Vital and

Health Statistics

Advance Data

From Vital and

Health Statistics:

Numbers 1-10

Series 16:

Compilations of Advance Data From

Vital and Health Statistics

No. 1

Data in ‘this report from health and demographic surveys present statistics

by age and other variables on hypertension height and ‘weight;

dermatological disease cholesterol levels dietary intake wanted and

unwanted births and expected family size among currently married

women, Estimates are based on the civilian noninstitutionalized population

of the United States, These reports were originally published in 1976 and 1977,

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Public Health Service

Centers for Disease Control

National Center for Health Statistics

Hyattsville, Maryland

May 1989

DHHS Publication No. (PHS) 89-1860
Copyright information

All material appearing in this report IS !n the public domain and may

be reproduced or copied without perm]sslon; cltatlon as to source,

however, IS appreciated

Suggested citation

National Center for Health Statistics, Advance data from vital and

health statistics: nos 1 –10, National Center for Health Statwtics. Vital

Health Stat 16(1 ). 1989.
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 AnaJysis

and Epidemiology

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

Extramural Programs

Peter L. Hurley, Associate Director for Wal and Health

Statistics Systems

Stephen E. Nieberding, Associate Director for Management

Charles J. Rothwell, Associate Director for Data Processing

and Services

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

and Methodology

Division of Health Examination Statistics

Robert S. Murphy, Director

Catherine E. Woteki, Ph.D., Deputy Director

Kurt R. Maurer, Chiej Survey Planning and Development

Branch

Peter Gergen, M.D., Chie$ Medical Statistics Branch

Clifford L. Johnson, ChieJ Nutrition Statistics Branch

Division of Health Interview Statistics

Owen T. Thornberry, Jr., Ph.D., Director

Deborah M. Winn, Ph.D., Deputy Director

Gerry E. Hendershot, Ph.D., Chiej Illness and Disability

Statktics Branch

Robert A. Wright, Chiej Utilization and E~enditure

Statzkics Branch

Stewart C. Rice, Jr., Chiej Sunzy Planning and

Development Branch

Nelma B. Keen, Chiej Systems and Programming Branch

Division of Vital Statistics

John E. Patterson, Director

James A. Weed, Ph.D., Depug Director

Robert Bilgrad, SpeciaJAssistant to the Director

Robert J. Armstrong, Actuarial Adviser

Harry M. Rosenberg, Ph.D., Chie$ Mortality Statistics

Branch

Robert L. Heuser, Chie$ Natality Statistics Branch

Robert L. Heuser, Acting Chiej Marriage and Divorce

Statistics Branch

George A. Gay, Chie$ Registration Methods Branch

William F. Pratt, Ph.D., Chie$ Family Growth Survey

Branch

Ronald Charnblee, Chiej Technical Services Branch

Mabel G. Smith, Chie$ Statistical Resources Branch

Joseph D. Farrell, Chief Systems and Programming

Branch
Blood pressure ofpersons6-74 years ofagein tie United States . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Hypertension: United States, 1974 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

Height and weight ofadults 18-74 years of age in the United States. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25

Prevalence ofdermatologicrd disease among persons l-74years ofage: United States . . . . . . . . . . . . . . . . . . . . . . . . . . . 33

A comparison of levels of serum cholesterol of adults 18-74 years of age in the United States in 1960-62

and 1971-74 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ................... 41

Dietary intake ofpersonsl-74years ofagein the United States . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49

Total serum cholesterol level ofadults 18-74 years of age, United States, 1971-74 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65

Total serum cholesterol levels ofchildren 4-17 years ofage, United States, 1971-74 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73

Wanted and unwanted births reported by mothers 15-44 yeamofage United States, 1973 . . . . . . . . . . . . . . . . . . . . . . . 85

~wted<we ofmmpleted fmilymong currently marfied women 15-44yearso fageUnitedS tates,l 973 . . . . . . . . 97

...

Ill
FROM VITAL & HEALTH STATISTICS OF THE NATIONAL CENTER FOR HEALTH STATISTICS

uS. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE I No. 1 Octobar 18, 1976 I Publ c Health Service. Heaith Resowces Admnwtration

Blood Pressure of Persons 6-74 Years of Age in the

United Statesa

Single blood pressure measurements were

obtained’ among a national probability sample of

persons representative of the U.S. civilian noninstitutionzdized population 6-74 years of age in

the Health and Nutrition Examination Survey

(HANES) from April 1971 through June 1974.

This first Health and Nutrition Examination

Survey program, in which these data were

obtained, was designed to measure the nutritional status of the U.S. population as well as certain

aspects of the general health status and medical

care needs of the U.S. population. This is the

fourth of the Health Examination Survey programs that obtain information on the prevalence

of medicalIy defined ikess, on unrecognized or

undiagnosed conditions, and on a variety of

physical, physiological, and psychological measures within the poptdation through direct examinations, tests, and measurements, as described

in previous publications. 1+

Blood pressure measurements of the persons

in this I-LANES sample were made at 65 preselected locations throughout’ the country by

aThis report prepared by Jean Roberts and Kurt

Maurer, Division of Health Examination Statistics.

the survey examining physicians using standardized methods based on the 1951 recommendations of the knerican Heart Association.5 Of

the 24,513 sample persons selected to represent

the 131.4 million persons 6-74 years of age in

the U.S. population, 17,796 (or 72.6 percent)

were examined. This corresponds to an effective

response rate of 74.4 percent when adjustment

is made for the effect of oversampIing among

the poor, preschooI chiIdren, women of childbearing age, and the eIderIy. National estimates

of the distribution of blood pressure levels, prevalence of hypertension, and related medical

history among the U.S. population based on

findings from. this HANES program have been

described and ardyzed in the report “Blood

Pressure Levels of Persons 6-74 Years: United

States, 1971 -1974,” Vital and Health Statistics,

Series 11, No. 2036 (in preparation). Selected

data and findings from that report are included

here in tables 1-6.

Highlights

Mean systolic blood pressure of the U.S.

population increases with age from 103.3 mm.

Advance Data from Vital and Health Statistics replaces the supplements to the Monthly Vital Statktics

Report as the means for early release of selected fiidings from the health and demographic surveys conducted by

the NCHS. Most of these releases VW be followed by detailed reports in the Vital and Health Statistics series.

Provisional vital statistics as well as advance reports of final data for a year will continue to be pubIished in

the Monthly Vital Statistics Report.

Advance Data is being distributed on the mailing keys for the Vital and Health Statktics series, and people

who now receive reports from a particuku series will also receive all Advance Data releases for that series.

Temporarily, the mailing list for the Monthly Vital Statistics Report (M VSR) is also being used. MVSR readers

who wish to continue to receive Advance Data issues, as well as other persons who wish to receive all issues,

should contact: National Center for Health Statistics, Room 8-20, 5600 Fishers Lane, RockviIle, Maryland

20852, Phone: (301) 443-1200.
2

Hg among children age 7-11 years to 150.1 mm.

Hg among the oldest adults in the study, those

ages 65-74 years. From 12 through 54 years of

age the mean leveIs of systolic pressure among

males exceed those for females, but from 55

through 74 years, the mean levels of women are

the higher.

Diastolic pressure (mean values) of males increases with age and significantly exceeds mean

levels of women from 18 through 54 years then

decreases slowly through 74 years, while among

women diastolic pressure levels off at ages 65-74

years but does not decrease significantly.

At 25-74 years of age, systolic and diastolic

mean pressures for Negro men exceed those for

white men, and those for Negro women exceed

the mean levels for white women.

Mean systolic and diastolic blood pressures

among the population decrease significantly

with an increase in family income and education.

While no regional differences in mean diastolic blood pressure is evident, mean systoIic

blood pressure of persons living in the South is

significantly higher for both white and Negro

men and women than for those living in the

Northeast or West,

There were an estimated 23.4 million persons 12-74 years of age, including 23.2 million

or 18.1 per 100 adults ages 18-74 years, in the

United States with definite hypertension-that is

either systolic blood pressure of at least 160

mm. Hg or diastolic blood pressure of at least 95

mm. Hg. The prevalence rate of definite hypertension, as defined here, increases rapidly with

age from 0.8 per 100 at ages 12-17 years to 40.7

per 100 at ages 65-74 years. At ages 18-54 years,

definite hypertension is more prevalent among

men than among women, but at ages 65-74 years

the condition is more prevalent among women

than among men. About one-fourth of the

adults with definite hypertension have diastolic

blood pressure of at least 105 mm. Hg.

Hypertension is substantially more prevalent

among Negro adults than among white adults in

the United States.

More than half of the adults with definite

hypertension have never been told by their doctors that they have this condition or high blood

pressure. One-fourth of those with definite

hypertension have been taking medication regularly or occasionally for high blood pressure

within the preceding 6 months.

Mean systolic blood pressure levels of U.S.

children and youths as determined in the present

1971-74 study are substantially lower and the

mean diastolic pressures somewhat Iower than

those national estimates for children from the

Health Examination Survey of 1963-65 and for

youths from the Health Examination Survey of

1966-70, apparently because of survey differences that have been analyzed in detail.G

Among adults 18-74 years, national estimates of mean systolic and diastolic blood pressure levels from the Health and Nutrition Examination Survey of 1971-74 are in closer agreement with those from the Health Examination

Survey of 1960-62 than with those for children

and youths at the two available points in time.

Mean systolic blood pressure level estimates for

U.S. adults ages 18-54 years are nearly identical

from both surveys, but from 55 through 74

years they are lower by an average of 4-8 mm.

Hg in 1971-74 than in 1960-62. The diastolic

pressure levels from the more recent survey are

consistently higher (by an average of 3 mm. Hg)

across the age range 18-74 years.

MEAN SYSTOLIC AND DIASTOLIC BLOOD PRESSURE

OF PERSONS 7-74 YEARS BY AGE AND SEX: UNITED

STATES, 1971-74

160 ~

n

0

CJ

m

140

120

103

60

I

..

./

— Male

. . . . . F~~~l~

“f-J-Q-u

10203O4O5OW 7oe(l

AGE IN YEARS AT LAST 61 RTHDAY
TECHNICAL NOTES

The sampling plan for the 65 examination

locations in the Health and Nutrition Examination Survey of 1971-74 followed a stratified,

multistage probability design in which a sample

of the civilian noninstitutionalized population of

the conterminous United States 1-74 years of

age was selected. The sample was stratified by

geographic region, population density, and rate

of population change between 1960 and 1970.

Within each stratum, cluster type sampling was

used for selecting households and sample persons to be included in each examination location. The sample design provided for oversampling among persons living in poverty areas,

preschool age chiIdren, and women 20-44 years

of age.

The bIood pressure level and related data in

this report are shown as population estimates,

that is, the examination findings for each individual have been “weighted” by the reciprocal

of the probability of selecting the person. An

adjustment for persons in the sample who were

not examined and a poststratified ratio adjustment were also made so that the final sample

estimates of the population size agree exactIy

with independent U.S. Bureau of Census estimates for the civilian noninstitutionalized population of the United States as of November 1,

1972, by color, sex, and age.

The tables in this report contain, for the vari ous statistics presented, estimates of their

sample variability (standard or sampling errors

of the mean) which have been specially derived

by a pseudoreplication method adapted specifically to the sample design used in the Health and

Nutrition Examination Survey.7 Data in the

tables exclude 6-year-olds because no measurements were clbtained for about one-fourth of

this group, and the estimates for them are consequently less reliabIe than for those 7-74 years of

age.6

REFERENCES

1National Center for Health Statistics: Plan and ini- vey, United States, 1971-73. Vital and Health Statistics.

tial program of the Health Examination Survey. Vital Series I-Nos. 10a and 10b. DHEW Pub. No. (HSM)

and Health Statistics. PHS Pub. No. 1000 -Series l-No. 4. 73-1310. Washington. U.S. Government Printing Office,

Public Health Service. Washington. U.S. Government Feb. 1973.

Printing Office, July 1965. 5Committee to Revise Standardization of High

2NationaJ Center for Health Statistics: Plan, opera- Blood Pressure iReadings: Recommendations for human

tion, and response results of a program of children’s ex- blood pressure determinations by sphygmomanometers.

aminations. Vital and Health Statistics. PHS Pub. No. New York. American Heart Association. Oct. 1951.

1000 -Series l-No. 5. Public Health Service. Washington. 6National Center for Health Statistics: Blood presU.S. Government Printing Office, Oct. 1967. sure levels of persons 6-74 years of age in the United

3National Center for Health Statistics: Plan and over- states. Vital and Health Statistics. Series 1l-No. 203.

ation of a Health Examination Survey of U.S. youths DHEW, Rockville, Md. In preparation.

12-17 years of age. Vital and Health Statistics. PHS Pub. 7National Center for Health Statistics: Replication:

No. 1000-Series l-No. 8. Public HeaIth Service. Washing- An approach to the analyses of data from complex surton. U.S. Government Printing Office, Sept. 1969. veys. Vital and Health Statistics. PHS Pub. No. 1000-

4Natlonzu Genter for Health Statistics: Plan and Series 2-No. 14. Public Health Service. Washington. U.S.

operation of the Health and Nutrition Examination Sur- Govemment Printing Office, Apr. 1966.
4

Table 1. Systolic and diastolic blood pressure of persons 7-74 years by age and sex, with means, standard deviations, and standard

error of means: United States, 1971-74

Blood pressure and age

Both sexes Male

T

—

Standard

Mean

Standard

:%%:. “:~f Mean Standard

deviation “:a”f

Female

I

Standard

error of

mean

0.93

0.57

0.59

0.45

0.64

1.28

0.94

0.98

Mean

I

Standard

deviation

SYSTOLIC Blood pressure in mu. S8

7-11 years-------------------

12-17 years------------------

18-24 years------------------

25-34 years------------------

35-44 years------------------

45-54 years------------------

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

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

0.65

0.65

0.67

0.64

0.81

1.23

1.16

1.05

103.3

113.4

119.0

120.9

125.6

134.1

142.0

150.1

12.1

13.7

13.8

14.7

17.6

22.7

23.5

25.2

0.6B 103.3

0.55 114.9

0.47 123.5

0.46 125.5

0.57 127.7

1.03 135.3

0.79 139.7

0.83 146.9

12.3

13.4

13.1

14.1

19.2

24.4

25.6

25.2

12.0

13.8

13.0

13.9

15.4

20.7

20.8

24.7

103.3

111.9

114.8

116.7

123.6

132.9

144.0

152.5

DIASTOLIC

7-11 years-------------------

12-17 years------------------

18-24 years------------------

25-34 years------------------

3<-44 years------------------

1,..54 years------------------

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

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

64.7

69.8

73.8

77.8

82.4

85.7

B6.7

85.7

9.8

9.9

10.4

10.9

12.2

13.6

12.5

13.0

0.61 65.1

0.40 70.5

0.41 76.3

0.30 81.7.

0.39 84.8

0.60 87.9

0.47 86.8

0.50 85.4

J::

10.0

10.3

11.5

13.1

12.3

13.2

0.57

0.38

0.52

0.48

0.55

0.68

0.68

0.57

64.3

69.0

71.5

74.9

80.2

83.6

86.6

B5.9

10.0

1;:;

10.6

12.5

13.7

12.7

12.9

0.7B

0.58

0.52

0.30

0.46

0.67

0.55

0.57

Table 2. Systolic and diastolic blood pressure of white and Negro persons 7-74 years by age and sex, with means and standard error

of meams: United — States. 1971-74

1

——

White

- Female+===--lNegro

Blood pressure ‘oth ‘exes II Male

and age

SYSTOLIC 3

Standard

error of

mean

Standard

error of

mean

Standard

Mean error of Mean

mean

Standard

error of

mean

Mean

Standard

error of

mean

Mean

mean

Blood pressure in nun.Yg

7-11 years----------

12-17 years---------

18-24 years---------

25-34 years---------

35-44 years---------

45-54

55-64

65-74

103.3

113.6

119.3

120.4

124.B

132.8

141.3

149.2

64.8

69.7

73.8

77.5

81.7

84.9

86.3

85.2

0.70

0.54

0.51

0.49

0.61

1.04

0.7B

0.85

0.64

0.40

0.43

0.35

0.40

0.61

0.45

0.55

103.6

115.1

123.7

125.2

127.0

134.7

139.6

146.0

65.3

70.4

76.4

80.8

84.2

87.5

86.4

84.9

0.67

0.67

0.75

0.67

0.88

1.15

1.08

1.06

103.1

112.0

115.1

116.2

122.6

131.1

143.0

151.6

64.2

69.0

71.3

74.6

79.3

82.6

86.2

B5.4

103.2

112.0

117.5

125.2

132.8

146.4

149.7

159.3

64.3

70.2

74.2

81.0

88.5

92.7

91.7

90.6

1.lB

1.17

1.26

0.88

1.19

:.;;

2:69

0.83

0.82

0.78

0.86

0.97

1.82

1.77

0.96

102.1

112.5

122.9

129.3

136.7

141.7

144.2

156.6

63.8

71.1

76.2

84.3

91.2

91.9

93.4

90.9

1.32

1.46

2.20

1.61

2.29

4.23

3.57

3.57

104.2

111.6

113.2

121.5

130.5

150.8

153.4

161.3

64.8

69.3

72.7

78.0

86.9

93.5

90.6

90.4

1.34

1.22

1.11

0.96

1.52

5.69

$;;

0.99

0.59

0.61

0.51

0.68

1.30

1.00

1.07

years ---------

years ---------

years ---------

DIASTOLIC

0.57

0.43

0.57

0.57

0.57

0.68

0.66

0.61

0.86

0.60

0.53

0.31

0.51

0.6B

0.53

0.64

1.20

0.95

1.03

1.60

1.43

2.45

2.23

1.20

0.89

1.02

1.02

0.95

1.29

2.20

2.23

1.31

7-11 years----------

12-17 years---------

lB-24 years---------

25-34 years---------

35-44 years---------

45-54 years---------

55-64 yeazs---------

65-74 years---------
5

Table 3. Systolic and diastolic blood pressure of persons 7-74 years by geographic region, annual family income, and sex, with

mea> , age-adjustedmeans, and standard error of means: United States, 1971-74

Both sexes 7-74 years Male 7-74 years I

Female 7-74 years

Age- Standard AgeMean

Standard Ageadjusted error of Mean

Standard

adjusted error of Mean ‘ adjusted error of

mean mean mean uean mean mean

Blood pressure, region,

and annual family income

GEOGRAPHIC FOIGION Blood pressure in mm NS

systolic:

Northeast------------------

Midwest--------------------

South----------------------

West-----------------------

0.91

0.65

0.86

0.94

0.72

0.37

0.57

0.80

:.;$

0:40

0.53

0.41

0.31

124.0

125.8

127.5

124.4

78.3

79.7

79.7

78.8

128.6

125.4

124.3

79.6

79.1

79.1

124.1

126.0

127.2

124.4

78.4

79.7

79.6

78.8

126.6

125.6

124.8

79.5

79.4

78.8

0.81

0.75

1.12

1.14

0.62

0.34

0.69

0.79

1.23

0.60

0.46

0.77

0.40

0.35

122.8 122.0

122.5 123.2

127.7 127.0

120.7 121.3

76.3 75.9

76.6 77.0

77.9 77.6

75.3 75.7

1.15

0.79

0.s9

0.99

0.95

0.51

0.62

0.97

0.82

0.84

0.54

0.55

0.56

0.41

123.4

124.2

127.6

122.5

77.3

78.2

78.8

77.0

130.4

124.2

122.0

79.6

77.9

77.1

123.1

124.7

127.0

122.7

77.2

78.4

78.5

77.2

126.4

124.7

123.3

78.5

78.3

77.3

Diastolic:

Northeast------------------

Midwest--------------------

South----------------------

West-----------------------

ANNUAL FAMTLY INCOME

systolic:

LeSS than $5,000-----------

$5,000-$9,999--------------

$10,000 or mOre------------

Diastolic:

Less than $5,000-----------

$5,000-$9,999--------------

$10,000 or mOre------------

131.6 126.3

123.1 124.0

119.5 121.8

--ELE

Table 4. Prevalence rates of definite hypertension among persons 18-74 years by age and sex, with standard errors, population estimates. and urouortion with this condition not previously diagnosed: United States, 1971-74

Condition and age

Both sexes II

Men

St =n&rd P:pUl&.n Rate

error of in per 100

rate thousands population

Standard

error of

rate

Population

est*t*

in

:houaands

?Oplat ion

estf.mate

:hous%fs

Rate

per 100

population

Rate

per 100

population

Standard

error of

rate

DEFINITE HYPERTENSION,

TOTAL1 0.58

23J7111 19.21 0.77

18.1

2::

15.5

24.2

33.2

40.7

54.9

68.5

65.5

57.9

60.6

48.6

48.5

11,656

I,&?

2,043

3,022

2,875

2,014

7,333

378

776

1,258

1,967

1,738

1,216

17.1

kz

12.3

21.9

%::

46.7

65.5

63.0

52.6

55.6

38.5

41.0

11,525

194

618

1,449

2,680

3,382

3,191

5,379

127

389

763

1,491

1,301

1,308

738

1,777

3,492

5,702

6,257

5,205

1.10

1.34

1.92

2.12

2.18

1.74

18-24 years----------------

25-34 years----------------

35-44 years----------------

45-54 years----------------

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

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

DEFINITE HYPERTENSION

NOT P8XVIOUSLY

DIAGNOSED, TOTAL2

18-24 years----------------

25-34 years----------------

35-44 years----------------

45-54 years----------------

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

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

1.29 12,712 I

62.9 1.76

9.45 505 69.5 12.62

5.24 1,165 66.9 7.57

3.13 2>021 61.6 5.18

3.22 3,458 65.1 3.82

3.10 3,039 60.4 4.13

1.76 2,525 60.5 2.24

ISystolic blood pressure of at least 160 ZZU.H qr diastolic blood pressure of at l[:ast95 -. W

2Proportion of persons with definite hypertensfon, as definedin footnote 1, who have never been told by their doctors that they

had high blood pressure; standard error of proportions and population estimates.
6

Table 5. Prevalence rates of definite hypertension among white and Negro persons 18-74 years by age and sex, with standard errors

and vrouortion with this condition not previously diz ~osed:United States, 1971-74

Condition and age

White

Both sexes Men

Negro

Women Both sexes Men Women

--————il— Rate

~

pOpulation

17.0

:::

13.6

22.2

31.4

39.3

56.6

66.9

69.1

63.3

61.9

50.4

49.2

Rate

Standard E;

error of

rate population

Rate

I’%

>Opu-

!ation

15.7

1.4

1::;

18.9

31.7

42.3

48.2

66.4

65.0

57.5

58.9

39.9

41.2

Rate

~

10pu-

.ation

28.2

1::;

32.0

44.0

52.6

55.1

47.2

78.1

54.0

39.6

55.6

39.2

43.7

II

Rae

Standard ~

error of

Rate

~

>Opulation

28.6

1:::

28.3

50.9

54.5

58.8

41.2

62.6

57.0

40.8

44,3

33.0

39.1

;tandard

~rror of

rate

0.84

1.29

1.28

1.97

2.06

2.14

1.85

2.00

13.68

8.84

6.48

3.74

4.34

2.32

:tandard

zror of

rate

Standard

Error of

rate

2.33

1.77

:.;;

7:95

7.86

4.28

5.13

Standard

error of

rate

it--- DEFINITE HYFERTSNSION, 2UTAL1

18-24 years---------

25-34 years---------

35-44 years---------

45-54 years---------

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

65-74 years--------- I

0.57

0.65

0.65

1.09

1.59

1.59

1.72

1.51

10.86

6.02

4.02

3.22

3.18

1.95

18.5

4.9

1%;

25.8

31.1

35.3

64.5

;5.:

66:8

64.3

62.1

61.9

0.72 1.75

1.06

2.S6

3.85

6.31

5.24

3.87

3.87

27.8

1$:$’

38.2

36.8

49.9

50.1

54.9

2.28

0.30

0.57

:.;;

2:02

2.26

1.06

1.95

4.71

7,69

7,11

4.73

DEFINITE HYFERTSNSION NOT PREVIOUSLY DL4GN3SED,

TOTALz 1.86 4.66

S.91 90.4 16.94

11.52 52.0 18.35

4.94 ;;.: 8.82

8.45 10.26

7.35 48:9 12.99

4.67 51.0 4.70

18.33

12.55

6.79

10.03

8.36

5.5s

18-24 years---------

25-34 years---------

35-44 years---------

45-54 years---------

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

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

12.00

6.67

4.57

4.71

4.71

2.56

]Systolic blood pressure of at least 160 nun.

9

or diastolic blood pressure of at least 95 mm. Hg.

zProportion of persons with definite hypertens on, as defined in footnote 1,who h~e never been told by their doctors that they

had high blood pressure; standard error of proportions and population estimates.

I$3TE: There are an estimated 19.4 million white persons at ages 18-74 years out of 113.6 million and 3.7 million Negro persons

at ages 18-74 years out of 13.0 million that have defi.nitehypertension as defined in footnote 1.

Table 6. Responses to selected medical history items by hypertensive status @r persons 18-74 years; population in thousands and

percent: United States, 1971-74

—

Definite

hypertension

Borderline

hypertension Normotension t least 105 nm. Hg

diastolic

Msdical history itsms —.

Population

in

thousands

23,171

Population

in

thousands

?opulation

in

:housands

‘0pu2ation

Percent ?ercent Percent in ~ercent

—

Total 18-74 years---------------------- 100.0 23,413 100.0 81,353 100.0 6,172 100.0

Has a Doctor Ever Told You That You Have

High Blood Pressure?

Yes, still have it---------------------------

Yes, not now---------------------------------

Yes, don’t know now--------------------------

No-------------------------------------------

Unknown--------------------------------------

7,701

1,846

904

12,712

7

33.2

8.0

5::;

0.0

3,421

1,598

562

17,810

21

14.6

6.S

7:::

0.1

2,997

2,371

596

75,::;

3.7

::?

92.5

0.1

2,731

~

2,716

4

44.2

i::

44.0

0.1

If Yes, HOW Many Years Ago Did You First

Have It?

3,6%

2,259

75,424

1,5%

1,793

2,732

1,471

307

4,390

4

2*:!

29.0

44.Y

Less than 1 year-----------------------------

1-5 years------------------------------------

6-70 years-----------------------------------

Not applicable,unknown----------------------

177

5,343

4,s74

12,777

2:::

21.0

55.1

3,2::

2,241

17,866

During the Past 6 Monthfi,Have You Sver

Used Any Medicine, Pills, or Dngs for

High Blood Pressure?

2,0s4

20,;Y2

2s

1,670

233

79,338

112

2.0

9%:

0.1

23.8

7:::

0.1

Regularly------------------------------------

Occasionally---------------------------------

No------------------------------------------

Unknown--------------------------------------

4,893

831

17,421

27
7

I I

Prevalence estimates of hypertension in the civilian noninstitutionalized population 17 years of age and over in 1974,

based on household interview findings from a special supplement used in the Health Interview Survey, will be reported in

Advance Data (HRA) 77-1250, No. 2.

SYMBOLS

Data not available-------— --------------------------- ---

Category not applicable--------------–--------–– . . .

Quantity zero ----------------------------------------- -

Quantity more than O but less than 0.05---- 0.0

Figure does not meet standards of

reliability or precision -------------------------- *
US. DEPARTMENT OF HEALTH, EmCATION, AND WELFARE I No. 2 November 8, 1976 I Pubkc Health Service. Health Resources Admmlstratlon

HYPERTENSION: UNITED STATES, 1974a

During 1974 the Division of Health Interview Statistics obtained hypertension prevalence

estimates for the U.S. civilian noninstitutionalized population 17 years of age and over. Whiie

hypertension data have been collected by this

Division in the past, this was the first year for

earmarking this condition as a supplemental

topic, enabling the collection of more detailed

information than had been obtained previously.

Special interest in this disease was generated

in 1972 with the establishment of the National

High Blood Pressure Education Program. The

long-range goaI of this program is to lower the

morbidity and mortality associated with high

blood pressure existing in this country today

through improved detection and treatment of

this disease. A more immediate program objective, however, is the education of both the public and the medical community about high blood

pressure.

This report contains population estimates

for four hypertension status categories, “ever

aThis report prepared by Abigail Moss and Geraldine

Scott, Division of Health Interview Statistics.

had hypertension,” “now have hypertension,”

%o longer have hypertension, ” and “never had

hypertension,” ‘by seven demographic characteristics—age, sex, race, family income, education

of individual, and geographic region and place of

residence. Data on a limited number of supplemental items are also included. A more detailed

report containing further analysis of these and

other related data is being prepared.

The following criteria were used to classify

persons into four hypertension status categories

which were developed for the purpose of presenting the hypertension data obtained by the

Division of Health Interview Statistics.

Persons comprising the category “ever had

hypertension” reported that they were told by a

medical doctor that they had either hypertension or high blood pressure. These persons are

also classified according to their current hypertension status: (1) persons who “now have hypertension” reported that they still had hypertension (high blood pressure) at the time of the

interview, that it was under control, or that they

were taking medicine prescribed by a doctor for

it; (2) persons who “no longer have hypertension” reported that this condition was cured and

I

Advance Data porn Vital and Health Statistics replaces the supplements to the Monthly Vital Statistics Report

as the means for early release of selected findings from the health and demographic surveys conducted by the

NCHS. Most of these releases will be followed by detailed reports in the Vital and Health Statistics series.

Provisional vital statistics as well as advance reports of final data for a year will continue to be pubIished in the

Monthly Vital Statistics Report.

Advance Data is being distributed on the mailing keys for the Vital and Health Statistics series, and people

who now receive reports from a particular series will also receive all Advance Data releases for that series.

Temporarily, the mailing list for the Monthly Vital Statistics Report (M VSR.) is also being used. M VSR readers

who wish to continue to receive Advance Data issues, as well as other persons who wish to receive all issues,

should contact:

National Center for Health Statistics

Room 8-20

5600 Fishers Lrme

I

Rockville, Maryland 20852

Phone: (301 ) 443-1200
2

that they were not presently taking medicine

prescribed by a doctor for it. Note that to be

classified to either category “now have hypertension” or “no longer have hypertension” a

person also had to have been told at some time

by a medical doctor that he had high blood pressure or hypertension. The category “never had

hypertension” comprises persons who were

never told by a medical doctor that they had

hypertension or high blood pressure.

According to data obtained in 1974 by the

Division of Health Interview Statistics, one in

five persons comprising the civilian noninstitutionalized population of the United States 17

years of age and over (20.6 percent) has been

told by a doctor that he has hypertension, and

an estimated 22.6 million Americans at these

ages (15.7 percent ) still have this condition

(table 1). There are marked differences in the

percents of persons that now have hypertension

for specific sex, age, and race groups.

Proportionately more women (18.5 percent)

than men (12.5 percent) currently have hypertension. This sex difference was apparent among

aged 17-24 years, where the percents of young

hypertensive men and women were about the

same. The likelihood of having this conditicm

also increased with advancing age. Whereas

about 4 percent of all persons aged 17-24 years

now have hypertension, this proportion rose ito

35 percent of all persons 65 years of age and

over.

Proportionately more black persons (22.2

percent) than white (15.0 percent) currently

have hypertension. This pattern was evident for

each age group except those aged 17-24 years;

differences between white persons and black of

the se ages were within sampling variation.

Among all persons 17 years of age and over,

white males had the lowest proportion (12.0

percent) of hypertensives, and black females had

the highest proportion (25.9 percent) of hypertensive, as shown in the cliart, while similar proportions with hypertension were found for white

females (1 7.7 percent) and black maIes (1 7.4 percent). Percent differences between white femal(es

and black males with hypertension for the age

groups 25-44, 45-64, and 65 years and over may

every age group shown in table 1-except those be due to sampling variability:

PERCENT OF PRESENTLY HYPERTENSIVE PERSONS BY AGE, RACE, AND SEX: UNITED STATES, 1974

60

I

-Wl,temale

50

m ~hlte female

m BIack male

=,,,., ‘mm,,

40t

!4’

20

10

0

At a

6.8

19.8

All ages 17 years 17.24 2544 45.64 65 and

and over over

AGE IN YEARS
When hypertension data are displayed by

family income, education of the individual, and

geographic region and place of residence the following patterns are found. As family income

rose, the percent of persons with hypertension

declined–from 25.7 percent of those with incomes of less than $5,000 to 11.8 percent when

income reached $10,000 or more (table 2). A

disproportionate number of older persons and

black persons in the lower income bracket, however, account for some of this difference. For example, when these data were age-adjusted to the

age distribution of the United States population

17 years and over (see Technical Notes), the percent changed as follows:

Percent

Unadjusted Age-adjusted

Less than $5,000 . . . 25.7 22.0

$5,000-$9,999 . . . . 17.2 17.1

$10,000 or more . . . 11.8 13.3

Likewise, as level of education increased the

percent of persons with hypertension decreased.

An estimated 22 percent of all persons who were

not high school graduates now have hypertension compared with about 13 percent of high

school graduates and about 10 percent of persons completing 1 year or more of college.

The South had the highest proportion of

persons with hypertension (16.9 percent) of any

geographic region in the country. A slightly

greater percent of persons residing outside of

standard metropolitan statistical areas (SMSA>S)

(16.9 percent) currently had hypertension than

did those living within SMSA’S (15.1 percent).

Within SMSA’S, the proportion of hypertensives

was more than 20 percent higher among people

Iiving in the central city (16.8 percent) than

those living in adjacent areas (13.8 percent).

Most health practitioners agree that a.11persons should have a blood pressure test periodically. Based on 1974 Health Interview Survey

findings, almost two-thirds of aI1 persons aged

17 years and over were given a test of this kind

within the 12-month period preceding the interview (table 3).

The percent of persons with a 12-month

blood pressure test gradually increased with each

older age group, from 62.6 percent of those

17-44 years to 70.4 percent of persons 65 years

and over. Proportionately more females (71.8

percent) than males (56.5 percent) had a test

within the year, while about the same proportion of white persons and black were given a

blood pressure test during this period. An estimated 1.4 million people 17 years of age or

older (about 1 percent of the U.S. civilian

noninstitutionalized adult population) reported

they had never had a blood pressure test.

The percents of persons having a blood pressure test during the previous year were. somewhat higher for the currently hypertensive population than for the general population. About 86

percent of the currently hypertensive population

had their blood pressure taken within 12 months

of the date of interview, and three out of every

four persons with high blood pressure had a test

as recently as within 6 months of the interview.

Proportionately more females than males

now with hypertension had a blood pressure test

within the past 6 months (76.3 compared with

70.4 percent) and within the past 12 months

(87.8 compared with 83.5 percent). The proportion of currently hypertensive persons with a

blood pressure test during the 6-month period

also rose with each older age group, from 66.9

percent of those aged 17-44 years to 78.6 percent of those aged 65 years and over. However

for the 12-mqnth period preceding the interview, although proportionately more persons 45

years and over had a blood pressure test than did

younger persons, the percents with a test during

this period for the two age groups 45-64 and 65

years and over were about the sqne.

Of persons with a blood pressure test within

the year, the proportion having multiple tests

during this period rose as age increased-from

58.2 percent of persons 17-44 years to 73.6 percent of those 65 years or older. The percent

with two tests or more was higher for females

(65.7 percent) than it was for males (56.9 percent), and it was higher for black persons (67.3

percent) than il~was for white persons (61.5 percent). Proportionately mo~e persons now having

hypertension had multiple blood pressure tests

during the year than did the total U.S. civilian

noninstitutiomdized population (8 1.4 percent

compared with 62.1 percent).

Persons whose blood pressure was taken in

the past year are classified according to the last

test result (table 4). Of the total United States
4 .

civilian noninstitutionalized population 17 years

of age and over with blood pressure taken in the

past year, a little more than half (53.1 percent)

were told their last blood pressure reading was

normal. Males had a higher percent of normal

readings than did females (57. 3 percent compared with 50.2 percent). About the same percent of males and females had a blood pressure

reading that was high (7. 1 and 7.8 percent, respectively), while females had almost twice as

high a percentile of blood pressure results that

were low as did males (4.8 compared with 2.6

percent).

By race, proportionately more black persons

(10.7 percent) than white (7. 1 percent) 17 years

and over had a blood pressure reading that was

high.

