 1984 

NHIS provided the opportunity to gather information in greater 

depth about the elderly in the community, including, at one 

extreme, ability to accomplish the activities of daily living2 

and, at the other extreme, pmticipation in various types of 

exercise. It cannot be overemphasized that older persons represent a very heterogeneous population, and the full spectrum 

from disabled people to marathon runners can be found. When 

considering this variability in the community, it must be remembered that a sizable component of the older population 

has been institutionalized in hospitals or nursing homes, and 

this group of the elderly are more likely to be disabled. 

NHANES, because of its direct participant examination, 

is a means of providing actual physical and biochemical data 

on health status and determinants of health status. Thus, survey 

data allow consideration of a complex chain of causation 

for chronic diseases. Information is available on the dietary 

patterns of older persons, including fatty food intake, and 

trends in nutrient ingestion. Such data can be considered along 

with risk factor measures, including elevated serum cholesterol, hypertension, and being overweight. Special surveys 

of subgroups such as Mexican Americans provide some information on older ethnic subgroups, although limited because 

of small sample numbers. 

The hospital discharge rate is often used as an indicator 

of morbidity trends in older people. However, the additional 

effect on hospital use of Medicare policy, such as the use 

of diagnosis-related groups and required outpatient surgery, 

must be recognized. The use of CAT scans (computerized 

axial tomography) and other procedures in the elderly is an 

example of new technology being applied more frequently 

to problems of older persons. Also, the reasons for office 

visits and types of prescribed medications can add to our 

knowledge of the medical care older people receive. 

Of particular relevance to long-term care issues are data 

from the 1985 National Nursing Home Survey. These data 

represent some of the most recent information concerning 

nursing home discharges and the age-race-sex distribution of 

nursing home residents. In addition, data are available on 

the functional ability of such institutionalized persons. A trend 

analysis can be made by comparing results with the previous 

surveys, completed in 1973–74 and 1977. 

Finally, in the National Medical Care Utilization and 

Expenditure Survey, a panel of noninstitutionalized individuals, including the elderly, were interviewed at more frequent 

intervals to determine use of health care and costs over a 

year. Information from this survey can be supplemented by 

other national medical expenditure data, including data on 

type of service, in order to develop a more complete picture 

of the cost of health care. 

The various data systems that were sources of information 

1

for this report are described in the appendix. The appendix 

material was prepared originally for a National Academy of 

Sciences, National Research Council, work group addressing 

the question of data needs for an aging population. In addition, 

this appendix contains information on public use data tapes 

now available or forthcoming from NCHS. For example, the 

“National Health Interview Survey: Data for the Study of 

Secular Change and Aging” tape became available in 1986. 

In addition to regular releases, the data tapes for the first 

phase of the Longitudinal Study of Aging Initial Followup, 

1984-86, and NHANES I Epidemiology Followup Study: Initial Followup, 1982–84, will become available in 1987. 

The current plan is to issue future reports on the health 

of older persons using the same format as this report. Updated 

information from various NCHS continuous surveys, as well 

as data available from periodic surveys such as the National 

Mortality Followback Survey and the 1985 National Ambulatory Medical Care Su~ey, will also be included in future 

reports. The data in this and future publications should provide 

valuable information for use in assessing both scientific and 

policy issues for older persons. 
Highlights


Health status-mortality 

�	 From 1970 to 1984, life expectancy at 65 years of age 

increased by 1,0- 1.7 years, depending on the race-sex 

subgroup. 

�	 At 85 years of age, black women have the longest life 

expectancy of the four major race-sex subgroups. 

�	 Over the 14-year period 1970-84, white females aged 

85 years and over had the largest absolute decrease in 

the death rate from all causes when compared with the 

other sex-race-age subgroups of those 55 years and over. 

�	 During the 5-year period 1979–84, death rates from all 

causes for age subgroups of women 55 years and over 

changed little. Such death rates for men aged 55-64 and 

65–74 years decreased about 6 percent, but for men 75 

years of age and over they remained stable. 

�	 Death rates for ischemic heart disease in the age group 

55–64 years declined 17.3 percent for men and 9.8 percent 

for women from 1979 to 1984. Among men and women 

aged 85 years and over, a decrease of about 7 percent 

occurred. 

�	 Death rates for cerebrovascular diseases decreased 7.2– 

40,3 percent in the 5-year period 1979–84 for males and 

females in each age-specific subgroup of those aged 55 

years and over. 

�	 During the period 1979–84, lung cancer death rates for 

those 55 years and over increased 26,943,3 percent in 

women and 4, 1–18, 3 percent in men, depending on the 

age-specific subgroup, 

�	 Death rates for suicide increased 6.7–9.2 percent among 

age-specific subgroups of men aged 55 years and over 

but did not increase in women of the same ages during 

the period 1979–84, 

�	 In 1985, 12,0 percent of the U.S. resident population 

was aged 65 years and over, and 1.1 percent was 85 

years and over. 

International comparisons 

�	 U.S. women at both ages 75 and 85 years had the longest 

life expectancy in the world among countries with 

available data for the early years of this decade. 

Measures of health among older persons 

living in the community 

�	 According to self-reports, more than one-third of persons 

aged 65 years and over living in the community are in 

excellent or very good health. 

�	 Black males and females aged 55 years and over are 

generally more likely than white people to consider their 

health status as only fair or poor. 

� Injury rates are higher among persons aged 85 years and 

over than among adults aged 55–84 years. 

� Impairments in vision and hearing are more common 

for each consecutively older age subgroup. 

�	 Arthritis is present in more than one-half of females aged 

65 years and over, and the highest rate is reported for 

the subgroup of black females aged 65 years and over. 

�	 Trends in the reported prevalence of ischemic heart disease, hypertension, and diabetes have been generally upward among sex-age-specific subgroups of persons 55 

years of age and over from 1972 or 1973 to 1982–84. 

Health status and determinantsmarriage, living alone, and risk of 

institutionalization 

�	 In 1984 about 70,000 persons aged 65 and over married 

in America—25 ,000 women and 45,000 men. 

.	 About 26.4 million Americans who had had their 65th 

birthday were living in communities outside nursing homes 

or other institutions in 1984. About one-third of them, 

an estimated 8.4 million people, were living alone. 

.	 The population of people aged 65 years and over living 

alone tends to be older, widowed, and female. 

.	 Many of the people who live alone are not disabled, 

in poor health, suffering from lack of medical care, or 

lacking family or companionship. 
Determinants of health 

Cardmvascutar risk factors 

�	 In most subgroups of white and black people aged 55 

years and over, the percent of women with high-risk 

serum cholesterol is almost twice as great as the percent 

of men. 

.	 About one-half of black females and Mexican-American 

females aged 55–74 years are overweight. 

�	 About 40 percent of male Mexican Americans aged 55-74 

years and 20 percent of female Mexican Americans aged 

55–74 years were current smokers in 1982–83. 

Exercise and activities of daily Iiiing 

.	 In 1984 the majority of older persons except those 85 

years and over reported no difficulty walking one-quarter 

of a mile or two blocks. 

.	 The most frequent limitation in activities of daily living 

was difficulty in walking, which affected 9–32 percent 

of men and 10-43 percent of women in age subgroups 

55 years and over in 1984. 

Use of health care 

Ambulatory medical care 

.	 Subgroups of those aged 55 years and over who are 

reported to be in fair or poor health have an annual 

rate of physician contacts twice as great as the rate for 

those reported to be in good or excellent health. 

.	 Essential hypertension, diabetes mellitus, chronic ischemic heart disease, and osteoarthritis are the most frequent diagnoses mentioned by physicians for office visits 

of those 55 years and over. 

.	 Diuretics, cardiovascular drugs, and analgesics represent 

the majority of drugs prescribed by office-based physicians 

for persons 55 years and over. 

Care in short-stay hospitals 

�	 In 1979, the rate of hip fracture for females aged 75-84 

was almost three times that for males in this age group, 

but in 1984 the rate for females was not quite twice 

that for males. 

.	 The rate of discharges for acute myocardial infarction 

in persons 55 years and over remained unchanged during 

a period of decreasing death rates for ischemic heart 

disease. 

Nursing home care 

�	 Data from the 1985 National Nursing Home Survey indicate that slightly less than 5 percent of the population 

aged 65 years and over, 10 percent of persons 75 years 

of age and over, and 22 percent of persons 85 years 

and over resided in a nursing home. 

�	 In 1985, 83 percent of women 85 years and over residing 

in a nursing home were unable to dress independently, 

and the same percent could not walk independently. 

Cost of health care 

.	 For persons 65 years and over living in the community, 

27.6 percent of health care costs were for diseases of 

the circulatory system, 12.9 percent for neoplasms, and 

9.2 percent for injury and poisoning. 
Chapter I


Health status-mortality


by Richard J. Havlik, M.D., National Center for Health 

Statistics, and Richard Suzman, Ph.D., National Institute on 

Aging 

Introduction 

Mortality statistics are fundamental to understanding the 

effects of the aging process and disease on the population 

of older persons. The general rise in mortality with increasing 

age may be caused by various biological and environmental 

factors. However, the patterns in death rates for all causes 

and for specific causes vary with race and sex. This is the 

basis of differing life expectancy estimates for subgroups of 

the population. Trend analysis of changes in death rates over 

time allows an assessment of possible etiological factors 

through the investigation of concurrent changes in potential 

causal agents. Finally, the establishment of long-term trends 

in mortality permits better projections of future death rates 

and population size. 

Sources of data 

Mortality data are based on information reported on death 

certificates filed in the State registration offices. This information is compiled by the National Center for Health Statistics 

through the vital statistics system, which is a cooperative 

effort between the States and the Federal Government. It 

is described in the appendix, The population estimates needed 

for computation of annual death rates are published annually 

by the U.S. Bureau of the Census in Current Population 

Reports, Series P-25. The death rates presented here have 

not been age adjusted except as indicated. 

Results and comments 

Mortalitytrends 

A review of trends in age-adjusted death rates reveals 

that the average annual percent change in rates for persons 

65 years of age and over during the period 1955-67 was 

stable in men and decreased 1 percent per year in women; 

in the period 1968–80 the death rate for this age group declined 

1.7 percent annually for men and 2.3 percent for women.3 

(The death rates in the later period were calculated using 

the appropriate intercensal population estimates prepared after 

the 1980 census.) The more rapid decline in the period 1968–80 

is attributable principally to a decline in mortality from diseases 

of the cardiovasc@tr system, 3 

From 1979 through 1984, death rates among males in 

the age groups 55-64 and 65-74 years decreased approximately 

6 percent, or about 1 percent per year (table 1). However, 

no clear trend emerged in death rates for men in the age 

groups 75–84 years and 85 years and over. No definite trends 

were found in death rates among any of the female age subgroups 55 years and over. Similarly, consistent variations 

over time in race-age-specific subgroups could not be distinguished (table 1). 

The interpretation of recent trends in death rates for older 

persons presents certain problems. First, the period 1979–84 

was relatively brief, and there may have been unexplained 

short-term fluctuations in death rates. (The year 1979 was 

selected as a baseline in the tables because of the desirability 

of making cause-specific comparisons within a period covered 

by the same revision of the International Classification of 

Diseases.) Second, from 1979 to 1980 there was a pronounced 

increase in death rates at older ages (table 1). This increase 

apparently was caused by an influenza epidemic in 1980.3 

Third, in 1984 the U.S. Bureau of the Census changed the 

assumptions concerning the effects of undocumented immigration and migration on population estimates. Despite its modest 

effect, this change resulted in an estimated 3-percent decrease 

in the size of the black population aged 85 years and over.4 

These lower population estimates could have resulted in 

slightly higher death rates for age-specific subgroups for 1984. 

By comparing death rates over a longer period of time 

(1970-84), a better indication of long-term trends can be 

identified, especially in the older age subgroups. Reductions 

occurred in the death rates for most race-, sex-, and age-specific 

subgroups of those 55 years and over. The largest percent 

change (26. 2 percent) was for white males aged 55-64 years. 

Changes for black males were smaller than changes for white 

males. During the period 1970-84, the reduction in the death 

rate for all causes was 23.3 percent for white females aged 

75–84 years and about 25 percent in black females aged 

55-64 and 65–74 years. The percent change in those aged 

85 years and over was generally less than that for the younger 

age subgroups. 

Because the age category 85 years and over is open ended, 

the “crude” rate for 1984 may be slightly higher in men 

simply because of the increased mean age of the subgroup 

85 years and over when compared with the same subgroup 

in 1970. In addition, because death rates are highest in the 

oldest age category, a similar absolute change in death rates 

in two age subgroups will result in a smaller percent change 

in the older subgroup. For example, during this longer period, 

for white males aged 75–84 yeais, h absolute difference 

in death rates of 1,639.7 per 100,000 resulted in a decrease 

of 16.2 percent, but for those 85 years and over, an absolute 

5 
decrease of 1,839.9 resulted in a 9. O-percent decrease. White 

females aged 85 years and over had the largest absolute decrease in rates—2,409.9 per 100,000, or 14.4 percent, from 

1970 to 1984, The rate for black females in the same age 

subgroup decreased 692.6 per 100,000, or 5.7 percent. 

As a result of minimal changes in death rates from 1979 

to 1984, life expectancies at older ages changed little (table 2). However, from 1970 to 1984 life expectancy at 65 

years of age increased by 1.0-1.7 years, depending on the 

race-sex subgroup. In each year and at each age, life expectancy for females exceeded that for males. Although life expectancy for black persons was lower than that for white persons 

at birth and at age 65 years, at age 75 life expectancy was 

similar for both races. In an apparent change from 1979 and 

more similar to 1970, in 1984 black persons aged 85 were 

expected to live longer than their white counterparts. 

Mortalii patterns 

During the period 1979–84, death rates for males were 

higher than rates for females in every age group 55 years 

and over (table 1). However, at ages 85 and over, death 

rates for men and women were more similar. Although death 

rates for black persons exceeded those for white persons among 

younger age groups, they were lower than rates for white 

persons in the subgroup 85 years and over. Indeed, black 

females had the lowest death rate of any race-sex cohort 

85 years and over. This “crossover” of death rates between 

races at older ages may represent survival of a selected and 

less disease-prone group of older black people. However, 

some oveneporting of age in the subgroup 85 years and over, 

especially in minority groups, has been suggested.s At the 

extreme ages, the Census Bureau has reduced downward the 

number of centenarians reported in the census of population 

because of age overreporting and other problems.5 This 

phenomenon is not unique to the United States. 

Table 3 shows leading causes of death in the population 

aged 55 years and over. Relative rankings vary with age, 

but the top three causes-diseases of heart, malignant 

neoplasms, and cerebrovascular diseases—are the same for 

each age subgroup 55 years and over, Although underlying 

causes are the basis of the death rates, multiple causes of 

death are often listed on death certificates for older persons. 

Multiple cause tabulations provide a more complete picture 

of disease in the elderly.6’7 

Disease-specfic mottalii trends 

The well-known trend of decreasing mortality from 

diseases of heart and the subgroup of ischemic heart disease 

is evident at all of the age groups 55 years and over (tables 4 and 5). From 1979 to 1984, death rates from ischemic 

heart disease among men of all races decreased 17.3 percent 

in the age group 55-64 years and 7.4 percent in the group 

85 years and over. Among women, death rates decreased 

only about 10 percent for ages 55-64; the magnitude of 

decrease was similar to that for men in the older age groups. 

Cerebrovascular mortality decreased 7.2+0.3 percent in 

the 5-year period for various sex-race-age subgroups, 

continuing a trend that began in the 1960’s and accelerated 

in the 1970’s8 (table 6). 

In contrast, mortality from cancer, especially respiratory 

tract cancer, increased from 1979 to 1984 (tables 7 and 8). 

This continues a trend seen in the period 1968-80, when 

the average annual percent change in death rates for malignant 

neoplasms among older men increased. The percent change 

for men varied-O.8, 1.3, and 1.7 percent for those aged 

65–74 years, 75–84 years, and 85 years and over, respectively. 

For women, the percent change varied somewhat less-O.6 

for the group 65–74 and 0.2 percent for each of the older 

age subgroups. During this earlier period, female death rates 

for cancer of the genital organs and colon decreased somewhat.3 During the period 1979–84, increases in death rates 

for respiratory cancer in men ranged from 4.1 percent to 

18.3 percent for the various older subgroups considered. The 

increases for women were much greater; they ranged from 

26.9 to 43.3 percent in the various age subgroups. However, 

because of lower cancer rates in females, the absolute changes 

in rates were similar to the changes for males. 

The authors of a report from the National Cancer Institute 

suggested that lung cancer incidence, as determined from 

local registries, is down, and they postulated a decrease in 

mortality in men based on 1983 data.g Because of an increase 

in lung cancer mortality in 1984, another year of data will 

be necessa~ before any conclusions can be drawn for men. 

In addition, incidence for women is still going up. most likely 

as a result of increased smoking in this C(hort of women 

at younger ages. 

Among those 65 years and over suicid r lks 14th, behind 

more common causes of death, such as : onic obstructive 

pulmonary disease, pneumonia and influ :T a, and diabetes. 

Suicide for white men is highest among th )se at older ages 

(table 9). The death rates for suicide during the period 1979-84 

increased among age-specific subgroups of men of all races 

by 6.7–9.2 percent, but no such upward trend was detectable 

among women. Although the absolute increase in the male 

rate is relatively small, a possible trend merits recognition. 

The longer term trend for race-age subgroups is less clear. 

Although the 1970 suicide death rates for white males aged 

75–84 years and 85 years and over were similar to those 

in 1979, rates for white males aged 55-64 years and 65–74 

years decreased (35.0 and 38.7 deaths per 100,000 in 1970, 

compared with 26.3 and 33.4 in 1979). The issues involved 

in the identification of causes and prevention of suicide in 

older persons have been addressed in a recent book.’0 

Population 

The U.S. total resident population was estimated to be 

238.7 million in 1985 (table 10), an increase of about 14 

million from 1979 and more than 35 million from 1970. 

The total number of those 65 years and over in 1985 was 

about 28.5 million, according to U.S. Bureau of the Census 

estimates. The number of those 65 years and over is projected 

to almost double by the year 2020, reaching about 51 million, 

and the total population is projected to reach almost 300 

million. 1] 

Of most interest to this discussion is the trend in the 

6 
age distribution of older persons. In 1985 persons aged 55-64 

years represented 9.4 percent of the population; those 65 

years and over, 12.0 percent; and those 85 years and over, 

1.1 percent. By contrast, in 1950 the comparable figures 

were 8.9 percent for persons 55-64 years, 8.1 percent for 

ages 65 and over, and only 0.4 percent for ages 85 and 

over.s According to projections using “middle series” 1* estimates of the Bureau of the Census, the proportion of those 

65 years and older will be 13 percent by the year 2000. 

By 2020, when the Baby Boom generation reaches older 

ages, the proportion aged 65 years and over will be 17.3 

percent, and the group 55 years and over will constitute about 

30 percent of the population. II Accordingtothese estimates ~ 

persons 85 years and over will constitute 2.4 percent of the 

population in 2020. 

Table 1. Oeath rates for all causes among pereons 55 yeare of age and over, by sex, race, and age United States, 1970 and 1979-84 

[Dalaare based on the National Vital SIatistica System] 

Sex, race, and age 1970 1979 1980 1981 1982 1983 1984 

MALE 

All races’ Number of deaths per lDO,COOresident population 

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,282.7 1,815.4 1,815.1 1,774.7 1,738.1 1,725.6 1,705.2 

85 yeare and over . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7,195.2 6,210.9 6,2J37.9 6,207.5 6,120.6 6,151.9 6,084.9 

65-74 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4,873.8 4,048.9 4,105.2 3,994.6 3,929.2 3,885.4 3,613.0 

75yearsand over . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11,432.6 10,306.6 10,735.6 10,387.6 10,190.9 10,384.4 10,291.5 

75-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10,010.2 6,565.4 8,816.7 8,519.6 8,391.4 8,539.1 8,445.9 

S5years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17,821.5 17,804.4 18,801.1 18,138.2 17,782.0 17,977.4 18,119.1 

White 

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,202.6 1,734.5 1,726.5 1,692.0 1,854.6 1,842.9 1,625.5 

65yearsand over . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7,238.9 6,221.6 6,377.3 6,205.4 6,118.3 6,146.3 6,076.0 

65-74 yeare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4,810.1 3,991.5 4,035.7 3,926.9 3,859.6 3,816.1 3,745.3 

75years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11,808.5 10,429.0 10,609.3 10,474.5 10,307.8 10,465.3 lo,3ao.2 

75-64 yeare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10,096.8 6,624.0 6,629.6 8,585.2 8,444.7 6,558.9 8,459.1 

S5yearaand over . . . . . . . . . . . . . . . . . . . . . 20,392.6 17,924.0 19,097.3 18.454.0 18,123.1 18,443.3 18,552.7 

Black 

65-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,258.9 2,794.6 2,873.0 2,804.1 2,758.1 2,713.1 2,658.3 

05years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7,151.7 6,403.6 6,919.2 6,701.8 6,658.8 6,725.0 6,671.3 

85-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5,803.2 4,916.8 5,131.1 5,048.3 5,040.1 4,949.3 4,874.5 

75yearsand over . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10,047.9 9,295.2 10,528.7 9,9000 9,708.6 10,127.4 10,150.6 

75-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9,454.9 6,165.5 9,231.6 6,635.1 6,477.2 9,100.0 9,023.1 

S5yeareand over . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14,415.4 14,485.4 16,096.8 15,398.4 15,117.9 14.155.6 14,842.9 

FEMALE 

All races’ 

5S-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,G96.9 917.7 934.3 925.2 913.9 923.8 916.4 

85 years and over . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4,950.6 4,280.1 4,464.2 4,370.1 4,329.4 4,413.3 4,436.2 

86-74 yeare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,579.7 2,0723 2,144.7 2,100.6 2,084.7 2,CQ2.3 2,098.4 

75 yeare and over . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8,518.4 7,330.3 7,699.8 7,423.1 7,297.5 7,457.3 7,465.9 

75-64 yeare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6,677.6 5,270.7 5,440.1 5,201.0 5,120.7 5,200.0 5,188.2 

L15year aandove r . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15,518.0 13,788.2 14,746.9 14,2)2.5 13,895.2 14,010.6 14,053.9 

White 

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,014.9 S62.8 876.2 889.4 859.8 667.8 884.9 

65years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4,952.6 4,287.4 4,462.7 4,378.5 4,343.7 4,423.9 4,448.7 

85-74 yeare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,470.7 1,887.9 2,088.6 2,032.6 2,022.9 2,024.7 2,032.5 

75years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8,610.9 7,393.3 7,740.2 7,479.3 7,359.7 7,510.6 7,511.1 

75-64 yeare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6,696.7 5,258.6 5,401.7 5,176.3 5,100.7 5,162.2 5,140.0 

6S yeare and over . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16,729.5 14,027.9 14,979.6 14,436.2 14,123.9 14,278.3 14,319.6 

Black 

5S-84 yeare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . 1,986.2 1,602.7 1,561.0 1,527.9 1,498.3 1,526.3 1,489.7 

85yeare andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5,150.9 4,381.1 4,769.8 4,578.1 4,%0.4 4,655.6 4,7C6.3 

65-74 yeare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,660.9 2,914.6 3,057.4 2,929.7 2,683.0 2,930.6 2,907.4 

75 years and over . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7,642.8 6,6022 7,615.0 7,207.7 7,037.5 7,353.3 7,476.0 

75-84 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6,691.5 5,594.4 6,2121 5,622.3 5,708.5 6,064.6 6,164.1 

66 yeare and over . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1~131.7 10,9627 12,387.2 11,933.0 11,660.0 11,329.5 11,439.1 

llnchrdes races other than white and black. 

SOURCES National Canter for Health Statistics V/ta/StaY/sties of the Urri&dSfates, Vol. 11,Mortality, Fari A. Public Health Service. Washington. U.S. Government Printing Orfice. Published 

annuall~ eelectectrates computed by the Office of Planning and ExtramuralProgramsfrom data compiled by the Division of Vital Statistics, National Centerfor Health Statistics. 

7 
Tabla 2. Life expectancy at specified ages, by race and sex United States, 1970,1979, and 1984 

[Data are based on the National Vital Statistics System] 

All races’ White Black 

Both Both Both 

Age and year 

At birth 

1970 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

1979 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

1964 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

At 65 years 

1970 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

1979 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

1964 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

At 75 years 

1970 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

1979 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

1964 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

At 85 years 

1970 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

1979 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

1964 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

1Includes races other than white and black. 

sexes Male Female 

70.8 67.1 74.7 

73.9 70.0 77.8 

74.7 77.2 78.2 

15.2 13.1 17.0 

16.7 14.3 18.7 

16.8 14.6 18.6 

9.6 8.3 10.5 

10.7 9.1 11.9 

10.7 9.0 11.8 

5.8 5.3 6.1 

6.3 5.4 6.8 

6.1 5.2 6.5 

sexes Male Female 

Remaining life expectancy in years 

77.7 66.0 75.6 

74.6 70.8 78.4 

75.3 71.8 78.7 

15.2 13.1 17.1 

16.8 14.4 18.8 

16.9 14.6 18.7 

9.5 8.3 10.4 

10.7 9.0 11.9 

10.7 9.0 11.8 

5.6 5.2 5.9 

8.2 5.3 6.8 

8.0 5.1 6.5 

sexes Male Female 

64.1 60.0 66.3 

66.5 64.0 72.9 

69.7 65.6 73.7 

14.2 12.5 15.7 

15.5 13.5 17.3 

15.5 13.5 17.2 

9.9 8.8 10.9 

10.4 9.0 11.6 

10.4 8.9 11.3 

6.6 5.9 7.0 

6.1 5.0 8.9 

6.8 5.8 7.3 

SOURCE National Canter for Health Statistics Vita/Statisticsof the United States, Vol. 11,Mortafity, Pert A. Public Health Service. Washington. U.S. Government Printing Office. Published annually. 

Table 3. Death rates fortha 10 Iaading causea of death forpereons 

[Oata are based on the National Vital Statistics System] 

55 yeare of age and over in rank order, by age Unitad States, 1984 

R 

a 

n 

k 

... 

1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

. . . 

1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

Age, cause of death, and


International Classification of Diseases code’


55-64 years 

All causes 

Diseases of heart. . . . . . . . . . . . ...390-396. 402,404-429 

Malignant neoplasms, including neoplasms 

of lymphatic and hematopoietic tissues . . . . . . . 140-206 

Cerebrovascular diseases . . . . . . . . . . . . . . . . ...430-436 

Chronic obstructive pulmonary diseases 

and allied conditions . . . . . . . . . . . . . . . . . . . ...490-496 

Accidents and adverse effects . . . . . . . . . . . . . E600-E949 

Chronic liver disease and cirrhosis . . . . . . . . . . . . . . . . 571 

Diabetes mellitus . . . . . . . . . . . . . . . . . . . . . . . . . . . ...250 

Suicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. E954)-E959 

Pneumonia and influenza . . . . . . . . . . . . . . . . . . . . 460-467 

Nephritis, nephrotic syndrome, and nephrosis... 560-569 

65-74 yeara 

All causes 

Diseases of heart. . . . . . . . . . . . ...390-396. 402,404-429 

Malignant neoplasms, including neoplasms 

of lymphatic and hematopoietic tissues . . . . . . . 140-206 

Cerebrovascular diseaaes . . . . . . . . . . . . . . . . ...430-436 

Chronic obstructive pulmonary diseases 

and allied conditions . . . . . . . . . . . . . . . . . . . . .. 4%496 

Diabetes mellitus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 250 

Pneumonia and influenza. . . . . . . . . . . . . . . . . ...460-467 

Accidents and adverse effects . . . . . . . . . . . . . E600~E949 

Chronic Iiverdiseaae and cirrhosis . . . . . . . . . . . . . ...571 

Nephritis, nephrotic syndrome, and nephrosis.. . 56&569 

Number of


deaths per R


10L,OOO a 

resident n 

population k 

1,287.8 ... 

450.3	 1 

2 

446.4 

55.8 3 

4 

46.0 

36.0 5 

35.0 6 

24.8 7 

17.3 8 

18.8 9 

9.2 10 

2,646.1 . . . 

1,102.7 1 

2 

635.1 3 

177.0 

4 

141.4 5 

59.4 6 

53.7 

50.3 7 

39.3 8 

26.8 9 

Number of 

deaths per 

100,009 

Age, cause of death, and resident 

International Classification of Diseases code’ population 

75-64 years 

All causes 6,399.3 

Diseases of heart . . . . . . . . . . . . . ..3S0-396.402.404-429 2,748.6 

Malignant neoplasms, including neoplasms 

of lymphatic and hematopoietic tissues. . . . ...140-206 

Cerebrovascular diseases . . . . . . . . . . . . . . . . ...430-436 

Chronic obstructive pulmonary diseases 

and allied conditions . . . . . . . . . . . . . . . . . . . ...490-496 

Pneumonia and influenza . . . . . . . . . . . . . . . . . ...480-467 

Diabetes mellitus . . . . . . . . . . . . . . . . . . . . . . . . . . . ...250 

Accidents and adverse effects . . . . . . . . . . . . . E6fwE949 

Atherosclerosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...440 

Nephritis, nephrotic syndrome, and nephrosis. ..560-569 

Septicemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...036 

65 years and over 

1,272.3 

626.2 

270.3 

216.0 

126.1 

107.2 

66.4 

76.1 

51.7 

All causes 15,223.6 

Diseases of heart. . . . . . . . . . . . ...390-396.402.404-429 7,251.0 

Csrebrovascular diseases . . . . . . . . . . . . . . . . ...430-438 

Malignant neoplasms, including neoplasms 

of lymphatic and hematopoietic tissues . . . . . . .140-206 

Pneumonia and influenza. . . . . . . . . . . . . . . . . ...460-487 

Atherosclerosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...440 

Chronic obstructive pulmonary diseases 

andalliad conditions . . . . . . . . . . . . . . . . . . . ...490-4% 

Accidents and adverae effects . . . . . . . . . . . . . E600-E949 

Oiabetes mellitus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 250 

Nephritis, nephrotic syndrome, and nephrosis.. .560-569 

Septicemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..O38 

1,863.8 

1,E04.o 

663.2 

466.4 

331.0 

256.9 

216.8 

201.0


Septicemia.. .................................038 19.8 10 142.1

1Coded according to the 9th Revision, international Classification of Diseases. (See reference 1.)


SOURCE National Center for Health Statistics Monthly Vita/ Statistics Report. Vol. 35, No. e Supp. 2. DHHS Pub. No. (PHS) S&l 120. Public Health Service. Hyattsville, Md., Sept. 26, 19S6.


8 
Table4. Daathrates fordiseasesof heart amongpersons55yeareof age andover,bysex,race,andage UnitedStates, 1979-84 

[Dala am based on the National Vital Statistics System] 

Sex, race, and age 1979 1980 1981 1982 1983 1984 

MALE 

All races’ Number of deaths per 100,ODfJresident population 

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 760.2 746.8 725.6 705.6 690.6 670.7 

65yeara andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,714.6 2,778.3 2,683.3 2,636.8 2,622.8 2,546.9 

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,714.8 1,728.0 1,688.9 1,639.2 1,607.6 1,537.2 

75years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4,611.6 4,778.2 4,590.5 4,495.5 4,509.6 4,416.6 

75-84 years, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,744.4 3,634.3 3,889.2 3,612.4 3,618.0 3,535.2 

85years andover, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8,240.8 6,752.7 8,379.6 8,221.3 8,266.0 8,154.8 

White 

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 746.1 730.6 70s.7 869.9 674.1 655.5 

65years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,755.0 2,812.4 2,719.8 2,671.7 2,653.1 2,576.1 

65-74 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,716.0 1,729.7 1,669.9 1,636.2 1,603.6 1,533.0 

75years andover, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4,711.3 4,661.6 4,666.9 4,592.4 4,586.4 4,489.9 

75-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,606.9 3,683.2 3,751.5 3,674.7 3,864.3 3,579.3 

85years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6,458.5 8,956.0 8.596.0 8,442.2 8,503.4 8,416.4 

Black 

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 969.3 987.2 981.5 950.4 928.0 895.9 

65years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,453.6 2,623.6 2,518.1 2,517.5 2,542.1 2,474.0 

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,805.7 1,647.2 1,812.7 1,822.5 1,604.5 1,734.7 

75years andover, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,713.8 4,190.0 3,s81 .0 3,826.8 3,955.5 3,905.4 

75-64 yeare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,193.7 3,578.8 3,302.5 3,245.9 3,457.5 3,375.7 

85years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6,094.2 6,819.5 6,394.5 6,378.6 5.907.9 6,015.9 

FEMALE 

All racesl 

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 269.2 272.1 267.4 2&3.9 262.2 255.4 

65years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,944.5 2,027.4 1,9S3.4 1,945.4 1,966.7 1,945.2 

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 805.8 828.6 798.0 786.2 770.0 764.3 

75years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,517.8 3,674.8 3,519.4 3,478.1 3,526.9 3,472.0 

75-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,439.8 2,497.0 2,357.0 2,325.6 2,341.7 2,263.2 

85years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6,897.8 7,350.5 7.085.9 6,970.8 6,967.6 6,685.9 

White 

55-64 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 246.1 246.1 243.7 237.9 237.5 231.6 

65years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,960.4 2,040.0 1,974.1 1,984.4 1,860.5 1,957.0 

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 775.0 786.7 769.4 759.6 745.6 735.3 

75years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,568.4 3,716.4 3,566.5 3,530.1 3,569.3 3,505.6 

75-64 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,447.1 2,493.6 2,359.0 2,331.7 2,332.4 2,273.1 

65years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7,053.7 7,501.6 7,215.1 7,118.6 7,133.7 7,044.7 

Black 

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 513.5 530.1 517.2 501.9 517.7 499.6 

65years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,870.0 2,036.2 1,709.8 1,809.1 1,997.0 1,975.5 

65-74 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,156.9 1,210.3 1,152.3 1,124.3 1,159.8 1,127.1 

75years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,044.0 3,411.2 2,599.2 3,125.2 3,305.9 3,281.7 

75-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,461.4 2,707.2 2,509.4 2,445.0 2,660.1 2,618.9 

85years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.(260.6 5,786.5 5,563.9 5,491.3 5,298.4 5,315.0 

1Includes races other than white and black. 

NOTE: Dlseaaes of the heart comprise codes 390-398,402, and 404-423 of the 9th Revision, /ntemationa/ Classification of Diseases. (See reference 1.) 

SOURCES National Center for Health Statistics Vita/Statistics of the United .9afes, Vol. 11,Mortality, Pert A. Public Health Service. Washington. U.S. Government Printing Office. Published 

annually; selected rates computed by the Office of Planning and Extramural Programa from data compiled by the Division of Vital Statistics, National Center for Health Statistics. 

9 
Table 5. Death ratea for iachemic hearf disease among persona 55 years of age end over, by sex, race, and age United States, 1979-84 

[Data are based on the National Vital Statistics System] 

Sex, race, and age 1979 1980 7981 1982 1983 1984 

MALE 

All races’ Number of deaths per lC0,000 resident population 

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 599.3 581.1 559.8 541.1 517.4 495.9 

65years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,115.4 2,140.2 2,047.4 2,002.0 1,950.7 1,669.9 

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,360.5 1,355.5 1,299.8 1,267.9 1,218.2 1,145.3 

75years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,547.3 3,634.5 3,453.0 3,365.6 3,312.1 3,211.6 

75-84 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,916.2 2,953.7 2,613.4 2,744.0 2,699.5 2,618.0 

85yaara andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6,16$3.6 6,501.6 6,141,8 5,937.7 5,667.2 5,729.4 

White 

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 604.0 585.5 562.3 544.5 521.2 499.9 

65years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,181.2 2,200.9 2,108.6 2,060.4 2,008.2 1,925.7 

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,391.2 1,384.6 1,325.9 1,293.4 1,243.3 1,169.0 

75years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,671.5 3,746.0 3,575.2 3,483.2 3,426.0 3,321.5 

75-84 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,010.9 3,035.2 2,9047 2,834.7 2,760.3 2,695.5 

85years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6,414.6 6,721.9 6,377.1 6,203.7 6,125.3 5,964.3 

Black 

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 597.6 566.3 591.7 665.9 531.1 510.5 

65years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,545.1 1,651.7 1,561.3 1,539.5 1,517.1 1,442.6 

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,134.2 1)157.1 1,137.7 1,102.6 1,067.7 1,004.4 

75years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,344.1 2,649.5 2,379.6 2,362.6 2,378.4 2,291.1 

75-84 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,018.9 2,286.6 2,046.0 1,990.7 2,068.4 1,891.6 

65years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,632.7 4,287.9 3,829.1 3,996.4 3,593.7 3,484.1 

FEMALE 

All races’ 

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 166.9 189.0 184.6 179.2 176.9 170.4 

65years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,432.0 1,477.9 1,413.2 1,392.0 1,383.1 1,347.4 

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 594.7 605.3 579.7 566.3 551.9 536,6 

75years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,566.9 2,677.0 2,535.9 2,481.4 2,473.1 2,395.6 

75-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,815.1 1,642.7 1,719.6 1,6S0.6 1,665.3 1,604.4 

85years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5,014.9 5,280.6 5,026.0 4,908.3 4,818.2 4,6434.0 

White 

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 178.9 177.9 174.2 168.9 166.8 160.7 

65years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,46S.8 1,508.9 1,443.7 1,425.4 1,413.3 1,378.1 

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5%.9 597.3 571.3 662.2 543.6 530.2 

75years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,653.4 2,736.0 2,597.0 2,547.1 2,532.3 2,452.8 

75-84 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,644.5 1,666.6 1,745.7 1,710.5 1,6%4.4 1,623.0 

85yeara andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5,167.4 5,435.5 5,169.2 5,052.0 4,975.6 4,635.2 

Black 

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 302.0 316.0 301.6 294.0 290.4 277.5 

65years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,168.5 1,244.6 1,197.0 1,149.7 1,180.0 1,146.4 

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 705.2 729.6 711.3 677.3 Oal .9 652.6 

75years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,906.9 2,102.6 1,971.7 1,681.6 1,956.8 1,936.6 

75-84 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,545.3 1,674.7 1,536.6 1,466.3 1,564.9 1,531.6 

85years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,156.7 3,552,2 3,455.4 3,326.1 3,112.4 3,057.9 

1Includss races other than white and black. 

NOTE Ischemic heart disease comprises cedes 410-414 of the 9th Revis/err,/ntemafiona/ Classification of Diseases.(Seereference 1.) 

SOURCES National Center for Health Statistics Vital Statistics of the Unifed States, Vol. 11,MortaW, PM A. public Health se~i=. Washington. U.S.Government Printing Office. Published 

annually selected rates computed by the Office of Planning and Extramural Programs from data compiled by the ~vislon of Vital Statiafics, National Center for Health Statistics. 

10 
I 

I Table 6. Death ratea for cerebrovascular dfseasea among persona 55 yeara of age and ove~ by sex, race, and a~ United Statea, 1979-s.4 

[Dataarebasedonthe NationalVitalStatisticsSystem] 

Sex, race, and age 1979 1960 1981 1982 19s3 1984 

MALE 

All raceal Number of deaths per 100,000 resident population 

55-64 yaars . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78.4 74.7 71.6 67.3 65.9 63.6 

05yaaraand over. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 564.2 556.9 516.0 484.7 454.7 447.7 

65-74 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 267.6 259.2 242.1 228.2 212.7 205.4 

75years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,126.7 1,123.7 1,022.8 961.1 933.0 892.8 

75-84 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 873.0 S6%.3 785.1 736.7 720.3 679.7 

S5yaamand over. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,18S.3 2,199.2 2,022.3 1,S0S.0 1,820.2 1,797.0 

White 

55-64 yaara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6s.0 64.2 61.6 57.3 56.5 54.3 

05years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 554.7 544.9 502.5 474.3 456.2 43s.0 

65-74 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 249.5 240.4 225.3 211.5 197.1 193.4 

75yaaraand over. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,130.5 1,121.2 1,022.0 961.6 936.4 894.8 

75-S4yaare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . S67.O S54.8 775.6 727.3 714.8 671.1 

S5yeare andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,Z24.5 2,238.9 2,051.4 1,944.7 1,S62.9 1,S46.4 

Black 

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 204.0 189.8 182.3 174.3 163.8 159.0 

E5yaara andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 691.7 720.3 663.7 634.0 543S.7 56s.9 

65-74 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 470.9 4728 437.0 428.1 388.0 379.8 

75yeara andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,121.0 1,219.6 1,101.7 1,021.9 973.2 935.0 

75-84 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 863.9 1,067.6 943.9 881.7 844.1 819.5 

S5yaarsand over. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,s40.4 1,873.2 1,787.3 1.637.5 1,479.4 1,395.2 

FEMALE 

All racea’ 

55-64 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5W2 56.9 55.3 51.6 50.3 48.8 

66yaarsand over. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 584.8 583.9 547.8 519.9 503.3 495.1 

65-74 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 195.8 189.0 178.8 167.0 15S.6 154.9 

75yaaraand ovar. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,122.3 1,126.6 1,044.2 9S6.6 955.5 934.9 

75-84 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 747.0 741.6 674.8 639.0 612.7 594.7 

S5yeara andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,29S.9 2,328.2 2,171.4 2,039.9 1,950.6 1,918.9 

White 

55-64 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50.6 46.7 47.7 44.0 42.6 42.0 

65yearsand over. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5S1.8 580.5 544.7 518.0 500.6 492.3 

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 179.2 172.8 154.2 144.6 140.9 

75yearaand ovar. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,127.9 1,130.1 1,04s.5 9S0.8 95s.7 937.7 

75-64 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 739.3 730.3 665.4 628.9 602.0 5s0.9 

fXyaaraand ovar. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,335.7 ~367.8 2,206.0 2,074.5 1,9s6.5 1,962.5 

Black 

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133.9 13s.7 1298 127.5 126.0 112.6 

E5yaareand ovar. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 645.1 654.6 619.0 577.5 572.9 665,6 

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 373.8 362.2 345.1 305.3 30s.4 304.6 

75yeare andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,093.1 1,141.4 1,055.9 999.2 9s6.5 %7.5 

75-84 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 865.3 918.6 828.3 S00.8 786.7 S03.4 

85 years and over. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,ss1 .7 1,s96.3 1,s32.1 1,6S9.6 l,@J3.1 1,470.7 

1 Includesracesotherthanwhiteand black. 

NOTE CerebrovaaculardiseasescernprisecodesKvJ-4S8of the 9th Revision, /ntemat/orra/ Classification of D/seases. (See referenca 1.) 

SOURCES NationalCenterforHealthStatktks Vita/ SWstks of the UnltedStates, Vol. 11,Mortality,partA.PubticHealthService.Washington.U.S.GovernmentPrintingOffice.Pubtished 

annually selectedratescomputedbytheOfficeofPlanningandExtramuralProgramsfromdatacompiledbytheOivision of Vital Statistics, National Center for Health Statistics. 

11

Tabfe 7. Death rates for malignant rwplasma, including neoplaams of lymphatic and hematopoiatii tfaaueaj among perscms S5 years of age and over, by sex, race, and 

w United States, 1979-64 

[Data are based on the National Vital Statistics System] 

Sex, race, and age 1979 1860 1%1 1962 1863 1964 

MALE 

All races’ 

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 514.2 520.8 518.1 522.4 524.2 530.7 

65yearsand over . . . . . . . . . . . . . . . . . . . : . . . . . . . . . . . . 1,346.0 1,371.4 1,359.7 1,360.6 1,363.6 1,387.2 

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,060.2 1,G93.2 1,CW6.4 1,093.2 1,066.5 1,066.0 

75years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,650.3 1,901.4 1,873.6 1,914.9 1,8321 1,941.2 

75-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,750.4 1,790.5 1,711r.o 1,797.6 1,823.3 1,826.6 

65yearaand over . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,266.3 2,369.5 2350.9 2#f08.7 2,365.8 2,427.2 

White 

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 491.8 497.4 494.4 497.3 499.5 504.5 

65yearsand over . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,335.0 1,355.5 1,341.0 1,3320 1,364.9 1,367.5 

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I,C61.2 1,070.7 1,0W3 1,M7.8 1$63.7 1,064.1 

75years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,651.7 1,884.7 1,667.1 1,6221 1,923.2 1,927.1 

75-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,747.3 1,779.7 1,749.5 1,7!?0.0 1,W5.3 1,606.9 

85yeara andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,265.1 2,375.6 2&6.7 Z413.4 2)416.3 2,436.6 

Black 

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 790.8 812.5 814.8 636.2 621.6 641.7 

65years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,542.4 1,642.9 1,673.0 1,7C8.6 1,7125 ‘f,727.8 

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,360.3 1,417.2 1,4621 1,477.3 1,457.4 1,444.9 

75yearsand over . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,6S6.6 2$96.2 2,060.3 2,144.4 2,201.3 2,275.5 

75-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,633.2 2,028.6 Z048.4 Z186.8 2,226.3 

L15year sandover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,166.5 2,393.9 2,363.6 2y5fM.1 2,219.0 2,471.4 

FEMALE 

All races’ 

X%4yeafs .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 354.7 361.7 361.7 367.2 371.3 375.6 

65years andovar . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 742.7 767.8 769.6 781.7 791.0 606.3 

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 565.6 607.1 6C6.6 619.2 626.7 636.1 

75years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 859.7 986.9 9(B.5 1,003.8 1,026.3 

75-64 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 666.8 803.1 *2 910.7 918.1 844.2 

65years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,191.6 1,255.7 1,244.2 1,256.5 1,252.8 1,271.5 

White 

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 346.9 355.5 356.3 361.5 366.8 370.0 

65years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 746.0 770.6 773.3 765.4 794.1 8121 

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 563.1 6U5.2 605.7 618.4 627.4 636.6 

75years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 967.1 993.6 9!!4.7 1,0025 1,006.7 1,032.0 

75-64 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 669.7 %)5.4 %)7.8 913.0 919.5 944.2 

85years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,207.5 1,266.8 1,257.2 1,270.6 1,266.7 1,264.3 

Black 

55-64 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 431.6 450.4 446.4 4M.4 4529 462.2 

65yearsand ovar . . . . . . . . . . . . . . . . . . . . . . . . . . ..—. 735.5 760.8 775.4 7’W.8 818.0 626.6 

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 636.9 662.4 656.2 674.9 684.2 665.6 

75years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6S5.0 977.9 SE5.6 865.6 1,011.6 1,046.4 

75-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 663.1 923.9 916.2 944.3 9724 1,013.7 

85years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,005,8 1,i59.9 1,133.9 1,129.6 1,1326 I,1!W9 

i Includss races other than white and black. 

NOTE Malignant neoplaams, including neoplasms of lymphatic and hematopoletlc tissues, comprise cedes 140-2C6of the efh Rav/slon, hrfarrrstlorral C/essWc.etbr of D/sa+ases. (Sss rufsrance 1.) 

SOURCES National Center for Health Statistics Vita/Statistics of the United States, Vol. II, Mortality, Psrt A. Pub4ic Health Service.Washington. U.S.Gc+ernment Printing Office.publkhad 

annuall~ selected rates computed by the Office of Planning and ExtramuralProgramsfrcm data compiled by the Dwisiorrof Vitsl Stetiafics, National Canterfor Health Stafiatica. 

12 
I 

I Table8. Deathmtea for malignantnaoplasmsof the respiratoryand intmthoracicorgansamongpersons55 yearaof age and over,by sex,race, and age 

UnitedStates, 1979-84 

I [Osta are baaed on the National Vital Statistics System] 

Sex, race, and age 19Kr 19W 1981 1982 1963 1984 

MALE 

All races’ 

55-64 year5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 221.5 223.8 222.9 227.3 224.6 231.2 

85yearaandover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 429.3 444.5 444.8 457.4 459.2 463.7 

85-74 yaare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 409.7 422.0 420.1 429.7 425.9 428.6 

75yaarsand over . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 466.3 487.4 491.3 508.9 521.0 532.6 

75-84 yeare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 488.3 511.5 !3)9.9 527.0 544.8 553.7 

S5yeareand over . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 374.4 388.3 413.5 432.6 421.9 442.8 

White 

55-84 yaare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 212.4 215.0 212.8 216.8 215.2 223.0 

85yearsand over . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 430.8 443.9 443.7 458.3 458.3 481.5 

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 408.0 416.4 415.1 424.1 420.7 421.3 

75yearsand over . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 473.7 492.1 497.4 515.8 528.0 535.7 

75-84 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 495.9 516.1 515.8 534.1 550.1 558.5 

05yaarsand over . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3812 391.5 420.6 439.1 435.9 446.6 

Black 

55-84 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 336.1 340.3 356.0 387.6 348.2 373.0 

05yaars andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 443.6 489.4 498.5 520.8 516.7 534.9 

85-74 yeare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 466.0 499.4 516.7 540.6 530.3 52e.3 

75yaarsand over . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 400.7 469.0 459.5 463.4 490.6 545.9 

75-84 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 421.6 488.2 505.7 536.8 576.5 

86yeareand over . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 303.6 337.7 343.6 365.7 309.5 423.6 

FEMALE 

All races’ 

65-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70.0 74.5 78.4 83.8 87.6 89.7 

85yaarsand over . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91.3 102.5 106.0 114.0 122.9 129.0 

86-74 yeafe . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94.3 1C6.1 111.4 120.2 129.6 135.1 

75yearsand over . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87.3 97.6 98.8 105.7 114.5 121.1 

75-84 yeare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89.8 98.0 101.3 108.9 120.7 128.0 

85yeara andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79.6 98.3 91.4 96.2 96.7 101.0 

White 

55-64 yeafe . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70.2 74.2 78.3 83.9 67.6 69.9 

85yearsand over . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 929 104.1 Ics.1 116.2 125.0 132.0 

85-74 yeare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . %.5 Ica.1 114.1 123.6 132.3 139.2 

75yearaand over . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88.1 98.7 103.1 108.7 115.7 122.8 

75-84 yeare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . CX).5 99.3 102.7 110.2 122.2 129.2 

85yearsand over . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80.6 98.6 92.0 %.1 98.7 102.5 

Black 

S5-64yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72.4 83.8 89.1 92.8 97.2 98.4 

85yaareand over . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74.6 88.6 87.5 97.3 108.7 lIMO 

85-74 yeafa . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73.6 91.7 89.6 98.0 110.2 108.1 

75yeareand over . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76.7 83.3 84.2 98.3 105.7 105.9 

75-84 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 792 81.1 63.5 98.5 108.5 112.3 

B5yaareand over . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88.3 93.5 88.6 88.7 98.9 &3.5 

‘Includes mces other than white and black. 

NOTE Malignant neoplasms of the respiratory and intrathorecic organs comprise codes 150-lL%of the 9tfr Revision, /rr?errratiorra/ Classification of Diseases. (See reference 1.) 

SOURCES National Center for Health SfefistisS Wta/Statisfice otfhe UnitedStates, Vol. 11,Mortality, part A. Public Health Service. Washington. U.S. Gevemment Pfinting Office. Published 

annuallfi selected ratea cemputed by the Office of Planning and Extramural Pregrams from data compiled by the Division of Vital Statistics, National C-enter for Health Statistics. 

13 
Table 9. Death rates for suicide among pareons 55 years of age and over, by e% race, and ag= United States, 1979-64 

[Data are based on the National Vital Statiatfcs System] 

Sex, race, and age 1979 1980 1981 1982 1963 1984 

MALE 

All racea’ Number of deaths per 100,000 resident population 

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24.9 24.5 25.0 26.2 25.8 27.2 

65yeara andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . %.2 35.0 33.5 36.4 37.8 3a.9 

65-74 yeare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31.4 30.4 28.4 31.1 31.2 33.5 

75yearsand over . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44.7 43.9 43.1 46.1 49.9 49.1 

75-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44.7 42.3 41.4 45.1 49.1 48.5 

85yearsand over. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47.6 50.6 50.2 60.2 53.0 51.7 

White 

65-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26.3 25.8 26.3 27.9 27.4 28.6 

65years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36.6 37.5 35.7 3a.9 40.2 41.6 

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33.4 32.5 30.3 33.1 33.2 35.6 

75yearsand over. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46.5 46.9 45.7 49.5 53.3 52.7 

75-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48.0 45.5 43.8 48.5 52.5 52.0 

85yearsand over. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50.2 52.8 63.6 53.9 56.8 66.8 

Black 

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.8 11.7 12.5 11.9 11.6 13.4 

65years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.8 11.4 12.2 12.4 14.2 14.0 

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13.5 11.1 9.7 12.1 13.6 13.8 

75years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.4 12.1 17.0 12.9 15.2 14.3 

75-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.5 10.5 18.0 12.2 15.8 15.1 

85years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15.4 18.9 12.7 16.1 12.7 11.1 

FEMALE 

All races’ 

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.3 8.4 8.8 6.8 8.4 8.5 

65yearsand over . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.9 6.1 6.0 6.2 6.7 6.7 

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.4 6.5 6.8 6.9 7.3 7.3 

75years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.1 5.4 4.8 5.3 6.0 5.9 

75-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.5 5.5 5.2 5.8 6.4 6.3 

85years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.7 5.5 3.8 3.9 5.1 4.9 

White 

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.9 9.1 9.4 9.5 9.1 9.1 

65yearsand over. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.2 6.5 6.3 6.6 7.2 7.2 

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.8 7.0 7.3 7.4 7.9 7.6 

75yeare andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.3 5.7 5.1 5.6 6.3 6.3 

75-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.7 5.7 5.5 6.1 6.6 6.8 

85years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.0 5.8 3.7 3.9 5.3 5.1 

Black 

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.8 2.3 2.9 2.2 1.7 3.1 

65years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.4 1.4 2.3 1.8 1.4 1.8 

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.6 1.7 3.0 2.1 1.3 2.5 

75years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.2 1.1 1.2 1.2 1.5 0.6 

75-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.5 1.4 1.0 1.3 1.3 0.5 

85years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.0 1.8 0.9 2.3 0.6 

1Includes races other than white and black. 

NOTE Suicide comprises codes E950-E959 of the 9th Revision, /nterrrationa/ Classification of Diseases. (see reference 1.) 

SOURCES National Canter for Health Statistics Vital Statlatics of the Urri@dStates, Vol. IL Mortality, PartA.PublicHealthservice.Washington.U.S.Gwemment PrintingOffice.published 

annually;selectedratescomputedbytheOfficeof PlanningandExtramuralProgramsfromdatacompiledbythe ~viaion ofVitalStatisfke, NationalC-enterforHealthStatistics. 

14 
Tab&a10. Number and pement disbibutiis of raaident population by age, according to raceand sex United States, 1978-85 

1979 1980 1961 1952 1983 1984 1965 

Numberin Percent Numbarin Percent Numberin Fwcent Number in Parcent Number in Percent Number in Percent Number in Percent 

Race, sex, and age 

Total’ 

Alleges . . . . . . . . . . . . . . . . . . . . . 

55-64 years . . . . . . . . . . . . . . . . . . 

65yearsand over . . . . . . . . . . . . . . 

65-74 yeara . . . . . . . . . . . . . . . . . . 

75yearsand over . . . . . . . . . . . . . . 

76-84 years . . . . . . . . . . . . . . . . . . 

B5yearsand over . . . . . . . . . . . . . . 

White male 

Alleges . . . . . . . . . . . . . . . . . . . . . 

55-64 years . . . . . . . . . . . . . . . . . . 

05yearsand over . . . . . . . . . . . . . . 

65-74 years . . . . . . . . . . . . . . . . . . 

75yearsand over . . . . . . . . . . . . . . 

75-84 years . . . . . . . . . . . . . . . . . . 

65yearsand over . . . . . . . . . . . . . . 

Black male 

Alleges . . . . . . . . . . . . . . . . . . . . . 

55-64 years . . . . . . . . . . . . . . . . . . 

65years andover . . . . . . . . . . . . . . 

65-74 years . . . . . . . . . . . . . . . . . . 

75yearsand over . . . . . . . . . . . . . . 

75-64 years . . . . . . . . . . . . . . . . . . 

B5yearsand over . . . . . . . . . . . . . . 

White female 

Alleges . . . . . . . . . . . . . . . . . . . . . 

55-64 years . . . . . . . . . . . . . . . . . . 

05years andover . . . . . . . . . . . . . . 

65-74 years . . . . . . . . . . . . . . . . . . 

75yearsand over . . . . . . . . . . . . . . 

75-84 years . . . . . . . . . . . . . . . . . . 

B5yearsand over . . . . . . . . . . . . . . 

Black female 

Alleges . . . . . . . . . . . . . . . . . . . . . 

55-64 years . . . . . . . . . . . . . . . . . . 

65years andover . . . . . . . . . . . . . . 

65-74 years . . . . . . . . . . . . . . . . . . 

75yearsand over . . . . . . . . . . . . . . 

75-64 years . . . . . . . . . . . . . . . . . . 

B5years andover . . . . . . . . . . . . . . 

thousands distribution thousands distribution thousands distribution thousands distribution thousands distribution thousands distribution thousands distribution 

224,567 100.0 226,546 lw).o 229,348 100.0 231,788 100.0 234,023 100.0 236,495 100.0 236,740 100.0 

21,448 9.6 21,703 9.6 21,936 9.6 22,113 9.5 22,234 9.5 22,314 9.4 22,334 9.4 

25,134 11.2 25,549 11.3 26,261 11.5 26,828 11.6 27,473 11.7 27,966 11.8 28,530 12.0 

15,338 6.8 15,561 6.9 15,900 6.9 16,145 7.0 16,S)4 7.7 16,733 7.1 16,995 7.1 

9,798 4.4 9,S69 4.4 10,361 4.5 10,683 4.6 10,969 4.7 11,233 4.7 11,635 4.8 

7,599 3.4 7,72!3 3.4 8,CC14 3.5 6,246 3.6 8,402 3.6 8,809 3.6 8,824 3.7 

2,197 1.0 2,240 1.0 2,357 1.0 2,437 1.1 2,567 1.1 2,624 1.1 2,711 1.1 

94,482 ICCLO 94,976 100.0 95,896 100.0 96,562 100.0 97,327 10Q.O 98>253 100.0 99,CHM 100.0 

9,061 9.6 9,151 9.6 9,226 9.6 9,284 9.6 9,328 9.6 9,355 9.5 9,356 9.4 

9,176 9.7 9,317 9.8 10.0 9,744 10.1 9,993 10.3 10,177 10.3 10,390 10.5 

5,997 6.3 6,098 6.4 6,230 6.5 6,331 6.6 6,491 6.7 6,5% 6.7 6,720 6.8 

3,179 3.4 3,221 3.4 3,325 3.5 3,413 3.5 3,502 3.6 3,578 3.6 3,670 3.7 

2,562 2.7 2,600 2.7 2,663 2.8 2,756 2.9 2,826 2.9 2,897 2.9 2,975 3.0 

617 0.7 621 0.7 642 0.7 657 0.7 676 0.7 681 0.7 695 0.7 

12,446 100.0 12,565 100.0 12,837 100.0 13,079 100.0 13,279 100.0 13,460 100.0 13,683 100.0 

845 6.8 854 6.8 863 6.7 871 6.7 911 6.9 927 6.9 939 6.9 

854 6.9 646 6.7 862 6.7 871 6.7 904 6.8 922 6.6 940 6.9 

564 4.5 567 4.5 568 4.4 569 4.4 594 4.5 608 4.5 619 4.5 

290 2.3 281 2.2 294 2.3 302 2.3 310 2.3 314 2.3 321 2.3 

238 1.9 228 1.8 239 1.9 246 1.9 247 1.9 251 1.9 256 1.9 

52 0.4 53 0.4 55 0.4 56 0.4 63 0.5 63 0.5 65 0.5 

99,253 100.0 69,635 103.0 100,768 100.0 101,495 100.0 102,266 100.0 103,047 100.0 103,762 100.0 

10,216 10.3 10,325 10.3 10,419 10.3 10,473 10.3 10,472 10.2 10,471 10.2 10,4W 10.1 

13,621 13.7 13,648 13.9 14,240 14.1 14,540 14.3 14,840 14.5 15,081 14.6 15,363 14.8 

7,841 7.9 7,951 8.0 8,107 8.0 8,217 8.1 8,350 8.2 8,430 8.2 8,529 8.2 

5,760 5.8 5,897 5.9 6,133 6.1 6,323 6.2 6,493 6.3 6,651 6.5 6,824 6.6 

4,373 4.4 4,457 4.5 4,808 4.6 4,740 4.7 4,818 4.7 4,933 4.6 5,045 4.9 

1,407 1.4 1,440 1.4 1,525 1.5 1,563 1.6 1,672 1.6 1,718 1.7 1,779 1.7 

13,662 100.0 14,046 100.0 14,316 lCSI.O 14,573 1OQ.o 14,793 100.0 14,891 I 00.0 15,204 103.0 

1,044 7.5 1,059 7.5 1,065 7.6 1,104 7.6 1,120 7.6 1,131 7.5 1,144 7.5 

1,230 8.9 1,242 6.8 1,282 9.0 1)313 9.0 1,351 9.1 1,374 9.2 1,403 9.2 

766 5.5 776 5.5 768 5.5 798 5.5 824 5.6 833 5.6 845 5.6 

464 3.3 466 3.3 494 3.5 515 3.5 527 3.6 541 3.6 559 3.7 

360 2.6 360 2.6 382 2.7 403 2.7 398 2.7 408 2.7 419 2.8 

104 0.8 108 0.8 112 0.8 115 0.8 129 0.9 133 0.9 140 0.9 

1Includes races other than white and black. 

NOTE 19S0 population enumerated aa of April 1; all other years estimated as of July 1. 

m	 SOURC& U.S. Bureau of the Census Cur/ent PopulationReports.Series P-25, Nos. 917,923949, !%5 and 965. Washington. U.S. Government Printing Officq U.S. Bureau of the Census unpublished 

data. 
Chapter II 

International comparisons 

By Louie Albert Woolbright, Ph.D., National Center for Health 

Statistics 

Introduction 

The significance of the elderly and the problems presented 

by an aging population are being recognized by many countries 

and international organizations. There are two reasons ~hat 

countries now have a much higher proportion of their populations in the older ages than ever before in history. The major 

reason is a marked decline in fertility, significantly reducing 

the numbers of persons in the younger age groups. The second 

reason is the notable increase in life expectancy since the 

beginning of this century. Life expectancy has increased more 

for women than for men, increasing the sex differentials in 

life expectancy for the aged. Because women have a higher 

life expectancy and often marry men older than themselves, 

they spend more years in the widowed state than men do. 

Many countries are establishing research centers for the 

study of aging and are funding research in gerontology. Individual countries and international organizations are addressing 

the need for more data on older persons. For example, a 

fact book on the health of the elderly has been prepared 

for Manitoba Canada.’ 2 It contains national information on 

older Canadi&s as well as information for other provinces. 

The potential impact of the aged on health care costs in 

Canada has been recognized, and it has been emphasized 

that better biological data on morbidity are needed to make 

more accurate projections. 

The aging of the Japanese population is of great concern 

to Japanese scholars and public officials.’3 Because of the 

rapid decline in fertility in Japan, the Japanese population 

has aged in one-half the time that it took for the populations 

of the other more developed countries to age. This very rapid 

rise in the proportion of the population in the older age groups 

and the special social position of older persons in Japanese 

society is creating significant social problems. The increase 

in the number of Japanese aged living alone is also of 

concern.’3 

Another country that is especially concerned about the 

older population is Israel. Because of the timing of its immigration and the age of its immigrants, the Israeli population 

has aged rapidly. As a result, a health survey of the elderly 

was recently conducted,’4 and a symposium on aging will 

be held by the Israeli Minist~ of Health and the U.S. Public 

Health Service. 

The European Regional Office of the World Health Organization (WHO) has prepared a general summary of anticipated health problems and drawn atiention to older persons.’5 

WHO projects that by the year 2000 about one-fifth of the 

population of most European countries will be over 60 years 

of age. 

An important source of information about the aged in 

more than 30 countries, including the United States, is the 

International Data Base on Aging, compiled for the National 

Institute on Aging by the Center for International Research, 

U.S. Bureau of the Census. A computerized database containing detailed demographic and socioeconomic information has 

been developed. When possible, data have been grouped in 

5-year age cohorts to provide more useful information. This 

data base has considerable potential for a number of research 

areas in the field of international aging. 

Source of data 

Data on life expectancy in this chapter were derived from 

the United Nations Demographic Yearbook, 1984.’6 Data on 

the percent of the population aged 65 years and over are 

from the United Nations World Population Prospects, Estimates and Projections as Assessed in 1982.’7 

Results and comments 

Statistics on life expectancy at selected ages similar to 

those shown for the United States in table 2 are available 

for most countries in the United Nations Demographic Yearbook. These figures vary in their reliability because of differences in age reporting and coverage of vital events. Nevertheless, they make it possible to make reasonable comparisons 

cross-nationally. 

For men, life expectancy at birth in the countries listed 

in table 11 ranges from 74.2 years in Japan to 69.2 years 

in Northern Ireland. The United States, at 71.0 years, falls 

near the middle of the list. However, American men fare 

better in terms of life expectancy at higher ages. At age 

75 years the life expectancy of U.S. men is 9 additional 

years. At age 85, U.S. life expectancy for men is 5.1 years— 

the same as in Hong Kong and Canada and second only 

to Puerto Rico (5.6 years). 

Table 12 shows life expectancy for females in selected 

countries. At birth, life expectancy ranges from 79.8 years 

in Japan to 75.0 years in Ireland, and the United States (78.3 

years) again falls near the middle of the list. At age 65, 

however, the United States and Canada have the highest life 

expectancy (18.8 years) among the countries listed. Further, 

16

at ages 75 and 85, American women can expect to live longer 

than the women in any of the other countries listed. 

Table 13 shows the percent of the population aged 65 

years and over for selected countries and includes projections 

for the future, The United Nations uses three sets of assumptions and produces three sets of estimates. These are called 

the low, medium, and high variants. The figures for the 

medium variant are used here because the fertility and mortality 

assumptions of this variant are deemed the most representative 

of future trends. For most countries, the percent 65 years 

and over rises steadily from 1950 to 1990. Then there is 

a slight plateau. After 2000, the populations age rapidly because of the Baby Boom cycle of the middle decades of 

this century. By 2025, about one-fifth of the population of 

many countries will be 65 years of age and over. In fact, 

every fourth person in Switzerland will be at least 65 years 

of age. For Japan, the elderly percent will quadruple from 

1950 to 2025. As shown in this table, all of these countries 

except Ireland will have a much higher proportion in the 

older age groups in 2025 than today. 

A final point is that gains in life expectancy have not 

been great enough to offset declines in fertility. As a result 

many countries have experienced population declines. Denmark, the German Democratic Republic, the Federal Republic 

of Germany, Luxembourg, and the United Kingdom all lost 

population during the years 1980-84. If not for immigration, 

the U.S. population also would soon begin to decline because 

fertility is below the replacement level. 

In conclusion, the growing number of older persons and 

their increasing proportion in the population are presenting 

challenges for many countries. This situation is becoming 

recognized as one that requires a major commitment of talent 

and resources in order to turn problems of aging into opportunities during the last two decades of the 20th century. 

Table 11. Life expectancy for males at specified age= Selactad countries, latest available year 

Expected remaining years of life at— 

Country Year Birth 55 years 65 years 75 years 85 years 

Japan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1983 74.2 23.0 15.2 8.7 4.6 

Iceland . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1981-82 73.9 22.9 15.4 9.8 4.8 

Sweden . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1983 73.6 22.3 14.7 8.6 4.5 

Netherlands . . . . . . . . . . . . . . . . . . . . . . . . 1982-83 72.8 21.4 14.0 8.4 4.7 

Switzerland . . . . . . . . . . . . . . . . . . . . . . . . . 1981-82 72.7 2.0 14.6 8.8 5.0 

Hong Kong . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1982 72.7 21.9 14.8 9.1 5.1 

Norway . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1982-83 72.7 21.9 14.5 8.7 4.8 

Israel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1983 72.5 21.9 14.4 8.7 5.0 

Australia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1983 72.1 21.5 14.2 8.5 4.7 

Canada . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1980-82 71.9 21.7 14.6 9.0 5.1 

Denmark . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1982-83 71.5 21.0 13.9 8.4 4.7 

England and Wales . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1981-83 71.3 20.3 13.2 7.9 4.7 

United States . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1983 71.0 21.4 14.5 9.0 5.1 

New Zealand . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1963 70.8 20.7 13.6 8.1 4.5 

Puerto Rico . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1981-83 70.5 22.3 15.3 9.6 5.6 

Federal Republlc of Germany . . . . . . . . . . . . . . . . . . . . . . . . 1981-63 70.5 20.4 13.2 7.7 3.4 

France . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1961 70.4 21.0 14.0 8.2 4.4 

Finland . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1983 70.2 19.7 12.9 7.6 . . . 

Austria . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1983 69.5 20.2 13.1 7.6 4.2 

Ireland . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1978-60 69.5 19.3 12.4 7.1 3.9 

German Democratic Republic . . . . . . . . . . . . . . . . . . . . . . . . 1983 69.5 19.6 12.5 7.1 3.7 

Scotland . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1981-63 69.3 19.0 12.4 7.4 4.3 

Northern Ireland . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1963 69.2 19.2 12.4 7.2 3.9 

SOURCE United NaUons Demographic Yearbook,1984.Pub.No.ST/ESAJSTAT/SER. R/14.New York. United Nations, 1984. 

17 
Table 12. Life expectancy for females at specified ages Selected countrfes, latest available year 

Expected remaining yeara of life at— 

Country Year Birth 55 vears 65 vears 75 vears 85 vears 

Japan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1983 79.8 27.1 18.4 10.8 5.3 

Sweden . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1983 79.6 27.1 18.5 11.0 5.6 

Switzerland . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1981-82 79.6 27.2 18.7 11.2 6.3 

Norway . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1982-63 79.5 27.0 18.5 11.0 5.7 

Netherlands . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I 982-63 79.5 27.1 18.6 11.2 5.8 

Iceland . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1981-82 79.5 26.8 18.5 11.2 6.1 

Canada . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1880-82 78.9 27.0 18.8 11.7 6.3 

Australia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1983 78.7 26.6 18.3 11.1 5.8 

France . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1961 78.5 26.7 18.2 10.6 5.4 

United States . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1983 78.3 26.7 18.8 11.9 6.6 

Hong Kong . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1962 78.3 28.3 18.1 11.1 5.8 

Finland . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1963 78.0 25.4 16.9 9.6 . . . 

Denmark . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1982-83 77.5 25.7 17.8 10.8 5.6 

Puerto Rico . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1861-63 77.4 26.1 18.0 11.1 6,3 

England and Wales . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1981-83 77.4 25.3 17.3 10.5 5.8 

Federal Republic of Germany . . . . . . . . . . . . . . . . . . . . . . . . 1861-63 77.1 25.2 16.9 9.8 5.0 

Austria . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1983 76.8 24.9 16.6 9.5 4.6 

Israel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1983 75.9 24.0 15.8 9.2 4,8 

Northern Ireland . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1983 75.7 23.9 16.1 9.5 5,0 

Scotland . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1981-83 75.5 23.7 16.1 9.6 5.3 

German Democratic Republic . . . . . . . . . . . . . . . . . . . . . . . . 1983 75.4 23.5 15.4 8.6 4.3 

Ireland . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1978-80 75.0 23.3 15.4 8.8 4.7 

SOURCE UnitedNations Demographic Yearbook, 19S4.Pub. No. ST/ESA/STAT/SER. PJ14. New York. United Nations, 19S4 

Table 13. Percent of the population agad 65 yaare and over Selected countries, 1950-2026 

Country 1950 1960 1970 1980 1990’ 2000’ 2025’ 

Japan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.9 5.7 7.1 9.0 11.2 14.9 20.6 

Iceland . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.7 8.0 8.9 9.6 10.2 11.4 17.7 

Sweden . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.3 12.0 13.7 18.2 17.7 17.2 22.3 

Netherlands . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.7 9.0 10.2 11.5 12.8 14.1 22.7 

Switzerland . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.6 10.1 11.4 14.8 17.3 20.6 27.1 

Hong Kong . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.5 2.8 4.0 6.5 8.0 9.6 17.3 

Norway . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.7 11.1 12.9 14.6 16.2 15.3 20.3 

Iarael . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.9 4.9 6.7 8.4 8.4 8.4 12.1 

Australia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.1 8.5 8.3 9.3 10.5 11.0 14.9 

Canada . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.7 7.5 7.9 8.9 10.6 11.8 18.1 

Denmark . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.1 10.6 12.3 14.2 15.4 15.4 22.3 

United Kingdom . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.7 11.7 12.9 14.8 15.1 14.9 16.3 

United States . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.1 9.2 9.8 11.3 11.9 11.7 17.2 

New Zealand . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.0 8.6 8.5 9.3 10.2 10,5 15.9 

Puerto Rico . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.8 5.2 6.5 7.9 8.0 8.3 12.5 

Federal Republic of Germany . . . . . . . . . . . . . . . . . . . . . . . . 9.4 10.8 13.2 15.0 14.8 16.5 22.1 

France . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.4 11.6 12.9 13.7 13.2 14.8 19.4 

Finland . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.7 7.2 9.2 12.0 13.0 14.1 22.3 

Austria . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.4 12.0 14.1 15.5 14.8 15.2 19.8 

Ireland . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.7 11.2 11.2 11.1 10.4 9.4 11.3 

German Democratic Republic . . . . . . . . . . . . . . . . . . . . . . . . 10.6 13.7 15.5 16.3 13.5 14,6 19.6 

1Medium variant assumption. 

SOURCE United Nations World Popu/afiofI Prospects, Estimates and Proiecfions as Assessed in 7962.Pub.No.ST/ESAfSER.M38.NewYork.UnitedNations,1965. 

16 “ 
Chapter Ill


Measures of health among


older persons living


in the community


By Patricia F. Adams and J. Gary Collins, National Center for 

Health Statistics 

Introduction 

Measures of health can be as simple and subjective as 

a qualitative self-assessment of health status or degree of 

activity limitation, or they can include reports of an acute 

illness in the recent pastor the presence of a chronic condition, 

either self- or physician-diagnosed. As a general rule, older 

persons can be expected to have a higher frequency of adverse 

measures of health. However, there are often differences between sexes and among races and age groups. The presence 

of impairments or other chronic conditions tends to increase 

an older person’s risk of being hospitalized, needing long-term 

care, and/or dying. Still, many older people cope quite 

adequately with adverse health. A major source of information 

on reported chronic and acute conditions, self-assessed health 

status, and limitation of activity among noninstitutionalized 

older persons is the National Health Interview Survey (NHIS). 

It should be emphasized that only persons residing in 

the community at the time of survey are included in NHIS. 

Thus, the sickest segment of the older population—the group 

in hospitals or nursing homes—is not represented in the survey. 

Because the presence of chronic conditions places an older 

person at increased risk of institutionalization, one should 

bear in mind that the figures presented are an underestimate 

of the prevalence of these conditions in the total older population. In 1985 an estimated 22 percent of the population aged 

85 years and over resided in Iong-temn care facilities (Chapter 

IX). Therefore, comparisons of the noninstitutionalized aged 

85 years and over with the younger age groups must be 

interpreted with great caution. F]nally, relatively small numbers in the age group 85 years and over could mean that 

observed differences are not statistically significant. 

Source of data 

The National Health Interview Survey is a continuing 

nationwide survey based on household interviews of the 

civilian noninstitutionalized population of the United States. 

(See the appendix for a more detailed description.) By combining data from several years of the survey, sufficient sample 

size is available to consider health conditions in race, sex, 

and age subgroups. Also, because of the recurrent nature 

of the survey, trend analysis is possible. In this chapter agespecific prevalence rates are shown for ischemic heart disease 

and hypertension for 1972, 1979-81, and 1982–84 and diabetes 

rates are shown for the years 1973, 1979-81, and 1982–84. 

These data were not age adjusted. 

The categories included in the acute conditions and orthopedic impairments displayed in tables in this chapter have 

been listed elsewhere. ]8 specific gth Revision, International 

Classification of Diseases codes for the chronic conditions 

shown in these tables have also been published. 19The Eighth 

Revision code for diabetes is the same as the code for the 

9th.20 Finally, specific Eighth Revision, International Classification of Diseases codes for chronic circulatory conditions 

in 1972 have beenpublished.21 

Results and comments 

Health assessment 

The simplest and most subjective estimate of health status 

is the response to a question on health assessment. The population of those aged 65 years and over tends to be divided 

into thirds of excellent or very good, good, and fair or poor 

health by responses concerning health assessment (table 14). 

However, if race-specific responses are investigated, it can 

be seen that only about one-quarter of older black persons 

are reported to have excellent or very good health, and the 

health of about 50 percent is assessed as relatively fair or 

poor. Although the proportion of persons with relatively poor 

health does not increase with age, rates of major activity 

limitation are higher in the group aged 85 years and over 

for all races and both sexes combined. 

Acute condtins 

The incidence rate of acute conditions (table 15), based 

on the respondent’s report of incidents occurring during the 

2 weeks prior to the week of interview, was about the same 

among the older age groups, except that injuries were more 

common in those 85 years and over. The group aged 55-64 

years had more reported respirato~ infections than the older 

age groups. Increasing rates of injury with age were particularly 

evident among white females. For persons 65 years and over, 

the most common types of injury were contusions, sprains 

and strains, and open wounds and lacerations. 22 The rates 

shown in table 15 include multiple injuries to the same person, 

which may be more frequent in older persons, so the percent 

of older persons with an injury may not be as great. Unfortunately, even when 3 years of data were combined, inadequate 

information was available to assess racial differences in older 

subgroups and to make reliable estimates for white males 

aged 85 years and over. 

19

Impairments 

The rates of reported visual impairments were higher 

with increasing age (table 16). The category of visual impairments is a combination of blindness in one or both eyes 

and other problems seeing. Whhe men had higher rates of 

visual impairments than white women in each age subgroup. 

The prevalence rate of cataracts was five times higher for 

persons 65 years and over than for those aged 55-64 years. 

Although high rates of visual impairments were reported for 

white men at each age, white females 65 years and over 

had a prevalence of cataracts that was about 75 percent higher 

than that for white males in that age group. 

The rate of hearing impairments among white persons 

aged 65 years and over was higher for men than for women. 

The rate of hearing impairments was higher for each consecutively oIder age group. By ages 85 years and over, deafness 

and other trouble hearing was reportedly present in about 

50 percent of both white men and white women. Black men 

aged 65 years and over had a similar rate of reported hearing 

impairments as black women that age. 

Among white persons, there was an increase in deformity 

or orthopedic impairments at age 85 years and over (table 16). Black males aged 55-64 years had more orthopedic 

impairments than those 65 years and over. This relationship 

was reversed for black females. 

Chronic condtins 

The reported rates of ischemic heart disease and hypertension in 1982–84 were similar for each age subgroup over 

64 years (table 17). There are various possible explanations, 

none of which has been proven. Fkst, because persons with 

these chronic diseases are at higher risk of death and institutionalization than is the general population, it is possible 

that their numbers are depleted from the population in the 

community at older ages. Certainly, mortaIity is higher at 

each older age group (table 1). Second, there may be a reporting 

bias because those at older ages failed to report a disease 

that had been present for many years. Third, there may be 

an age beyond which people do not tend to develop these 

diseases; in other words, incidence may level off with increasing age. 

A comparison of rates of chronic cardiovascular conditions 

revealed differences among race and sex subgroups. For example, reported rates of ischemic heart disease were higher for 

white males than for white females at each age; however, 

reported rates of hypertension were higher for white females 

than for white males at each age. The reported rate of hypertension was much higher for black females than for white females. 

Finally, rates of reported cerebrovascular disease increased 

with age in both men and women. Rates were higher for 

white males aged 65–74 years than for white females that 

age and higher for black males aged 65 years, and over than 

for their female age counterparts. 

The rate of emphysema in each age-specific subgroup 

of whhe men aged 55 years and over was higher than in 

white women of the same age subgroup, however, the rate 

of chronic bronchitis was similar. The observation on emphysema may reflect the fact that more males than females 

in age cohorts 55 years and over have a history of smoking. 

The rate of reported diabetes was higher for white females 

than for white males aged 65–74 years but higher for white 

males than for white females aged 75 years and over. In 

the age group 65 years and over, diabetes rates were approximately 50 percent higher for black males than for white males 

and about 150 percent higher for black females than for white 

females. 

For each age subgroup, rates of reported arthritis were 

higher in females than in males. Arthritis is present in more 

than one-half of females aged 65 years and over. The rates 

did not increase markedly with age beyond 65 years. Black 

males and females aged 65 years and over had higher rates 

than their white peers; arthritis was reportedly present in about 

64 percent of black women aged 65 years and over. 

Trends 

An indirect indicator of the effect of declining ischemic 

heart disease mortality that has occurred since the mid- 1960’s 

could be an increase in the prevalence of ischemic heart disease. That would occur if the case-fatality rate were dropping 

in the absence of a change in incidence. For each of the 

age-specific subgroups shown in table 18, the rate of reported 

ischemic heart disease increased from 1972 to 1979-81 and 

1982–84. (Data on persons 85 years and older are not shown.) 

The increase from the earliest to the latest period ranged 

from 29 to 60 percent, depending on the age group. It is 

possible that more diagnostic studies have been done in recent 

years, resulting in an increase in the number of cases being 

diagnosed. This phenomenon could also be attributed to 

changes in reporting. The period of study crosses two codhg 

periods of the International Classification of Diseases but an 

attempt was made to achieve comparability by the addhion 

of appropriate diagnostic codes. 

A dramatic increase in the rate of reported hypertension 

occurred from 1972 to 1979-81. This increase may have 

been the result of changes in the International Classification 

of Diseases. It may also be attributable to the National High 

Blood Pressure Education Program, through which increased 

awareness of hypertension in-this country led to increased 

casefindhg and treatment. The rate of reported diabetes was 

also higher for most sex-age-specific subgroups in the two 

later periods than in 1973, but the rate of increase was relatively 

low when compared with the increase in reported cardiovascular diseases. 

20 
Tabfe 14. Average annual percent dktribuffona of persons 55 years of age and over by respondent-assessed heafth status and degree of activity fimitation due to 

shrunk conditions, aooot’dfrrgto race, sex, and age: United States, 1963-64 

[Data are based on household interviawa of the civifian noninstitutiona fized population] 

Respondent-assessed’ 

/rea/tfr status Degree of activity limitation 

Limited in 

Exce//ent Limited but amount or Unable to 

or very Fair or No activity not in major kind of major carry on 

Rase, sex, and age good Good poor limitation activity activity major activity 

Total* Percent distributions 

65-64 years . . . . . . . . . . . . . . . . . . . . . 44.8 30.4 24.2 70.4 6.6 11.7 11.3 

65yeara andover . . . . . . . . . . . . . . . . . 35.9 31.0 32.6 60.4 14.6 14.4 10.6 

65-74 years . . . . . . . . . . . . . . . . . . . . . 36.2 31.7 31.7 62.7 13.5 12.9 10.9 

75years andover . . . . . . . . . . . . . . . . . 35.2 30.0 34.1 56.7 16.3 16.8 10.2 

75-84 years . . . . . . . . . . . . . . . . . . . . . 35.2 30.5 33.6 S0.5 17.2 14.4 7.9 

S5years andover . . . . . . . . . . . . . . . . . 35.5 27.8 36.2 40.4 12.4 27.3 19.9 

White male 

55-64 years . . . . . . . . . . . . . . . . . . . . . 49.0 28.8 21.8 71.8 4.7 9.2 14.3 

05yaars andover . . . . . . . . . . . . . . . . . 36.7 30.6 323 61.3 15.6 10.3 12.8 

65-74 yeara . . . . . . . . . . . . . . . . . . . . . 37.3 30.5 31.8 62.1 13.2 9.7 15.0 

75yearsand over . . . . . . . . . . . . . . . . . 35.4 30.8 33.1 59.6 20.2 11.5 8.6 

75-64 years . . . . . . . . . . . . . . . . . . . . . 35.2 31.4 32.7 62.8 20.5 9.7 7.0 

05years andover . . . . . . . . . . . . . . . . . 36.8 28.3 34.8 44.2 18.5 20.7 16.7 

Black male 

55-64 years . . . . . . . . . . . . . . . . . . . . . 30.8 27.3 41.4 61.6 3.5 8.4 26.5 

66years andover . . . . . . . . . . . . . . . . . 26.8 25.1 47.7 53.5 14.9 13.1 18.5 

65-74 years . . . . . . . . . . . . . . . . . . . . . 26.2 26.0 47.4 53.9 12.6 11.3 22.4 

75years andover . . . . . . . . . . . . . . . . . 27.3 23.2 46.1 53.2 19.2 16.5 11.1 

75-64 years . . . . . . . . . . . . . . . . . . . . . 27.7 23.1 46.1 55.0 19.6 15.0 10.0 

05yearsand over . . . . . . . . . . . . . . . . . “24.3 ‘24.3 “46.6 ‘40.5 “16.2 ‘27.0 �18.9 

White female 

55-64 years . . . . . . . . . . . . . . . . . . . . . 44.7 32.4 22.4 71.5 8.2 13.4 7.0 

65years andover . . . . . . . . . . . . . . . . . 36.8 32.5 30.1 61.2 14.0 16.4 8.3 

65-74 years . . . . . . . . . . . . . . . . . . . . . 37.2 33.9 28.4 64.8 13.6 74.7 6.9 

75yearsand over . . . . . . . . . . . . . . . . . 36.4 30.4 32.6 56.1 14.6 18.9 10.4 

75-64 years . . . . . . . . . . . . . . . . . . . . . 36.5 31.1 31.9 60.4 15.9 16.1 7.6 

S5yearsand over . . . . . . . . . . . . . . . . . 36.3 27.8 35.2 39.4 9.7 29.9 21.0 

Black female 

55-64 years . . . . . . . . . . . . . . . . . . . . . 24.3 27.0 47.6 55.5 10.5 19.0 14.9 

65yeareand over . . . . . . . . . . . . . . . . . 24.1 21.2 53.0 47.4 14.5 24.1 13.9 

65-74 yeara . . . . . . . . . . . . . . . . . . . . . 23.8 20.6 54.5 49.7 16.3 22.0 12.0 

75yeareand over . . . . . . . . . . . . . . . . . 24.6 22.2 50.6 43.9 11.6 27.6 16.9 

75-64 yeara . . . . . . . . . . . . . . . . . . . . . 25.4 21.6 50.8 47.2 11.8 26.1 14.8 

05yearsandover . . . . . . . . . . . . . . . . . �21.8 25.5 50.0 31.8 ‘10.0 32.7 24.5 

1Excludes unknown respondentessessed health status. 

‘Includes races other than white and black. 

NOTE Asterisk indicates that the numerator or the estimate has a relative standard error more than SO percent. 

SOURCE Division of Health Interview Statistics, National Center for Health Stafiatics Data from the National Health Interview Survey. 

21 
Table 15. Average annual rate of acute conditions for persons 55 yeare of age and over, by type of acute condition, race, sex, and agw United States, 1862-64 

[Data are based on household inten’iawsof the civilian noninafitutionalized population] 

Typeof impairment 

Race, sex, and age Respiratory Digestive Injuries Other 

Totall Number per lCXIpersons 

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

65years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

75years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

75-84 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

85yeara andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

White male 

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

65years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

75years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

75-84 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

85years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Black male 

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

65years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

White female 

55-64 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

65years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

75years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

75-84 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

85years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Black female 

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

65years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

<Includes races other than white and black. 

51.2 3.7 19.2 30.4 

36.7 6.2 21.0 31.4 

42.4 5.8 18.1 32.9 

32.6 6.8 25.8 28.9 

32.6 8.3 22.3 28.5 

32.7 ‘8.9 40.5 30.6 

43.7 ‘2.2 16.2 23.3 

37.6 4.7 15.8 23.2 

40.6 5.2 14.3 23.9 

31.8 ‘3.9 18.6 21.7 

32.7 “3.2 16.1 20.0 

�27.4 ‘7.3 ‘31.1 “30.2 

33.5 ‘7.4 �13.1 *29.4 

‘16.8 �1O.1 “6.9 44.2 

60.4 4.5 22.6 36.3 

40.5 7.5 26.4 36.1 

45.5 6.8 22.3 3a.2 

33.3 6.4 32.1 33.0 

31.7 7.8 27.8 33.3 

39.5 ‘10.8 4S.8 31.6 

39.1 “5.3 ‘ 17.7 37.1 

41.1 ‘1.6 �16.4 33.2 

NOTE Asterisk indicates that the numerator of the estimate has a relative standard error more than 20 percent.


SOURCE CWision of Health Interview Statistics, National Center for Health Statistics Data from the National Haalth Interview Survey.


22 
I 

Table 16. Average annual rate of selected reported impairments for pereons 55 yeare of aga and ovar, by type of impairrnant, race, sex, and ag~ United Statea, 1982-64 

~ [Data are based on household interviews of the civilian noninatitutionalized population] 

I 

Visual 

Race, sex, and age impairment 

Type of impairment 

Deformity or 

Hearing orthopedic 

Cataract impairment impairment 

Totall 

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

65yeara andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

75years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

75-84 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

85years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

White male 

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

65years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

75years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

75-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

85yeara andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Black male 

55-64 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

65years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

White female 

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

65yeara andovar . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

65-74 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

75years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

75-84 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

65years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Black female 

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

65years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

1Includes raceaother Ihan white and black. 

55.5 

98.0 

73.2 

138.5


119.7 

218.6 

72.0 

105.6 

83.8 

147.7 

127.6 

‘79.6 

147.9 

35.5 

88.6 

61.7 

127.2 

108.7


196.3 

97.8 

112.9 

Number per 1,000 persons 

30.8 181.4 

149.3 308.7 

94.4 260.7 

236.6 366.8 

217.8 361.3 

327.4 495.7 

27.3 255.3 

105.0 368.1 

64.2 329.4 

183.9 442.8 

163.8 429.7 

283.4 508.2 

“21.1 “74.9 

“79.8 261.7 

33.0 129.2 

185.6 275.6 

121.0 219.8 

278.6 355.7 

256.6 320.4 

355.4 492.7 

“34.4 152.2 

136.1 261.4 

NOTE: Asterisk Indicates that the numerator of tha estimate has a relative standard error more than 20 percent. 

SOURCE DMslon of Health Interview Statistics, National Center for Health Statistics Data from the National Health Interview Survey. 

150.3 

167.6 

165.2 

171.3 

162.1 

211.1 

150.7 

143.5 

145.9 

138.8 

132.9 

168.2 

186.2 

171.4 

145.3 

179.7 

175.4 

185.9 

176.1 

224.0 

168.5 

208.0 

23 
Table 17. Average annual rate of selectad reported chronic conditions forperaons 55 yeara of age snd over, by type of chronic condition, race, sex, and age 

United States, 1962-64 

[Data are based on household interviews of the civilian noninstltutionalized population] 

Type of chronic condition 

Lschemic CerebroRace, sex, and age 

Totall 

55-64 years . . . . . . . . . . . . . . . . . . . 

65years andover . . . . . . . . . . . . . . . 

65-74 years . . . . . . . . . . . . . . . . . . 

75yearsand over. . . . . . . . . . . . . . . 

75-64 years . . . . . . . . . . . . . . . . . . 

65years andover . . . . . . . . . . . . . . . 

White male 

55-64 years . . . . . . . . . . . . . . . . . . . 

65years andover . . . . . . . . . . . . . . . 

65-74 yeara . . . . . . . . . . . . . . . . . . 

75years andover . . . . . . . . . . . . . . . 

75-64 years . . . . . . . . . . . . . . . . . . 

85years andover . . . . . . . . . . . . . . . 

Black male 

51X34years. .. . . . . . . . . . . . . . . . . 

65years andover . . . . . . . . . . . . . . . 

White female 

55-64 years . . . . . . . . . . . . . . . . . . . 

65years andover . . . . . . . . . . . . . . . 

65-74 years . . . . . . . . . . . . . . . . . . 

75years andover . . . . . . . . . . . . . . . 

75-64 years . . . . . . . . . . . . . . . . . . 

85years andover . . . . . . . . . . . . . . . 

Black female 

55-64 years . . . . . . . . . . . . . . . . . . . 

65yearsand over. . . . . . . . . . . . . . . 

1Includes races other than white and black. 

heart vascular Chronic 

disease Hypertension disease Emphysema bronchitis Diabetes Arthritis 

Number per 1$00 persons 

93.4 306.9 22.7 31.5 50.6 72.0 350.7 

135.5 394.9 56.0 40.5 57.8 90.5 485.6 

137.1 393.6 41.8 43.2 62.9 93.6 475.7 

133.0 397.1 64.5 36.2 49.5 85.5 501.9 

135.4 398.1 60.9 40.8 51.1 66.5 497.7 

122.2 392.8 99.7 “16.6 ‘42.9 60.9 519.8 

141.7 266.2 25.4 50.8 41.5 63.5 260.1 

178.4 316.7 62.9 75.0 52.6 79.7 392.2 

192.2 334.9 52.9 73.8 52.3 73.8 390.7 

151.7 261.3 82.1 77.2 53.3 91.0 395.0 

146.0 289.0 79.5 64.7 57.4 92.0 366.2 

168.2 245.0 �95.1 ‘40.2 ‘32.9 ‘85.9 438.8 

�59.7 365.3 “46.0 “23.4 “45.7 153.4 283.4 

“61.0 370.9 108.0 *4I .1 ‘ 16.4 120.9 468.3 

59.7 301.0 17.4 16.3 55.8 63.0 412.8 

118.6 428.8 50.4 20.3 66.5 85.2 540.4 

109.6 414.2 29.8 24.2 75.0 90.4 527.2 

131.5 449.9 60.0 �14.6 54.3 77.7 559.2 

137.5 446.2 74.9 ‘ 17.5 54.6 79.6 560.0 106.2 464.4 99.6 “3.4 ‘53.2 “70.4 5%.2 

%6.0 503.6 ‘29.9 ‘27.2 78.8 1466 471.0 

76.6 642.7 75.8 ‘11.6 ‘36.3 211.1 639.6 

NOTE Astsrisk indicates that the numerator of the estimate has a ralative standard error more than 30 percent.


SOURCE Division of Health Interview Statistics, National Center for Health Statistics Oata from the National Health Intewiew Survey.


Table 18. Rate of selected reported chronic conditions for persons 55 yeare of age and over, by type of chronic condition, sex, and age 

United States, selected yeare 1972-64 

[Data are based on household intewiews of the civilian nonlnstitutionalized population] 

Sex and age 

Both sexes 

55-64 years . . . . . . . . . . . . . . . . . . . 

65years andover . . . . . . . . . . . . . . . 

65-74 years . . . . . . . . . . . . . . . . . . 

75years andover . . . . . . . . . . . . . . . 

Male 

55-64 years . . . . . . . . . . . . . . . . . . . 

65years andover . . . . . . . . . . . . . . . 

65-74 years . . . . . . . . . . . . . . . . . . 

75years andover . . . . . . . . . . . . . . . 

Female 

55-64 years . . . . . . . . . . . . . . . . . . . 

65years andover . . . . . . . . . . . . . . . 

65-74 yeara . . . . . . . . . . . . . . . . . . 

75years andover . . . . . . . . . . . . . . . 

Ischemic heart disease 

1972 1979-81 1982-84 

47.4 56.8 75.7 

84.0 103.7 116.2 

60.0 105.0 115.7 

93.8 101.3 117.1 

65.1 77.6 107.5 

95.7 125.0 142.8 

97.3 133.9 149.9 

92.5 1C6.6 128.9 

31.7 42.1 47.9 

75.7 86.8 97.9 

66.8 82.8 89.4 

89.7 96.2 110.4 

Type of chronic condition 

Hypertension 

1972 1979-81 1982-84 

Number per l,fX30 persons 

165.6 286.4 306.5 

252.1 376.6 393.8 

251.4 365.6 392.5 

253.4 395.8 396.1 

146.2 275.2 291.2 

177.8 297.3 318.6 

182.3 305.6 335.7 

169.2 260.4 285.6 

218.8 296.4 320.0 

305.3 431.9 445.8 

304.4 411.7 436.0 

306.5 463.7 460.0 

Diabetes 

1973 19~9-81 1982-84 

54.1 66.1 71.6 

78.5 85.9 89.7 

77.4 87.7 92.8 

60.4 82.8 64.7 

51.3 65.3 72.1 

60.3 62.8 63.0 

63.3 64.8 79.9 

54.6 78.6 6a.7 

56.6 66.9 71.3 

91.3 66.1 94.3 

68.2 90.0 102.7 

96.2 85.3 82.3 

SOURCE Division of Health Interview Statistic, National Centar for Health Statistics Data from the National Health Intewiew Survey, 

24 
Chapter IV


Health status and


determinants-marriage, living


alone, and risk of


institutionalization


by Barbara Wilson, Mary Grace Kovar, Dr.P.H., and 

Richard J. Havlik, M. D., National Center for Health Statistics 

Introduction 

The living arrangements of older persons may have important effects on the happiness, independence, and risk of institutionalization of this group. Marriages and marriage rates 

are direct indicators of trends in formal and legal living arrangements, 23 Also of interest is the segment of the older population 

living alone for any reason, These people are of concern 

because it is important to understand their particular problems, 

such as lack of social support, use of medical care, and 

access to community services. Preliminary data on this subgroup of the population have been published.24 

Research findings suggest that living alone increases the 

probability of need for long-term care and institutionalization. 25 Various approaches have been used for planning longterm care needs in the community .26 One approach is to 

recognize that, compared with the noninstitutionalized, individuals in a nursing home tend to be older and more infirm 

with chronic disease. They are likely to have lived alone 

before admission and are often unable to do one of the activities 

of daily living. 2s27It follows that in planning for long-term 

care needs, whether in a nursing facility or at home, researchers 

should take into account the percent and number of persons 

with such problems in the community .26 

Numberof 

marriages 

40


[


30


t


20


10 

0 

Sources of data 

The marriage analysis is based on published and unpublished data collected annually from the 42 States and the 

District of Columbia that comprise the marriage-registration 

area. In 1970 and 1980, samples were also drawn from an 

additional five States that record age on their marriage records. 

(See the appendix.) The national estimates shown for 1970 

through 1984 were calculated by multiplying the total of marriages reported by the registrars in all States by the proportion 

of marriages of the elderly in the registration area. 

Information about people aged 65 and over living outside 

institutions is from the Supplement on Aging of the 1984 

National Health Interview Survey. (See the appendix.) 

Results and comments 

Marriage 

In 1984 about 70,000 older persons married in America— 

about 25,000 women and 45,000 men 65 years of age and 

over (figures 1 and 2). Most of the older brides were among 

the younger old: About 13,000 were 65-69 years, 7,000 were 

7CL74 years, and only 4,000 brides were 75 years of age 

and over. The number of older brides was 28 percent greater 

Marriage 

Number in thousands rate m 

40.0 —	 Rate per 1,000 population 1 

30.0


-i


20.0


10.0


0.0


1970 1971 1972 1973 1974 1975 1976 1977 1976 1979 1980 1981 1982 1983 1984 

NOTE Numbs and rates are estimated.


SOURCE Oivision of Vital Statistii, National Center for Heatth statistics! Data from the National Vial Statistics System


Fgure 1. Marriagesand matriage rates of women 65 years of age and over: UnitedState~ 1970-S4 

25 
Number of Marriage 

marriages n Numbar in thousands rate 

50 - _ Rate per 1,000 population -50.0 

40 ~ — — — - 40.0 

? 

30 - 30.0 

20 20.0 

~“ - - \ . b \ ~ m ­ - - ~ “ — -

10 10.0 

0 0.0 

1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1963 1984 

NOTE Numbers and rates are estimated.


SOURCE Division of Vital Statistics, National Center for Health Statistics Data from the National Vital Statistics System.


Fgure 2. Marriages and marriage rates of men 65 yeara of age and ovec United Stateaj 1970-64 

in 1984 than it had been in 1970. From 1970 to 1984, the 

greatest increase was for brides75 and over, whose numbers 

increased 80 percent. In 1984 more than 1,000 American 

women in their eighties got married. 

The number of older American grooms increased about 

13 percent from 1970 to 1984. As with elderly brides, the 

greatest absolute increases were for those 65-69 years. However, the greatest proportionate increases were for men 80 

years of age and ove~ About 4,000 men in their eighties 

mamie.d in 1984. The increased number and proportion of 

brides and grooms among those 80 years and over would 

be expected, of course, in an aging population. Rates of 

marriage for men and women 65–74 years were lower in 

1984 than in 1970, but marriage rates for men and women 

75 years and over increased slightly. 