About the same proportion of white persons

(4.0 percent) and black (3.2 percent) had a

blood pressure reading that was low. Overall, the

proportion of persons having a blood pressure

reading that was high was much greater among

persons now having hypertension (29.7 percent)

than among the total United States adult population (7.5 percent).

Data on doctor visits and bed days for hypertension which occurred during the 12-month

period preceding the interview are presented in

table 5. About three-fourths of the currently

hypertensive population saw a doctor for this

condition at least once during the year, while

26.9 percent reported five doctor visits or more.

The percent of currently hypertensive persons

with one doctor visit or more of this kind increased somewhat for two broad age groups—

from about 62 percent of persons aged 17-44

years to about 77 percent of all persons aged 45

years and over. Over one-third of all persons

comprising the oldest age category had five doctor visits or more for hypertension within this

period compared with ordy about 9 percent of

persons 17-24 years of age.

The percent of persons reporting one doctor

visit or more for hypertension was higher for

presently hypertensive females (76.4 percent)

than it was for males (68.7 percent). Differences

in the percents of white and black persons now

with hypertension having one doctor visit or

more during the year, however, were within

sampling variation.

Only a small proportion of persons now with

hypertension (8.3 percent) had to stay in bed all

or most of the day for 1 day or more during the

year because of this condition. Furthermore, the

number of days spent in bed for this condition

in the 12-month period totaled less than 1 week

for more than one-half of those persons reporting any bed days because of their high bloc)d

pressure.

The percent of currently hypertensive women with bed days for this condition was slightly

higher than was the percent of men with bed

days (9.6 compared with 6.3 percent). Arid

proportionately more hypertensive black individuals (18.9 percent) reported 1 bed day or

more for this condition than did the white population (6.5 percent).

Data on interval since last doctor visit (for

any reason) are included in table 6. Highlighted

below are some of the differences noted in this

table among certain population groups.

Proportionately more persons now with

hypertension than persons comprising the general population had a doctor visit within the past

6 months (79.2 compared with 61.4 percent)

and within the past 12 months (89.5 compared

with 77.1 percent).

Currently hypertensive females were somewhat more likely to have had a recent doctc~r

visit than were hypertensive males; within 6

months, 81.5 percent and 75.3 percent, respectively, and within the year, 91.7 percent amd

85.9 percent, respectively.

In general, as age increased, the proportion

of currently hypertensive persons that saw a

doctor within 6 months and 12 months prior to

the interview also rose. Whereas about 74 percent of hypertensive persons aged 17-44 years

saw a doctor within 6 months, about 82 percent

of those 65 years or older had a visit within this

period. Similarly, 87.7 percent of the hypertensive population aged 17-44 visited a doctor during the year compared with 90.7 percent of persons comprising the age group 65 years and over.

No - racial differences were found between

the proportion of white persons and black with

hypertension that saw a doctor either within 6

or 12 months of the date of interview.
5

Table 1. Number aad percent dis tributk.n Of persons 17 years Of age and over by hypertension status, according to race, sex, and

age; based on data collected in health interviews: United States, 1974

Race, sex, and age

ALL RACES2

Both sexes

All ages 17 years

and over---------

17-24 year8-------------

25-44 yearn-------------

45-64 years-------------

65 years and over-------

Hale

Al1 ages 17 years

and over-----------

17-24 years-------------

25-44 years-------------

45-64 years-------------

65 years and over-------

Fema1e

All ages 17 years

and over-----------

17-24 years-------------

25-44 years-------------

45-64 years-------------

65 years and over-------

WWITE

Both sexes

A;Hda~er17 years

-----------

17-24 years-------------

25-44 years-------------

45-64 years-------------

65 years and over-------

Male

A~;da~~e=17 years

-----------

17-24 years-------------

25-44 yeara-------------

45-64 years-------------

65 years and over-------

Female

All ages 17 years

and over-----------

17-24 years-------------

25-44 years-------------

45-64 yeara-------------

65 years and over-------

m6cl(

Both sexes

All ages 17 yeaqs

and over-----------

17-24 years-------------

25-44 years-------------

45-64 years-------------

65 years and aver------Male

A3.1ages 17 yearn

and over----------

17-24 years-------------

25-44 years-------------

45-64 years-------------

65 years and over-------

Female

A~;dag~e=27 yearn

-----------

17-24 years-------------

25-44 years-------------

45-64 years-------------

65 vears and over-------

All

>ersoaa

.7 years

md over

Hypertension status

Tetal

h--i

Now h.W

ever hypertension Never

with had

hyper -~

hyper- k%an

tension Yes NO tension

U$4.38Q

29,Sd2

51,216

42,M?

20,740

67,%7

14,252

24,6s9

20,419

8,578

76,433

15,310

26,518

22,443

12,163

127,787

25,464

44,934

m,;5;

60,482

12,375

21,922

18,414

7,771

67,305

13,8i18

23,012

2Q,1OO

2,1,1Q4

14,865

3,725

5,415

3,982

1,743

6,614

l,fis

2,343

1,853

749

8,252

2,0S7

3,1372

Number in thousands

29,789

2,069

7,235

1:,96:

,

11,562

837

2,989

4,953

2,784

18,228

1,232

4,247

7,007

5,742

25,598

1,789

6,037

10,194

7,578

10,063

761

2,617

4,252

2,433

15,535

1,029

3,421

5,941

5,145

3.943

270

1,114

1,668

890

1,377

3;:

650

324

2,566

194

787

1,018

567

22,626

-

1;147

$.:;:

7;267

8,479

507

1,869

3,829

2,273

14,147

640

2,691

5,823

4,993

19,143

959

3>614

8,132

6,438

7,244

468

1,564

3,236

1,976

11,898

491

2,050

4,896

4,461

3,294

-

179

887

1,441

787

1,154

*4O

279

550

285

2,140

140

607

891

502

5,345

-

675

2,129

1,657

g84

2,156

205

837

774

339

3,189

470

1,291

W:

4,871

611

1,936

1,501

822

1,990

191

790

688

321

2,881

420

1,147

813

501

439

*64

176

137

*62

148

*L4

*37

79

*19

290

*49

139

*59

*44

105,004

-

24,966

40,590

:;,:;:

,

49,784

11,744

19,135

13,468

5,437

55,220

13,223

21,455

1$,:5:

,

93,930

21,557

36,024

25,708

10,640

44,707

10,218

17,092

12,377

5,019

49,223

11,339

L8,932

13,331

5,621

9,725

-

3,084

3,847

2,016

779

4,423

1,341

1>687

1,;;:

5,302

1,742

2,160

1,012

388

9,587

2>527

3,391

2,926

744

6,601

1,672

2,574

1,998

357

2,986

855

816

927

388

8,259

2,117

2,873

2,612

657

5,712

1>397

2,213

1,784

319

2,547

721

660

828

338

1,197

372

454

299

74

814

251

329

199

*35

384

120

125

100

*39

Hypertension status

“E%%%=+’

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.cl

100.C,

100.CI

100.0

100.CI

100.0

;:Cl.:

100:0

100.0

100.0

100.0

100.0

100.II

100.0

100.O

100.0

100.D

100.L3

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

Percent distribution

20.6

J:!

27.9

41.1

17.0

5.9

12.1

24.3

32.5

23.8

1:::

31.2

47.2

20.0

7.0

13.4

26.5

40.1

16.6

1:::

23.1

31.3

23.1

Ii:;

29.6

46.3

26.5

2::2

41.9

51.1

20.8

12::

35.1

43.3

31.1

2?:!

47.8

57.0

15.7

=

3.9

2;:;

35.0

12.5

3.6

7.6

18.8

26.5

18.5

1::?

25.9

41.1

15.0

3.8

2!:?

34.1

12.0

;:?

17.6

25.4

17.7

3.8

2!::

40.2

22.2

122

36.2

45.2

17.4

*2.4

17..9

29.7

38.1

25:9

6.8

19.8

41.9

50.5

3.7

!::

:::

3.2

;::

;::

4.2

2:;

3.9

4.5

3.8

—.

::$

:;:

3.3

$::

;:z

4.3

3.2

:::

4.5

3.0

*1.7

3.3

3.4

*3.6

2.2

*0.8

*1.6

4.3

*2.5

3.5

*2.4

4.5

*2.8

*4.k

72.7

84.5

79.3

65.3

55.3

73.3

82.4

77.s

66.0

63.4

72.2

86.4

80.9

64.6

49.6

73.5

84.7

80.2

66.7

56.4

73.9

;:.:

67:2

64.6

73.1

86.6

82.3

66.3

50.6

65.4

—.

82.8

71.0

50.6

44.7

66.9

80.4

72.0

54.2

52.2

64.3

84.7

70.3

47.5

39.*

6.6

8.5

6.6

6.8

3.6

9.7

11.7

10.4

2::

3.9

;:?

4.1

3.2

6.5

8.3

6.4

6.8

3.5

9.4

11.3

10.1

1:[

3.8

5.5

:::

3.0

8.1

10.0

8.4

;:2

12.3

15.0

14.0

10.7

*4,7

4.7

:::

4.7

*3.9

‘Includestimm w-t &erteruionstatus. 21ncludes other races.
Table 2. Number and percent distribution of persons 17 years o? age and over by hypertensim status, according to selected char. acteristics;based on data collected in health intemiews s IJnitedstates, 1974

Characteristic

All persons 17 years

and over2----------

FAMILY INCOME

Less than $5,000--------

$5,000-$9,999-----------

!E::::-::4A::2:::::::::

EDUCATION OF

INDIVIDUAL

Less than 9 years-------

9-11 years--------------

12 years----------------

13 years or nmre --------

GEOGRAPHIC REGION

Northeast ---------------

North Central-----------

South-------------------

West--------------------

PLACE OF RESIDENCE

8NSA--------------------

Central city----------

Outside central city--

Outside Sl.lSA ------------

Nonfam ---------------

Farm------------------

m 1 1 1

Number in thousands

144,38C

24,753

32,SS1

33,8s1

43,629

27,132

27,1S4

50,548

37,512

34,985

3s,430

j;,;l;

,

99,s07

44,504

55,30

44,57*

39,370

5,203

29,789

7,665

7,22s

5,542

7,442

8,871

5,s15

8,979

5,791

7,228

7,737

9,S24

5,000

19,966

9,541

10,425

9,S24

8,729

1,095

1Includes unknown present hypertension status.

2Includes unknown income and education.

12,626

6,35o

5,655

3,923

5,214

7,402

4,443

6,632

3,S66

5,469

5,749

7,646

3,761

;,~m;

7:621

7,534

6,671

S63

5,345

913

1,219

1,174

1,759

993

965

1,sss

1,470

1,321

1,489

1,556

980

3,566

1,469

2,097

1,779

1,597

181

105,001

16,14[

23,94!

26,08L

32,92(

17,015

19,435

38,341

29,082

25,110

28,0S1

32,448

19,364

72,956

32,001

40,955

32,048

28,182

3,866

9,587

94s

1,70s

2,255

3,261

1,246

1,935

3,228

2,63S

2,646

2,612

2,S4S

1,480

6,885

2,962

3,923

2,702

2,460

242

All

persons

17 years

and over

100.0

100.0

100.0

100.0

100.0

7.00.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

Hypertension status

Percent distribution

20.6

31.0

22.0

16.4

17.1

32.7

21.4

17.8

15.4

20.7

20.1

21.s

19.3

20.0

21.4

18.9

22.0

22.2

21.0

SYMBOLS

Data not available ---------------------------------------- ---

Category not applicable ------------------------------- . . .

Quantity zero ---------------------------------------------- -

Quantity morethan Obut Iessthan 0.05----- 0.0

15.7

25.7

17.2

11.6

12.0

27.3

16.3

13.1

10,3

15.6

15.0

16.9

14.6

15,1

16.8

13.s

16.9

16.9

16.6

3.7

3.7

::;

4.0

3.7

::?

3.9

::;

3.4

3.s

3.6

3.3

:::

4.1

3.5

72.7

65.2

72.8

77.0

75.5

62.7

71.5

75.9

77.5

71.8

73.1

71.9

74.9

73.1

71.9

74.1

71.9

71.6

74.3

6.6

3.8

5.2

6.7

7.5

4.6

:::

7.0

:::

6.3

5.7

6.9

6.’7

7.’1

6.1

6.:Z

4.7

Figure does not meet standards of

reliability or precision (more than

30 percent relative standard error) ---------- *
Table 3. Number of ersons 17 years of age and over and percent distribution by interval s:

ber of persons witE blood pressure taken during year and percent distribution b! times blc

tension status, age, sex, and race; based on data collected in health interview! United <

e last blood pressure test, and numpressure taken, according to hypertes. 197&

Interval since last blood

pressure test

II I I 1

Persn2

blood

pressure

taken in

past

year in

thousands

133 59! -

73,79!

39,85S

19,945

60,72S

72,87c

118,625

54,30C

64,324

13,418

5,671

7,747

29,401

9,182

11,787

8,432

11,462

17,939

25,286

9,987

15,299

3,875

1,362

2,513

22,352

Times blood pressure taken

Al1 in past year

persons

17 years

and ovex

in thousands

Hypertension status, age

sex, and race Less 2

rotall than 6-11 1

6

years

months year or

months nmre

10

rotalz & ?-4 5-9 times

tunes times or

more

ALL STATUSES3 Percent distribution Percent distribution

A:2.dp~e:~5 17 years

-------------- 144,38C 100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

7.00.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100,0

100.0

100.0

100.0

47.1

43.4

48.6

58.4

39.8

53.6

46.7

39.8

52.8

51.2

40.3

60.0

68.3

60.9

69.6

74.6

63.8

71.1

68.3

63.9

71.2

68.4

63.3

71.1

74.1

17.6

19.2

17.1

3.2.1

16.7

18.3

17.8

16.8

18.7

15.3

16.1

14.6

14.3

17.7

14.5

10.3

15.5

13.6

14;6

15.6

14.0

11.5

13.9

10.2

12.1

11. [

12. $

11.1

8.8

12.5

11.1

11.9

12.7

11.:

10.7

12,2

9.4

7.7

15.8

15.5

;;.;

19.9

12.1

16.1

20.1

12.4

12.4

1:.:

8.2

100. c

100.C

100.c

100.C

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

33 c

J

38,1

32.i

21.5

38.E

30.4

34.5

38.6

31.5

28.4

39.3

21.8

39.(

39.(

38.~

38.1

39.t

38.1

39.C

40.1

38.3

38.9

38.3

39.2

38.0

39.4

37.7

36.9

40.4

36.6

3s.0

40.6

36.5

37.8

40.0

36.7

38.3

11.:

1;:;

16.(

8.;

13.;

11.:

8.;

13.:

13.(

11:;

1s.9

15.2

20.0

21.1

15.5

20.9

19,1

15.7

21.1

18,0

13.9

20.1

20.7

11.4

1:::

18.8

1!:2

l&~

13:1

14.9

10.1

17.8

20.3

16,1

20.4

24.3

17.9

21.7

19.5

17.4

20.8

25.1

21.5

27.0

22.4

Age :

17-44 years-------------------

45-64 years-------------------

65 years and over-------------

sex:

Male--------------------------

Fen!-ale------------------------

80,77~

42,862

20,740

67,947

76,433

Race:

White------------------------- 127,7S7

60,482

67,305

14,865

6,614

8,252

Male----

FmMe--

Black-------------------------

Male----

Female--

EV8R HAD HYPERTENsIONS

All persons 17 years

and cwerd---------------- 29,789

9,304

11,960

8,525

11,562

18.228

25,598

10.063

15,535

3,943

1,377

2,566

19.0

—

2S.7

18.0

13.8

22.1

17.2

19.6

22.1

18.1

15.2

22.2

11.6

Age:

17-44 years-------------------

45-64 years-------------------

65 years and over-------------

10.7

6.9

5.7

9.2

6.S

H

6.S

i:?

6.9

6.5

Sex:

Male --------------------------

Female------------------------

Race:

~ite----------------~~i; ----

----

Female--

Black-------------------------

Male----

Female--

NOW HAVB HYPERTENSION

All per80ns 17 years

and 0ver4------------------ 22,626

5,708

9,652

7,267

8,479

14,147

19,143

7,244

11,89S

3,294

1,154

2,140

L5. o

Age:

17-44 years-------------------

45-64 years-------------------

65 years and over-------------

Sex:

Male--------------------------

Female-----------------------

66.9

74.9

78.6

70.4

76.3

74.3

70.4

76,7

72,8

70.0

74.3

44.5

14.3

12.3

10.0

E.:

.

12.3

13.1

11.s

10.6

12.6

9.5

19.8

20.9

19.7

14.0

19.0

20.5

20.0

19.0

20.9

18.3

19.2

17.6

5,636

9,513

7,203

8,401

:13,951

18,912

7,174

1:,;::

1:146

2,104

102,458

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

20.2

14.0

12.5

16.7

14.0

3.5.3

16.6

14.5

13.1

17.7

10.6

40.6

38.0

37.0

41.0

36.7

3s.3

41.0

36.8

37.9

42.2

35.6

39.4

16.9

22.0

21.8

17.5

22.6

21.0

17.7

23.0

1s.9

15,5

20.7

9.1

18.9

22.4

25.0

20.8

23.4

21.7

20.2

22.5

26.7

23,2

28.6

8.2

Race:

White -------------------------

M21e--- -

Female-Black-------------------------

Male----

Female--

N8VER HAO HTPERTSNS7.ON

All persons 1? years

and over4---------------- 105,004

65,556

27,977

11,471

49,784

55,220

93,930

44,707

49,223

9,725

4,423

5,302

39.3

Age:

17-44 years -------------------

45-64 years-------------------

65 years and over-------------

#:$

48.4

38.8

49.7

~.:

48:8

49.6

39.5

58.1

14.2

13.s

11.5

14.8

12.9

14.0

14.9

13.1

12..7

15.4

10.5

—

17.5

20.6

23.4

24.3

14.2

;:::

14.7

14.2

19.4

10.0

63,713

27,519

11>226

4S,496

53,962

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

40.2

41.2

29.4

39.?

38.8

39.7

39.6

39.3

39,4

40.0

39.0

39.5

37.3

41.0

;::

13.3

1::$

Soo

5.3

10.0

10.2

1:::

Sex:

M.21e--------------------------

F~le-.-..--.-.. .............

44.1

35.8

Race:

White------------------------

Male----

Famale--

Black-------------------------

Male----

Female--

91,844

43,668

48,175

9,315

4,199

5,116

39,8

43.7

36.8

34.7

$$.$

.

iIncludes never and unknown inter.rals.

Zzncludas unkmwn tipas.

3Include~ tmknc.wnhypertension status.

41ncludes persons of other races.

51ncludesnow have hypertension,no longer have hypertension, and unknown if now have hypertenzion
Table 4. Number of persons 17 years of age and over with blood pressure taken in past year and percent distribution by last test

results, according to hypertensionstatus, sex, and race; based on data collected in health interviews: United States. 1974

Hypertension status, sex, and race

1

Persons

ith blood

pressure

taken in

,astyear

hou.%ds

ALL STATUSES2 Percent distribution

All persons 17 years and over3------------ 93.342 100.0 53.1 3,9 3.2 30.9

Sex:

Male --------------------------------------------

Female------------------------------------------

38,425

54,917

100.0

100.0

57.3

50.2

28.3

32.8

Race:

Nhite--------------------------------------------

Male----

Female--

B1ack--------------------------------------------

Male----

Female--

53.1

57.4

50.0

53.5

56.7

51.6

31.1

28.1

33.2

29.3

29.4

29.2

EVER HAO HYPERTENSION~

All persons 17 years and over3----------------- 24,606 100.0 45.5 25.3 1.3 6.1 20.4

Sex:

Male---------------------------------------------

Female-------------------------------------------

9,167

15,439

100.0

100.0

25.4

25.3

1.4

1.3

6.2

6.0

16.9

22.5

Race:

Nhite--------------------------------------------

Male----

Female--

Black--------------------------------------------

100.0

100.0

100.0

m:.:

100:0

21,235

7,998

13,237

;,;:;

2:088

24.6

24.8

24.4

30.9

30.7

30.9

1.4

1.6

1.3

*o.5

6.4

{::

*4:1

*2.8

20.3

16.6

22.6

21.1

19.3

22.0

Male----

Female-- *O.8

NOW HAVE HYPERTENSION

All persons 17 years and over’-----------------

Sex:

Male---------------------------------------------

Fale -------------------------------------------

100.0 40.9

44.1

39.2

29.7

29.9

29.6

6.8

6.9

6.8

19,499 1.2

1.6

1.0

19.8

15.9

22.0

7,078

12,421

100.0

100.0

Race:

White---------------------------------------------

Male----

Female--

Black--------------------------------------------

p@le-_-.

Female--

NEVER HAD HYPERTBNS1ON

16,582

6,049

10,532

2,746

953

1,793

28.9

29.4

28.7

34.3

32.9

35.1

1.3

1.9

0.9

*0.6

*0.9

7.4

;:;

3.5

*3.8

*3.3

19.8

15.6

22.2

19.5

17.5

20.6

All persons 17 years and over’--------------- 67,538 100.0 55.9 1.0 4.9 2.2 34.7

32.0

36.8

Sex:

Male---------------------------------------------

Finale -------------------------------------------

2.4

2.1

100.0

100.0

60.2

52.8

1.2

.8

3.1

6.3

Race:

Nhite--------------------------------------------

Male----

Female--

Black--------------------------------------------

Male----

Female--

100.0

100.0

100.0

100.0

100.0

100.0

55.7

60.1

52.3

58.7

61.4

57.0

1.0

1.3

1::

*1.1

*1.o

2.3

2.5

2.2

1.3

*1.4

*1.2

34.9

31.7

37.3

33.1

33.8

32.7

#wludes unknown status of blood pressure reading.

~Includes unknown hypertension status.

Includes persons of ocher races.

41ncludesnow have hypertension,no longer have hypertension,and unknown if nm have hypertension.
9

Table 5. Number of hypertensive persons 17 years of age and over and percent distributim by number of doctor visits and bed days

for hypertension in past year, according to hypertension status, age, sex, and race; based on data collected in health interviews: United States, 1974

Hypertension status, age,

sex, and race

Number of doctor visits for hypertension

in past year

11 1 ! I

Number of bed days for

hypertension in past year

All

persons

L7 years

md over

h) thousands Total] IINone I

1I

2-4 O= ~re

EVRR HAD RTPEMENSION3 Percent distribution Percent distribution

All perscms 17 years

and mere -------------------- 29.789 100.0 II 34.9 25.1 21.9

Ii:;

23.8

30.5

18.0

24.4

21.4

17.6

23.9

25.2

20.0

28.0

26.9

100.0

_

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

16.6 92.8 2.9

92.2

93.8

91.9

93.4

94.6

91.7

94.3

95.7

93.3

S3.3

S6.1

81.9

91.5

Age:

L7-24 years-----------------------

25-44 years-----------------------

45-64 year& ----------------------

65 years and over-----------------

Sex:

Male------------------------------

Female----------------------------

2>069

7,235

11,960

8,525

11,562

18,228

25,598

10,063

15,535

3,943

1,377

2,566

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

23.9

19.2

16.2

13.3

16.0

17.0

16.8

16.2

17.2

15.6

14.6

16.2

18.7

18.2

2s.0

2S.6

&~

.

25.3

24.5

25.S

23.7

23.5

23,7

29.8

*2.2

1.s

3.5

2.9

2.4

3.2

2.2

1.8

2.4

+:!

3.6

Race:

white-----------------------i;----

...-

Female--

Black-----------------------------

Male----

Female--

NOW HAVE HYPERTENSION

-1- 100.0 25.2

100.0 39.2

100.0 36.5

100.0 22.3

100.0 19.7

L-16.8

27.4

21.4

15.8

13.6

All persms 17 years

and over4---------------------- 22.626

-

Age:

17-24 years-----------------------

25-44 years-----------------------

45-64 years-----------------------

65 years and over-----------------

1,1.47

4,560

;,;;;

>

24.3

23,4

32.5

31.1

29.8

29.9

30.3

30.2

30.4

26.9

27.5

26.5

1?:!

28.2

34.1

23.0

29.3

26.7

22.7

29.1

28.3

23.S

30.7

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

90.7

91.5

90.5

93.1

93.6

90.2

93.3

95.1

92.3

80.8

84.1

79.1

*5.S

5.6

5.1

3.4

3.2

5.6

2::

1?::

*7.9

11.1

Sex:

Male ------------------------------

Female----------------------------

S,479

14,147

100.0

I

;;.:

100.0

15.9

17.3

Race:

White-----------------------------

Male----

Female--

Black-----------------------------

Male----

Female--

19,143

7,244

11,898

3,294

1,154

2,140 1

100.0 24.9

100.0 ;>;

100.0

100.0 26:7

100.0 30.7

100.0 24.5

17.0

16.1

17.5

16.0

15.2

16.4

lIncludesunknown doctor visits.

21ncludesunknown bed days.

%ncludes now have hypertension, no lonser have hypertension, and unknown if now have hypertension.

41ncludeapersona of other races.
10

Table 6. Number of persons 17 years of age and over and percent distribution by interval since Iast doctor visit, according to

hypertensionstatus, age, sex, and race; based on data collected in health interviews: United States, 1974

...——.—__ —_ ——

Interval since last doctor visit

In ~st 2 weeks 6 months

Totall to less to less 1 year

2-4 5 years

than than weeks 6 months

years or more

1 year

All

personw

17 years

and cwer

in

thousands

Hypertensionstatus, age, sex, and race

ALL STATUSES2

All persona 17 years and 0ver3----------

Percent distribution

144,3SC

T

100.0 15.7

100.0 14.2

100.0 16.3

100.0 20.2

45.7

46.(

44.1

47;<

15.s

17.7

14.9

9.9

S.s

9.7

S.3

6.7

10.7

7.2

1:::

7.2

1::;

7.2

5.s

g.i 4.2

$::

6.5

Age:

17-44 years-----------------------------------

45-64 yeara-----------------------------------

65 years and over-----------------------------

S0,77E

42,S62

20,74C

67,947

76,43?

127,7S7

60,4S2

67,305

14,S65

6,614

8,252

29,7S9

9.(

lo.!

s.!

12./

6.L

&

6.$

1;:;

5.5

4.7

Sex:

Male ------------------------------------------

Female----------------------------------------

100.0 I

12.6

100..0 1s.4

41.2

49.7

16.7

14.9

5,5

3.1

Race:

White-----------------------------------------

Male----

100.0 15,6

100.0 12.6

100.0 1s.4

100.0 16,S

100.0 12.7

100.0 20.1

Female--

Black-----------------------------------------

Male----

Female--

EVER RAD HYPERTENSION4

All ages 17 years and over3--------------- iv100.0 23.0

100.0 20.s

100.0 22.9

100.0 25.7

100.0 20.7

100.0 24.6

52.1 12.4 1.9

Age:

17-44 years-----------------------------------

45-64 years-----------------------------------

65 years and over-----------------------------

9,304

11,960

8,525

11,562

1S,228

49.5

53.0

53.6

16.1

11.s

9.1

4,9

4,s

4.4

1.8

2.0

1.s

Sex:

Nale ------------------------------------------

Female----------------------------------------

49.5

53.7

13.0

12.0

6.5

3.5

2.3

1.6

Race:

White----------------------------------------- 25,598

10,063

15,535

3,943

1,377

2,566

4.9

6.5

3.s

3.s

7.3

*1.9

Male----

Female--

Black-----------------------------------------

Male----

Female--

+

100.0 25.1

100.0 23.7

100.0 24.5

100.0 27.0

NOW RAVE HYPERTENSION

All persons 17 years and over3-------------- 22,626

5,70s

9,652

7,267

54.1 10.4 3.s 1.4

Age:

17-44 years-----------------------------------

45-64 years-----------------------------------

65 years and mar-----------------------------

50.3

55.4

55.2

52.9

54.8

54.5

52.9

55.5

51.6

54.7

50.0

44.4

13.s

9.s

S.4

6.2

5.2

4.5

:::

;.;

;:]

5;7

9.4

9.6

9.5

7.7

1:.:

.

9.4

10.9

S,o

9,0

10.s

7.6

4.6

3.6

3.3

1.3

1.4

1.5

Sex:

Male ------------------------------------------

Female----------------------------------------

S,479

14,147

100.0 22.4

100.0 26.7

10.6

10.2

5.3

2.9

1.7

1.2

Race:

white---------------------------------~i:----

----

Female--

Black-----------------------------------------

MaLe----

Female--

100.0 24.S

100.0 22.1

100.0 26.4

100.0 26.9

100.0 22.9

100.0 29.1

19,143

7,244

11,s9s

3,294

1,154

2,140

10.4

11.0

10.1

10.1

1:::

1.4

1.7

1.2

*1.7

*1.6

*1,7

NEVER SAD WFERTENSION

.

All persons 17 years and over3------------ 1004 ‘3.s 105,004 16.S

1s.1

16.3

10.5

10.5

9.3

12.6

11.6

4.s

3.0

6.S

9’9

Age:

17-44 years-----------------------------------

45-64 yeare-----------------------------------

65 years and over-----------------------------

65,556

27,977

11,471

49,7s4

55,220

100.0 13.5

100.0 13.6

100,0 16.1

Sex:

Nale ------------------------------------------

Female----------------------------------------

100.0 10.9

100.0 16.4

39.7

4s.7

17.s

15.9

14,1

7.2

6,1

3.6

Race:

White-----------------------------------------

Male----

Female--

Black-----------------------------------------

93,930

44,707

4;,;;;

4;423

5,302

100.0 13.s

100.0 11.1

100.0 16.4

100.0 14.0

10000 9.7

100.0 17.6

16,9

17.9

;:.:

18:0

14.9

10.4

14,0

J::

14,7

7.0

4.8

6.1

H

7,1

3,5

Male----

F6ntale--

lIncludesnever and unknown doctor visits.

21ncludesunknown hypertension status,

31ncludespersons of other races.

41ncludesnow have hypertension,no longer have h~ertens ion, and unknown if now have hypertension.
&3dkamcxxiMal 11

TECHNICAL NOTES

SOURCE OF DATA. The data presented inthis

report were obtained from household interviews

in the Health Interview Survey. These interviews

were conducted throughout 1974 in a probability sample of the civilian noninstitutionalized

population of the United States. During that

year approximately 116,000 persons living in

about 4.0,000 households were included in the

sample. The hypertension questions were asked

of each household member 17 years of age and

over who was identified as a “sample person. ”

This subsample included approximately 26,000

persons.

SAMPLING. The sampling pattern for sample

person selection was based on the total number

of related and unrelated household members.

Sample persons (approximately a ope-third subsample of the actual Health Interview Survey

sample) were selected by the interviewer at the

time of interview. To determine which household member(s) to designate as a sample person,

the interviewer referred to a preselected flashcard after listing all related and unrelated persons in the household on the questionnaire. The

flashcard contained, for each household size,

one or more person numbers that were to be

identified as the sample person(s).

Since the estimates shown are based on a

sample of the population rather than on the entire population, they are subject to sampling error. Standard errors appropriate for the estimates of the number of persons are shown in

table I; standard errors appropriate for percentages are shown in table IL

Table 1. Standard errors of estimates of aggregates

1

Size of estimate

Standard

error in

in thousands thousands

70............................................................................

10,000 .....................................................................

20,000.....................................................................

m.wo ...... .. ...... .......... .. ................ ........ ........... ........

50.000.....................................................................

100,000...................................................................

20

24

42

54

64

77

170

238

329

394

485

593

Table 11. Standard errors, expressed in percentage points, of

estimated percentages

Base of parentage

in thousands

70 ..............................

100............................

300............................

500............................

700............................

1,000.........................

5,000.........................

10,000.......................

20,000.......................

30,000.......................

60,000.......................

100,000.....................

Estimated percentage

4.1 6.3 8.7

3.4 5.3 7.3

2.0 3.1 4.2

1.5 2.4 3.3

1.3 2.0 2.8

1.1

0.5

0.3

0.2

0.2

0.2

0.1

1.7 2.3

0.7 1.0

0.5 0.7

0.4 0.5

0.3 0.4

0.2 0.3

0.2 0.2

20

50

;:

11.6 14.5

9.7 12.1

5.6 7.0

4.3 5.4

3.7 4.6

3.1 3.8

1.4 1.7

1.0 1.2

0.7 0.9

0.6 0.7

0.4 0.5

0.3 0.4

LIMITATIONS AND QUALIFICATIONS OF

DATA. When the 1974 Health Interview Survey

hypertension prevalence estimates for the U.S.

civilian noninstitutionalized population 17 years

of age and over are compared with the 1972

Health Interview Survey hypertension estimates,

marked differences are found (15.7 percent and

11.9 percent, respectively). Some of this variation can be attributed to improved data collection procedures implemented in 1974 as well as

to definitional differences between the 2 years.

These differences will be described in detail in a

forthcoming report. However, evidence from

other sources also indicates that some of the increase reflects a real difference resulting from a

greater awareness of this condition among some

respondents.

In this report, terms such as “similar” and

“the same” mean that no statistical significance

exists between the statistics being compared.

Terms relating to differences (i.e., “greater,”

“less,” etc.) indicate that differences are statistically significant. The t test with a critical value

of 1.96 (0.05 level of significance) was used to

test all comparisons which are discussed. Lack of

comment regarding the difference between any

two statistics (does not mean the difference was

tested and found to be not significant.

Age adjustment is computed by multiplying

the specific rate for each age group in the total
12

U.S. civilian noninstitutionalized population 17

years and over in 1974. The rate is obtained by

dividing the cumulative figures previously computed by the total population 17 years and over.

For a more detailed discussion of the limitations and ‘qualifications of data collected in the

Health Interview Survey, see an earlier report

entitled “Current Estimates from the Health Interview Survey, United States, 1974, Vital and

Health Statistics, Series 10, No. 100, DHEW

Publication No. (HRA) 76-1527.

B1ood pressure measurements of persons

in the civilian noninstitutionalized population 6-74 years of age collected in the

Health and Nutrition Examination Survey

from April 1971 through June 1974 have

been reported in Advance Data (HRA) 77-

1250, No. 1, Oct. 18, 1976.
FROM VITAL & HEALTH STATISTICS OF THE NAT/ONAL CENTER FOR HEALTH STATISTICS

uS. DEPARTMENT OF HEALTH, EOUCATION, AND WELFARE I No. 3 November 19, 1976 I Public Health Serwce. Heaith Resources Admmlstratlon

Height and Weight of Adults 18-74 Years of Age in the United States’

The height and weight measurements in this

report were obtained as a part of the Health and

Nutrition Examination Survey (HANES).

HANES is a program in which measures of nutritional status are collected for a scientifically designed sample representative of the civilian noninstitutionalized population of the United States

in a broad range of ages, 1-74 years.2

The HANES findings are based on examinations of the 13,671 persons aged 18-74 years

from a total group of 20,749 examined persons

aged 1-74 years in the 65 primary sampling units

(PSU’S) which make up the total sample. A nationwide probability sample of 28,043 persons

was selected to be examined in 65 PSU’S, which

were visited between April 1971 and June 1974.

The HANES nutrition examination included a

1This report prepared by Sidney Abraham, Clifford

L. Johnson, and Matthew F. Najjar, Division of Health

Examination Statistics.

‘National Center for Health Statistics: Plan and operation of the Health and Nutrition Examination Survey,

United States, 1971-1973. Vital and Health Statistics.

Series 1-Nos. 10a and 10b. DHEW Pub. Nos. (HRA)

76-1310 (lOa) and (HSM) 73-1310 (lOb). Health Resources Administration. Washington. U.S. Government

Printing Office, Feb. 1973.

general medical examination for indicators of

nutritional de~lciencies by a physician, a skin examination by a dermatologist, and a dental examination by a dentist. Body measurements

were taken by a trained technician; a dietary

interview, consisting of a 24-hour recall of food

consumption and a food frequency questionnaire, was administered; and numerous laboratory tests were performed on whole bIood, serum, plasma, and urine. A description of the

sampling process, HANES operation, and response rates has been published.z

Estimates in this report are based on

weighted observations. The data obtained for

the examined persons were inflated to the level

of the total population using the appropriate

weights to account for both sampling fractions

and response results. National estimates of the

distribution c)f height and weight among the

U.S. population based on findings from the

HANES program will be analyzed and discussed

in a future report: “Height and Weight Measurements of AduIts 18-74 Years: United States,

1971 -74,” Vital and Health Statistics, Series 11.

Selected data from that report are discussed here

and shown in tables 1-7. “

Advance Data j%om Vital and Health Statistics replaces the supplements to the Monthly Vital Statistics Report

as the means for early release of selected findings from the health and demographic surveys conducted by the

NCHS. hfost of these releases will be followed by detailed reports in the Vital and Health Statistics series.

Provisional vital statistics as well as advance reports of final data for a year will continue to be published in the

Monthly Vital Statistics Report.

Advance Data is being distributed on the mailing keys for the Vital and Health Statistics series, and people

who now receive reports from a particular series will also receive all Adr.rance Data releases for that series.

Temporarily, the mailing list for the Monthly Vital Statistics Report (M VSR,) is also being used. MVSR readers

who wish to continue to receive Advance Data issues, as well as other persons who wish to receive all issues,

should contact:

National Center for Health Statistics

Room 8-20

5600 Fishers Lane

Rocliville, Maryland 20852

Phone: (301) 443-1200
2

PRINCIPAL FINDINGS

The mean weight of men aged 18-74 years

was 172 pounds. The mean weight of men increased from 165 pounds in age group 18-24

years to 178 pounds in age group 35-44 years.

Thereafter, it decreased with age to 175 pounds

in age group 45-54 years, 171 pounds at 55-64

years, and a low of 164 pounds in the oldest age

group measured, 65 years and over.

The mean weight of women was 143

pounds, 29 pounds less than that for men. The

mean weight increased with age from a low of

132 pounds at 18-24 years to a high of 149

pounds at ages 45-64 years and then declined to

146 pounds in the oldest age group.

The cross-sectional data on body measurements of adults were obtained on different age

cohorts. The age trends show the mean body

measurements for successive cohorts of persons

of different age groups and reflect the effect of

different environmental as well as hereditary influences. The limitations of cross-sectional data

are recognized in considering ,group age changes.

The mean height for men aged 18-74 was

69.0 inches. The highest mean height, 69.7

inches, was found in the youngest age group,

Figure 1. MEAN HEIGHT IN INCHES OF U.S. ADULTS 18-74

YEARS BY AGE AND SEX.

~ 65

$

1

WOMEN

‘-” ------------- . . . . . . . . . . . . . . . . . . . . ..q -

!2 64 . . . . . . . . . .

: . . .. . . .. . .

63 . . .. . .

. . . . . .. . . .

--”- . .. . . .

62

61

60

1,

0 I I I I I

18-24 25.34 35.44 45.54 55.64 65 and

over

AGE IN YEARS

18-24 years, and is 2.4 inches taller than the

height in age group 65 years and over, 67.3

inches. This corresponds with a small decrease in

height with increasing age, which averages less

than one-half inch per decade of age over the

range 18-74 years.

Among women the mean height was 63.6

inches, 5.4 inches less than the mean height

among men. The mean height for women was

highest (64.3 inches), in the youngest age group,

as it was for men. The mean height decreased

slightly to 64.1 inches at 25-34 years, remained

constant at 35-44 years, and then decIined to

63.6 inches at 45-54 years, 62.8 inches at 55-64

years, and 62.3 inches in the oldest age group,

65 years and over. The difference between the

youngest and oldest age groups is 2.0 inches.

The decrease in height with age averages less

than one-half inch per decade over the age range

of 18-74 years.

In each of the five age groups in the range

18-64 years white men were taller than Negro

men. The average difference bet we en heights of

white and Negro men in the same age group was

about one-half inch. At age group 65 years and

over, however, the mean height for Negro and

white men was the same. This pattern by age

and race is not observed for women. At age

groups 18-24 and 25-34 years, white women

were, on the average, 0.25 inches taller than Negro women. At ages 35-44, Negro women were

Figure 2. MEAN WEIGHT IN POUNDS OF US. ADULTS 18-74

YEARS BY AGE AND SEX.

200

1

MEN

! ’75 ~

g

g

WOMEN

z 150

. .. . ..""" ""."" .""-" """"" """---" "-."" """"" """- . . . . . . .. . ..

. .. .. .

.. . ..

.. . . .

.. . ...--”

... .. .

125

18.24 25.34 35.44 45.54 55.64 65 and

over

AGE IN YEARS

—
3

0.1 inch taller than white women; at ages 45-54,

they were 0.2 inch taller; and at ages 65 and

over, they were 0.3 inch taller. At ages 55-64

years, the mean height for both races was the

same.

Mean weights increased among white men

from a low of 165 pounds at 18-24 years to a

high of 178 pounds at 35-44 years. Among Negro men, mean weight increased consistently

with age from 166 pounds at ages 18-24 years to

182 pounds at ages 35-44 years. The mean

weights of both Negro and white men decreased

with age from the group 45-54 years on. Negro

and white men showed little consistent difference in mean weights among the different age

groups.

Data on weight by age for Negro and white

women tend to parallel those seen for men, with

the exception that the increase in mean weight

of women continued up to the age group 45-54

years and then declined. However, at each age

Negro women had larger mean weights than

white women, with the differences between

races being very large, averaging about 20

pounds heavier for the age groups 35-64 years.

Although heights of U.S. adults as measured

from the Health and Nutrition Examination Survey, 1971-74, were taller than those from the

Figure 3. MEAN HEIGHT IN INCHES OF U.S. ADULTS 18-74

YEARS BY AGE, SEX, AND RACE.

e3

t

62

r

%1

t

—Whim

.-. Negro

wOMEN

,.. . ..whl~

“--- . .. .. . .... . .. .. .

-- Neg,o

.—_-*-----

.... .... ....

-.%

-%+_

.... ... .... .

1S.24 25-34 354 46+4 55.64 65 and

ovar

AGE IN YEARS

Health Examination Survey (HES), 1960 -62,s

the differences are numerically small. HANES

data for men’s heights range from less than

one-half inch to an inch taller than the HES

data. Corresponding values for women are from

less than one-half inch to slightly more than

three-quarters of an inch taller.

U.S. adults in HANES were heavier than

those in HES. The HANES data on weights for

men are consistently higher by an average of 6

pounds across the age range 18-74 years; for

women they are higher by an average of 3

pounds for this age range.

Relatively more men and women in the most

recent survey,, 1971-74, are taller than those

in HES, 1960-62. Fifty-one percent of the men

in HANES were 69 inches or taller as compared

to 38 percent in HES across the age range of

18-74 years. The corresponding values for

HANES and HES for heights of 70 inches or

more are 36 percent and 28 percent, respectively. In this age range, 45 percent of the

women in HANES were 64 inches or taller as

3h’ational Center for Health Statistics: Weight,

height, and selected body dimensions of adults, United

States, 1960-1962. Wtal and Health Statistics. Series

11-No. 8. DHEW Pub. No. (HRA) 76-1074. Health Resources Administration. Washington. U.S. Government

Printing Office, June 1965. -

1

Figure 4. MEAN WEIGHT IN POUNDS OF U.S. ADULTS 18-74

YEARS BY AGE, SEX, AND RACE.

200

175

[

In I

MEN

— white

. _ .N~ro

lz:~, ! 1 , 1 1

18-24 25.34 35.44 45.54 55.s4 65 and

Owr

AGE IN YEARS
4

Figure 5. MEAN HEIGHT IN INCHES OF U.S. ADULTS 18-74

YEARS IN HES (1960-62) AND HANES (1971-74).

70 r

2

i

HES, 1960-62

~ 66

--. Men

g —-~omen

~ ~~

~

1

HANES, 197174

““”------------- . . . . . . . . . . . . . . . . . . .

: 64 — Men

. . . . . . . . . . . . . . ..

z -—- .. . . . . Women

.- %.

63 - \ - ...% . .. . . . . ..

-A -----------

62 \\

-.

“tOF

1 I 1 I I I

18.24 26.34 3544 45.54 55.64 65 and

over

AGE IN YEARS

compared to 37 percent for HES. The correspon-ding values (or HANES and HES for 65

inches and more are 30 percent and 21 percent,

respectively.

The proportions of men and women whose

height exceeded any other specified height may

be found from the data presented in tabIes 4 and

6.

1

Figure 6. MEAN WEIGHT IN POUNDS OF U.S. ADULTS 18-74

YEARS IN HES (1960-62) AND HANES (1971-74).

HES, 1960.62

2W

F

--- Men

-- ~~men

1

HAN ES, 1971.74

— Mm

v)

1“7

----

Womn

~ 175

~

0. /0---------- -..

~

‘..

,/’

--.

./

5

---

~

$ 150 .. .. . . ..-.. ---------ye.--=%%

.. . . . . . . .

..-. ---

-../

/

. .. ..

.. .. ..

. . . . . .

//’

125

18.24 25.34 3544 46.54 55.64 65 and

over

AGE IN YEARS

TECHNICAL NOTES

The sampling plan of the Health and Nutrition Examination Survey (HANES) followed a

highly stratified multistage probability design in

which a sample was selected of the civilian noninstitutionalized population of the coterminous

United States 1-74 years of age. Successive elements dealt with in the process of sampling were

the primary sampling unit (PSU), census enumeration district (ED), segment (cluster of

households), household, eligible person, and finally, sample person. The sampling design focused special attention on groups of people

known to be at greater risk of malnutrition by

oversampling these groups-the poor, preschooI

children, women of childbearing ages, and the

elderly.

All height and weight data presented are

based on “weighted” observations. That is, data

recorded for each sample person were inflated to

characterize the subuniverse from which that

sample person was drawn. For each examinecl

person, this is a product of the reciprocal of the

probability of selecting the person, an adjustment for nonresponse cases (i.e., persons not examined), and a poststratified ratio adjustment

which increases precision by bringing survey results into closer alignment with known U.S. population figures for 20 age, race, and sex groups

as of November 1, 1972, the approximate mid- . .

point of HANES.

SYMBOLS

Data not available -----------------------------------------

Category not applicable -----------------------------. . .

Quantity zero -------------------------------------------- -

Quantity more than O but less than 0.05 ---0.0

Figure does not meet standards of

reliability or precision ---------------------------- *
5

Table 1. Height in inches of adults aged 18-74 years, by sex and age: sample size, estimatedpopulationin

thousands,mean, standarddeviation,st~dard error Of the mea, and

1971-74

selectedpercentiles,United States,

Sex and age

MA

18-74 years18-24 years-------

25-34 years-------

35-44 years-------

45-54 years-------

55-64 years-------

65 years and OverWomen

18-74 years18-24 years-------

25-34 years-------

35-44 years-------

45-54 years-------

55-64 years-------

65 years and overI I I I I

Estimated

Sample population

size in

thousands

I

Standard Percentile

Standard

M’=an deviation the mean ~th

error of

10th 25th 50th 75th 90th 95th

II Height in inches

5,260 \ 60,565

772 11,351

:3; 12,766

10,804

765 11,260

597 8,888

1,657 5,496

=+=+

69.7 2.8

69.6 2.9

69.1 2.7

68.9 2.6

68.3 2.6

67.3 2.6

II

=EA

0.18 65.1

0.12 64.8

0.13 64.7

0.13 64.7

0.16 64.1

0.08 63.2

I

844 67,372 63.6 2.5 0.04 59.5

1,524 12,111 64.3 2.5 0.08 60.2

1,896 13,996 64.1 2.4 0.08 60.2

1,663 11,772 64.1 0.09 59.9

836 12,264 63.6 ;:: 0.10. 59.9

670 9,953 62.8 2.4 0.10 58.6

1,822 7,277 62.3 2.4 0.08 58.2

65.5

66.1

66.0

~;.:

65:1

64.2

60.5

61.2

61.2

60.8

60.6

59.6

59.3

67.1

67.8

67.6

67.3

67.1

66.7

65.6

62.0

62.6

62.4

62.3

62.1

61.2

60.8

69.0

69.7

69.5

69.2

68.8

68.2

67.3

63.7

64.3

64.0

64.1

63.7

62.8

62.3

70.8

71.5

71.5

71.1

70.6

70.1

69.1

65.3

65.8

65,7

65.7

65.2

64.5

63.9

72.6 ] 73.6

73.4 74.4

73.4 74.3

72.6 73.4

72.4 73.2

71.7 72.5

70.6 71.6

t

66.8 67.8

67.4 68.4

67.3 68.2

67.3 68.4

66.7 67.3

65.6 66,6

65.3 66.2

NOTE: Height was measuredwithout shoes.

Table 2. Weight in pounds of adults aged 18-74 years, by sex and age: sample size, estimatedpopulationin

thousands,mean, standarddeviation,standarderror of the mean, and selectedpercentiles,United States,

1971-74

+ I I 1

Sex and age

Estimated

population

in

thousands

@

18-74 years18-24 years-------

25-34 years-------

35-44 years-------

45-54 years-------

55-64 years-------

65 years and overWomen

18-74 yearsI=I====

772 11,351

804 12,766

665 10,804

765 11,260

597 8,888

1,657 5,496

I

8,411 67,372

18-24 years------- 1,524 12,111

25-34 years------- 1,896 13,996

35-44 years------- 1,663 11,772

45-54 years------- 836 12,264

55-64 years------- 670 9,953

65 years and over- 1,822 7,277

Standard Percentiles

Standard error of W’== deviation the mean sCh 10th 25th 50th 75th 90th 95th

Weight in pounds

172 31.1 0.64 128 137 152 170 189 211 225

165 29.6 1.64 124 132 145 161 180 204 222

176 35.0 1.45 132 140 153 172 193 217 233

178 30.0 1.56 132 143 160 176 196 213 225

175 29.2 1.12 130 139 157 175 192 215 225

171 30.0 1.28 125 137 1.52 170 187 208 222

164 27.0 0.88 122 130 147 163 180 198 211

143 32.3 0.53 104 110 122 137 159 185 203

132 27.4 0.69 100 106 114 128 142 163 181

140 32.0 0.82 103 109 119 132 152 181 202

148 35.0 1.14 109 114 124 139 163 195 215

149 32.0 1.39 109 114 127 145 164 191 213

149 33.3 1.26 104 111 ;;: 144 166 191 203

146 29.1 1.07 105 112 142 163 183 195

NOTE: Total weights of all clothingranged from 0.20 to 0.62 lb.,whichis not deducted from weights shown

in table.
6

Table 3. Height in inches of adults aged 18-74 years, by sex, race, and age: sauple size, estimated population in thousands,mean,

standard deviation, standard error of the mean, and selected percentiles, United States, 1971-74

Sample

size Sex, race, and age

+

:stime.ted Standard Percentile

,opulation Mean Standard

deviation :~:e:; ~th

hou~nds 10th 25th 50th 75th 90th 95th

yEQ

-

18-74 years---- A

Heig

64.6

65.3

65.3

:3.; !

64:2

63.2 ~

64.1

——

64.6

64.1

62.4

64.5

64.1

63.1

59.5

60,3

60.2

60.1

59.9

58.6

5S.2

59.6

-

60.2

60.2

59.s

60.2

58.4

58.7,

: in inches

4,343 65.6

66.3

66,3

65.9 I

65.6

65.1

64.2 I

64.8

67.2 IT69.1 70.9 72.7

69.8 71.4 73.4

69.7 71.7 73.4

.55.; 71.1 72.6

70.7 72.5

68:2 70.1 71,7

67.3 69.1 70.6

2,8 0.0s

0.20

0.13

0.13

0.14

0.17

0.09

0.16

73.6

18-24 years----------

25-34 years----------

35-44 years----------

45-54 years----------

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

65 years and over----

Negro

lSGears ----

625

672

570

628

504

1,344

847

9,849

11,191

9,857

10,117

S,125

4,970

69.8

69.7

69.2

6S.9

68.3

67.3

2.8

2.8

2,6

2.6

2.6

2.6

67,9

67.7

67.5

67.2

66.7

65.6

66.8

74.5

74.3

73.4

73.3

72.5

71.7

73.3

73.6

73.7

74.3

72.3

71,s

70.9

67.8

==4=== 2.s

.—

69.8 71.7 72.9

68.6 70.6 72.6

69.2 71.3 72.8

67.9 69.5 71.3

68.1 70.1 70.9

67.5 69.1 70.2

18-24 years----------

25-34 years----------

35-44 years----------

45-54 years----------

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

65 years and over----

132

119

1:]

294

6,758

1,287 69.5

1,377 68,6

820, 69.1

1,0s7 68.2

672 68.2

486 67,3

2.s

2.9

3.1

2.4

2.3

2.4

0.45

0.38

0.44

0.26

0.32

0.18

0.05

0.09

0.0s

0.09

0.11

0.11

0.09

0.09

65.3

64.4

65.6

65,4

64.4

64,2

60.6

67.4

66.6

67.2

66.6

66.6

65.6

62.0

WOI.C3N

myh

18-74 years---- T59,482 63.7

10,298 64.3

12,338 64.1

10,250 64,1

11,091 63.6

S,905 62.8

6,601 62.3 IT63.7 65.3 66.8

64.3 65.9 67.4

64.1 65.8 67.3

64.1 65.7 67.3

63.7 65.2 66.7

62.8 64.5 65.6

62.3 63.9 65.3

2.5

——

2.5

2.5

2.5

2.4

2.4

2.4

18-24 years----------

25-34 years----------

35-44 years----------

45-54 years----------

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

65 years and over----

Negro

18-74 years----

1,165

1,539

1,301

705

552

1,496

1,557

61.3

61.2

60,9

60.6

59.7

59.2

60.6

62.7

62.4

62,4

62.0

61.2

60.7

62.1

68.4

6S.3

68.4

67.3

66.6

66.2

67.8

-

2.5

2.4

2.3

2.5

2.2

2,6

2.4

—

18-24 years----------

25-34 years----------

35-44 years----------

45-54 years----------

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

65 years and over----

329

335

334

126

115

318 -J- 1,618 64.0

1,540 63.9

1,354 64.2

1,131 63.S

971 62.S

654 62.6

0.20

0.20

0.19

0.30

0.24

0.18

60.9

61.2

60.7

60.7

59.5

59.6

62.4

62.3

62.8

62.3

61.3

61.2

64.0 65.4 66.9

63.7 65.3 67,1

64.3 65.6 67.7

63.6 65.6 66.8

62.8 64.7 66.2

62.5 64.1 65.5

68.1

67.S

68.8

67.6

66.9

66.2

NOTE: Height was measured without shoes.

Table 4. Cumulativepercent distribucion of height in inches of adult males, according to age: United States, HES (1960-62)and

HANES (1971-74)

Age

Height 55-64 years I 65 years and over

in inches

18-74 years ~~18-24 years 25-34 yeare I 35-44 years I 45-54 years

l;~l- l:;o- l;#- l:;o- l;~lXmulative percent distribution

Under 60------

Under 61------

Under 62------

Under 63------

Under 64------

Under 65------

Onder 66------

Under 67------

Under 68------

Under 69------

Under 70------

Under 71------

Under 72------

Un&r 73------

~der 74------

under 75------

Under 76------

76 and over---

:::

1.0

:::

12.4

19.1

32.1

$.:

72:5

84.5

90.8

96.2

98,4

99.5

99.7

100.0

0.1

0.4

0.7

1.7

3,7

11::

23,5

35.9

49,5

63.7

76.0

85,0

92.0

96.6

98.4

99,1

100.0

—.

0.0

0.2

0.3

0.4

;::

1;:;

29,3

40.1

55.8

69.2

7s.4

87.1

94.2

97,0

98,4

100.0

0.1

0.2

0.5

1.9

::;

14.8

27.0

38.6

;;.:

84:0

92,9

97.3

98.9

99.8

100.0

100.0

0.1

0.4

0.9

1,6

3.4

6,2

11,1

20,4

31.8

47,0

;:::

84,7

92,9

97.3

99,0

99.7

100.0

0.2

~:~

1!::

19.1

31.5

;:;

86.4

91.5

96.7

99.0

99.6

99.9

100.0

0.2

::;

:::

1!::

22.7

37.1

52.6

66,9

78,9

86.2

94.0

97.8

99.4

99;8

100.0

0.2 0.7

1.1

::: 3.2

5,7

i:i

2%:

1::: 35.7

30,1 54.2

46,1 65,4

$:.; S2.O

88.4

83:8 95.4

93.1 99.0

96.7 99.6

98.9 100,0

99.7 Loo,o

99.7 100,0

100.0 100.0

0.6

;::

4,4

1%:

30.7

44.3

59.3

74.1

84.3

92.6

95.9

99.2

99.7

100.0

100.0

100.0

0.;

1.5

3,7

7.7

12.8

28.6

41.3

:;.;

81:0

86.2

94.7

97.8

99.2

99.8

100.0

0.;

0,4

1.7

::;

1::3

26.4

39.0

:;.:

80:1

87.5

93.9

96.8

97.7

100,0

0.;

0.2

1.5

3,1

1;:;

22,1

33,0

50.4

:;,;

84:4

92.4

95.7

98.8

99.0

100.0
7

Table 5. Weight in pounds of adults aged 18-74 years, by sex, race, and age: s~le s~~e, estmted Population inthOusands,man,

standard deviation. standard error Of the mean- and selected percentiles. ~ited Seatess 1971-74

sex, race, and %+=

I

Sample

size

T18-74 years----

l==

18-24 years----------

25-34 years----------

35-44 years----------

45-54 years----------

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

65 years and ovez----

625

672

570

628

504

1,344

Negro

18-74 years----

1==

847

18-24 years---------- 132

25-34 years---------- 119

35-44 years----------

45-54 years---------- 1:;

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

65 years and over---- 294

wOMEN

e

18-74 years---- 6,758

18-24 years----------

r

1,165

25-34 years---------- 1,539

35-44 years---------- 1,301

45-54 years---------- 705

55-64 years---------- 552

65 years and over---- 1,496

Negro

18-74 years----

L

1,557

18-24 years----------

25-34 years----------

35-44 years----------

45-54 yeaz-s----------

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

65 years and over----

,

Estimated Standard Percentile

p0pu2#i0n Mean Standard

deviation =me:: Sth

thousands 10th 25th 50th 75th 90th 95th

I

Wei8ht in pounds

54,109 173 30 0.75 129 138 153 171 190 211 224

9,849 165 1.89 125 133 146

11,191

162 182 205 222

7.77 :: 1.40 134 142 155 173 ;;’3 217 232

9,857 178 1.66 133 145 160 177 211 224

10,117 176 ;; 1.23 129 141 158 176 193 214 225

8,125 171 29 1.49 125 136 153 171 187 208 220

4,970 164 27 0.99 123 :!31 148 164 180 198 210

5,730 171 40 2.54 125 134 145 163 189 217 239

1,287 166 j.;; 123 131 142 159 176 202 227

1,377 175 x 124 134 14s 162 193 219 235

820 182 37 4:59 130 3.37 151 180 201 236 255

1,087 168 3.75 135 136 145 162 185 220 230

672 172 :! :.:; 119 138 145 163 186 237 249

486 161 30 . 121 127 137 156 179 205 218

59,482 142 31 0.59 104 110 121 136 157 182 199

10,298 132 26 0.82 100 :106 115 128 142 162 177

12,338 138 31 1.02 104 109

10,250

118 131 150 179 201

146 34

11,091

1.29 109 114 124 137 159 191 213

147 30 1.32 109 113 126 143 162 188 204

8,905 147 30 1.35 103 111 127 143 164 187 201

6,601 145 28 1.08 105 113 126 142 162 180 192

7,268 3.56 41 1.53 104 Ill 129 148 176 207 228

1,618 ;;; 2.47 100 ’107 114 130 150 184 203

1,540 2; 3.20 100 :108 127 141 170 190 226

1,354 165 2.68 112 121 136 158 185 216 238

1,131 169 i; 4.53 115 :L28 139 162 186 215

971 168 48 6.37 104 L18 139 156 191 215 %

654 155 36 3.28 94 :L09 133 153 177 202 219

NOTE: Total weights of all clothing ranged from 0.20 to 0.62 lb., which is not deducted from weights shown in table.

Table 6. CUMUlative percent distribution of height in inches of adult fmales, according to age: United States, HSS (1960-62)and

HANhS (1971-74)

Age

Height 18-74 years 18-24 years

in inches

25-34 years 35-44 years 45-54 years 55-64 years 65 years and over

——-

l:;o- 1971- l:;o- 1;:1. l:;o- 1;;1- l;;o- l;;l- l:;o- 1971- l;;o- l;;l- l:;o- l;;l74 74

Onder 55------

Under 56------

Under 57------

Under 58------

Under 59------

Under 60------

Under 61------

~der 62------

Under 63------

~der 64------

Under 65------

Under 66------

~der 67------

Under 68------

~der 69------

~der 70------

~der 71------

71 and over---

0.2

0.4

0.7

2.3

1::;

18.5

32.8

50.7

63.2

78.8

87.1

94.8

97.2

99,3

;;.;

100:0

:.;

0:6

1.4

3.0

1:::

24.6

39.6

54.8

69.7

83.0

90.8

95.4

98.1

;;:;

100.0

0.1

0.3

:::

12.0

24.6

40.1

51.3

70.6

81.2

91.9

95.3

98.8

99.5

99.9

100.0

Cumulative percent distribution

0.0

0.2

0.2

0.8

:::

1;:!

33.1

49.3

;;.;

87:8

93.9

97.7

98.9

99.7

100.0

0.1

:::

1,3

2.2

1::?

27.2

43.8

57.6

75.4

83.9

94.6

97.0

99.1

99.8

99.9

100.0

0.0

0.1

0.3

0.6

::2

11.2

19.5

32.9

47.2

63.6

79.4

87.8

93.3

97.3

99.0

99.6

100.0

82

0.5

::t

11.5

20.8

34.0

55.2

68.1

82.5

89.4

94.4

97.2

99.8

99.9

99.9

100.0

0.0

0.0

0.4

0.6

;:;

13.4

;;.;

55:0

72.4

84.4

92.9

96.8

98.7

99.5

99.7

100.0

0.6

1.0

1.6

3.3

1;.:

22.9

43.5

62.2

76.3

87.0

92.4

96.4

98.1

99.4

99.4

100.0

100.0

I I I

:.;

.

k:

12:i

27.2

43.3

61.3

75.5

86.2

94.0

;:.;

99:8

100.0

100.0

100.0
8

Table 7. Comparison of mean heights and weights in HES (1960-62) and HANES (1971-74), by aex and age:

United States

—

Age

18-24

25-34

35-44

45-54

55-64

18-74 years -------------------------

years ------------------------- ------

years -------------------------------

yeara -------------------------------

years -------------------------------

veara -------------------------------

65 yea~s and over -------------------------

18-74 years -------------------------

18-24 years -------------------------------

25-34 years -------------------- -----------

35-44 years -------------------------------

45-54 years -------------------------------

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

65 years and over -------------------------

68.3

—.—

68.7

69.1

68.5

68.2

67.4

66.9

166

I

158

169

170

170

164

158

69.0

——

69.7

69.6

69.1

68.9

68.3

67.3

172

165

176

178

175

171

164

Height in inches

T

+0.7 63,1

+1.0 63,8

+0.5 63.7

+0.6 63.5

+0.7 62.9

+0.9 62.4

+0.4 61.5

Weight in pounds

+6

i-7

+7

+8

+5

+7

+6

127

;:;

145

150

144

63,6 I +0.5

64.3 +0.5

64.1 +0.4

64.1 +0.6

63.6 +0.7

62.8 +0.4

62.3 +0.8

143 ] +3

132

140

148

149

149

146

+5

+6

z

-1

+2

NOTE : Height was meaaured without shoes. 2 lb. are deducted from HES data to allow for weight of

clothing; total weights of all clothing for HANES ranged from 0.20 to 0.62 lb., which is not deducted

from we~ghts shown. -
FROM VITAL & HEALTH STATISTICS OF THE NATIONAL CENTER FOR HEALTH STATISTICS

US. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE I No. 4 January 26, 1977 I Publlc Health Service. Health Resources Admmistratlon

Prevalence of Dermatological Disease Among Persons

1-74 Years of Age: United States a

This report presents national estimates of

the prevalence of skin pathology, or dermatological disease, among the civilian noninstitutionalized population 1-74 years of age in the United

States, based on examination findings from the

Health and Nutrition Examination Survey of

1971-74

The Health and Nutrition Examination Survey program in which these data were obtained

was designed to measure the nutritional status of

the U.S. population as well as certain aspects of

general health status and medical care needs in

the U.S. population. This is the fourth of the

Health Examination Survey programs authorized

by the 84th Congress under the National Health

Survey Act of 1956. These programs secure information on the prevalence of medically defined illness, including previously unrecognized

and undiagnosed conditions, as well as on a variety of physical, physiological, and psychological

measures within the population through direct

examinations, tests, and measurements, as described in previous publications.l’4

The dermatology component of the Health

and Nutrition Examination Survey (HANES)

was planned at the request of and in cooperation

with the Committee on Planning for the National Program for Dermatology of the National

Academy of Dermatology. Dr. Marie-Louise T.

Johnson, Chairman of the Data Collection Unit

for the National Program, was primarily responsible for planning the content of the examination,

recruiting the dermatologists, and training them

aPrepared by Marie-Louise T. Johnson, M.D., Ph.D.,

New York University School of Medicine, and Jean

Roberts, Division of Health Examination Statistics.

in the examination methodology so as to minimize interobserver variation. This part of the

HANES examination incIuded a complete clinical examination of the skin and surrounding tissue that considered normal variations in texture

and color, certain manifestations of aging, and

all pathoIo&cal changes. Significant diagnoses

were documented by tissue biopsy to determine

mali~ancy cn- culture to identify fungi whenever possible. Estimates were made of actinic exposure experienced , as well as actinic damage

sustained, and of occupational risk from irritant

and allergic contractants. For an examinee with

a si~ificant hand, foot, or generalized problem,

the dermatologist made a judgment about the

burden to the examinee in terms of discomfort

or disability, about care sought, and about the

effect expected from current best care possible.

The examinations of persons in this HANES

sampIe were made at 65 preselected locations

throughout the country. Of the 28,043 sample

persons selected to represent the 194 miIIion

persons 1-74 years of age in the U.S. population,

there were 20,749, or 74.0 percent, examined.

This correspcmds to an effective response rate of

75.2 percent after adjustment is made for the

effect of oversampling among the poor, preschool children, women of childbearing age

(20-44 years), and the elderly.

This summary is limited to national estimates by age and sex of the prevalence of skin

disorders and the principal types of skin disease.

The Code of Skin Diseaes of the Department of

DermatoIo~, New York University (NYU)

School of Medicine5 was used for identifying

and classifying skin disorders. Further information on the geographic and socioeconomic

distribution of skin pathology, the extent of ’dis-
2 advancedata

ability or handicap caused by skin conditions,

and the extent”to which medical care has been

sought or needed among the U.S. population

will be presented in a forthcoming Series 11 report in the Vital and Health Statistics series.h

TRENDS

Among persons 1-74 years of age in the United States, nearly one-third (3 1.2 percent), or an

estimated 60.6 million, have one or more significant skin conditions (table 1). These include

3.2 percent, or an estimated 6.1 million, who

have three different types of skin conditions; 6.4

percent, or 12.4 million, with two; and 21.6 percent, or 42.0 million, with only one condition.

Since the examiner was limited to the identification of no more than three conditions, only the

three most serious were recorded. Hence the estimates obtained may somewhat underestimate

the true prevalence of specific skin conditions in

the population.

The pattern of increase in skin pathology

with age is shown in figures 1 and 2 and table 2.

The prevalence rates are 10 west among children,

more than double by ages 12-24 years, decrease

slightly by 25-34 years, then steadily increase

with age to a maximum at 65-74 years:

Figure 1. PREVALENCE RATES FOR SIGNIFICANT SKIN PATHOLOGY AND PREVALENCE RATES OF SIGNIFICANT

SKIN CONDITIONS AMONG PERSONS 1-74 YEARS BY

AGE: UNITED STATES, 1971-74.

700 —

...””

600 ...””

. . ...””

. . . ...’””

~z 500

#

. . .

. .. . . .

,....” .. . .

. ...”

: %....-””””

; 400 ./

-.

cc

& 300

P

~ ~.

— Persons wth s(gntimnt skm pathology

. . . . . . . . Significant skin cO”&t;C,”S

100

I I I I I I I

o 10 20 30 40 xl 80 70

AGE IN YEARS

fiwm 2. PREVALENCE RATES FOR THE FOUR LEADING TYPES

OF SIGNIFICANT SKIN PATHOLOGY AMONG PERSONS 1-74

YEARS BY AGE: UNITED STATES, 1971-74.

300

— Diseases of sebaceous glands

250

. . . . . . . Dermatophytoses

--- Tumors

--- Seborrhelc derrnatni$

9

0

2

200

:

g

150

--

cc

f

r

100

~

50

10 20 30 40 50 60 70

AGE IN YEARS

The most frequently occurring groups of

.-

skin conditions are those affecting the sebaceous

glands (84.8 per 1,000 persons); dermatophy -

toses, or fungal diseases (81.1 per 1,000); malignant or benign tumors (56.5 per 1,000); and seborrheic dermatitis (28.2 per 1,000). Among the

individual conditions diagnosed, the most prevalent is acne vulgaris (68.1 per 1,000); followed

by benign tumors (38.2 per 1,000); fungal conditions of the feet, tinea pedis (38.7 per 1,000);

seborrheic dermatitis (28.2 per 1,000); fungal

conditions of the nails, tinea unguium (21.8 per

1 ,000); p~ecancerous and unspecified tumors

(12.4 per 1,000); folliculitis (8.0 per 1,000); verruca vulgaris (8.5 per 1,000); and atopic dermatitis (6.9 per 1,000).

One-third of those persons with significant

skin pathology (36.4 percent, or an estimated

22.0 million persons 1-74 years of age) are concerned about their skin problem, and 3.4 percent, or an estimated 2.1 million persons, have a

disability severe enough to be a handicap to

gainful employment or housework. The principal skin conditions of concern are those affecting the sebaceous glands (28.2 per 1,000); dermatophytoses, or fungaI diseases (2 1.6 per

1,000); the atopic dermatitis/eczema group

(10.8 per 1,000); and tumors (8.1 per 1,000)

(table 3). However, among those with significant

skin pathology diagnosed, persons are most
advancedata 3

Figure 3, PREVALENCE RATES FOR THE SIX LEADING TYPES

OF SKIN PATHOLOGY AMONG PERSONS 1-74 YEARS OF AGE

BY SEX: UNITED STATES, 1971-74.

140

h-l

,::x

1$$

<.,*,

120 j:fi

,:::~.:

:.t’.:

sebicmus eczema

glands

likely to be concerned if they have psoriasis (69

percent of those with this dia~osis), atopic dermatitis/eczema (58 percent), diseases of the sebaceous gb.nds (33 percent), vitiligo (28 percent), and furlgal conditions (dermatophytoses,

27 percent).

Skin pathology is more prevalent among

males than among females (34 percent compared

with 29 percent), and the proportion with the

major types of skin conditions is generally

greater among maIes than among females (fi,qure

3). Of the most frequently occurring skin conditions, males are substantially more likeIy than

females to have a fungal condition or folliculitis,

the prevalence being about three times as great

in males.

REFERENCES

1National Center for Health Statistics: Plan and ini- 4National Center for Health Statistics: Plan and optial program of the Health Examination Survey. Vital

and Health Statistics. PHS Pub. No. 1000-Series l-No. 4.

Public Health Service. Washington. U.S. Government

Printing Office, July 1965.

2NationaI Center for Health Statistics: Plan, operation, and response results of a program of children’s examinations. Vital and Health Statistics. PHS Pub. No.

1000-Series l-No. 5. Public Health Service. Washington.

U.S. Government Printing Office, Oct. 1967.

3National Center for Health Statistics: Plan and operation of a Health Examination Survey of U.S. youths

12-17 years of age. Vital and Health Statistics. PHS Pub.

No. 1000-Series 1-No. 8. Public Health Service. Washington. U.S. Government Printing Office, Sept. 1969.

eration of the Health and LNutritionExamination Survey,

United States, 1971-73. Vital and Health Statistics. Series 1-Nos. 10a and 10b. DHEW Pub. Nos. (HRA)

76-1310 (IOa) and (HSM) 73-1310 (lOb). Health Resources Administration. Washington. U.S. Govemment

Printing Office, Feb. 1973.