That economic and social policy decisions affect American 

marital patterns, at the very least the timing of marital events, 

is shown clearly in the trend in rates during the late 1970’s 

(figures 1 and 2). From 1978 to 1979, the rate for men 

increased almost 25 percent and the rate for women increased 

39 percent. This followed the passage of the Social Security 

Amendments of 1977, which established that, starting in 1979, 

widows who remarried after age 60 would remain eligible 

for widows’ benefits. As a result, instead of the typical 12,000 

brides 65-69 years who had been marrying annually, the 

number dipped to 11,000 in 1978 and rebounded to 15,000 

in 1979. The older age groups of women showed similar 

increases in 1979. The impact of the Social Security Amendments show more clearly on marriages of men. From an 

annual level of 40,000 for the period 1970 through 1976, 

marriages of men 65 years and over dipped to 38,000 in 

1977 and 1978, then increased to 47,000 in 1979. Obviously 

economic policies dld influence marital decisions for a sizable 

group of older Americans. 

26 

living alone 

About 26.4 million Americans who had had their 65th 

birthday lived in communities outside nursing homes or other 

institutions in 1984. About one-third of them, an estimated 

8.4 million people, lived alone. 

People aged 65 years and over who live alone are, on 

the average, older than those who live with others. Their 

average age was 75.2 years, compared with 73.4 years for 

those living with others. One-half were age 75 years and 

ove~ 10.2 percent were aged 85 years or over (table 19). 

In contrast, only one-third of those who lived with others 

were aged 75 years and over, and 6 percent were aged 85 

years and over. 

Most people who lived alone were widowed. They were 

also more likely than people living with others to be divorced 

or separated or never married. For example, 77 percent of 

the people living alone, but only 15 percent of those living 

with others, were widowed; 14 percent, compared with 3 

percent, were divorced or separated; and 9 percent, compared 

with 3 percent, had never married. 

Eighty percent of the older people living alone were 

women, compared with 50 percent of those living with others 

(table 19). Of people aged 65 years and over and living 

alone, about 11 percent were men aged 65–74 and 39 percent 

were women that age; 9 percent were men aged 75 and over 

and 40 percent were women that age. 

Thus, the population of people aged 65 years and over 

and living alone tends to be older, widowed, and female. 

Many of these characteristics result from the higher death 

rates and shorter life expectancies of men. Fewer males survive 

to age 65 years, and even at age 65 years, a man’s expectation 

of life is less than that of a woman the same age. In 1984 

the difference at. age 65 years was 4.0 years (table 2). In 
addition, women tend to marry men older than themselves, 

which increases their likelihood of being widowed. 

Despite these characteristics, many of the people who 

were living alone were not disabled, in poor health, suffering 

from lack of medical care, or lacking family or companionship. 

Although the potential for social isolation certainly exists, 

the evidence from the Supplement on Aging is that the majority 

of older people who were living alone lived close to family 

with whom they had frequent contact. Many of them had 

been living in exactly the same place for many years: 62 

percent had not moved in the previous 10 years, and 32 

percent had lived in the same place for 25 years or more .24 

Only 24 percent had moved into their current house, apartment, 

or mobile home within the previous 5 years, About 1I percent 

lived in retirement communities. The long residence in the 

same place and the relatively high proportion in retirement 

communities may account for their having social contacts. 

Another reason that these people living alone were not 

as isolated as they might have been is that 95 percent of 

them had telephones, and most apparently used them. The 

telephone was a major means of contact with children and 

other relatives and with friends and neighbors. Given the 

importance of the telephone for maintaining social contacts, 

it appears that elderly men living alone were at greater risk 

of isolation than elderly women were. Although 97 percent 

of the women had telephones, only 84 percent of the men 

did,24 

The distributions of number of doctor contacts and hospitalizations in the past year are similar for those living alone 

and those living with others. 

Finally, those living alone are more likely to use community services (figure 3), and they tend to use more of them 

than those living with others.28 

Seniorcenter I 

Senior center meals I 

Special transportation I 

o Living alone

Living with 

W others 

I I 1 I J 

0510152025 

Percent 

SOURCE Oiv[slonof Health Interview Statistics, Natiinal Center for Health Statistics 

Data from the National Health Interview Survey 1984 Supplement on Aging. 

Figure 3. Percent of the noninstitutionaliied population 65 yeara of age 

and over usingoommurrltyaervkeq by type of aervbe and whether Iiing 

abne or with others United Stateq 1964 

Risk of institutionalization 

With an increasing number and proportion of older persons 

in the population, there is concern about providing appropriate 

long-term care services, including those in the home, community, or an institution. A subgroup of individuals with certain 

characteristics may be at higher risk for various forms of 

long-term care. 

A planning matrix for which information about such individuals in the population is used has been developed in Kentucky to assist communities in making estimates of risk of 

institutionalization. It is included in a larger summary of various approaches prepared by the Wisconsin Institute for Health 

Planning.*b In the Kentucky strategy, the variables of a mental, 

visual, or hearing impairment; living alone; and inability to 

do one of the activities of daily living are evaluated simultaneously. Individuals with these characteristics, especially those 

with multiple conditions, are assumed to be at a higher probability of needing long-term care. A more medically oriented 

model involves the presence of cardiovascular disease or arthritis in the context of mental or sensory impairment and 

living alone. 

A comparable matrix comprised of national estimates of 

potential numbers and percents of persons needing long-term 

care by level of difficulty with activities of daily living (ADL’s) 

or instrumental ADL’s ,27 different living arrangements, and 

the presence or absence of impairments has been prepared 

(tables 20-23). Individuals at the greatest risk of needing 

long-term care are those in the cell indicating difficulty with 

one or more ADL’s, living alone, having an impairment, 

and being 75 years and over (tables 20 and 21). For example, 

124,077 men, or about 6.4 percent of the 1,935,000 males 

75 years and over, would be at high risk. A matrix showing 

the relationships with cardiovascular disease and arthritis or 

rheumatism has also been developed (tables 24-27). It should 

be emphasized that, for mental impairments, only interview 

responses dealing with trouble remembering and frequent confusion were available. There were no proxy responses. However, proxy responses were collected on other impairments 

and diseases. Although this situation could have led to a 

potential undercount of those with impairments, only 296 

of the total 16,148 selected persons in the sample population 

were classified as unknown. 

The application of such distributional data to planning 

for long-term care requires expert judgment and adequate 

empirical data. In the Kentucky approach, a technical advisory 

committee estimated what percent of those in each cell of 

the matrix would need formal services. In addition, there 

was an attempt to determine which types of services were 

most appropriate. In North Carolina the strategy was to apply 

risk scores to individuals and target for services only {hose 

at highest risk. 29 rt wa5 concluded that, in a typical communitY 

of 100,000 people, only about 200 older persons would be 

at highest risk. National estimates of outcome are forthcoming 

from the Longitudinal Study of Aging. Further information 

concerning the data system can be found in the appendix. 

27 
Table 19. Number in sample, population in thousands, and percent distributions of pereons 65 yeare of age and over by selected characteristics, according to whether 

living alone or with others United Statea, 1964 

[Data are baaedon household Interviewsof the civilian noninatitutionalized population] 

Lives Lives 

Characteristic Total alone with others 

Number in sample 

Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11,497 3,655 7,642 

Population in thousands 

Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26,433 8,397 16,036 

Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Age 

65-74 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

75-84 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

85years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Sex 

Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Female . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Race 

White . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Black . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Another . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Marital status 

Married . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Divorced orseparated . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Widowed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Never married . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Telephone 

Hasatelephone . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Doesnot haveatelephone . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Doctor contacts in past year 

None . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

l-2viaits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

3-6visits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

7-12visits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

13-24 visits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

25visits ormore . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Hospitalizations in paat year 

None . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

2ormore . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Percent distribution 

100.0 1OQ.o 10Q.O 

61.8 50.7 66.9 

31.1 39.2 27.3 

7.1 10.2 5.7 

40.9 20.0 50.5 

59.1 80.0 49.5 

S0.9 91.2 90.8 

7.9 7.9 7.9 

1.2 0.9 1.3 

54.0 0.3 78.9 

6.3 13.8 2.9 

35.0 77.2 15.4 

4.7 8.7 2.8 

96.9 94.5 98.0 

3.1 5.5 2.0 

17.9 17.5 18.1 

29.1 28.8 29.2 

32.1 32.3 32.0 

13.1 13.6 12.6 

4.7 5.1 4.8 

3.1 2.7 3.3 

80.4 60.7 60.3 

13.7 13.9 13.7 

5.8 5.4 6.0 

SOURCP Division of Haalth InterviewStatktka, National Centerfor Health Statistics Data from the National Health InterviewSurvey1984Supplement on Aging. 

28 
-----------------------------------------------------------------

-------------------------------------------------------------------------------------------------

TABLE20. NUM8ERIN SAMPLE,PCY41LATION IN THOUSANDS, AND NUttEIER OF PERSONSAGES55-75YEARSAND OVERWHO HAD tlENTAL
 OR


SENSORYINPAIRtlENTS, EiYACTIVITIES OF DRILYLIVIN6FUNCTIONAL ABILITY,ItlPfiIRMENT,
 SEX,AND ~GE: UNITEDSTATES,1984


(DATAEIASED ON THE NATIONALHEALTHINTERVIEW SURVEY1984SUPPLEMENT
ON AGING)


ACTIVITIES OF D91LYLIVINGFUNCTIONAL
IY31LITY


NO A81LITY


POF’ULATION3 NO DIFFICULTY DIFFICULTY ABILITY UNKNOWN


IMPAIRMENT;
 SEX, NLK18ER21N IN DIFFICULTYLIVESWITH DIFFICULN LIVESWITH UNMOWN LIVESWITH


IINDAGE SAttPLE THOUSINDSLIVESALONE OTHER LIVESALONE OTHER LIVESALONE OTHER


NO I!iPAIRtUiNT


HALE


TOTAL.............


55-74YEARsm,.,.***.


75 YEARSAND OVER ...


FEMilLE


TOTAL.............


55-74YEARS,...,
S,S.


75 YEARSAND OVER ...


HAD INPRIRtlENTS


tfflLE


TOTAL,,,.,..,.,...


55-74YEARS..*..,...


75 YEARSANDOVER ...


FEM(lLE


TOTAL.............


55-74YEARS.........


75 YEflRS
AND OVER ...


4,129 13,3b7


~,4(J6 11,462


723 1,706


6,150 lB,b21


4,661 15,256


i,489 3,365


2,536 7,272


1,729 5,337


E07 1,935


3,037 8,313


1,743 5,380


1,294 2,932


1,409,95610,578,442


1,104,258 9~491,383


305,698 1,087,059


4,445,87311,525,340


3,076,76610,479,535


1,369,107 1,045,805


711,747 4,826,846


440,342 3,775,783


271,405 1,051,063


NUt18ER


189,656 1,189,343


139,076 92b,lJ22


50,580 262,521


990,107 1,650,724


526,030 1,164,583


464,077 486,141


289,789 1,434,217


165,712 950,803


124,077 483,414


2,068,961 3,524,859 1,073,077 1,632,321


1,203,659 2,771,236 447,430 951,838


865,3(I2 75S,623 625,647 680,483


7,127 2,188


7,127 2,188


9,156


4,493


4,663


6,437 7,157


4,213 2,033


2,224 5,124


-—--------
—---—,


‘ TROU8LEREMEMBERING OR CONFUSEDFREQUENTLY,
(HIBLINDOR OTHERTROU8LESEEIN6,OR DEAFOR OTHERTROUBLEHEARING.


2 THEREWERE296 PERSONSWITHUNKNOWNIMPAIRMENT
DATA.


3 F16URESHAY NOT ADDTO TOTAL8ECAI.M(F UNKNOWNSAND ROU+JDIN6.


29 
-------------------------------------------------------------------------------------------------- -------

------------------------------------------------------------------------------------------------------------

----

----------------------------------------------------------------------

TABLE21. NIJHEER IN SAMPLE,POPULATIONIN THOUSANDS, ANDPERCENT DISTRIBUTION OFPERSONSAGES55-75 YEARSAND OVERWHO HAD 

!tENTAL OR SENSORYIF!WIIRNENTS, BY ACTIVITIES OF DAILYLIVINGFUNCTIONAL IWLITY, ACCORDINGTO IMPAIRMENT,
 SEX,AND hGE:

UNITEDSTATES,1984 

(DATABASED ONTHENOTIONALHEALTHINTERVIEW SIMVEY1984SUPPLEMENTON AGING) 

ACTIVITIES OF DAILYLIVINGFUNCTIONAL ABILITY

NO NO ABILITY ABILITY 

2 POPULATION DIFFICULTY DIFFICULTY DIFFICULTY DIFFICULTYUNKNOWN UNMOWN 

IMPAIRMENT: SEX, NMER IN IN ALL LIVES LIVESWITH LIVES LIVES WITH LIVES LIVES WITH 

flNDME SAtlPLE THOUSANDSABILITIES ALONE OTHER ALONE OTHER ALONE OTHER 

NOIfWAIRHENT 

MOLE


TOTAL.............


55-74y13qRs. ,m*,..
*,


75 YEARSAND OVER...


FEMLE


TOTAL.............


55-74YEARS.........


75 YEARSAND OVER ...


HAD INPAIRHENTS


MLE


TOTAL.............


55-74YEARS,..,,....


75 YEARSAND OVER.,.


FEMALE


TOTAL.,...,
....s..


55-74YEARS.........


75 YEARSAND OVfR.s.


PERCENTDISTRIBUTIM
 -


4,129 13,367 10.5 79.1 1.4 8.9 

3,406 11,662 7.5 81.4 1.2 7*9 

723 1,706 17.’7 63.7 3,() i5.4 

6,150 18,621 23.9 61.9 5*S 8,9 

4,461 15,256 20.2 68.7 3.4 7.b (). [1 

1,489 3,365 40.7 31.1 13.8 14.4 

2,534 7,272 9.8 66.4 4.(1 19.7 (1. i 

1,729 5,337 8.3 70,7 3,1 17,8 0,1 

8(?7 1,935 14.0 54.3 6.4 25.0 0.2 

3,037 8,313 24.9 42,4 12.9 i9.6 0.1 0,1 

1,743 5,380 22.4 51.5 8=3 17.7 (1.1 (),[) 

1,294 2,932 29.5 25.7 21,3 23,2 0.1 0,2 

—-- —-—--—-— .---—------—-- .-- —-—- ———--—--—-. 

‘ TROUBLEREMEMBERING OR CONFUSEDFREQUENTLY, OR BLINDOROTHERTROUBLESEEING,OR DEAFOR OTHERTROUBLEHEARING.

2 THERENERE296 PERSONS WITHUNKNOHN IfiPAIRtlENTDATA. 

3 FIGURESHAYNOT ADD TO TOTALBECAUSEW UNKNO#NSAND ROUNDIN6.

-----

--------------------------------------

------

TABLE22. NUtlKRIN SANPLE, POPULATION IN THOUSANDS, AND HUNGEROF PERSONSIIGES55-75YEARSAND OVEROiH(i HI%)tlENTALOR 

SENSORYINPAIRHENTS, BY INSTRUMENTAL ACTIVITIES OF DAILYLIVINGFUNCTIONAL (3EILITY, IHPAIRHENT,SEX,AND ME: 

UNITEDSTATES,1984 

(DATABASEDON THE NATIONALHEALTHINTERVIEW SURVEY19B4SUPPLEMENT
ON AGING)


.--—-. —---- ——-----— -— -—— — —— -——-——--


INSTRIMENTAL KTIVITIE5OFDAILYLIVINGFU+lCTIONAL ABILITY ——— -—--— ————- ——--————— 

NO AMLIT’f 

POPULfiTION3 NO DIFFICULTY DIFFICULTY ABILITY UNKNOWN 

ItlPAIRtiENT: SEX, NUhlEIE: IN IN DIFFICULTYLIVEStiITH DIFFICULTYLIVESWITH UNKMIWNLIVESWITH 

AND ME SMPLE lHOUSANDSLIVESALONE OTHER LIVESALONE OTHER LIVESALO#E OTHER
 ——----—


NO ItFAIRtlENT


hi4LE


TOTAL.............


55-74YEARS.........


75 YEARSANDOVER ...


TOTAL.............


55-74YEARS.........


75 YEARSAND OVER...


HAD INFMIRNENTS 

HALE 

TOTAL.............


55-74YEARS,.*......


75 YEARSAND OVER.,.


FEHALE


TOTAL.............


55-74YEARS.........


75 YEMS AND OVER...


4,129 13,367 

3,406 11,662 

7X 1,706 

6,150 18,621 

4,461 15,J5A


1,489 3,565


2,536 7,272


1,729 5,337


807 1,935


3,Q37 8,313


1,74s 5,380


1,294 2,932


MMER 

-— ________________________ 

1,437,13010,764,416 162,482 1,013,369 

1,131,530 9,645,672 111,804 772,533 

X35,600 1,118,744 5G!678 2S9,836 

4,170,361 10,809,811 1,268,544 2,361,708 

2,884,375 9,8/S7143 721,346 1,776,430 

1,285,986 946,668 547,198 585,278 

706,703 4,821,174 294,833 1,435,590


446,597 3,803,869 159,457 92[],b78 

260,106 1,017,31)5 135,37b 514,912 

1,712,(117 2,975,348 1,425,615 2,174,879 

1,015,212 2,411,427 633,689 1,308,828 

696,805 563,921 791,926 868,051 

4,202 6,733 

4,202 6,733 

13,455


6,552 

6,923 

10,843 12,11(1 

6,401 4,852 

4,442 7,258 

‘ TROUBLEREHEHBERING OR CONFUSEDFREQUENTLY, OR EILIND OR OTHERTROUEfLE
 SEEIN6,OR DEAFOR OTHERTROUBLEHEARING. 

2 THEREWERE29b PERSONSWITHUNKNOWN IHPAIRHENT DATA.

3 FIGURES HAYNOTADDTO TOTALBECAUSEOF UNKNOliNSAND ROUNDING. 
--------

------------------------------------------------------------------------------------------------------------

TABLE23. NUtlBER IN SAHPLE,POPU4.ATIWIN THWWIS, AND PERCENTDISTRIBUTION
 OF PERSONSAGES55-75YEARSAND OVERWHO HAD


MENTALOR SENSORYIMPAIRMENTS, BY INSTRUtiENTAL ACTIVITIES OF DAILYLIVINGFUNCTIONAL ABILITY,ACCORDIl#3
 TO ItiPfWWNT,SEX,


AND AGE: UNITEDSTfWES,1984


{DATABASEDON THENATIIM9LHEALTHINTERVIEW sumY i9e4 SUppLEtItENT m 981N6)

———— —--———.--—-— —-—-----------—.. --——----—— 

INSTRUMENTAL ACTIVITIESOF DAILYLIVINGFUNCTIONAL WLITY

—---—--—— ———————- —.-— 

No No ABILITY ABILITY 

POPULATION DIFFICULTYDIFFICULTYDIFFICULTYDIFFKULTY UNKNOHNUNKNOHN 

IIIPAIRMEHT: SEX, NUtlE&R21N IN ALL LIVES LIVES WITH LIVES LIVES WITH LIVES LIVESHITH 

AND AGE SAHPLE THOUSANDSABILITIES ALONE OTWR ALOW OTHER ALONE OTHER 

NOIHPMR!’!ENT 

MALE


TOTAL.............


55-74YEARS. . . . . . . . . 

75 YEARSAND OVER... 

FE#ALE


TOTAL............s


55-74YEARS.......m.


75 YEARSAND OVER ...


HAD IHPAIRHENTS


HALE


TOTAL.............


55-74YEARS.........


75 YEARSAND OVER...


FEMALE


TOTAL.............


55-74YEARS......... 

75 YEARSANDOVER. . . 

PERCENTDISTRIBUTION
 --------------------—-— --—-——-- —- —---.— ——---—------


4,129 13,367 100 10.8 80.5 1.2 7.5 

3,466 11,662 100 9.7 82,7 1.0 6.6 

723 i,706 100 17.9 !55.4 3.0 13.5 

6,150 18,621 100 22.4 58.1 6.8 12.7 0.0 0.0 

4,661 15,256 100 i8.9 64.6 4.7 11.6 0. L-1 0.0 

1,489 3,345 100 58.2 28.1 16.3 17.4 

2,53b 7,272 100 9.7 66.3 4.1 19.7 0.2 

1,729 5,337 100 8.4 71.3 3.(J 17.3 0.1 

807 1,935 100 13.4 52.6 7.0 26. b 0,4 

3,037 8,313 100 20.6 35.8 17. i 26.2 o*1 0.1 

1,743 5,300 100 18.9 44.8 11.0 24.3 0.1 0.1 

1,294 2,932 100 23.8 19.2 27.0 29.6 (L2 0.2 —— — 

‘ TROUBLE REHEHBERING ORCONFUSEDFREQUENTLY, OR BLINDOROTHERTRtHJBLE SEEIW, OR DEAFUI OTHERTROUBLEIHRING� 

2 THEREIERE296 PERSONS WITHUNKNDWN IttPAIRHENTDATA. 

3 FIGURESHAY NOT ADD TO TOTALBECAUSEOF UNKNOWNSANDROUNDING. 

32 

I 
-----------------------

TAM 24. NUt18ER
IN SAHPLE,POPIMTIONIN THOWWS, MD NUtKR OF PERSONSAGES55-75YEW/SMD OVERUHO MD HENTAL(Xl


SENWIY IfiPIIIRllENTS, BY CARI)IOVGSCLMR FUNCTI(NUIL
 GBILITY,MWWNT, SEX,AND ME: MUTED STMES, 1984 

(DATII BASEDON Tlf NRTIONALtR3LTHINTERVIEUSURVEY1984WWEHENT ON MIW) 

— 

CIWDIWISCWR4FLNCTIW ABILITY 

——— —.. 

No MHLITY 

PCHJLATION3 NO DIFFICULTY DIFFICULTY IMULITY W&NOUN 

NlJtiBEi2IN IN DIFFICULTYLIVESWITH DIFFICfkTY LIVES idITH UNKtWN LIVES HITH 

SMPLE THOUSANDSLIVESMME OTHER LIVESALONE NllER LIVESALONE IIIKR 

IHFWIRIIENT: SEX, 

AND ME


NO ItlPAIRHENT


MLE


TOTAL.............


55-74YEARS.........


75 YEARSfiNDOVER...


FEI’MLE


TOTflL
.............


55-74YEARS.........


75 YEARSAM) OVER...


MD IfiPAIRNENTS


HALE


TOTAL.............


55-74YEARS.........


75 YEARSAND OVER...


FEMLE


TOTAL...........s.


55-74YmRs ● ..,*.... 

75 YEMS AND OVER ... 

4,129 13,~b7 

S,406 11,662 

723 1,706 

6,150 lB,b21


4,661 15,256


i,409 3,3&5


2,536 7,272


1*729 5,337


807 i,935


3,037 B,313


1,743 5,3B~


1,294 2,9S2


NnIEER -—--

1,405,31410,419,475 169,123 1,280,958


1,091,905 9,222,540 l~5x25Q 1,140,533


313,409 1,196,935 33,B73 140,425


4,9B1,675 12,361,115 4[i3,B39 737,1043


3,3(15,7~ll,~b,B~ 272S452 569,525 

1,675,947 1,.WJ06 131;3B7 ib7,51B 

BO0,164 4,9B1,092 171,559 1,190,10:1


48B,933 3,7Lt4,0b3 9B,91O B99,917 

311,231 j,217,(129 72,649 290~lB3 

2,694,810 4,439,735 5B0,451 b13,B2B


1,415,539 3,277,269 20S,421 373,6EW 

1,2B1,271 1,162,466 177,030 24QJ78 

25Z175 67,352


16,179 55,132


B,9?6 12,220


57,593 wl,[194


31,74s 69,972


25,B50 m,m


29,813 99,027


1B,211 &7,@99


11,602 xl,9B


73,214 11(!,774


38,342 749Me


34,872 36,586


; TROUDLEREHEH8ERING OR CONFLtSED FREQUENTLY,
OR BLINDOR OTHERTROUBLESEEING,OR DEBFOR OTHERTROU8LEHEARING.


THEREHERE296 PERSONSWH UNKNOHNIHIWRMENTDATli
 .


~ FUMES HAY NOTADD TO TOTALBECAUSEOF UNKNOWNSAND ROUNDING.


EVERHAD RHEIJMTICHEARTDISEME, CORDNARYHEARTDISEASE,I)HYOCARDMLINFARCTION
OR ANY OTHERHEMT IWMCK.


33 
-----------------------------------------------------------------------

----------------------------------------------------------------------------------

---

-----

TABLE25. NUMBER IN SAMPLE, POPULATION IN THOUSANDS, MD PERCENT DISTRIBUTION OFPERSONS MES 55-75 YEARS ANDOVERWHO HAD

HENTAL ORSENSORY IMPAIRMENTS, EIYCARDIOVASCULAR FUNCTIONAL ABILITY,fICCORDIN8 TO ItlPf41Rt4ENT, SEX, ANDAGE: 

UNITEDSTATES,19B4 

(DATABASED ONTHENATIilNfIL HEALTH INTERVIEki SURVEY 1984 SUPPLEMENT ONffiIN6)

CWDIOVN3CULPR4FUNCTIONAL ABILITY 

No NO 9BILITY ABILITY 

POPULATION DIFFICULTY DIFFICULTY DIFFICULTYDIFFICULTYUNKNOWNUNKNOWN 

IMPAIRMENT; SEX , NLMlBEi2 IN IN f+LL LIVES LIVESMITH LIVES LIVESWITH LIVES LIVESHITH 

ilNDAGE SA?tPLE THOUSONDSABILITIES ALONE OTHER ALONE OTHER hLoNE OTHER 

NOIMPAIRMENT PERCENTDISTRIBUTION 

---————-—— —-- ————.—-——————— 

MALE


TOThLs,........... 4,129 13,367 100 10.5 77.9 1.3 9.6 (J*2 0.5 

55-74YEflRs....***.* 3,406 11,662 10[) 9.4 79.1 1.2 9.8 0.1 0.5 

75 YEARSAND OVER..a 723 1,706 100 18.4 70.2 2,0 8.2 0.5 0s7 

FEHALE


TOT(’!L
 ............. 6,150 10,621 100 24.8 6b.4 2s2 4.0 0.3 %4 

55-74YEARS.
....... 4,461 15,256 100 21.7 72.1 1.8 s. 7 0.2 0.5

75 YEARSANDOVER. a, 1,489 3,365 i(j(l 49,8 40.2 3.9 5,(I 0,8 ().3


HADIMPAIRMENTS 

MALE 

TOTAL............. 2,536 7,272 100 11.0 68.5 2.4 16.4 0.4 1.4 

55-74YW?S *.....*.. 1,729 5,337 100 9.2 70.5 1.9 i6.9 0,3 1,3 

75 YEARSPND OVER ... 807 1,935 100 16.1 62.9 3.8 15.0 &6 1.7 

FEMALE


.,.......s... 3,037 6,313 100 32.4 53.4 4.6 7,4 0.9 1.3 

55-74YEARS.,.,..... 1,743 5,384 100 26.S 60.9 3.8 6.9 0.7 1.4 

75 YEARSANDOVERs. . 1,294 2,932 160 43.7 39.6 6.0 8.2 1.2 1.2 

—---—-------------- .-—-------—— ———-— —-— 

TOT(IL


‘ TROUBLE REMEMBERING ORCONFUSED FREQUENTLY, ORBLINDOROTHER TROUBLESEEING,OR DEAFOR OTHERTROUBLEHEARIN8. 

2 THERE WERE 296 PERSONS WITH UNKNOWN IHFMIRMENTDf+Th. 

3 FIGURES HAYNOTADDTOTOTflLBECAUSE OFUNKNOHNS ANDROUNDING.

4 EVERHADRHEUHATIC HEART DISEASE,CORONARY HEART DISEASE,f+tlYOCARDIf+L IWFRRCTION ORANYOTHER HEARTATTACK. 

34 
---------------------------------------------------------------------------------------------------

----------------------------------------------------------

----------------------------------------------------------------------------------------

---------------------------------------------------------------------------------------

TABLE26. NUMEIER IN	SAMPLE,F’DHJLATION IN THOUSANDS, AND NUMBEROF PERSONSA8ES55-75YEARSAND OVERWHO HAD tlENTflL
 OR


SENSORYIMPilIRMENTS, )3YORTHRITICOR RHEUMATICFUNCTIONAL AEiILITY, IMPf+IRtIIENT,
 SEX,(WD AGE: UNITEDSTATES,1984


(DATABASEDON THE NATIONALHEALTHINTERVIEW SURVEY1984SUPPLEMENT
ON AGING)


.--—


ARTHIIITIC OR RHEUIIATIC FUNCTIONAL
A.81LITY


NO ABILITY


POPULATION NO DIFFICULTY DIFFICULTY ABILITY UNKNOWN


IMPAIRMEN;, SEX, NUMllEif IN
 IN DIFFIU)LTY LIVES WITH DIFFICULTYLIVESWITH UNKNOWN LIVES WITH 

AND AGE SAMPLE THOUSANDSLIVESALONE OTHER LIVESALONE OTHER LIVESALONE OTHER -----.---------

NOIMPAIRMENT 

M/ILE


TOTAL,,...,..
 s.,..


55-74YEARS,,,,.,...


75 YEARSANDOVER .n.


FEMALE


TOTAL.............


55-74YEARS,,,.,,,,,


75 YEARSAND OVER ...


HAD IMPAIRMENTS


MALE


TOTAL.............


55-74YEARS......,..


75 YEARSAND OVER ,.,


FEMALE


TOTAL,.,,,..,,,,,,


55-74YEARS,..,,..,,


75 YEflRS
OND OVER ...


4,129 13,367


3,406 11,462


723 1,7#b


6,150 18,A21


4,661 15,254


1,489 3,365


2,534 7,272


1,729 5,337


8~7 1,935


3,037 8,313


1,743 5,380


1,294 2,932


NUtiEIER


1,026,412 7,843,659 563,506 31796,531


801,701 6,977,340 431,939 3,320,034


224,711 866,319 131,567 47&,497


2,554,579 6,920,527 2,824,029 6,080,172


1,761,496 6,262,474 1,795,564 5,239,960 

793,083 658,053 1,028,465 840,212 

461,084 3,210,445 503,752 ~,9b7,1b2


267,351 2,457,221 320,888 2,210,995


193,733 753,224 182,864 756,167


978,039 1,779,120 2,127,929 3,319,311


508,905 1,326,061 1,124,868 2,356,393 

469,134 453,059 l,oo3,0bl 962,918 

9,694 127,595


9,694 120,831


6,764


64,499 177,553


52,863 14?,872


11,636 33,681


3b,70[) 92,612


17,815 62,863


18,885 29,749


42,507 65,906


P1,529 42,653


20,978 23,253


1 TROUBLEREMEflEIERING OR CONFUSEDFREQUENTLY,
OR BLINDOR OTHERTROUBLESEEING,OR DEOFOR OTHERTROUBLEHEARING.


2 THERE WERE 296 PERSONSWITH UNKNOWN IMPAIRMENT
DATA.


3 FIGURESMAY NOT ADD TO TOT9LEIECAUSE
 OF UNKNOWNSAND ROUNDING.


35 
-------

---------------------------------------------------------------

----------------------------------------------------------

TABLE27. NUMBER IN SA!IPLE,PWJIATIONIN THOUSANDEi, ANDPERCENT DISTRIBUTION OF PERSONS MS 55-75 YEARSAND OVER

HI HRD tlENTAL ORSENSORY IHPMRIIENTS,BY ART14?ITICORRl%m i%NCTIONAL ABILITY, ACCORDING TOIMPAIRMENT, SEX, ANDME: 

UNITEDSTATES, 1984 

(DklTA EIASED ONTHENATIONAL HEALTHINTERVIEW SURVEY1984 SUPPLEMENT ONAGIN8)

——-—— .——--- -— ——-— ----—---——-— —--------- —--------

ARTHRITIC ORRHMATICFUNCTIONAL MILIIY

NO No ABILITY ABILITY 

POPULflTION3 DIFFICULTYI)IFFICULTYDIFFICULTYDIFFICULTYUNKNOWNUNKNOWN 

ItlPMRllENT~SEX, MBE/IN IN bLL LIVES LIVES ldITH LIVES LIVES WITH LIVES LIVES HITH 

ANDAGE SAllPLE THOUSANDSABILITIES ALOK OTHER ALONE OTHER ALONE OTHER 

———---— —-———-——— 

NOItlPfW/HENT PERCENTDISTRIBUTION


NALE 

TOTAL. . . . . . . . . . . . . 4,129 13,3&7 lo# 7.7 58.7 4.2 28.4 0.1 1.0 

55-74 YEARS. . . . . . . . . 3,406 11$662 100 6.9 59.8 3.7 28,5 0.1 1.0 

75 YEARSANDOVER. . . 723 1,706 100 13.2 50.8 7*7 27.9 (L4 

FEtlALE 

TOTAL. . . . . . . . . . . . . 6,150 1B,621 1O(J 13.7 37.2 15.2 :2.7 0.3 1.(I 

55-74 YEARS=......*. 4,6&i 15,256 ioo 11.5 41.0 11.8 34.3 (1.3 0.9 

75 YEARSIINDCiVER. . . 1,489 3,365 100 23,4 19,6 3[1, b 25.0 0.3 1,0 

HADIfiPMIHENTS 

HALE 

TOTAL..s . . . . . . . . . . 2,536 7,272 100 b.3 44.1 6.9 4[1,8 (). 5
 1.3 

55-74 YEARS. . . . . . . . . 1,729 5,337 100 5.0 44,0 6.0 41.4 0.3 1.2 

75 YEQRSANDOVER... E07 1,935 100 10.0 38s9 9.5 39.1 1.0 1.5 

FEMALE


TOTAL............. 3,037 8,313 1(JO 11.8 21.4 25.6 39=9 0,5 &8 

55-74 YEARS ** SS.SW=* 1,743 5,380 100 9,5 24s6 20.9 43.8 (L4 0.8

75YEARS ANDIIVER... 1,294 2,932 100 16.0 15.5 34.2 32.8 0.7 0.8 

‘ TROUBLE REKNBERIN8ORCONFUSED FREQUENTLY, ORBLINDOROTHERTRCHJBLE SEEIN8, ORDEAFOROTKR TROUBLEHEARIN8. 

2 THEREWERE296PERSONS WITHUtWOUNIMPAIRMENT DATA. 

3 F18URES HAYNOTADDTOTOTAL BECAUSE OFUNKNOMSANDROUNDItt3
 .
Chapter V€

Determinants of health-€

cardiovascular risk factors€

by Richard J. Havlik, M.D.,


National Center for Health Statistics


Introduction 

Cardiovascular disease is a major cause of mortality and 

morbidity in older persons (tables 3 and 17). This is true 

even though there has been a decline in ischemic heart disease 

mortality and cerebrovascular disease mortality over the past 

5 years in each sex-race-age subgroup of those aged 55 years 

and over (tables 5 and 6). Of the traditional cardiovascular 

risk factors, high blood pressure maintains its accuracy for 

predicting cardiovascular disease in those 65 years and over, 

but elevated serum cholesterol and cigarette smoking may 

have somewhat reduced capabilities to predict outcome in 

older persons. ‘o Results on the strength of cardiovascular risk 

factors in older persons vary among studies. 

Although the ability to predict disease may be less at 

older than at younger ages, the potential effect of any risk 

factor modification on disease reduction would be magnified 

because of the high rate of cardiovascular disease at older 

ages. (It is assumed that risk factor changes in older persons 

would be efficacious to some extent.) In addition, the high 

frequency of risk factors in older people makes a modification 

program relevant. 

Although the adverse effects of risk factors for a chronic 

disease must be considered in terms of a lifetime of exposure, 

the current level of risk factors maybe an indicator of previous 

levels of risk factors, especially in those without overt disease. 

Modification of such identified risk factors through hygienic 

measures or drug therapy may still be appropriate in older 

persons, A series of goals for health promotion and disease 

prevention has been formulated for achievement by 1990.31 

Some of these goals are targeted directly to the elderly and 

involve cardiovascular risk factors. In addhion, commitment 

by government to improvement in the health of minorities, 

including the older black and Hispanic populations, has 

increased, 

Sources of data 

The first and second National Health and Nutrition Examination Surveys (NHANES) were conducted in the periods 

1971-74 and 1976-80. (See the appendix.) Estimates of national cardiovascular risk factor levels for older persons were 

obtained from survey data.’ In addhion, a 24-hour recall of 

dietary intake was obtained on participants in both surveys. 

A special Health and Nutrition Examination Survey using 

similar measurement techniques was conducted among Hispanic persons in selected areas of the United States during 

the period 1982–84. (See the appendix. ) Data from the Mexican-American component, collected in 1982–83, are used here. 

Although most Mexican Americans are considered white, they 

represent a small proportion of the total white population 

and data on them do not unduly affect estimates. Smoking 

data come from the National Health Interview Survey. 

Results and comments 

Hypertension 

The proportion of females with definite hypertension, 

defined as elevated systolic and/or diastolic blood pressure 

or treatment with antihypertensive medication, was higher 

in those aged 65–74 years than in those 55-64 years and 

higher in black than white women in both time periods (table 28). During the period 1976-80, 76.5 percent of black 

females aged 65–74 had definite hypertension. The percents 

of those with definite hypertension were similar for the two 

examination periods in white men and women of both age 

subgroups and in black people aged 55-64 years (table 28). 

This apparent lack of change may be a combined effect of 

a decrease in mean systolic blood pressure and an increase 

in the proportion of hypertensive being treated.32 From one 

NHANES survey to the next, the proportion being treated 

with medication increased from 16 to 20 percent for white 

adults of both sexes aged 55-64 years, from 21 to 30 percent 

for white adults aged 65–74 years, from 26 to 32 percent 

for black adults aged 55-64 years, and from 25 to 44 percent 

for black adults aged 65–74 years. 32The percent with undiagnosed hypertension decreased over this period. 

For Mexican-American females, the percent with definite 

hypertension is intermediate between the levels of white 

females and black females in both age subgroups (tables 28 

and 29). The prevalence of definite hypertension in MexicanAmerican males aged 55-64 years (48.3 percent) is intermediate between the levels of white males and black males, 

but Mexican-American males aged 65–74 years have the highest prevalence (59.6 percent) among males this age in the 

three subgroups. 

Results of the Hypertension Detection and Followup 

Program (HDFP) indicate that lowering of diastolic blood 

pressure, even in those aged 60-69 years, can result in decreased total mortality as well as reduced cardiovascular mortality. 33 However, the effect on outcome of treating isolated 

systolic high blood pressure is unknown. Results from the 

followup of people screened for participation in HDFP indicate 

37 
that those aged 60-69 years who had elevated systolic hypertension—systolic blood pressure equal to or greater than 160 

millimeters of mercury (mm Hg) and diastolic blood pressure 

less than 90 mm Hg—were at higher risk of cardiovascular 

mortality than were those with systolic blood pressure less 

than 160 mm Hg. 34 In the second NHANES, the levels of 

systolic hypertension varied from 4.5 to 11.3 percent for 

adults aged 55–74 years, depending on race and sex. 32 The 

National Institute on Aging and the National Heart, Lung, 

and Blood Institute are sponsoring a randomized clinical trial 

of treatment of elevated blood pressure in the elderly .35 

Overweight 

Excess weight is associated with elevated blood pressure 

and elevated glucose, thus affecting the prevalence of hypertension and non-insulin-dependent diabetes mellitus. Using a 

measure of overweight defined as being above the 85th percentile of the age group 20-29 years (used as an ideal), overweight 

is defined as a body mass index greater than or equal to 

about 27 kilograms/meter.2 Overweight estimated in this manner approximates excess body fatness, or obesity. From the 

early to the late 1970’s, the percents of those 55-64 and 

65–74 years who were overweight changed little (table 28). 

About one-quarter of men aged 55-64 and 65–74 were overweight. A larger proportion of females than males these ages 

were overweight, and black females were especially likely 

to be overweight. 

The proportions of overweight Mexican-American females 

were higher than those of overweight males in the two age 

subgroups (table 29). The percent overweight was similar 

for Mexican-American females and black females (about onehalf). Although the percent of overweight Mexican Americans 

may be higher in those 55-64 years than in those 65–74 

years, small sample sizes preclude reliable estimates. 

Overweight may contribute to the relatively high frequency 

of definite hypertension in Mexican Americans. Because blood 

pressure is correlated with weight, the higher percent of overweight among Mexican-American males than among white 

or black males could affect the blood pressure distribution. 

Similarly, Mexican-American females were, on the average, 

heavier than white females (tables 28 and 29), and this might 

be related to the higher prevalence of definite hypertension 

for Mexican-American women. 

High-risk cholesterol 

A National Institutes of Health consensus conference has 

recommended guidelines for management and treatment of 

those with high-risk cholesterol levels. These levels are based 

on cutoff points of the cholesterol distribution and the age 

of the respondent .36 

The percent of persons with high-risk serum cholesterol 

was aImost two times as high for older black and white women 

than for older black and white men in 1976-80 (table 28). 

The finding of a greater percent of high-risk older women 

than men is partly attributable to the fact that cholesterol 

is higher in women than men at older ages, whereas levels 

are higher for men than women at younger ages.37 The percent 

of the population at high risk was similar for the first and 

second NHANES in most subgroups. 

The percent of Mexican Americans with high-risk cholesterol levels was much lower than the percent for the total 

U.S. population in three of four comparison groups (tables 28 and 29). Only in Mexican-American women aged 

65–74 years was the percent similar to that for the total U.S. 

population. Reliability of estimates is compromised by small 

numbers. Serum cholesterol values were obtained for 191 

men aged 55-64 years, 79 men aged 65–74 years, 219 women 

aged 55-64 years, and 114 women aged 65–74 years. 

Dietary trends 

Trends in the dietary intake of fat components are of 

particular interest because of the effect of fat components 

on the blood cholesterol level. Although NHANES data show 

that little or no change in total fat and saturated fat intakes 

occurred during the 1970’s, dietary cholesterol decreased significantly in four of the eight subgroups and Iinoleic acid 

increased in all eight of the groups (table 30). These changes 

in intake maybe caused by many factors. First, the availability 

and use of a variety of vegetable oils rather than animal 

fats in home cooking and foods eaten in restaurants and fastfood services may have affected the pattern of fat intake 

during the 1970’s. Second, and of more public health significance, is the possibility that educational messages concerning 

the relationship of fat intake, serum cholesterol, and cardiovascular mortality may have prompted large numbers of individuals to make conscious choices about the types of fat ingested. 

Third, the observed changes may bc attributable to 

methodological differences in dietary data collection or in 

the nutrient data bases used to process the data. It is not 

yet known whether any of these factors, any other factors, 

or a combination of factors resulted in the observed changes 

over time. 

Smoking 

Of men aged 65 years and over, 19.6 percent were smokers 

in 1985 (table 31). This percent, although not age adjusted, 

is similar to the percent for 1979. L]ttle evidence exists that 

the percent of smokers in these older age subgroups has decreased over time. However, the level for those 55-64 years 

was 31.9 percent in 1985, lower than the 1979 level of 36.0 

percent. The percent of female smokers was about the same 

in both years. Among both men and women, the percent 

of former smokers increased for the subsequent survey year. 

The percent of male Mexican-American smokers aged 

55-64 years and 65–74 years is higher than the percent for 

the general U.S. population in 1985 (tables 29 and 31). About 

40 percent of male Mexican Americans aged 55–74 years 

and 20 percent of female Mexican Americans this age were 

current smokers in 1982–83. With mortality rates for lung 

cancer increasing in the country (table 8), this is an area 

for potential disease prevention activities within the Hispanic 

community. 
I 

I 

I 

I 

Table 26. Percent of pareons 55-74 yeare of age with selected cardiovascular risk factors, by race, sex, and age United States, 1971-74 and 1976-60 

[Dataare from the first and second National Health and Nutrition Examination Surveys] 

Definite High-risk serum 

hypertension’ cholesterol Overweight 3 

Race, sex, and age 1971-74 1976-60 1971-74 1976-80 1971-74 1976-80 

White male Percent 

55-64 years . . . . . . . . . . . . . . . . . . . . . 38.1 3a.o 14.2 18.6 24.9 28.6 

65-74 years . . . . . . . . . . . . . . . . . . . . . 41.3 43.6 15.3 13.7 23.1 25.8 

Black male 

55-84 years . . . . . . . . . . . . . . . . . . . . . 54.0 53.9 19.0 16.7 25.6 26.0 

65-74 years . . . . . . . . . . . . . . . . . . . . . 58.6 45.2 20.4 12.1 21.6 26.4 

White female 

55-64 years . . . . . . . . . . . . . . . . . . . . . 39.2 38.8 28.7 30.6 36.6 34.8 

65-74 years . . . . . . . . . . . . . . . . . . . . . 53.1 53.4 32.6 29.9 37.0 36.5 

Black female 

55-84 years . . . . . . . . . . . . . . . . . . . . . 63.6 61.7 29.2 29.7 56.7 59.4 

65-74 years . . . . . . . . . . . . . . . . . . . . . 68.5 76.5 25.4 25.0 49.2 60.8 

..— 

lUsirrg a single blood pressure measurement done in the seat~.position, definite hypertension is defined as systolic bid pressure equai to or greater than 160 millimeters of mercury (mm Hg),


diastolic blood pressure equal to or greater than 95 mm Hg, andlor taking anti hypertensive medication.


‘High.risk serum cholesterol levels are defined by age-specific cutoff points. For persons 40 years of age and over, high.risk levels are those greater than 2138milligrams per deciliter.


30verwelght is defined for men as a body mass index greater than or equai to 27.8 kilcgramsfmete~ and for women as an index greater than or equai to 27,3 kilogramslmete$.


Table 29. percent of Mexican.American persona 55-74 years of age with selected cardiovascular risk factors, by sex and age United Statas, 1982-83 

[Data are from the Hispanic Health and Nutrition Examination Survey] 

High-risk 

Definite serum Current 

Sex and age hyperfensionl cholesterol Overweight smoke~ 

Both sexes Percent 

66-84 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48.5 10.6 46.1 31.8 

85-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63.5 18.9 40.8 27.2 

Male 

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46.3 9.2 37.5 44.1 

65-74 yeare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59.6 8.6 30.3 41.0 

55-84 yeare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44.9 11.8 57.3 20.9 

85-74 years . .: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88.8 27.7 49.7 17.7 

lUslng the average of two blood pressure measurements done in the seatad position, definite hypertension is defined as systolic blocd pressure equai to or greater than 160 milligrams of mercury 

~mrnHg),diastollcbldpressureequai toorgreaterthan~,mrn Hg,amYortaki”g a“tihy~rte”siwmeticatio”. 

High.risk serum cholesterol ievels are defined by agcq3eclfic cutoff points. For persons 40 years of age and over, high-risk ieveis are those greater than 26S milligrams per deciliter. 

%verwalght is defined for men as a body mass index greater than or equal to 27a kilogramaJmete# and for women as an index greater than or equal to 27.3 kilograms/mete#. 

4A current smoker is a person who has smoked at least 103 cigarettes and who now smokes. Occasional smokers are included. 

39 
Table 30. Intake of fat components and cholesterol for persons 55-74 years, by race, e.exjand age: United States, 1971-74 and 1976-80 

[Dataarefromthefirstand=ond NationalHaalthandNubition Examination Suweys] 

Totalfat Saturs@dfat Lrholeic acid Cholesterol 

Race, sex, and age 1971-74 1976-80 1971-74 1976-M 1971-74 1976-60 1971-74 1976-80 

White male Mean intake in grams Mean intake in milligrams 

55-64 years . . . . . . . . . . . . . . 88 87 33 32 9 12 458 429 

65-74 years . . . . . . . . . . . . . . 74 76 27 27 7 10 405 383 

White female 

55-84 years . . . . . . . . . . . . . . 58 57 xl m 6 8 308 282 

65-74 yeare . . . . . . . . . . . . . . 52 51 18 17 5 8 271 240 

Black male 

55-84 yeare . . . . . . . . . . . . . . 77 77 25 28 8 9 507 401 

6%74years . . . . . . . . . . . . . . 65 68 23 24 7 9 466 42U 

Black female 

55-84 years . . . . . . . . . . . . . . 49 54 17 19 6 8 26a 302 

65-74 years . . . . . . . . . . . . . . 51 45 18 15 5 7 323 235 

NOT12Mean intakeis basadonone24-hourrecallof dietaryintake. 

Tabfe 31. Percent of persons 55 years of age and war, by smoking status, sw and agx UnitedStates, 1979 and 1985 

[Data ara baaed on household interviews of the civilian fioninstitutionalized population] 

Sex and age 

Male 

55.Wyears . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

65yearsand over. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

65.74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

75years andwer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

75-84 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

65yearsand over. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Female 

55-64 yeare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

65yeare andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

65.74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

75years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

75Wyears . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

85yearsand wer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Current smoker’ Former smoker 

1979 1985 1979 1986 

,Ll cent 

38.0 31.9 40.4 47.2 

20.7 19.6 46.6 52.5 

24.5 21.9 47.1 53.2 

12.9 15.0 45.8 51.1 

14.0 15.7 47.5 52.2 

8.0 10.9 38.6 44.9 

28.4 27.4 18.8 22.2 

13.0 13.5 13.9 21.2 

16.8 17.9 17.7 23.5 

7.0 7.0 7.9 17.9 

8.0 8.0 8.5 19.1 

3.0 1.9 5.5 11.3 

1A current smoker is a person wfro has smoked at least 1W cigarettes and who now smokes. Osmaional smokers are included. 

40 
Chapter VI


Determinants of health-


exercise and activities of daily


living


by Andrea Z. LaCroix, Ph. D., National Center for 

Health Statistics 

Introduction 

Older persons have a full range of functional abilities, 

from regular exercise or walking a mile every day to difficulty 

getting in and out of a chair or getting outside. For those 

who are able, regular exercise can have a positive effect 

on well-being and vitality as well as the maintenance of weight 

and cardiovascular fitness. For those with chronic illness or 

other impairments, inability to perform the multiple activities 

of daily living2.27or the instrumental activities of daily 1iving27 

may be an indicator of high risk for in-home assistance or 

long-term care in an institution. 