5The Department of Dermatology, New York University School of hfedicine: Code of Skin Diseases, 1st

rev. New York. New York University, Feb. 1968.

6National Center for Health Statistics: Skin conditions and need for medical care among persons 1-74

years of age, United States; 1971-74. Vital and Health

Statistics. Series 11. Health Resources Administration,

DHEW, Rockvillc, hid. To be published.
4 achmncedata

Table 1. Prevalence o~i;~~.f icant skin patholo y

t

, all types and the most frequently occurring types of con-

, among persons 1-7 years, by sex: United states, 1971-74

~ ~=

Condition and NYU code

Persons with one or more significant skin conditions -------

All types of significant skin conditions -------------

Diseases of sebaceous glands----------------------7l4l-7l49

Acne wlgaris-------------------------------------.7l4l5C

@tiC aCne-------------------- .------------------- 7l4l8o

Acne scars------------------------.----------------7l4lgO

Xerosis --------------------------------------------7l493o

De-tophytoses-----------------------.-----------------l3l

Tinea pedis-----------------------.----------------l3lOOTines un~iw -------------------------------------- 131z--

Tinea versicolor-----------------------------------l3lglo

Tines cruris----------------------------.--.-------l3l3l.

Tumors ----- ‘--------------------------------19x,22x,23x,23y

Malignant-----------------.----.------------------.---lgx

Basal cell (nodular-ulcerative- solid) --------- .--l9xl4x

Basal cell epithelioma--------------------------.l9xl8~

Benignl-----------------------------------------------22x

Lipoma-----------------------.----.--------------22xg5g

Precancerous and not specified--.------------------ 23x,23Y

Actinic keratosis--------------------------------23xo8l

Seborrheic demtitis--------”-. ---------------------- 7OOOlO

Atopic dermatitis/eczema-----------701,708300,708310,708320

Atopic de-tit is----------------------------------7og3lo

Lichen simplex chronicus---------------------------7o832o

Hand eczema----------------------------------------7olooo

Nummular-------------------------------------------701010

Dyshidrotic-----------------.--.----------------.--7OlO3O

Ichthyosis/keratos is--------------------------7lOl3O,7lOl5O

F0lliculitis-----------------------------------------7l39o8

Verruca vulgar is--

PsOriasis----

‘----------------------------------696030

----------------------------------------706090

SebOrrheickeratOsis---------------------------------22x44x

Vitiligo'--------------------------------------------7l62lO

Herpes simplex------------------------------------------096

All other skin conditions----------------------------------

Both

sexes IIMale I

Female

II

Rate per 1,000

persons

312.4

439.7

84.8

68.1

1.9

::;

81.1

38.7

21.8

8.4

6.7

56.5

5.9

0.6

3::;

12:4

9.6

28.2

18.4

::2

1.6

1.7

2.1

:::

;:;

5.2

4.9

12t:;

339.8

499.4

87.9

70.5

:::

5.3

131.4

68.4

30,3

10.9

12.9

59.6

6.4

0.6

3;:!

17:4

13.9

26.4

19.5

::;

1:0

3.1

1:::

10.3

5.9

4.6

:::

124.6

286.6

383.4

81.9

65.9

0.6

;:;

33.7

10.7

13.9

::;

53.7

5.3

0.7

4:!

1.6

;:;

29.9

17.4

;::

:;i

1.2

:::

;::

5.8

:::

124.4

*:

Number in thousands

3!!IE

16,465 8,279

13,217 6,638

375 312

321 192

1,260 497

15,733 12,372

7,509 ;,;;;

4,232

1,623 1;022

1,301 1,214

10,968 5,606

1,136 602

119

247 1%

7,412 3,372

401 244

2,420 1,632

1,858 1,306

5,47611 2,490

:

3,575 1,837

1,332 771

882 441

311 105

332

405 2%

1,835 880

1,553 1,;;;

1,684

1,070 556

l,;CI; 431

341

824 376

24,137{ 11,729

28,613

38,269

8,1.86

6,579

63

1.29

763

3,361

1,071

1,:176

601

87

5,362

534

1;:

4,040

157

788

552

2,986

1,738

561

441

206

240

117

955

399

717

514

579

616

448

12,408

1Excludes seborrheic keratosis (22x44x) , which in the NYU classification is grouped’ with benign tumors.
ac’hancedata 5

Table 2. Prevalence of sigrdficant skin pathology, all types and the most freciuently occurrinz tvmes of conditions.amen.z

persons 1-74 years, by-a

Conditionand NYU code

Persons with one or more significantskin conditions---------

All types of significantskin conditions----------<----

Diseases of sebaceous glands----------.-------.-----7l4l-7l49

Acne mlgaris----------------------.---------------.-7l4l5O

Cystic acne--------------------------------.---------7l4l8O

Acne scars------------------------------.------------7l4lgO

Xer0sis----------------------------.--------------.--7l4g3O

Demtophytoses-------------.--.----.-----..-----.---.--.-l3l

Tines pedis------------------------------------------l3lOOTines ~Wim------------------------------------.---l3l2--

Tines versicolor-------------------------------------l3l9lO

Tines cruris-------------------------------.-.-------l3l3lTumors----------------------------------------l9x,2&,23x,23y

Malignant-----------------------------------------------l9x

Basal cell (nodular-ulcerative-solid)--------------19x14x

Basal cell euithelim-----------------------------l9xl8x

Beni~1-------~-----------------------------------------2ti

LiPm---------------------------------------------22X959

Precancerousand not specified----------------.--.--23x,23y

Actinic keratosis----------------------------------23xO8l

Seborrheicdermstitis----------------------------------7OOOlO

Atopic dermatitis/eczema------.------sol,708300,708310,708320

Ato ic demtitis-----------------------------------.7o83lO

LicEen simplex chronicus---------------.----.--------7O832O

Hand eczsm-----------------------------------------.7OlooO

Numular ---------------------------------------------7ololo

~shidrotic-------------------------.--.-------------7OlO3O

Ichthyosis/keratosis----------------------------7lOl3O,7lOl5o

Folliculitis----------------------.--------------------7l39O8

Verruca vulgaris

Psoriasis

---------------------------------------696030

'---------------------------------------------7O6O9O

Seborrheickeratosis

Vitiligo

-----------------------------------22x44x

'----------------------------------------------7l62lO

Herpes simplex‘-------------------------------------------096

All other skin conditions------------------------------------

!: United States,‘1971-74

.. , ––”

1-5 6-11 12-17 18-24 25-34 35.44 45.54 55-64 65-74

years years years years years years years years ye~rs

142.3

166.4

6.3

0.4

2.;

3.4

0.4

l.i

21.7

21.;

9.6

24.9

19.3

1.;

8.6

;:!

0:2

0.6

7::!

174.2

195.4

21.4

11.9

6.i

8.4

4.0

0.9

1.5

18.9

18.;

0.8

6.7

20.0

13.8

1.7

1.;

1.9

15.5

1::;

.

5.;

7;:;

Rate per 1,000 persons

L

362.0 365.1

468.5 499.9

249.9 191.1

23;.; 172.2

5.4

4:5 5.2

3.9 3.7

33.2

1$;

11:;

.

3:.;

.

30.7

o.i

.

18.5

17.0

10.7

4.1

0.2

%:

16.7

5.3

1;.;

.

;:?

72.5

61.7

24.9

J::

6.7

4;.:

.

40.7

0.9

2.2

38.7

15.4

5.1

k:

4.9

2.6

1:::

12.4

::2

3.6

3.2

101.2

L

318.0 328.2

452.9 475.2

99.6 44.1

83.6 25./

5.2 2.(

1.;

M 6.2

87.7 121.:

49.1 62.(

1;.$ 24.5

13.(

10:2 11.;

39.6

0.1

38.;

0.6

0.6

41.9

28.0

H

4.9

:::

1

11.5

15.4

::;

0.4

3.0

[02:;

46.E

3.5

0.1

0.:

38.>

H

~.~

41.1

14.7

M

3.7

0.1

1.3

7.7

12.8

6.2

H

3.4

16$:!

1Excludes seborrheickeratosis (22x44x),which in the NYU classificationis grouped with benign tumrs.

SYMBOLS

Datanot available ---------------------------------------- ---

Category not applicable ------------------------------- . . .

Quantity zero ---------------------------------------------- -

Quantity morethan Obutless than0.05----- 0.0

356./

529.;

21.:

8.;

().;

5.1

155.;

80.$

46.2,

1::;

84.9

9.5

1.1

5:::

2;:2

15.9

31.9

13.9

i:!

::?

4.0

2.7

5.5

1;::

R

17::;

L

361.9 409.5

563.9 654.8

3;.:

.

15.;

150.8

57.9

68.5

7.3

8.9

1::.;

::i

44.9

3;::

32.8

27.4

12.8

::;

6::

7.0

ti

10,9

18.3

12.6

.8;:?

25.5

0.7

0,1

14.;

126.8

59.6

54.7

2.3

1.3

184.1

3$:

.

6;:;

79:6

65.1

36.3

1:.;

10:3

0.9

3.2

0.4

::?

::;

::.$

4:$

205.’

I

Figure does not meet standards of

reliability or precision ------------------------------- *
6 advancedata

Table 3. Prevalence of skin conditions of concern, all types and the most frequently occurring types of conditions, among persons

1-74 years, by part of body affected and sex: United States, 1971-74

Condition and NYU code

All types of skin conditions of concern---

Diseases of sebaceous glands-----------7l4l-7l49

Acne vulgaris---------------------------7l4l5O

Cystic acne-----------------------------7l4l8O

Acne scars------------------------------7l4l9O

XerOsis---------------------------------7l493O

Dermatophytoses------------------------------l3l

Tines pedis-----------------------------l3100-

Tines unguimn---------------------------l3l2--

‘rineaversicOlOr------------------------l3l9lO

Tines cruris----------------------------l3l3l-

‘wmors --------------------------- 19x,22x,23x,23Y

Malignant----------------------------------l9x

Basal cell (nodular-ulcerative-solid)-19x14x

Basal cell epithelioma----------------l9xlSx

Benignl------------------------------------22x

LiPoma--------------------------------22x959

Precahcercnm and not specified---------23x,23y

Actinic keratosis---------------------23xO8l

Seborrheic demtitis--------------- .-----7OOOlO

Atopic dermatitis/

eczema-----------------701,70S300,70S310,7OS32O

Atopic de?.nmtitis-----------------------7OS3lO

Lichen simplex chronicus----------------7O832O

Hand eczem-----------------------------7olooo

Numnular--------------------------------7OlOlO

Dyshidrotic-----------------------------7OlO3O

Ichthyosis/keratosis---------------7lOl3O,7lOl5O

Folliculitis------------------------------7l39O8

Verruca vulgaris--------------------------696O3O

Psoriasis---------------------------------7O6O9O

Seborrheic keratosis----------------------22x44x

vitiligO----------------------------------7l62lO

Herpes simplex-------------------------------O96

All other skin conditions-----------------------

Both sexes

Total Hand Foot Other

t

113.6 10.8

28.2 0.1

23.6 0.1

1.7 -

0.3

0.9 0.;

21.6

9.7 ;:;

4.5 0.2

2.7 -

3.2 -

8.1 0.6

2.0 0.0

0.3 -

0.8

2.4 0.;

0.1

0.;

::; 0.5

5.4 0.1

10.s 3.1

4.5 0.6

1.9 0.1

1.1 2..1

0.s 0.2

1.6 1.0

1.3 -

1.s -

1.4

3.s 8:;

0.7

1.4 o.i

2;:! 4.;

17,9

0.1

0.1

0.0

0.;

12.5

9.3

3.1

0.4

0.1

0.;

0.0

0.1

0.0

1.3

0.1

0.2

0.;

0.5

0.;

0.0

0.:

3.;

Male Female

Total Hand Foot Other Total Hand Foot Other

87.5 100.3

29.0

23.1

3.1

0.;

1;.:

1:6

:::

7.6

$:

1.3

;:;

4.0

3.3

4.5

6.4

;.;

0.;

1.3

::;

::;

0.5

1$?

lExcludes seborrh~ic keratosis (22x44x),which in the NYU classification is grouped with benign tumors.

S4.9

28.0

23.4

:::

0.s

8,0

0.3

1.2

2.7

3.2

7.1

;::

0.8

3:1

3.1

2.6

5.3

6.4

3.8

1.6

O.z

0.1

1.3

::2

::?

1.3

2:::

Rate per 1,000 persons

4

127.7

29.0

23.1

3.1

0.;

35.9

17.8

5.7

3.5

6.3

8.3

:::

1.3

::2

4.5

3.s

4.s

11.7

5.1

2.1

1.0

0.s

2.1

1.3

3:;

:::

0.7

2%:

2.6

:::

0.3

0.5

0.;

0.5

0.2

3.4

0.8

1.6

0.3

1.0

0.;

0.7

0.;

5.2

27.6

0.0

0.6

0.6

21.3

17.1

3.8

0.2

0.2

0.1

::;

0.4

0.;

1.1

o.i

0.;

3.;

—

27.5

24.1

8:;

0.9

8.2

2.0

;::

0.2

8.1

1.8

0.3

0.3

3.4

0.0

;:2

5.9

10.0

3.s

1.8

1.2

0.8

1.2

1.3

0.9

1.s

3.8

1.1

2.0

2;::

9.0

0.2

0.2

0.6

0.4

0.0

0.2

0.8

0.1

0.;

0.:

0.4

:::

0.1

1.2

1.6

1.3

0.2

0,;

3.i

=4== 0.2

0.1

o.i

4.4

2.0

2.3

0.5

0.1

0.0

0.1

8:?

0.0

0.;

0.;

0.1

0.6

2.i

27.1,

23.[1

0.3

0.7’

O.fl

3.4

0.()

0,7

2.CI

0.2!

6.81

1,7

0.:1

130:1

2.7

O.cl

2.4

2.CI

5.9,

6.4.

3.4.

1.7

0.;!

0.2

1.:,

0.$,

0.3

3.5

1.1.

2.CI

().$1

22.9I
TECHNICAL NOTES

The sampling plan for the 65 examination

locations in the HeaIth and Nutrition Examination Survey from April 1971 through June 1974

followed a stratified multistage probability design in which a sample of the civilian noninstitutionalized population of the coterminous

United States 1-74 years of age was seIected.

The sampIe was stratified by geographic region,

population density, and rate of population

change between 1960 and 1970. Within each

stratum, cluster-type sampling was used for selecting households and sample persons to be inCIuded in each examination Iocation. The sample

design provided for oversamplin.q among persons

living in poverty areas, preschool-age children,

and women 20-44 years of age.

Prevalence rates of skin conditions are

shown as population estimates; that is, the examination findings for each individual have been

“weighted” by the reciprocal of the probability

of selecting the person. An adjustment for persons in the sample who were not examined and a

poststratified ratio adjustment were also made

so that the final sample estimates of the population size agree exactly with independent U.S.

Bureau of the Census estimates for the civilian

noninstitutionalized population of the United

States as of November 1, 1972, by color, sex,

and age.

Previous issues of Advance Data from Vital and Health Statistics

No. 1 Blood Pressure of Persons 6-74 Years of Age in the United States

(Issued: October 18, 1976)

No. 2 Hypertension: United States, 1974 (Issued: November 8, 1976)

No. 3 Height and Weight of Adults 18-74 Years of Age in the United States

(Issued: November 19, 1976)
FROM VITAL & HEALTH STATISTICS OF THE NATIONAL CENTER FOR HEALTH STATISTICS

US. DEPARTMENT OF HEALTH, EDJCATION, AND WELFARE I No. 5. February 22, 1977 I Pubhc Health Serwce. Health Resources Admmistration

A Comparison

18-74 Years of Age

of

in

Levels of Serum Cholesterol of Adults

the United States in 1960-62 and 1971-74a

Serum cholesterol data obtained from the

findings of the Health and Nutrition Examination Survey (HANES), 1971-74, present an opportunity to reexamine the level of serum cholesterol of the U.S. population aged 18-74

years.1 Earlier determinations of serum cholesterol levels were made in the first cycle of the

Health Examination Survey (HES), 1960-62, in

order to provide reference data for the general

population of the United States.2 This was

prompted by the epidemiologic studies associating levels of total blood cholesterol with the

risk of development of coronary heart disease.3’5

Field data collection operations for the first

HANES survey were started in April 1971 and

completed in June 1974. Of the 28,043 persons

aged 1-74 years who were selected in the national probability sample to represent the 194

miIlion persons in that age group in the civilian

noninstitutionalized population, 20,749, or 74.0

percent, were examined. When adjustments were

made for the differential sampling ratios used

for the effect of oversampling among the poor,

preschool chiIdren, women of childbearing age,

and the elderly, this corresponds to an effective

response rate of 75 percent. Among those 18-74

years of age at interview for whom serum cholesterol determinations were made, there were

13,645 examined out of the probability sample

of 19,572 selected to represent the 128 million

of that age in the population. This is an unadaThis report prepared by Sidney Abraham, Clifford

L. Johnson, and Margaret D. Carroll, Division of Health

Examination Statistics.

justed response rate of 70 percent and am effective adjusted response of 70 percent. A detailed

description of the sample and response of the

Health Examination Survey of 1960-62 has been

published.6 Detailed estimates of the distribution of serum cholesterol levels will be described

and analyzed in a forthcoming report in Series

11 T of 14tal and Health Statistics. Selected data

and findings from that report on the comparison

of levels of serum cholesterol in the United

States in 1960-62 and 1971-74 are presented

here (tabIes 1-2 and figures 1-4). -

Figure 1, MEAN SERUM CHOLESTEROL LEVEL OF MEN 1S-74

YEARS BY ACE: UNITEO STATES, 196062 AND 1971-74

231,8

230.5

22s.s . . . . . . . . . . . . . . . . .."" . . . . . .." . . . . . .." . . . . . . . . . . . ..~5

/.

?286 229.4

~:~fl

... 22%s

..... ~R9

.....

....”

2m9 /“.

/.

,..”. :m.*

--....1960.62 /.”

— 1971.74

...”.

z ,>&=

;

180 ,78,,

J ,

170 —

I I I I

1824 25:34 3544 4554 55.64 65 and

over

AGE IN YEARS
2 achmncedata

CHOLESTEROL DETERMINATIONS–

HES AND HANES

Serum cholesterol determinations for HES

were made using a modified ferric-chloride technique at the Lipid Standardization Laboratory

of the (then) Communicable Disease Center

(CDC), Public Health Service, Atlanta, Georgia.

A comparative study of cholesterol methods

which was conducted by CDC during the course

of the Health Examination Survey determined

that the ferric- sulfuric method in use was positively biased with respect to the method of

Abell, Levy, Brodie, and Kendall, which was

chosen as a basis of reference for its close approximation to “true” serum cholesterol values. z The data in the HES report presented here

are therefore the original ferric-chloride values

reduced by a factor of 7.6 percent to approximate Abell et al. determinations.

All serum cholesterol determinations for

HANES were made in the Lipid Standardization

Laboratory of what is now the Center for Disease Control, Public Health Service, Atlanta,

Georgia. The analytical method was based on

that of Abell et al.8 but was modified for a semiautomated production line. The method, described in detail by Eavenson et al.g was made

possible by the development of a relatively

stable Liebermann color reagent and was designed for automatic pipetting units.

The Lipid Laboratory at the Center for Disease Control compared the results obtained with

this semiautomated Abell et al. method and

those obtained from their standardized version

of Abell et al.8 For examining the bias of the

semiautomated method, data were obtained

from pools of sera analyzed by the reference

method and the semiautomated method. For

pools ran@ng from 134 to 343 mg per 100 ml,

there was in 1972 an average positive bias of

4.07 percent for the semiautomated method

compared with the standard method; for the

1973-74 period, the corresponding figure was a

positive bias of 4.9 percent. The weighted average bias was 4.5 percent. Therefore the data

presented here are the original values produced

by the semiautomated method diminished by

4.5 percent to approximate Abel] et al. determinations.

Figure 2. MEAN SERUM CHOLESTEROL LEVEL OF WOMEN 16-74

YEARS BY AGE UNITEO STATES, 1960-62 ANO 1971-74

270 — 2057

262.3

2-?,

; 250 —

E

; 240 —

k!

w

S 230 —

g

...”’

A ...”’

g 220 — ...”’

r m 3.6 ..,”

y *,O

g

o

= 200 —

3

cc .. . . ..1960.62

: —1971.74

z

<

u

= 180 ~’”

170/7

8 I I I I J

18.24 25.34 35.44 45.54 55.64 65 and

over

AGE IN YEARS

Figure 3. MEAN SERUM CHOLESTEROL LEVEL OF ADULTS IW4

YEARS BY AGE AND SEX: UNITED STATES, 1960-62

270

[

265.7

262,3

260

. . . . . . . . . ..- /...

/

.....

250 ...”.

/

240 236,8/

...””

I

~’ 23o 226.8 ../.~30.5 232,8

.....

222,s

220 .....

/

210

..”.212.6

205.9 .. ... .

.. .“.

200 . ...

.+97.9

. . .

. .. — Men

190 . .’

. . . . . . ~~m~”

184.:. . .. .

160 ,78,,

}

T70

o~

18.24 25.34 3544 45$4 55.64 65 and

over

AGE IN YEARS
Zxh@mwkh 3

However, in the later report,7 HANES

1971-74 serum cholesterol data wilI be presented without correction for bias when no comparisons are made between HANES data and the

data from HES, 1960-62. Those data will thus

provide population reference standards for determinations made by the semiautomated

methodology now in use.

FINDINGS

Figure 1 and table 2 show that in all age

groupings mean serum cholesterol levels for men

in the HES sample are slightly higher than those

for men in the HANES sample except for the

age group 18-24 years, when the HANES sample

is O.4 mg per 100 ml higher than that for the

HES sample. In other age groups the differences

range from 1.9 to 5.9 mg per 100 ml, and are

not significant (0.05). The mean levels for men

in both data sets increase rapidIy to the age

group 35-44 years and increase less rapidly to

the age groups 45-54 and 55-64 years. A slight

decline occurs in the age group 65-74 years.

Figure 2 and table 1 show that the mean

levels for women in the HES sample are higher

than the levels for women in the H~TES sample

in all age groups. In the age groups under 55

years, with the exception of ages 35-44 years,

the differences are small, 1.6 to 5.1 mg per 100

ml, and are nc~t significant (>.05). In age group

35-44 and in the older age groups 55 years and

over the mean levels in the HES sample are significantly higher than those in the HANES sample. The differences in mean levels are 17.1 and

15.9 mg per 100 ml, respectively, for age groups

55-64 and 65-74 years and 6.8 mg per 100 ml

for the. age group 35-44 years.

The mean levels for women from HES and

HANQS sets c~f data increase with age but in a

slightly different. pattern. The mean levels for

women in the HES sample increase to the age

group 55-64 years, with the rate of increase

more rapid for those in the midfifties and midsixties than for those in the earIier ages. The rate

of increase then diminishes substantially, with

the levels attaining a peak in the oldest age

group 65-74 years. The rate of increase in the

mean levels in the HANES sample show a similar

pattern before age 55. However, the mean levels

increase less rapidly in the midsixties, and then

flatten out, with the levek also attaining a peak

in the age group 65-74 years.

Figure 4. MEAN SERUM CHOLESTEROL LEVEL OF ADULTS 18-74

YEARS BY AGE AND SEX UNITED STATES, 1971-74

2/0

260

F

J

~’

249.8

z 250 . . . .

~

245.2 . . . ...--”.

/..

= 240 .. ..

t

.....

u 23!.7 . . . . . .

= 230 /

g

228,6 2W,4

J 220,9 ...

: 220

2756

.....

F /

q

210 .....

0

~ Xm ...LW.8

.. ...

> 200

3

.....

cc

# — Men

:

..,..194.1

190

....

. . . . . . w~~~”

5 ~B3J.....

.

= 180

17&6

170 L

>

I I I I I

18-24 25.34 354 45.54 55.64 65 and

over

AGE IN YEARS

Sex Difference by Age–HES and HANES

Figure 3 sho~vs that in the HES sample in

each sex group the mean level increases \vith age

but in different patterns. Levels for men increase

rapidly to the decade 35-44 years. The rate of

increase then flattens out, with levels reaching a

peak in the clecade 55-64 years and declining

slightly thereafter. hlean levels for women are

higher than those for men in the youngest age

group, 18-24 years. They increase less rapidly

than those fo:r men in the midthirties and midforties but increase much more rapidly than

men’s levels after age 45. Thus the mean levels

for women exceed those for men in the age

group 45-54 years and at all ages thereafter.

Figure 4 shows the mean serum cholesterol

levels in the HANES sample of adults. As in the

HES sample, mean levels for women are higher

than those for men in the youngest age group,

18-24 years. After age 25, the mean levels in the

HANES sample generally show the same pattern

as observed in the HES sample for women and
4 aci’klncedata

men. The mean levels for women increase less

rapidly than those for men in the age groups

25-34 and 35-44 years but increase much more

rapidly than men’s levels after age 45. Here the

levels for women exceed those for men in the

age group 45-54 years and at all older ages. The

levels for men peak at the age group 55-64 years

and then decline, while the levels for women

continue to rise.

A comparison of proportions of persons in

HES and HANES whose serum cholesterol values exceed any specified level may be found in

table 2 for men and in table 3 for women.

SUMMARY AND CONCLUSION

Prospective as well as cross-sectional epidemiologic studies associate the level of serum cholesterol with risk of developing coronary heart

disease. The two surveys conducted in representative samples of the U.S. population by the National Center for Health Statistics were presented and analyzed by age and sex. They

provide cross-sectional data of serum cholesterol

determinations of adults obtained on different

age cohorts. The age trends present the mean

levels for successive cohorts of persons of different age groups reflecting the effect of environmental as well as hereditary influences. The

mean level of serum cholesterol of men in each

age group for the HANES sample shows a slight

decrease over that obtained for the HES sample.

The percent decrease in mean levels ranges from

0.8 percent in the age group 45-54 years to 2.6

percent in the age group 35-44 years.

The actual differences in means of the levels

of serum cholesterol of men from the two surveys at corresponding ages are numerically small.

Maximum differences are 5.9 mg per 100 ml at

age 35-44 years. At other ages the HES data

range from 1.9 mg per 100 ml to 5.1 mg per 100

ml greater than the HANES data.

For women in the age groups under 55 years

with the exception of ages 35-44 years, the

mean levels of serum cholesterol in the HANES

sample show a slight decrease over the levels of

the HES sample. The maximum difference is 5.1

mg per 100 ml at ages. 45-54 years. At ages

18-24 and 25-34 years, the differences are 1.6

and 3.8 mg per 100 ml, respectively. The differences at ages 35-44, 55-64, and 65-74 years are

6.8, 17.1, and 15.9 mg per 100 ml. Only at these

ages were the differences significant at the O.0!5

level.

Both laboratory methods (1960-62 and 1971-

74) show positive biases relative to a COmmon reference method. These biases can be com~-

pared and corrected for comparisons between

the 1960-62 and 1971-74 surveys. This has been

done in this report. The 1971-74 data are diminished by 4.5 percent to make them comparable

to the 1960-62 data which were presented already corrected by 7.6 percent to the reference

method. The reference method may be presumed to be stable over time, but there were no

pools of sera which were analyzed in both study

periods to assure that a shift in the accuracy of

this reference method did not occur because

such pools are not available.

REFERENCES

1 National Center for Health Statistics: Plan and operation of the Health and Nutrition Examination Survey,

United States, 1971-1973. Vital and Health Statistics.

Series I-Nos. 10a and 10b. DHEW Pub. No. (HSM)

73-1310. Health Services and Mental Health Administration. Washington. U.S. Government Printing Office, Feb.

1973.

2National Center for Health Statistics: Serum Cholesterol Levels of Adults, United States, 1960-1962. Vital and Health Statistics. PHS Pub. No. 1000-Series

11 -No. 22. Public Health Service. Washington. U.S. Government Printing Office, Mar. 1967.

3Keys, A.: The diet and plasma lipids in the etiology

of coronary heart disease, in Russek, H. L, and Zohman,

B. L., eds., Coronary Heart Disease. Philadelphia. J. B.

Lippincott Co., 1971. p. 59.

4Keys, A,, Taylor, H. L., Blackbum, H., Brozek, J.,

Anderson, J. T., and Simonson, E.: Coronary heart disease among Minnesota ‘business and professional men followed fifteen years. Circulation 28:381, 1963.

5 Gordon, T., and Verter, J. I.: The Framingham

Study: An epidemiological investigation of cardiovascular disease. Section 23. Serum cholesterol, systolic blood

pressure, and Framingham relative weight as discrimina-
acwncedata 5

tors of cardiovascular disease. Bethesda, Md. National

Institutes of Health, 1969.

6National Center for Health Statistics: Cycle I of the

Health Examination Survey, Sample and Response,

United States, 1960-1962. Vital and Health Statistics.

PHS Pub. No. 1000-Series 1l-No. 1. Public Health Service. Washington. U.S. Government Printing Office, Apr.

1964.

7National Center for Health Statistics: Serum cholesterol levels of adults 18-74 years, United States,

1971-74. Vital and Health Statistics. Series 11. Health

Resources Administration, DHEW, Rockville, Md. To be

published.

8Abell, L. L., Levy, G. B., Brodie, B. B., and

Kendall, F. E.: A simplified method for the estimation

of total cholesterol in serum and demonstration of its

specificity. J. BioL Chem. 195: 3.57, 1952.

‘Eavenson, D., Grier, O. T., Cisson, J. G., and

Witter, R. F.: A semiautomated procedure for the determination of serum cholesterol using the AbelI-Kendall

method. J. Amer. Oil Chem. Sot. 43:652.1966.

SYMBOLS

Data not available ------------------------------------- ---

Category not applicable -------------------------------- . . .

Quantity zero --------------------------------------------- -

Quantity more than Obut less than 0.05 ------- 0.0

Figure does not meet standards of reliability

or precision ----------------------------------------

*

Table 1. Serum cholesterol level of adults aged 18-74 years by sex and age, with number of examined persons, mean, and standard

daviation: United States, 1960-62 (H ES) and 1971-74 (HAN ES)

I I

I

Men I

Women

Age I

1960-62

I

1971-74

I

196CI-62

I

1971-74

18-24 years..

25-34 years.,

3544 years..

45.54 yaars..

55-64 years..

65-74 years..

ET=

406

661

691

533

410

262

178.1

205.9

226.8

230.5

232.8

229.5

40.7 772

44.6 804

49.4 665

45.6 765

49.0 697

47.3 1,657

I

In denotes number of examined Persons.

z~ denotes standard deviation.

Mean ~2 ~1 Mean

1 1 I

178.5

200.8

220.9

228.6

229.4

225.6

35.0

42.0

43.9

44.9

48.9

51.3

515

729

762

679

426

289

184.7

q97.9

2! 3.6

X6.8

262.3

265.7

I 1 1 —

47.9

41.9

45.3

50.0

63.0

58.8

1,524 183.1

1,896 194.1

1,663 206.8

836 231.7

670 245.2

1,822 249.8

39.1

40.3

41.5

49.6

46.0

49.6

NOTE: The distribution of the number of persons examined by age and sex is different for HES and HANES because different sampling rates were applied to the subgroups, but within subgroups sampling rates are representative of the U.S. population at the time of

the survey.
6 ackincedata

Table 2. Cumulative percent distribution Of serum cholesterol levels Of adult males by age: United States, 1960-62 (H ES) and

1971-74 (HAN ES)

55-64 65-74

years years

18-74 18-24 25-34 3544 45-54

Serum years years years years years

cholesterol

level

(mg/100ml)

Under 100 .. ......

Under 120..., ....

Under 140, .......

Under 160 ........

Under 180 ........

Under 200 ........

Under 220 ........

Under 240...,.,..

Under 260, .......

Under 280 ........

Under 300 .........

Under 320 ........

Under 340 ........

Under 360 ........

Under 380 ........

960- 1971- 1960- 1971- 1960- 1971- 1960- 1971- 1960- 1971-

62 74 62 74 62 74 62 74 62 74

1971- 1960- 197:1-

74 62 74

Cumulative percent distribution

0.1

0.8

3.3

9,6

21.2

35,7

53.4

70.4

82.4

90,6

95.3

97.9

98.9

99.4

99.6

0.2

0.9

4.1

12.2

25.7

42.3

59.0

74.5

85,3

91.8

95.9

97.8

99.0

99.4

99.6

0.4

2.9

14.4

33.1

57.9

73.8

86.8

93.6

96.1

99.1

99.4

99.6

99.8

99.8

99.8

0.1

2.4

11.8

31.1

55.1

76.6

87.5

94.1

97.2

98.6

99.8

99.8

100.0

100.0

100.0

0.1

1.1

4.1

14.7

3~.7

53.6

70.8

84.3

91.8

96.3

97.9

98.7

99.0

99.4

99.4

0.1

0.6

1.5

5.3

14.1

25.4

45.8

66.1

79.8

88.3

93.0

96.9

97.9

99.0

99.6

0.2

0.7

1.5

4,4

11.1

22.1

36.4

58.3

76.5

87.8

93.0

96.4

98.6

99.1

99.3

0.1

0.1

1.7

3.3

12.4

24.2

42.9

63.2

79.8

87.3

93.3

96.2

97.9

98.8

99.1

(0.2

0.7

:2.7

6.2

14.6

29.8

47.9

6!5.5

79.1

86,8

94.3

96.9

97.8

9[3.9

99.1

0.7

0.7

1.4

6.0

11.8

24.2

41.8

62.6

75.9

86,4

94.4

96.5

98.9

99.7

100.0

0.6

2,6

10,2

27.5

47.7

66.5

81.4

89.6

95,5

98.0

99.8

99.8

99.8

99.8

0.1

1.7

6.2

17.6

32.8

51.6

68.5

82.9

90.0

93.8

97.8

99.3

99.4

99.7

0.1

0.3

3.7

9.4

22.6

42.6

60.8

74.3

86.3

94.7

98.6

99.4

99.9

99.9

1.3

4.1

10.3

26.5

43.3

62.0

78,4

86,7

93.9

96.5

98.3

98.9

99.5

Table 3. Cumulative percent distribution of serum cholesterol levels of adult females by age: United States, 1960-62 (H ES) and

1971-74 (HANESJ

18-74

years

18-24 25-34

years years

I I

35-44 45-54 55-64 65-74

years years years years

—

1960- 1971- 1960- 1971- 1960- 1971- 1960- 1971-

62 74 62 74 62 74 62 74

—

Serum

cholesterol

level

(mg/100ml) 960- 1971-

62 74

Cumulative percent distribution

0.3

0.7

1.1

1.5

6.0

8.8

17.6

31.4

49.0

64.8

0.3

0.7

3.2

11.0

23.5

46.3

67.0

80.7

90.4

94.7

97.8

98,9

99.5

99.6

99.7

Under 100 ........

Under 120 ....... .

Under 140 ........

Under 160 ........

Under 180 ........

Under 200 ........

Under 220 ........

Under 240 ........

Under 260 ........

Under 280,.., ....

Under 300..., ....

Under 320..., ....

Under 340., ......

Under 360., ......

Under 380 .. ......

0.1

0,8

2.8

9.3

20.9

35.2

51,9

64.9

77.3

85.5

91.8

95.4

97.8

98.8

99.4

0.2

1.1

4.5

12.3

24.3

41.4

57.9

71.8

82.5

89,4

94.3

97.1

98.2

99.2

99,5

0.3

2.9

9.2

28.3

49.4

69.8

84.9

91.0

95.4

97.5

98.2

99.0

99.7

99.9

99.9

0.4

2.9

11.5

28.9

49.7

69.5

83.5

92.1

97.0

97.9

99.3

99.8

99.8

99.8

99.9

0.6

1.6

7.1

17.4

36.3

60.4

77.5

88.3

94.4

97.5

98.8

99.1

99.7

99.8

99.8

0.6

2,7

7.9

18.1

35.0

53.0

72.0

84.7

93.7

96.3

98.6

99.5

99.6

0.3

0.1

3.5

7;7

17.9

29.9

50.3

64,1

79.1

88.3

95.3

98.3

99.6

0.1 0.6 0.8

4.4

15.1

33.8

66.8

74.5

86.5

92.6

95.7

98,6

99.3

99.6

99.7

99.9

0.6

1.8

6.5

19.6

38.3

62.1

76.8

87.1

93.0

97.1

98.4

98.9

99.3

99.5

‘1.7

:3.1

6.0

13.0

24.9

42.5

593

76.0

8(5.1

92.2

96.2

9B.3

99.1

0.7

4.8

11.6

25.7

43.7

61.8

75.5

85.0

90.8

95,3

96.5

98.4

99.0

0.4

2.7

6.3

15.3

29.8

47.3

64.7

76.9

88.1

94.4

96.4

98.9

99.4

73.3

84.7

91.8

94.2

97,0
TECHNICAL NOTES

The sampling plan for the 65 preselected examination locations in the Health and Nutrition

Examination Survey followed a highIy stratified

multistage probability design in which a sample

of the civilian, noninstitutionalized population

of the conterminous United States 1 to 74 years

of age was selected. Successive elements dealt

with in the process of sampling were the primary

sampling unit, census enumeration district, segment (a cluster of households), household, eligible person, and sample person. The sampling design provided for oversampIing among persons

living in poverty areas, preschool children,

women of childbearing age, and the elderly.

The serum cholesterol determinations are

shown as population estimates, that is, the serum cholesterol findings for each individual have

been “weighted” by the reciprocal of the probability of selecting the person. An adjustment

for persons in the sample who were not examined and poststratified ratio adjustments were

also made and so the finaI sampling estimates of

the population size agree exactly with the U.S.

Bureau of the Census independent estimates for

the civilian, noninstitutionalized population of

the United States as of November 1, 1972, by

race, sex, and age.

Previous issues of Advance Data From Vital and Health Statistics

No. 1 Blood Pressure of Persons 6-74 Years of Age in the United States

(Issued: October 18, 1976)

No. 2 Hypertension: United States, 1974 (Issued: November 8, 1976)

No. 3 Height and Weight of Adults 18-74 Years in the United States (Issued: November 19, 1976)

No. 4 Prevalence of Dermatological Diseases Among l?ersons 1-74 Years of

Age, United States (Issued: January 26, 1977)
FROM VITAL & HEALTH STATISTICS OF THE NATIONAL CENTER FOR HEALTH STATISTICS

US. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE I No. 6 March 30, 1977 I Public Health Service. Health Resources Admmlatrabon

Dietary Intake of Persons 1-74 Years of

‘Information on food intake for 1 day was

obtained during the Health and Nutrition Examination Survey (HANLS) conducted by the

National Center for Health Statistics April 1971

through June 1974 from a national probability

sample of persons 1-74 years of age in the U.S.

civilian noninstitutional population.

Dietary intake data in HANES were obtained at 65 primary sampling units on 28,043

sample persons selected to represent 194 million

persons aged 1-74 years in the U.S. population.

The program examined 20,749 persons, or 74

percent of the sample. This represents an effective response rate of 75 percent when adjustment is made for the effect of oversampling

among the poor, preschool children, women of

childbearing age, and the elderly. Detailed estimates of the distribution of calories and selected

nutrient intakes ingested on a single day and the

proportions of persons who did not ingest on

that day the levels of nutrients necessary to

meet the recommended daily allowance will be

described and analyzed in a forthcoming report

in the Vital and Health Statistics series.l SeIected means as they relate to the recommended

daily allowances from that report are presented

here in tables 1-8 and in figures 1-3.

Information on food intake was obtained by

the 24-hour recall method for the day, midnight

to midnight, preceding the interview. The 24-

hour period accounted for all regular meals eaten

as well as for between-meal foods or snacks. Food

recall included foods eaten on Monday through

aThis report prepared by Sidney Abraham, Margaret

D. Carroll, M.S.P.H., Connie M. Dresser, R.D., and

Clifford L. Johnson, M.S.P.H., Division of Health Examka tio n Statistics.

Friday

Age in the United Statesa

but excluded foods eaten on weekends

which may pertain to unusual food intakes.

Individual nutrient intakes for the single

day reported are evaluated in relation to recommended dietary allowances. The mean of the percentages of the nutrient standard is presented.

This mean is a crude estimate of desirable

or expected nutrient intakes, and it proves useful for comparisons of dietary intake data between population subgroups. However, percents

of standard below 100 do not necessarily mean

inadequate nutrient intakes. The recommended

allowances are designed for the maintenance of

good nutrition in healthy persons in the United

States. They allow for some margin above what

is really needed by most individual with the

objective of maintaining good health in all. As a

guideline to interpreting the dietary data, a set

of recommended daiIy allowances for the evacuation of HANES dietary data was developed with

advice from an ad hoc advisory group. The

groups considered recommended daily allowances from the World HeaIth Organization,z the

Interdepartmen.tal Committee on Nutrition for

National Defense Manual,a the National Research Council Food and Nutrition Board Recommended Dietary Allowances,A and from

those used in the Ten-State Nutrition Survey.5

Except for protein and caIories, the recommended daily allowances as presented in table A

are all related to age, physiological state, or to

caloric intake.

Standards foI assessing caloric and protein

allowances for adults are based cm expected

median body weight for sex and height ~.t ages

20-29 years. More specificaI1y, an expected body

weight at ages 20-29 years was computed for

each individual adult based on height and sex.

The median of the distribution of expected
2 achmncedata

weight for each height and sex group was deter- individual was then divided by this standardized

mined. The standardized allowance for each in- allowance to arrive at the “percent of recomdividual 20 years ancl over was then calculated mended daily allowance. ” Height-sex-specific

by multiplying the median expected weight for weight at ages 20-29 is used because at these

height and sex by the recommended nutrient al- ages it is thought to most closely approximate

lowance per kilogram of body weight (table A). the body’s cell mass. Cell mass, the metabcdiThe resultant product was then taken as that caIly active part of the body, is the major detm--

individual’s sex-height-standardized allowance. minant of adult nutrient needs. Weight gain after

The reported caloric or protein intake for each 20-29 years is presumed to be fat, with little

Figure 1. Mean intake of calories and selected nutrients as a percent below recommended dietary allowance, by income level, sex, and

age: United States, 1971-74.

[Based on l-day diet; 24-hour recall]

—

I

Calories I

Protein (gin) ICalcium (mg}

Sex and age

Al I

income:

Male I

1 year ... .......

2-3 years ......

4-5 years ......

6-7 years ...... L

8-9 years .... ..

E

)

10-11 years.. )

12-14 years.. x)

15-17 years.. x)

18-19 years.. )

20-24 years.. )

25-34 years.. )

35-44 years.. )

45-54 years.. x)

55-64 years.. x)

65 years and

over ......... xx>

Female

1year ..........

2-3 years ......

4-5 years ......

6-7 years ......

8-9 years .. ....

10-11 years..

12-14 years..

15-17 vears..

18-19 years..

20-24 years..

25-34 years..

35-44 years..

45-54 years..

55-64 years..

65 years and

over .... .. ...

xx:

x)

xx:

xxx;

F

x:

xx:

x:

x:

x:

x:

xx:

Below

>overty

levell

x

xxx

xxx

xxx

xx

xx

xx

x

xxx

Xxxx

Xxxx

x

xx

xx

xxx

Xxxx

xx

xxx

xx

xxx

xx

xxx

xxx

I

$

Above

poverty Al I

levell incomes

x

x

xx

xx

x

x

x

x

xx

xx

xxx x

x

xxx

xx

xxx

Xxxx x

xx

xxx

xx

xx

xx

xx >

xxx 1’

I

KEY I

x = Below by 1-10 percent

xx = Below by 11-20 percent

xxx = Below by 21-29 percent —

xxxx = Below by 30 percent or

1, more

x

x

xx

x

x

x

x >

xx x )

xx x )

All

incomes

Xxxx

Xxxx

x

x

x

x

Xxxx

Xxxx

xx

x

x

Xxxx

Xxxn

Xxxx

xxx) ——

xxx>

xxx>

xxx> ——.

xxx>

>

)

Iron (mg)

——

Below

)overty

levell

Xxxx

Xxxx

x

——

x

xxx

xx

Xxxx

Xxxx

xx

xx

Xxxx

Xxxx

Xxxx

Xxxx

Xxxx

Xxxx

Xxxx

.—Xxxx

xx

x>

Above

poverty

levell

Xxxx

Xxxx

x

——

?

x

x

Xxxx

Xxxx

xx —.

x

x

Xxxx ——

Xxxx

Xxxx

Xxxx —— X)(XX

X}:Xx

Xxxx ——X)(xx

x

x

I Excludes persons with unknown income.

NOTE: There was no one ot)wrvcd hclow the recommended dietary allowance for vitamins A and C, thiamine, and riboflavin.
increase of the body’s cell mass. In fact, cell mass

tends to decrease with age even as weight increases,6 which indicates that these standardized

allowances tend to overstate the nutrient needs

of older people as compared with younger. This

bias is much less, however, than the presentation

of nutrient intake per kilo@-am of body weight.

Those who weigh less than the height-sex-spec;fic

weight at 20-29 years of age are presumed to be

underweight, and their nutrient needs may be presumed to be greater than their weight implied.

A similar method was used to obtain heightstandardized allowances for assessing caloric and

protein dietary intakes of children. The expected median body weight for age, sex, and

height was derived from anthropometric data

collected in HANES.

In addition to age and race, income status

is another population characteristic considered

when nutritional data are presented because

quantity and quality of dietary intake have been

known to be associated with level of income.

Table A. Standards for evaluation of dailv dietarv intake used in the Health and Nutrition ExaminationSurveV, by a9e. $ex~ and

physiological state: United States, 1971-74

Age, sex, and

physiological state

Age and sex

1-5 yaars:

12-23 months, male and

female .................................

2447 months, male and

femala ......................... .......

48-71 months, male and

female ................................

6-7 years, male and female ..........

8-9 years, male and famale ..........

10-12 years ..................Male ........

Femala ....

13-16 yaars ..................Maie ........

Famale .. ..

17-19 years ... ...............Male ... .....

Female ....

20-29 years ..................Male ........

Female .. ..

30-39 years ..................Male ........

Female ....

40-49 yaars ..................Male ........

Female ....

50-54 years ..................Male ........

Female ....

55-59 years ..................Male ........

Famale ....

60%9 years ..................Male ........

Female ....

70 yaars and ovar ........Male ........

Female ....

Physiological state

Pragnancy (5th month and

beyond), add to basic

standard .................................

Lactating, add to basic

standard ..... ............................

Calories

(per kg)

90

86

82

82

82

68

64

60

48

44

35

40

35

38

’33

37

31

36

30

36

30

34

29

34

29

200

1,000

Protein

(gm per

kg)

1.9

1.7

1.5

1.3

1.3

1.2

1.2

1.2

1.2

1.1

1.1

1.0

1.0

1.0

1.0

1.0

1.0

1.0

1.0

1.0

1.0

1.0

1.0

1.0

1.0

20

25

Calcium

(mg)

450

450

460

450

450

650

650

650

650

550

550

400

600

400

600

400

600

400

600

400

600

400

600

400

600

200

500

Iron

(mg)

‘15

‘15

‘1o

10

10

10

18

18

18

18

18

10

18

10

18

10

18

10

18

10

10

10

10

10

10

Vitamin

Al

(l-u.)

2,000

2,000

2,000

28500

2,500

2,500

2,500

3,500

3,500

3,500

3,500

3,500

3,500

3,500

3,500

3,500

3,500

3,500

3,500

3,500

3,500

3,500

3,500

3,500

3,500

1,000

1,000

Vitamin

c

(mg)

40

40

40

40

40

40

40

50

50

55

50

60

55

60

55

60

55

60

55

60

55

60

55

60

65

Z5

5

B vitamins

(all ages)

Thiamine

0.4 mg

par 1,000

calorias

Riboflavin

0.55 mg

per 1,000

calories

Niacin

6.6 mg

per 1,000

calories

l~su~ed 70 p~~cent CarOtMh3, 30 p~rcerit ‘etinO1.

2 For all pregnan ties.
4 ZKktlCWkki

The income status for each examined person is

expressed by the Poverty Income Ratio (table

B). Families and unrelated individuals are classified as being above or below the low income or

poverty level, using the poverty level index adopted by the Federal Interagency Committee

in 1969. This index, in contrast with total family

income, reflects the different consumption requirements of families based on their size, composition, sex, age of the family head, and farmnonfarm residence.

For analysis, two groups of income levels are

presented–income below poverty level, a ratio

of Iess than one, and income at and above poverty level, a ratio of one or more. A later, more

detailed analysis may show differences not apparent here. There were 723 persons (3.5 percent of the total) examined whose income wals

Figure 2. Mean intake of calories and selected nutrients as a percent below recommended

[Based on l-day diet;

Sex and age

White male

1 year .. ........................................................................

2-3 years ....... ......................................... .................... .

4-5 years ............... ................. .....................................

6-7 years .....................................................................

8-9 years ...... ... ............................................................

10-11 years ................................. ................................

12-14 years .................................................................

15-17 years ............... .................................. ................

18-19 years ................................. ................................

20-24 years .................................. ...... .........................

25-34 years .................................................................

3544 years ................ .................................................

45-54 years .................................. ...............................

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

65 years and over ........................................................

Negro male

1 year ......... ................................................................ .

2-3 yaars ................ ............... .... ..................................

4-5 years ..................... ........... .................... .................

6-7 years .................................................................... .

8-9 years .................................................................... .

10-11 years .................................................................

12-14 years .... .. .................. ........ .................................

15-17 years ....................... ..........................................

18-19 years .... .. ........ ........ .......................... .................

20-24 years ..... ............................................................

25-34 years .................................................................

35-44 years ...................................................... ...........

45-54 years ....................................................... ..........

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

65 years and over ........................................................

1 Excludes persons with us-known into ‘e<

Al I

incomes

x

x

xx

xx

x

x

x

x

xx

xx

xxx

xx

xxx

xxx

xxx

xx

xx

x

xx

xxx

Xxxx

Xxxx

Calories

Below Above

poverty poverty

Ievell Ievell

+-HXxxx I

xx

xxx xxx

1

xx I xxx

*

T

xx xx

xxx xx

xx x

xx xx

Xxxx xxx

Xxxx xxx

Xxxx Xxxx

Al I

incomes

—.—

xx

Protein (gin)

-1-

Below Above

poverty poverty

Ievell Ievell

1

1

x

x

I

—4----

-1-- xx

xx x)(

NOTE: There was no one observed below the recommended dietary allowance for thiamine and riboflavin.
admc@aa5

unknown. These persons were excluded from

the two income classification gfoups, but they

were included in the total group.

The mean nutritive content of diets consumed by different age, sex, race, and income

groups was compared with the recommended

dietary allowances for calories, protein, calcium,

iron, vitamins A and C, thiamine, and riboflavin.

Iron, on the basis of mean intakes, was the

nutrient most often found below the recommended dietary allowance in population groups.

This was shown in nearly all age groups for

white and Negro females in both income groups.

Children of ages 1-3 years had means that were

41 to 68 percent below the recommended dietary allowance ; adolescents 12-17 years had

means that were 35 to 55 percent below the

recommended allowance; and women of childdietary allowance for males, by income level, race, and age: United States, 1971-74.

24-hour recall]

Calcium (mg) I

1ron (mg)

All

incomes

Below Above Al I

poverty poverty

Ievell level 1

incomes

Xxxx

Xxxx

x

x

x

x

Xxxx

Xxxx

x

x

x

xxx

xx

Below Above

poverty poverty

Ievell level 1

Xxxx I

Xxxx

Xxxx Xxxx

%

x x

x x

xxx x

xx x

Xxxx IXxxx

Xxxx Xxxx

xx x

x

x

Xxxx

x

x

xxx

xxx

+

Vitamin A (1. U.) I Vitamin C (mg)

All

incomes

Below Above All Below Above

poverty poverty incomes poverty

levell

poverty

levell level 1 levell

I I

KEY I

tlx = Below by 1-10 percent

kx =’ Below by 11-20 percent

xxx = Below by 21-29 percent

xxxx = Below by 30 percent or

more

I

x

x
6 admncedata

bearing ages, 18-44 years, had means that were for both income levels had iron intakes that eii41 to 53 percent below the recommended allow- ther approached or were above the recomante. mended allowance. The exceptions were boys

White females aged 65 years and over in the aged 1-3 years who had means consistently beupper income group approached the recom- Iow the recommended allowances for alI race

mended allowance (96 percent of the recom- and income groups, 41 to 56 percent. Whit,e

mended allowance), but white females in the male youths 15-19 years in the lower incoml:

lower income group and Negro females in both group had means that averaged 17 percent below

income groups had mews ranging from 16 to 26 the recommended allowance. Negro boys 4-5

pe~cent below the recommended allowance. years in the lower income group had means 13

White and Negro males in most age groups percent below the recommended allowance. NeFigure 3. Mean intake of calories and selected nutrients aS a percentbelow~~CO~rnen&j

[Based on 1-day diet;

Sex and age

White female

1 year .................m........................................................

2-3 yea rs .....................................................................

4-5 years .............m.......................................................

6-7 yeers .....................................................................

%9 years .....................................................................

10-11 years .................................................................

12-14 years ......................................... ........................

15-17 years .................................................................

18-19 years ........................................................... .. ....

20-24 years .................................................................

25-34 years .................................................................

3544 years ............................................ ................ .....

45-54 years .................................................................

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

65 years end over .... ................ ................ .......... ..........

Negro female

1yeer ..... .....................................................................

2-3 years .......... ...........................................................

4-5 years .....................................................................

6-7 years .......... ...........................................................

8-9 years .......................................... ...........................

10-11 years ..........................................................d......

12-14 years .................................................................

15-17 years .. ...............................................................

18-19 years .......... .................................................d.....

20-24 years .................................................................

25-34 years .................................................................

3544 years .. ................................ ...............................

45-54 years ........................................... ................ ......

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

65 years and over ... ......................... ............................

1Excludes persons with unknown into me.

Al I

incomes

xxx

x

xxx

Xxxx

xx ——

xxx

xx

xx —— xx

xx

xxx

x

Xxxx

xxx

xxx

xxx

xx

xxx

xx

xxx

xxx

xxx

Xxxx

Calories

8elow

poverty

levell

xx

x

xxx

Xxxx

xxx

xxx

xx

xxx

xx

xxx

xxx

xx

xxx

xxx

xxx

Xxxx

xx

xxx

xx

xxx

xxx

Xxxx

Xxxx

Above

poverty

levell

.— x

xxx

x

xxx

Xxxx

xx

xxx

xx

xx

xx

xx

xxx

x

Xxxx

xx

xxx

xxx

xxx

xxx

xxx

Xxxx

xxx

xxx

xxx

Al I

incomes

x

——

x

.—

x

x

xx

x

xx

xx

Protein (gin)

Below Above

poverty poverty

Ievell Ievell

T1

xx

x I

a--

T

xx

xx x

+-l-x x

xx xx

x x

xxx I

xx

xx xx

NOTE: There was no one observed below the recommended dietary allowance for thiamine and riboflavin.
ackmeMa7

gro male youths 15-17 years in the lower income

group had means 30 percent below the recommended allowance, and those 15-19 years in upper income groups had means that averaged 26

percent below the recommended ‘allowance.

Higher density iron food sources are needed,

especially by women , if the recommended dietary allowances for iron are to be attained. The

desirability of meeting these recommended dietary allowances cannot, however, be determined

from data presented in this report, but must depend upon finding physiological and health related evidence of inadequate iron nutrition in

the population,, The second Health and Nutrition Examination Survey (HANES II), now in

operation, will provide some additional data relevant to making such a determination.

White boys 1-9 years in both income groups

had mean caloric intakes that approached or exceeded the recommended dietary allowances.

This was also true for white girls and Negro boys

1-7 years. For Negro girls, however, the corredietary allowance for females, by income level, race, and age: United States, 1971-74.

24-hour recall]

Calcium (mg)

Al I

Below Above

incomes poverty poverty

Ievell levell

x

x x

x x x

x

x xxx

xx xx xx

Xxxx xxx Xxxx

Xxxx Xxxx xxx

Xxxx xxx Xxxx

xxx Xxxx xxx

xxx xxx xxx

Al I

incomes

Xxxx

Xxxx

xx

x

x

Xxxx —.

Xxxx

Xxxx

Xxxx

Xxxx

Xxxx

Xxxx —.

Xxxx

x

Xxxx

Xxxx

xx

x

xx

Xxxx

Xxxx

Xxxx

Xxxx

Xxxx

Xxxx

Xxxx

Xxxx

xx

xxx

Iron (mg)

Below

poverty

levell

Abcwe

poverty

Ievell

I

Xxxx Xxxx

Xxxx Xxxx

-++

T

Xxxx Xxxx

Xxxx Xxxx

Xxxx Xxxx

Xxxx Xxxx

Xxxx Xxxx

Xxxx Xxxx

xx x

xx —x

--1-- Xxxx Xxxx

Xxxx Xxxx

x xx

x x

x xxx

-t

Xxxx Xxxx

Xxxx Xxxx

Xxxx Xxxx

Xxxx Xxxx

-

xxx Ixx

xxx xx

Vitamin A (1. U.)

Al I

incomes

x

Below

poverty

level I

x

x

xx

x

x

xxx

—,

Above

poverty

level 1

Vitamin C (mg)

All

incomes

Below Above

poverty poverty

Ievell Ievell

x = Below by 1-10 percent I

I

xx = Below by 11-20 percent

xxx = Below by 21-29 percent

xxxx = Below by 30 percent or I

I

more

I

xx
8 acimncedata —

spending pattern was evident only at ages 1-5

years for those in the lower income group and at

ages 1-7 years for those in the upper income

group.

White boys and men 10 through 74 years in

the lower income group generaIly had mean caloric intakes below the recommended dietary allowances. In the upper income group, this observation was evident only at ages 12-17 and 45-74

years. For those in the upper income group at

ages 10-11 and 18-44, the mean caloric intake

approached the standards.

Negro males and white and Negro females at

all ages from 8 through 74 years and in both

income groups had mean caloric intakes below

the standards.

The distribution of the mean caloric intake

as a percent of the recommended dietary allowances in population subgroups does not correspond to the distribution of the Iean and obese

persons across similar population subgroups.

Various possible explanations for this discrepancy range from reporting biases in the 24-hour

recall method of dietary interview to differences

in physical activity that are not reflected in the

recommended dietary allowances or to the adIowances themselves. The National Center for

Health Statistics is presently collecting data for

the purpose of examining the caloric-exerciseobesity relationship.

Mean protein intake for white boys and men

approached or exceeded the recommended di(etary allowances for all income groups. Negro

boys and men 1-54 years in both income groups

also had high protein in relation to the recommended dietary allowances, but at ages 55-64

years men in the lower income group and those

65 years and over in both income groups had

mean protein intakes that averaged about 13

percent below the recommended dietary allovrantes.

Mean protein intake for white girls and

women in the income group above poverty level

approached or exceeded the recommended dietary allowances at all ages. Corresponding values

for white girls and women in the lower income

group were similar except for those aged 15-17

and 55 years and over whose mean vzdues ave]raged about 16 percent below the recommended

dietary allowances.

Table B. Weighted average thresholds at the low income level in 1971, by farm-nonfarm residence, sex of family head, and size of family:

United States, 1971

Size of family

All unrelated individuals ........

Under 65 years ...................

65 years and over ...............

All families ...... ............ ...........

2 persons ............................

Head under 65 years ......

Head 65 years and

over ..............................

3 persons ............................

4 persons ............................

5 persons . .... .......................

6 persons ............................

7 persons or more ..............

--l Total

Total

$2,033 $2,040

2,093 2,098

1,931 1,940

3,700 3,724

2,612 2,633

2,699 2.716

2,424 2,448

3,207 3,229

4,113 4,137

4,845 4,880

5,441 5,489

6,678 6,751

1 For unrelated individuals, sex of the individual.

Nonfarm

Male

headl

$2,136

2,181

1,959

3,764

2,641

2,731

2,450

3,246

4,139

4,884

5,492

6,77J

Female

headl

$1,978

2,017

1,934

3,428

2,581

2,635

2,437

3,127

4,116

4,837

5,460

6,583

Total

$1,727

1,805

1,652

3,235

2,219

2,317

2,082

2,745

3,527

4,159

4,688

5,736

Farm

Male

head 1

$1,783

1,853

1,666

3,242

2,224

2,322

2,081

2,749

3,528

4,159

4,689

5,749

Female

headl

$1,669

1,715

1,643

3,079

2,130

2,1915

2,089

2,627

3,513

4,148

4,65I6

5,516

Source: U.S. Bureau of the Census: Characteristics of the low-income population, 1971, CWwerrt Population Reports, Series P-6 ID,

No. 86. U.S. Government Printing Office, Washington, 1972.
achmcda9

Negro girls and women also had average protein intakes above the recommended dietary allowances in both income groups except for

those women aged 35-44 and 55 years and over

in both income groups whose values averaged

about 16 percent below the recommended dietary allowances.

Other nutrients examined showed even less

evidence of any inadequacy in the general diet.

White and Negro males and white females of

all ages (1-74 years) and in both income groups

had mean calcium intakes that approached or

were above the recommended dietary allowances. Only Negro females at ages 20-74 years in

the lower income group and at ages 18-74 years

in the upper income group had calcium intakes

that ranged from 12 to 39 percent, on the average, below the recommended dietary allowances.

Males had mean vitamin A intakes at all ages

in both race and income groups that approached

or exceeded the recommended allowances. This

was also true for females in almost all age, race,

and income groups. The exceptions were white

females 20-24 yearn in the lower income group

whose means were 12 percent below the recommended allowances, and Negro females 12-14

years in the upper income group and those

15-17 years in the lower income group whose

means were 15 and 27 percent, respectively, below the recommended allowances.

Mean nutrient intakes of thiamine and riboflavin were above the recommended allowances

for all age, race, sex, and income groups. Mean

nutrients for vitamin C intakes were above the

recommended allowances for all age, race> sex,

and income groups, except for white males

25-34 and 45-54 years in the lower income

group whose intakes averaged 15 percent below

the recommended allowances.

CONCLUSION AND SUMMARY

The mean percent of dietary intake relative

to recommended dietary allowances has been

presented for calories, protein, calcium, iron, vitamins A and C, thiamine, and riboflavin. These

data, however, did not consider the distribution

of nutrient intakes because only the mean was

presented. The mean intake has limited value in

light of the variability of some nutrient distributions. High mean intakes can mask the fact that

a substantial proportion of individuals within a

group may have usual nutrient intakes far below

the recommended dietary allowances. However,

thk habitual intake of indhiduals cannot be estimated from knowledge of a single-day’s intake

as collected in HANES 1.7 Single-day intake

data, in contrast with intake data over larger periods of time, resuIt in greater variability of nutrient intakes that leads to a higher prevalence of

low intake when compared with the recommended dietary allowances, thus overestimating

the prevalence of habitual low nutrient intakes.

In spite of the limitations of the single-day

intake data tcl estimate individual habitual intake, the distributions of the means across

population subsamples are useful in identifying

influences on the diet related to population

characteristics. The presentation of dietary intakes relative to the recommended daily allowances of nutrients permits a co mpanson across

age and sex groups, which have different dietary

requirements.

Some nutrients, namely riboflavin and thiamine, show adequate or more than adequate

mean intake for all population subgroups defined by two levek of poverty, race, sex, and

age. Other nutrients, nameIy protein, calcium,

and vitamins A and C revealed some, but not

most, population subgroups with lower mean intake than the recommended dietary allowance.

Calcium mean intake was consistently lower

than recommended allowances only for adult

Negro women regardless of income. Vitamin A

mean intake was below recommended daily allowance in white adolescents and young adult

women in low income groups and among adolescent Negro women regardless of income. Protein

mean intake was also below the recommended

allowances for adolescents, adult women, and

older men in the low income group. This pattern

was also observed for adult Negro females and

Negro older men and for older white females in

the upper income group.

The mean dietary intakes of calories and

iron were below the recommended daily allowances for most of the population subgroups. Caloric intake was below the recommended daily

allowances for all except the younger child regardless of sex, race, and income group. Iron

intake was below the recommended daily allow-
10 adwlncedata

ante for al the female income, race, and age recommended daily aI1owances, as compared with

groups and for males in the preschool years and the much smaller extent of inadequacy as measadolescence. urecl by physiological measures, g,9 that one

There is such a discrepancy between these must reserve judgment about the relationships of

patterns of nutrition adequacy of iron and calo- income, race, sex, and age to malnutrition until

ties as measured by the mean intake relative to these measures are interpreted together.

REFERENCES

1National Center for Health Statistics: Calorie and

Selected Nutrient Intake Values of Persons, 1-74 Years,

United States, 1971-1974. Vital and Health Statistics.

Series 11. Health Resources Administration, DHEW,

Rockville, Md. To be published.

2 Caloric Requirements, FAO Nutr. Stud. No. 15,

Rome (1957); Protein Requirements, FAO/WHO, FAO

Nutr. Meetings Rep. Ser. No. 37, WHO Tech Rep. Ser.

No. 301, Rome (1965); Calcium Requirements, FAO/

WHO. FAO Nutr. Meet. Rep. Ser. No. 30. WHO Tech.

Rep. Ser. No, 230, Rome (1962); Requirements of Vitamin A, Thiamine, Riboflavin, and Niacin. FAO/WHO

FAO Nutr. Rep. No. 41. WHO Tech. Rep. Ser. No. 362,

Rome (1967); and Requirements of Ascorbic Acid, Vitamin D. Vitamin BI ~, Folate and Iron, FAO Nutr. Meet.

Rep. Ser. 47. WHO Tech. Rep. Ser. No. 452, Geneva

(1970).

31nter-departmental Committee on Nutrition for National Defense: Manual for Nutrition Surveys, 2d. ed.

National Institutes of Health. Bethesda, Md., 1963.

4National Academy of Sciences-National Research

Council: Recommended Dietary Allowances. National

Research Council Pub. 1694, 7th ed. Washington, D. C.,

1968.

5 Center for Disease Control: “Ten-State Nutrition

Survey in the United States, ” 1968-1970. V-Dietary,

DHEW Pub. No. (HSM) 72-8133. Atlanta, Ga. Health

Services and Mental Health Administration, 1972.

6Keys, A., and Grande, F.: Body weight, body corrRposition, and calorie status in R. S. Goodhart and M. E.

Shils, eds., Modern Nutrition in Health and Disease. Philadelphia. Lea and Febiger, 1973. p. 20.

7 Hegsted, D. M.: Dietary Standards. J. Am. Dietetic

Association, p. 13-21, 1974.

8 National Center for Health Statistics: prelimiriarY

findings of the First Health and Nutrition Examination

Survey, United States, 1971-1972, Dietary Intake and

Biochemical Findings. DHEW Pub. No. (HRA)

74-1219-1. Health Resources Administration. Washington. U.S. Government Printing Office, Jan. 1974.

9 National Center for Health Statistics: Preliminary

findings of the First Health and Nutrition Examination

Survey, United States, 1971-72, Anthropometric and

Clinical Findings. DHEW Pub. No. (HRA) 75-1229.

Health Resources Administration. Washington. U.S. Government Printing Office, Apr. 1975.
acimncedata 11

Table 1. Mean caloric intake as a percent of recommended dietary allowance, by race, sex, and age for income levels: United States,

1971-74 (HANES 1)

White male

I

Negro male White female Negro female

Age Income Income

below above

poverty poverty

1evel level

Income

below

poverty

level

Income

above

poverty

level

Mean caloric intake

139

132

124

127

99

87

78

80

81

86

80

98

82

70

71

125

124

121

112

95

95

84

88

94

97

93

90

85

81

75

116

128

120

108

77

82

74

71

82

84

94

85

75

78

64

126

116

124

904

87

94

75

66

79

78

81

78

89

77

72

125

119

109

98

78

98

72

69

85

78

83

85

86

81

79

117

111

104

88

72

78

74

69

89

78

81

74

71

66

68

126

116

111

91

65

81

76

71

71

79

79

70

72

74

71

1year .............................

2-3 years ........................

4-5 years ........................

6-7 years ............ ............

8-9 years ........................

10-11 years ..... ...............

12-14 years ....................

15-17 years ....................

18-19 yaars ........... ...... ...

20-24 years ....................

25-34 years ....................

35-44 years ....................

45-54 years ........ ............

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

65 years and over ...........

115

126

103

107

87

68

69

66

87

78

87

83

67

57

67

Table 2. Mean protein intaka asa percant of recommended dietary allowance, by race, sex, and age for income levels: United States,

1971-74 (HANES 1)

I I I

White male

I

Negro male I Wlqitefema,e I Negrofemale

Age Income Income Income Income Income Income Income

below above below above below above below

poverty poverty poverty poverty poverty poverty

level level level

poverty

level level level level

Income

above

poverty

level

Mean protein intake

224

214

222

249

162

179

135

123

122

119

142

134

122

115

85

254

232

247

243

214

185

126

85

99

95

100

97

98

85

83

——

1year, ... .........................

2-3 years ..... ...................

4-5 years ..................... ...

6-7 years ........................

8-9 years ..... ...................

10-11 years ....... .......<.....

12-14 years ....................

15-17 years ....................

18-19 years ....................

20-24 years ............. .......

25-34 years ............ ........

35-44 yaars ....................

45-54 years ....................

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

65 years and over ...........

224

238

195

237

187

135

127

120

138

122

149

110

114

87

88

244

221

214

226

180

172

119

101

119

105

107

104

109

100

92

217

203

206

197

164

161

110

93

124

92

94

88

95

73

85

224

225

214

209

142

154

126

101

106

106

97

87

91

87

85

256

243

232

293

233

192

156

142

147

124

137

154

113

92

92

236

228

235

265

216

200

164

159

161

148

142

134

126

116

103
12 adwncedata

Table 3. Mean calcium intake as a percent of recommended dietary allowance, by race, sex, and aqe for income levels: United States,

1971-74 (HANES 1)

1 1 1

White male I

Negro male IWhite female INegro female

Age

1year ...................... .... ...

2-3 years ........................

4-5 years ............... .........

6-7 years ........................

8-9 years ..................... ...

10.11 years ....................

12-14 years ....................

15-17years ....................

18-19 years .................. ..

20-24 years ....................

25-34 years ............. .......

35-44 years ....................

45-54 years ....................

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

65 years and over ...........

Income

below

poverty

level

234

218

207

219

238

189

181

250

209

238

210

331

207

204

155

Income Income Income Income Income Income Income

above below above below above below above

poverty poverty poverty poverty poverty poverty poverty

level level level level level level level

Mean calcium intake

213

196

234

260

276

192

211

239

242

294

276

228

217

198

188

174

160

152

204

205

115

120

139

148

247

157

146

161

134

140

160

159

206

242

194

158

140

144

164

162

198

194

145

160

135

252 207

181 199

214 204

248 234

243 132

135 183

144 156

109 139

119 143

106 116

100 113

99 104

104 102

102 98

91 98

134

152

157

163

155

119

118

99

112

88

74

66

74

68

78

182

162

166

172

164

I:~4

108

114

79

85

69

72

61

7’6

7’2

Table 4. Mean iron intake as a percent of recommended dietary allowance, by race, sex, and age for income levels: United States,

1971-74 (HANES 1)

Age

1 year .............................

2-3 years ............... .........

4-5 years ........................

6-7 years ...... ..................

8-9 years ........................

10-11 years ....................

12-14 years ..... ...............

15-17 years ....................

18-19 years ....................

20-24 years ....................

25-34 years ....................

35-44 years .......... ..........

45-54 years ....................

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

65 years and over ...........