Results of recent studies suggest that, in the absence 

of chronic diseases that impose limitations on activities, older 

persons do not have to experience a marked reduction in 

physical fitness with aging. 38In many cases declines in physical fitness are caused by simple reconditioning, probably 

the main contributor to the inability to perform modest physical 

exercise at older ages. A key aspect of the recent emphasis 

on disease prevention and health promotion involves encouraging increased physical activity in those who can accomplish 

it, 

Sources of data 

National estimates of the range of activity in older persons 

have been obtained from the Supplement on Aging (SOA) 

of the 1984 National Health Interview Survey. A full descriptionis in the appendix. It should be noted that some questions 

on “health opinions” and participation in more rigorous forms 

of physical activity were not asked unless the person responded 

for himself or herself. It is not possible to estimate the physical 

activity level of persons not asked these questions because 

there were several reasons for not obtaining information by 

self-response. Proxy responses were provided on more than 

25 percent of those 85 years and over, so this age subgroup 

is particularly vulnerable to uncertainty regarding functional 

status, This situation could result in conservative estimates 

of functional disability in this subgroup. No attempt was made 

to investigate the capacity to do various activities that were 

not performed, For example, if a person never tries to prepare 

meals, no attempt was made to find out whether he could 

do so if he had to, 

Information on basic and instrumental activities of daily 

living is also available from SOA. Briefly, activities of daily 

living (ADL’s) refer to the ability to independently accomplish 

self-care activities such as personal hygiene and mobility. 

In SOA, subjects were asked about difficulty in performing 

ADL’s that was attributable to a health or physical problem. 

When any difficulty was reported, subjects were asked about 

the level of difficulty performing ADL’s without the help 

of others or the use of special equipment. Instrumental activities of daily living (IADL’s) refer to activities inside and 

outside the home, such as meal preparation, shopping, managing money, using the telephone, and doing housework. The 

successful performance of IADL’s depends on abilities that 

extend beyond physical function to aspects of cognitive and 

social functioning. 

Results and comments 

Except for women 85 years and over, about one-quarter 

of men and women in age subgroups of those 55 years and 

over indicated that they exercised regularly (table 32). In 

fact, about 16 percent of men and 10 percent of women 

65 years and over responded that they walked 1 mile or 

more at a time without resting every day (table 33). However, 

the range of those who never walked a mile at a time varied 

from 36 percent of men aged 55-64 years to 49 percent 

of men 85 years and over and from 45 percent of women 

aged 55-64 to 62 percent of women aged 75–84 years. 

Except for those 85 years and over, the majority of older 

persons had no difficulty walking one-quarter of a mile or 

two or three blocks (table 34). Slightly greater percents had 

no difficulty walking up 10 steps, or the equivalent of a 

flight of steps. The ability to lift, especially for women, 

was reduced. About 46 percent of women aged 65 years 

and over had difficulty lifting 25 pounds (defined to respondents as the equivalent of two full bags of groceries), as 

did 70 percent of women 85 years and over. However, most 

people who could not lift 25 pounds were able to lift 10 

pounds, or the equivalent of a gallon of milk, without difficulty 

(table 35). The question concerning difficulty lifting 10 pounds 

was asked only of those with difficulty lifting 25 pounds. 

Among persons who responded for themselves, self-perception of their own physical activity level compared with 

that of others represented an optimistic perspective, with 3543 

percent of those in sex-age subgroups of persons 55 years 

and over feeling that they were more active than others their 

age (table 36). However, when comparing their present activity 

level with that of 1 year earlier (table 37), the proportions 

of persons who felt that their activity level had declined were 

greater than the proportions who felt that the level had in41

creased. The majority felt that their activity level was 

unchanged. 

The most frequent limitation in the group of activities 

ofdaily living was difficulty walking. Theage-specific values 

for proportions of persons experiencing difficulty walking 

ranged from 9 to 32 percent for men and from 10 to 43 

percent for women (table 38). In contrast, both sexes were 

less likely to experience difficulty with getting outside or 

in and out of a bed or chair than with walking (tables 38 

and 39). Almost all noninstitutionalized individuals ate unassisted with no difficulty (table 40). Fourteen percent of men 

aged 85 years and over and 18 percent of women of the 

same age had difficult y dressing (table 40). Females at all 

ages had more difficulty than males using the toilet and controlling urination (table 41). Difficulty in using the toilet could 

contribute to an incontinence problem for some individuals. 

In addition, incontinence was more common in those with 

multiple medical conditions. 39However, certain pelvic muscle 

Walking 

I 

Bathing 

I 

Getting outside 

I 

Getting in and 

out of bed or chair 1 

Dressing 

I 

Using toilet 

Eating 

1 1 I I 

05101520 

Percent 

SOURCE Divis”bnof Health Interview Statfstfca, Nstional Center for Health Stalisliw. 

Data from the National Heailh Interview Suwey 19S4 Supplement on Aging. 

Fgure 4. Percent of the noninatiiutionefinedpopulation 65 yeare of age 

and over who have d~utty with activ”hiesof daily Eving by type of 

ec6vii United States, 19S4 

42 

exercises and scheduled voiding programs have been successful 

in reducing the frequency of incontinence. 40 Figure 4 shows 

the percent of those aged 65 and over who had difficulty 

with activities of daily living. 

For the instrumental activities of daily living, age-specific 

subgroups of men 55 years and over had more difficulty 

than women with talking on the telephone (table 42). Otherwise 

women were more likely than men to have had difficulty 

with this group of activities (tables 42-44). It should be noted 

that this differential could be partly caused by the somewhat 

older age distribution of women than of men. The estimates 

for the proportion of men with difficulty may be conservative 

because about 15 percent of men 65 years and over did not 

do heavy housework (including 0.7 percent who did not provide information), and 8 percent did not do light housework 

(table 44). Figure 5 shows the percent of those aged 65 and 

over who had difficulty with instrumental activities of daily 

living. 

Heavy housework I 

Shopping 

I 

Light housework I 

Preparing meals 

Managing money 

I 

Using telephone 

1 I I 1 I 

o 5 10 15 20 25 

Percent 

SOURCE Oivision of Health Interview Statistfca, Nstionsl Center for Health Statistics 

Data from the National Health Interview Suwsy 1984 Supplement on Aging. 

FQure 5. Percent of the noninatiiutionakd population 65 yeara of age 

and over who have dtiutty with instrumental activities of daily Iiiing, by 

type of aetiv-ti: United Stateq 1964 
---------------------------------------------------------

--------------------------------------------------------------------------------

----------------------------------------------------------------------------------------------------------

I 

TABLE52. NlM8ERIN SAtlPLE~ POPULATION IN THOUSANDS, AND PERCENTDISTRII?LITION RF PERSONSAGES55-i35
YEARSAND (I’VER


BY lIMETHER THEYHAD REGULAREXERCISE,
ACCORDINGTO SEX ANDAGE: UNITEDSTATES,1984


(DATABASEDON THE NATIONALHEALTHINTERVIEW SURVEY1984SUPPLEMENT
ON AGING)


REGULAREXERCISE


NIJi’18ER IN
 POPULATION ML ANSNERED ANSiiERED NOT


SEX ANDAGE SANPLE IN THOUSANDS EXERCISE YES NO ANSWERED iJNMObJN 

——--------——— 

HALE


55-64YEARS.........


65 YEARSAND OVER...


65-74YEARS.......


75 YEARSAND OVER...


75+34Y
EARS.......


!35YEARSAND OVER...


FEIIALE


55-64YEARS.........


65 YEARSANQOVER...


65-74YEARS.......


75 YEARSAND OVER...


75-84YEARS.......


85 YEARSAND OVER...


PERCENTDISTRIBUTION


---———


2,150 10,2EI4 100 25=9 50.4 12.2 1.6 

4,(J43 1(3,787 100 2e.5 59.4 10.I3 1.3 

Z,[lm 7,075 1(XI M. i M. 1 8.8 1.1 

1,560 S7712 100 25.h 58.3 14.4 1.7 

1,311 

249 

3,128 

585 

1(JQ 

100 

26.i) 

~;=1 

60.3 

47.2 

11.8 

28.5 

1.8 

1.1 

2,501 11,76E loo 27.2 67.9 3.8 1.1 

6@4 15,645 100 25.4 65.? 7.4 1.3 

4,010 9,213 1(I() 27.7 66.6 4.6 ii} 

2~844 69433 I@ 22.(J 64.9 11s5 I.& 

2,267 5,121 10[} 23.7 b7. 1 7.7 1.5 

577 i,mz 100 15.4 5b.5 26.4 1.7 

43 
------------------------------------------------------------------------------------------------------

---------------------------------------------------------

-----------------------------------------------------------------------------------------------------------

---------

----------------------------------------------------------------------------------------------------------

Tf4ELE 33. NUtlEER IN SAIIPLE, POPULATIONIN THOUSANDS, AND PERCENTDISTRIBUTION
 OF PERSONSA88S55-85YEARSANDOVERBY


FREQUENCYOF WALKINGLINEMILEPER WEEK,ACCORDIN6TllSEX AND AGE: UNITEDSTATES,1984


(DATABASEDON THE NATIONALHEALTHINTERVIEW SURVEY1984SUPPLEMENT
ON A81N81


FREQUEEY OF !#ALKIN8
 PER WEEK


POPULATION NOT 

NUMBERIN IN ALL i DAY OR ANSWEREDOR 

SEX ANDAEE SAMPLE THOUSANDSFREQUENCIES 7 DAYS 2-b DAYS LEss NEVER UNKNOWN 

WALE


55-64YEARS.......SS


65 YEARSAND OVER ...


65-74YEARS.......


75 YEARSAND OVER...


75-84YEARS.......


85 YEARSAND OVER ...


FEMALE


55-b4 YEARS .........


65 YEARS AND OVER...


65-74YEARS.......


75 YEARSANDOVER .s.


75-84YEARS..0.m
 . .


85 YEARSAND OVER...


PERCENTDISTR18UiION
 —--------—-—- —--———-—-—— ---------------—


2,150 10,2H4 100 19.0 14.1 17.i 35=7 14.2 

4,643 10,787 100 15.9 13.8 14.6 43.5 12.2 

3,083 7,075 10(J 17.4 15.2 16.1 41,2 10.1 

1,560 3,712 100 13.2 il.~ 11.7 48.0 16.1 

1,311 3,128 100 14.2 12.2 12.X 47=7 13.6 

249 585 100 8.0 4.8 8.5 49.2 29.7 

2,5(H 11,768 100 13.7 15.9 20.4 44.7 5.4 

6,854 15,645 100 9.5 11.9 Is.s 56.2 9.2 

4,010 9,213 i(lf) 11.1 14.8 15.3 52.7 6.1 

2,844 !#,433 100 7.2 7.9 1(%3 61.0 13.6 

2,267 5,121 100 8.1 9.1 11.7 61.6 9.5 

577 1,312 100 T-J*8 & 2 4.5 58.8 29.6


44 
---------------------------------

-------------------------------------

-- -------------

I 

I TMLE 34. N#19ERIN SMPLE, POPULATION ITHOLISANDS, ANDPERCENT DISTRIBUTION OF PERSONSAGES!?!5-85 YEARSANDOVERBY 

WETHERTHEYHADDIFFICULTYIN MLKIN6UP 10 STEPSOR ME QLMRTEllOF (1MILE,ACCORDINGTO SEX MD ME:


UNITEDSTATES,1984


I 

(DATAIMSED ON THE NATIONflL HEALTH INTERVIEW SURVEY 1984 S!JPPLENENT ON AGINGI 

——--—-—--—-—--—--—-----—-—---- —---—-

DIFFICIILN W/lLKING UP 10 STEPS DIFFICULTYWALKING1/4 tlILES -—------------------------

NUNEIER POPULA- ALL HAD NO RLL HAD NO 

IN TiON IN IIIFFIUI- DIFFIEUL- DiFFICLiL- I)IFFU3JL- DIFFICUL-DIFFNllLSEX 4ND AGE sfi~nLETHous~AjjSTiE5 Ty 7Y LiNiiNOWNTIES TY iY UNKNOWN —--—------— ——--——------—-- ——-----------------------------

HALE PEK’’ENT DISTRIBUTION F’ERCENTDISTRIBUTION ——-——— _________________ _______________ —----

55-b4 YEARS. . . . . . . . . 2,150 10,284 100 il.A 87.0 1.5 100 i5.5 m.o 1.5 

65 YE(MSANDOVER.,. 4;64s 1~,787 100 19.1 79.5 1.3 100 25.4 73.b 1.0 

45-74YEfiRS....... s,w 7,075 I(ii 16.2 62*7 1.0 100 21.9 77.2 (1.9 

75 YEARSAND OVER... 1,5M 3,712 100 24.6 73.5 1.9 1~[1 32=1 h% 1) 1,3 

75-f14YEARSm.,.... 1,311 3,128 1(X1 22.4 75.9 1.7 I(j(l 29.1 69.9 1.[) 

85 YEARSANDOVER ... 249 5a5 lCM] 36=5 ML4 5=1 l[tlq 48.3 48.7 z 1 

FEMLE


55-64YEARS......... 2,501 11,748 100 16.3 82.9 0.8 1(M 16.3 82.9 (~.
 8


65 YEARSANllOVER... 6,854 15,645 108 28.5 69,~ 2,2 lWJ 32.5 A6.2 1.3


65-74YEARS....... 4,010 9,213 100 22.6 76.(I 1.5 100 24.5 74.4 1.0


75 YE/!RS
ANDOVER ... 2,844 6,433 Ioo 57.0 59.8 3,3 100 43.9 54.4 1.8


75-84YEARS....... 2,2b7 5,121 100 33.3 64.0 2.7 1#~ 39.4 59.2 1.5


i35YEARSANDOVER... 577 i,312 103 51.2 43.2 5.6 100 61.5 35.6 2.9


45 
----------------------------------------------------------------------- ----------------

------------------------

-------------------------------------------------------------------------------------------------------------

----------------------------- -----------

--------------------------------------------------------------------

TFIRLE 35. NUMBERIN SAHPLE,POPULATION IN THOUSANDS, AND PERCENTDISTR18UTIDN GF PERSONS AGES55-85 YEfiRSAND OVERFJY 

WHETHERTHEYHAD DIFFICULTYIN LIFTING10 OR 25 POUNDS,ACCORDINGTO SEX AND AGE: UNITEDSTATES, 1984 

{DATAEASEDONTHENATIONAL HEALTH INTERVIEW SWEY 1984 SUPPLEIIENTDNMING) 

.——------—--------— 

DIFFICULTYLIFTIIW 25 LRS DIFFICULTYLIFTING10 LE% 

—------------—---- —-—------—-— - _—---—— 

NUIIBER POPUM- RLL HAD No ML HfiD No 

IN TIONIN DIFFICUL-IHFFICIJL-DIFFICUL- DIFFICUL-DIFFICUL-DIFFICULT% SEX ANDAGE SMPLE THOUS9NDSTIES TY TY !J*W TIES ,{ N UNKNOWN 

MALE PERCENTDISTRIBUTION PERCENTIIISTRHWTION -------— _-—-——-—_-----------— 

55-64 YEARS........s 2,150 10,284 100 14.4 !34.5 1.1 ~mj 5.2 92.6 2.2 

65 YEARSAND OVER... 4,645 10,787 100 22.9 75.8 1,2 10C 8.2 89.8 2.[) 

55-74YEflRS ....... 3,(M3 7,(375 iilfi 19.8 79s4 0.9 1(IQ il. b
 91.5 1,8

75 YE(IRS
AND OVER ... 1,560 3,712 1(10 29.0 69.1 1.9 Iw, 11.4 86.2 2.3 

75-84YEARS....... 1,311 27128 100 26.S 72.~ 1.7 1~1 9.9 87.9 2.2 

85 YEORS(+NDOVER... 249 585 1[)() 43.7 53.7 2.7 100 19.9 77.0 3.(1 

FEMAE 

55-b4YEARS.......ss 2,501 11,7$8 100 28.b 70.1 1.5 i[fi 8.8 88.A 2.6 

h5 YEARSAND OVER... 6,854 15,645 100 45.8 51.1 3.i liy] 18.A 77.& :.8 

65-74 YEARS....... 

75 YEARSAND OVER ... 

4,01(3 

2,844 

9,21S 

b,433 

1(M 

1O(I 

S7.8 

57.1 

59.9 

38.i! 

2.3 

4.3 

~~ 

loci 

12.6 

27.2 

84.5 

67.7 

2.9 

5.1 

75-84YEAR$....... 2,267 5,121 100 53.8 4~*9 ~,3 1(0 23.7 71.8 4.5 

85 YEARSAND OVER... 577 i,312 100 7(J. 1 Z.n 7.9 104 40.8 51.6 7.6


—--—--—----------


46 
------- ---------------------------------------------------------------------------------------------------------------

------------- ------- ------------------

------------------------------------------------------------------------------------------------------------

-------------------------------------------------------------------

----------------------------------- -----------------------------------------------------------------------------

I 

TABLE36. NUMBERIN SflMFILE, POPULflTION IN THOUSANDS, AND PERCENTDISTRIEIUTION OF PERSONSiM3ES 55-85YEARSAND iJVER
EiY


COIIFARISONF THEIRIICTIVITY
 LEVELSWITHOTHERS,MCORDiNGTO SEX AND AGE: UNITEDSTRTES,1984 

(DATABASEDON THE NATIONALHEALTHINTERVIEW SURVEY1984SUPPLEMENT
ON AGING)

ACTIVITYLEVELCOMPflRED
 TO OTHERS
 ________________________________


POPULATION


NUM.8ER
IN IN ,QLL NOT


SEX AND AGE SAMF’LE THOUSANDSCOMPARISONS MORE LESS SAME ANSWERED UNKNOWN


MALE PERCENTDISTRI)?UTION


55-64YEARS,,.,..,.. 2,15(1 10,284 100 55.(1 10.2 40,6 12,2 2.1


65 YEARSAND OVER... 4,441 10,787 10[1 41.3 9.5 56.8 1[1,8 1.7


45-74YEARS,,..,.. 3~083 7,075 100 40,9 9.8 39.0 8.8 1.4


75 YEARSANI)OVER,,, 1,56(1 3,712 i00 41.9 8.8 52,5 14.4 2=3


75-84YEARS,,.,,., 1,311 3,128 1!20 41.7 9.1 35,1 11.8 2’
.d


85 YEARSAND OVER... 249 585 1O() 42.8 7.5 19.0 28.5 z.;


FEHALE


55-b4YE4Rs,.,..,.,. 2,501 11,768 100 35.() 12.4 47.5 5.8 1,2 

65 YEARSANDOVER ..s 6,854 15,645 I(lfi 39.5 10=8 40.1 7.4 2.1 

65-74YEARS,,,,.,, 4,010 9,213 10[1 S8.7 11.1 44,0 4.6 1.6 

75 YEARSAND OVER .,, 2,844 b, 433 100 40.7 10.4 34.5 11.5 2s8 

75-84YEARS.,,,.,, 2,267 5,121 100 41.2 11.1 37.3 7.7 2.8 

05 YEARSAND OVER ,,. 577 1,312 100 38.9 8.0 23.8 26.4 2.8 

47 
---------------- -----------------------------------------------------------------------------------------------

------------------ ---------------------------------------------------

--------------------------------------------------------------------- ------------------------------------------- -----

----------------------- ------------------------------ ----------------

-----------------------------------------------------------------------------------------------------------

T/&LE17. NUMBERIN SAMPLE,POPULATION IN THUUSANDS, AND PERCENTDISTRIBUTION
 OF PERSONSAGES55-85YEARSAND OVEREIY


COMPARISON
OF THEIRACTIVITYLEVELSTO 1 YEARAGO,ACCORDINGTO SEXAND AGE: UNITEDSTATES,1984


(DATABASEDON THE NATIONALHEALTHINTERVIEW SURVEY1984SUPPLEMENT
ON AGING;


-


ACTIVITYLEVELCOMPAREDTO 1 YEARAGO


POPULATION


NUMBERIN IN ALL MORE LESS ABOUTTHE NOT


SEX ANDAGE SAMPLE THOUSANDSCOMPARISONSACTIVITY ACTIVITY SAME ANSWERED UNKNOWN


MALE PERCENTDISTRIBUTION


55-64YEARS......... 2,150 10,294 100 8s1 11,1 /?7. 12,2 1,4 

k5 YEARSAND OVER... 4,643 N, 7a7 loo 5.9 15.6 66.B jijc B 1,() 

AZ-74YEARS....... 3,03s 7,[)75 100 6.7 11, ~ 69, A 8.R (1.8 

75 YEARSANDOVER ... 1,560 3,712 100 4.5 18.2 61.5 14.4 1,3 

75-84YEARS....... 1,311 3,128 100 4.4 18.9 b3.5 11,8 1.4 

85 YEARSAND OVER ..s 249 585 100 4.5 14.9 50,9 28,5 1,1 

1


FEMALE


55-b4YEARS......... 2,5(Ji 11,768 100 9.5 i~.b 72.3 3.8 fl.8 

65 YEARSAND OVER... 6,854 15,645 100 7.2 17.3 66.8 7.4 1,2 

65-74 YEARS....... 4,010 9,213 1[1(1 7.7 14.9 71.7 4,6 1,0 

75 YEARSAND OVER... 2,844 b,43s 100 6.4 20,8 59nfl 11.5 1.5 

75-84YEARS..aa... 2,267 5,121 100 6.9 21.1 63.0 7,7 1.3 

85 YEARSAND OVER... 577 1,312 100 4s2 19.8 47.6 26.4 2.0 

48 
---------------------------------------------------------------------------------------------------------- ------------

-------------------------------------- ------------------- --------

-----------------------------------------------------------------------------------------------------------

-----------------------------------------------------------------------

------------------------

I 

TABLE38. NUMBERIN SAtiPLE, POPULATION IN THOUSANDS, lINDPERCENTDISTRIF41TION
 OF PERSONSAGES55-85YEARSAND OVERWITH


DIFFICULTYIN ACTIVITIES OF DAILYLIVINGBY WHETHERTHEYHAD DIFFICULTYIN WALKINGAND GETTINGOUTSIDE,ACCORDING
TO


SEX fiNDAGE: UNITEDSTATES,1984


(DATABASEDON THE NATIONALHEALTHINTERVIEW SURVEY19E4SUPPLEMENT
ON AGING)


DIFFICULTY WALKING DIFFICULTY
GETTINGOUTSIDE
 .—-.—-—-


NdMEIER POPULA- ALL DOESNOT ALL DOESNOT 

IN TIONIN DIFFICiJl- DOOR DIFFICUL- DOOR 

SEXAND AGE SAMPLE THOUSANDS TIES YES NO LIiitiNOWNTIES YES NO UNKNOWN 

MALE PERCENTDISTRIBUTION PERCENTDISTRIEWTION


55-64YEARS.,,,,,,., 2,15(J 2
 f~,~84 1[111 8.8 9(1. l.fj lilo 3.1 95.7 1.2


AND OVER... 4,643 10,787 IQ(J 15.5 83.? 0.6 l[~i) & T
 65 YEflRS .%, 92.9 0.8


6%74 YEARSu,a..a. ~,[)83 7,075 100 12.9 8b.& G*5 10(1 4.5 94.9 (LA


75 YEARSANDOVER... 1,560 3,712 1(]0 20.5 78.8 0.7 100 9.8 89.0 1.2


75-84YEARS.....a. 1,311 3,128 100 18.3 80,9 {).8 100 7.5 91.3 1.2


85 YEARSAND OVER... 249 585 10s ~~,? &7.4 0.4 1(’)0 21.8 77.Ij 1.2


FEM9LE


55-&4YEARsnn,st*,,, 2,5[)1 11,768 100 9.5 89,9 (), 1(10 s.b 95.8 :1.6 

65 YEARSAND OVER r.. A,854 15,645 100 20,9 78.3 ().8 100 11.8 87.[] 1.1 

65-74YEARS,.s.,,. 4,010 9,213 100 15.1 84.2 0.6 l@ij 6.5 92.6 ().8 

75 YEARSAND OVER... 2,844 6,433 100 29.2 69.7 1.0 100 19.4 79.0 1.6 

75-84 YEMS,,,,,,. 2,267 5,121 100 25.7 73.5 &8 100” 15.3 83.4 1*3 

5


85 YEARSAND OVER... 577 1,312 100 43.; 54.8 2.0 100 35.4 61.9 2s7 

&------------------------------------------------------------------------------------
------------------------------------------------------------------------------------------------------------

-----------------------------------------------------------------------

------------------------------------------------------------------------------------------------------------------------

-------------------------------------- --------------------------------------

------------------------------------------------------------------------------------------------------------

TABLE39s NUMBERIN SA!IPLE, POPULATIONIN THOUSANDS, 9ND PERCENTDISTRIBUTION
 OF PERSONSAGES55-85YEARSANDOVERWITH


DIFFICULTY IN ACTIVITIES OF DAILYLIVINGBY WHETHERTHEYHAD DIFFICULTY
GETTINGIN OR OUT OF BED OR CHRIRAND BATHINGOR


SHOWERING,
ACCORDINGTO SEX AND AGE: UNITEDSTATES,1984


(DATABASEDON THE NATIONALHEALTHINTERVIEW SURVEY1984SUPPLEMENT
ON AGINGI


DIFFICULTY
GETTINGIN OR OUT


BED OR CHAIR DIFFICULTY
BATHINGOR SHOWERING


NUHBER POPULA- ALL DOESNOT AllL DOESNOT


IN TION IN DIFFICUL- 00 OR DIFFICUL- DO OR


SEX AND AGE SAIIPLETHOUSANDS TIES YES NO UNKNOWN TIES YES NO UFKNOWN


MALE PERCENTDISTRIBUTION PERCENTDISTRIBUTION


55-44YEARS.....*... 2,150 10,2E4 100 4.4 94.5 1.1 j(l[) 4.1 94,9 1.0 

65 YE4RSAND OVER... 4,643 10,7H7 100 5.& 93.9 0.6 100” 7.4 91.8 0.6 

65-74YEARS0....ss 3,0B3 7,075 Io(l 4.8 94.7 0.5 1(IO 5.L! 93,9 0,5 

75 YEARSAND OVER,.. 1,%0 3,712 100 7.0 92.3 0.7 100 11.4 07.8 0.8 

75-f14
YEARS....... 1,311 3,128 10(I 5.9 93.s (1.7 1(1(1 9.2 89,9 0.9

85 YEARSAND OVER... 249 585 100 12.7 86.9 0.4 103 23.1 74.5 0,4


FEMALE


55-tI4
YEARS...s..... 2,501 11,768 100 5.5 94.0 0.5 1[)0 4.6 94.9 0.b 

65 YEARSAND OVER... 6,854 15,645 100 9.7 09.6 0.7 Ioo 11*2 88.0 0.7 

65-74YEARS....... 4,010 9,213 100 7.0 92.4 0.6 100 6.9 92.5 6.6 

75 YEARSAND OVER..s 2,B44 6,433 100 13.5 85.6 0.9 100” 17,4 81.6 1.0 

75-84YEARS,,..,.. 2,267 5,121 100” 11.2 88.0 0.8 1(NI 14.2 85.1 0.8 

85 YEARSAND OVER... 577 1,312 100 22*2 76,2 lmb 100 50=1 68.2 1.7 

50

-------------------------------------------------------------------------------------------------------------

-----------------

--------------------------------------

TABLE40. NUH8ERIN SMPLE, POPULATION IN THOUSRNDS, AND PERCENTDISTRIBUTION OF PERSONSAGES55-85YEiIRS AND OVERWITH


DIFFICULTY IN ACTIVITIES OFDAILYLIVINGEIYWHETHER THEYH(JDDIFFICULTY EATING ORDRESSING, ACCORDiNG TO SEX AND AGE:

UNITEDSTATES,19Ei4


(DATABASEDON THENATIONALHEALTHINTERVIEW SURVEY1984SUPPLEMENT
ON AGING)


DIFFICULTY EATING DIFFICUL~f
DRESSING


—---------------—------—--------------------------------


NUf18ER POPULA- (tLL DOESNOT ALL DOESNOT


IN TIONIN DIFFICLiL- DOOR DiFFICUL- 00 OR


SEX AND AGE SAMPLE THOUSflNDSTIES YES NO UNKNOWN TIES YES No UNKNOWN


MILE PERCENTDISTRIBUTION PERCENTDISTRI!3UTION
 ----——------------------------------


55-b4YEARS......... 2,150 10,284 1O(I 0.8 98.0 1.2 10(I Z.b 95.3 1.1 

65 YEARSANDOVER... 4,b43 10,7H7 100 2.0 97.4 (Lb i(l(i 5.8 9s. 7 tj,b 

b5-74YEARS,...m.. s,W 7,075 100 1.5 98.(I 0,5 1(IO 4.4 95.1 0.5 

75 YEARSAND OVER... 1,5b0 3~712 100 2.8 9b.4 0.8 100 8.5 91,0 0,7 

75-E14YEARS....... 1,311 3,128 100 2.5 9b.b 0.9 100 7.3 92’.0 0,7


E15YEARSAND OVER... 249 585 100 4.3 95.3 0.4 100 14.1 85.5 0.4


FEMLE


55-b4YEARS......... 2,5I?l ll,7bH 100 (). b
 9B.9 0.5 1O(I 3.0 9b.5 ().5


65 YEARSANDOVER ... b,E154 15,b45 100 1.7 97.b 0.7 100 b.5 92.7 o.fl


b5-74YEARS....... 4,010 9,213 100 0.9 9B.5 0s6 100 4.2 95.2 (0.

75 YEARSANDOVER... 2,844 !!),4s3 100 2.3 96.3 0,9 100 9.8 89.2 1,0 

75-84YEARS....... 2,2b7 5,121 100 2.4 9b,9 0.7 Iolj 7.7 91.5 0.8 

85 YEARSAND OVER*“‘ ---~-----::slz ~o~ 4“4 94’0 1“4 1~~ 17”7 80”2 ---::! 

b

--------------------------------------------------

-------------------------------------- ------------------------------

------------------------------------------------------------------------------------------------------------

-------------------------------------- ----------- -------

----------------------------------------------------------------------------------------------------------

TR!3LE 41. NUMBERIN SAMPLE,POPULATIONIN THOUSANDS, AND PERCENTDISTRIBUTION
 tJFPERSONSMl% 55-85YEARSANDOVERWITH


DIFFICULTY IN ACTIVITIES OF DAILYLIVIN8BY HHETHERTHEYHAD DIFFICULTY USIN8TOILETOR CDNTROLLIN8
URINRTIIIN,


ACCORDINGTO SEX AND AGE: UNITEDSTflTES,
 1984


iDATil BASEDON THE NATIONALHEALTHINTERVIEW SURVEf1984SUPPLEMENT
ON GGIN!3


---.----—---—------—--.-—---—


iliFFICULTY
 CONTROLLING


DIFFICULTY
USINGTOILET LKIINATION


------—


N!Jt18ERPOPULA- ~L DOESNGT kL DOESNOT 

IN TIONIN DIFFICUL- liOOR !lIFFiEUii- DO OR 

SEX AND A!3E SAMPLE THOUSANDS TIES YES No UNKNOWN TIES YES NO uNKNowN 

HALE PERCENTDISTRIEWION F’ERCENT
 DISTRIFJJTIQN
 ---------— ——--—


55-64YEARS......... 2,150 10,284 ilm 1.2 97.6 1,2 1[10 2,(I %.a 1.2


65 YEARSAND OVER... 4,&43 10,707 io(l 5.1 9b.1 0,7 1(K3 6.5 92.7 0.8


$5-74YEARS,....,. 3,083 7,Q75 iol 2.4 97.6 0.7 l(j(l 5.[) ?4.3 0.8


75 YEARSAND OVER... 1,%0 3,712 100 4.6 94.5 [1.9 Icfi:} 9.5 H9,& 0.9


75-84YEARS....... 1,311 3,128 100 Z.b q5.5 0.9 loo 8.8 90.2 1.0


85 YEARSANDOVER... 249 505 100 10.0 89,2 O.fl lg[l 13.0 E%.6 0.4


FEMALE 

55-$4YEARS......... 2,501 ll,7fi3 100 1.5 97.9 [).6 ici:) 5,~ 94.1 0.7 

45 YEARSAND OVER... 6,854 15,645 100 5.1 94.1] 0.9 10Q 9.3 90.() 0.7 

&5-74YEARS....... 4,010 9,213 100 2.7 96.4 0.8 l[io b.B 92.6 0.b 

75 YEARSANDOVER.� . 2,844 &,433 100 8.4 9[1.5 ;.(I 1[10 12.9 86.2 0.9 

75-84YEARS....... 2,247 5,121 100 6.5 92.6 (}. 8
 lfij 11.2 88.(3 0.7


85 YEARSAND OVER... 577 1~312 100 15.9 82.4 1s8 100 19.6 78.8 1.6


52 
------------------

------------------

TABLE42, NUMI?ER INSMIPLE, POPULATION INTHOUStlNilS, AND PERGENTDE3TRIIWTION OF PERSONS
AGES55-85YEORSMl OVERWITH


DIFFICULTYIN ACTIVITIES
OF DAILYLIVINGBY WHETHERTHEYHADDIFFICULTYF’RWARINGOWN MEALSOR USIN6TELEPHONE, 

ACZORDINGTO SEX AND AGE: UNITEDSTRTES,19E14 

(DATAEASEDON THENATIONALHEALTHINTERVIEii SURVEY1984SUPF’LEMENT
 ON AGING;


---— _- _______ ________________________


DIFFICULTY PREPARING134N?IE9LS DIFFICULTY
USINGTHE TELEPHONE
 —_____________________ —--— ____________________


NUMBER POFIJLA- ALL DOESN~T ALL DUESNflT


IN TION IN DIFFICUL- Dii Lifl DIFFIiliL- DUOR 

SEX AND AGE SAHPLE THOUSANDS TIES YES NCi UNKNUiIJNTIES YES NO UNKNONN -— -—----—----— _____________ 

HALE PERCENTDISTRIEIUTIUN PERCENTDISTRIBUTION
 ______________________________ —-----—-------------—-


55-64YEARS......... 2,150 10,284 10(1 1.3 90.5 8.2 1(1(1 1.3 97.4 1.3 

6S YEARSAND OVER... 4,543 iO~787 1[10 4.7 83,7 11.6 Ii)o 5.b 92.7 1.7 

65-74YEARS....... 3,m 7,075 1(IO ;.[] 86s6 10.4 lm 3.5 95.1 1.4 

75 YEARSAND OVER... 1,560 3,712 llxl 8.0 78.S Ix.g 10[) 9.5 aa.o 2.5 

75-84YEARS.,..... 1,311 3,128 100 A.(1 81,2 12.8 l(x) 7.9 89.9 2,3 

85 YEARSANDOVER... 249 585 100 ia.4 62.a 18.7 iijij 18.4 77.9 3.7 

FEtlALE


55-44YEARS......... 2,X)1 11,768 100 :,~ 96.3 [].7 100 1.[] 98.4 ()./)

65 YEARSANDOVER ... 6,854 15,645 100 8.7 89.3 1.9 100 4.2 94.6 1.3 

45-74YEARS.,...,. 4,010 9,213 ioo 4.8 94.1 1.1 1[)0 2.0 97.1 1.() 

75 YEARSAND OVER... 2,844 6,433 100 14.4 82=5 -.l. L~
 1~~ 7.3 91.G 1.7


75-84YEARS....... ~,z~, 5,121 100 Ifi.s 87.2 2.2 Ii](l 4.8 93.a 1.3


85 YEARSANDOVER... 577 1,312 llxl 29.5 64.0 6.5 100 17.1 79.7 3.2


53 
---------------------------------------------------------------------------------------------

-------------------------------------------------

-----------------------------------------------------------------------------------------------

---

---

TABLE43. NUMBERIN SAMPLE,PUPULi+TION IN THOUSANDS, flNil PERCENTDISTRIi?UTiON
 OF PERSONSAGES55-85YEARSANDOVERWITH


DIFFICULTYIN ACTIVITIES OF DAILYLIVINEBY WHETHERTHEYHAD DIFFICULTYIN SHOPPINGOR MANAGINGHONEY,ACCORDING
TO SEX


AND AGE: LINITED
 STATES,1984


(DATABASEDON THE NATIONALHEALTHINTERVIEW ON AGINGI I SURVEY19B4SUPPLEMENT


—— -- ---—— 

DIFFICULTY SHOPPING DIFFICULTY
HANAGINGHONEY


---— —--— --——-


NUMEER POPULA- i+LL DOESNOT ALL DES NOT


IN TIONIN DIFFICUL- DO OR DIFFICUL- DOOR


SEX fiNDAGE SAMPLE THOUSANDS TIES YEs NO UNKNOWN TIES YES No UNwoHN


--—--—--——­


tlALE PERCENTDISTRIBUTION PERCENTDISTRIBUTICR/
 ------—---------—--------—--------- —---—-- —--—— ——------—--


55-64YEARS......... 2,150 10,284 1~(1 3.0 94s9 2.1 1[1[) 1.0 96.6 2.3 

65 YEARSAND OVER... 4,643 10,787 100 7.3 89.6 5.1 l[h~ 4.4 93.0 2.6 

65-74YEARS,....0. 3,00s 7,075 1(?0 4.6 93.o 2.4 100” 2.8 95.1 2.1 

75 YEARSANDOVER ... 1,560 3,712 100 12.3 83.1 4.& 100 7.5 88.8 3.4 

75-84YEARS....... 1,311 3,128 100 9.6 06.7 3s7 100 5.4 91,6 3.0 

85 YEARSAND OVER... 249 585 100 26.8 63=8 9.4 100 19.0 74.0 7.0 

FEMALE


55-64YEARS,.n....
o. 2,501 11,768 100 4.3 94.8 0.9 1O(I 1.0 97.6 1.4


65 YEARSANDOVER ... b, 854 15,445 100 14.1 83.6 2.4 100 5.5 91.9 2.6 

65-74 YEARS....... 4,010 9,213 100 7.8 91.1 1.2 1(M 1.8 96.5 1.7 

75 YEARSAND OVER ... 2,844 6,433 100 Jr c>. 1 72.8 4.1 1(XJ 10.7 85.4 3.9 

75-84 YEARS,,..s.. 2,267 5,121 100 18.4 78.b 3.0 j00 6.8 91L2 3.0 

85 YEARSANDOVER ., , 577 1,312 __loo 41. b 50.() --Q:A- 100 ~b.~ &5 7.s 

———-------


54 
--------------------------------------------------------------

------------------------------------------------------------------------------------------------------------

-------- ----------------------------

----------------- ---------------------------------------------------------------------------------------------------------

TRi3LE 44. NUMBERIN SAMPLE,F’LF’ULATION IN THOUSANDS, AND PERCENTDISTRIBUTION OF F’EFiSONS
 AGES55-K YEARSAND OVERWITH


DIFFICULTYIN ACTIVITIES OF DAILYLIVING13YWHETHERTHEYHADDIFFICULTYIN DOINGLIGHTOR HEAVYHOUSEWORE, AiiCORDING
 TO


( SEX AND AGE: UNITEDSTATES,i9%l


(DATAEIASED ON THENATIONALHEALTHINTERViEW SURVEYi9843JF’F’LEMENT
 O AGING)


____________________________________________________________________________________________________________

DIFFICL!LTY DOINGHEAVYHOUSEWORK DIFFICULTY
DOINGLIGHTHOUSEWORK


NUMBER F’OflJLA- ALL DOESNOT ALL DOESN~T 

IN TIONIN DIFFICUL- DOOR DIFFICUL- DOOk 

SEX AND AGE SAMPLE THOUSANDS TIES YES NO UNKNflWN TIES YES NO LINitNOWN 

llfiLE F’ERCENT
 OISTRILKITION PERCENTOISTRIEHTION
 — __________________________


m-b4YEARss. u*...., 2,150 1i),

65 YEARSAND OVER ... 4,64s 10,787 1{1(1 15,7 71,2 15.1 loo 4.9 87=i g,[) 

&5-74 YEARS,,.,... J,[183 7,[175 100 11,2 75.5 13.4 1[10 75 89,k 6.9 

75 YEARSANDOVER ,,. 1,560 3712 10(I 10,7 62.9 18,4 100 ;:6 82.2 lij.z 

75-04YEARS....... 1,311 3,128 100” 15.9 66.9 17,2 100” A.2 84.EI 9.0 

85 YEAFiSANDCIVEfl

2134 1(1(} e.1 79.8 12,1 1[}() 2.1 90.b 7.3


... 249 585 ICI(J ~;.s 42,() 24.7 1{1[) 15.2 68.5 16.3


FEMALE


55-IJ4
YEARS,..,,,,,, p,5(]l 11,768 100 17.7 79.9 2.4 1(}(1 3.1 ?5.5 1s5 

65 YEARSANDOVER ... b, 854 15,645 10(1 ;(I.8 !51. 7.s iij[} 8.7 89.t~ 2,4 ? 

65-74YEARS,,,,.,. 4,010 9,213 1[10 24.3 7(1.5 5,2 i00 5.0 93.7 1.1 

[] 49.7 10,3 1[10 lg.i] 82,2 75 YEARSAND OVER... 2,844 6,433 I[)fi 4[),
 3.8

75-84YEARS,..,... 2,257 5~121 100 36.4 54.2 9,3 100 10,5 8LI. 1
 3.4


E15YEARSANDOVER ,., 577 lJi2 1(10 54*Z 31.9 13.9 lot) 27.4 67.1 5.5


55 
Chapter Vll


Use-of health carc+ambulatory


medical care


by Hugo Koch and Richard J. Havlik, M. D., National Center 

for Health Statistics 

Introduction 

Most older persons are not hospitalized in any year, so 

the majority of medical care occurs in ambulatory settings. 

These locations are usually the offices of general and family 

physicians and internists. However, the variety in available 

sites, such as walk-in clinics, surgicenters, and hospital outpatient facilities, is increasing. This variability may result from 

a number of factors, including distance, availability of transportation, personal choice, new location options, insurance 

coverage, and other unknown factors. Although some of the 

factors affecting selection of location also might affect the 

amount of use of ambulatory care, symptoms and disease 

would be expected to be the most important contributing factors. It is not surprising that those individuals in the community 

whose health is perceived to be fair or poor have the most 

physician contacts per year. 41In addition, subgroups of persons 

in the population defined as low, intermediate, or high users 

of ambulatory care have been identified .42 

In addition to interviewing persons in the community 

concerning physician contacts at any site, including outpatient 

clinics and emergency rooms, physicians are interviewed because they can provide the most reliable information on the 

medical diagnoses made and drugs prescribed during visits 

to their offices-as The typeof patient on whom information 

is obtained in physician interviews may differ somewhat from 

the general population in socioeconomic status or other factors. 

Information from the patient in the community and the provider 

in the office must be blended to give the most complete 

picture of ambulatory medical care for older persons. 

Sources of data 

Person-level data on hospital, ambulatory care, and prescription drug use in 1980 are available from the. National 

Medical Care Utilization and Expenditure Survey (NMCUES). 

The National Health Interview Survey (NHIS) is the source 

of person-level data on physician contacts during the period 

1982–83. The National Ambulato~ Medical Care Survey 

(NAMCS) was an annual survey of physician providers conducted in 1980 and 1981, and data on diagnoses and prescribed 

drug therapy are available for the combined years. This survey 

was repeated in 1985. See the appendix for details of the 

Sumeys. 

Results and comments 

Locationof care 

According to NMCUES data (table 45), 86.4 percent 

of men and 87.6 percent of women aged 55-64 years had 

no days of hospitalization in 1980. Even at 75 years and 

over, about 75 percent of men and women had no hospitalizations. In contrast, depending on age, only 10 to 20 percent 

of persons had no health care visits. According to NHIS 

data,41 60.4 percent of physician contacts for those 65 years 

and over occurred in a physician’s office; 12.1 percent in 

hospital emergency rooms, clinics, or other hospital facilities; 

6.8 percent at home; 12.5 percent by phone; 0.3 percent 

at a company clinic; and 8.0 percent at other locations. 

Frequency of care 

According to NHIS data for the period 1982–83, the 

average annual number of physician contacts per person ranged 

from 6.2 to 9.2 visits per year, depending on the age, race, 

and sex subgroup (table 46). However, for all races combined, 

the number of visits for those whose health was considered 

to be fair or poor ranged from 10.2 to 12.9 visits per year, 

depending on the age and sex subgroup, compared with a 

range of 4.1 to 6.1 visits for those whose health was considered 

good or excellent. Data from NMCUES show that 3.8-6,7 

percent of men 55 years and over, depending on age subgroup, 

and 7.7–12.5 percent of women at similar ages were high-level 

users of ambulatory care (table 45). High use was defined 

as 20 or more health care visits to a physician or nonphysician. 

Of persons in this age range, 7. 1–19.7 percent were high-level 

users of prescription drugs. High-1evel users were those with 

25 or more prescribed medicine acquisitions. 

NAMCSproviderdata 

Because older persons tend to have multiple problems, 

an oftice visit is likely to include consideration of more than 

one complaint. For example, about 52 percent of visits for 

patients 75 years and over involved multiple diagnoses .43 

The 25 most frequent diagnoses for males and females aged 

75 years and over have been published.43 

When the first-, second-, and third-listed diagnoses reported by physicians for office visits are cumulated, essential 

hypertension is the most frequently mentioned diagnosis in 

56 
all groups of people 55 years and over except men 85 years 

and over, for whom chronic ischemic heart disease is ranked 

first (table 47). In fact, a quartet of diseases consisting of 

essential hypertension, diabetes mellitus, chronic ischemic 

heart disease, and osteoarthritis is mentioned most frequently 

as the diagnosis for physician visits of older persons. In the 

group 85 years of age and over, cataract becomes the fourth 

most frequent diagnosis, replacing diabetes mellitus. The frequency of cataract mentions is higher in each older subgrou~ 

29 per 1,000 visits in the subgroup 65–74 years, 50 per 

1,000 in the subgroup 75–84 years, and 68 per 1,000 in 

the subgroup 85 years and over. Other frequently mentioned 

conditions for the various ages often overlap with the most 

common diagnoses, resulting in the concentration of diagnoses 

into a relatively few categories. For example, other listed 

cardiovascular diagnoses include cardiac dysrhythmias, hypertensive heart disease, heart failure, angina pectoris, and the 

general condition of atherosclerosis. In addition to osteoarthritis, mention is made of arthropathies, other and unspecified, 

a diagnosis less frequently reported but present in each of 

the age groups. Besides cataract, eye problems include disorders of refraction and accommodation and glaucoma. 

Almost 70 percent of physician visits by those 75 years 

and over resulted in at least one prescribed medication, and 

44 percent of patients received multiple drugs .43 The most 

frequently prescribed or provided drugs for persons 55 years 

and over are included in the classes of diuretics, cardiovascular 

drugs, and analgesics (table 48). In the subgroup 85 years 

and over, hydrochlorothiazide and digoxin are the generic 

drugs mentioned most often by physicians. Interestingly, vitamin B 1z is still common] y prescribed for older persons. 

57 
Table 45. percent disufbufiona of persons 55 years of age and over by level of hospital, ambulatory care, and prescription drug use, acsotding to sex and agfs 

United States, 1960 

[Data are bassd on a household aufvey of the civilian noninstitutionalizsd !Japulation] 

Level of use’ 

Type of use, sex, and age Total None Low Intermediate High 

LEVEL OF HOSPITAL USE’ 

Male Percent distribution 

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 26.4 1.3 8.4 3.9 

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 77.3 1.6 15.2 5.9 

75years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 75.1 3.1 10.7 11.1 

Female 

55-84 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . lm.o 87.6 1.4 8.6 2.3 

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Icx).o 82.7 1.6 10.8 4.9 

75years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 74.9 1.8 15.0 8.3 

LEVEL OF AMBULATORY 

CARE USE2 

Male 

55-84 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 19.7 13.6 62.9 3.8 

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 19.7 10.0 61.8 8.5 

75years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . lcct.o 16.6 9.7 67.0 6.7 

Female 

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 14.4 12.8 85.2 7.7 

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 14.3 9.4 &3.9 9.4 

75yeara andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 10.2 7.2 70.1 12.5 

LEVEL	 OF PRESCRIPTION 

DRUG USE3 

Male 

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 32.9 10.7 49.3 7.1 

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 29.1 8.2 52.0 10.7 

75years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . IOQ.O 19.5 4.4 59.2 18.9 

Female 

55-84 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 23.2 7.1 59.4 12.3 

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ICO.O 19.7 5.2 60.0 15.1 

75yeakand over . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 13.4 4.8 62.1 19.7 

1Low users had 1 or 2 hospital daya during the yeac high users had 17 or more hospital days. 

2Low ussrs had 1 nondental visit to a physician or nonphysiciav high users had 2U or more visits. 

‘Low users had 1 prescription medicine acquisition high users had 25 or more acquisitions. 

SOURCtZ S. E. Berki, J. N. Lepkowstd, L Wyszewianski, et al: High-volume and low-volume users of health Sewices, lfnitsd Statea, 1990. National Medical CareUtilizationandExpenditureSUIWV 

SeriesC, No.2. DHHS Pub. No. 66-20402..National Canter for Health Statistics, Public Health Ssrvice. Washington. U.S. Government Printing Office, Nov. 1985. 

58 
1

2

3

4

5

6

7

1

2

3

4

5

6

7

8

9

1

2

3

4

5

6

7

8

9

10

Table 48. Average annual number of physician contacta per pereon, by race, sex, respondent-assessed health status, and age United States, 1982-83 

[Data are basedon householdinterviews of the civilian nonlnstitutionalized population] 

Respondent-assessed All races’ White Black 

health status and age Male Female Male Female Male Female 

All health statusesz Number per person per year 

55-64 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.2 6.9 6.2 6.7 7.5 6.2 

65years andover . . . . . . . . . . . . . . . . . . . 7.2 8.0 7.2 8.0 7.6 7.9 

65-74 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.6 7.8 6.7 7.8 6.7 8.6 

75years andover . . . . . . . . . . . . . . . . . . . . . . . 8.2 8.3 8.2 8.4 9.2 7.7 

Good or 

excellent health 

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.1 4.7 4.1 4.8 4.1 4.8 

65years andover . . . . . . . . . . . . . . . . . . . . . . . 5.1 5.6 5.1 5.9 4.5 4.4 

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.e 5.5 4.8 5.6 4.4 4.5 

75years andover . . . . . . . . . . . . . . . . . . . . . . . 5.6 6.1 5.7 6.3 “4.7 4.3 

Falror poor health 

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.6 12.9 12.7 12.9 12.0 12.7 

65years andover . . . . . . . . . . . . . . . . . . . . . . . 11.1 12.4 11.3 12.7 10.0 10.7 65-74 years. . .,, . . . . . . . . . . . . . . . . . . . . . . 10.2 12.7 10.5 13.0 6.7 10.7 

75years andover . . . . . . . . . . . . . . . . . . . . . . . 12.7 12.2 12.8 12.3 12.3 10.6 

1Includes races other than white and black.