White male

I

Negro male I

White female I

Negro female

Income Income Income Income Income Income Income Income

below above below above below above below above

poverty poverty poverty poverty poverty poverty poverty

level

poverty

level level level level level level level

Mean iron intake

49

53

92

124

116

130

95

78

88

143

174

174

129

111

113

51

56

95

112

112

128

97

95

94

171

168

160

148

140

125

44

58

87

94

107

94

105

x

132

174

136

123

108

112

59

52

97

105

111

133

90

77

71

140

159

149

133

139

104

32

49

86

89

111

66

65

45

51

52

53

52

54

86

81

51

47

82

97

98

57

56

53

58

56

58

59

59

99

96

43

45

93

90

98

61

56

49

57

54

54

47

48

75

74

46

58

89

98

74

59

61

59

51

59

53

49

5’0

84

84
ackmedm 13

Table 5. Mean vitamin A intake as a percent of recommended dietary allowance, by race, sex, and age for income levels: United States,

1971-74 (HANES 1)

White male I

Negro male I

White female Negro female

Income

below

poverty

level

Income Income Income

above below above

poverty poverty poverty

level level level

Income

below

poverty

level

Income

above

poverty

level

Income

below

poverty

level

Incoma

above

poverty

level

Age

Mean vitamin A intake

138

154

239

243

194

196

112

97

105

159

158

166

158

197

170

138

144

187

145

258

184

126

95

94

88

86

98

260

136

125

——

276

190

196

174

183

167

161

133

109

113

148

195

121

109

97

187

179

186

164

191

211

157

178

174

148

151

149

148

165

167

179

213

198

203

139

151

170

101

105

215

149

126

167

257

167

175

147

178

141

153

165

167

108

117

106

127

121

150

180

157

181

195

171

176

138

138

129

73

139

134

121

100

142

164

128

266

464

160

153

108

129

85

108

126

103

104

133

141

170

160

1year ...................... .......

2-3 years ........................

4-5 years ........................

6-7 years ............. ...........

8-9 years ........................

10-11 years ....................

12-14 years ....................

15-17 years ....................

18-19 years ....................

20-24 years .................. ..

25-34 years ................. ...

3544 years ................ ....

45-54 years ....................

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

65 years and over ...........

Table 6. Mean vitamin Cintake asa percent of recommended dietary allowance, byracE,, sex, andagefor income levels: United States,

1971.74 {HANES I)

White male Negro male White female Negro female

Age Income

below

poverty

Iavel

Income Income Income

above below above

poverty poverty poverty

level level level

Income Income Income Income

below above below above

poverty poverty poverty poverty

level level level level

I I I

Mean vitamin C intake

148 97

147 167

199 153

260 166

211 275

180 178

247 126

130 149

106 181

185. 151

139 107

150 111

129 107

203 124

128 130

109

195

173,

158

183

133

163

156

170

147

88

115

82

112

95

191

220

226

214

200

232

200

203

228

185

155

139

143

163

158

163

177

194

203

165

118

175

190

151

138

107

164

158

122

148

161

189

198

203

207

213

176

147

192

155

140

150

155

182

174

242

154

238

227

123

208

194

142

136

140

139

135

118

199

167

1 year .............................

2-3 years ........................

4-5 years ........................

6-7 years ........................

8-9 years ........................

10-11 years ....................

12-14 years ....................

15-17 years ....................

18-19 years ....................

20-24 years ....................

25-34 years ....................

35-44 years ....................

45-54 years ....................

55-84 years ............ ........

65 years and over ... ........

139

152

220

190

223

215

170

127

164

138

123

127

106

123

132
14 acklncedata

Table 7. Mean thiamine inteke as a percent of recommended dietary allowance, by race, sex, and age for income levels: United States,

1971-74 (HANES i)

Age

I

1 year .............................

2-3 years .................. ......

4-5 years ........................

6-7 years ........................

8-9 years ........................

10-11 years ....................

12-14 years ....................

15-17 years ....................

18-19 years ....................

20-24 years ....................

25-34 years ....................

3544 years ....................

45-54 years ....................

55-64 yeers ...... ..............

65 years and over ...........

White male Negro male

Iricome Income Income Income

below above below ebove

poverty poverty poverty poverty

level level level Ievel

158

168

168

165

145

175

170

152

147

155

163

157

145

160

167

175

173

165

163

152

163

150

152

145

145

156

147

155

165

172

173

195

193

165

152

165

165

158

163

152

162

165

172

177

182

White female

Income Income

below above

poverty poverty

level level

Mean thiamine intake

193

163

208

163

170

163

163

143

140

145

150

147

172

163

172

163

175

163

150

180

167

170

135

167

160

160

163

147

172

180

198

173

163

163

163

150

158

158

157

160

163

163

170

180

185

Negro female

Income Income

below above

poverty poverty

level level

163

163

180

168

168

175

160

152

150

172

167

157

198

167

190

205

188

188

163

165

173

165

198

163

170

155.

165

170

177

170

Table 8. Mean riboflavin intake as a percent of recommended dietary allowance, by race, sex, and age for income levels: United States,

1971-74 (HANES i)

Age

1 year .............................

2-3 years ........................

4-5 years ............. ...........

6-7 years ........................

8-9 years ........................

10-11 years ....................

12-14 years ....................

15-17 years ....................

18-19 years ....................

20-24 years ....................

25-34 years ....................

35-44 years ....................

45-54 years ....................

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

65 years and over ...........

White male Negro male White female Negro female

Income Income Income Income Income Income income

below

Income

above below above below above below above

poverty poverty poverty poverty poverty poverty poverty

level level

poverty

level level level level level level

Mean riboflavin intake

256

215

185

169

181

196

184

185

173

167

162

181

162

180

169

242

207

200

202

202

195

187

175

169

158

160

158

163

173

178

233

193

173

196

162

164

189

149

129

169

145

129

154

205

158

222

175

218

189

175

167

145

142

145

132

140

153

156

154

200

293

218

198

198

202

167

178

158

149

158

162

178

222

191

194

260

215

205

196

195

193

187

181

173

167

175

167

178

196

196

200

211

176

173

156

164

165

142

140

156

149

142

193

153

176

247

180

180

167

173

160

142

185

149

136

134

163

158

171

165
adwncedata 15

TECHNICAL NOTES

The sampling plan for the 65 preselected examination locations in the Health and Nutrition

Examination Survey (HANES) followed a highly

stratified multistage probability design in which

a sample of the civilian noniristitutionalized population of the conterminous United States 1-74

years of age was selected. Successive elements

dealt with in the process of sampling were the

primary sampling unit, census enumeration district, segment (a cluster of households), house5oId, eligible person, and finally, sample person.

The sampling design provided for oversarnpling

imong persons living in poverty areas, preschool

:hildren, women of childbearing age, and the

:lderly.

The caloric and selected nutrient intake values are shown as population estimates, that is,

the dietary intake findings for each individual

have been “weighted” by the reciprocal of the

probability of selecting the person. An adjustment. for persons in the sample who were not

examined and poststratified ratio adjustments

were also made, so that the final sampling estimates of the population size agree exactly with

the independent U.S. Bureau of the Census estimates for the civilian noninstitutionalized population of the United States as of NTovember 1,

1972, by race, sex, and age.

Previous issues of .lduance Data From I“italand Healtlz Statistics

No. 1. Blood Pressure of Persons 6-74 Years of Age in the United States

(Issued: October 18, 1976)

No. 2. Hypertension: United States, 1974 (Issued: November 8, 1976)

No. 3. Height and Weight of Adults 18-74 Years in the United States (Issued: November 19, 1976)

Nc). 4. Prevalence of Dermatological Diseases Among Persons 1-74 Years of

Age, United States (Issued: January 26, 1977)

No. 5. A Comparison of Levels of Serum Cholesterol of Adults 18-74 Years

of Age in the United States in 1960-62 and 19;71 -74
FROM VITAL & HEALTH STATISTICS OF THE NATIONAL CENTER FOR HEALTH STATISTICS

U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE ] No. 7 May 25, 1977 I Pubhc Health Serwce. Health Resources Admln!stratlon

Total Serum Cholesterol Level of Adults 18-74 Years of Age,

United States, 1971-74a

The serum cholesterol level in this report

were obtained as a part of the Health and Nutrition Examination Survey (HANES). HANES is a

program of the National Center for Health Statistics in which measures of nutritional status are

coIlected for a scientifically designed sample representative of the civilian, noninstitutionalized

population of the United States in a broad range

of ages, 1-74 years.1

Field data collection operations for the first

HANES survey were started in April 1971 and

completed in June 1974. Of the 28,043 persons

aged 1-74 years who were select ed in the national probability sample to represent the 194 million persons in that age group in the civilian noninstitutionalized population, 20,749, or 74 percent, were examined. When adjustments were

made for the differentizil sampling ratios used.

for the effect of oversampling among the poor,

preschool children, women of childbearing age,

and the elderly, this corresponds to an effective

response rate of 75 percent. There were 13,645

people ages 18-74 years on whom serum cholesterol level determinations were made. Selected

from the national probability sample of 19,572,

these individuals represented the 128 mfllon of

that age group in the population. This is an unadjusted response rate of 70 percent and an effective adjusted response rate of 70 percent. Detailed estimates of the distribution of serum cholesterol levels till be described and analyzed in a

forthcoming report in Series 112 of Vital and

Health Statistics. Selected data and findings

‘This feport prepared by Sidney Abraham, Clifford L.

Johnson, and Margaret D. Carrel.

from that report are presented in tables 1-5 and

figures 1-3 of this Advance Data.

Serum cholesterol levels have been identified

as one of the important multiple risk factors in

the development of coronary heart disease. The

results of epidemiologic studies based on adult

data from longitudinal studies such as the Frarningham Heart Studys have demonstrated that

persons with eIevated serum cholesterol values

developed coronary heart disease with greater

frequency. Serum cholesterol levels of adults

aged 18-74 years are presented and analyzed by

age, sex, and race because of medical interest in

such data. HANES provided cross-sectional data

of serum cholesterol levels obtained on different

age cohorts representative of the U.S. population. The age trends represented mean levels for

successive cohorts of different age groups. The

limitation of cross-sectional data are recognized

in considering group age changes because they

reflect effects of environmentaI as well as developmental and heredity influences.

AU serum cholesterol determinations for

HANES were made in the Lipid Standardization

Laboratory of the Center for Disease Control

(CDC), Public Health Service, AtIanta, Georgia.

The analytical method was based on that of

Abell et al.,4, but was modified for a semiautomated production line. ‘l%e method, described

in detail by Eavenson et al.s was made possible

by the development of a relatively stable Liebermann color neagent and was designed for automatic pipetting units.

The Lipid Laboratory compared the results

obtained with this semiaut omat ed method with

those obtained from their .@ndardized version.A

To examine the bias of the semiautomated
2 acwncedata

method, data were obtained from pools of sera

analyzed by the reference method and by the

semiautomated method. In 1972, pools ranging

from 134 to 343 mg per 100 ml had an average

positive bias of 4.07 percent for the semiautomated method as compared to the standard

method; for the 1973-74 period, the corresponding figure was a positive bias of 4.9 percent. The

weighted average bias was 4.5 percent. The

1971-1974 data in this report are presented

without correction for bias so that they provide

population reference standards for determinations made by the semiautomated methodology

now in use. However, in the series report,

HANES’ 1971-1974 serum cholesterol data are

corrected for bias when HANES data are compared with Health Examination Survey data of

1960-1962.

PRINCIPAL FINDINGS

For men, the lowest mean serum cholesterol

level occurs in the youngest age group measured,

18-24 years. However, the mean level increases

steadily with age until the age group 35-44

years. Then it increases by a small increment to

a maximum level of 240.2 mg per 100 ml at the

age group 55-64 years, declining slightly to a

mean level of 236.2 mg per 100 ml at the oldest

Figure 1. MEAN SERUM CHOLESTEROL LEVELS OF ADUI_TS

BY SEX AND AGE: UNITED STATES, 1971-74

270

r m ,6

260

-~’

2568 . ...””’

. . . . . . . ...’

. .

,..

# 25o ,...”

~

2426 /...” ~40,2

/“’

~ 240 23s 2

&

239,4

: 230

2313 /“”

...””

z

...”.

$

220 /“”

? 2103 .. .

.“”>165

: 210 ...””

...

& ...

I

~ 200

. ..””203.2

. . .

~ ,9, , . ““

. . .

— Men

g 190 . . . . . . l/+J~~”

z ,86s

<

s

180

k

170

0

I I I I I

18.24 25-34 3544 45.54 55.64 65.74

AGE IN YEARS

age group measured, 65-74 years (table 1, figure

1).

For women, the mean serum cholesterol

levels do not parallel those of men in the same

Table 1. Serum cholesterol level of adults 18-74 years by sex and age with mean, standard deviation, and standard error of the mean:

United States, 1971-74

Age

All ages

18-74 years, . ...... ...

18-24 years .. ............ .. ..

25-34 years .. ................

3544 years ..................

45-64 years, ................ .

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

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

Meanl

223.4

189.4

206.6

223.6

241.1

248.9

250.7

Both sexes

Standard

deviation

51.5

39.0

43.2

45.3

49.7

50.3

54.2

Standard

error of

the mean

0.80

1.41

1.42

1.50

1.48

2.48

1,35

Mean 1

221.8

186.9

210.3

231,3

239.4

240.2

236.2

Men

Standard

deviation

49.9

36.7

44.0

45.9

47.0

51.2

53.8

Standard

error of

the mean

1.09

1.89

2.27

2.53

2.54

3.17

2.05

Women

I

Meanl

Standard

deviation

I

I

==+--=

L

191.7 41.0

203.2 42.2

216.5 43,5

242.6 . 52.0

256.8 48.2

261.6 51.9

Standard

error of

the mean

0.991

1.92!

1.391

1.37

2.36

2.71!

1.92!

lMg per 100 ml.
ackmeMa3

age groups. The serum cholesterol levels are

slightly higher for women than for men in the

age group 18-24 years. However, in the older age

groups, there is a slight but consistently higher

mean serum cholesterol level for men as compared with that for women until the age group

45-54 years. Thereafter the mean levels for men

show a plateau effect and a slight decrease, while

the mean levels for women continue upward to

256.8 mg per 100 ml at age 55-64 years and to a

maximum value of 261.6 mg per 100 ml at the

age group 65-74 years (table 1, figure 1).

The standard deviations of the distributions

by age and sex are shown in table 1. The variability within each age and sex group increases

with age as indicated by the standard deviations.

Although the differences are small, men show

greater variations around their mean levels at

most age groups than women do. The percent

distribution of men and women 18-74 years of

age falling into each of the 16 groups according

to their levels of cholesterol are shown in tables

2 and 3.

Mean serum cholesterol leveIs for white men

are consistently higher than those for Negro men

at ages 18-24, 35-44, and 45-54. The differences

in mean IeveIs range from 2.3 to 6.8 mg per 100

ml. The same direction is not evident at ages

25-34 and ages 55 years and older, when Negro

men have higher mean serum cholesterol levels

than those of white men. However, the differences in mean levels are smaIl and range from

1.0 to 4.3 mg per 100 ml (table 4 and figure 2).

The mean serum cholesterol level for white

and Ne~o men generally increases with age. The

mean level fcm white men increases rapidly to

the age group 35-44 years. The mean level then

continues up~vard at a slower rate of increase,

reaching a peak of 239.9 mg per 100 ml at ages

45-64 years, and declines slightly thereafter. The

mean levels for Negro men also increase with age

but at a slower rate; they are slightly higher at

the older ages and peak at a later age–55-64

years-than those for white men. A slight decline

in mean level also occurs in the age group 65-74

years.

Table 4 and figure 3 show that mean serum

cholesterol leveIs for hyegro women are consistently higher than those of white women in the

age groups under age 65 years. In the oldest age

group measured, 65-74 years, the mean levels for

white women are slightIy higher than those for

Negro women, a difference of 2.1 mg per 100

mI. The mean levels for Negro and white women

Table 2, Percent distribution of serum cholesterol levels of men by age: United States, 1971-74

Serum cholesterol level

(mg per 100 ml)

Total .............................................

Under 100 ..........................................,

100.119 ...............................................

120-139 ...............................................

140-159 ...............................................

160-179 ..............................................

180-199 ..............................................

200-219 ..............................................

220-239 ..............................................

240-259 ..............................................

260-279 ..............................................

280-299 ..............................................

300-319 ..............................................

320-339 ..............................................

340-359 ..............................................

360-379 ..............................................

380 or more ........................................

0.1 0.1

0.4 1.0

2.1 5.6

5.6 16.4

11.5 23.5

15.6 23.1

16.2 13.4

16.0 7.4

12.0 5.5

8.8 2.0

4.6 0.8

3.3 1.0

1.7 0.0

x

35-44 45-54

years years

Percent distfibutlon

100.0

0.3

2.8

5.3

15.4

20.6

19.9

13.9

9.8

5.6

3.4

0.9

0.8

0.3

0.4

0.6

100.0

0.1

0.8

2.3

9.1

12.9

18.1

17.2

14.3

11.7

4.8

3.3

3.7

1.1

0.0

0,6

100.0

0.4

0.3

0.3

3.0

5.4

8.3

16.4

20.1

15.7

11.3

7.3

6.5

1.6

2.9

0.2

0.3

55-64 65-74

years years

100.0

0.1

0.0

1.3

1.1

4,4

13,6

12.8

23.2

13.8

12,7

6.2

5.3

2.2

1.2

0.9

1.2

100.0

0.2

0.3

1.2

2,8

5.9

12.3

17.3

16.0

14.8

12.7

7.1

4.3

2.4

0.8

0.9

1.0

NOTE: Percents may not add to 100.0 due to rounding.
4

Figure 2. MEAN SERUM CHOLESTEROL LEVELS OF MEN

BY AGE AND RACE: UNITED STATES, 1971-74

270

260

F

~

243.9

cc 240 —

23s0 . . . . ..””%...-

:

23! s

2383

g 230 —

z

g 220 —

K

:

/

3 210 —

.

g

z

3

a — White

:

190 . . . . . . Negro

6

~ 180 —

J’

o

I I I I I

18.24 25.34 3544 45.54 5564 65.74

AGE IN YEARS

Figure 3. MEAN SERUM CHOLESTEROL LEVELS OF WOMEN

BY AGE AND RACE: UNITED STATES, 1971-74

270 ~

260

260,8 26$,8

2169

— White

...... Negro

.1911

z

a

~ 180

t

;+

18.24 55=54 65.74

AGE IN YEARS

Table 3. Percent distribution of serum cholesterol levels of women by age: United States, 1971-74

All

Serum cholesterol level ages 18-24 25-34 35-44 45-54 55-64

(mg per 100 ml) 18-74

65-74

years . years years yea rs years years

yaars

Total ... ... ........ ........................... 100.0

Under 100.. . ....................................... 0.1

loo.li9 .......... .... ................................. 0.4

120.139 ................................................ 2.2

140.159 .......... .......... ........ ........ ...... ...... 5.8

160.179 .......................... .. ........ ............ 10.6

180.199 .... ........ .................................... 15.2

20021 9 ................................................ 16,2

220.239 ................................................ 14.6

240.259 ............... ............. .................... 11.7

260.279 .............................................. .. 9.1

28 0.299 ................................................ 5.6

3oo.319 ........ ........ ................................ 3.8

32 0.339 ............................................... . 2.2

340.359 ........ ................ ........ ........ ........ 1.0

36@379 ......................... ....................... 0.8

380 or more .... ...................................... 0.7

100.0

Percent distribution

100.0

0.3

0.6

3.1

8.1

16.2

21.8

20.6

12.2

8.0

5.4

1.6

1.0

0.4

0.3

0.1

0.3

100.0

0.1

0.3

1.3

4.9

11.0

19.0

21.5

16.4

11.8

6.3

3.2

2.5

1.0

0.3

0.1

0.3

100.0

0.1

0.6

2.6

5.0

11.7

15.4

18.5

14.4

12.0

8.1

3.9

3.3

1.2

1.7

1.5

100.0

0.1

0.2

1.0

2.6

7.4

11.8

14.8

16.2

16.8

10.8

8.9

4,4

2.0

1.9

1.1

. 100.0

0.4

0.8

1.6

2.0

5.1

9.1

14.3

77.7

14.7

13.6

9.0

5.4

3.0

1.8

1.5

NOTE: Percents may not add to 100.0 due to rounding.
acklcd@5

increase with age to 55-64 years. Then the mean

Ievel for Negro women declines slightly while it

continues to rise less rapidly for white women

although it slightly exceeds the Negro women’s

level.

Age not only affects the comparison of

mean serum cholesterol levels between races but

also the comparison levels between sexes. For

example, the mean Ievek of white and Negro

men in the youngest age group measured, 18-24

years, are slightly lower than the mean levels for

women of both races at the same age (table 4).

Although a crossover occurs in the midthirties,

the pattern reverses again after age 45, when the

mean levels for women are higher and increase

more rapidly than those for men, particularly

after age 55.

The distribution of serum cholesterol levels

was also used to note the proportion of persons

in any race-sex-age group that exceeds the level

of 260 mg per 100 ml and more. These measurements were used to estimate the prevalence of

elevated serum cholesterol levels. Although there

is no statistical information regarding the actual

level of serum cholesterol separating “high”

from “low” risk individuals, the level of 260 mg

per 100 ml has been cited in studies to distinguish “high” from ‘less high” or “Iow”.

Among men, proportions varied from a low

of 4.0 percent in age group 18-24 years to a high

of 30.1 percent in age group 45-54 years. The

level then declines to about 29 percent at ages

55 and older (table 5).

Among women, the Iowest proportion also

occurs at the youngest age group measured—

18-24 years-with the proportion increasing

steadily with age until it reaches a maximum of

49.2 percent at the age group 65-74 years.

At the younges$-age group measured, 18-24

years, and at the ages of 45 years and older,

there are higher proportions of women with serum cholesterol levels of 260 mg per 100 ml and

more than there are of men. This pattern is not

evident for age groups 25-34 and 35-44 years

when the proportions are higher for mzdes than

for females. III the age groups 18-24 and 45-54

years, the differences in proportions between

the sexes are small-slightly more than 1.5 percent. These differences are much larger in the

ages 55 years and older. Elevated serum cholesterol levels increase with age for women but

show a slight decrease for men at ages 55 years

and over.

There are higher proportions of white and

Negro women with serum cholesterol levels of

260 mg per 100 ml and more than there are of

Table 4. Swum cholesterol levels of adults 18-74 years by race, sex, and age with mean, standard deviation, and standard error of the

mean: United States, 1971-74

1 White I Negro

‘ge +

Meanl

Standard

deviation

All ages

18-74

years ........

18-24 years..

25-34 years..

35-44 years..

45-54 years..

55-64 years..

65-74 years..

222.2 49.7

187.3 37.2

209.9 42.4

231.5 45.5

239.9 47.4

239.9 50.6

236.3 54.3

Standard

error of

the mean

1.09

2.07

2.38

2.49

2.61

3.41

2.40

vlean 1

225.1

191.1

202.8

216.4

242.5

256.4

261.8

Women Men

Standard

ieviation

63.0

41.1

42.4

42.8

52.5

47.8

52.3

Standard

error of Meanl

he mean

L1.02 218.9

2.11 185.0

1.47 214.2

1.56 224.7

2.49 237.1

2.89 243.8

2.02 237.3

Standard

ieviatims

——

52.7

32.5

57.0

51.7

422

.5t3.8

4s.4

Standard

error of

the mean

3.41

3.75

9.26

8.56

5.61

11.65

3.40

klean 1

224.0

194.7

207.3

216.9

244.7

260.8

258.7

Women

Standard

~eviation

50.5

38.9

40.7

42.2

46.5

52.6

47.7

standard

error of

he mean

1.78

3.33

3.42

3.25

6.49

5.68

3.78

lMg per 100 ml.
6 achtancedata

men in ages 18-24 and 45 years and older (table

5). This pattern is reversed for the age groups

25-34 and 35-44 years, when the proportions

are higher for white and Negro men than for

women of both races. In the age group 45-54

years, the differences in proportions between

white men and women are O.6 percent while the

differences between Negro men and women are

11.8 percent. The differences are larger in the

ages 55 years and older, particularly for white

amen as compared to white women, 16.8 and

20.5 percent, respectively.

The proportion of white men and women

with serum cholesterol levels of 260 mg per 100

ml and more in the youngest age group measured, 18-24 years, are consistently higher than

those of their Negro counterparts (table 5).

However, the pattern is reversed for the age

group 25-44 years, when the proportions of serum cholesterol levels for Negro men and

Table 5. Prevalence rates for serum cholesterol levels of 260 or more among adults 18-74 years by race, sex, and age with standard errors:

United States, 1971-74

Sex and age

Both sexes

All agas 16-74 years ..........

18-24 years .. ..........................

25-34 years ..................... ...... .

3544 years .. .......... ......... .......

45-54 years ............................

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

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

—Men

All ages 18-74 years ..........

18-24 years .. .. ........................

25-34 years ............................

35-44 years ............................

45-54 years ............................

55-64 yaars ............................

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

Women

All ages 1B-74 years ..........

18-24 years ................. ...........

25-34 years ............................

35-44 years ......... ............. ......

45-54 years ....................... .....

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

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

Rata

per

100

Rersonsl

21.9

4.8

10.5

19.3

31.0

38.2

40.6

20.4

4.0

12.1

25.3

30.1

29.7

29.2

23.2

5.6

9.1

13.7

31.8

45.9

49.2

opulation

estimate

in

housands

27,974

1,134

2,81>

4,352

7,28S

7,203

5,185

12,35E

451

1,53:

2,73!

3,39:

2,63E

1,60!

15,616

6K

1,27!

1,61[

3,89i

4,56i

3,577

tandard

!rror of

rat e

0.58

0.54

0.84

1.22

1,61

2.32

1.27

0.87

0.78

1.46

2.13

2.22

2.39

1.38

0.79

0.87

0.97

1.19

2.08

3,04

1.81

Prevalence rate for serum Standard error of prevalence

cholesterol levels of 260 rate for serum cholesterol

or moral levels of 260 or morel

—

White Negro White Negro

22.1

4.9

10.3

19.2

31.2

38.2

40.9

20.6

4.1

11.7

24.9

30.9

29.4

29.2

23.5

5.6

9.0

13.7

31.5

46.2

49.7

Rate per 100 persons

20.4

4.0

12.5

18.4

30.2

40.3

38.7

19.0

2.5

14.9

25.6

24.2

34.0

30.3

21.6

5.3

10.4

14.1

36.0

44.6

44.9

0.60

0.62

0.84

1.18

1.69

2.44

1.37

0.92

.0.88

1.54

2.03

2.25

2.59

1.57

0.63

1.05

0.98

1.22

2.19

3.19

1.90

1.30

0.82

3.50

3.43

4.58

4.54

3.32

1.87

—

1.68

5.10

7.00

5.82

10.20

3.38

1.58

1.48

2.87

2.71

6.81

5.67

4.29

lMg per 100 ml.
adumsaa7

women are slightly higher than their white levels than white women and Negro men. In concounterparts. Consistent findings are not found trast, in the age groups 55-64 and 65-74 years,

in the

years,

higher

;Ider age groups. In the ;ge group 45-54 Negro men an~ w-tite-women have a higher elewhite men and Negro women have a vated serum cholesterol level than white men

proportion of elevated serum cholesterol and Negro women.

REFERENCES

1National Center for Health Statistics: Plan and operation of the Health and Nutrition Examination Survey,

United States, 1971-1973. Vital and Health Statistics.

Series 1, No. 10a and 10b. DHEW Pub. No. (HSM)

73-1310. Washington. U.S. Government Printing Office,

Feb. 1973.

2National Center for Hezdth Statistics: Total Serum

Cholesterol Level of Adults, 18-74 Years of Age, United

States, 1971-1974. Vital and Health Statistics. Series 11.

Health Resources Administration. To be published.

3Gordon, T., and Verter, J. I.: The Framinghasn

Study: An Epidemiological Investigation of Cardiovascular Disease. Section 23. Serum cholesterol, systolic

blood pressure and Framingham relative weight as discriminators of cardiovascular disease. Bethesda, Md., National Institutes of Health, 1969.

4Abell, L.L., Levy, G. B., Brodie, B.B., and Kendall,

F.E.: A Simplified Method for the Estimation of Total

Cholesterol in Serum and Demonstration of Its Specificity. J.Biol. Chem. 195:357, 1952.

5Eavenson, ;D., Gner, O.T., Cisson, J. G., and Witter,

R. F.: A semiautomated procedure for the determination

of serum cholesterol using the AbeII-Kendall method.

J.Am. Oil Chem. Sot. 43:652,1966.

TECHNICAL NOTES

The sampIing plan for the 65 pre-selected

examination locations in the Health and Nutrition Examination Survey (HANES) followed a

highly stratified muIti-stage probability design in

which a sample of the civilian, noninstitutionalized population of the conterminous United

States, 1-74 years of age, was selected. Successive elements dealt with in the process of sampling were the primary sampling unit, census

enumeration district, segment (a cluster of

households), household, eligible person, and

sample person. The sampling design provided for

over-sampling among persons living in poverty

areas, preschool children, women of childbearing

age, and the elderly.

The serum cholesterol determinations are

shown as population estimates, that is, the serum cholesterol findings for each individual have

been “weighted” by the reciprocal of the probability of selecting the person. Adjustments were

made for persons in the sample who were not

examined and for post-stratified ratio. Adjustments were also made so that the final sampling

estimates of the population size were brought

into closer alignment with the U.S. Bureau of the

Census independent estimates for the civilian

noninstitutionalized population of- the United

States as of November 1, 1972, by race, sex,

and age.

SYMBOLS

Data not available---–--------——-—-———-- ---

Category not applicable ----------------------- . . .

Quantity zero—--—-—-----–-— ------- -

Quantity more than Obut less than 0.05—- 0.0

Figure does not meet standards of

reliability or precision-—------------—– *
8

Previous issues of Advance Data From Vital and Health Statistics

No. 1.

No. 2.

No. 3.

No. 4.

No. 5.

No. 6.

Blood Pressure of Persons 6-74 Years of Age in the United States

(Issued: October 18, 1976)

Hypertension: United States, 1974 (Issued: November 8, 1976)

Height and Weight of Adults 18-74 Years in the United. States (Issued: November 19, 1976)

Prevalence of Dermatological Diseases Among Persons 1-74 Years of

Age, United States (Issued: January 26, 1977)

A Comparison of Levels of Serum Cholesterol of Adults 18-74 Years

of Age in the United States in 1960-62 and 1971-74 (Issued: February 22, 1977)

Dietary Intake of Persons 1-74 Years of Age in the United States

(Issued: March 30, 1977)
FROM VITAL & HEALTH STATISTICS OF THE NATIONAL CENTER FOR HEALTH STA TISTiCS

US. DEPARTMENT OF HEALTH, EWCATION AND WELFARE I No. 8 Ju Iy 11, 1977I Pubhc Health Serv!ce. Health Resources Administration

Total Serum Cholesterol Levels

of Children 4-17 Years of Age, Unitedl States, 1971-74a

Serum cholesterol levels of children 4-17

years of age in this report were obtained as part

of the Health and Nutrition Examination Survey

(HANES). HANES is a program of the National

Center for Health Statistics in which measures of

nutritional status are collected for a scientifically designed sample representative of the civilian noninstitutionalized population of the United States in the broad range of ages 1-74

years.1

Field data collection operations for the first

HANES survey were started in April 1971 and

completed in June 1974. Of the 28,043 persons

aged 1-74 years who were selected in the national probability sample to represent the 194 million persons in that age in the civilian noninstitutionalized population, 20,749, or 74.0 percent,

were examined. When adjustments are made for

the differential sampling ratios used for the effect of oversampling among the poor, preschool

children, women of childbearing age, and the elderly, this fiawre corresponds to an effective response rate of 75 percent. Among children 4-17

years of age at interview for whom serum cholesterol deterrninations were made, there were

5,334 examined out of the probability sample of

6,356 selected to represent the 56 million of this

age in the population. This is an unadjusted response rate of 84 percent and an effective adjusted response rate of 84 percent.

Detailed estimates of the distribution of serum cholesterol levels will be described and analyzed in the report “Total Serum Cholesterol

Levels of Children 4-17 Years, United States,

‘This report prepared by Sidney Abraham, Clifford

L. Johnson, M.S.P.H., and Margaret D. Carroll, M.S.P.H.

1971 -1974,” Vital and Health Statistics Series

11.2 Selected. data and findings from that re:

port are presented here in tables 1-5 and figures

1-4.

CHOLESTEROL DETERMINATIONS

All serum cholesterol determinations were

made in the Lipid Standardization Laboratory

of the Center for Disease Control (CDC), Public

Health Service, Atlanta, Georgia. The analytical

method was based on that of Abell and others3

but was modified for a semiautomated production line. The method described in detail by

Eavenson and others4 was made possible by the

development of a relatively stable Llebermann

color reagent and was designed for automatic

pipetting units.

The Lipid Laboratory at CDC compared the

results obtained with this semiautomated Abell

method and those obtained from their standardized version of Abell and others. For examining

the bias of the semiautomated method, data

were obtained from pools of sera analyzed by

the reference method and the semiautomated

method. For pools ranging from 134 to 343 mg

per 100 ml, there was in 1972 an average positive bias of 4.07 percent for the semiautomated

method as compared to the standard method;

for the 1971-1974 period the corresponding figure was a pclsitive bias of 4.9 percent. The

weighted average bias was 4.5 percent. In this

paper the 1971-1974 data are presented without

correction for bias so that they provide population reference standards for determinations made

hy the semiautomated methodology now in use.
2 adwncedata

For serum cholesterol measurements, sufficient numbers are available for presenting children in single years of age, from age 4 to 17. .~ll

such ages are presented by sex and race. The

number of missing serum cholesterol test values

was acceptable for children of ages 4 through 17

years. This was not the case for serum cholesterol

values for children of ages 1-3 years, which are

nevertheless presented, but were not analyzed because of possil)le bias due to missing values.

PRINCIPAL FINDINGS

The mean serum cholesterol level of boys in

the younger ages from 4 through 11 years tends

to increase with age to a high average value of

181.8 mg per 100 ml at ages 9-11 years. Another

pattern in mean values is observed from these

ages through 17 years, when the mean values

consistently declined to a low mean value of

167.5 mg per 100 ml at age 17 years (table 1,

figure 1). Table 1 and figure 1 also show that the

mean values of girls were relativeJ.y stable at ages

4-7 years, ranging from 17’4.7 to 177.1 mg per

100 ml with the mean values increasing abruptly

to 186.5 mg per 100 ml at age 8. From this age

on through age 13 years the mean levels consistently decreased from the peak at age 8 to

170.4 mg per 100 ml at age 13 years, a decrease

in mean level of 16.1 mg per 100 ml. This direction is not evident at ages 14 through 17 years,

when the mean levels increased irregularly each

year from 172.8 mg per 100 ml at age 14 years

to 180.6 mg per 100 ml at age 17 years.

Overall, the mean serum cholesterol levels

for girls increased from 174.7 mg per 100 mI at

age 4 years to 180.6 mg per 100 ml at age 17

years, an increase of 5.9 mg per 100 ml. The

decrease in mean levels between similar ages for

boys is slightly less, 3.8 mg per 100 ml. Girls in

each age group except ages 7, 11, 12, and 13

years, had higher mean serum cholesterol Ievells

than boys in the same age group.

The main serum cholesterol patterns observed previously for the tots? male population

aged 4-17 years were similar to those observed

Figure 1. MEAN SERUM CHOLESTEROL LEVELS OF CHILDREN AGED 1-17 YEARS BY AGE AND SEX: UNITED STATES, 1971-74

203 r

190

L’=~-

— soys

-... -.. Gwls

... . . . . . . . . ..o -

...

“.%...

I eo

.. . . . ...”” . . . .

... .. . .

““%. .. .. . . . . . . . . . . . . . . . . - ”. . . . . . . . . . . . . . . . . .=”

. ..”

. . . .

. . . . . . . ..”

... . . . . . . . . . . .

. . .

. . . . . . ... . ..

... . . . .

. . ...”

...

. . . .

170

. . ..-. ““”””-

..

..-

160

160

140

[

k

o I I I I I I I I I I I I I I I I

1 2 3 4 5 6 7 8 9 10 -11 12 13 14 15 16 17

AGE IN YEARS
aduancedata 3

for white boys separately (table 2, fi~re 2).

Mean cholesterol levels of white boys were highest at 9-11 years and decreased with age. For

Negro boys the peaks h values were at ages 7-12

years, with the exception of a drop in mean

value at age 10 years, and then a decline in mean

value from 184.1 mg per 100 ml at age 12 years

to a low of 161.8 mg per 100 ml at age 14 years.

From 14 years on the mean levels increased

rapidly to 178.7 mg per 100 mI at age 16 and

then declined (tabIe 2 figure 2). At every age

except ages 10, 13, and 14 years Ne,gro boys had

higher mean serum cholesterol values than white

boys.

The age-cholesterol pattern found for girls in

the total population was generally found for

white and Negro girls separately. The mean

serum cholesterol values of white girls increased

irregularly from an average value of 173.5 mg

per 100 ml at ages 4-5 years to the highest mean

value of 183.6 mg per 100 ml at ages 8-9 years

and then declined to 168.3 mg per 100 ml at a:e

13 years. Thereafter with age there was a general

increase in mean level to 180.3 mg per 100 ml at

age 17 years (tabIe 2 and fi=qme 3).

The mean levels of Negro girls also increased

irregularly each year from 177.1 mg per 100 ml

at age 4 to a peak of 202.8 mg per 100 ml at age

8. From this highest mean level at age 8 there is

a decrease in mean values through age 12 and

then a general increase to 194.5 mg per 100 mI

at age 15. AL ages 16 and 17 years the mean

cholesterol levels declined from those at age 15

(table 2 and figure 3). At each age, with the

exception of ages 6, 11, and 12 years, Negro

,girIs had a higher mean serum cholesterol levels

than white girls.

Both white and Negro girls generally had

higher mean cholesterol levels than their male

counterparts, particularity NTegro girls. In addition, NTegro boys and girls had generally higher

mean serum levels than their white counterparts.

The proportion of children in HANES whose

serum cholesterol levels exceeded any specified

Figure 2. MEAN SERUM CHOLESTEROL LEVELS OF BOYS AGED 1-17 YEARS BY AGE AND RACE: UNITED STATES, 1971-74

— White

.. . . . . . . . Newo

..................... ...........

... %+

..””

...”

. . ...--”

.,.!

. . .

,.. fike . ..””

......’”

I I I I I I I I I I I I I I I I

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17

AGE IN YEARS
4 acklncedata

Figure 3. MEAN SERUM CHOLESTEROL LEVELS OF GIRLS AGED 1-17 YEARS BY AGE AND RACE: UNITED STATES, 1971-74

&

iL—L_L_L L~L.L. I I I I I I I I

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17

AGE IN YEARS

level may be found in table 3 for boys and in

table 4 for girls.

The U.S. estimates of serum cholesterol levels of children aged 4-17 can be compared with

those reported in HANES for adults of ages

18-74 years. Table 5 shows the mean serum

cholesterol levels of children and adults obtained in 1971-1974 by age and sex with the

standard deviations of the population distribution. Figure 4 shows the adult mean levels as

a continuation of the mean levels of those presented for children of individual ages of 4-17

years.

hlales show a mean serum level of 167.5 mg

per 100 ml at age 17 after a consistent decline

from a mean level of 182.5 mg per 100 ml at age

9. The mean levels for adult males in the age

group 18-24 is 186.9 mg per 100 ml, an increase

of 19.4 mg per 100 ml, or 11.6 percent, from

the mean level at age 17. The mean levels for

male adults increase rapidly to the age group

35-44 and increase less rapidly in the age groups

45-54 and 55-64 years. A slight decline occurs in

the age group 65-74 years.

A similar analysis of the mean level at age 17

for girIs with that at ages 18-24 for females also

shows a rise in mean levels. The mean Ievel increases to the age group 45-54 years and increases less rapidly in the later age groups. The

rise in mean level among men does not start until the earIy adult ages, 18-24 years, whereas in

females the rise begins earIier.

The mean levels for women are higher than

those for men in the youngest age group, 18-24

years. The mean levels for women increase less

rapidly than those for men in the age groups

25-34 and 35-44 years but increase much more

rapidly than men’s levels after age 55. The mean

levels for women are about the same as those for

men in the age group 45-54 years. The mean

levels for men peak at ages 55-64 years and then

decline, while the mean levels for women continue to rise.

The mean levels in adults are consistently

higher than those in children aged 4-17 years.

Table 5 shows that the distributions have greater

variability in adults than in children of ages 4-17

years.
dmcedaa5

Figure 4. MEAN SERUM CHOLESTEROL LEVELS OF CHILDREN AGED 1-17 YEARS AND ADULTS AGED 18-74 YEARS BY AGE AND SEX:

UNITED STATES, 1971-74

270 r

I

260 —

...”’

..””

...””

...

250 — _ Male

...

...

-------- Female

240 —

i

230 —

;

= 220 —

:

w

; 210 —

I

g

E 200 —

~

: ..

; 190 —

...

...

~ ...

/“””””-.....-

% ...

z 180 ... ..

...

<

... ...

2 ..... . . . . . . . . . . . .

...

170

...

160

t

150

t

J

140

/f

o I I I I I I I I I I I [ I 1 +~

1 2345678 9101112131415 16172030409J~ 7060

AGE IN YEARS

DISCUSSION AND

CONCLUSION

The Ievel of serum cholesterol has been identified as one of the muItiple risk factors in the

development of coronary heart disease. The results of epidemiological studies based on adult

data from longitudinal studies such as the Framingham Heart Study6 have demonstrated that

persons with elevated serum cholesterol values

developed coronary heart disease with greater

frequency. Similar longitudinal data obtained

from adolescents that relate serum cholesterol

levels in younger ages to future morbidity or

mortality are not available. There is some evidence, however, that atherosclerosis, more frequently manifested by coronary heart disease,

may originate in childhood. Holman and others

reported finding evidence of atherosclerosis in

post mortems of chiIdren.6 Enos, and others

reported gross evidence of coronary atherosclerosis in 77 percent of American soldiers,

average age of 22 years, killed in the Korean

war.7

Reference data of levels of children 4-17

years of age were presented “md analyzed by age,
6 achtancedata

sex, and race because of the medical interest in

such data. There are no such previous data for

the general population of ages 4-17 years. Such

data as are available are taken from selected segments of the population and special study

groups. Such estimates could not be generalized

to the U.S. population. HANES, on the other

hand, provided cross-sectional data of serum cholesterol levels obtained on different age cohorts

representative of the U.S. population. The age

trends represented mean levels for successive cohorts of persons of different age groups. The

limitation of cross-sectional data are recognized

in considering group changes because they reflect effects of environment as well as developmental and hereditary influences.

Girls in most ages had higher mean serum

cholesterol levels than boys. By race and sex,

white girls generally had higher mean serum cholesterol Ievels than white boys of comparable

ages. Similarly, among Negroes, girls had higher

mean levels than boys. For both whites and Negroes, only boys of ages 11 and 12 years had

higher mean serum cholesterol levels than girls

of comparable age.

At each age group, with few exceptions, Negro boys had higher mean levels than white

boys. This pattern is also evident for INegro girls

as compared to white girls. The differences in

mean levels between white and Negro were

greater for girls than for boys. The average differences between the mean levels of whites and

Negroes over the 14 ages was 7.1 mg per 100 ml

for females and 3.8 mg per 100 ml for males.

The mean serum cholesterol level obtained

for males age 17 years is consistent with the

finding that serum cholesterol levels rise sharply

with age for young men. Similar analysis of the

mean cholesterol level for females age 17 years

with those of females age 18-24 years shows that

the mean values rise less rapidly than those of

males. The increase in mean cholesterol levels

observed in the data for females between the

ages of 16 and 17 years is followed by an increase during the age group 18-24 years and a

continued rise in serum cholesterol level among

females in the 25-34 and 35-44 age groups,

whereas in adult males the rise is not ordy more

rapid but it begins earlier. Not only are the mean

serum cholesterol levels higher in adults than in

children but also the distributions have greater

variability in adults than in children aged 4-1 ‘?’.

REFERENCES

‘ National Center for Health Statistics: Plan and operation of the Health and Nutrition Examination Survey,

United States, 1971-73. Vital and Health Statistics. Series 11, Nos. 10a and 10b. DHEW Pub, No, (HSM)

73-1310. Health Senvces and Mental Health Administration. Washington. U.S. Government Printing Office, Feb.

1973.

‘National Center for Health Statistics: Serum cholesterol levels of children 4-17 years of age, United States,

1971-74. Vital and Health Statistics. Series 11. Health

Resources Administration, DHEW, Rockville, Md. In

pre aration.

~Abell, L.L.; Levy, G. B.; Brodie, B.B.; and Kendall,

F.E.: A simplified method for the estin ation of total

cholesterol in serum and demonstration of its specificity.

j. .&bchenz. 195:357, 1952.

4 Jjavenson, D.; Grier, O. T.; Cisson, J. G.; and Witter,

R. F.: A semiautomated procedure for the determinaticm

of serum cholesterol using the Abell-KendaIl Method. ,J.

Am, Chem. Sot. 43:652, 1966.

5KanneIl, W.B.; Castelli, W.P.; Gordon, T.; and MC

Namara, P.M.: Serum cholesterol, lipoproteins, and the

risk of coronary heart disease. Ann. Intern. Med.

74:1-12.1971.

6H01man, R.L.; McGill, H.C.; Strong, J.P.; and Geer,

J.C.: The natural history of atherosclerosis: The early

aortic lesions as seen in New Orleans in the middle of the

20th century. Amer. J. Pathol. 34:209-235, 1958.

7 Enos, W.J.; Holmes, R. H.; and Beyer, J.: Pathogenesis of coronary heart disease in American soldiers killed

in Korea. JAMA 158:912-914, 1955.
7

Table 1. Srrum cholesterol levels of children 1-17 years by sex and age with mean, standard deviation, and standard error of mean:

United States, 1971-74

Both sexes

Age

1year ................ .....

2 years ...................

3 years ...................

4 years ...................

5 years ...................

6 years ...................

7 years ...................

8 years ......... ........ ..

9 years .......... ...... ...

10 years ...... .......... .

11 years .............. ...

12 years .................

13 years ....... ..........

14 years ........ .........

15 years ................ .

16 years .................

17 years .................

lMg per 100 ml.

Mean r

165.4

176.6

170.8

172.9

172.6

173.6

175.4

180.0

183.9

181.5

179.2

177.7

171.8

171.0

173.2

171.3

173.3

Standard

deviation

34.9

33.7

31.6

30.2

36.2

30.0

30.7

30.1

35,2

32.6

32.8

33.3

37.7

34.7

35.2

32.0

33.7

Standard

error of

mean

-t

:

2.08

1.84

2.22

2.81

2.21

2.49

2.48

2.74

2.54

2.67

1.83

2.59

1.87

2,64

Mean 1

167.2

172.5

167.7

171.3

168.9

170.1

175.8

173.4

182,5

181.4

181.4

179.9

173.3

169.1

168.8

168.6

167.5

Boys

Standard

deviation

38.5

36.2

29.3

28.7

35.8

26.8

28.1

27,6

36.6

25.4

32.4

37.0

40.4

36.8

33.9

29.3

30.9

~Standard error of mean not included because of possiblebiasdue to missingvalues

Standard

error of

mean

;

t

1.97

2.66

2.07

4.45

2.63

3.43

2.43

3.16

3.95

4.46

2.80

3.08

2.89

3.18

SYMBOLS

Data notavailable--–----------––----—-–——-- ---

Category notapplicable---—---—--—-——- . . .

Quantity zero-–-----–----------–— ------ -

Quan.ity more than Obut less than 0.05— 0.0

Figure does not meet standards of

reliabilityy or precision-----—-------———— *

Mean 1

163.2

180.6

174.3

174.7

176.0

177.1

175.0

186.5

185.2

181.6

176.8

175.0

170.4

172.8

177.8

174.0

180.6

Girls

Standard

deviation

28.6

30.6

33.6

31.7

36.1

32.5

33.4

31.2

33.8

38.2

33,0

27.9

35.2

32.4

35.9

34.3

35.7

Standard

error of

mean

-t

;

3.52

2.80

3.93

2.95

3.14

3.00

4,24

3.49

3.51

3.16

2.82

4.12

3.04

3.44
8 ackmedata

Table 2. Serum cholesterol levels of white and Negro children 1-17 years by sex and age with mean, standard deviation, and standard

error of mean. United States, 1971-74

.

White Negro

Boys

Standard

jeviation

Girls

>tanda rd

Ieviation

Boys Girls

Mean 1

162.4

180.3

172.2

173.8

173.2

177.8

172.8

183.6

183.6

179.9

179.0

177.1

168,3

171.4

174.4

173.3

180.3

kleanl

Age Standard

error of

mean

Standard

error of

mean

standard

error of

mean

standard

error of

mean

standard

Ieviation

Standard

feviation

vlean 1 ffean 1

1year . . . . . . .

2 years ... ...

3 years, .....

4 years, .....

5 years ......

6 years ......

7 years ...,..

8 years ......

9 years ......

10 years.,..

11 years,...

12 years ...<

13 years .,,.

14 years ....

15 years..<.

16 years ....

17 years .,,.

166.5

172.8

168.0

170.5

168.0

168.7

174.5

171.5

182.0

182.9

180.8

179.0

174.3

169.6

166.3

167.2

166.9

40.2

36.3

29.2

28.4

35.7

26.9

27.6

26.8

35.9

25.1

31.7

37.2

40,2

35.8

28.1

28.8

30.8

t

‘1

‘i

2.27

2.69

2.41

4.64

3.15

4.07

2.57

3.49

4.34

5<14

3,17

2.70

3.28

3.61

;

t

3.93

3.36

3.96

3.44

3.35

3.46

4.83

3,34

4.19

3.52

3.03

3.55

3.50

3,93

:

i’

5.03

6.46

6.60

6.82

7.52

5.71

5.18

10.29

7.50

5.98

7.58

12.36

8.44

7.10

30.0

30.1

33.3

32.6

35,6

31.7

32.8

30.5

33.9

39.8

31.3

26.9

35.7

30.8

33.6

34.4

35.8

70.5

75.6

70.6

75,6

74.3

76.3

85.1

86.0

84.5

72.0

185.7

184.1

167.2

161.8

169.7

178.7

173.8

28.2

31.5

30.0

30.5

36.2

25.7

29.9

28,5

39.1

26.2

36.9

36.1

41.1

40.7

29.4

30.7

32.2

;

f’

5.50

8,84

5.15

6.21

4,97

6.89

5.59

8.04

6.61

7.90

8.66

3.49

5.62

7.92

176.6

181.4

192.4

177.1

190.3

175.3

186.9

202.8

194.1

192,2

164.6

166.0

183.6

175.1

194.5

182.4

183.3

19.4

33.0

29.0

25.4

35.9

35.2

34.5

29.7

29.5

26.0

38,7

31.1

28.9

38.0

41.5

31.7

36.3

lMg per 100 ml.

~Standard error of mean not included because of possible bias due to missing values.

Table 3, Cumulatwe percent dwtr!bution of serum cholesterol levels of boys aged 1.17 vears bv age: United States, 1971-74

Serum

cholesterol

Ievsl

Imgl10f3 ml)

1 2

vears I

3 4

years years

0.0 1.59

0,71 2.24

2,39 3.30

7.4a 6.a5

17.12 12.86

28.11 21.55

41.90 31.84

55.34 45.22

69.01 63.60

79.05 79.19

a6.50 a5.44

a9.72 91.7a

94.74 95.49

96.1 e 96.7a

96.72 97.69

99.53 99.93

00.00 100.00

00.00 100,00

00.00 100.00

224 304

1,254 1,707

T

13 14

years years

15

years

0.30

0.51

3.21

7.06

15.53

24.S4

40.13

57.34

ffl.oa

s2.4a

89.35

93.75

94.72

95.41

95.60

97.57

9a.40

9a.40

I00.00

171

2,106

I

la 17

tears years

6

{ears

0.0

0.0

0.67

3.2a

lo.ao

19.88

3a.67

50.47

71.91

al .56

69.02

9a.14

97.64

98.26

98.62

9a.77

98,77

98,77

00.00

?79

1,783

5

years

0.42

1.06

2,a7

11.84

18.46

26.a3

43.53

S7.35

68.71

74.37

81.05

90.26

93.73

95.71

96.69

97.57

98.aa

99.53

Co.oo

273

1,720

vear

0.0

0.98

3.32

8.44

19.35

35.20

45.19

57.51

67.01

76.97

81.37

e7 .a3

96.21

95.93

99.07

00.00

00.00

00.00

00.00

176

2,007

Under 100 ...............

Under 110 .... ...........

Under 120 .......... .....

Under 130 ...............

Under 140 ...............

Under 150 ...............

Under 1aO . .. . .. . .

Under 170 ...............

Under leO ...............

Under 190 ............. ..

Under 200 ...............

Under 210 ...............

Under 220 ...............

Undw 230 ...............

Under 240 ...............

Under 250 ...............

Under 260 .. .......... ...

Under 270 ...............

270 and over............

Examined

children ................

Estimated

population in

thousands .............

3.78

5.01

6.72

12.61

22.93

33.45

43.a3

56.36

a6.71

77.05

al .27

90.07

91.70

94.52

96.76

97.80

99.16

99.la

00.00

133

793

1.62

1.74

4.59

6.7a

12.06

21.21

35.17

52.27

67.00

77.49

63.4a

86.53

93.98

96.01

97.06

97.71

97.71

97 .az

I00.00

166

1,042

0.0

0.12

1.42

3.18

5.62

19.61

2a.47

42.43

61.58

71 .3a

81 .ea

87.04

91.92

96.20

99.71

99.71

99.71

9!J,al

100.00

164

1,e79

0.0 0.0

1,78 0.63

3.14 0.63

6.09 2.89

10,86 9.25

?6.22 16.35

26.59 27.17

48.65 35.25

62.10 47.67

74.59 62.25

84.84 74.71

a7.9a 88.51

94.96 92.3a

97.22 94.54

99.37 94.75

99.66 94.87

99.a5 94.a7

00.00 9a.40

00.00 100.00

0.0

0.0

0.45

2.55

3.91

8.75

7a.45

32.3a

61.60

54.43

7a.37

a6.03

92.22

95.16

98.08

99.8a

99.a8

I00.00

00.00

184

2,054

0.0

0.50

2.40

9.74

19.18

27.94

36.S7

50.79

62.00

70.20

78.91

85.24

93.93

95.75

97.72

96.58

9a.aa

99.35

00.00

178

2,095

0.19

2.13

2.13

3.13

7.55

17.01

27.13

44.05

54.15

67.42

78.85

84.75

a9.44

94.25

95,m

96.33

9a.12

9a.25

00.00

200

2,13a

0.16

1.10

1.37

7.49

16.66

27.93

42.73

53.00

63.45

74.11

77.a4

a5.15

91.16

94.56

95.64

97.62

97.a4

97.84

00.00

174

2,125

0.26

3.28

5.14

10.42

22.68

31 .a3

43.37

55.75

84.09

77.3a

82.47

8a.09

91,31

93.86

95.39

97.09

9a.40

9a.51

00.00

174

2,111

0.0

0.0

0.16

2.97

16.13

33.46

43.33

55.76

73.14

7a,24

aa,ol

a9,63

91.75

95.03

95.70

99.03

99.72

99.72

00.00

169

2,072

152 169

*
dEmdata9

Table 4. Cumulative percent distribution of serum cholesterol levels of girls aged 1-17 Years by age: United States, 1971-74

S3um

cholesterol

level

(mg/100 ml) --L11 12

years years

13

years

6 6 7 8 9

{ears years years years years

10

wars

1 I 1 I

Cumulative percent distribution

0.0 0.0 2.79

1.44 0.0 2.79

2,41 2.74 3.61

4.22 3.59 5.61

6.14 4.81 7.6U

8.13 12.45 17.36

17.11 22.78 22.70

28.57 33.22 33.26

43.65 46.72 53.00

51.06 50.22 65.25

K1.ao 6S.38 75.22

78.72 60.92 81.82

66.61 84.18 87.63

91.27 66.66 93.9a

95.34 93.70 95.77

aa91 95.67 96.64

98.52 97.69 97.03

98.52 97.87 97.03

100.00 100.00 100.00

1.45

1.45

4.%

5.94

10.52

16.2U

28.63

45.77

55.65

66.60

76.m

87.61

91.31

92.56

95.08

97.88

97.ea

99.23

I00.00

166

2,018

0.26

0.49

0.49

4.25

15.13

24.83

33.67

44.77

59.09

5996

79.02

85.16

8Q.81

91.93

95.63

97.81

97.81

99.19

I0000

169

1,812

0.0

0.0

1.79

2.59

8.98

18.78

31.19

42.25

53.23

67.13

75.91

81,91

86.77

90.08

91.40

95.26

95.48

97.96

100.00

157

1,985

0.0

1.41

4.73

6.64

13.57

26.52

39.92

53.71

65.96

76.58

65.82

91.14

84.67

97.23

97.52

97.73

98.08

98.66

00.00

198

2,054

Under 100 ...............

Under 110 ...............

Under 120 ...............

Under 130 ...............

Under 140 ...............

Under 1547 ..............

Under 150 ...............

Under 170 .. .............

Under 160 ...............

Under 190 .. .............

Under 2U0 ...............

Under 210 ...............

Under 220 ...............

Under 230 ...............

Under 240 ............

Under 250 ...............

Under 260 ...............

Under 270 ...............

270 and over ............

Examined

children ................

Estimated

population in

thousands .............

125

1.60

1.33

3.53

14S7

22.07

29.18

47,18

57.01

68.s4

77.50

86.8a

60.38

86.74

97.72

99.62

98.73

88.73

100.00

281

1,642

2.01

2.01

2.81

6.33

1427

2129

30.68

38.86

55.64

66.73

72.11

6345

58.71

95.67

99.10

00.00

00.00

00.00

00.00

176

1,718

0.14

0.14

2.23

3.27

6.22

16.70

27.11

50.53

61.04

70.37

78.&l

69.43

95.07

97.35

97.54

97.54

99.85

99.85

00.00

177

2,05a

0.0

o.5a

3.60

7.12

10.78

21.54

40.09

52.45

63.64

70.37

81.67

37.82

90.66

94.62

97.18

98.36

98.38

99.18

00.00

164

2.040

0.0

0.0

0.88

4.50

13.11

23.39

29.99

42.34

56.65

73.16

77.99

62.82

6%53

93.90

95.34

95.34

95.34

96.&S

00.03

171

2,038

0.0

0.76

6.67

9.17

72.06

25.67

30.62

46.86

59.91

71.40

80.06

86.04

92.37

94.51

84.77

96.81

99.19

99.81

00.00

175

2,012

2.65

3.53

4.81

13.59

23.09

36.51

43.07

49.11

67.02

78.29

91.36

94,71

98.27

99.46

I00.00

Imoo

IOo.oa

100.00

I00.00

109

757

0.0 1.04

0.26 1.86

2.75 2.78

6.57 6.63

6.77 14.72

9.85 25.47

22.65 33.31

36.54 46.77

52.00 55.74

67.05 67.66

74.70 81,27

37.517 36.55

60.68 90.40

93.60 94.55

97.31 95.44

97.31 98.8S

97.60 99.54

99.23 99.54

00.00 100.00

158 204

998 1,206

0.0

1.11

4.o6

8.81

15.30

22.78

31.75

44.36

56.55

72.97

79.38

83.53

66.37

93.36

94.44

95.43

95.93

98.05

00.00

314

1,667 M -

Table 5. Serum cholesterol levels of persons by sexandage, with number of persons examined .mean. and standard deviation: Unltea

States, 1971-74 ‘- “

Male

Meanl

Female

Number

examined

171

169

176

772

124

135

104

112

107

94

96

804

665

765

597

1,657

Standard

Deviation

Number

examined

Standard

Deviation

Age Meanl

15 years ...................................................................

16 years .................... ................ ........ .......................

17 years ..................... ...................................... ........

18-24 years ......................... .............. ......................

18 years .......... .............. .. .................... ................

19 years ... ........ .............. ............................ .........

20 years ................ ................ ...................... ........

21 years ........... ............ ........................ ...............

22 years ... .................... ........................ ...............

23 year$ .... ...................... ...... .............. ...... ..........

24 yesrs ........... ...................................................

25-34 years ............ ............................ ...... ................

35-44 years ................ ................ ..............................

45-54 years ................. .......... ...... .. .................... .......

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

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

168.8

168.6

167.5

186.9

178.6

174.4

183.1

186.2

190.7

200.5

195.4

210.3

231.3

239.4

240.2

236.2

23.9

29.3

30.9

S6.7

29.2

36.4

35.7

34.4

38.3

34.1

39.6

44.0

45.9

47.0

51.2

53.8

171

175

157

1,524

144

137

236

257

249

253

248

1,896

1,663

836

670

1,822

177.8

174.0

180.6

191.7

175.4

186.3

188.6

198.1

197.9

198.0

196.7

203.2

216.5

. 242.6

256.8

261.6

35.9

34.3

35.7

41.0

34.1

36.9

38.2

45.8

40.1

44.3

39.6

42.2

43.5

52.0

48.2

51.9

lMgperl 00 ml.
10 achncedata

STATISTICAL NOTES

The sampling plan for the 65 preselected examination locations in the Health and Nutrition

Examination Survey followed a highly stratified

multistage probability design in which a sample

of the civilian noninstitutionalized population of

the conterminous United States 1-74 years of

age was selected. Successive elements dealt with

in the process of sampling were the primary sampling unit, census enumeration district, segment

(a cluster of households), household, eligible

person, and finally, sample person. The sampling

design provided for oversampling among persons

living in poverty areas, preschool children, women of childbearing age, and the elderly.

The serum cholesterol determinations are

shown as population estimates; that is, the serum cholesterol findings for each individual have

been “weighted” by the reciprocal of the probability of selecting the person. An adjustment for

persons in the sample who were not examined

and poststratified ratio adjustments were also

made, and so the final sampling estimates of the

population size were brought into closer aliOmment with the independent U.S. Bureau of the

Census estimates for the civilian noninstitutionalized population of the United States as of

November 1, 1972, by race, sex, and age.
adwncedata 11

Previous issues of Advance Data From Vital and Health Statistics

No, 1.

No. 2.

No. 3.

No. 4.

No. 5.

No. 6.

No. 7.

Blood Pressure of Persons 6-74 Years of Age in the United States

(Issued: October 18, 1976)

Hypertension: United States, 1974 (Issued: November 8, 1976)

Height and Weight of Adults 18-74 Years in the United States (Issued: November 19, 1976)

Prevalence of Dermatological Diseases Among Persons 1-74 Years of

Age, United States (Issued: January 26, 1977)

A Comparison of Levels of Serum Cholesterol of Adults 18-74 Years

of Age in the United States in 1960-62 and 1971-74 (Issued: February 22, 1977)

Dietary Intake of Persons 1-74 Years of Age in the United States

(Issued: March 30, 1977)

Total Serum Cholesterol Levels of Adults 18-74 Years of Age, United States, 1971-74 (Issued: May 25, 1977)
FROM VITAL & HEALTH STATISTICS OF THE. NATIONAL CENTER FOR HEALTH STATISTICS

U.S. DEPARTMENT OF HEALTH. EDUCATION. AND WELFARE I NO. 9 August 10, 1977 I Pubhc Health Serwce. Health Resources Admmistration

Wanted and Unwanted Births Reported by Mothers

15-44 Years of Age: United States, 1973a

According to the results of a national survey

of households conducted in 1973 by the National Center for Health Statistics, one-fifth of all

births (13.9 million out of 68.2 million) to

mothers 15-44 years would not have occurred if

these women had given birth only to those babies they reported as “wanted” at the time of

conception. These estimates are based on answers to direct questions about the “wontedness” of each pregnancy that were asked during

personal interviews with a sample of women

aged 15-44 years who had ever been married or

had children of their own living in the household.b These women participated in the National Survey of Family Growth which is based on

a mtitistage area-probability sample of households in the conterminous United States. The

interviews for Cycle I of the survey were conducted during an 8-month period the midpoint

of which was September 13, 1973.

“Wanted” births are pregnancies resulting in

at least one live birth that were reported as

wanted or probably wanted prior to conception

(see TechnicaI Notes for the exact definition of

these categories). On the other hand, “unwanted” births are pregnancies resulting in at

least one live birth that were reported as not

wanted or probably not wanted prior to conception. Pregnancies resulting in at least one live

birth that were reported as neither wanted nor

aPrepared by Martha Little Munson, M. S., Dim”sion of

Vital Statistics.

b “Children of their own” does not include adopted

or foster children, or other children in the household

who were not born to the woman interviewed.

unwanted at the time of conception are classified as “undetermined” in these data. Pregnancies that did not result in at least one live birth

(i.e., those that ended in miscarriage, stillbirth,

or induced abortion) are excluded from this report. Although the word “birth” is used, wantedness is actually defined in relation to the

pregnancy leading up to each birth. The questions asked in the interview focused on the time

just before the woman became pregnant. This

clearly distinguishes her desire for a baby before

the pregnancy began from her later feelings toward the child who was born. In particular, it is

incorrect to conclude that “unwanted births”

are the same as “unwanted children, ” for many

unplanned or undesired pregnancies result in

children who are cherished. Because the figures

presented are for pregnancies, not for births,

multiple births such as twins and triplets have

been counted only once since the multiple outcome presumably could not affect the woman’s

feelings about wantedness of the pregnancy at

the time of its conception. It should be noted

that the data on wanted and unwanted births

presented in this report cannot be compared directly with data reported in previous fertility

studies because different definitions of wontedness were usecl. This report is based on numbers

of wanted and unwanted births, rather than on

the number clf women who have had an unwanted birth. The definition of wontedness is

based solely on the woman’s responses to questions about her feelings and not those of her

husband. A later report will make comparisons

with previous studies using comparable defkitions.
2 achncedata

HIGHLIGHTS

Table 1 shows that 4 out of every 5 births

were reported by their mothers as wanted. But

the 13.1 percent of births that were unwanted

and the 7.3 percent of births for which the

wontedness was undetermined together constitute 1 out of every 5 births to mothers aged

15-44 years in 1973. The proportion of births

reported as unwanted increased with age, starting with about 1 out of every 12 births to mothers 15-24 years and rising to nearly twice that

proportion, or 1 out of every 7 births to mothers aged 35 years and over. The differences by

race are even more striking— 1 in every 10 births

to white mothers was reported as unwanted

compared with 1 in every 4 births to Negro

mothers. Similarly, Negro mothers had twice as

many undetermined births in proportion to

white mothers, leaving only 7 wanted births to

Negro mothers (58.9 percent) for every 10

wanted births to white mothers (83.2 percent).

The proportion of unwanted births increased

as parity increased. While women with 3 children reported 1 out of every 10 births as unwanted, women with 5 children reported twice

as many unwanted births, and women with 6

children or more reported that 1 out of every 4

births was unwanted. There were no significant

differences in wontedness by region or between

mothers of Spanish origin and all other mothers.

Less education for both the woman and her current husband (if any) was associated with fewer

wanted births. There was no significant difference in the proportion of wanted births between

mothers in, and those out of, the labor force.

However, mothers with family incomes below

the poverty level had a strikingly lower proportion of wanted births (66 percent) than mothers

with family incomes at least 50 percent above

the poverty level (83.6 percent). The difference

in the reporting of wanted births between Protestants and Catholics was not statistically significant. But Jewish women reported a significantly larger proportion of wanted births compared

with Catholics, Protestants, and those reporting

other religions or no religious preference.

The proportion of unwanted births decreased from 3-in-10 to l-in-10 as desired family

size (an alternative measure of the number of

wanted births) increased from O to 4, with a

slight increase in unwanted births for larger desired family sizes. Among women who had never

been married but who had children of their own

living in the household,’ the percentages of

births reported as wanted and unwanted were

significantly different from those reported by

women who had been married at least once;

only a little over half of the births to nevermarried mothers were reported as wanted. Between users and nonusers of contraception,

there was no significant difference in the proportions of births reported as wanted or unwanted.

But there was a marked difference in these proportions between those who were contraceptively sterilized (either male or female) and

those using other methods of family planning.

Those using sterilization reported fewer wanted

births than those using other methods by 7 to

10 percentage points.

The pattern of wontedness by age and parity

varied considerably between white and Negro

mothers. Table 1 shows that the difference between the highest and lowest categories of age in

the proportions of births reported as not wanted

was 7.1 percentage points. Table 2 shows that

this difference was almost doubIed (to 13.5 percent) for Negro mothers, whereas it was virtually

the same (7.2 percent) for white mothers. Looking at the pattern of unwanted births at the lowest and highest parity levels, table 1 shows a

difference of 20.7 percentage points for all

mothers. When this differential is examined by

race, the difference shrinks to 16.3 percent for

white mothers and expands to 24,7 percent for

Negro mothers. Figure 1 shows the dramatic differences in the proportions of unwanted and un~-

determined births for white and Negro mothers

and is helpful in identifying the specific groups

that tend to have the largest proportions of unwanted births in the United States.

The proportions of wanted and unwanteld

births also differed by the current marital status

cAlthough the National Survey of Family Growth is

predominantly a survey of ever-married women, it also

includes families consisting of never-married mothers

and their child(ren) if they reside in the same household.

Hence the term “mother” refers to women who have not

just borne a child but raised it as well.
dmcedaa3

Figure 1. PERCENT OF PREGNANCIES RESULTING IN A LIVE BIRTH, BY WHETHER THEY WERE REPORTED AS

UNWANTED OR UNDETERMINED, BY RACE, AND PARITY: NATIONAL SURVEY OF FAMILY GROWTH, 1973

‘0 rI

I

I

. . . . . . . . . . . .

Unwanted

I

40

t 1

..... . ....

..... ...(

20

1-

t

101-- I

I

.....................

.......................

.....................

............

White Negro White Negro White Negro White Negro White Negro White Negro

1 2 3 4 5 6-F

PARITY (NUMBER OF LIVE BIRTHS)

of women. A comparison of tables 1 and 3 and mothers clf alI marital statuses was found

shows that the proportion of wanted births was among Negro women; there were 5 percentage

2.6 percentage points higher for currently mar- points more wanted births and 4 percentage

ried mothers included in the survey. The greatest points fewer umwanted births among the curdifference between currently married mothers rently married.
4 achamedata

Table 1. Number of mothers and of live births, and percent distribution of births, to mothers 15-44 years of age, by whether wanted, unwanted or undetermined, according to selected characteristics: United States, 1973

Characteristic

Total ............................................

Age group

15-24 years .......... .............. ................... .

25-29 years ............................................

30-34 years ............................................

35-39 years ............................................

4044 years ............................................

Race

White ........................................ ........ .....

Negro ..... ......... .......................................

Parity

One live birth ............ .. ...........................

Two live births .......................................

Three live births .....................................

Four live births .................................... ..

Five live births ... .................................. ..

Six live births or more ... .........................

Oriqin

Spanish .......................................... .. ......

All other ............. ............................. ......

Region

Northeast ........................ .......................

North Central ........ ........................... ...

South ......................... ............................

West ................................. .. ....................

Woman’s education

Less than high school ......... ....................

High school, 1-3 years ............................

High school, 4 years ..................... ..........

College, 1-3 years ........ ...........................

College, 4 years or more .............. ..........

Husband’s education

Less than high school .............................

High school, 1-3 years .. ...... .......... ... ...... .

High school, 4 years .............. .................

College, 1-3 years ...................................

College, 4 years or more .........................

Number of

mothers in

thousands

25,803

4,375

5,487

5,617

5,108

5,216

22,182

3,359

64297

8,164

5,458

2,812

1,510

1,572

1,900

23,903

5,406

6,757

8,500

5,139

2,622

5,697

12,161

3,182

2,140

3,397

4,830

8,943

3,739

4,123

Number of

births in

thousands

68,184

6,542

11,471

15,469

16,686

18,015

57,551

9,984

6,297

16,221

16,238

11,088

7,429

10,911

5,501

62,683

14,032

18,502

21,771

13,880

9,123

16,884

29,917

7.585

4,675

11,782

13,610

22,526

9,081

9,787

Percent distribution

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100,0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

79.7

81.9

83.6

80.5

76.7

78.3

83.2

58.9

87.7

90.1

83.0

76.6

72.0

63.0

76.4

80.0

80.9

79.0

79.1

80.3

72.6

73.3

82.5

86.1

87.9

73.3

74.4

82.1

83.5

89.2

13.1

8.3

10.3

12.1

15.2

15.4

10.5

27.9

*5.1

4.3

10.7

16.6

20.1

25.8

13.7

13.0

12.0

14.0

13.3

12.6

16.5

17.9

11.1

9.7

7.4

16.9

16.6

11.7

9.9

7.7

7.3

9.8

6.1

7.4

8.1

6.2

6,2

13,2

7.2

5.6

6,3

6.9

8,0

11.2

10.0

7.0

7.1

7.0

7.6

7,2

10.9

8.8

6.5

*4.2

*4.8

9.8

9.0

6.2

6.6

*3.2
a&medaa5

Table 1. Number of mothers and of live births, and percent distribution of births, to mothers 15-44 years of age, by whether wanted, unwanted or undetermined, according to selected characteristics: United States, 1973—Con.