21ncludes unknown respondent-assessed health status.


NOTE Asterisk Indicates relative standard error more than 34 percent. 

SOURCE Olvision of Health InterviewStatistics, National Centerfor Health Statistics Unpublished data from the National Health InterviewSurvey. 

Table 47. Number of mentions of most frequent all.fisted diagnosas for ambulatory patients 55 years and over and rank by sex and age United States, 1980 and 1981 

Number 

R of R of 

n all-listed’ diagnoses, per 1,000 rank n all-listed’ diagnoses, per 1,000 rank 

k and ICD-9-CM codez visits Female Male k and ICD-9-CM codez visits Female Male 

55-64 years 75-84 years 

Essential hypertension . . . . . . . . . . . . . . . 401 167 1 1 Essential hypertension . . . . . . . . . . . . ...401 175 1 1 

Diabetea mellltus . . . . . . . . . . . . . . . . 250 66 2 3 Chronic ischemic heart disease . . . . . ...414 91 2 2 

Chronic lschemic heart diseaee . . . . . . . . 414 42 8 2 Diabetes mellitus . . . . . . . . . . . . . . . . . . ..25IJ 70 4 3 

Osteoarthritis andallled disorders . . . . . . 715 35 3 4 Osteoarthritis andallied disorders . . . ...715 57 3 9 

Neurotic dieordere, . . . . . . . . . . . . . . . . . . 300 31 4 7 Cataract . . . . . . . . . . . . . . . . . . . . . . . . ...366 50 5 7 

Obesity,., . . . . . . . . . . . . . . . . . . . . . . . . . . 278 27 5 11 Heart failure . . . . . . . . . . . . . . . . . . . . . ...428 39 7 4 

Arthropathies, other and unspecified . . . . 716 25 6 9 Arthropathies, other and unspecified . ...716 36 6 14 

6 Disorders of refraction and Cardiac dysrhythmias . . . . . . . . . . . . . ...427 34 8 8 

accommodation . . . . . . . . . . . . . . . . . ...367 22 9 8 Glaucoma . . . . . . . . . . . . . . . . . . . . . . . . .. 365 28 10 13 

9 Acute upper respiratory infectione ... ,. .465 19 10 14 Angina pectoris . . . . . . . . . . . . . . . . . . ...413 26 11 11 

10 Cardiac dyerhythmias . . . . . . . . . . . . . ...427 17 14 6 

85 years and over 

65-74 years 1 Essential hypertension . . . . . . . . . . . . ...401 171 1 2 

Eesentlal hypertension . . . . . . . . . . . . . ..4o1 192 1 1 2 Chronic iechemic heart disease . . . . . ...414 117 2 1 

Diabetes mellitus . . . . . . . . . . . . . . . . . . . .25(I 76 2 3 4 Osteoarthritis andallied disorders . . . ...715 74 3 8 

Chronic ischemic heart disease . . . . . ...414 ez 4 2 2 Cataract . . . . . . . . . . . . . . . . . . . . . . . . . ..3S6 6% 4 3 

Osteoarthritis and related disorders . . ...715 45 3 5 5 Heart failure . . . . . . . . . . . . . . . . . . . . . ...428 65 5 4 

Arthropathies, other and unspecified . ...716 31 5 12 6 Diabetes mellitus . . . . . . . . . . . . . . . . . ...250 49 9 5 

Cataract . . . . . . . . . . . . . . . . . . . . . . . . ...366 29 6 9 7 Cardiac dysrhythmias . . . . . . . . . . . . . ...427 47 10 6 

Hypertensive heart disease . . . . . . . . . . . . 402 24 8 8 8 Atherosclerosis . . . . . . . . . . . . . . . . . ... .44o 37 8 9 

a Age, most frequent mentions Comparable a Age, most frequent mentions Comparable 

Heart failure . . . . . . . . . . . . . . . . . . . . . ...428 24 9 6 9 Arthropathies, other and unspecified . ...716 37 7 13 

Chronic airway obstruction, 10 Hypertensive heart diseaee. . . . . . . . . ...402 37 6 25 

not eleewhere classified. . . . . . . . . . . ...496 22 24 4 

10 Neurotic disorders . . . . . . . . . . . . . . . . . ..3ccI 20 7 26 

— l,iA1l.llsted,, meam Iistad as Ist, 2nd, or 3rd diagnosis.


‘Coded according to the 9th flevision, hr(ernationa/ C/assi//cafion of Diseases,C/hrica/Modification, (Seereference 45.)


SOURCE Dlvlelonof Health CareStatistics, National Centerfor Hesfth Statistics Data from the National Ambulatory Medical CareSurvey. 

59 
Table4S. Numkrofmentions ofaelwteddmgs frequently oderedorprovided forambulatoypstienfs 55yeamofage andover, byage United Statea,l9Wandl98l 

Generic name of drug Therapeutic effect 55-64 years 65-74 years 75-84 years 85years andover 

Number of mentions’ per l,OfXI vlaits 

Hydrochlorothiezide Diuretic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100 122 123 136 

Propranolol Cardiac drug . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 52 43 34 

Aspirin Analgesic, antipyretic, and anti-inflammatory . . . . . . . . . . . . . . . . . 39 39 44 36 

Digoxin Cardiac drug . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33 65 104 135 

Triamterene Diuretic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 39 44 54 

Methyldopa Antihypertensive agent . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29 42 36 �29 

Furosemide Diuretic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 53 63 95 

FOtassium replacement solutions Replacement solution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 32 31 55 

Chlorthalidone Diuretic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 23 24 �16 

Acetaminophen Analgesic andantipyretic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 19 24 �I9 

Nitroglycerine Vaaodilating agent . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 25 31 35 

Isosorbide Vasodilating agent . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78 27 30 “23 

lbuprophen Analgesic andanti-inflammatory . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 20 19 ’20 

Vitamin B12 Vitamin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 24 30 43 

1Includes mentions of an agent as a single-ingredient drug and aa an ingredient of a combination drug. 

NOTE Asterisk indicatea that either the numerator or denominator (i.e.number of drug mentions or number of visits) has a relative standard error more than 30percent. 

SOURCE Division of Health CareStatistics, National Centerfor Health Statistics Data from ths National Ambulatory Msdical CareSurvey. 

m 
I 

Chapter Vlll ~


I Use of health car~are in


short-stay hospitals 

by Mary Moien, National Center for Health Statistics, and 

Barbara Marzetta IA, Northwest Institute 

Introduction 

Although the majority of medical care takes place in 

the ambulatory setting, inpatient care assumes greater importance with increasing patient age. According to estimates from 

the National Medical Care Utilization and Expenditure Survey 

(NMCUES), 23 percent of males and 17 percent of females 

aged 65–74 years who were living in the community were 

hospitalized at some time during 1980 (table 45). For the 

population 75 years of age and over, approximately 25 percent 

of both sexes experienced at least one episode of hospitalization; 9 percent of the population spent a total of 17 days 

or more in the hospital .42 

A characterization of the utilization of inpatient care by 

older persons sheds important light on the general health of 

that segment of the population and on the natural history 

of the aging process. It also provides another perspective 

on recent changes in medical technology and health care delivery, In addition, care in hospitals is of great interest to 

policymakers because of its cost. In 1985 hospital care accounted for 45 percent of national expenditures for personal 

health. care; in terms of public expenditures, 69 percent of 

the Medicare budget went for hospital care.~ 

Source of data 

Data on utilization of short-stay hospitals were collected 

by means of the National Hospital Discharge Survey, a continuous voluntary survey that has been conducted since 1965. 

The data for the survey are obtained from the face sheets 

of a sample of inpatient medical records obtained from a 

national sample of short-stay general and specialty hospitals 

located in the United States. Coding is by the International 

Classification of Diseases, 9th Revision, Clinical il40di@cation.45 (See the appendix for details.) 

Results and comments 

Hospital discharge rates and lengths of stay 

During 1984 an estimated 37 million patients, excluding 

newborn infants, were discharged from non-Federal short-stay 

hospitals. 46 More than 11 million (30 percent) of those discharged patients were 65 years of age or older—a discharge 

rate of 400 per 1,000 population aged 65 years and over. 

Within the aging population, discharge rates increased markedly with advancing age: Expressed per 1,000 population, 

rates were 208 for those aged 55–64 years, 320 for those 

65–74 years, 498 for those 75–84 years, and, finally, 591 

for persons 85 years and over. 

Of the 245 million days of care in 1984, 100 million, 

or 41 percent, were recorded for the population 65 years 

of age and over. The large number of days of care reflects 

both higher hospitalization rates and longer average lengths 

of stay for older persons than for younger persons. Average 

length of stay increased with advancing age from 7.5 days 

for those aged 55-64 years to 9.8 days for those aged 85 

and over. Older people tend to have relatively high rates 

of chronic illness and the older age group has the highest 

proportion of multiple diagnoses, both of which are associated 

with long average lengths of stay. 

From midadolescence through 44 years of age, discharge 

rates for females generally exceed those for males, even when 

deliveries are excluded from consideration .46 However, a reversal of that phenomenon begins to occur in the age groups 

45–54 and 55-64 years. At these ages, the rates are similar 

for both sexes. By ages 65–74, discharge rates have become 

proportionately higher for males, and the disparity increases 

with each progressive age subgroup. For example, the 1984 

discharge rate for males 65 years of age and over was 11 

percent higher than that for females. 46 For the subgroup aged 

85 years and over, the discharge rate for males (682 per 

1,000 population) was 23 percent higher than that for females. 

However, the average lengths of stay for elderly males and 

females were comparable, which suggests equivalent severity 

of illness, albeit for different diagnoses. 

Diagnosis 

For males aged 55 years and over discharged in 1984, 

the most common first-listed diagnosis, which is generally 

the principal diagnosis, was diseases of heart, followed by 

malignant neoplasms and cerebrovascular diseases (table 49). In the subgroup aged 55-64 years, inguinal hernia, 

hyperplasia of the prostate, and alcohol dependence syndrome 

ranked fourth, fifth, and sixth, respectively, in terms of frequent listing. At ages 65–74 years, alcohol dependence syndrome was no longer a leading diagnosis, but eye diseases 

and conditions, a catego~ that includes cataract, became a 

leading diagnosis. In persons 75 years and over, pneumonia 

moved to fourth place, replacing inguinal hernia as a leading 

diagnosis. Finally, in those 85 years of age and over, fractures 

of all sites became the fifth ranking diagnosis. 

A comparison with data from 1979 indicates that the 

discharge rate for diseases of heart remained stable at each 

61

age group. The only significant increases in rates were noted 

for cerebrovascular diseases and pneumonia among males 85 

years and over. 

From 1979 to 1984, average lengths of stay for men 

decreased for most of the previously mentioned diagnoses 

within all age groups (table 49). Decreases of approximately 

2 days were observed for diseases of heart and malignant 

neoplasms in the subgroup 65 years and over. Interestingly, 

too, the diagnosis-specific age gradient in the length of stay 

diminished over time. In 1984, the only diagnosis for which 

the average length of stay was remarkably longer at older 

ages was hyperplasia of the prostate. 

For females discharged in 1984, diseases of heart was 

also the most common first-listed diagnosis for all older age 

groups (table 50). Next in rank for females 55–64 years of 

age were malignant neoplasms, diabetes, cerebrovascular diseases, fractures of all sites, and cholelithiasis. The rankings 

shifted gradually in older cohorts. For women 65–74 years 

and 75–84 years, cholelithiasis was no longer a leading diagnosis, but eye diseases and conditions had increased. By 85 

years of age and over, fractures of all sites was the second 

most frequently listed diagnosis, followed by cerebrovascular 

diseases, pneumonia, malignant neoplasms, and eye diseases 

and conditions (including cataracts). In terms of average length 

of stay, the previously mentioned observations concerning 

time trends and age gradients for males generally also apply 

to females. In addition, large average length-of-stay decreases 

from 1979 to 1984 were noted for fractures, all sites. 

In recent years death rates for ischemic heart disease 

have been declining (table 5). Hospital utilization rates for 

acute myocardial infarction, however, either remained the 

same or increased very slightly from 1979 to 1984 (table 51). On the other hand, average length of stay for acute 

myocardial infarction decreased for both sexes and most age 

subgroups of the population 65 years and over. This decrease 

in length of stay was apparent for a number of diagnoses, 

however, and was not unique to acute myocardial infarction. 

Hip fracture (fracture of neck of femur) is a significant 

health problem for the aged, especially older women (table 52). Fractures, all sites, is a leading diagnosis for men 

only in the oldest age group (85 years and over), but it 

is a leading diagnosis for each subgroup of women from 

age 55 upward. In fact, by age 85 years and over, almost 

two-thirds of all fractures for both men and women are hip 

fractures. The overall rates of hospitalization for hip fracture 

are significantly higher for older women than for men at 

each age subgroup, but the gap between men and women 

seems to be narrowing in the subgroup aged 75–84 years. 

In 1979, the rate of hip fracture for females aged 75–84 

was almost three times that for males in this age group, 

but in 1984 the rate for females was not quite twice that 

for males. 

Surgical rates for open reduction of fracture of the femur 

with internal fixation showed no significant changes from 

1979 to 1984. In women, the rates for 1979 and 1984 were 

153.9 and 201.4 per 100,000 for ages 65–74, 582.8 and 

590.6 per 100,000 for ages 75–84, and 1,386.7 and 1,375.7 

per 100,000 for ages 85 years and over. Small numbers resulted 

in unstable rates for males. 

62 

Surgical and nonsurgical procedures 

In 1984, almost 21 million patients underwent a surgical 

or nonsurgical Procedure as a hospital inpatient .46 Almost 

5.6 millio~of th&e patients were 65 years and older. Relatively 

high proportions of persons in the age groups 1544 and 

45-64 years underwent a procedure (64 and 57 percent, respective y). Only about one-half of persons aged 65 years and 

over underwent a procedure. Of the elder]y who had a procedure approximately 70 percent had a surgical procedure. 

The leading surgical procedures for males 65 years and 

older in 1984 were prostatectomy and extraction of lens (table 53). Leading surgical procedures for the age subgroups 

are somewhat different, with cardiac catheterization, followed 

by repair of inguinal hernia and prostatectomy, leading in 

the age group 55-64 years; prostatectomy, followed by cardiac 

catheterization, in the age group 65–74 years; prostatectomy 

and extraction of lens in the age groups 75–84 and 85 years 

and over. 

For all females 65 years and over and for the two subgroups 

65–74 and 75–84 years, extraction of lens was the leading 

surgical procedure. This procedure was not among the leading 

procedures for women 55-64 years, for whom the top three 

were cardiac catheterization, hysterectomy, and cholecystectomy. By age 85 years and over, the lens procedures shared 

the lead with reduction of fracture (table 54). 

Because of technological breakthroughs, the number of 

nonsurgical procedures performed has increased in recent 

years. For all men 65 years and over and for each age subgroup, 

cystoscopy, computerized axial tomography (CAT scan), and 

radioisotope scan were the leading procedures in 1984 (table 55). In contrast, for the age group 55–64 years, angiocardiography was among the top three procedures and 

radioisotope scan was not. For females, also, CAT scan and 

radioscope scan were leading procedures (table 56). In addition, diagnostic ultrasound and endoscopy of large intestine 

were ranked higher on the leading procedures chart for females 

than for males. When these leading procedures were calculated 

into population rates, however, the rates were either higher 

for males or equal to those for females in each case. For 

no procedures cited were the rates higher for females. 

Data on surgical procedures performed on hospitalized 

older persons show several interesting changes from 1979 

to 1984. For males, the rate of cardiac catheterization doubled 

in the age group 55-64 and more than tripled for those 65–74 

years of age (table 53). Although the procedure was performed 

far less frequently in females, the time trend for them was 

similar. Although the rate for extraction of lens stabilized 

for men, it continued to increase for women 75 years and 

over. Rates for arthroplasty and hip replacement also increased 

among these women. Data on nonsurgical and diagnostic procedures show a huge increase over time in the rates at which 

CAT scans and diagnostic ultrasound were performed (tables 55 and 56). Rates for arteriography also increased markedly, particularly for older males (table 55). 
I 

I	 Outcoms of hwpitsktion and difipmMon of 

Cnscharges 

In 1984, 957,000 deaths were recorded among discharges 

from short-stay hospitals-2.6 percent of the discharged popuIation.ti Patients aged 65 years and over accounted for 689,000 

deaths, or 72 percent of the total recorded. Indeed, the hospital 

fatality rate for patients 65 years and over was 6.1 per 100 

discharges, compared with a rate of 1.0 px 100 discharges 

for the group of patients under 65 years of age. Hospital 

fatality rates in the age group 65 years and over were higher 

for males (6.9 per 100 discharges) than for females (5.6 

per 100 discharges). 

For persons aged 65 years and over, the highest fatality 

rates were recorded for the diagnoses of nephritis, nephrotic 

syndrome, and nephrosis (26.1 per 100 discharges) and acute 

myocardial infarction (22.4 per 100 discharges). Other high 

fatality rates for this older group were attributed to malignant 

neopksms (12.7 per 100 discharges), cardiac dysrhythmias 

(12.7 per 100 discharges), pneumonia (11.5 per 100 discharges), and cerebrovascular diseases (10.0 per 100 

discharges). 

Of persons aged 65–74 years discharged in 1983, 84 

percent were classified as “routine” discharges (generally, 

discharged home); 4 percent were discharged to long-term 

care facilities; and 5 percent were discharged dead. In contrast 

only 60 percent of the group 85 years of age and over were 

discharged routinely; 23 percent were discharged to long-term 

care facilities, and 11 percent were discharged dead.47 

a3 
Table49. Numberof patientsdischarged,rate of discharges,dayaof care, andaveragelengthof stayformales 55 yeareof age and over,by age and selectedfirst4isted 

diagnoses UnitedStates, 1979and 1964 

[Discharges from rron.Federalshort-stay hospitals] 

Age, diagnosis, and ICD-9-CM code’ 

55-64 years 

Diseases of heart. . . . . . . . . . . ..391 -392.0. 393-396, 

402,404,410-416,420-429 

Malignant neoplaams. . . . . . . . ...140-208.230-234 

lnguinal hernia . . . . . . . . . . . . . . . . . . . . . . . . . ...550 

Cerebrovascular diseaae . . . . . . . . . . . . . . . . 430-438 

Hyperplasiaof prostate . . . . . . . . . . . . . . . . . . ...600 

Alcohol dependence syndrome . . . . . . . . . . . . . . . 303 

65 years and over 

Diseases of heart. . . . . . . . . . . . .391 -392.0. 393-396, 

402,404,410-416,420-428 

Malignant neoplasms. . . . . . . . ...140-208.230-234 

Cerebrovascular disease . . . . . . . . . . . . . ...430-438 

Hyperplasiaof prostate . . . . . . . . . . . . . . . . . . ...600 

Pneumonia, allsites . . . . . . . . . . . . . . . . . ...460-466 

Eye diseases, conditions . . . . . . . . . . . . . . . . 360-379 

65-74 years 

Diseases of heart . . . . . . . . . . ...391-392.0.393-396. 

402,404,410-416,420-429 

Malignant neoplasms . . . . . . . . . . . 140-206,230-234 

Cerebrovascular disease . . . . . . . . . . . . . . . . 430-438 

Hyperplasia of prostate . . . . . . . . . . . . . . . . . . ...600 

Eye diseases, conditions . . . . . . . . . . . . . ...360-379 

Inguinal hernia . . . . . . . . . . . . . . . . . . . . . . . . . ...550 

75 years and over 

Diseases of heart. . . . . . . . . . . . .391 -392.0. 393-396, 

402,404,410-416,420-428 

Malignant neoplasms . . . . . . . . . . . 140-206,230-234 

Cerebrovascular diseaae . . . . . . . . . . . . . . . . 430-436 

Pneumonia, all forms . . . . . . . . . . . . . . . . ...460-466 

Hyperplasia of prostate . . . . . . . . . . . . . . . . . . ...600 

Eye diseases, conditions . . . . . . . . . . . . . ...360-379 

75-84 years 

Diseasea of heart . . . . . . . . . . . . .391 -392.0. 393-398, 

402,404,410-416,420-429 

Malignant neoplaams. . . . . . . . ...140-206.230-234 

Cerebrovascular diaeaae . . . . . . . . . . . . . . . . 430-436 

Pneumonia, all forms . . . . . . . . . . . . . . . . ...460-466 

Hyperplasia of prostate . . . . . . . . . . . . . . . . . . ...600 

Eye diseases, conditions . . . . . . . . . . . . . . . . 360-379 

65 years and over 

Diseases of heart. . . . . . . . . . . ..391 -392.0. 393-396, 

402,404,410-416,420-428 

Malignant neoplasms . . . . . . . . . . . 140-206,230-234 

Cerebrovascular disease . . . . . . . . . . . . . . ..430-436 

Pneumonia, all forms . . . . . . . . . . . . . . . . ...480-466 

Fracturee, allsites . . . . . . . . . . . . . . . . . . ...600-829 

Hyperplasia of prostate . . . . . . . . . . . . . . . . . . ...600 

Average 

Discharges Days of care /errgfh of stay .— 

1979 1984 1979 1984 1979 1984 19i9 1984 

.,..—L--. — . . ––, Numuer m mmoer per Number in Stay 

thousands l,COOpopulation thousanda in days 

424 492 42.2 47.0 3,745 3,608 6.6 7.3 

195 212 19.4 20.3 2,256 2,151 11.6 10.1 

76 70 7.6 6.7 441 281 5.6 4.1 

65 75 6.4 7.2 663 702 10.3 9.3 

56 65 5.8 6.2 437 406 7.5 6.3 

55 35 5.5 3.4 554 339 10.0 9.6 

769 949 75.7 64.0 7,658 7,637 10.2 6.1 

463. 534 45.6 47.2 5,955 5,692 12.9 10.7 

235 298 23.2 26.4 2,963 2,956 12.6 9.9 

159 190 15.7 16.8 1,6W 1,480 10.4 7.8 

130 177 12.8 15.6 1,407 1,659 10.6 9.4 

127 161 12.5 14.2 493 426 3.9 2.6 

4ca 524 61.4 71.6 4,125 4,120 10.1 7.9 

273 289 41.1 40.8 3,433 3,107 12.6 10.4 

108 125 16.2 17.1 1,296 1,228 12.1 9.6 

97 111 14.6 15.1 9Q3 766 9.3 6.9 

69 79 10.4 10.7 264 210 3.6 2.7 

6a 65 10.2 8.9 425 289 6.3 4.4 

360 424 102.8 106.6 3,732 3,516 10.4 8.3 

190 235 54.3 59.0 2,522 2,665 13.2 11,0 

128 174 36.5 43.6 1,665 1,728 13.0 10.0 

77 108 22.0 27.4 640 1,063 10.9 9.7 

62 79 17.6 19.9 756 711 12.3 9.0 

56 82 16.7 20.7 228 216 3.9 2.6 

275 316 97.1 86.4 2,684 2,609 10.5 6.3 

154 187 54.3 5a.1 2,044 2,078 13.3 11.1 

96 124 34.0 38.7 1,265 1,240 13,2 10.0 

54 71 18.9 22.1 539 644 10.1 9.1 

50 64 17.8 20.0 595 544 11.8 8.5 

47 65 16.6 20.2 160 173 3.8 2.7 

66 106 126.7 140.5 649 906 9.9 8.4 

37 4s 54.5 62.5 476 507 13.0 10.5 

32 49 46.9 64.0 398 466 12.6 9.9 

24 3a 35.1 49.2 302 416 12.7 11.0 

17 19 25.0 24.0 26s 247 15.9 13.4 

11 15 16.8 19.3 163 167 14.3 11.2 

kocfed according to the 9fh Revision, hrfematkmal Classification of Diseases,C/hrica/Modification. (Sea reference 45.)


SOURCE: Division of Health Care Statistics, National Center for Health Statistics Unpublished data from the National Hospital Discharge Survey,


64 
Table WI. Number of patienta discharged, rate of discharges, dsys of care, and avarage length of stay for femafes 55 yaara of age and over, by age and selected firstIiafad diagnose.% United Statea, 1979 and 1964 

[Discharges from nonfederal shorl.stay hospitals] 

Average 

Discharges Days of care /ength of stay 

Age, diagnosis, and ICD-9-CM code’ 1979 1984 1979 1984 1979 1984 1979 1984 

Number in Number per Number in Stay 

55-64 years thousands 1,000 population thousands in days 

Diseases of heart . . . . . . . . . . . . .391-392.0,393-398, 

402,404,410-416,420-429 265 295 23.2 24.9 2,450 2,227 9.2 7.5 

Mallgnant neoplasms . . . . . . . . . . . 140-208,230-234 226 278 19.8 23.5 2,669 2,457 11.9 6.8 

Diabetes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...250 76 Oa 6.6 5.8 739 55Q 9.7 8.0 

Fractures, allsites . . . . . . . . . . . . . . . . . . ...800-829 62 62 5.5 5.3 717 567 11.5 9.1 

Cholelithiasis . . . . . . . . . . . . . . . . . . . . . . . . . . ...574 57 50 5.0 4.2 533 382 9.4 7.6 

Cerebrovascular disease . . . . . . . . . . . . . . . . 430-438 54 64 4.8 5.4 609 650 11.2 10.2 

65 years and over 

Diseases of heart . . . . . . . . . . . ..391 -392.0. 393-398, 

402,404,410-416,420-429 916 1,161 61.1 69.3 9,910 10,022 10.6 8.6 

Malignant neoplasms. . . . . . . . ...140-208.230-234 421 536 28.1 32.0 5,842 5,774 13.9 10.8 

Cerebrovascular disease. . . . . . . . . . . . . ...430-438 319 369 21.3 22.0 4,109 3,953 12.9 10.7 

Fractures, all sites . . . . . . . . . . . . . . . . . . ...800-629 291 321 19.4 19.2 4,760 4,209 16.4 13.1 

Eye diseases, conditions. . . . . . . . . . . . . ...360-379 235 326 15.7 19.6 971 872 4.1 2.7 

Diabetes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..2WI 159 152 10.6 9.1 2,022 1,532 12.8 10.1 

65-74 years 

Diseases of heart . . . . . . . . . . . . . 391-392.0,393-398, 

402,404,410-416,420-429 373 472 43.0 50.1 3,946 4,034 10.6 6.5 

Malignant neoplasms . . . . . . . . . . . 140-208,.230-234 230 285 26.5 30.3 2,975 2,630 12.9 9.9 

Cerebrovascular disease . . . . . . . . . . . . . . . . 430-438 108 125 12.4 13.3 1,287 1,346 11.9 10.8 

Eye diseases, conditions . . . . . . . . . . . . . ...360-379 105 126 12.1 13.3 422 343 4.0 2.7 

Fractures, allsites . . . . . . . . . . . . . . . . . . ...800-829 93 w 10.7 10.5 1,313 1,159 14.1 11.7 

Diabetes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...250 91 86 10.5 9.1 1,179 664 12.9 10.3 

75 years and over 

Diseases of heart. . . . . . . . . . . . .391 -392.0. 393-398, 

402,404,410-418,420-429 542 669 66.2 94.2 5,963 5,966 11.0 8.7 

Cerebrovascular disease . . . . .. . . . . . . . . . . . 430-438 211 243 33.5 33.3 2,822 2,605 13.4 10.7 

Fractures, allsites . . . . . . . . . . . . . . . . . . ...800-829 198 222 31.5 30.4 3,466 3,050 17.5 13.7 

Malignant neoplasms . . . . . . . . . . . 140-206,230-234 190 251 30.2 34.3 2,667 2,943 15.1 11.7 

Eye diseases, condition . . . . . . . . . . . . . . . . 360-379 130 203 20.7 27.7 549 528 4.2 2.6 

Pneumchia, all forms . . . . . . . . . . . . . . . . ...460-466 80 136 12.8 18.6 W4 1.405 TO.8 10.3 

75-84 years 

Diseases of heert . . . . . . . . . . . . . 391-392.0,393-398, 

402,404,410-416,420-429 376 495 78.9 91.6 4,153 4,255 11.0 8.6 

Malignant neoplasms . . . . . . . . . . . 140-206,230-234 146 201 31.0 37.1 2,255 2,307 15.2 11.5 

Cerebrovascular disease . . . . . . . . . . . . . . . . 430-438 140 156 29.5 26.9 1,846 1,716 13.2 11.0 

Fractures, allsites . . . . . . . . . . . . . . . . . . . ..800-829 119 127 25.0 23.4 1,962 1,701 16.6 13.4 

Eye diseases, conditions. . . . . . . . . . . . . ...360-379 104 154 27.7 28.5 428 406 4.1 2.6 

Diabetes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...250 53 53 11.2 9.7 661 528 12.4 10.0 

85 years and over 

Diseases of heart . . . . . . . . . . . . . 391-392.0,393-396, 

402,404,410-416,420-429 166 194 109.2 101.8 1,610 1,733 10.9 6.9 

Fractures, all sites . . . . . . . . . . . . . . . . . . ...800-829 79 96 51.7 50.3 1,464 1,349 18.9 14.1 

Cerebrovascular diaease . . . . . . . . . . . . . ...430-436 70 67 46.1 45.8 975 669 13.9 10.2 

Malignant neoplasms . . . . . . . . . . . 140-206,230-234 42 50 27.8 26.3 612 636 14.5 127 

Pneumonia, all forms . . . . . . . . . . . . . . . . . ..460-466 33 66 21.5 30.4 337 616 10.3 10.7 

Eye diseases, conditions. . . . . . . . . . . . . ...360-379 27 46 17.4 25.5 121 123 4.6 2.5 

lCoded according to the 9th Revision,hrternatlonal C;assificatlon of Diseaaes,Cfinlcal Modification. (Seereference 45.) 

SOURCE Division of Health Care Statistics, National Center for Health Statistics Unpubfishad data from the National Hospital Discharge Survey. 

65 
Table 51. Number of patients discharged, rate of discharge, and average length of stay for persons 56 yeara of ege and over with a diagnosis of acute myocardial 

infarction, by sex and age United States, 1979, 1982j and 1984 

[Discharges from nonfederal shorktay hospitals] 

Dischages Average /ength of stay 

Sex and arre 1979 1982 1984 1978 1882 1984 1979 1982 1984 

Both sexes Number in thousands Number per 1,000 population Stay in daya 

55-64 years . . . . . . . . . . . . . . . . . . . 165 191 166 8.6 8.6 8.4 12.8 11.0 10.0 

65years andover . . . . . . . . . . . . . . . 363 449 461 14..5 16.7 17.2 13.4 12.3 10.8 

65-74 years . . . . . . . . . . . . . . . . . . 166 220 242 12.1 13.6 14.4 13.3 12.5 10.6 

75years andover . . . . . . . . . . . . . . . 177 229 239 18.1 21.4 21.3 13.5 12.1 11.1 

75-64 years . . . . . . . . . . . . . . . . . . 136 175 164 17.9 21.2 21.4 13.7 11.7 10.8 

65years andover . . . . . . . . . . . . . . . 41 54 55 18.8 22.1 20.9 12.7 13.5 11.9 

Male 

55-64 years . . . . . . . . . . . . . . . . . . . 122 129 131 12.2 12.5 12.5 12.7 11.0 9.6 

65years andover . . . . . . . . . . . . . . . 190 234 247 18.7 21.7 21.8 13.0 11.7 10.3 

65-74 years . . . . . . . . . . . . . . . . . . 109 131 143 16.3 18.6 19.5 12.5 11.9 10.1 

75years andover . . . . . . . . . . . . . . . 81 103 104 23.2 27.3 26.2 13.6 11.3 10.6 

75-S4years . . . . . . . . . . . . . . . . . . 65 63 82 23.0 27.2 25.6 13.2 11.1 10.3 

85years andover . . . . . . . . . . . . . . . 16 20 21 24.2 27.6 26.4 15.4 12.4 11.6 

Female 

55-64 years . . . . . . . . . . . . . . . . . . . 63 62 57 5.5 5.2 4.8 13.1 11.1 10.9 

65years andover . . . . . . . . . . . . . . . 173 216 234 11.6 13.4 14.0 13.8 13.0 11.3 

65-74 years . . . . . . . . . . . . . . . . . . 77 90 99 8.9 9.8 10.5 14.3 13.2 11.1 

75years andover . . . . . . . . . . . . . . . 96 126 135 15.2 18.2 18.6 13.5 12.8 11,5 

75-84 years . . . . . . . . . . . . . . . . . . 71 92 102 14.9 17.7 18.8 14.4 12.3 11.3 

85years andover . . . . . . . . . . . . . . . 25 34 33 16.5 19.8 17.9 10.9 14.1 12.1 

NOTE Acute myocardial infarction comprises code 410 of the 9th Revision,hrtemational Classification of Diseaaes,Clinical Modification. (Seereference45.) 

SOURCE Division of Health Care Statistic, Nationsl Centsr for Hsalth Statistics Unpublished data from the National Hospital Discharge Survey. 

Table 52. Rate of patienta discharged with a diagnosis of fractures, all aitea, and hip fracture (fracture of neck of famur) for persona 55 yeare of age and over, by sex and 

ag= United States, 1979 and 19S4 

[Discharges from nonfederal short-stay hospitals] 

Fractures, all sites Hip fracture 

Sex and age 1978 1984 19KJ 1984 

Male Number of discharges per l,CKrOpopulation 

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.4 3.1 ‘0.5 “0.6 

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.8 5.3 “1.4 2.0 

75-S4years . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.8 12.7 4.5 6.6 

85years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27.3 24.0 16.6 15.0 

Femala 

55-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.5 5.3 ‘0.9 1.1 

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11.0 10.5 3.6 3.4 

75-S4yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29.6 23.4 12.2 12.0 

85years andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62.3 50.3 32.8 32.0 

NOTES Fractures, all sites, comprise codes WI-82S of the 9th Revkiorr,Infernatiorrd C/assif/cation of D/seases,Clfnical Modificatim and hip fracture comprisas code 8’20 (8ee reference45.) 

Asterisk indicatea sample size of 30-59 or ralafive standard error more than 30 percent. 

SOURCE Oiviaion of Health Care Stafiaffcs, National Center for Health Statistics Unpublished data from the National Hospital Discharge Survey. 

66 
I 

Table 53. Number and rata of surgical procedures for males 55 years of age and over discharged from short-stay hospitals, by age and selected procedures 

United States, 1979 and 1984 

[Discharges from nonfederal short.stay hospitals] 

Age, procedure categorfi and ICD-9-CM code’ 7979 1984 1979 1984 

55-64 years Number of procedures Number of procedures 

in thousands per 10,000 population 

Repair of Inguinal hernia. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...53.0-53.1 79 74 78.3 70.4 

Cardiac catheterization.........,.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37.21 -37.23 62 116 62.2 112.6 

Prostatectomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...60.2-60.6 59 70 56.9 67.1 

Direct heart revascularlzation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..36.1 39 60 39.3 57.4 

Extraction of lens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...13.1-13.6 32 29 31.4 27.7 

65 years and over 

Prostatectomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...60.2-60.6 218 275 214.6 243.3 

Extraction of lens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...13.1-13.6 108 132 1C6.O 116.6 

Repair oflnguinai hernia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...53.0-53.1 112 120 109.9 106.2 

Pact?maker lnsertion2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...37.7-37.8 62 64 61.0 74.6 

Cardiac catheterization . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . 37.21 -37.23 29 101 28.6 89.1 

65-74 years 

Prostatectomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..60.2-6fJ.6 122 151 183.0 2(26.9 

Repair ofingulnal hernia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..53.o-53.1 72 68 107.6 93.2 

Extraction of lens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...13.1.-13.6 56 65 85.0 88.8 

Pacemaker insertion. , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...37.7-37.8 23 40 35.3 55.3 

Cardiac catheterization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .37.21 -37.23 22 83 33.8 113.8 

75 years and over 

Prostatectomy, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...60.2-60.6 96 124 274.6 310.3 

Extraction of lens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...13.1-13.6 51 67 145.8 167.8 

Repalrof lngulnal hernia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...53.0-53.1 40 52 114.4 130.0 

Pacemaker insertion. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...37.7-37.8 39 44 109.9 110.2 

Cholecystectomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51.2 17 23 47.7 57.4 

75-84 years 

Prostatectomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...60.2-60.6 79 102 279.4 317.3 

Extraction of lens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13.1-13.6 42 51 146.9 15a.4 

Repalrof ingulnal hernia, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...53.0-53.1 32 45 111.9 139.3 

Pacemaker lnaertionz . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...37.7-37.8 31 32 107.9 101.0 

Cholecystectomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..5I.2 14 19 48.0 60.7 

85 years and over 

Prostatectomy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...60.2-60.6 17 22 254.6 281.1 

Extraction of lens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...13.1-13.6 10 16 140.7 207.2 

Repair ofinguinal hernia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .53.0+3.1 8 7 124.9 91.4 

Pacemaker insertlon2 .,..,,,,,.,.. . . . . . . . . . . . . . . . . . . . . . . . . . . . ...37.7-37.8 8 11 118.2 148.5 

Reduotion of fractures. . . . . . , . . . . . . . . . . . . ., , ,....76.70,76.78-76.79, 79.0-79.6 8 9 113.9 113.0 

1Coded according to the9th Revislorr,/nterrrat/ona/ C/assificafion of Diseases,C/irrica/Mod/f/cat/on. (Seereferance 45.) 

Zlncludlng replacement, remcwd, and rePak 

3Excluding skull, nose, and jaw, 

SOURCE DMalon of Health Care Statistics, National Center for Health Statistics Unpublished data from the National Hospital Discharge Survey. 

67 
Table 54. Number and rate of surgical procedures for females 55 yeare of age and over discharged from short.stay hospitals, by age and selected procedures 

United States, 1979 and 1984 

[Discharges from non-Federalshort.stay hospitals] 

Age, procedure categorfi and ICD-9-CM code’ 1979 1984 1979 1984 

I 

55-64 years Number of procedures Number of procedures 

in thousands per 10,000 population 

Diagnostic dilation and curettage of uterus . . . . . . . 69.09 

Cholecyatectomy . . . . . . . . . . . . . . . . . . . . . . . . . . ...51.2 

Hysterectomy . . . . . . . . . . . . . . . . . . . . . . . . ...68.3-68.7 

Reduction of fracturez . . . . . 76.70,76.76-76.79,79.0-79.6 

Oophorectomy and salpingo-oophorectomy . . . 65.3-65.6 

65 yeara and over 

Extraction oflena . . . . . . . . . . . . . . . . . . . . . ...13.1-13.6 

Reduction of fracture2 . . . . . 76.70,76.78-76.79,79.0-79.6 

Cholecystectomy . . . . . . . . . . . . . . . . . . . . . . . . . . ...51.2 

Arthroplasty and replacement of hip . . . . . . ...81.5.61.6 

Pacemaker insertion3 . . . . . . . . . . . . . . . . . . . . . 37.7-37.8 

65-74 years 

Extraction of lens . . . . . . . . . . . . . . . . . . . . . ...13.1-13.6 

Reduction of fracturez . . . . .76.70,76.78-76.79, 79.0-79.6 

Cholecystectomy . . . . . . . . . . . . . . . . . . . . . . . . . . ...51.2 

Hysterectomy . . . . . . . . . . . . . . . . . . . . . . . . ...68.3-68.7 

Cardiac catheterization . . . . . . . . . . . . . . . . . . 37.21-37.23 

75 years and over 

Extraction of lens . . . . . . . . . . . . . . . . . . . . . ...13.1-13.6 

Reduction of fracture2 . . . . 76.70,76.78-76.79,79.0-79.6 

Arthroplasty and replacement of hip . . . . . . . . . 81.5-81.6 

pacemaker insertion3 . . . . . . . . . . . . . . . . . . . . . 37.7-37.8 

Cholecyatectomy . . . . . . . . . . . . . . . . . . . . . . . . . . ...51.2 

75-84 years 

Extraction of lens . . . . . . . . . . . . . . . . . . . . . ...13.1-13.6 

Reduction of fracturez.. . ..76.70.76.78-76.79, 79.0-79.6 

Pacemaker insertion3 . . . . . . . . . . . . . . . . . . . . . 37.7-37.8 

Arthroplasty and replacement of hip . . . . . . . . . 81.5-81.6 

Cholecyatectomy . . . . . . . . . . . . . . . . . . . . . . . . . . ...51.2 

85 years and over 

Reduction of fracturez . . . . . 76.70,76.78-76.79,79.0-79.6 

Extraction of lens . . . . . . . . . . . . . . . . . . . . . ...13.1-13.6 

Arthroplasty and replacement of hip . . . . . . . . . 81.5-81.6 

Pacemaker insertions . . . . . . . . . . . . . . . . . . . . . 37.7-37.8 

Cholecyatectomy . . . . . . . . . . . . . . . . . . . . . . . . . . ...51.2 

59 31 

55 .50 

47 51 

40 38 

3a 44 

198 277 

133 145 

77 91 

73 104 

66 80 

87 100 

47 56 

45 57 

29 43 

15 57 

110 177 

86 68 

46 72 

43 66 

32 34 

89 136 

52 54 

30 41 

29 44 

25 29 

34 35 

22 41 

17 27 

13 16 

7 5 

51.6 26.1 

48.2 42.0 

41.5 43.2 

34.9 32.3 

33.0 37.4 

132.1 165.6 

66.7 86.5 

51.4 54.3 

48.7 62.2 

45.6 47.8 

100.7 106.0 

53.7 59.6 

51.6 60.1 

33.1 46.0 

17.5 60.0 

175.5 242.4 

137.2 120.8 

73.6 96.1 

66.1 76.9 

50.9 468 

185.7 251.5 

109.9 99.1 

63.5 74.9 

61.7 82.2 

53.2 53,1 

222.6 182.6 

143.6 216.6 

111.9 143.2 

62.8 62.5 

43.5 26.6 

1Ceded according to the 9th Revision,international Classification of Diseases,Clinical Modification. (Seereference45.)


‘Excluding skull, nose, and jaw.


31ncludingreplacement, removal,and repair.


SOURCE Oivisionof Health CareStatistics, National Centerfor Health Statistics Unpublished data from the National Hospital OiachargeSurvey. 

68 
Tabla 55. Number and rate of diagnoatis and other nonsurgical procedures for male hospital discharges 5Syeare of age and over,by age and selected procedures 

United Statea, 1979 and 1984 

[Dischargesfromnonfederal short-stayhospitals] 

Age, procedure categor~ and ICD-9-CM code’ 1979 1984 1979 1984 

55-64 years Number of procedures Number of procedures 

in thousande per 10,000population 

CyStOSCOpy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..57.31 -57.32 

Anglocardiography using contrast material. . . . . . . . . . . . . . . . . . . . . . . ...88.5 

Radioisotope scan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...92.0-92.1 

Arterlography using contrast material. . . . . . . . . . . . . . . . . . . . . . . . . . . ...88.4 

Endoecopyof large intestine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .45.21-45.24 

Computerized axial tomography (CATscan) . ...87.03.87.41,87.71, 88.01,88.38 

65 years and over 

CJfstoscopy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..57.31 -57.32 

Radlolsotope scan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...92.0-92.1 

Endmscopyof large intestine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45.21-45.24 

Arterlography using contrast material. . . . . . . . . . . . . . . . . . . . . . . . . . . ...88.4 

Diagnostic ultrasound. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...88.7 

Computerized axial tomography (CATscan). . . . 87.03,87.41,87.71,68.01, 88.38 

65-74 years 

Cystoscopy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .57.31 -57.32 

Radlolsotope scan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...92.0-92.1 

Endoacopy oflarge intestine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45.21-45.24 

Arterlography ueing contrast material.. . . . . . . . . . . . . . . . . . . . . . . . . . ...88.4 

Dlagnostlc ultrasound . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...88.7 

Computerized axial tomography (CATscan) . . . . 67.03,87.41,87.71,86.01,68.38 

75 years and over 

Cyatoscopy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..57.31 -57.32 

Radlolaotope scan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...92.0-92.1 

Endoscopy of large Intestine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .45.21-45.24 

Diagnostic ultrasound. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...88.7 

Arterlography ualng contrast material . . . . . . . . . . . . . . . . . . . . . . . . . . . ...88.4 

Computerized axial tomography (CATscan) . . . . 87.03,87.41,87.71,88.01, 88.38 

75-84 years 

cye.toscop y . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .57.31-57.32 

Radioisotope scan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...92.0-92.1 

Endoscopy oflarge intestine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..45.21 -45.24 

Arteriogtiaphy using contrast material.. . . . . . . . . . . . . . . . . . . . . . . . . . ...88.4 

Diagnostic ultrasound . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...66.7 

Computerized axial tomography (CATscan) . ...87.03.87.41,87.71, 88.01,88.38 

85 yeara and over 

Cystoscopy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .57.31-57.32 

Radioisotope acan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...92.0-92.1 

Endoscopyof]arge intestine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..45.21 -45.24 

Olagnostic ultrasound . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...88.7 

Computerized axial tomography (CATscan) . ...87.03.87.41,87.71, 86.01,88.38 

Endoscopyof small intestine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45.11-45.13 

99 95 98.6 W.6 

54 107 53.6 101.9 

52 71 52.2 67.9 

47 64 47.3 61.0 

45 43 45.2 41.5 

17 87 16.5 82.7 

259 316 255.4 280.0 

105 171 103.0 151.8 

83 134 82.2 119.0 

59 130 58.0 115.5 

36 140 35.0 124.1 

33 224 32.4 186.3 

145 163 218.3 222.6 

60 84 80.1 115.1 

51 66 76.5 89.8 

46 75 69.2 102.2 

21 70 31.7 86.2 

20 109 30.7 146.7 

114 153 326.1 385.5 

45 87 127.4 219.1 

33 69 93.1 172.7 

14 70 41.2 175.4 

13 56 36.8 139.9 

12 115 35.6 289.5 

90 127 316.7 397.1 

36 67 126.7 207.7 

26 56 92.9 174.4 

12 48 43.8 149.6 

11 56 40.1 175.3 

10 88 35.6 274.2 

25 26 365.4 337.4 

9 21 130.2 266.7 

6 13 93.7 165.7 

3 14 45.9 175.4 

2 27 35.9 353.1 

2 12 30.2 159.4 

1Coded according to the 9th Rev/s/on, hrternat/ona/ C/ass/f/cat/on of Diseases, C//n/ca/Modification. (See reference45.)


SOURCE Division of Health CareStatistics, National Center for Health Statistics Unpublished data from the National Hospital DischargeSurvey.


69 
Table 56. Numbar and rata of diagnostic and other nonsurgical procedures for female hospital discharges 55 years of age and over, by age and selected procedures 

United States, 1979 and 1984


[Discharges from non-Federalshort.stay hospitals]


Age, procedure category and ICD-9-CM code’ 

55-64 years 

Radioisotope scan. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..92.O-92.l 

Cystoscopy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..57.37 -57.32 

Endoscopyof large intestine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .45.21 -45.24 

Arteriography using contrast material . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...68.4 

Angiocardiography using contrast material . . . . . . . . . . . . . . . . . . . . . . . . . .66.5 

Computerized axial tomography (CAT scan) . . . . .67.03,87.41,87.71,68.01, 66.36 

65 years and over 

Radioisotope scan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...92.0-92.1 

Endoscopyof large intestine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .45.21 -45.24 

Cystoscopy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..57.31 -57.32 

Arteriography using contrast material . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .88.4 

Diagnostic ultrasound . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...66.7 

Computerized axial tomography (CAT scan) . . . . .87.03,87.41,87.71,88.01, 68.38 

85-74 yeara 

Radioisotope scan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..92.O.92.l 

Endoscopy oflarge intestine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .45.21 -45.24 

Cystoscopy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..57.31 -57.32 

Arteriography using contrast material. . . . . . . . . . . . . . . . . . . . . . . . . . . . ...68.4 

Diagnostic ultrasound . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...86.7 

Computerized axial tomography (CAT scan) . . . . .87.03,87.41,67.71,88.01, 86.38 

75 years and over 

Radioisotope scan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...92.0-92.1 

Endoscopy of large intestine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..45.21 -45.24 

Cystoscopy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .57.31 -57.32 

Arteriography using contrast msterial . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...88.4 

Diagnostic ultrasound . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...88.7 

Computerized axial tomography (CAT scan) . . . . .87.03,87.41,87.71,88.01, 643.38 

75-84 years 

Radioisotope scan. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...92.0-92.1 

Endoscopy of large intestine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..45.21 -45.24 

Cystoscopy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..57.31 -57.32 

Arteriogram using contrast material . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...68.4 

Computerized axial tomography (CAT scan) . . . . .87.03,87.41,87.71,88.01, 66.38 

Diagnostic ultrasound . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...66.7 

85 years and over 

Radioisotope scan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..92.O.92.l 

Endoscopy of.large intestine. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .45.21 -45.24 

Cystoscopy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..57.3 l.57.32 

Diagnostic ultrasound . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...88.7 

Computerized axial tomography (CAT scan) . . . . .87.03,87.41,87.71,68.01, 88.38 

Endoscopy of small intestine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .45.11 -45.13 

1979 1984 

Number of procedures 

in thousanda 

55 80 

52 34 

50 64 

31 47 

23 56 

16 92 

127 207 

112 200 

96 86 

51 108 

35 193 

34 277 

67 95 

56 66 

52 42 

34 66 

19 80 

19 116 

60 113 

54 113 

45 45 

18 42 

16 113 

15 161 

47 82 

43 80 

34 34 

15 35 

12 123 

11 64 

13 31 

11 32 

11 11 

4 29 

3 3a 

3 23 

1979 1984 

Number of procedures 

per 10,000 population 

47.8 67.2 

45.5 28.8 

44.2 53.7 

26.9 39.6 

20.2 47.5 

14.4 78.1 

84.5 123.9 

74.8 119.6 

64.3 51.5 

34.3 64.6 

23.4 115.1 

22.6 165.7 

76.7 100.6 

66.8 92.9 

59.7 44.2 

38.6 70.5 

22.4 84.7 

21.5 123.4 

95.3 153.9 

86.0 154.0 

70.8 61.1 

28.3 57.1 

24.9 154.2 

24.1 220.3 

97.9 151.5 

89.5 148.4 

70.9 62.0 

31.3 64.9 

24.7 227.8 

23.8 154.9 

87.2 160,9 

74.8 170.0 

70.4 68.4 

28.2 152.3 

22.4 199.0 

21.7 121.0 

1Coded according to the 9th Revision, International Classification of Diseases, Clinical Modification. (See reference 45.) 

SOURCE Division of Health CareStatistic, National Centerfor Health Statistics Unpublished data from the National Hospital DischargeSurvey. 

70 
Chapter IX


Use of health care-nursing


home care


by Esther Hingand EdwardSekscenski, National Center for 

Health Statistics 

Introduction 

Although the majority of older Americans are able to 

maintain their residence in the community, the risk of institutionalization in a nursing home increases with advancing 

age. Preliminary data from the National Nursing Home Survey 

indicate that slightly less than 5 percent of the population 

aged 65 years and over resided in nursing homes in 1985. 

That figure increased to 10 percent for persons 75 years of 

age and over and to 22 percent for persons in the subgroup 

85 years and over. With the “graying” of the U.S. population, 

nursing home care is receiving increased attention, in part 

because it is the only major type of health care expenditure 

that is generally not reimbursable by private medical insurance. 

An understanding of the characteristics of nursing home residents, their functional disabilities, and the services they require 

is important to assess risk of insti*l-’. ..dization and alternative 

care strategies, 

Source of data 

Data on nursing homes were collected by means of the 

1973–74, 1977, and 1985 National Nursing Home Surveys. 

In these nationwide sample surveys, information was obtained 

on all types of nursing homes, their residents, their discharges, 

und their staff. 

Results and comments 

Resident characteristics 

In 1985 an estimated 1.4 million persons aged 55 years 

and over resided in nursing homes (table 57). The vast majority 

of those residents (93 percent) were aged 65 years and over, 

78 percent were 75 years or over, and 42 percent had passed 

their 85th birthday. Rates of institutionalization were generally 

lower for males than for females and lower for black persons 

than for white persons. By far, white females had the highest 

rates of nursing home use: 6 percent of the population aged 

65 years and over and 26 percent of those 85 years and 

over were in nursing homes in 1985. By contrast, only 3 

percent of white males aged 65 and over and 15 percent 

of those aged 85 years and over were institutionalized. 

Comparisons with 1977 data show little change in the 

rate of nursing home residency for the population aged 65 

years and over. A change, however, occurred in the age 

distribution of nursing home residents during the period 1977-

85, with a shift toward the oldest age groups (table 58), 

Whereas 35 percent of all residents in 1977 were 85 years 

of age and over, 40 percent of 1985 residents were in that 

age group. The proportion of residents aged 95 years and 

over increased from 3 to 6 percent during that time period. 

The distribution of residents according to sex and marital 

status did not change from 1977 to 1985. 

Length of stay 

The notion that everyone who enters a nursing home 

stays for an extended period of time has recently been largely 

dispelled. Indeed, long-term care institutions may be viewed 

as having two fairly distinct populations: resident patients 

who stay for many years and patients admitted for recuperative 

or terminal care of specific ailments who stay for relatively 

short penods.48 Examples of the former are patients with 

chronic conditions such as arteriosclerosis, blindness, or 

chronic brain syndrome, whose disabilities are such that they 

can no longer be cared for in the community. Examples of 

the latter, short-stay patients, are persons recovering from 

acute myocardial infarction or hip fracture and persons suffering from terminal cancer. Cross-sectional data collected on 

nursing home residents in 1985 reveal a median length of 

stay since admission of 614 days (table 58). By age group, 

that figure ranged from 510 days for persons aged 70-74 

years to 917 days for those aged 95 years and over. More 

information on short-stay patients is gained from data on 

discharges than from data on residents because patients staying 

for a short time account for a disproportionate share of discharges compared with residents. The median length of stay 

for patients discharged in 1984-85 was 82 days. Persons 

discharged alive had a median length of stay of 70 days; 

those discharged dead had a median stay of 163 days. 

Deaths 

During the period 1984-85, 343,800 deaths occurred in 

nursing homes, of which 329,800 were among persons 65 

years and over, These nursing home deaths accounted for 

roughly 23 percent of the 1.4 million deaths among the entire 

U.S. population 65 years and over in 1984. An even greater 

proportion of deaths among persons 85 years and over occurred 

in nursing homes: 174,900 or 44 percent, of the 399,500 

deaths among persons 85 years and over in the United States 

in 1984. In the National Nursing Home Survey, information 

was obtained on the type of place or facility to which a 

live discharge went after discharge and, if the discharge was 

sent to another health facility, whether he or she was known 

71

to have died there. Of the 877,400 live discharges recorded, 

30 percent were discharged to a private or semiprivate residence, and 67 percent went to another health facility, most 

commonly a general or short-stay hospital. Twenty percent 

(1 16,600) of those discharged to another facility were known 

to have died there. To estimate the number of nursing home 

discharges whose outcome of care was death (including persons 

discharged in terminally ill states to hospitals to die), the 

number of deaths known to have occurred in those discharges 

to other health facilities was added to the number of deaths 

in nursing homes, and death rates were calculated. The resultant adjusted nursing home death rates are minimum estimates 

because they include only known deaths in other health facilities. Nonetheless, these statistics are useful in enhancing our 

understanding of nursing home utilization rates. During the 

period 198485, 30 percent of deaths among persons aged 

65 years and over and 55 percent of deaths among persons 

aged 85 years and over followed a stay in a nursing home. 

These data indicate that nursing homes play an important 

role in providing service to older persons in their final years. 

Functional status 

A consideration of various functional disabilities present 

in the nursing home population reveals increasing disability 

with advancing age (table 59). The proportion of residents 

experiencing difficulty in performing activities of daily living 

(dressing, using the toilet room, mobility, continence, and 

eating)2 increased progressively from the age group 55-64 

years to the group 85 years or older. In general, older women 

were more severely disabled than older men: Of those 85 

years and over, 83 percent were unable to dress independently 

and 83 percent could not walk independently. Of men in 

that age group, 77 percent could not dress independently 

and 78 percent could not walk independently. Difficulties 

with continence increased with age but were similar for men 

and women. 

Although the nursing home residents surveyed in 1985 

had lower rates of visual and auditory impairments than residents surveyed in 1977 had, the proportion with difficulties 

in activities of daily living was higher in 1985 than in 1977 

for most of the categories. The increased level of disability 

seen in the 1985 nursing home population may be partially 

explained by a shift in the age distribution of nursing home 

residents to the older age groups, In 1977, 10 percent of 

residents in the group 85 years and over had passed their 

95th birthday; that figure was 15 percent in 1985. As the 

rates presented here are not age adjusted, they do not reflect 

the older age distribution. Another possibility is that the Medicare prospective payment system, by which hospitals are encouraged to reduce a patient’s length of stay, may have resulted 

in a greater proportion of very sick people being cared for 

in nursing homes. 

72 
Table 57. Number and rate of nursing home residents 55 yeare of age and over, by sex, race, and age United States, 1973-74,1977, and 1985 

[Data are based on a sample of nursing homes] 

Sex, race, and age 

Tota12 

55-64 years. . . . . . . . . . . . . . . . . . . . . 

65years andover . . . . . . . . . . . . . . . . 

65-74 years. . . . . . . . . . . . . . . . . . . . 

75years andover, . . . . . . . . . . . . . . . 

75-84 years. . . . . . . . . . . . . . . . . . . . 

85years andover . . . . . . . . . . . . . . . . 

White male3 

55-64 years. . . . . . . . . . . . . . . . . . . . . 

65years andover . . . . . . . . . . . . . . . . 

65-74 years. . . . . . . . . . . . . . . . . . . . 

75years andover . . . . . . . . . . . . . . . . 

75-84 years. . . . . . . . . . . . . . . . . . . . 

85years andover . . . . . . . . . . . . . . . . 

Black male 

55-64 years. . . . . . . . . . . . . . . . . . . . . 

65years andover . . . . . . . . . . . . . . . . 

65-74 years. . . . . . . . . . . . . . . . . . . . 

75years andover . . . . . . . . . . . . . . . . 

75-84 years. . . . . . . . . . . . . . . . . . . . 

85years andover . . . . . . . . . . . . . . . . 

White female3 

55-64 years. . . . . . . . . . . . . . . . . . . . . 

65years andover . . . . . . . . . . . . . . . . 

65-74 years. . . . . . . . . . . . . . . . . . . . 

75years andover . . . . . . . . . . . . . . . . 

75-84 years. . . . . . . . . . . . . . . . . . . . 

65years andover . . . . . . . . . . . . . . . . 

Black female 

55-64 years. . . . . . . . . . . . . . . . . . . . . 

65years andover . . . . . . . . . . . . . . . . 

65-74 years. . . . . . . . . . . . . . . . . . . . 

75years andover . . . . . . . . . . . . . . . . 

75-84 years. . . . . . . . . . . . . . . . . . . . 

65years andover . . . . . . . . . . . . . . . . 

1973-74’ 1977 1985 1973-74’ 1977 1985 

62,500 100,800 91 ,8CQ 

981,500 1,126,000 1,315,800 

163,100 211,400 212,100 

798,400 914,600 1,103,200 

384,900 464,700 509,0W 

413,600 449,900 594.700 

23,703 38,400 34,400 

250,803 272,600 302,700 

59,1CKI 69,400 70,600 

191,700 203,200 232,200 

97,500 115,800 127,600 

94,200 87,300 104,600 

3,300 4,600 8,700 

13,100 16,600 26,800 

5,400 9,200 8,900 

7,700 9,600 17,900 

4,0Q0 5,400 11,700 

3,800 4,200 6,200 

32,100 51,800 41,800 

869,800 787,300 922,100 

91,000 l18,1fXI 117,200 

Number of residents per 1,000 population 

3.2 4.9 

45.1 47.9 

12.3 14.5 

98.4 102.6 

59.4 68.0 

4.1 

46.1 

12.5 

95.6 

57.7 

253.7 216.4 219.4 

2.9 4.4 3.7 

31.4 31.6 29.1 

11.4 12.2 10.5 

68.8 69.4 63.3 

42.5 49.4 42.9 

191.1 149.7 160.4 

4.4 5.7 9.3 

18.3 23.3 28.5 

11.0 16.5 14.5 

33.6 3a.2 55.7 

21.4 28.3 45.6 

63.8 70.0 95.6 

3.5 5.4 4.0 

56.4 62.1 60.1 

13.4 15.8 13.7 

578,700 669,200 604.71Y3 123.6 128.2 117.9 

272,200 327,400 73.9 83.3 66.6 

306,600 341,800 458,900 307.5 264.6 256.0 

2,900 5,700 4,800 3.2 5.9 4.2 

24,600 42.000 55,200 25.4 37.3 39.4 

6,900 12;600 13,500 11.0 17.6 16.0 

17,7(JI 29,200 41,400 51.8 73.4 74.1 

9,400 14,4rY3 18,900 36.0 51.6 45.1 

8,300 14,900 22,600 103.5 125.2 162.7 

1Excludes patients in psrsonal care or domiciliary homes.


‘Includes races other than whits and black.


3Data for 1973-74and 1977includa persons of Hispanic origin.


SOURCES OMslon of Health CareStatistic, National Center for Health Statistics Unpublished data from the National Nursing Home Survey U.S.Bureau of the Census Estimates of the


population of the United .Yatea, by age, sex,and race, 1970-1977.Current Population Reports. SeriesP-25, No. 721.Washington. U.S.Government Printing 0ffice,1978; U.S.Bureau of the Census


Eatlmates of the population of the United States, by age, sex, and race 19S0to 19S5.Current Popu/atiorr Reports. Series P-25, No. SS5.Washington. U.S.Government Printing Office, 19%.


73 
Table S6. Pamentdstnbutions andmefian length ofatayaince admission ofnuming homeresidents, hvedischawes, anddeadtischawes byage, aex, andmefital 

statu= United States, selected yeare 1976-85 

All residents Live discharges Dead discharges 

1977 1985 1976 1984-65 1976 1984-85 

Percent Median Percent Median Percent Medien Percent Median Percent Median Percent Median 

Age, sex, and distri- stay distri- stay distri- stay distri- stay distri- stay distri- stay 

marita/ status bution in days bution in days bution in days bution in days bution in days bution In days 

Total 100.0 597 100.0 614 100.0 60 10Q.O 70 10Q.O 130 100.0 163 

Age 

Under 45 years. . . 2.5 657 3.1 551 3.9 37 3.6 87 “0.4 ’27 “0.6 “30 

45-54 years. . . . . 3.3 766 2.5 676 3.6 5.6 3.1 36 “1.2 “53 “0.6 ’225 

55-64 years. . . . . . 7.7 632 6.2 666 6.7 73 6.5 m 4.7 37 2.8 34 

65-69 yeara. . . . . . 6.3 592 5.5 657 8.0 62 6.1 60 5.1 40 2.9 162 

70-74 years . . . . . . 10.0 440 8.7 510 11.6 42 10.2 53 9.2 91 8.6 48 

75-79 years. . . . . . 15.3 517 14.6 544 19.3 48 16.5 66 15.5 110 14.8 74 

80-84 years. . . . . . 20.4 513 19.6 560 20.8 65 21.8 56 24.0 119 18.7 114 

85-89 years. . . . . . 20.2 621 19.6 615 17.6 74 17.1 85 22.3 263 24.2 195 

80-94 years . . . . . . 10.8 621 14.0 664 6.7 140 11.1 89 12.1 302 16.8 404 

95 years 

And over . . . . . . . 3.4 940 6.0 917 1.8 169 4.0 118 5.5 791 9.6 563 

Sex 

Male . . . . . . . . . . . 28.8 48% 28.4 575 37.3 55 37.0 65 34.3 84 37.7 74 

Female . . . . . . . . . 71.2 643 71.6 630 62.7 65 63.0 72 65.7 175 62.3 246 

Marital status 

Married . . . . . . . . . 11.9 335 12.8 357 24.0 36 22.5 42 19.9 % 21.9 36 

Widowed . . . . . . . . 62.2 5S9 61.3 629 54.0 73 52.3 81 62.7 177 60.9 232 

Divorced or. . . . . . 

separated . . . . . . 6.7 552 7.8 536 7.6 63 7.6 81 4.3 112 5.2 116 

Never married . . . . 19.1 6a7 18.2 665 11.9 98 13.7 65 9.9 309 8,9 308 

Unknown . . . . . . . 2.6 71 3.8 91 3.1 135 3.1 237 

SOURCE5 National Center for Health Statistics, J. F Van Nostrand, A. ZSPPOIO, E. Hing,et al: The Nationsl Nursing Home SUrVeY, 1977 summary for the United States. V/ta’/ arrd Hea/fh Stat/sf/cs. 

Series13, No. 43. DHEW Pub. No. (PHS) 79-1794. Public Health Service. Washington. U.S. Government Printing Office, July 197% Oivision of Health Csre Statistics, National Center for Health 

Statistics Unpublished data rrom the 1965 National NursingHomeSurvey. 

74 
I 

I Table 59. %unttistnbutions ofnuminghome msidents55 yeamofageand over by functional atatus, accotingto ageandsex: United States,l985 

I 

55-64 years 65-74 years 75-64 years 85 years and over 

Functions/status Total Male Female Male Female Male Female Male Female 

I 

Percent distribution 

Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 100.0 lGQ.O 100.0 Irmo I@).o 100.0 100.0 100.0 

Dressing 

Independent . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23.3 40.3 35.5 35.8 26.2 28.9 22.3 22.7 17.1 

Requires assistancel . . . . . . . . . . . . . . . . . . . . . . . . . 76.7 59.7 64.5 84.2 73.8 71.1 77.7 77.3 82.9 

Using toilet room 

Independent . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37.8 58.6 48.2 50.7 39.0 44.8 37.7 37.6 30.4 

Requires assistance . . . . . . . . . . . . . . . . . . . . . . . . . . 50.3 34.5 39.2 42.5 47.8 45.9 48.5 50.8 57.3 

Doesnot usetoilet rcmm . . . . . . . . . . . . . . . . . . . . . . 11.9 “6.9 12.6 6.8 13.2 9.3 13.8 11.6 12.3 

Mobility 

Walks independency . . . . . . . . . . . . . . . . . . . . . . . . . . 27.8 52.5 45.0 45.0 %.3 35.4 28.5 22.3 17.1 

Walks withassistance . . . . . . . . . . . . . . . . . . . . . . . . 25.5 13.6 16.4 17.2 22.4 23.4 25.3 30.5 29.5 

Chalrfast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40.2 29.1 30.2 33.4 33.9 36.3 39.6 43.0 45.9 

Bedfast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.5 ‘4.6 “8.4 “4.4 7.5 4.9 6.6 4.2 7.5 

Continence 

No difficulty controlling bowels or bladder. . . . . . . . 48.9 69.3 84.3 61.1 54.6 45.8 44.6 41.6 42.0 

Difficulty controlling bowela . . . . . . . . . . . . . . . . . . . 1.8 “2.9 “2.7 “1.5 ‘2.1 1.6 “1.8 2.0 

Difficulty controlling bladder . . . . . . . . . . . . . . . . . . . 10.7 “5.5 12.0 8.4 7.0 11.0 11.0 13.6 11.7 

Difficulty controlling both bowels and bladder. . . . . 32.5 18.7 12.5 24.1 29.6 31.3 34.5 33.9 38.4 

Ostomy in either bowels or bkrdder.. . . . . . . . . . . . . 8.1 “3.5 11.1 5.7 7.2 9.9 8.3 9.2 7.9 

Eating 

Independent . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80.3 71.2 69.5 67.1 88.2 67.7 5s.3 80.8 54.9 

Requires assiatancez . . . . . . . . . . . . . . . . . . . . . . . . . 39.7 28.8 30.5 32.9 33.8 32.3 41.7 39.2 45.1 

Vision 

Notimpaired . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75.2 88.2 88.8 85.7 61.8 75.2 76.8 71.3 67.2 

Psrtiallyimpaired . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15.1 “6.8 ‘5.2 8.7 10.8 16.8 13.2 17.0 19.7 

Severely impaired . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.9 “2.8 “2.9 ‘3.5 4.8 4.5 3.9 6.8 8.8 

Completely lost . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.5 “23 “3.1 “0.7 “1.7 “2.0 2.1 “3.8 3.1 

Unknown . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.3 ‘1.4 “0.8 “1.5 2.0 �1.1 1.2 

Hearing 

Notimpaired . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77.5 92.3 95.9 93.8 90.1 77.6 84.6 61.6 66.9 

Partially impaired . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17.5 “6.8 “3.6 7.6 7.3 19.4 13.0 27.7 24.8 

%verelyi repaired . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.6 ‘0.4 “0.3 “1.6 “1.6 1.5 8.9 6.4 

Completely lost . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.6 ‘0.5 “0.3 “0.4 “0.6 “0.6 ‘1.0 “0.8 

Unknown . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.6 “0.6 “0.9 “0.6 “0.8 ‘0.4 “0.9 1.2 

1Includespsrsoiwwhode notdressthemselves.


%r~lutis parsonswhoare fedbytubeorintfSWSnOIJ51Y.


SOURCE Divisionof HealthCareStatiatlcs,NationslCentsrforHealthStatistics Unpublisheddatafromthe 1995NationalNursingHomeSurvey.


75 
Chapter X 

Cost of health care 

by P. Ellen Parsons, National Center for Health Statistics, and 

Barbara Marzetta Liu, Northwest Institute 

Introduction 

U.S. expenditures for health care totaled $425 billion 

in 1985, an amount equal to 10.7 percent of the gross national 

product. That figure represents expenditures averaging $1,721 

per person during the year. Forty-seven percent of the Nation’s 

health dollars went for hospital and nursing home care. Despite 

numerous strategies to contain costs, health spending in 1985 

was up 8.9 percent from the previous year.49 

Because older persons are more likely than their younger 

counterparts to need both acute and long-term care, they account for a disproportionately high percent of national health 

care expenditures. As the number of aged Americans increases, 

developing strategies to pay for their medical care has become 

an important priority. 

Sources of data 

Information on health care expenditures reported for 1980 

was derived from the National Medical Care Utilization and 

Expenditure Survey (NMCUES), which was designed and 

conducted as a collaborative effort between the National Center 

for Health Statistics and the Health Care Financing Administration. Data were collected by means of a household interview 

survey based on a national probability sample of the civilian 

noninstitutionalized population residing in the United States. 

Residents of nursing homes were excluded from the survey, 

along with all expenditures for any health services provided 

to residents. (See the appendix for details.) 

Data on national expenditures for health care and sources 

of payment were compiled by the Health Care Financing 

Administration. 

Results and comments 

Although persons 65 years of age and over represent 

only 12 percent of the U.S. population, they account for 

31 percent of national expenditures for health care.50 In 1984 

per capita health care expenditures for persons 65 years of 

age and over were $4,202 (table 60). Of that amount, almost 

one-half ($1,900) went for hospital charges. Expenditures for 

nursing home care were $880 per person, a remarkably high 

figure when one considers that only 5 percent of the population 

aged 65 years and over resides in a nursing home. 

Of the total per capita expenditures for the aged of $4;202, 

25 percent was paid out of pocket and 67 percent was covered 

by government programs, chiefly Medicare. However, there 

was considerable variation in the source of funds according 

to type of service. For instance, government programs paid 

for the lion’s share (89 percent) of hospital charges for older 

persons in 1984; private funds paid for only 11 percent. In 

contrast, private funds (generally, out-of-pocket payments and 

private insurance) paid for 40 percent of expenditures for 

physicians’ services. More than one-half of expenditures for 

nursing home care were covered by the consumer out of 

pocket; Medicaid contributed an additional 42 percent. 

Information on the distribution of charges for health services according to diagnostic category is presented in table 61. For the civilian noninstitutionalized population aged 

65 years and over in 1980, the highest charges (28 percent 

of the total) were for diseases of the circulatory system. Neoplasms accounted for 13 percent of charges, and injury and 

poisoning represented 9 percent of the total. 

Diseases of the circulatory system also accounted for 

the greatest proportion (nearly 40 percent) of nursing home 

expenditures in 1980. Another 21 percent of nursing home 

expenditures were attributable to mental disorders .50 

Although the aged, as a group, consume a disproportionate 

share of the health dollar, that does not mean that all, or 

even most, older persons have high medical care expenditures. 

Rather, it has been demonstrated that a small proportion of 

persons aged 65 years and over account for the bulk of that 

group’s health care expenditures. An analysis of data from 

NMCUES51 revealed that about 5 percent of persons aged 

65 years and over who were living in the community at 

the beginning of 1980 left during the course of the year 

through death or institutionalization. They accounted for 22 

percent of total charges for persons in the community in 

their age group even though they were in the community, 

on average, for only one-half of the year. Their per capita 

charges, which were mostly for hospitalization, were high: 

$7,000 per person, or a yearly average of $13,000. 

In contrast, older persons who lived in the community 

all year had low charges for health care. The mean charge 

was $1,327 because a few had very high charges, but the 

median charge was only $329. High charges were almost 

uniformly attributable to hospitalization. A person’s level of 

charges was not related to age, sex, or socioeconomic status— 

only to health status. 

A large portion of expenditures for health care among 

older persons is associated with persons who are in their 

last year of life. In a recent study, reimbursement and use 

76 
.

of services by Medicare enrollees who died in 1978 were 

compared with those of enrollees who survived the year.s2 

The average reimbursement for those who died was $4,909, 

an amount four times as great as the reimbursement for those 

who lived, Decedents comprised 6 percent of the group studied, 

yet accounted for 28 percent of Medicare reimbursement. 

Decedents had five times as many hospital discharges per 

1,000 enrollees as did survivors and seven times as many 

days of care per 1,000 enrollees. 

There has been some concern that the use of heroic measures to extend life in recent years has contributed to increases 

in health care expenditures in this country. Recently, increases 

in Medicare reimbursements from 1967 to 1982 were compared 

for survivors and decedents .53 It was found that per capita 

expenditures for both groups increased at the same rate over 

that time span. Thus, it appears that there has not been an 

increase in the cost of treating dying persons as compared 

with persons who do not die. 

Tabla 80. Per capita personal health care axpanditures for pereons 65 yaare of age and over, by type of service and source of fund= United States, 1s84 

Source of funds 

Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Private . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Consumer . . . . . . . . . . . . . . . . . . . . . . . 

Outofpocket. . . . . . . . . . . . . . . . . . . . 

Insurance . . . . . . . . . . . . . . . . . . . . . . . 

Other private . . . . . . . . . . . . . . . . . . . . . 

Government . . . . . . . . . . . . . . . . . . . . . . . 

Medicare . . . . . . . . . . . . . . . . . . . . . . . . 

Medicaid . . . . . . . . . . . . . . . . . . . . . . . . 

Other government . . . . . . . . . . . . . . . . . 

1Less than$.50. 

Type of service 

All Nursing 

services Hospital Physicien home Other 

$4,202 $1,930 $888 $880 $554 

1,379 216 344 457 382 

1,363 209 344 451 359 

1,059 59 227 441 332 

304 150 117 10 27 

16 7 1 6 3 

2,823 1,684 524 423 192 

2,051 1,420 502 19 110 

536 91 16 365 63 

236 172 6 39 19 

SOURCEOffice of Financial and Actuarial Analyaia, Health Care Financing Administration 

Table 61. Total charges for health sarvlces and percent distribution for pereons 45 yeare of age and ovar by selected diagnostic categories, according to age 

United Statas, 1980 

45-64 65 years 45-64 65 years 

Diagnostic category’ years and over years and over 

Amount in millions percent distribution 

Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $35,732 $37,925 100.0 100.0 

Neoplasm,. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,946 4,684 11.0 12.9 

Endocrine, nutritional, and metabolic diaeaaes and immunity disorders . . . . . . 1,643 1,097 4.3 2.9 

Diseaees of the nervous system and eense organs . . . . . . . . . . . . . . . . . . . . . . . 2,264 2,906 6.3 7.7 

Diseaaesofthecirculatory system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6,715 10,486 18.8 27.6 

Dlseaaes of theresplratoryaystem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,639 2,364 7.4 6.2 

Diseases of thedlgestive system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4,020 2,55J3 11.3 6.7 

Dlseasee of theganltourlnary system,.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,357 2,066 6.6 5.5 

Diseases of the musculoskelatal system and connective tiaaue. . . . . . . . . . . . . 4,33o 2,948 12.1 7.6 

lnjuryand poisoning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,332 3,478 6.5 9.2 

Allothers andunknown, , ...,,.... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5,597 5,147 15.7 13.6 

1Categories ars from the 9th Revk/err,/ntemat/ona/ C/ass/f/cation of D/seases,C//rrba/ Mod/f/cation. (Seeraference 45.) 

SOURCE t? E. Paraons, R. Liechtenstein, S. E, Berid;et al: Costa of Illness, United Statea, IWO. iVationa/Medics/ CareLWizatiorrand ExparrdltureSuNSy Sarias C, No. 3. DHHS Pub. No. 66-20403. 

National Center for Health Statistics, Public Health Sewice. Washington. U.S. Government Printing Office, Apr. 19S6. 

77 
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z9w, G. wei~se~: Hard choices’, Targeting long-term care to the 

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~~p. E. Leavefion, R. J. Havlik, and L. Ingster-Moore: Coronary 

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32Nationa1 Center for Health Statistics. T. Drizd, A. L. Dannenberg. 

and A, Engel: Blood pressure levels in persons 18–74 years of 

age in 197680 and trends in blood pressure from 1960 to 1980 

in the United States. Vi~a/ and Health Statistics. Series 11, No. 

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34J D curb, N. 0. Borhani, (j, Entwisle, et a].: Isolated SYStOhC 

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36National Institutes of Health Consensus Development panel: ‘ational Institutes of Health consensus development statement on Iowering blood cholesterol to prevent heart disease. JAMA 253(14):2080-

2086, 1985. 

~TNationa[ Center for Health Statistics and National Heart, Lung> 

and Blood Institute Collaborative Lipid Group: Trends in sesum 

cholesterol levels among U.S. adults aged 20 to 74 years. JAMA. 

257(7):937-942, 1987. 

~8J D posner, K. M. German, H. S. Klein, and A. WOldOW: 

Ex&ci;e capacity in the elderly. Am. J. Cardiol. 57:52C-58C, 1986. 

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eighties, Prevalence and impact of urinary problems in individuals 

age 65 years and over, Preliminary data from the Supplement on 

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11(8519):1316-1317, 1986. 

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by sociodemographic and health characteristics, United States, 1982-

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No. (PHS) 87–1589. Public Health Service. Washington. U.S. Government Printing Office, Apr. 1987. 

42S. E. Berki, J. N. Lepkowski, L, Wyszewianski, et al.: High-volume and low-volume users of health services, United States, 1980. 

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~-, ..-.
 Nn. 2. DHHS pub. No. 86-20402. National Center for Health

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Office-based ambulatory care for patients 75 years old and over,


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Data From Vital and Hea/th Statistics. No. 110. DHHS Pub. No.


(PHS) 85-1250. Public Health Service. Hyattsville, Md., Aug. 21,


1985.


~National Center for Health Statistics: Health, United States, 1986.


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U.S. Government Printing Office, Mar. 1987.


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tjlcation. DHHS Pub. No. (PHS) 80-1260. Public Health Service.


Washington. U.S. Government Printing Office, Sept. 1980.


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of short-stay hospitals, United States, 1984, annual summary. Vital


and Health Statistics. Series 13, No. 84. DHHS Pub. No. (PHS)


86-1745. Public Health Service. Washington. U.S. Government


Printing Office, Mar. 1986.


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A Focus on the Oldest Old. Paper presented at the Annual Meeting


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1985.


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No. 03222. Office of Research and Demonstrations, Health Care 

Financing Administration. Washington. U.S. Government Printing 

Office, Spring 1986. 

79 
Appendix


Contents 

National Mortality Statistics File... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...82


Life Tables, Vital Statistics of the United States . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85


National Death Index (NDI) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88


NationaI Maniage Statistics . . . . . . . . .’ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..92


National Divorce Statistics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..”95


National Natality Statistics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..98


National Longitudinal Mortality Study. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101


National Mortality Followback Surveys . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105


National Health Interview Survey (NHIS): Basic Health and Demographic Questionnaire . . . . . . . . . . . . . . . 109


National Health Interview Survey (NHIS): Current Health Topics . . . . . . . . . . . . . . . . . . . . . . . . . . . 113


National Health Interview Survey (NHIS): Supplement on Aging (SOA), 1984 . . . . . . . . . . . . . . . . . . . . 116


Longitudinal Study of Aging (LSOA) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 119


National Health Interview Survey (NHIS): Data for the Study of Secular Change and Aging . . . . . . . . . . . . . . 122


First National Health and Nutrition Examination Survey (NHANES I) . . . . . . . . . . . . . . . . . . . . . . . . . 125


Second National Health and Nutrition Examination Survey (NHANES II) . . . . . . . . . . . . . . . . . . . . . . . 129


Hispanic Health and Nutrition Examination Survey (HHANES) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133


NHANES I Epidemiologic Followup Study: Initial Followup, 1982–84 . . . . . . . . . . . . . . . . . . . . . . . . 136


National Medical Care Utilization and Expenditure Survey (NMCUES), 1980 . . . . . . . . . . . . . . . . . . . . . 140


National Ambulatory Medical Care Survey (NAMCS) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 144


National Hospital Discharge Survey (NHDS) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 147


National Nursing Home Survey (NNHS). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 150


National Master Facility Inventory (NMFI) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 154


80 
Appendix


Data systems with statistics on aging


The National Center for Health Statistics is one of the major Federal


statistical agencies. It operates a diverse survey and inventory program with


legislative authorization to collect statistics on:


o	 The extent and nature of illness and disability of the population of


the United States, including life expectancy, maternal morbidity,


and mortality;


o	 The impact of illness and disability of the population on the


economy of the United States and on other aspects of the well-being


of its population;


o Environmental, social, and other health hazards;


o Determinants of health;


o	 Health resources, including health professionals by specialty and


type of practice and the supply of services by hospitals, extended


care facilities, home health agencies, and other health


institutions;


o	 Utilization of health care, including ambulatory health services,


the services of hospitals, extended care facilities, home health


agencies, and other institutions;


o Health care costs and financing; and


o Family formation, growth, and dissolution.


The Center’s own data collection staff is very small. It collects most of


its data through interagency agreements with the U.S. Bureau of the Census or


through contracts with non-Federal organizations. Its major data collection


programs are:


Vital Statistics: births, deaths, marriaqes, and divorces


National Survey of Family-Growth - - -


National Health Interview Survey


National Medical Care Utilization and Expenditure Survey


National Health and Nutrition Examination Survey


National Hospital Discharge Survey


National Ambulatory Medical Care Survey


National Nursing Home Survey


National Master Facility Inventory


These are described briefly in “Data Systems of the National Center for


Health Statistics,” (Series l,-No. 16, DHH~ Pub. No. 82-1318, December 1981),


which also carries a description of the publication series (A series is used


to publish data from a particular survey or data collection system.) The


Center releases an annual Catalog of Publications of the National Center for


Health Statistics. The Center also releases annually a Catalog of Public Use


Data Tapes From the National Center for Health Statistics. The majority of


these data tapes are now sold by the National Technical Information Service.


Requests for publications and information or inquiries concerning data


tapes, special tabulations, and other assistance should be directed to:


Scientific and Technical Information Branch


National Center for Health Statistics


Public Health Service


3700 East-West Highway, Room 1-57


Hyattsville, MD 20782


81 
SPONSOR:


TITLE:


PURPOSE:


DESIGN:


CONTENT:


YEARS OF DATA


COLLECTION:


PUBLICATIONS: 

AVAILABILITY 

OF UNPUBLISHED


DATA:


CONTACT:


National Center for Health Statistics (NCHS),


Department of Health and Human Services (DHHS)


National Mortality 

Project Director:


To produce uniform


Statistics File 

Harry M. Rosenberg, Ph.D.


Chief, Mortality Statistics Branch


Division of Vital Statistics


National Center for Health Statistics


3700 East-West Highway


Hyattsville, MD 20782


national, State, and local data on numbers of


deaths, causes of death, and sociodemographic characteristics of


decedents.


Mortality data include all deaths (approximately 2 million)


occurring annually within the United States reported to State


vital registration offices. In 1972, a 50 percent sample of


mortality data was used; generally, however, 100 percent of


deaths are included. Data are collected annually. Data are


available for the entire U.S. annually since 1933 and for


selected States since 1900.


Demographic and medical information is coded from information


reported on the death certificate including residence, age, race,


sex, underlying cause of death, and multiple causes of death.


Data are collected annually. National data available since


1933.


National Center for Health Statistics: Vital Statistics of the


United States, Volume II, Mortality, Parts A and B, and Monthly


Vital Statistics Report.


Public use data tapes for 1968 and subsequent years are


available from the National Technical Information Service,


5285 Port Royal Road, Springfield, VA 22161. Mortality Detail


Files, 1969-83 (ICPSR 7632) are also in the collection of the


National Archive of Computerized Data on Aging maintained by the


Inter-University Consortium for Political and Social Research,


P.O. Box 1248, Ann Arbor, MI 48106.


HarryM. Rosenberg, Ph.D.


(301) 436-8884

SPONSOR:	 National Center for Health Statistics (NCHS), Department of Health and


Human Services (DHHS)


TITLE : National Fbrtality Statistics File 

TYPES OF DATA COLLECTED


Data Public


File Use


Ta~e


DEMOGRAPHIC DATA


Educational level


x x Race 

x x Ethnicity 

x x Sex 

x x Marital status 

Migration or mobility


VITAL STATISTICS


Natality


x x	 Mortality


Marriage


Divorce


HOUSING


Type of dwelling


No. of persons in household


Relationship of persons in


household


INCOME AND WEALTH


Labor force participation


Total income


Sources of income


Net assets


SOCIAL SERVICES


HEALTH RESOURCES


General hosDitals


Private psychiatric hospitals


Public mental health hospitals


Nursing homes


Other institutional resources


Community-based resources


Health professions


Other professional resources


HEALTH EXPENSES


Costs of care


Out-of-pocket costs


Medicare


Medicaid


State expenditures


Private insurance coverage


Data Public


File Use


Ta~e


HEALTH


(1) (1) Acute and chronic conditions


Disability days


Chronic limitations


of activity


of mobility


Impairments


Usual activity status


ALCOHOL, DRUG ABUSE,


AND MENTAL HEALTH


Cognitive impairment scale


Behavior problems


Depression


Alcohol use


Drug abuse


CHANGES IN HEALTH STATUS


Morbidity


Functional limitations


Self-perceived health


FUNCTIONAL LEVELS


Social interaction


Activities of daily living


Instrumental activities of


daily living


HEALTH CARE UTILIZATION


(1) (1)	 General hospital services


Nursing home services


Home health care


Rehabilitation


Mental health hospitalization


Mental health outpatient


services


Alcohol and drug abuse centers


Physician services/visits


Dental services/visits


Prescription drugs


Other


OTHER BROAD CATEGORY


FOR SAMPLING UNIT


~ Cause of death.


83 
SPONSOR:	 National Center for Health Statistics (NCHS), Department of 

Health and Human Services (DHHS) 

TITLE: National Mortality Statistics File


SELECTEDITEMSIN DATASET 

SIZE OF SAMPLE 

Age 

Total


Under 65


65-74


75-84


85+


1
Age distribution excludes deaths with age not stated.


Number in Samplel


2,039,369


612,421


476,570


550,912


399,466


AVAILABILITY AND LOCATIONOF SPECIFIC DATAITEMS


Item


Date of birth


Social Security no.


Veteran status


Geographic data


Largest unit


Smallest unit


Age classes


Single years


60-64


65+


65-74, 75-84, 85+


Other


Data File Public Use Tape


Us. Us. 

County/city of County/city of


10,000+pop. 100,000+pop.


x x


Published Tables


Us. 

County/city of 

10,000+pop. 

x


x


x


x

SPONSOR:


TITLE:


PURPOSE:


DESIGN:


CONTENT:


National Center for Health Statistics (NCHS), Department of


Health and Human Services (DHHS)


Life Tables, Vital Statistics of the United States 

Project Directors:	 Harry Rosenberg, Ph.D.


Chief, Mortality Statistics Branch, and


Robert Armstrong


Actuarial Advisor


Division of Vital Statistics


National Center for Health Statistics


3700 East-West Highway


Hyattsville, MD 20782


To summarize death rates in order to obtain standardized


measures of comparative longevity.


For annual complete tables, numerators are deaths by single


years of age for a calendar year; for decennial tables,


numerators are deaths by single years of age for the 3-year


period around a census year. Abridged life tables contain


values by age group. Provisional life tables are based on a


10 percent sample, compared with final tables, which are based


on a complete count of deaths. Denominators for decennial


tables are based on decennial census data; denominators for


annual tables are based on midyear postcensal population


estimates from the Bureau of the Census. Life tables are also


computed by cause of death.


See Publications.


YEARS OF DATA Complete life tables, United States, decennially since


COLLECTION: 1900 and annually since 1960.


Abridged life tables, United States, annually since 1945.


Provisional life tables, United States, annually since 1958.


Decennial life tables, States since 1940 (every 10 years).


PUBLICATIONS:	 Complete tables--National Center for Health Statistics: Vital


Statistics of the United States, Mortality, Vol. II, Part A.


National Center for Health Statistics: U.S. Decennial Life


Tables. (Publication includes tables for individual States and


for selected causes of death).


Provisional tables--National Center for Health Statistics:


Annual summary of births, deaths, marriages, and divorces,


United States. Monthly Vital Statistics Report.


AVAILABILITY Latest tables available on request.


OF UNPUBLISHED


DATA:


CONTACT: Robert J. Armstrong (decennial life tables), (301) 436-8951


Harry M. Rosenberg, Ph.D. (annual data-provisional


and final life tables),


(301) 436-8884


85 
SPONSOR:	 National Center for Health Statistics (NCHS), Department of Health


and Human Services (DHHS)


TITLE: Life Tables, Vital Statistics of the United States 

TYPES OF DATA COLLECTED


Data Public


File Use


Tape


DEMOGRAPHIC DATA


Educational level


x	 Race


Et~nicity


x


Marital status


Migration or mobility


VITAL STATISTICS


Natality


x	 Mortality 

Marriage 

Divorce 

HOUSING


Type of dwelling


No. of persons in household


Relationship of persons in


household


INCOME AND WEALTH


Labor force participation


Total income


Sources of income


Net assets


SOCIAL SERVICES


HEALTH RESOURCES


General hos~itals


Private psy~hiatric hospitals


Data Public


File Use


Ta~e


“ HEALTH


(1)	 Acute and chronic conditions


Disability da.vs


Chronic limitations


of activity


of mobility


Impairments


Usual activity status


ALCOHOL, DRUG ABUSE,


AND MENTAL ILLNESS


Cognitive impairment scale


Behavior problems


Depression


Alcohol use


Drug abuse


CHANGES IN HEALTH STATUS


Morbiditv


Function~l limitations


Self-perceived health


FUNCTIONAL LEVELS


Social interaction


Activities of daily living


Instrumental activities of


daily living


HEALTH CARE UTILIZATION


Public mental health hospitals


Nursing homes


Other institutional resources


Conmwnity-based resources


Health professions


Other professional resources


HEALTH EXPENSES


Costs of care


Out-of-pocket costs


Medicare coverage


Medicaid coverage


State expenditures


Private insurance coverage


General hospital services


Nursing home services


Home health care


Rehabilitation


Mental health hospitalization


Mental health outpatient


services


Alcohol and drug abuse centers


Physician services/visits


Dental services/visits


Prescription drugs


Other


OTHER BROAD CATEGORY


FOR SAMPLING UNIT


1

Decennial life tables by cause of death. 
SPONSOR:	 National Center for Health Statistics (NCHS), Department of 

Health and Human Services (DHHS) 

TITLE: Life Tables, Vital Statistics of the United States 

SELECTED ITEMS IN DATA SET 

SIZE OF SAMPLE 

Age Number in Sample Nonresponse Rate 

Total

Under 65

65-74 Not applicable

75-84 

85+ 

AVAILABILITY ANDLOCATIONOF SPECIFIC 

Item Data File 

Date of birth 

Social Security no. 

Veteran status 

Geographic data 

Largest unit 

Smallest unit 

Age classes 

Single years

60-64

65+

65-74, 75-84, 85+ 

Other 

DATAITEMS 

Public Use Tape Published Tables 

Us. 

State 

x (decennial) 

x (annual) 

x (annual) 

x (annual) 
I 

SPONSOR:


TITLE:


PURPOSE:


DESIGN:


CONTENT:


YEARS OF DATA


COLLECTION:


National Center for Health Statistics (NCHS), Department of


Health and Human Services (DHHS)


National Death Index (NDI) 

Project Director:	 Robert Bilgrad


Special Assistant to the Director


Division of Vital Statistics


National Center for Health Statistics


3700 East-West Highway, Room 1-44


Hyattsville, MD 20782


The National Death Index (NDI) is a computerized central file of


death record information. It is compiled from magnetic tapes submitted


to the National Center for Health Statistics (NCHS) by the State vital


statistics offices. These tapes contain a standard set of identifying


information for each decedent, beginning with deaths occurring in 1979.


Investigators conducting prospective and retrospective studies can use


the NDI to determine whether persons in their studies may have died,


and, if so, be provided with the names of the States in which those


deaths occurred, the dates of death, and the corresponding death


certificate numbers. The NDI user can then arrange with the appropriate


State offices to obtain copies of death certificates or specific


statistical information such as cause of death.


The NDI file contains identifying death record information


for virtually all deaths in the United States, Puerto Rico, and the


Virgin Islands.


The identifying information on the NDI file is provided to NCHS on


magnetic tapes submitted by the State vital statistics offices via


contractual agreements. The items of information are: State of deatk,


death certificate number, date of death, first and last name, middle


initial, father’s surname, social security number, date of birth, race!,


sex, marital status, State of residence, State of birth, age at death.


The NDI file contains 14.6 million death records for 1979-85.


Deaths are added to the file annually, approximately 12 months


after the end of a calendar year. About 2 million records are added


each year.


PUBLICATIONS: Patterson, B.H., and Bilgrad, R., “Use of the National Death Index in


Cancer Studies,” Journal of the National Cancer Institute, Vol. 77,


No. 4, October 1986. Includes references.


Patterson, J.E., and Bil rad, R., “The National Death Index


Experience: 1981-1985” ?Presented at the Workshop on Exact Matching


Methodologies, Arlington, VA. May 1985). Includes published and


unpublished references.

SPONSOR:	 National Center for Health Statistics (NCHS), Department of


Health and Human Services (DHHS)


TITLE: National Death Index (NDI) (continued) 

National Center for Health Statistics, DHHS User’s Manual: The 

National Death Indexz DHHS Pub. No. (PHS) 81-1148, September . 

AVAILABILITY The data on the NDI file are used solely for matching purposes


OF UNPUBLISHED to assist health investigators in their mortality ascertainment


DATA: activities. The file is confidential and copies are not available.


CONTACT:	 Robert Bilgrad


(301) 436-8951


89 
SPONSOR	 National Center for Health Statistics (NCHS), Department of Health and Human


Services (DHHS)


TITLE: National Death Index (NDI) 

TYPES OF DATA COLLECTED 

Data Public Data Public 

File Use File Use 

Ta~e Tape 

“ DEMOGRAPHIC DATA


Educational level


x Race


Ethnicity


x Sex


x Marital status


Migration or mobility


VITAL STATISTICS


Natalitv


x	 Mortali~y


Marriage


Divorce


HOUSING


Type of dwelling


No-.of persons in household


Relationship of persons in


household


INCOME AND WEALTH


Labor force participation


Total income


Sources of income


Net assets


SOCIAL SERVICES


HEALTH RESOURCES


General hospitals


Private psychiatric hospitals


Public mental health hospitals


Nursing homes


Other institutional resources


Community-based resources


Health professions


Other professional resources


HEALTH EXPENSES


Costs of care


Out-of-pocket costs


Medicare coverage


Medicaid coverage


State expenditures


Private insurance coverage x


HEALTH


Acute and chronic conditions


Disability days


Chronic limitations


of activity


of mobility


Impairments


Usual activity status


ALCOHOL, DRUG ABUSE,


AND MENTAL ILLNESS


Cognitive impairment scale


Behavior problems


Depression


Alcohol use


Drug abuse


CHANGES IN HEALTH STATUS


Morbidity


Functional limitations


Self-perceived health


FUNCTIONAL LEVELS


Social interaction


Activities of daily living


Instrumental activities of


daily living


HEALTH CARE UTILIZATION


General hospital services


Nursing home services


Home health care


Rehabilitation


Mental health hospitalization


Mental health outpatient


services


Alcohol and drug abuse centers


Physician services/visits


Dental services/visits


Prescription drugs


Other


OTHER BROAD CATEGORY


FOR SAMPLING UNIT


Identifying death record


information

SPONSOR: National Center for Health Statistics (NCHS), Department of Health 

and Human Services (DHHS) 

TITLE: National Math Index (NDI) 

SELECTED ITEMS IN DATA SET


SIZE OF POPULATION


Age Number in File


Total 10,289,958


Under 60 2,448,436


60+ 7,841,522


AVAILABILITY ANDLOCATIONOF SPECIFIC DATA ITEMS 

Item


Date of birth


Social Security no.


Veteran status


Geographic data


Largest unit


Smallest unit


Age classes


Single years


60-64


65+


65-74, 75-84, 85+


Other


Data File Public Use Tape Published Tables


lx


lx


State


County


x


1 Available solely for matching purposes. Actual information is not


disclosed.


91

SPONSOR:


TITLE:


PURPOSE:


DESIGN:


CONTENT:


YEARS OF DATA


COLLECTION:


PUBLICATIONS:


AVAILABILITY


OF UNPUBLISHED


DATA:


CONTACT:


National Center for Health Statistics (NCHS), Department of


Health and Human Services (DHHS)


National Marriage Statistics 

Project Director:	 Robert L. Heuser


Acting Chief, Marriage and Divorce


Statistics Branch


Division of Vital Statistics


National Center for Health Statistics


3700 East-West Highway


Hyattsville, MD 20782


To collect demographic data on marriages performed in the


United States.


Count of marriages performed from all States. Data on


characteristics from sample of marriages occurring in States


meeting criteria for marriage-registration area (42 States and


the District of Columbia in 1984). Systematic sample designed


to include at least 2,500 records from each State.


Characteristics include: age, race, number of the marriage,


previous marital status, interval since last marriage, and


education of the bride and groom; type of ceremony (civil or


religious).


Marriage-registration area (MRA) established in 1957. Data


collected annually.


National Center for Health Statistics: Vital Statistics of the


United States, Vol. III, Marriage and Divorce. Published


annually.


Periodic reports in Vital and Health Statistics, Series 21, and,


in 1987, Advance Report of Final Marriage Statistics, 1984 in


the Monthly Vital Statistics Report, published by the National


Center for Health Statistics.


Public use data tapes for 1968 and subsequent years are


available from National Technical Information Service,


5285 Port Royal Road, Springfield, VA 22161.


Robert L. Heuser


(301) 436-8954

SPONSOR:€ National Center for Health Statistics (NCHS), Department of Health and 

Human Services (DHHS) 

TITLE: National Marriage Statistics 

TYPES OF DATA COLLECTED 

Data Public Data Public 

File Use File Use 

Tape Ta~e 

DEMOGRAPHIC DATA 

x x Educational level 

x x Race 

Ethnicity 

x x Sex 

x x Marital status 

Migration or mobility 

VITAL STATISTICS 

Natality 

Mortality 

x x€ Marriage 

Divorce 

HOUSING

Type of dwelling

No. of persons in household

Relationship of persons in

household 

INCOME AND WEALTH

Labor force participation

Total income

Sources of income

Net assets

SOCIAL SERVICES

HEALTH RESOURCES

General hospitals

Private psychiatric hospitals

Public mental health hospitals

Nursing homes

Other institutional resources

Community-based resources

Health professions

Other professional resources

HEALTH EXPENSES

Costs of’care

Out-of-pocket costs

Medicare coverage

Medicaid coverage

State expenditures

Private insurance coverage

HEALTH 

Acute and chronic conditions 

Disability days 

Chronic limitations 

of activity 

of mobility 

Impairments 

Usual activity status 

ALCOHOL, DRUG ABUSE,

AND MENTAL ILLNESS

Cognitive impairment scale

Befiaviorproblems

Depression

Alcohol use

Drug abuse

CHANGES IN HEALTH STATUS

Morbidity

Functional limitations

Self-perceived health

FUNCTIONAL LEVELS

Social interaction

Activities of daily living

Instrumental activities of

daily living 

HEALTH CARE UTILIZATION 

General hosDital services 

Nursing home services 

Home health care 

Rehabilitation 

Mental health hospitalization 

Mental health outpatient 

services 

Alcohol and drug abuse centers 

Physician services/visits, 

Dental services/visits 

Prescription drugs 

Other 

OTHER BROAD CATEGORY 

FOR SAMPLING UNIT 

93 
SPONSOR:	 National Center for Health Statistics (NCHS), Department of


Health and Human Services (DHHS)


TITLE: National Rarriage Statistics 

SELECTED ITEMS IN DATA SET


SIZE OF SAMPLE


Age


Total


Under 65


65-85+ 

Number in Samplel


1,904,243


1,885,396 women


1,869,947 men


18,847 women 

34,296 men 

1 Weighted numbers, MRA, 1984.


AVAILABILITY AND LOCATION OF SPECIFIC 

Item


Date of birth


Social Security no.


Veteran status


Geographic data


Largest unit


Smallest unit


Age classes


Single years


60-64


65+


65-74, 75-84, 85+


Other


Data File


MRA


State


x


DATA ITEMS 

Public Use Tape Published Tables


MRA Us.


State County (totals)


x


x 
SPONSOR:


TITLE:


PURPOSE:


DESIGN:


CONTENT:


YEARS OF DATA


COLLECTION:


PUBLICATIONS:


AVAILABILITY


OF UNPUBLISHED


DATA:


CONTACT:


National Center for Health Statistics (NCHS), Department of


Health and Human Services (DHHS)


National Divorce Statistics 

Project Director: Robert L. Heuser, Acting Chief


Marriage and Divorce Statistics Branch


Division of Vital Statistics


National Center for Health Statistics


3700 East-West Highway


Hyattsville, MD 20782


To collect demographic data on divorces, dissolutions of 

marriages, and annulments in the United States. 

Count of divorces granted from all States. Data on


characteristics from sample of divorces occurring in States


meeting criteria for divorce-registration area (31 States in


1984). “Systematic sample designed to include at least 2,500


records from each State.


Characteristics include: age, race, number of the marriage


being dissolved, and education of husband and wife, place and


duration of marriage, and number of children involved in the


divorce.


Divorce-registration area (DRA) established in 1958. Data


collected annually.


Vital Statistics of the United States. Vol. III, Marriage and 

Divorce. 

Periodic reports in Vital and Health Statistics, Series 21,


published by the National Center for Health Statistics.


Public use data tapes for 1968 and subsequent years are


available from National Technical Information Service,


5285 Port Royal Road, Springfield, VA 22161.


Robert L. Heuser


(301) 436-8954

SPONSOR:	 National Center for Health Statistics (NCHS), Department of Health 

and Human Services (DHHS) 

TITLE: National Divorce Statistics 

TYPES OF DATA COLLECTED


Data Public Data Public


File Use File Use 

Tape Tape 

DEMOGRAPHIC DATA 

x x Educational level 

x x Race 

Ethnicity 

x x Sex 

x x Marital status 

Migration or mobility


VITAL STATISTICS 

Natalit.v


Mortali~y


Marriage


x x Divorce


HOUSING


Type of dwelling


x x No. of ~ersons in household


Relationship of persons in


household


INCOME AND WEALTH


Labor force participation


Total income


Sources of income


Net assets


SOCIAL SERVICES


HEALTH RESOURCES


General hospitals


Private psychiatric hospitals


Public mental health hospitals


Nursing homes


Other institutional resources


Community-based resources


Health professions


Other professional resources


HEALTH EXPENSES


Costs of care


Out-of-pocket costs


Medicare coverage


Medicaid coverage


State expenditures


Private insurance coverage


‘Children involved in divorce.


HEALTH


Acute and chronic conditions


Disability days


Chronic limitations


of activity


of mobility


Impairments


Usual activity status


ALCOHOL, DRUG ABUSE,


AND MENTAL ILLNESS


Cognitive impairment scale


Behavior problems


Depression


Alcohol use


Drug abuse


CHANGESIN HEALTH STATUS


Morbidity


Functional limitations


Self-perceived health


FUNCTIONAL LEVELS


3ocial interaction


Activities of daily living


Instrumental activities of


daily living


HEALTHCARE UTILIZATION 

General hospital services


Nursing home services


Home health care


Rehabilitation


Mental health hospitalization


Mental health outpatient


services


Alcohol and drug abuse centers


Physician services/visits


Dental services/visits


Prescription drugs


Other


OTHER BROAD CATEGORY


FOR SAMPLING UNIT


96

SPONSOR	 National Center for Health Statistics (NCHS), Department


of Health and Human Services (DHHS)


TITLE: National Divorce Statistics 

SELECTED ITEMS IN DATA SET


SIZE OF SAMPLE


Age


Total


Under 65


65+ 

Number in Sample 1


567,783


498,272 men


499,175 women 

7,845 men 

4,221 women 

1 Weighted numbers, DRA, 1984. (Age distribution 

excludes cases with age not stated.)


AVAILABILITY AND LOCATIONOF SPECIFIC DATA ITEMS 

Item


Date of birth


Social Security no.


Veteran status


Geographic data


Largest unit


Smallest unit


Age classes


Single years


60-64


65+


65-74, 75-84, 85+


Other


Data File Public Use Tape


U*S. U.S. 

State State


x x


Published Tables


Us. 

County


(Totals only)


x


x

SPONSOR:	 National Center for Health Statistics (NCHS),


Department of Health and Human Services (DHHS)


TITLE: National Natality Statistics


Project Director:	 Robert L. Heuser


Chief, Natality Statistics Branch


Division of Vital Statistics


National Center for Health Statistics


3700 East-West Highway


Hyattsville, MD 20782


PURPOSE:	 To collect demographic and health data on births for use in


the study of fertility and in the planning and evaluation of


health programs.


DESIGN:	 Data are obtained from live-birth certificates collected by State


vital registration offices. For some years data are based on a


50 percent systematic sample; for some years on a 100 percent


sample; and for some years a combination of 50 percent and


100 percent samples.


CONTENT:	 Demographic and health characteristics including age of mother,


live-birth order, race, sex, plurality, marital status and


education of mother, residence, birth weight, length of gestation,


prenatal care, attendant at delivery, and in- or out-of-hospital


delivery. Information on births of Hispanic parentage was


available for 23 States in 1982.


YEARS OF DATA Annual. National data available since 1933.


COLLECTION:


PUBLICATIONS:	 Vital Statistics of the United States, Volume I, Natality.


Periodic reports in Vital and Health Statistics, Series 21, and


provisional data in the Monthly Vital Statistics Report published


by the National Center for Health Statistics.


AVAILABILITY Public use data tapes for 1968 and subsequent years are


OF UNPUBLISHED available from the National Technical Information Service,


DATA: 5285 Port Royal Road, Springfield, VA 22161.


CONTACT:	 Robert L. Heuser


(301) 436-8954

SPONSOR: National Center for Health Statistics (NCHS), Department of


Health and Human Services (DHHS)
 I


TITLE: National Natality Statistics 

TYPES OF DATA COLLECTED


Data Public


File Use


Tape


DEMOGRAPHIC DATA 

x x Educational level 

x x Race 

x x Ethnicity 

x x Sex 

x x Marital status 

Migration or mobility 

VITAL STATISTICS


x x	 Natality 

Mortality 

Marriage 

Divorce 

HOUSING


Type of dwelling


No. of persons in household


Relationship of persons in


household


INCOME AND WEALTH


Labor force participation


Total income”


Sources of income


Net assets


SOCIAL SERVICES


HEALTH RESOURCES


General hospitals


Private psychiatric hospitals


Public mental health hospitals


Nursing homes


Other institutional resources


Community-based resources


Health professions


Other professional resources


HEALTH EXPENSES


Costs of care


Out-of-pocket costs


Medicare


Medicaid


State expenditures


Private insurance coverage


Data Public


File Use


Tape


HEALTH


Acute and chronic conditions


Disability days


Chronic limitations


of activity


of mobility


Impairments


Usual activity status


ALCOHOL, DRUG ABUSE,


AND MENTAL HEALTH


Cognitive impairment scale


Behavior problems


Depression


Alcohol use


Drug abuse


CHANGES IN HEALTH STATUS


Morbidity


Functional limitations


Self-perceived health


FUNCTIONAL LEVELS


Social interaction


Activities of daily living


Instrumental activities of


daily living


HEALTH CARE UTILIZATION


x x	 General hospital services


Nursing home services


Home health care


Rehabilitation


Mental health hospitalization


Mental health outpatient


services


Alcohol and drug abuse centers


x x	 Physician services/visits


Dental services/visits


Prescription drugs


Other


OTHER BROAD CATEGORY


FOR SAMPLING UNIT 

99 
SPONSOR:	 National Center for Health Statistics (NCHS), Department of


Health and Human Services (DHHS)


TITLE: National Natality Statistics 

SELECTED ITEMS IN DATA SET


SIZE OF SAMPLE


Age Number in Samplel Nonresponse Rate


Total 3,669,141 Est. 99.3%


(1984) registration


completeness


lLive births


AVAILABILITY AND LOCATION OF SPECIFIC DATA ITEMS


Item Data File Public Use Tape Published Tables


Date of birth


Social Security no.


Veteran status


Geographic data


Largest unit


Smallest unit


Age classes


Single years


(Age of mother)


100


x


Us. 

County/city


of 10,000 

or more 

population 

x


x


Us. Us. 

x x


x x

I€

SPONSORS: National Center for Health Statistics (NCHS), National Heart, Lung, 

1 and Blood Institute (NHLBI), and Bureau of the Census 

I TITLE: National Longitudinal Mortality Study 

1€

I Project Director: 

I Investigators: 

Eugene Rogot, Statistician

National Heart, Lung, and Blood Institute

Federal Building, Room 2C-08

Bethesda, MD 20892

Diane Makuc, Dr.P.H.

Chief, Analytical Coordination Branch

Division of Analysis

National Center for Health Statistics

3700 East-West Highway

Hyattsville, MD 20782

Norman Johnson, Mathematical Statistician

Bureau of the Census, Room 3725-3

Washington, DC 20233

PURPOSE: To study socioeconomic differentials in mortality. 

DESIGN:€ Universe--noninstitutionalizedpopulation of the United States 

sampled through the Current Population Survey (CPS). 

Records for about 1 million persons included in several CPS samples 

(March 1973; February 1978; March 1979; April, August, December 

1980; March 1981-83) are being linked to the National Death Index 

to identify deaths. Cause of death is obtained for all deaths. 

CONTENT:€ The information collected is all CPS data (socioeconomic, demographic, 

labor force participation information) and death certificate data 

for all deaths. The March CPS files contain more detailed information 

on income, occupation, and labor force participation than other CPS 

files. 

YEARS OF DATA CPS data--l973, 1978, 1979, 1980, 1981, 1982, 1983. 

COLLECTION:€ Mortality data--l979-83. Additional data for 1984-85 have 

been budgeted. 

101€
SPONSORS:	 Natio~al Center for Health Statistics (NCHS), National 

Heart, Lung, and Blood Institute (NHLBI), and Bureau of the Census 

TITLE: National Longitudinal MortalityStudy (continued) 

PUBLICATIONS:	 Makuc et al., An Overview of the U.S. National Longitudinal 

Mortality Study. 1984 ASA Proceedings of the Social Statistics 

Section. 

Roqot et al. On the feasibility of linking Census samples to the


ND~ for epidemiologic studies. - Vol.- 73, No. 11; November


1983, 1265-69.


Rogot et al. Mortality by cause of death among selected Census


Bureau sample cohorts, 1979-81; 1985 ASA Proceedings of the


Social Statistics Section.


AVAILABILITY In-house tapes now being developed for use of sponsors. Future


OF UNPUBLISHED plans not yet determined.


DATA:


CONTACT: Diane Makuc, Dr.P.H.


(301) 436-5975


102

SPONSORS:	 National Center for Health Statistics (NCHS), National Heart, Lung, 

and Blood Institute (NHLBI), and Bureau of the Census 

TITLE: National Longitudinal Mortality Study 

TYPES OF DATA COLLECTED


Data Public Data Public


File Use File Use


Tape Ta~e


DEMOGRAPHIC DATA HEALTH


x Educational level 81 

x Race Disability days 

x Ethnicity Chronic limitations 

x Sex of activity 

x Marital status of mobility 

x Migration or mobility (1) Impairments 

Usual activity status 

(1) Acute and chronic conditions


VITAL STATISTICS


Natality


x	 Mortality


Marriage


Divorce


HOUSING


x Type of dwelling


x No. of persons in household


x Relationship of persons in


househula


INCOME AND WEALTH


x Labor force Dartici~ation


x Total income” ‘


x Sources of income


x Net assets


SOCIAL SERVICES


HEALTH RESOURCES


General hospitals


Private rxwchiatric hos~itals


Public menial health hospitals


Nursing homes


Other institutional resources


Comnunity-based resources


Health professions


Other professional resources


HEALTH EXPENSES


Costs of care


Out-of-pocket costs


Medicare


Medicaid


State expenditures


Private insurance coverage


ALCOHOL, DRUG ABUSE, 

AND MENTAL HEALTH


Cognitive impairment scale


Behavior problems


Depression


Alcohol use


Drug abuse


CHANGES IN HEALTH STATUS


Morbidity


Functional limitations


Self-perceived health


FUNCTIONAL LEVELS


Social interaction


Activities of daily living


Instrumental activities of


daily living


HEALTH CARE UTILIZATION


General hos~ital services


Nursing home services


Home health care


Rehabilitation


Mental health hospitalization


Mental health outpatient


services


Alcohol and drug abuse centers


Physician services/visits


Dental services/visits


Prescription drugs


Other


OTHER BROAD CATEGORY


FOR SAMPLINGUNIT 

L Cause of deathi


103

SPONSORS:	 National Center for Health Statistics (NCHS), National


Heart, Lung, and Blood Institute (NHLBI), and Bureau of


the Census


TITLE: National Longitudinal hrtality Study 

SELECTED ITEMS IN DATA SET


SIZE OF SAMPLE


Age


Total


Under 65


65+


Approximate Number


in all CPS Samples


1,000,000


896,000


104,000


AVAILABILITY ANDLOCATIONOF SPECIFIC DATAITEMS 

ITEM Data File Public Use Tape Published Tables 

Date of birth x 

Social Security no. x 

Veteran status x 

Geographic data


Largest unit Us.


Smallest unit


Age classes 

Single years x 

60-64 x 

65+ x 

65-74, 75-84, 85+ x 

Other 

104 
SPONSOR:


TITLE:


PURPOSE:


DESIGN:


CONTENT:


National Center for Health Statistics (NCHS),


Department of Health and Human Services (DHHS)


National !kmtality Followback Surveys 

Project Director: Gloria Kapantais


National Mortality Followback Survey


Office of Vital and Health Care Statistics


National Center for Health Statistics


3700 East-West Highway


Hyattsville, MD 20782


To expand knowledge about the mortality experience of the U.S.


population, without burdening the ongoing State and national


vital statistics registration system.


Data sources: next of kin of the decedents, identified as the


informants on the death certificate. Hospitals, nursing homes,


and other facilities used by the decedent in the last year of


life.


A systematic sample of all deaths in the United States.


1961


1962-63


1964-65


1966-68


1986 survey


1961


1962-63


1964-65


1966-68


1986


n = 5,145; nonresponse 7%


n= 10,822; nonresponse 8%


n = 10,408; nonresponse 9%


n = 19,526; nonresponse 8%


underway


Utilization of hospitals and institut ons dur”ng the


last vear of life.


Utilization of hosDitals and institutions in the


last year of life;’household composition, education,


income, residence.


Utilization; hospital and surgical insurance coverage,


charges for hospital care and source of payment,


surgeon’s bills and source of payment, household


composition, assets, and income.


Utilization; family composition, smoking habits.


Care in the last year of life; lifestyle habits and


risk factors; socioeconomic status; reliability of


selected items reported on the death certificate.


YEARS OF DATA 1961


COLLECTION:	 1962-63


1964-65


1966-68


1986


105 
SPONSOR: 

TITLE: 

PUBLICATIONS: 

AVAILABILITY 

National Center for Health Statistics (NCHS),


Department of Health and Human Services (DHHS)


National lkmtality Followback Surveys (continued) 

National Center for Health Statistics, G. F. Sutton:


Hospitalization in the last year of life, United States, 1961.


Vital and Health Statistics. Series 22, No. 1. PHS Pub. No. 1000.


Public Health Service. Washington. U.S. Government Printing


Office, Sept. 1965.


National Center for Health Statistics, G. S. Wunderlich and


G. F. Sutton: Episodes and duration of hospitalization in the


last year of life, United States, 1961. Vital and Health


Statistics. Series 22, No. 2. PHS Pub. No. 1000. Public Health


Service. Washington. U.S. Government Printing Office, June 1966.


National Center for Health Statistics, E. S. Mathis:


Socioeconomic characteristics of deceased persons, United States,


1962-63 deaths. Vital and Health Statistics. Series 22, No. 9.


PHS Pub. No. 1000. Public Health Service. Washington.


U.S. Government Printing Office, Feb. 1969. -


National Center for Health Statistics, E. J. Timmer: Health


insurance coverage of adults who died in 1964 or 1965, United


States. Vital and Health Statistics. Series 22, No. 10. PiiS


Pub. No. 1000. Public Health Service. Washington. U.S. Government


Printing Office, Oct. 1969.


Public use tape for 1966-68 and future surveys. Unpublished


OF UNPUBLISHEDdata for prior surveys available through the National Center 

DATA : for Health Statistics. 

CONTACT:	 Gloria Kapantais 

(301) ., 436-7107

106 
SPONSOR:	 National Center for Health Statistics (NCHS), Department of Health and


Human Services (DHHS)


TITLE: National Mortality Followback Surveys


TYPES OF DATA COLLECTED 

Data Public Data Public 

File Use File Use 

Tape Taoe 

DEMOGRAPHIC DATA HEALTH 

x x Educational level Acute-and chron c conditions 

x x Race Disability days 

x. x Ethnicity Chronic limitat”ons 

x x Sex x x of activity 

x x Marital status of mobility 

Migration or mobility Impairments


Usual activity status 

VITAL STATISTICS. 

Natality ALCOHOL, DRUG ABUSE, 

x x Mortality AND MENTAL HEALTH 

x x Marriage Coqnitive impairment scale 

x x Divorce x x Be~avior problems 

Depression 

HOUSING x x Alcohol use 

Type of dwelling Drug abuse 

x x No. of persons in household 

x x Relationship of persons in CHANGES IN HEALTH STATUS 

household Morbidity 

Function~l limitations 

INCOME AND WEALTH Self-perceived health 

x x Labor force participation 

x x Total income FUNCTIONAL LEVELS 

Sources of income Social interaction 

x x Net assets x x Activities of daily living 

Instrumental activities of 

Limited SOCIAL SERVICES daily living 

HEALTH RESOURCES HEALTH CARE Utilization 

General hospitals x x General hospital services 

Private psychiatric hospitals x x Nursing home services 

Public mental health hospitals x x Home health care 

Nursing homes Rehabilitation 

Other institutional resources x x Mental health hospitalization 

Community-based resources x x Mental health outpatient 

Health professions services 

Other professional resources x x Alcohol and drug abuse centers 

x x Physician services/visits 

HEALTH EXPENSES Dental services/visits 

Costs of care Prescription drugs 

x x Out-of-pocket costs Other 

x x Medicare 

x x Medicaid OTHER BROAD CATEGORY 

State expenditures FOR SAMPLING UNIT 

x x Private insurance coverage 

1 Utilization in last year of life.


107 
SPONSOR:	 National Center for Health Statistics (NCHS), Department of 

Health and Human Services (DHHS) 

TITLE: National Mortality Followback Surveys 

SELECTED ITEMS IN DATA SET


SIZE OF SAMPLE


Age Number in Sample 1


Total 20,000 

L Sample--25 years and over.


AVAILABILITY ANDLOCATIONOF SPECIFIC DATAITEMS 

Item Data File Public Use Tape Published Tables


Date of birth


Social Security no.


Veteran status


Geographic data


Largest unit


Smallest unit


Age classes


Single years


60-64


65+


65-74, 75-84, 85+


Other


108 

x x


x


x x


U*S. 

U*S. 

x

SPONSOR: 

TITLE: 

PURPOSE: 

DESIGN: 

CONTENT: 

National Center for Health Statistics (NCHS), Department of 

Health and Human Services (DHHS) 

National Health Interview Survey (NHIS): Basic Health and 

Demographic Questionnaire 

Project Director: Owen T. Thornberry, Jr., Ph.D. 

Director 

Division of Health Interview 

Statistics 

National Center for Health Statistics 

3700 East-West Highway 

Hyattsville, Maryland 20782 

To provide data on the incidence of acute conditions, limitation 

of activity, episodes of persons injured, hospitalizations, 

disability days, physician contacts, the prevalence of selected 

chronic conditions, and assessed health status. 

The NHIS is a continuing, nationwide, household interview survey. 

A probability sample of households in the civilian 

noninstitutionalized population of the United States is 

interviewed each week by interviewers from the Bureau of the 

Census. Since 1985 a full sample consists of about 50,000 

households representing about 130,000 persons. The NHIS “basic” 

is not longitudinal and historically has not been linked to 

other files. An NHIS/National Death Index linkage capability 

was made possible after the 1984 NHIS survey year. In the future, 

beginning at the conclusion of the 1987 NHIS survey year, linkage 

capabilities will also exist between the NHIS and the National 

Survey of Family Growth. 

The NHIS provides current information on the amount, distribution, 

and effects of illness and disability in the United States, and 

the services rendered for or because of such conditions. The 

~~I~9~~asic” has changed about every 10 years and most recently . . 

YEARS OF DATA Annual since 1957. 

COLLECTION: 

PUBLICATIONS:€ Current Estimates, an annual publication of the basic statistics 

derived from the NHIS, is the primary publication. Other 

publications of specialized analyses-are referenced as Series 10 

reports in the Catalog of Publications of the National Center 

for Health Statistics and Advance Data reports. 

National Center for Health Statistics, M.G. Kovar and G.S. Poe: 

The National Health Interview Survey Design, 1973-84, and 

Procedures, 1975-83. Vital and Health Statistics. Series 1, 

No. 18. DHHS Pub. No. (PHS) 85-1320. Public Health Service. 

Washington. U.S. Government Printing Office, August 1985. 

109 
SPONSOR:	 National Center for Health Statistics (NCHS), Department of


Health and Human Services (DHHS)


TITLE:	 National Health Interview Survey (NHIS): Basic Health and 

lkmographic Questionnaire (continued) 

AVAILABILITY Data are available both in public use data tape form and


OF UNPUBLISHED in unpublished tabulations. Public use data tapes are


DATA: available through 1984. Unpublished tabulations exist for all


years through 1985 and are on a variety of subjects relative to


health status information. These data can be obtained by


contacting the Division of Health Interview Statistics,


National Center for Health Statistics.


Data tapes for 1970, 1975, 1977, 1978, 1979, and 1980 are in 

the collection of the National Archive of Computerized Data on 

Aging maintained by the Inter-University Consortium for 

Political and Social Research, Ann Arbor, MI 48106 (ICPSR 7838, 

7672, 7839, 8044, 8049, 8223) . 

Data tapes are also in the collection of the Duke University 

Archive for Aging and Adult Development (DAAAD), Durham, NC 

27710. 

CONTACT:	 Owen T. Thornberry, Jr., Ph.D. 

(301) 436-7085 

110

I 

SPONSOR:	 National Center for Health Statistics (NCHS), Department of Health and


Human Services (DHHS)


TITLE:	 National Health Interview Survey (NHIS): Basic Health and Demographic 

Questionnaire 

TYPES OF DATA COLLECTED


Data Public


File	 Use


Tape


DEMOGRAPHIC DATA 

x x Educational level 

x x Race 

x x Ethnicity 

x x Sex 

x x Marital status 

Migration or mobility


VITAL STATISTICS


Natality


Mortality


Marriage


Divorce


HOUSING 

x x T.v~eof dwellinq 

x x N6’.of persons in household 

x x Relationship of persons in 

household 

INCOME AND WEALTH 

x x Labor force participation 

x x Total income 

Sources of income


Net assets


SOCIAL SERVICES


HEALTH RESOURCES


General hospitals


Private psychiatric hospitals


Public mental health hospitals


Nursing homes


Other institutional resources


Community-based resources


Health professions


Other professional resources


HEALTH EXPENSES


Costs of care


Out-of-pocket costs


Medicare coverage


Medicaid coverage


State expenditures


Private insurance coveracie


Data Public


File	 Use


Ta~e


HEALTH 

x x Acute and chronic conditions 

x x Disability days 

Chronic limitations 

x x of activity 

of mobility 

x x Impairments 

x x Usual activity status 

ALCOHOL, DRUG ABUSE,


AND MENTAL ILLNESS


Coqnitive impairment scale


Befiaviorproblems


Depression


Alcohol use


Drug abuse


CHANGES IN HEALTH STATUS


Morbidity


Functional limitations


x x Self-assessed health 

FUNCTIONAL LEVELS


Social interaction


Activities of daily living


Instrumental activities of


daily living


HEALTH CARE UTILIZATION 

x x General hos~ital services 

x x Nursing home services (1968) 

Home health care


Rehabilitation


Mental health hospitalization


Mental health outpatient


services


Alcohol and drug abuse centers 

A x Physician services/visits 

x x Dental services/visits (1981) 

x x Prescription drugs (1965) 

Other


OTHER BROAD CATEGORY


FOR SAMPLING UNIT


111

SPONSOR:	 National Center for Health Statistics (NCHS), Department of 

Health and Human Services (DHHS) 

TITLE:	 National Health Interview Survey (NHIS): Basic Health and 

Demographic Questionnaire 

SELECTED ITEMS IN DATA SET


SIZE OF FINAL SAMPLE


Age Number in Sample Nonresponse Rate


Total 92,000 - 135,000 3-5%


Under 65 81,000 - 120,400


65-74 6,600 - 8,800


75+ 4,100 - 5,700


AVAILABILITY ANDLOCATIONOF SPECIFIC DATAITEMS 

Item


Date of birth


Social Security no.


Veteran status


Geographic data


Largest unit


Smallest unit


Age classes


Single years


60-64


65+


65-74, 75-84, 85+


Other


112


Data File


x


x


Total U.S.


4 regions


x


x


Public Use Tape


x


x


Total U.S.


4 regions


x


x


Published Tables


Total U.S.


4 regions


x

SPONSOR:


TITLE:


PURPOSE:


DESIGN:


CONTENT:


YEARS OF DATA


COLLECTION:


PUBLICATIONS:


AVAILABILITY


OF UNPUBLISHED


DATA:


CONTACT:


National Center for Health Statistics (NCHS), Department of


Health and Human Services (DHHS)


National Health Interview Survey (NHIS): Current Health Topics 

Project Director:	 Owen T. Thornberry, Jr., Ph.D.


Director


Division of Health Interview Statistics,


National Center for Health Statistics


3700 East-West Highway


Hyattsville, MD 20782


To provide data, in addition to the basic NHIS data, on special


topic areas pertinent to the aging population, such as living


arrangements, activities of daily living (ADL), instrumental


activities of daily living (IADL), retirement status, and support


systems.


The universe studied is those persons in the U.S.


noninstitutionalized civilian population in the age categories of


interest, as represented by persons in those age categories in the


NHIS probability sample of households.


Selected health topics have been covered annually in the NHIS for


the past 20 years. Items of coverage in the health topics vary


from year to year and may or may not apply to the aging


population. Among those that include or are designed specifically


for an aging population are:


Residential mobility--l979, 1980.


Hearing aid--l97l, 1977, 1979.


Visual and hearing impairment--l97l, 1977, 1984


(sample--otheryears).


Edentulousness--1971,1983, 1986.


Home care--l979, 1980.


Supplement on Aging--l984.


Functional limitations--l986.


Disability--l977


See Content.


NCHS Series 10 publications in the Catalog of Publications


of the National Center for Health Statistics.


Public use data tapes are available for most selected health


topics through 1985. Requests should be directed to the


Director, Division of Health Interview Statistics, National


Center for Health Statistics, 3700 East-West Highway, Rm. 2-44,


Hyattsville, MD 20782.


Owen T. Thornberry, Jr., Ph.D.


(301) 436-7085


113

SPONSOR:	 National Center for Health Statistics (NCHS), Department of Health


and Human Services (DHHS)


TITLE: National Health Interview Survey (NHIS): Current Health Topics


TYPES OF DATA COLLECTED


Data Public Data Public


File Use File Use 

Tape Tape 

DEMOGRAPHIC DATA 

x x Educational level 

x x Race 

x x Ethnicity 

x x Sex x x 

x x Marital status 

Migration or mobility


x x


VITAL STATISTICS


Natality


Mortality


Marriage


Divorce


HOUSING


Type of dwelling


No. of persons in household


Relationship of persons in


household


INCOME AND WEALTH x x


Labor force participation


x x	 Total income 

Sources of income 

Net assets 

SOCIAL SERVICES


HEALTH RESOURCES


General hospitals


Private psychiatric hospitals


Public mental health hospitals


Nursing homes


Other institutional resources


Community-based resources


Health professions


Other professional resources


HEALTH EXPENSES


Costs of care


Out-of-pocket costs


Medicare coverage


Medicaid coverage


State expenditures


Private insurance coverage


Note: Among all the NHIS health topics, items


cited in this list are included.


HEALTH


Acute and chronic conditions


Disability days


Chronic limitations


of activity


of mobility


Impairments


Usual activity status


ALCOHOL, DRUG ABUSE,


AND MENTAL ILLNESS


Cognitive impairment scale


Behavior problems


Depression


Alcohol use


Drug abuse


CHANGES IN HEALTH STATUS


Morbidity


Functional limitations


Self-perceived health


FUNCTIONAL LEVELS


Social interaction


Activities of daily living


Instrumental activities of


daily living


HEALTH CARE UTILIZATION


General hospital services


Nursing home services


Home health care


Rehabilitation


Mental health hospitalization


Mental health outpatient


services


Alcohol and drug abuse centers


Physician services/visits


Dental services/visits


Prescription drugs


Other


OTHER BROAD CATEGORY


FOR SAMPLING UNIT


on many of the types of data


114 
I


SPONSOR: National Center for Health Statistics (NCHS), Department of Health


and Human Services (DHHS)


TITLE: National Health Interview Survey (NHIS): Current Health Topics 

SELECTED ITEMS IN DATA SET 

SIZE OF SAMPLE1 

Age Number in Sample Nonresponse Rate 

Total


Under 65


65-74 (Varies with survey)


75-84


85+


lSample sizes vary by supplement.


AVAILABILITY AND LOCATION OF SPECIFIC DATA ITEMS


Item


Date of birth


Social Security no.


Veteran status


Geographic data


Largest unit


Smallest unit


Age classes


Single years


60-64


65+


65-74, 75-84, 85+


Other


Data File


x


x


Total U.S.


4 regions


x


x


Public Use Tape


x


x


Total U.S.


4 regions


x


x


Published Tables


Total U.S.


4 regions


115

SPONSOR:	 National Center for Health Statistics (NCHS), Department of


Health and Human Services (DHHS)


TITLE:	 National Health Interview Survey (NHIS): Supplement on


Aging (SOA), 1984


PURPOSE:


DESIGN:


CONTENT:


YEARS OF DATA


COLLECTION:


PUBLICATIONS:


AVAILABILITY


Project Director:	 Owen T. Thornberry, Jr., Ph.D.


Director


D~vision of Health Interview Statistics


National Center for Health Statistics


3700 East-West Highway


Hyattsville, MD 20782


The Supplement on Aging (SOA) provides data on functional


limitations and the health and social care received by the


elderly, noninstitutionalizedpopulation, to complement the


National Nursing Home Survey.


Persons ages 55 years and older in the 1984 NHIS household


sample, which has a response rate of 97 percent, were selected


for the SOA sample: 50 percent of NHIS respondents ages 55-


64 and 100 percent of persons ages 65 and older were included.


Of those selected from the NHIS, 96 percent had completed SOA


interviews.


Health status, functional ability, health and community


service utilization, employment status, social activities,


family relationships and social support, housing


characteristics and living arrangements, and existence of


health conditions specific to the elderly population. The


information in the supplement for each person can be associated


with the basic health and condition information in the NHIS


core questionnaire.


1984 only.


Five Advance Data reports were published in 1986.


NCHS Plan and Operation. Fitti, J. and Kovar, M.G. Series 1.


In press.


Public use data tapes (a person file and a condition file)


OF UNPUBLISHED can be obtained through the National Center for Health


DATA: Statistics, Division of Health Interview Statistics,


3700 East-West Highway, Rm. 2-44, Hyattsvile, MD 20782.


CONTACT:	 Mary Grace Kovar, Dr.P.H.


(301) 436-7104


Gerry Hendershot, Ph.D.


(301) 436-7089


116

I SPONSOR:	 National Center for Health Statistics (NCHS), Department of Health


and Human Services (DHHS)


TITLE:	 National Health Interview Survey (NHIS): Supplement on Aging (SOA),


1984


TYPES OF DATA COLLECTED


Data Public


File Use


Tape


DEMOGRAPHIC DATA 

x x Educational level 

x x Race 

x x Ethnicity 

x x Sex 

x x Marital status 

Migration or mobility


VITAL STATISTICS


Natality


Mortality


Marriage


Divorce


HOUSING -’dwellin9 x x 

x x No. of persons in household 

x x Relationship of persons in 

household


INCOME AND WEALTH 

x x Labor force participation 

x x Total income 

x x Sources of income 

Net assets 

SOCIAL SERVICES


HEALTH RESOURCES


General hos~itals


Private psy~hiatric hospitals


Public mental health hospitals


Nursing homes


Other institutional resources


Community-based resources


Health professions


Other professional resources


HEALTH EXPENSES


Costs of care


Out-of-pocket costs


Medicare coverage


Medicaid coverage


State expenditures


Private insurance coverage


Data Public


File Use


Ta~e


x x 

x x 

x x 

x x 

x x 

x x 

x x 

x x 

x x 

x x 

x x 

x x 

x x 

x x 

x x 

HEALTH


Acute and chronic conditions


Disability days


Chronic limitations


of activity


of mobility


Impairments


Usual activity status


ALCOHOL, DRUG ABUSE,


AND MENTAL ILLNESS


Cognitive impairment scale


Behavior problems


Depression


Alcohol use


Drug abuse


CHANGES IN HEALTH STATUS


Morbidity


Functional limitations


Self-perceived health


FUNCTIONAL LEVELS


Social interaction


Activities of daily living


Instrumental activities of


daily living


HEALTH CARE UTILIZATION


General hospital services


Nursing home services


Home health care


Rehabilitation


Mental health hospitalization


Mental health outpatient


services


Alcohol and drug abuse centers


Physician services/visits


Dental services/visits


Prescription drugs


Other


OTHER BROAD CATEGORY


FOR SAMPLING UNIT


117

SPONSOR: National Center for Health Statistics (NCHS), Department of


Health and Human Services (DHHS)


TITLE:	 National Health Interview Survey (NHIS): Supplement on Aging


(SOA), 1984


SELECTED ITEMS IN DATA SET


SIZE OF SAMPLE


Age Number in Sample


Total 55+ 16,820


Under 65 4,926


65-74 7,344


75+ 4,550


Nonresponse Rate


AVAILABILITY AND LOCATION OF SPECIFIC DATA ITEMS


Item


Date of birth


Social Security no.


Veteran status


Geographic data


Largest unit


Smallest unit


Age classes


Single years


60-64


65+


65-74, 75-84, 85+


Other


Data File Public Use Tape


x x 

x 

x x 

Total U.S. Total U.S.


4 regions 4 regions


x x 

x x 

x x 

x x 

4%


4%


3%


3%


Published Tables


Total U.S.


4 regions


x 

x 

x 

118

SPONSORS:	 National Center for Health Statistics (NCHS), and National


Institute on Aging (NIA), Department of Health and Human Services


(DHHS)


TITLE: Longitudinal Study of Aging (LSOA)


Project Director:	 Mary Grace Kovar, Dr.P.H.


National Center for Health Statistics


3700 East-West Highway


Hyattsville, MD 20782


PURPOSE:	 Study changes in functional status. Develop transitional


probability models. Study relationship between social and health


factors and death.


DESIGN:	 The Longitudinal Study of Aging is a prospective study based


on respondents to the Supplement on Aging, a special set of


questions added to the National Health Interview Survey in 1984.


Thus the base is a national probability sample of people age 55


and older living in the conmnunity. All respondents will be


followed by linkage with death records through the National Death


Index. Respondents age 65 and older will be followed by linkage


with Medicare records. One-half of respondents age 70-79 and all


respondents age 80 and older, or their contact persons, were


reinterviewed by telephone.


CONTENT:	 Interview focuses on changes in functioning, care giving,


and living arrangements.


YEARS OF DATA Baseline survey, 1984.


COLLECTION: First reinterview, 1986.


Record linkage biannually.


PUBLICATIONS:	 Kovar, M.G., and J. Fitti: “A Linked Followup Study of Older


People.” Proceedings of the Survey Research Section of the


American Statistical Association, 1985.


AVAILABILITY Public use data tapes from the first phase of followup will


OF UNPUBLISHED become available in the sumner of 1987. The first public use


DATA: tape will contain SOA baseline data plus responses to 1986


reinterview and matches to 1984 and 1985 National Death Index.


CONTACT:	 Mary Grace Kovar, Dr.P.H.


(301) 436-7104


119

SPONSORS:	 National Center for Health Statistics (NCHS), and National Institute


on Aging (NIA), Department of Health and Human Services (DHHS)


TITLE: Longitudinal Study of Aging (LSOA)


TYPES OF DATA COLLECTED 

Data Public Data Public 

File Use File Use 

Tat)e Tape 

DEMOGRAPHIC DATA 

x Educational level x 

x Race x 

x Ethnicity 

x Sex 

x Marital status 

Migration or mobility x 

x 

VITAL STATISTICS


Natalitv


Mortali~y


Marriage


Divorce


HOUSING


Type of dwelling


No. of persons in household


Relationship of persons in


household


INCOME AND WEALTH


Labor force ~artici~ation


Total income’ ‘


Sources of income x


Net assets x


x 

SOCIAL SERVICES


HEALTH RESOURCES


General hospitals .,


Private psychiatric hospitals ;


Public mental health hospitals x


Nursing homes


Other institutional resources


Connnunity-basedresources


Health professions


Other professional resources


x


HEALTH EXPENSES


Costs of care


Out-of-pocket costs


Medicare coverage


Medicaid coverage


State expenditures


Private insurance coverage


HEALTH


Acute and chronic conditions


Disability days


Chronic limitations


of activity


of mobility


Impairments


Usual activity status


ALCOHOL, DRUG ABUSE,


AND MENTAL ILLNESS


Coqnitive impairment scale


Befiaviorproblems


Depression


Alcohol use


Drug abuse


CHANGES IN HEALTH STATUS


Morbiditv


Function~l limitations


Self-perceived health


FUNCTIONAL LEVELS


Social interaction


Activities of daily living


Instrumental activities of


daily living


HEALTH CARE UTILIZATION


General hospital services


Nursing home services


Home health care


Rehabilitation


Mental health hospitalization


Mental health outpatient


services


Alcohol and drug abuse centers


Physician services/visits


Dental services/visits


Prescription drugs


Other


OTHER BROAD CATEGORY


FOR SAMPLING UNIT


120 
SPONSORS:	 National Center for Health Statistics (NCHS), and National


Institute on Aging (NIA), Department of Health and Human


Services (DHHS)


TITLE: Longitudinal Study of Aging (LSOA) 

SELECTED ITEMS IN DATA SET


SIZE OF REINTERVIEW SAMPLE


Age


Total


Under 70


70-79 

so+ 

Number in 1984 Sample


7,541


5,44: 

2,095 

Number in 1986


Reinterview


5,151 

0 

3,061 

2,090 

AVAILABILITY AND LOCATION OF SPECIFIC DATA ITEMS


Item


Date of birth


Social Security no.


Veteran status


Geographic data


Largest unit


Smallest unit


Age classes


Single years


60-64


65+


65-74, 75-84, 85+


Other


Data File Public Use Tape Published Tables


x x


x


x x


U*S. U.S. 

Region Region


x x


121

SPONSORS:	 National Center for Health Statistics (NCHS) and National


Institute on Aging (NIA), Department of Health and Human


Services (DHHS).


TITLE:	 National Health Interview Survey (NHIS): Data for the Study 

of Secular Change and Aging 

Project Director:	 Mary Grace Kovar, Dr.P.H.


Interview and Examination Survey Program


National Center for Health Statistics


3700 East-West Highway


Hyattsville, MD 20782


PURPOSE: To monitor change in the health of the U.S. population.


DESIGN:	 Sample of the civilian noninstitutionalized population.


Response rate each year is greater than 95 percent.


CONTENT: Items that were on the core questionnaire of the National


Health Interview Survey during the period 1969-81 have been


abstracted and put in common format. There is one record


for each person who was age 30 and over at the time of the


interview.


YEARS OF DATA 1969-81.


COLLECTION:


PUBLICATIONS:	 Vital and Health Statistics Series 10 is the primary


publication for data from the National Health Interview


Survey.


National Center for Health Statistics, M.G. Kovar and G.S.


Poe: The National Health Interview Survey Design, 1973-84,


and Procedures, 1975-83. Vital and Health Statistics.


Series 1, No. 18. DHHS Pub. No. (PHS) 85-1320. Public


Health Service. Washington. U.S. Government Printing Office,


August 1985.


AVAILABILITY Public use data tape can be obtained from the National


OF UNPUBLISHED Archive of Computerized Data on Aging (NACDA),


DATA: P.O. Box 1248, Ann Arbor, MI 48106, and from the Division


of Health Interview Statistics, National Center for Health


Statistics, Rm. 2-44, 3700 East-West Highway, Hyattsville,


MD 20782.


CONTACT:	 Mary Grace Kovar, Dr.P.H.


(301) 436-7104


122 
SPONSORS:	 National Center for Health Statistics (NCHS) and National Institute 

on Aging (NIA), Department of Health and Human Services (DHHS) 

TITLE:	 National Health Interview Survey (NHIS): Data for the Studyof 

Secular Change and Aging 

TYPES OF DATA COLLECTED


Data Public


File	 Use


Ta~e


Data Public


File Use


Tape


HEALTH


Acute and chronic conditions


Disability days


Chronic limitations


of activity


of mobility


Impairments


Usual activity status


ALCOHOL, DRUG ABUSE,


AND MENTAL ILLNESS


Coqnitive im~airment scale


Behavior problems


Depression


Alcohol use


Drug abuse


CHANGES IN HEALTH STATUS


Morbidity


Functional limitations


Self-perceived health


FUNCTIONAL LEVELS


Social interaction


Activities of daily living


Instrumental activities of


daily living


HEALTH CARE UTILIZATION


General hospital services


Nursing home services


Home health care


Rehabilitation


Mental health hospitalization


Mental health outpatient


services


Alcohol and drug abuse centers


Physician services/visits


Dental services/visits


Prescription drugs


Other


OTHER BROAD CATEGORY


FOR SAMPLING UNIT


DEMOGRAPHIC DATA


Educational level


Race


Ethnicity


Sex


Marital status


Migration or mobility


VITAL STATISTICS 

Natality


Mortality


Marriage


Divorce


HOUSING 

Type of dwelling


No. of persons in household


Relationship of persons in


household


INCOME AND WEALTH


Labor force participation


Total income


Sources of income


Net assets


SOCIAL SERVICES 

HEALTH RESOURCES


General hospitals


x x 

x x 

x x 

x x 

x x 

x x 

x x 

x x 

x


x


x


x


x


x


x


x


x 

x 

x


x


x 

x 

x 

x 

x 

x 

Private psychiatric hospitals x


Public mental health hospitals x


Nursing homes


Other institutional resources


Comnunity-based resources


Health professions


Other professional resources


x


HEALTH EXPENSES x


Costs of care


Out-of-pocket costs


Medicare coverage


Medicaid coverage


State expenditures


Private insurance coverage


123 
SPONSORS:	 National Center for Health Statistics (NCHS) and National 

Institute on Aging (NIA), Department of Health and Human Services 

(DHHS) 

TITLE :	 National Health Interview Survey (NHIS): Data for the Study of 

Secular Change and Aging 

SELECTED ITEMS IN DATA SET


SIZE OF SAMPLE


Age Number in Sample Nonresponse Rate


Total


Under 65


65-74 See NHIS description


75-84


85+ 

AVAILABILITY ANDLOCATIONOF SPECIFIC 

“Item


Date of birth


Social Security no.


Veteran status


Geographic data


Largest unit


Smallest unit


Age classes


Single years


60-64


65+


65-74, 75-84, 85+


Other


Data File


x


x


U*S. 

State


x


DATAITEMS


Public Use Tape Published Tables


x


x


U.S. 

Region


x


124 
SPONSOR:


I 

TITLE:


PURPOSE:


DESIGN:


CONTENT:


National Center for Health Statistics (NCHS), Department of


Health and Human Services (DHHS)


First National Health and Nutrition Examination Survey (NHANES I)


Project Director: Robert S. Murphy


Director


Division of Health Examination Statistics


Center Building, Room 2-58


3700 East-West Highway


Hyattsville, MD 20782


Established under the National Health Survey Act of 1956 to


obtain those kinds of health data optimally obtained by direct


physical examinations and physiological and biochemical measurements.


Measures and monitors health and nutritional status of the U.S.


population. Permits estimation of the prevalence of certain diseases


and the distributions of a broad variety of health-related measurements


Probability sample of the U.S. civilian noninstitutionalized


population ages 1 through 74 years. Cross-sectional study of 31,973


persons of whom 23,808 were examined. Composed of two overlapping


sets of examination components referred to as the nutrition


examination and the detailed medical examination. Six distinct


probability samples were contained within the overall survey. This


study was used as the baseline for a later study called the NHANES I


Epidemiologic Followup Study.


Demographic information; medical histories; dietary information;


electrocardiograms; body measurements; dermatological and


ophthalmological examinations; general medical examination;


hematological, blood chemistry, and urological laboratory


determinations. In the detailed medical examination, additional


data were collected on a subsample of adults 25-74 years by


supplementary questionnaires concerning arthritis, respiratory


conditions, and cardiovascular conditions; an extended medical


examination, X-rays of the chest for heart size and pathology as


well as lung volume and pathology; X-rays of the hip, sacroiliac,


and knee joints for assessment of arthritic and related changes;


spirometry and additional laboratory determinations.


YEARS OF DATA 1971 to 1975. NHANES II was conducted from 1976 to 1980.


COLLECTION:


125

SPONSOR:	 National Center for Health Statistics (NCHS), Department of


Health and Human Services (DHHS)


TITLE:	 First National Health and Nutrition Examination Survey 

(NHANESI) (continued) 

PUBLICATIONS:	 National Center for Health Statistics, H. K. Miller: Plan and 

operation of the Health and Nutrition Examination Survey, United 

States, 1971-73. Vital and Health Statistics. Series 1, No. 10a 

and 10b. DHEW Pub. No. (HSM) 73-1310. Health Services and 

Mental Health Administration. Washington. U.S. Government 

Printing Office, Feb. 1973. 

National Center for Health Statistics, A. Engel, R. S. Murphy,


K. Maurer and E. Collins: Plan and operation of the NHANES I


Augmentation Survey of Adults 25-74 Years, United States,


1974-75. Vital and Health Statistics. Series 1, No. 14. DHEW


Pub. No. (PHS) 78-1314. Public Health Service. Washington. U.S.


Government Printing Office, June 1978.


See also Catalog of Publications from the National Center for


Health Statistics. Publications listed in Series 11 of Vital


and Health Statistics and Advance Data reports.


AVAILABILITY Data tapes are available on virtually all the information


OF UNPUBLISHED collected in NHANES I. A catalog is available from the


DATA:	 Scientific and Technical Information Branch, National Center


for Health Statistics, Room 1-57, 3700 East-West Highway,


Hyattsville, MD 20782.


Data collected in the NHANES can be located by means of HINDEX,


available in hard copy or on a floppy diskette. Each line of


HINDEX contains information on an individual data item, giving


its contents, classification, method by which the data were


obtained, the age range for which it was collected, the survey


year in which it was collected, and the location of the data


item on the tape. HINDEX has been released in three volumes:


one indexes the data items in an alphabetical sort by data


category; the second is an alphabetical sort by data field; and


the third, a numerical sort by tape and position field.


Data tapes for the First National Health and Nutrition


Examination Survey (NHANES I) are also in the collection of the


National Archive of Computerized Data on Aging, maintained by


the Inter-University Consortium for Political and Social


Research, P.O. Box 1248, Ann Arbor, MI 48106.


CONTACT:	 Patricia A. Vaive


(301) 436-7080


126 
SPONSOR:	 National Center for Health Statistics (NCHS), Department of Health


and Human Services (DHHS)


TITLE: First National Health and Nutrition Examination Survey (NHANESI) 

TYPES OF DATA COLLECTED 

Data Public Data Public 

File Use File Use 

Tape Tape 

x x 

x x 

x x 

x x 

x x 

x x 

x x 

x x 

x x 

x x 

x x 

DEMOGRAPHIC DATA


Educational level x x


Race


Ethnicity


Sex x x


Marital status x x


Migration or mobility x x


x x 

VITAL STATISTICS


Natality


Mortality


Marriage


Divorce


x x 

HOUSING


Type of dwelling


No. of persons in household


Relationship of persons in


household


INCOME AND WEALTH


Labor force participation


Total income


Sources of income


Net assets


SOCIAL SERVICES


HEALTH RESOURCES


General host)itals


Private psychiatric hospitals


Public mental health hospitals


Nursing homes


Other institutional resources


Comnunity-based resources


Health professions


Other professional resources


x x 

HEALTH EXPENSES x x 

Costs of care 

Out-of-pocket costs 

Medicare coverage 

Medicaid coverage 

State expenditures 

Private insurance coverage x x 

x x 

HEALTH


Acute and chronic conditions


Disability days


Chronic limitations


of activity


of mobility


Impairments


Usual activity status


ALCOHOL, DRUG ABUSE,


AND MENTAL ILLNESS 

Coqnitive impairment scale


Befiaviorproblems


Depression


Alcohol use


Drug abuse


CHANGES IN HEALTH STATUS


Morbidity


Functional limitations


Self-perceived health


FUNCTIONAL LEVELS


Social interaction


Activities of daily living


Instrumental activities of


daily living


HEALTH CARE UTILIZATION


General hospital services


Nursing home services


Home health care


Rehabilitation


Mental health hospitalization


Mental health outpatient


services


Alcohol and drug abuse centers


Physician services/visits


Dental services/visits


Prescription drugs


Other


OTHER BROAD CATEGORY


FOR SAMPLING UNIT


Examination findinqs


Nutritional status-


127

SPONSOR: National Center for Health Statistics (NCHS), Department of 

Health and Human Services (DHHS) 

TITLE: First National Health and Nutrition Examination Survey (NHANESI) 

SELECTED ITEMS IN DATASET 

SIZE OF SAMPLE 

Age Number in Samplel Nonresponse Ratel 

Total 28,043 26.1%


Under 65 22,651 23.7%


65-74 5,392 35.7%


1 Numbers and rates apply to the largest of the


NHANES I subsamples, the 65 location nutrition


examination sample.


AVAILABILITY ANDLOCATIONOF SPECIFIC 

Item


Date of birth


Social Security no.


Veteran status


Geographic data


Largest unit


Smallest unit


Age classes


Single years


60-64


65+


65-74, 75-84, 85+


Other


Data File


x 

x 

National


County


x 

x 

x 

65-74


1-74 years


DATAITEMS 

Public Use Tape


x 

x 

National


Region


x 

x 

x 

65-74


1-74 years


Published Tables


National


National


65-74


10-year age


intervals


128 
SPONSOR:	 National Center for Health Statistics (NCHS), Department of Health 

and Human Services (DHHS) 

TITLE: Second National Health and Nutrition Examination Survey (NHANESII) 

Project Director:	 Robert S. Murphy


Director


Division of Health Examination Statistics


Center Building, Room 2-58


National Center for Health Statistics


3700 East-West Highway


Hyattsville, MD 20782


PURPOSE:	 Established under the National Health Survey Act of 1956 to obtain


those kinds of health data optimally obtained by direct physical


examinations and physiological and biochemical measurements. Measures


and monitors health and nutritional status of the U.S. population.


Permits estimation of the prevalence of certain diseases and the


distributions of a broad variety of health-related measurements.


DESIGN:	 Probability sample of the U.S. civilian noninstitutionalized


population ages 6 months to 74 years. Cross-sectional study of 27,801


persons of whom 20,322 (73.1 percent) were interviewed and examined.


CONTENT:	 Demographic information, medical histories, dietary information,


electrocardiograms, body measurements, allergy test results, X-rays of


chest and cervical and lumbar spine, glucose tolerance test results,


liver function and anemia testing results, lipid testing results,


pesticide test results, and hematology tests. Target conditions


included diabetes, kidney pathology, liver disease, allergy,


osteoarthritis and disc degeneration, cardiovascular conditions, and


body burdens of carbon monoxide, lead, and pesticide residues.


YEARS OF DATA NHANES II was conducted from February 1976 to February 1980. 

COLLECTION: Current plans are under way for an NHANES III to begin in 1988. 

PUBLICATIONS:	National Center for Health Statistics, A. McDowell, A. Engel,


J. T. Massey and K. Maurer: Plan and operation of the Second National


Health and Nutrition Examination Survey, 1976-80. Vital and Health


Statistics. Series 1, No. 15. DHHS Pub. No. (PHS) 81-1317. Public


Health Service. Washington. U.S. Government Printing Office, July 1981.


See also Catalog of Publications from the National Center for Health


Statistics. Publications listed in Series 11 of Vital and Health


Statistics and Advance Data reports.


129

SPONSOR:	 National Center for Health Statistics (NCHS), Department of


Health and Human Services (DHHS)


TITLE:	 Second National Health and Nutrition Examination Survey (NHANES II) 

(continued) 

AVAILABILITY Data tapes are available on a major portion of the


OF UNPUBLISHED information collected in NHANES II. A catalog is available


DATA: from the Scientific and Technical Information Branch,


National Center for Health Statistics, Room 1-57,


3700 East-West Highway, Hyattsville, MD 20782.


Data collected in the NHANES surveys can be located by means of 

HINDEX, available in hard copy or on a floppy diskette. Each 

line of HINDEX contains information on an individual data item, 

giving its contents, classification, method by which the data 

were obtained, the age range for which it was collected, the 

survey year in which it was collected, and the location of the 

data item on the tape. HINDEX has been released in three volumes: 

one indexes the data items in alphabetical sort by data category; 

the second is an alphabetical sort by data field; and the third, 

a numerical sort by tape and position field. 

Data tapes for the Second National Health and Nutrition


Examination Survey (NHANES 11) are also in the collection of the


National Archive of Computerized Data on Aging maintained by the


Inter-University Consortium for Political and Social Research,


P.O. Box 1248, Ann Arbor, MI 48106.


CONTACT:	 Patricia A. Vaive


(301) 436-7080


130

I 

SPONSOR:	 National Center for Health Statistics (NCHS), Department of Health


and Human Services (DHHS)


TITLE: Second National Health and Nutrition Examination Survey (NHANES11) 

TYPES OF DATA COLLECTED


Data Public


File Use


Tar)e


x x 

x x 

x x 

x x 

x x 

x x 

x x 

x x 

x x 

x x 

x x 

DEMOGRAPHIC DATA


Educational level


Race


Ethnicity


Sex


Marital status


Migration or mobility


VITAL STATISTICS


Natalit.y


Mortality


Marriage


Divorce


HOUSING


Type of dwelling


No; of persons ;n household


Relationship of persons in


household


INCOME AND WEALTH


Labor force Darticit)ation


Total income” ‘


Sources of income


Net assets


SOCIAL SERVICES


HEALTH RESOURCES


General hospitals


Private psychiatric hospitals


Public mental health hospitals


Nursing homes


Other institutional resources


Community-based resources


Health professions


Other professional resources


HEALTH EXPENSES


Costs of care


Out-of-pocket costs


Medicare


Medicaid


State expenditures


Private insurance coverage


Data Public


File Use


Tape


HEALTH


x x Acute and chronic conditions 

Disability days 

Chronic limitations 

x x of activity 

x x of mobility 

x x Impairments 

x x Usual activity status 

ALCOHOL, DRUG ABUSE,


AND MENTAL ILLNESS


Cognitive impairment scale


Behavior problems


Depression


Alcohol use


Drug abuse


CHANGES IN HEALTH STATUS


Morbidity


Functional limitations


Self-perceived health


FUNCTIONAL LEVELS


Social interaction


Activities of daily living


Instrumental activities of


daily living


HEALTH CARE UTILIZATION


General hospital services


Nursing home services


Home health care


Rehabilitation


Mental health hospitalization


Mental health outpatient


services


Alcohol and drug abuse centers


Physician services/visits


Dental services/visits


Prescription drugs


x x Other--Some condition-specific


utilization data


OTHER BROAD CATEGORY


FOR SAMPLING UNIT 

x x Examination findinas 

x x Nutritional status” 

131

SPONSOR:	National Center for Health Statistics (NCHS), Department of Health


and Human Services (DHHS)


TITLE: Second National Health and Nutrition Examination Survey (NHANES II) 

Age


Total


Under 65


65-74


SELECTED ITEMS IN DATA SET


SIZE OF SAMPLE


Number in Sample Nonresponse Rate


27,801 27%


23,589 25%


4,212 38%


AVAILABILITY ANDLOCATIONOF SPECIFIC DATAITEMS


Item


Date of birth


Social Security no.


Veteran status


Geographic data


Largest unit


Smallest unit


Age classes


Single years


60-64


65+


65-74, 75-84, 85+


Other


132


Data File


x


x


National


County


x


x


x


65-74


6 mos-74 yrs


Public Use Tape


x


x


National


Region


x


x


x


65-74


6 mos-74 yrs


Published Tables


National


National


65-74


10-year age


intervals

SPONSOR:


TITLE:


PURPOSE:


DESIGN:


CONTENT:


YEARS OF DATA


COLLECTION:


PUBLICATIONS:


AVAILABILITY


OF UNPUBLISHED


DATA:


CONTACT:


National Center for Health Statistics (NCHS), Department of


Health and Human Services (DHHS)


Hispanic Health and Nutrition Examination Survey (HHANES)


Project Director:	 Robert S. Murphy


Director


Division of Health Examination Statistics


Center Building, Room 2-58


National Center for Health Statistics


3700 East-West Highway


Hyattsville, MD 20782


To produce estimates of health and nutritional status for the


three major Hispanic subgroups comparable to estimates available


for the general population from the National Health and Nutrition


Examination Surveys. These estimates would include the prevalence


of certain diseases and the distribution of a broad variety of


health-related measurements.


The HHANES was a cross-sectional study covering three universes:


Mexican-Americans in five southwestern States; Cuban-Americans in


Dade County, Florida; and Puerto Ricans in and around New York


City. Overall, of approximately 16,000 sample persons,


approximately 12,000 persons (75 percent) were interviewed and


examined. Sample persons were aged 6 months through 74 years


inclusive and were noninstitutionalized civilians.


Laboratory analyses, diagnostic tests, interviews, body


measurements, and physical and dental examinations were used to


collect measures of health and nutritional status. Target


conditions of this survey included: diabetes, hypertension, heart


disease, gallstones, dental disease, otitis media and hearing


problems, vision, kidney disease, liver disease, alcohol


consumption, drug abuse, depression, iron status, overweight and


obesity, dietary adequacy, and body burden of pesticide residues.


July 1982 through December 1984.


National Center for Health Statistics, “Plan and Operation of the


Hispanic Health and Nutrition Examination Survey, 1982-1984.” K.


Maurer. Vital and Health Statistics, Series l-No. 19, DHHS Pub.


NO. (PHS) 85-1321, September 1985.


Public use data tapes for Mexican Americans have been released


and release of the Puerto Rican and CubanAmerican components is


scheduled for 1987.


Patricia A. Vaive


(301) 436-7080


133

SPONSOR:	 National Center for Health Statistics (NCHS), Department of Health


and Human Services (DHHS)


TITLE: Hispanic Health and Nutrition Examination Survey (HHANES) 

TYPES OF DATA COLLECTED 

Data Public Data Public 

File Use File Use 

Tape Ta~e 

DEMOGRAPHIC DATA 

x Educational level x 

x Race 

x Ethnicity 

x Sex 

x Marital status 

Migration or mobility x 

x 

VITAL STATISTICS


Natality


Mortality


Marriage


Divorce


x 

HOUSING x 

Type of dwelling x 

No. of persons in household 

Relationship of persons in 

household


INCOME AND WEALTH


Labor force participation


Total income


Sources of income


Net assets


SOCIAL SERVICES


HEALTH RESOURCES


General hosi)itals


Private psy~hiatric hospitals


Public mental health hospitals


Nursing homes


Other institutional resources


Coirrnunity-based
 resources


Health professions


Other professional resources


x


HEALTH EXPENSES x


Costs of care x


Out-of-pocket costs


Medicare coverage


Medicaid coverage


State expenditures


Private insurance coverage x


x


HEALTH


Acute and chronic conditions


Disability days


Chronic limitations


of activity


of mobility


Impairments


Usual activity status


ALCOHOL, DRUG ABUSE,


AND MENTAL ILLNESS


Cognitive impairment scale


Behavior problems


Depression


Alcohol use


Drug abuse


CHANGES IN HEALTH STATUS


Morbiditv


Function~l limitations


Self-perceived health


FUNCTIONAL LEVELS


Social interaction


Activities of daily living


Instrumental activities of


daily living


HEALTH CARE UTILIZATION


General host)italservices


Nursing homk services


Home health care


Rehabilitation


Mental health hospitalization


Mental health outpatient


services


Alcohol and drug abuse centers


Physician services/visits


Dental services/visits


Prescription drugs


Other


OTHER BROAD CATEGORY


FOR SAMPLING UNIT


Examination findings


Nutritional status


134 
SPONSOR:	 National Center for Health Statistics (NCHS), Department of


Health and Human Services (DHHS)


TITLE: Hispanic Health and Nutrition Examination Survey (HHANES) 

SELECTED ITEMS IN DATA SET


SIZE OF SAMPLE 

Age Number in Samplel Nonresponse Rate


Total 15,931 27%


Under 65 15,320 26%


65-74 611 39%


1 Figures are preliminary.


AVAILABILITY AND l~fn.TION OF SPECIFIC 

Item Data File


Date of birth


Social Security no.


Veteran status


Geographic data


Largest unit


Smallest unit


Age classes


Single years x 

60-64 x 

65+ 

65-74, 75-84, 85+ 65-74


Other 6 mos.-74 yrs


DATA ITEMS 

Public Use Tape Published Tables


1 Mexican-American population in 5 southwestern States, Cuban-/3nericansin


Dade County, Florida, and Puerto Ricans in and around New York City.


2 The three groups above, separately and at the county or borough level.


135 
SPONSORS:


TITLE:


PURPOSE:


DESIGN:


CONTENT:


YEARS OF DATA


COLLECTION:


PUBLICATIONS:


National Center for Health Statistics (NCHS), National Institute


on Aging, and other institutes


NHANES I Epidemiologic Followup Study: Initial Followup, 

1982-84 

Project Director:	 Helen E. Barbano


Special Assistant


Division of Analysis


National Center for Health Statistics


3700 East-West Highway


Hyattsville, MD 20782


Identify chronic disease risk factors associated with morbidity


and mortality; ascertain changes in risk factors, morbidity,


functional limitation and institutionalizationbetween NHANES I


and the followup recontacts; and map the natural history of


chronic diseases and functional impairments in an aging population.


The baseline survey, the first National Health and Nutrition


Examination Survey (NHANES), conducted by NCHS from 1971 to


1975 was a probability sample of the civilian noninstitutional­


ized coterminous U.S. population ages 1-74 years. The


population of the followup study includes the 14,407 persons


who were ages 25-74 at the time they were examined in the


original NHANES I Survey.


See Types of Data Collected.


The NHANES I Epidemiologic Followup Study: Initial Followup


1982-84; data tapes will be available in mid-1987. Continued


::l]~:p of the elderly 1985-86; data tapes will be available
 .
 Continued followup of total sample 1987; data tapes


will be-available in 1990.


Cornoni-Huntley, J., Barbano, H.E., Brody, J.A., Cohen, B.,


Feldman, J.J., Kleinman, J.C., and Madans, J. National Health


and Nutrition Examination Survey--EpidemiologicFollow-up Survey.


Public Health Reports 98:245-251,1983.


Madans, J., Kleinman, J.C., Cox, C.S., Barbano, H.E., Feldman,


J.J., Cohen, B. Finucane, F.F., and Cornoni-Huntley, J. 10


Years after NHANES I: Report of initial followup, 1982-84.


Public Health Reports 101:465-473, 1986.


Madans, J., Cox, C.S., Kleinman, J.C., Makuc, D., Feldman, 

J.J., Finucane, F.F., Barbano, H.E., and Cornoni-Huntley, J. 

10 Years after NHANES I: Mortality experience at initial 

followup, 1982-84. Public Health Reports 101:474-481, 1986. 

136

SPONSORS:	 National Center for Health Statistics (NCHS)


with National Institute on Aging and other institutes


TITLE:	 NHANESI Epidemiologic Followup Study: Initial Followup, 

1982-84 (continued) 

AVAILABILITY While data tapes are being prepared, collaborators from


OF UNPUBLISHED National Institute on Aging, other National Institutes of


DATA: Health, and the Alcohol, Drug Abuse, and Mental Health


Administration are using data tapes. Public use data tapes


available in mid-1987.


CONTACT:	 Jennifer Madans


(301) 436-5975


137

SPONSORS:	 National Center for Health Statistics (NCHS), National Institute on


Aging and other institutes


TITLE: NHANES I Epidemiologic Followup Study: Initial Followup, 1982-84 

TYPES OF DATA COLLECTED


Data Public Data Public


Filel Use Filel Use


Tape Tape 

DEMOGRAPHIC DATA HEALTH 

x Educational level x Acute and chronic conditions 

x Race Disability days 

x Ethnicity Chronic limitations 

x Sex x of activity 

x Marital status x of mobility 

Migration or mobility x Impairments 

x Usual activity status 

VITAL STATISTICS 

x Natalit.v ALCOHOL, DRUG ABUSE, 

x Mortali;y AND MENTAL ILLNESS 

x Marriage x Coqnitive im~airment scale 

x Divorce Befiaviorproblems 

x Depression 

HOUSING x Alcohol use 

x TY~e of dwellinq Drug abuse 

x N;; of persons ;n household 

x Relationship of persons in CHANGES IN HEALTH STATUS 

household x Morbidity 

Functional limitations 

INCOME AND WEALTH x Self-perceived health 

x Labor force participation 

x Total income- FUNCTIONAL LEVELS 

X Sources of income x Social interaction 

Net assets x Activities of daily living 

x Instrumental activities of 

SOCIAL SERVICES daily living


HEALTH RESOURCES HEALTH CARE UTILIZATION


General hospitals x General hosDital services


Private psychiatric hospitals x Nursing home services


Public mental health hospitals Home health care


Nursing homes x Rehabilitation


Other institutional resources x Mental health hospitalization


Community-based resources Mental health outpatient


Health professions services


Other professional resources x	 Alcohol and drug abuse centers


Physician services/visits


HEALTH EXPENSES Dental services/visits


Costs of care x Prescription drugs (selected)


Out-of-pocket costs Other


Medicare coverage


Medicaid coverage OTHER BROAD CATEGORY


State expenditures FOR SAMPLING UNIT


Private insurance coverage


lInitial followup.


21npatient only.


130

I 

SPONSORS: National Center for Health Statistics (NCHS), National


Institute on Aging, and other institutes


TITLE: NHANES I Epidemiologic Followup Study: Initial Followup, 1982-84 

SELECTED ITEMS IN DATA SET


SIZE OF SAMPLE


Number in Sample % Traced but 

Ag~l at Baseline % Lost to FO11OWUP Not Interviewed 

Total 14,407 7.1 8.7 

Under 65 10,554 8.4 

65+ 3,853 3.7 1::: 

1 At time of sample selection in 1971-75 these data are the


most current and take into account 78 additional birth-date


changes that were made in September-October 1986. These data


will be reflected in the NHEFS Plan and Operations series


report.


2 Percent of sample successfully traced not responding to


questionnaire (includes refusal and subjects living outside


the coterminous U.S.). 

AVAILABILITY ANDLOCATIONOF SPECIFIC 

Item


Date of birth


Social Security no.


Veteran status


Geographic data


Largest unit


Smallest unit


Age classes


Single years


60-64


65+


65-74, 75-84, 85+ 

Other


Data File


x


x


Us. 

Cluster of


counties


x


DATAITEMS 

Public Use Tape Published Tables


x


Us. 

Region (4)


x


139

SPONSOR:


TITLE:


PURPOSE:


DESIGN:


National Center for Health Statistics (NCHS) and


Health Care Financing Administration (HCFA)


National Medical Care Utilization and Expenditure Survey (NMCUES), 

1980 

Project Director: Robert A. Wright


Chief, Utilization and Expenditure


Statistics Branch


Division of Health Interview Statistics


National Center for Health Statistics


3700 East-West Highway


Hyattsville, MD 20782


and


Herbert A. Silverman


Chief, Program Statistics Branch


Office of Research and Demonstrations


Health Care Financing Administration


6340 Security Boulevard


Baltimore, MD 21235


The National Medical Care Utilization and Expenditure Survey was


conducted in 1980 and early 1981 by the National Center for Health


Statistics and the Health Care Financing Administration. Data


were collected on health, access to and use of medical services,


associated charges and sources of payment, and health insurance


coverage for the U.S. civilian noninstitutionalized population.


Data for the year 1980 were collected in five rounds of interviews


conducted at approximately 3-month intervals during 14 months of


1980-81.


The survey consisted of three components: the national household


component, the State Medicaid household component, and the


administrative records component. A sumnary of responses was


computer generated from data recorded in the core questionnaire


during previous interviews and was mailed to both the reporting


unit and the interviewer before the next interview. The summary


served as a check to make sure that recording of data entry errors


was held to a minimum.


The national household component included 17,123 persons in about


6,600 participating reporting units (families). The State Medicaid


household survey sample consisted of about 11,600 persons in


4,800 responding families selected from Medicaid eligibility


files in California, Michigan, New York, and Texas (1,200 per


State). Administrative records were used to obtain information


on program eligibility and payments for medical care for persons


receiving Medicare and Medicaid.


The sample excluded persons living in institutions, members of


the active Armed Forces, and persons residing outside the United


States. Sample persons were grouped into “reporting units,”


140

SPONSORS: National Center for Health Statistics (NCHS)


and


Health Care F“nancing Administration (HCFA)


TITLE:	 National Medical Care Utilization and Expenditure Survey (NMCUES), 

1980 (continued) 

which were defined as all persons related to each other by blood,


marriage, adoption, or foster care status and living in the same


housing unit or group quarters.


An overall response rate of 91.1 percent was achieved in the


first interview for the national household survey. Attrition


over the course of interviewing resulted in final response rates


of 87.9 percent for the national household survey.


CONTENT: The core questionnaire was designed to obtain the same information 

in each of the five rounds. Supplements were administered in


selected rounds. The supplements obtained information not expected


to change or to change very slowly or to be measured only once.


The core questions obtained information about health insurance


coverage, bed days, restricted activity days, hospital stays,


physician visits, dental visits, other medical provider visits,


emergency department visits, hospital outpatient department visits,


prescribed medicines, and other medical expenses. For each contact


with the medical care system, data were obtained on the health


conditions, the type of provider, services provided, charges,


sources, and amounts of payment. Questions included in the


supplements pertained to access to medical care, limitation of


activities, occupation, income, and other sociodemographic


characteristics.


YEARS OF DATA 1980.


COLLECTION:


PUBLICATIONS:	 See National Medical Care Utilization and Expenditure Survey, 

Data Reports Series, Methodological Reports Series, Descriptive 

Reports Series, and Analytic Report Series issued by the National 

Center for Health Statistics and the Health Care Financing 

Administration. 

AVAILABILITY National Household Survey public use tapes available from


OF UNPUBLISHED National Technical Information Service (NTIS). Requests for


DATA:	 information on the NMCUES family public use data tape should be


directed to the Division of Health Interview Statistics, National


Center for Health Statistics, Rm. 2-44, 3700 East-West Highway,


Hyattsville, MD 20782. Data tapes are also in the collection of


the National Archive of Computerized Data on Aging, maintained


bythe Inter-UniversityConsortium for Political and Social


Research, P.O. Box 1248, Ann Arbor, MI 48106 (ICPSR 8239).


CONTACT:	 Robert A. Wright


(301) 436-7100


141 
SPONSORS:	National Center for Health Statistics (NCHS) and


Health Care Financing Administration (HCFA)


TITLE: National Uedical Care Utilization and Expenditure Survey 

(NMCUES), 1980 

TYPES OF DATA COLLECTED


Data Public


File Use


Tape


DEMOGRAPHIC DATA 

x x Educational level 

x x Race 

x x Ethnicity 

x x Sex 

x x Marital status 

Migration or mobility 

VITAL STATISTICS 

x x Natality 

x x Mortali~y 

Marriage


Divorce


HOUSING


Type of dwelling


Data


File


x


x


x


x


x


x


Public


Use


Ta~e


HEALTH


Acute and chronic conditions


Disability days


Chronic limitations


of activity


of mobility


Impairments


Usual activity status


ALCOHOL, DRUG ABUSE,


AND MENTAL ILLNESS


Cognitive impairment scale


Behavior problems


Depression


Alcohol use


Drug abuse


CHANGES IN HEALTH STATUS


Morbidity


Functional limitations


Self-perceived health


FUNCTIONAL LEVELS


Social interaction


Activities of daily living


Instrumental activities of


daily living


HEALTH CARE UTILIZATION


General hospital services


Nursing home services


Home health care


Rehabilitation


Mental health hospitalization


Mental health outpatient


services


Alcohol and drug abuse centers


Physician services/visits


Dental services/visits


Prescription drugs


Other


OTHER BROAD CATEGORY


FOR SAMPLING UNIT


x 

x 

x 

x 

x 

x 

x 

x 

x 

x 

x 

x 

x 

x 

x 

x 

x x No; of persons in household 

x x Relationship of persons in 

household x 

x 

INCOME AND WEALTH x 

x x Labor force ~artici~ation 

x x Total income’ ‘ 

x x Sources of income 

Net assets


SOCIAL SERVICES


HEALTH RESOURCES 

x x General hosRitalsl x 

x x	 Private psychiatric hospitals 

Public mental health hospitals x 

Nursing homes 

Other institutional resources 

Comnunity-based resources x 

Health professions 

Other professional resources 

x 

HEALTH EXPENSES x 

x x Costs of care2 x 

x x Out-of-pocket costs2 x 

x x Medicare 

x x Medicaid 

State expenditures 

x x Private insurance coverage 

1 NMCUES identified the type of hospital. 2 NMCUES collected charges, not costs. 

3 NMCIJESgrouped conditions together. 

142

SPONSORS:


TITLE:


I


I


National Center for Health Statistics (NCHS) and 

Health Care Financing Administration (HCFA) 

National Medical Care Utilization and Expenditure Survey


(NMCUES), 1980


SELECTED ITEMS IN DATA SET


SIZE OF SAMPLE (National Household Component)


Age Number in Sample Nonresponse Rate


Total 17,123


Under 65 15,251


65-74 1,183


75-84 689


85+


AVAILABILITY AND LOCATIONOF SPECIFIC 

Item


Date of birth


Social Security no.


Veteran status


Geographic data


Largest unit


Smallest unit


Age classes


Single years


60-64


65+


65-74, 75-84, 85+


Other


Data File


x


x


U.S. 

4 regions


x


x


x


X 

x


12.1%


(75 years and over)


DATA ITEMS 

Public Use Tape Published Tables


x


Us. 

4 regions


x


x


x


x 

x


Us. 

4 regions


x


x 

x


143 
SPONSOR:


TITLE:


PURPOSE:


DESIGN:


CONTENT:


National Center for Health Statistics (NCHS), Department of


Health and Human Services (DHHS)


National Ambulatory Medical Care Survey (WCS) 

Project Director:	 James DeLozier


Chief, Ambulatory Care Statistics Branch


National Center for Health Statistics


3700 East-West Highway


Hyattsville, MD 20782


To provide general purpose statistics describing the


public’s use of office-based physician services, the health


problems presented to physicians by ambulatory patients, and


the diagnostic and therapeutic services received.


Universe: all patient visits to office-based physicians in


contiguous United States. Multistage sample design including


3,000 to 5,000 physicians in about 80 geographic areas.


Probability sample, response of approximately 75 percent. Sample size


3,000 physicians, 50,000 patient visits through 1981. Sample size


in 1985: 5,000 physicians, 75,000 visits.


Information includes patient age, sex, race, ethnicity, and


reason for visit; physician’s diagnostic and therapeutic services


ordered or provided; diagnosis and disposition decision and drugs


prescribed. Variations from year to year are slight.


YEARS OF DATA Data collected annually from 1973 through 1981. Repeated


COLLECTION: in 1985 and scheduled on a triennial basis thereafter. Data from


the 1985 survey will be released in 1987.


PUBLICATIONS:	 See advance data releases and Series 13: Data on Health Resources


Utilization, National Center for Health Statistics.


AVAILABILITY Data are also available in published and unpublished form as


OF UNPUBLISHED well as on public use data tapes for all years in which


DATA: survey has been completed.


Data tapes are in the collection of the National Archive of


Computerized Data on Aging, maintained by the Inter-University


Consortium for Po’itical and Social Research, Ann Arbor, MI 48106.


1977--ICPSR 8046, 1978--ICPSR 8047, 1979--ICPSR8O48.


Data tapes are also in the collection of the Duke University Data


Archive for Aging and Adult Development (DAAAD), Durham, NC 27710.


CONTACT:	 Raymond Gagnon


(301) 436-7132

SPONSOR:	 National Center for Health Statistics (NCHS), Department of Health


and Human Services (DHHS)


TITLE: National Ambulatory Medical Care Survey (NAMCS) 

TYPES OF DATA COLLECTED


Data Public Data Public


File	 Use File Use


Tape Ta~e


DEMOGRAPHIC DATA


Educational level x x


x x Race


x x Ethnicity


x x Sex


Marital status


Migration or mobility


VITAL STATISTICS


Natality


Mortality


Marriage


Divorce


HOUSING


Type of dwelling


No. of persons in household


Relationship of persons in


household


INCOME AND WEALTH


Labor force ~articipation


Total income” “


Sources of income


Net assets


SOCIAL SERVICES


HEALTH RESOURCES


General hospitals


Private psychiatric hospitals


Public mental health hospitals


Nursing homes


Other institutional resources


Community-based resources


Health professions


Other professional resources


x x


HEALTH EXPENSES


Costs of care


Out-of-pocket costs


Medicare


Medicaid


State expenditures


Private insurance coverage


HEALTH


Acute and chronic conditions


Disability days


Chronic limitations


of activity


of mobility


Impairments


Usual activity status


ALCOHOL, DRUG ABUSE,


AND MENTAL HEALTH


Cognitive impairment scale


Behavior problems


Depression


Alcohol use


Drug abuse


CHANGES IN HEALTH STATUS


Morbiditv


Function~l limitations


Self-perceived health


FUNCTIONAL LEVELS


Social interaction


Activities of daily living


Instrumental activities of


daily living


HEALTH CARE UTILIZATION


General hospital services


Nursing home services


Home health care


Rehabilitation


Mental health hospitalization


Mental health outpatient


services


Alcohol and drug abuse centers


Physician services/visits


Dental services/visits


Prescription drugs


Other


OTHER BROAD CATEGORY


FOR SAMPLING UNIT


145 
SPONSOR:	 National Center for Health Statistics (NCHS), Department of


Health and Human Services (DHHS)


TITLE: National Ambulatory Medical Care Survey (NAMCS)


SELECTED ITEMS IN DATA SET 

SIZE OF SAMPLE 

Age Number in Sample Nonresponse Rate 

Total 46,100 visits 20% 

AVAILABILITY ANDLOCATIONOF SPECIFIC


Item


Date of birth


Social Security no.


Veteran status


Geographic data


Largest unit


Smallest unit


Age classes


Single years


60-64


65+


65-74, 75-84, 85+


Other


Data File


x


U.s 

4 regions


x


DATAITEMS 

Public Use Tape


x


Us. 

4 regions


x


Published Tables


Us. 

4 regions


x 

x 

146

I SPONSOR:


TITLE:


PURPOSE:


DESIGN:


CONTENT:


YEARS OF DATA


COLLECTION:


PUBLICATIONS:


AVAILABILITY


OF UNPUBLISHED


DATA:


CONTACT:


National Center for Health Statistics (NCHS), Department of


Health and Human Services (DHHS)


National Hospital Discharge Survey (NHDS) 

Project Director:	 Mary Moien 

Chief, Hospital Care Statistics Branch 

National Center for Health Statistics 

3700 East-West Highway 

Hyattsville, MD 20782 

The survey provides information on the utilization of short-stay


non-Federal hospitals in the United States. Only hospitals with


six or more beds and an average length of stay of less than 30


days are included.


The sample is a two-stage stratified probability sample of


hospitals and patients within hospitals. Stage 1 includes a


10 percent sample of all short-stay non-Federal hospitals, and


stage 2 includes a sample of discharges. Approximately 200,000


records per year are collected and weighted up to national


estimates. The nonresponse rate is approximately 15 percent in


the last 10 years and less before that.


Data in medical records for discharges from hospitals are


collected for patient age, sex, race, marital status, disposition;


patient’s length of stay and (since 1977) expected source of


payment; and diagnoses and surgical procedures. Information is


available on size, ownership, and region of country of hospital.


Annually since 1965.


Annual data are published in NCHS Advance Data series, in NCHS


Vital and Health Statistics Series 13, and in Special Reports.


Unpublished data are available for all years. Data tapes are


available for 1970-84 from National Technical Information


Service, 5285 Port Royal Road, Springfield, VA 22101, and from


the collection of the National Archive of Computerized Data on


Aging maintained by the Inter-University Consortium for Political


and Social Research, P.O. Box 1248, Ann Arbor, MI 48106.


Hospital Care Statistics Branch


(301) 436-7125


147 
SPONSOR:	 National Center for Health Statistics (NCHS), Department of Health


and Human Services (DHHS)


TITLE: National Hospital Discharge Survey (NHDS) 

TYPES OF DATA COLLECTED 

Data Public Data Public 

File Use File Use 

Tat)e -. Tape

‘ DEMOGRAPHIC DATA HEALTH


Educational level x x Acute and chronic conditions


x x Race 

x x Ethnicity 

x x Sex 

x x Marital status 

Migration or mobility


VITAL STATISTICS


Natalit.v


Mortality


Marriage


Divorce


HOUSING


Type of dwelling


No’.of persons in household


Relationship of persons in


household


INCOME AND WEALTH


Labor force participation


Total income


Sources of income


Net assets


SOCIAL SERVICES


HEALTH RESOURCES


General hospitals


Private psychiatric hospitals


Public mental health hospitals


Nursing homes


Other institutional resources


Comnunity-based resources


Health professions


Other professional resources


HEALTH EXPENSES


Costs of care


Out-of-pocket costs


Medicare


Medicaid


State expenditures


Private insurance coverage


Disability days


Chronic limitations


of activity


of mobility


Impairments


Usual activity status


ALCOHOL, DRUG ABUSE,


AND MENTAL HEALTH


Cognitive impairment scale


Behavior problems


Depression


Alcohol use


Drug abuse


CHANGES IN HEALTH STATUS


Morbidity


Functional limitations


Self-perceived health


FUNCTIONAL LEVELS


Social interaction


Activities of daily living


Instrumental activities of


daily living


HEALTH CARE UTILIZATION


x x	 General hospital services


Nursing home services


Home health care


Rehabilitation


x x Mental health hospitalization ‘


Mental health outpatient


services


Alcohol and drug abuse centers


Physician services/visits


Dental services/visits


Prescription drugs


Other


OTHER BROAD CATEGORY


FOR SAMPLING UNIT


148

1 

I SPONSOR: National Center for Health Statistics (NCHS), Department of Health 

and Human Services (DHHS) 

TITLE: National Hospital Discharge Survey (NHDS) 

Age


Total


Under 65


65-74


75-84


85+


SELECTED ITEMS IN DATA SET 

SIZE OF SAMPLEPer Year 

(Approximate)


Number in Samplel Nonresponse Rate


200,000 15% 

150,000


27,000


21,000


7,500


1 Sample is weighted up to national estimates.


AVAILABILITY ANDLOCATIONOF SPECIFIC DATAITEMS


Item


Date of birth or age


Social Security no.


Veteran status


Geographic data


Largest unit


Smallest unit


Age classes


Single years


60-64


65+


65-74, 75-84, 85+


Other


Data File Public Use Tape


x x


Us. U*S. 

Division Division


x x


Published Tables


x


Us. 

Usually region


x


x


149 
SPONSOR:


TITLE:


PURPOSE:


DESIGN:


CONTENT:


National Center for Health Statistics (NCHS), Department of


Health and Human Services (DHHS)


National Nursing HomeSurvey (NNHS) 

Project Director:	 Evelyn Mathis


Chief, Long-Term Care Statistics Branch


Division of Health Care Statistics


National Center for Health Statistics


3700 East-West Highway


Hyattsville, MD 20782


To collect data on nursing homes, their services, staffs, and


financial characteristics, and on personal and health


characteristics of residents and discharges.


Data are collected from a sample of all nursing homes in the


coterminous United States (in 1985, 1,200 nursing homes listed


in the Master Facility Inventory). In each nursing home, samples


are selected of current residents, persons discharged (deceased


or alive) in the last year, and staff members. Data on residents


and discharges are collected by interviewing the nurse who obtains


the needed information from the medical records and the next of


kin. Estimates are produced for the United States, census regions,


and DHHS regions, and in 1977 for the five States with the largest


nursing home population.


The survey collects data on characteristics of the facility and


its finances, of residents, of discharges, and of staff, as


follows:


Facility: size, ownership, Medicare and Medicaid certification,


staffing patterns, and services offered.


Financial characteristics: Total expenses and major components


of operation.


Residents: Demographic characteristics, living arrangements


prior to admission, diagnosis and conditions, functional status,


receipt of services (medical, nursing, and therapeutic), cost


of care, source of payment.


Discharges: A subset of items collected for current residents


available from the medical record.


Staff: Data varied with survey. In 1985 survey, characteristics


of registered nurses--work schedule, experience, activities in


facility, demographic characteristics, and salary were collected.


Next of kin: Information about residents’ and discharges’ living


arrangements, health and functional status prior to nursing


home admission, lifetime use of nursing home care, Medicaid


spend-down.


150

SPONSOR:


TITLE:


YEARS OF DATA


COLLECTION:


PUBLICATIONS:


AVAILABILITY


OF UNPUBLISHED


DATA:


CONTACT:


National Center for Health Statistics (NCHS), Department of


Health and Human Services (DHHS)


National Nursing Home Survey (NNHS) (continued) 

1973-74, 1977, 1985, and proposed for 1990.


NCHS Series 13 for utilization and patient characteristics,


NCHS Series 14 for staffing characteristics, and Advance Data


reports.


Public use tapes available through the Scientific and


Technical Information Branch, National Center for Health


Statistics, Rm. 1-57, 3700 East-West Highway, Hyattsville, MD


20782, and NTIS, 5265 Port Royal Road, Springfield, VA 22151.


With the exception of individual or establishment identifiers,


all data collected are available on the public use data tape.


Data tapes are also in the collection of the National Archives


of Computerized Data on Aging maintained by the Inter-University


Consortium for Political and Social Research, Box 1248, Ann


Arbor, MI 48106 ( ICPSR 7946).


Data tapes are also in the collection of the Duke University


Data Archive for Aging and Adult Development (DAAAD), Box 3003,


Duke University Medical Center, Durham, NC 27710.


Evelyn Mathis


(301) 436-8830 

151

SPONSOR:€ National Center for Health Statistics (NCHS), Department of Health and

Human Services (DHHS)

TITLE: National Nursing HomeSurvey (NNHS) 

TYPES OF DATA COLLECTED

Data Public Data Public

File Use File Use

Tape Tape

DEMOGRAPHIC DATA

Educational level x x 

x x Race 

x x Ethnicity 

x x Sex x x 

x x Marital status 

Migration or mobility x x 

VITAL STATISTICS

Natalitv

x x€ Mortali;y 

Marriage 

Divorce x x 

x x 

HOUSING 

x x Type of dwelling 

x x No. of persons in household 

x x Relationship of persons in 

household!

INCOME AND WEALTH 

Labor force l)artici~ation 

Total income’ ‘ 

Sources of income 

Net assets x x 

x x 

SOCIAL SERVICES

HEALTH RESOURCES

General hospitals

Private psychiatric hospitals x x

Public mental health hospitals

x x€ Nursing homes 

Other institutional resources 

Community-based resources 

Health professions 

Other professional resources 

HEALTH EXPENSES

x x Costs of care 

Out-of-pocket costs 

x x Medicare coverage 

x x Medicaid coverage 

State expenditures

Private insurance coverage

1 1985 survey only.

HEALTH

Acute and chronic conditions

Disability days

Chronic limitations

of activity

of mobility

Impairments

Usual activity status

ALCOHOL, DRUG ABUSE,

AND MENTAL ILLNESS

Cognitive impairment scale

Behavior problems

Depression

Alcohol use

Drug abuse

CHANGES IN HEALTH STATUS

Morbidity

Functional limitations

Self-perceived health

FUNCTIONAL LEVELS

Social interaction

Activities of daily living

Instrumental a tivities of

daily living!

HEALTH CARE UTILIZATION

General hospital services

Nursing home services

Home health care

Rehabilitation

Mental health hospitalization

Mental health outpatient

services

Alcohol and drug abuse centers

Physician services/visits

Dental services/visits

Prescription drugs

Other

OTHER BROAD CATEGORY

FOR SAMPLINGUNIT 

152
SPONSOR:	 National Center for Health Statistics (NCHS), Department of


Health and Human Services (DHHS)


TITLE: National Nursing HomeSurvey (NNHS) 

SELECTED ITEMS IN DATA SET


SIZE OF FINAL 1977 RESIDENT SAMPLE1


Age


Total


Under 65


65-74


75-84


85+


Number in Sample Nonresponse rate


7,033 2% 

939


1,130


2,509


2,455


1 Discharge sample about 6,000.


AVAILABILITY ANDLOCATIONOF SPECIFIC DATAITEMS 

Item


Date of birth


Social Security no.


Veteran status


Geographic data


Largest unit


Smallest unit


Age classes


Single years


60-64


65+


65-74, 75-84, 85+


Other:


Under 55, 55-64


Data File


x


x (only in 1985)


x (only in 1985)


Us.


DHHS regions


x


x


x


X


x


Public Us( Tape


x


x


Us.


DHHS reg.ons


x


x


x


x


x


Published Tables


Us.


DHHS regions


x


x


x


x

SPONSOR:


TITLE:


PURPOSE:


DESIGN:


CONTENT:


YEARS OF DATA


COLLECTION:


PUBLICATIONS:


National Center for Health Statistics (NCHS), Department of


Health and Human Services (DHHS)


National #laster Facility Inventory (NH) 

Project Director: Evelyn S. Mathis


Chief, Long-Term Care Statistics Branch


National Center for Health Statistics


3700 East-West Highway


Hyattsville, MD 20782


The NMFI has two basic purposes. It is an important national


source of statistics on the number, type, and geographic


distribution of inpatient facilities in the United States. In


addition, it serves as the universe from which probability


samples are selected for conducting sample surveys.


The NMFI is a comprehensive file of all facilities in the United


States with three or more beds that provide medical, nursing,


personal, or custodial care to groups of unrelated persons on an


inpatient basis. Facilities are categorized into three broad


types: hospitals, nursing and related care homes, and other


custodial or remedial care facilities.


Basically, the types of data collected for the three categories


of facilities are: ownership; major type of service; number of


beds; patient census; number of admissions, discharges, and deaths;


and information about staffing.


Data were collected for the following years: 1963, 1967, 1969,


1971, 1973, 1976, 1978, 1980, 1982. Because an evaluation of


the NMFI program is under way, the Inventory will not be conducted


before 1988. Starting with the 1978 NMFI, only the nursing and


related care homes were surveyed.


Data from the NMFI are published in Health, United States and in


Vital and Health Statistics, Series 14.


National Center for Health Statistics. A. Sirrocco: An


Overview of the 1982 National Master Facility Inventory Survey


of nursing and related care homes. Advance Data From Vital and 

Health Statistics. No. 111. DHHS pub. NO (PHS) 85-1250. 

Public Health Service. Hyattsville, Md., Sept. 20, 1985. 

National Center for Health Statistics. D.A. Roper: Nursing and


related care homes as reported from the 1982 National Master


Facility Inventory Survey. Vital and Health Statistics.


Series 14, No. 32. DHHS Publ. No. (PHS) 86-1826. Public


Health Service. Washington. U.S. Government Printing Office,


Sept. 1986.


154

SPONSOR:	 National Center for Health Statistics (NCHS), Department of


Health and Human Services (DHHS)


TITLE: National Master Facility Inventory (WI) (continued) 

AVAILABILITY Data are available in the form of public use tapes for all


OF UNPUBLISHED years. These tapes can be obtained from the National Technical


DATA:	 Information Service, Springfield, VA 22161. Additional data are


released in the form of special tabulations prepared specifically


for individual requesters.


Data tapes for the 1976 National Master Facility Inventory are


in the collection of the National Archive of Computerized Data


on Aging, maintained by the Inter-UniversityConsortium for


Political and Social Research, P.O. Box 1248, Ann Arbor, MI


48106 (ICPSR 9630 and 7631).


CONTACT:	 Al Sirrocco


(301) 436-8830


155 
SPONSOR: National Center for Health Statistics (NCHS), Department of


Health and Human Services (DHHS)


TITLE: National Master Facility Inventory (NMFI)


TYPES OF DATA COLLECTED


Data Public Data


File Use File


Tape


x 

(1) (1) 

(1) (1) 

(1) (1) 

~1) ~1)


x


DEMOGRAPHIC DATA


Educational level


Race


Ethnicity


Sex


Marital status


Migration or mobility


VITAL STATISTICS


Natality


Mortality


Marriage


Divorce


HOUSING


Type of dwelling


No. of persons in household


Relationship of persons in


household


INCOME AND WEALTH


Labor force participation


Total income


Sources of income


Net assets


SOCIAL SERVICES


HEALTH RESOURCES


General hospitals (1) 

Private psychiatric hospitals x -


Public mental health hospitals


Nursing homes


Other institutional resources (1)


Connwnity-based resources


Health professions


Other professional resources (1)


HEALTH EXPENSES


Costs of care


Out-of-pocket costs


Medicare coverage


Medicaid coverage


State expenditures


Private insurance coverage


Public


Use


Tape


(1) 

x 

(1) 

(1) 

HEALTH


Acute and chronic conditions


Disability days


Chronic limitations


of activity


of mobility


Impairments


Usual activity status


ALCOHOL, DRUG ABUSE,


AND MENTAL ILLNESS


Cognitive impairment scale


Behavior problems


Depression


Alcohol use


Drug abuse


CHANGES IN HEALTH STATUS


Morbidity


Functional limitations


Self-perceived health


FUNCTIONAL LEVELS


Social interaction


Activities of daily living


Instrumental activities of


daily living


HEALTH CARE UTILIZATION


General hospital services


Nursing home services


Home health care


Rehabilitation


Mental health hospitalization


Mental health outpatient


services


Alcohol and drug abuse centers


Physician services/visits


Dental services/visits


Prescription drugs


Other


OTHER BROAD CATEGORY


FOR SAMPLING UNIT


1 These facilities are on files from 1963-76 only.


156 
SPONSOR:	 National Center for Health Statistics (NCHS), Department of


Health and Human Services (DHHS)


TITLE: National Uaster Facility Inventory (NMFI) 

SELECTED ITEMS IN DATA SET


SIZE OF SAMPLE


Nonresponse 

Facility Number in Universe Rate 

Hospitals 6,915 10.3% 

Nursing homes 17,819 4.0% 

1 Hospital data provided by the American Hospital


Association.


AVAILABILITY AND LOCATION OF SPECIFIC DATA ITEMS


Item


Date of birth


Social Security no.


Veteran status


Geographic data


Largest unit


Smallest unit


Age classes


Single years


60-64


65+


65-74, 75-84, 85+


Other


Data File Public Use Tape Published Tables


Us. Us. Us. 

ZIP code ZIP code State


x x


157 
I€

Vital and Health Statistics 

series descriptions 

SERIES 1.	 Programa and Collection Procedures-Reports describing the 

general programs of the National Center for Health Statistics 

and its offices and divisions and the data collection methods 

used. They also include definitions and other material necessary 

for understanding the data. 

SERIES 2.	 Data Evaluation and Methods ResearcHtudies of new statistical methodology including experimental tests of new survey 

methods, studies of vital statistics collection methods, new analytical techniques, objective evaluations of reliability of collected 

r	 data, and contributions to statistical theoty. Studies also include 

comparison of U.S. methodology with those of other countries. 

>ERIES 3.	 Analytical and Epidemiologicel Studie*Reports presenting 

analytical or interpretive studies based on vital and health statistics, carrying the analysis further than the expository types of 

reporis in the other series. 

ERIES 4.	 Dooumenta and Committee Report+nal repotis of major 

committees concerned with vital and health statistics and documents such as recommended model vital registration laws and 

revised birth and death certificates. 

‘ERIES 5.	 (bmparetive International Vial and Health Statistics Reporte-Analytical and descriptive reporfs comparing U.S. vital 

and health statistics with those of other countries. 

ERIES 10.	 Data From the National Health Interview Survey-Statistics 

on Illness, accidental injuries, disability, use of hospital, medical, 

dental, and other services, and other health-related topics, all 

based on data collected in the continuing national household 

interview survey. 

:RIES 11.	 Data Fmm the National Health Examination Survey and the 

Natbnal Health and Nutrition Examination Survey-Data from 

direct exam[natlon, testing, and measurement of national samples 

of the civilian noninstitutlonalized population provide the basis 

for (1) estimates of the medically defined prevalence of specific 

diseases in the United States and the distributions of the population 

with respect to physical, physiological, and psychological characteristics and (2) analysis of relationships among the various measurements without reference to an explicit finite universe of persons. 

‘RIES 12.	 Data Fmm the lnstitutionaliied Population Surveye-Discontinued in 1975. Reports from these surveys are included in Series 

13, 

RIES 13.	 Data on HeaIth Resources Utiiiition-Statistics on the utilization of health manpower and facilities providing long-term care, 

ambulatory care, hospital care, and family planning services. 

SERIES 14. 

SERIES 15. 

SERiES 20. 

SERIES 21. 

SERIES 22. 

SERIES 23. 

Data on Health Resources Manpower and Faciiiiiee-Statktics on the numbers, geographic distribution, and characteristics 

of health resources including physicians, dentists, nurses, other 

health occupations, hospitals, nursing homes, and outpatient facilities. 

Data Fmm Special Surveye-Statistica on health and healthrelated topics coilected in special surveys that are not a part 

of the continuing data systems of the National Center for Health 

Statistics. 

Data on Mortalii-Various statistics on mortality other than 

as included in reguiar annual or monthiy reports. Speciai analyses 

by cause of death, age, and other demographic variables; geographic and time series analyses; and statistics on characteristics 

of deaths not available from the vital records based on sampie 

surveys of those records. 

Data on NateIii, Marnsge, and Divorc&Various statistics 

on natality, marriage, and divorce other than as included in regular 

annuai or monthly reports. Speciai analyses by demographic 

variables; geographic and time series analyses: studies of fertility; 

and statistics on characteristics of births not available from the 

vital records based on sample surveys of those records. 

Data From the Nat”mnal Mortatii and Natality Surveys-Discontinued in 1975. Reperk from these sample surveys based 

on vital records are inciuded in Series 20 and 21, respectively. 

Data From the National Survey of Family Growth-Statistics 

on fertility, family formation and dissolution, family planning, and 

reiated maternai and infant health topics derived from a periodic 

survey of a nationwide probability sample of women 15-44 years 

of age. 

For answers to questions about this report or for a list of titles of reports 

published in these series, contact: 

SCiefltifiC and Technical information Branch 

National Center for Heaith Statistics 

Public Health Service 

Hyansville, Md. 20782 

301 -436-e500 

1