Characteristic

Woman’s labor force status

Not in labor force .................................

In labor force ................. ............. ..........

Working full time ........................... ..

Working part time ................. ...........

Not working ...................... ...... .........

Poverty levell

Below 100 percent ................ .................

100-149 percent .....................................

150 and above ............. ... ........................

Religion

Catholic ...................................... ...........

Protestant .... ........ ............ ......................

Jewish .. ................ ..................................

Other ......................... ............................

None ........... .......................................... .

Desired family size

No children ............ ................................

One child ............................... ...............!

Two children ..... ............ ........ ................

Three or four children ...........................

Five or six children ...............................

Seven children or more ..... ....................

Fetal losses

No losses ............... ................................

One loss ...... ........ ............. .....................

Two Iosses........... ..................................

Three losses or more .................... ........ .

Times married

Never married ........ ................................

Once married ......... ..................... ...........

Twice married or more ................ ...........

Most recent contraceptive use

Nonusers ................ ................................

Users ..................... .................................

Sterilization ......................................

Pill or IUD .... ....................................

Other methods ..................................

Number of

mothers in

thousands

15,678

10,125

6,570

2,716

838

3,222

2,596

19,985

7,294

17,028

398

343

739

1,337

989

10,880

10,477

1,603

517

19,205

4,551

1,247

800

771

21,493

3,539

2,166

22,623

4,821

10,278

7,523

Number of

births in

thousands

42,230

25,954

16,654

7,110

2,190

10,697

8,211

49,277

20,259

44,684

898

824

1,520

3,562

1,928

23,361

29,514

6,918

2,903

48,713

12,757

4,133

2,581

1,399

55,980

10,806

5,228

59,635

16,574

23,512

19,550

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

1cm.o

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

Percent distribution

80.6

78.2

77.2

81.4

75.5

66.0

73.8

83.6

81.5

78.7

88.7

81.8

76.5

60.9

68.6

80.4

82.0

81.6

75.8

79.7

80.2

77.3

80.2

53.4

80.9

76.9

79.9

79.5

73.5

80.4

83.4

12.3

14.4

15.1

12.7

●14.5

21.5

16.6

10.6

11.4

13.9

‘6.6

●12.6

●15.4

30.9

20.4

13:0

10.7

12.0

13.3

12.7

13.2

16.4

13.8

27.9

12.1

16.4

10.3

13.4

18.5

12.5

10.0

Undetermined

7.2

7.4

7.7

5.9

*10.O

12.6

9.6

5.7

7.1

7.4

*4.7

*5.6

●8.1

*8.1

●11.O

6.5

7.3

6.4

●1O.9

7.6

6.6

*6.3

●6.O

‘ 18.7

7.1

6.7

9.9

7.2

8.0

7.1

6.6

1,,povert ~ IeveI,$ designates the ratio of total family income to poverty level income. Set: the definitions in the Technical Notes.
6 adfancedata

Table 2. Number of mothers and of live births, and percent distribution of births, to mothers 15-44 years of age, by whether wanted, unwanted or undetermined, according to age and race, and parity and race: United States, 1973

.—

Characteristic .,

Total ........ .................................. .......

AGE AND RACE

White

15-24 years .... ........ ................................

25-29 years .... ............ .. ..........................

30-34 years ....... .....................................

35-39 years ....... .................. ....... ........ ....

4044 years .... ............................. ...........

Negro

15-24 years .... ............. ...........................

25-29 years ............................ ................

30-34 years ..................................... .......

35-39 years ............................... ............ .

4044 years .... ........................................

PARITY AND RACE

White

One live birth, ............ ............................

Two live births ... ....................................

Three live births .......... ...........................

Four live births ......................................

Fiw live births ................. ......................

Six live births or more ............................

Negro

One child .................... ............... ............

Two children ................ ......... .................

Three children ........................ ................

Four children ......... ...... ..........................

Fiw children ......................... .................

Six children or more ............................ ..

Number of

mothers in

thousands

25,803

3,410

4,799

4,938

4,436

4,601

940

632

615

596

576

5,224

7,257

4,895

2,435

1,261

1,111

1,003

809

519

345

229

453

Number of

births in

thousands

68,184

5,029

9,764

13,262

14,174

15,321

1,468

1,579

2,024

2,330

2,583

5,224

14,441

14,579

9,603

6,213

7,491

1,003

1,604

1,537

1,357

1,120

3,363

Total Wanted Unwanted

Undetermined

Percent distribution

100.0II 79.7

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

86.9

87.2

83.5

80.6

81.8

64.6

61.9

60.3

52.7

58.2

91.4

92.5

85.2

78.5

74.1

69.6

68.0

69.1

62.4

61.8

60.9

47.8

13.1

‘5.4

8.2

9.9

12.3

12.6

● 18.7

●23.6

26.4

32.9

32.2

*3.1

3.0

9.5

15.3

18.6

19.5

● 15.8

●I 5.7

*22.2

●26.O

‘28.4

40.5

7.2

7.8

4.6

6.6

7.0

5.6

● 16.6

●14.5

●13.2

●14.4

●9.5

“5.5

4.4

5.3

6.1

7.:3

I I .10

*16.2

* 15.2

● 15.4

*12.:2

*1 0.8

11.7
7

Table 3. Number of mothers and of live births, and percent distribution of births, to currently married mothers 15-44 years of age, by

whether wanted, unwanted or undetermined, according to race and parity: United States, 1973

Characteristic

Total ...... ..........................................

RACE

White ........... ..... ................. ....................

Nagro ... ........ .............. ............................

Parity

One live birth ................................. ........

Two live births ................. ................ ......

Three live births .....................................

Four live births .. ............................ ........

Fiw live births ................................. ......

Six live births or more ............. .............. .

Number of

mothers in

thousands

21,816

19,764

1,822

5,086

7,107

4,740

2,352

1,277

1#254

Number of

births in

thousands

57,524

51,391

5,561

5,086

14,146

14,098

9,268

6,287

8,637

Total Wanted Unwanted

Undetermined

Percent distribution

100.0 84.2

100.0 63.9

100.0 92.0

100.0 92.1

100.0 85.1

100.0 78.3

100.0 73.9

100.0 66.2

11.2

9.8

23.9

●2.8

3.1

9.4

15.1

17.9

22.9

6.6

6.0

12.2

*5.1

4.8

5.5

6.7

8.1

10.9
8 aduancedata

TECHNICAL NOTES

DESIGN OF THE SURVEY: The National Survey of Fam,ily Growth (NSFG), initiated in

1971, is designed to provide data on fertility,

family planning, and related aspects of maternal

and child health. Field work for Cycle I was

carried out by the National Opinion Research

Center in 1973 and early 1974 with September

13, 1973, as the midpoint of the interviewing.

A multistage probability sample of women

in the noninstitutional population of the conterminous United States was used. Approximately

33,000 households were screened to identify the

sample of women who would be eligible for the

NSFG; i.e., women between the ages of 15 and

44 years, inclusive, who were currently married

or previously married or who had never married

but had natural children presently Iiving in the

household. In households with more than one

eligible woman, a random procedure was used to

select only one to be interviewed. Since the interviews were always conducted with the sample

person, the term “woman” is used throughout

this report as synonymous with sample person.

Interviews were completed for 3,856 Negro

women and for 5,941 women of other races. A

detailed description of the sample design will he

presented in a forthcoming report “Sample Design, Estimation Procedures, and Variance Estimat ion for a National Survey of Family

Growth.”

The interview was narrowly focused on the

respondents’ marital and pregnancy histories, on

their use of contraception and the planning

status of each pregnancy, on the respondents’

intentions regarding the number and spacing of

future births, on maternity and family planning

services, and on a broad range of social and economic characteristics. While the interviews varied greatly in the time required for their completion, they averaged about 70 minutes. Quality

control procedures were applied at all stages of

the survey. This included a verification of listing

completeness with unlisted dwelling units being

brought into the sample, a preliminary field review of completed questionnaires for possible

missing data or inaccurate administration, a

10-percent sample recheck of all households to

be screened in the survey, observation of interviews in the field, and an independent recoding

of a 5-percent subsample of completed interviews.

RELIABILITY OF ESTIMATES: Since the statistics presented in this report are based on a

sample, they may differ somewhat from the figures that would have been obtained if a complete census had been taken, using the same

questionnaires, instructions, interviewing personnel, and field procedures. This chance difference between sample results and a complete

count is referred to as “sampling error. ” In addition, the results are also subject to nonsampling

error due to respondent misreporting, data processing mistakes, and nonresponse. It is very difficult, if not impossible, to obtain accurate measures of nonsampling errors. These types of

errors were kept to a minimum by the quality

control procedures and other methods incorporated into the survey design and administration.

Sampling error, or the extent to which

samples may differ by chance from a complete

count, is measured by a statistic called the

“standard error of estimate. ” Approximate standard errors for estimated numbers and percentages from this survey are shown in tables I

and II for all pregnancies, regardless of their outcome.

The chances are about 68 out of 100 that an

estimate from the sample would differ from a

Table 1. Approximate standard errors for estimated numbers for

pregnancies: 1973 National Survey of Family Growth

Size of estimate

100,000...................

250,000 ..... ..............

500,000 ... .... .... .. ......

1,000,000 ................

2,500,000 ...... ..........

5,000 ,000 ................

10,000,000 ..............

25,000 ,000 ..............

50,000 ,000 ..............

Relative

standard

error

46.4

29.3

20.7

14.6

9,2

6.4

4.5

“ 2.6

1.6

Standard

error

46,000

73,000

104,000

146,000

230,000

322,000

445,000

658,000

811,000
acivancdata 9

Table 11. Approximate standard errors for astimated percentages expressed in percentage points for pregnancies: 1973 National Survey of

Family Growth

Base of 2 or 98

percentage

700,000 ............ 2.5

1,000,000 ......... 2.1

3,000,000 ......... 1.2

7,000,000 ......... 0.8

10,000,000 ....... 0.6

30,000,000 ....... 0.4

70,000,000 ....... 0.2

5 or 95

3.8

3.2

1.8

1.2

1.0

0.6

0.4

100r90

5.3

4.4

2.5

1.7

1.4

0.8

0.5

complete census by less than the standard error.

The chances are about 95 out of 100 that the

differences between the sample estimate and a

complete count would be less than twice the

standard error. The relative standard error is the

ratio of the standard error to the statistic being

estimated. In this report, numbers and percentages that have a standard error that is more than

25 percent of the estimate itself are considered

“unreliable. ” They are mzu-ked with an asterisk

to caution the user but may be combined to

make other types of comparisons of greater precision.

In this report, terms such as “similar” and

“the same” mean that any observed difference

DEFINITION

Wantednem.–The definition of wontedness

is based on direct responses to several questions

about each time that a woman has conceived.

For a woman who reports that contraceptive use

was stopped prior to conception, and for those

who report that no contraceptive method was

used in the interval preceding conception (which

begins with the end of the preceding pregnancy,

if applicable), the question on wontedness is

phrased as follows: Was the reason you (were

not/stopped) using any method because you,

yourself, wanted to become pregnant?” An affirmative response to this question is defined as a

“wanted” pregnancy. If the woman answers negatively, she is asked two followup questions

which are identical to those asked of all other

respondents. These questions are: “At the time

20 or 80

7.0

5.9

3.4

2.2

1.9

1.1

0.7

30 or 70

8.0

6.7

3.9

2.5

2.1

1.2

0.8

40 or 60

8.6

7.2

4.1

2.7

2.3

1.3

0.9

50

8.8

7.3

4.2

2.8

2.3

1.3

0.9

between twcl estimates being compared is not

statistically significant. Simil;rly, t&-ms such as

“greater,” “less,” “larger,” “smaller,” etc., indicate that the observed differences are statistically significant. The normal deviate test with a

.05 level of significance was used to test all comparisons that are discussed in the text. A statistically significant difference is one large enough

that in repeated samples of the same size and

type as this one, such a large difference would

be expected to be found in less than 5 percent

of the samples. Lack of comment in the text between any two statistics does not mean the difference was tested and found not to be significant.

OF TERMS

you became pregnant (THIS INTERVAL)d did

you, yourself, actuaUy want to have a(nother)

baby at some time?” and “AS yotl recall, is that

how you felt be-fore you became pregnant, or

did you come to feel that way later?” The latter

question is rephrased as follows for women who

indicated that they did not know or care

whether or not they wanted to have a(nother)

baby: “It is sometimes difficult to recall these

things, but as you look back to just before that

pregnancy began, would you say you probably

‘Parentheses indicate that the interviewer chose the

appropriate wording for respondent. “THIS INTERVAL” means that the interviewer inserted the name or

dates of the child or pregnancy that defined the interval

in question.
10 achncedata

wanted a(nother) baby some time or probably

not?”

A pregnancy is defined as “wanted” if the

woman reports that (a) contraception was not

used in the interval or was stopped prior to conception because the woman wanted to become

pregnant, or (b) she wanted to have a(nother)

baby at some time and felt that way before becoming pregnant, or (c) she reported that she

probably wanted a(nother) baby at some time.

A pregnancy is defined as “unwanted” if the

woman reports that she did not want, or probably did not want to have a(nother) baby at

some time and felt that way before becoming

pregnant. All other pregnancies are termed “undetermined. ” Table HI shows the breakdown by

the subcategories of the components of wontedness for pregnancies ending in live births and

fetal losses.

Age.–In this report, age is classified by the

age of the respondent at her last birthday before

the date of interview.

Race. –Classification by race, based on interviewer observation, was reported as Negro,

white, or other. Race refers to the race of the

woman interviewed.

Spanish origin .–A respondent was classified

as being of Spanish origin if she reported her

origin or descent as Mexican, Chicano, Mexican

Am eri can, Puerto Rican, Cuban, or other

Spanish.

Region. –Region refers to the part of the

country where the respondent was Iiving at the

time of the survey according to the definition of

the U.S. Bureau of the Census.

Marz”tal Status. –Persons are classified by

marital status as married, widowed, divorced,

separated, or never married. Married persons include those who report themselves as married or

as informally married, such as living with a partner or common-law spouse. Persons who are

temporarily separated for reasons other than

marital discord, such as vacation, illness, or

Armed Forces, are classified as married. Divorced persons are those whose most recent marriage was legally dissolved and who are free to

remarry. The annulled, while having the legal

status of never having been married, are classified together with the divorced. The category

“separated” includes those who are legally or

informally separated from their most recent

spouse due to marital discord. The “never marTable I I 1. Percent distribution of subcategories of wontedness by race for all pregnancies regardless of outcome: United States, 1973

Category of wontedness

Total ...................... ................................................

Wanted

Contraception stopped or not used .............................

Wanted prior to conception ................. .......................

Probably wanted prior to conception .........................

Unwanted

Unwanted prior to conception .............................. ......

Probably unwanted prior to conception .....................

Undetermined

Wanted after conception .............................................

Unwanted after conception ............... .........................

Don’t know or care ....... ..............................................

Total

100.0

44,7

27,0

1.0

18.6

0.3

5.9

2.2

0.3

Negro

100.0

29.5

29.4

1.1

28.3

0.4

7.0

3.9

0.4

White and other

100.0

56.8

25.2

0.9

10.9

0.2

4.9

0.9

0.2
aduancedata 11

tied” include those who have never had a formal

marriage and do not consider themselves in any

of the preceding categories. However, in the

NSFG, single women with children of their own

in the household were included.

Times mam”ed. –The number of times a

woman has been married, according to the definition of marital status as offered in the preceding paragraph.

Education.–The highest year of regukr schooling completed is used to define education for the

woman and her. current or most recent husband.

Labor force status. –A woman is categorized

as being in the labor force if she was working

full time or part time, had a job but was not at

work because of temporary illness, vacation, or a

strike, or if she was unemployed, laid off, or

looking for work.

Poverty level. –The poverty index ratio was

calculated by dividing the totaI family income

by the weighted average threshold income of

nonfarm residents, head under 65, based on the

poverty levels shown in the U.S. Bureau of the

Census, Current Population Reports, Series P-60,

No. 98, “Characteristics of the Low-Income

Population, 1973,” table A-3. This definition

takes into account the sex of the famiIy head

and the number of persons in the family. Total

family income includes income from all sources

for all members of the respondent’s family.

Reli~”on. –Women were asked whether they

were Protestant, CathoIic, Jewish, or something

else. Protestant includes most of the Christian

groups other than Roman Catholic. The “other”

category includes non-Chnstians except those

answering “none.”

Parity. –Parity refers to the number of live

births the respondent has had.

Desired fami13t size.–The number of children

a woman reported that she would have if she

could start Iife over again and have exactly the

number of children she wanted.

Fetal losses. –The number of pregnancies reported by the respondent ending in miscarriage,

stillbirth, or induced abortion.

Alost recent contraceptive use. —Nonusers are

women who have never used a contraceptive

method or gave no indication of ever having

used a method for the purpose of delaying or

preventing a pregnancy. Users are women who

have et?er used at least one contraceptive method

(including sterilization at least partly for contraceptive reasons) for that purpose, and this is the

current method for women using contraception

at the date of the interview.

EFFECTS OF IMPUTATION: In 477 cases out

of 27,198 records of pregnancies, there was no

code for determining the \vantedness status of

the pregnancy concerned. Interviewer’s error,

coding and keypunching errors or the respondent’s nonrespnnse for a specific item are some

possible reasons for this. Thus, for 1.8 percent of

all pregnancies, a code for wontedness was imputed on the basis of respondents matched on

race, age, pregnancy interval order, and parity,

using the “hot deck” procedure for imputations.

It is possible to assess the effects of this procedure by comparing the resulting distribution

with one incIuding the unknown values as a separate category. The imputed proportions differ

from the unimputed proportions by an average

of 0.4 percentage points, with the largest difference being in the “wanted” category for Negro

women of 0.9 percent.

SYMBOLS

Data not available-–----–--------------—---—---- ---

Category not applicable----–-—----–------—--- . . .

Quantity zero—–—–-–--–------—-—– -

Quantity more than O but less than 0.05-— 0.0

Figure does not meet standards of

reliability y or precision—-------—–— *
12

Previous issues of Advance Data From Vital and Health Statistics

No. 1. Blood Pressure of Persons 6-74 Years of Age No. 5. A Comparison of Levels of Serum Cholesterol

in the United States (Issued: October 18, of Adufts 18-74 Years of Age in the United

1976) States in 1960-62 and 1971-74 (Issued:

February 22, 1977)

No. 2. Hypertension: United States, 1974 (Issued:

November 8, 1976) No. 6. Dietary Intake of Persons 1-74 Years of Age

in the United States (Issued: March 30, 1977)

No. 3. Height and Weight of Adults 18-74 Years in No. 7. Total Serum Cholesterol Level of Adults

the United States (Issued: November 19, 18-74 Years of Age in the United States in

1976) 1971-74 (Issued: May 25, 1977)

No.”4. Prevalence of Dermatologica.1 Diseases Among

~

No. 8. Total Serum Cholesterol Level of Children

Persons 1-74 Years of Age, United States 4-17 Years of Age in the United States in

(Issued: January 26, 1977)
FROM VITAL & HEALTH STATISTICS OF THE NATIONAL CENTER FOR HEALTH STATISTICS

US. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE j No. 10 August 12, 1977 I Fubhc Health Serwce. Health Resources Adm!mstratlon

Expected Size of Completed

Women 15-44 Years of

Currently married women aged 40-44, who

are near the end of their childbearing period,

expect to have an average of 3.3 chiIdren. But

those aged 20-24, who are beginning their childbearing, expect an average of only 2.3 children.

Although the younger women are less sure about

their expectations than the older women, the

statistics reflect definite age differences in birth

expectations. If realized in actual fertility, Figure 1 shows that these differences will result in a

Family Among Currently Married

Age: United States, 1973a

nearly all subgroups of the population, even

though there are different IeveIs of expectations

among these subgroups. For instance, the total

number of births expected by currently married

women decreases as education increases and as

age at marriage increases. Also, Negro wives,

Catholic wives, wives who participate more in

religious activities, wives who are not in the 1abor force, and wives whose first child was born

before marriage, expect more total births than

significant decline in completed family size. other wives.

The expected decline in fertility is found in

Figure 1. Average number of children ever born and total

births expected per currantly married woman 15-44 years

old by age: United States, 1973

‘r m Children ever born

15-44 15-19 20-24 25-29 30-3? 35-39 40-44

AGE IN YEARS

aPrepared by Gordon Scott Bonham, Ph. D., Division

of Vital Statistics.

These and other findings presented in this

report are from Cycle I of the NationaI Survey

of Family Growth (NSFG), conducted by the

NationaI Center for Health Statistics. The NSFG

was designed to provide information about

fertility, family planning, and aspects of maternal and child health related to childbearing.

Data on these topics were colIected by personal

interviews with about 9,800 women aged 15-44

years who had ever been married or who had

children of their own living in the household.

Interviews were conducted between July 1973

and February 1974, centering on September

1973. The statistics in this report refer to currentl y married women living in the conterminous United States, and are based on interviews with a representative sample of 7,566 such

women. Further discussion of the survey design,

definition of terms, and sampling variability are

in the TechnicaI Notes.

RANGE OF BIRTH EXPECTATIONS

The number of births that women expect to

have may not forecast future births accurately

because women may change their minds, they
2 aklnceckta

may not be able to have the expected births, or

they may unintentionally have more births than

expected. The NSFG allowed for some of these

uncertainties in interviewing women on expectations. Wives were asked how many additional

births they intended to have, if any, and how

certain they were of achieving those intentions.

Those who expressed uncertainty, about onethird of the total, were asked the minimum and

maximum numbers they actually expected to

have.

The range of births expected per 1,000 currently married women 15-44 years old is shown

in table 1. Overall, women expected to have

between 2,653 and 2,985 births per 1,000

women (or 2.7 and 3.0 births each) by the time

they finish childbearing. Of these expected

births, 2,180 (or 2.2 births each) have already

occurred. The differe~nce between minimum and

maximum expected births decreases as age increases. Most of this difference is due to the

higher proportion of expected births that have

already occurred among older women and therefore present no uncertainty. About one-fourth

of the minimum births expected by women

15-19 years old have occurred, and this proportion increases to almost 1.00 percent for

women 40-44 years old.

Regardless of the certainty of her intentions,

a central number of births was determined for

each woman by a procedure described in the

TechnicaI Appendix. The central number of

births expected by women in the sample population is between the minimum and maximum,

although it is slightly closer to the minimum.

This number increases with age, except for a statistically insignificant decrease between ages

15-19 and 20-24. The increase is not solely due

to events associated with different stages of the

life cycle. It also represents diversified birth expectations of different cohorts of women. Those

aged 40-44 in 1973 had most of their children

during the high fertility period of the 1950’s and

the early 1960’s, often referred to as the “baby

boom.” However, women in their twenties in

1973 were starting their families during a period

of low fertility. The age compariso~ in table 1

reflects the changes in fertility shown in table

A. There is not much difference in the number

of total births expected or children ever born by

the time of the interview among women aged 30

or over between 1960 and 1973. However, there

are dramatic changes for women under age 30.

Wives 18-24 years old in 1973 expect to have an

average of 0.8 children fewer by the time they

complete childbearing than wives 18-24 years

old in 1960 or 1965. Wives 25-29 years old in

1973 expect to have 1.0 fewer children than

wives of a similar age in either 1960 or 1965.

This expectation of smaller families is not unreasonable since they have already had an average of 0.5-0.8 fewer children than the wives of

comparable age 8 to 13 years earlier.

COMPARISON WITH

OTHER DATA

Other surveys have collected data on birth

expectations, as indicated in table A. Most

notably, the U.S. Bureau of the Census asked

about birth expectations in the June 1973 Current Population Survey (CPS). A comparison of

the NSFG of 1973 with the CPS of 1973 is

shown in table B. Except for wives 35-39 years

old, the NSFG reports slightly higher birth expectations than the CPS does. While the differences are of demographic significance, they

are approximately equal to the standard error of

the differences, and thus not statistically significant. The small differences in the two estimates could be due to differences between the

surveys in any or all of the following: 1) allowances for uncertainty in birth expectations in

the NSFG, 2) characteristics of wives reporting,

3) dates of survey, 4) total content of the

interview, or 5) categorization of marital status.

BIRTHS DESIRED

The number of births that a woman would

like (or desire) if she could have just the number

she wanted, is shown in table 1. The number of

births desired by wives of all ages is approximately equal to the central number of births

they expect to have. However, wives under age

30 expect to have fewer births than they would

like, while wives age 30 or older expect to have

more births than they would like. These differences could be due to differential ability to

control fertility, specific temporal conditions or
akncdaa3

Table A. Average number of total births expected and children ever born per currently married woman 18-39 years old in selected years

by age: United States, 1960-1973

Total births expected, children

ever born and age

Total births expected

18-24 years old ......................

25-29 years old ......................

30-34 years old ......................

35-39 years old ......................

Children ever born

18-24 years old ......................

25-29 years old ......................

30-34 years old ......................

35-39 years old ......................

1960a

3.1

3.4

3.3

3.0

1.4

2.4

2.7

2.7

1965a

3.1

3.4

3.6

3.4

1.5

2.5

3.1

3.2

1967b

2.9

3.0

3.3

3.3

1.2

2.3

3.1

3.2

1970a

2.6

2.8

3.1

3.4

1.1

2.1

2.9

3.3

1971b

2.4

2.6

3.0

3.3

1.0

1.9

2.8

3.2

1972b

2.3

2.5

2.9

3.2

0.9

1.8

2.7

3.2

1973=

2.3

2.4

2.9

3.2

0.9

1.7

2.6

3.1

aFigures are from the 1960 Growth of American Families Survey and the 1965 and 1970 National Fertility Surveys as reported in

U.S. Bureau of the Census, Current Population Reports, Series P-20, No. 263 (April 1974), table C.

bU.S. Bureau of the Census, Current Popuhtion Reports, Series P-20, No. 269 (September 1974).

‘National Survey of Family Growth.

Table B. Number of total births expected per 1,000 currently

married women 18-39 years of age for the National Survey of

Family Growth and the Current Population Survey: United

States, 1973

I I

National

Survey of Current

Age Family Population

Growth Survey

u

Source: Data for the Current Population Survey is from U.S.

Bureau of the Census, Current Popu&rtion Reports, Series P-20,

No. 265, “Fertility Expectations of American Women: June

1973,” Washington. U.S. Government Printing Office, 1974.

di fferentiaI interpretations of expected and

desired numbers of births. There is less variation

by age of women in the number of births they

desire than in the number of births they actually

expect.

having borne 20 percent of their expected births,

while wives age 40-44 have borne 99 percent of

their expected births. Ii’ives 15-19 years old expect to have 79 percent of their births by the time

they are 20-24, while wives 20-24 years old at the

date of the !sumey had ordy had 40 percent of

their expected births by this same age. Similarly,

wives 20-24 years old expected to have 85 percent of their total births by the time they are

25-29 while wives currently 25-29 years old have

had 68 percent of their births. These observations suggest at least one of the following: 1)

women who marry at younger ages, who predominate among women aged 15-19, have different patterns of childbearing than women who

marry at slightly older ages, who are more numerous among women aged 20-24; 2) births

among younger women are concentrated within

a narrower time period than they were among

oIder women; or 3) younger women do not have

realistic expectations of the timing of their future births.

VARIATIONS IN BIRTH EXPECTATIONS

TIMING OF BIRTHS

Table 2 shows that 78 percent of the total

births expected by currently married women

15-44 years old have already occurred. This

varies directly by age with wives under age 20

Table 1 shows that Negro wives at all ages

expect to have more total births than do white

wives. However, the difference decreases from

1,111 births per 1,000 wives aged 40-44, to 140

births per 1,000 wives aged 15-19. The higher
4 advancedata

total birth expectations of Negro wives is due to

their already having had more children than

white wives.

Table 3 shows that the fertility of wives of

Spanish origin or descent is more similar to that

of Negro wives than to white wives. Compared

with wives of other origins or descents, Spanish

wives expect to have almost 25 percent more

total births. This is due to their already having

more children and expecting more children in

the future than wives of other origin.

The greater the education of currently married women, the fewer total births they expect.

This pattern is similar for each age group. The

timing of births, however, is different for

women with different amounts of education.

Except for those with 1-3 years of high school,

the more educated women expect more births

in the future than their less educated counterparts, and have had fewer births in the past.

Wives in the labor force expect fewer totai

births than wives not in the labor force. Those

working full-time expect fewer total births than

women working part-time. Women working

full-time have also postponed a larger number of

births than women either working part-time or

who are not in the labor force.

Currently married women whose family income is 150 percent or more of the poverty

threshold expect to have fewer total births than

women whose family income is less than 150

percent of the poverty threshold. This pattern

applies to all ages 20 years or older. There is no

difference in birth expectations for women below

the poverty threshold and those whose family income is 100-149 percent of the poverty threshold.

Roman Catholic wives expect to have more

total births than Protestant wives. Protestant

wives, in turn, expect to have more total births

than Jewish wives or wives of other or no religious identification. There is no difference in

the timing of the births for Catholic, Protestant

and Jewish wives because the pattern is apparent

in both categories—children ever born and additional births expected. Catholic and Protestant

wives who participate more frequently in religious activities expect more total births by the

end of their childbearing than do women of the

same religious identification who participate less

frequently.

The older the woman was at the time of her

first marriage, the fewer births she expects by

the time she completes hex childbearing. The

difference between women married at ages 20 to

21 and those married at ages 22-24 years, however, is not statistically significant. The pattern

of decreasing numbers of total births expected

with increasing age at marriage is observed for

most age groups. However, there is also a general

pattern of increasing numbers of additional

births expected with increasing age at marriage

indicating a difference by age of marriage in the

timing of childbearing.

The timing of the first birth in relationship

to marriage affects the total number of children

a woman expects to have. Women who had a

premarital birth expect to have 699 more births

per 1,000 women tKan those whose first birth

occurred after marriage. Except for women

40-44 years old, there is no difference in the

total number of births expected by wives whose

first child was born within 8 months of marriage

and those whose first child was born 8-14

months after marriage. However, women who

waited 15 months or more for the birth of their

first child have significantly lower total birth expectations than those having a birth sooner after

marriage. Wives with no live births by the survey

date expect fewer total births than wives with at

least one birth, regardless of its timing.

For all ages, women using contraception expect the same number of total births as women

not using contraception. However, women whcI

are using contraception have already borne more

children. At ages 30 or older women using contraception expect to have more total births than

women not using contraception. Among women

who report that they are not using contraception, sterile women have had more births

than other women expect to have; sterile women

are older than other women not using contracep t ion. Women who were preLgnant, post

partum, or trying to become pregnant at the

date of interview are predominantly in the early

years of their childbearing. While they expect

about the same number of totaI births as women

not using contraceptives, they have borne fewer

children. Women sterilized for contraceptive reasons, or whose husbands have been sterilized,

have borne more children than any other group

of contracepting or noncontracepting women

expect to have.
adwncedata 5

Table 1. Number of currently married women 15-44 years old, number of children thdy have borne, minimum, maximum, and central

number of births expected, and number of births desired per thousand, bIYrace and age: United States. 1973

Race and age

All races

1544 years .... .........

15-19 years ..................

20-24 years ..................

25-29 years .. ................

30-34 years .......... .. ......

35-39 years ..................

4044 years ..... .. ...........

White

1544 years ... ..........

15-19 years ......... .........

20-24 years ..................

25-29 years ... ...... .........

30-34 years ... ...... ....... ..

35-39 years .......... ........

4044 years ... ...............

Nagro

1544 years .............

15-19 years ... .... ...........

20-24 years ............ ......

25-29 years ........ ..... .....

30-34 years .............. ....

35-39 years ..................

4044 years ...... .. ...... ....

Number of

wives in

thousands

268646

1,028

4,949

6,063

5,248

4,632

4,726

24,249

915

4,469

5,579

4,768

4,199

4,320

2,081

96

451

417

402

347

367

Children

ever

born

2,180

479

921

1,651

2,575

3,054

3,251

2,139

438

875

1,614

2,523

3,041

3,172

2,712

820

1,365

2,147

3,160

3,513

4,255

Minimum

births

expected

2,653

2,047

2,057

2,250

2,791

3,155

3,279

2,607

2,022

2,025

2,208

2,737

3,130

3,198

3,198

2,197

2,336

2,749

3,447

3,671

4,303

Central

number

of births

axpected

2,783

2,376

2,313

2,445

2,879

3,183

3,297

2,737

2,358

2,283

2,406

2,821

3,157

3,215

3,326

2,498

2,575

2,922

3,534

3,714

4,326

SYMBOLS

Data not available---—-----—---–—-—--——— ---

Category not applicable-------------------—- . . .

Quantity zero–----——-——— ---------- .

Quantity more than Obut less than 0.05— 0.0

Figure does not meet standards of

reliability or precision-—------–––— *

Maximum

births

expected

2,985

2,684

2,653

2,696

3,063

3,313

3,361

2,933

2,672

2,612

2,661

2,998

3,281

3,276

3,610

2,777

3,024

3,295

3,782

3,933

4,413

Births

desired

2,753

2,644

2,491

2,530

2,712

3,036

3,104

2,749

2,621

2,484

2,523

2,688

3,049

3,119

2,759

2,692

2,540

2,627

2,844

2,909

2,960
6 aduancedata

Table 2. Number of children already born, additional births expected by timing, and percent total of births expected per 1,000 currently

married women 1544 years old, by race and age: United States, 1973

Race and age

All races

1544 years ........... ..

15-19 years ... .......... .....

20-24 years ..................

25-29 years ..................

30-34 years ..................

35-39 years ............... .. .

4044 years ....... .. ....... ..

White

1544 years ..... ........

15-19 years ............. .....

20-24 years ..................

25-29 years .. ................

30-34 years ..................

35-39 years ..................

40-44 years ..................

Negro

1544 years .............

15-19 years.., ...............

20-24 years .. ................

25-29 years ... ........ .......

30-34 years ........ ..........

35-39 years ........ ..........

4044 years ........ .. ........

Children

already

born

2,180

479

921

1,651

2.575

3,054

3,251

2,139

438

875

1,614

2,532

3,041

3,172

2,712

820

1,365

2,147

3,160

3,513

4,255

Additional births expected

Within

2 years

153

458

283

226

104

46

15

151

467

286

224

100

43

14

157

411

255

238

119

52

21

Within

5 years

447

1,391

1,049

598

223

82

26

444

1,406

1,065

594

207

76

23

459

1,249

930

600

310

77

41

In all

future

years

603

1,897

1,392

794

304

130

47

599

1,920

1,408

793

289

116

43

613

1,678

1,210

775

374

200

71

Total

births

expected

2,783

2,376

2,313

2,445

2.879

3,183

3,297

2,737

2,358

2,283

2,406

2,821

3,157

3,215

3,326

2,498

2,575

2,922

3,534

3,714

4,326

Percent total of births expected

Already

occurred

78

20

40

68

89

96

99

78

;

67

90

96

99

82

33

53

73

89

95

98

—

ompleted

within

2 years

84

39

52

77

93

97

99

84

38

51

76

93

98

99

86

49

63

82

93

96

99

;ompleted

within

5 years

94

79

85

92

97

99

99

94

788

85

92

97

99

99

95

83

89

94

98

97

99
akmedaa7

Table 3. Number of total births expected and children ever born per 1,000 currently married woman 1544 years old by age and by seIacted characteristics: Unitad States, 1973

Selected characteristics

All woman ....... .................... ..................................

Origin

Spanish ....... ..... ................. ..........................................

Other ................. .......................................... ........ ..... ..

Education

Less than high school ............................ .................... ..

High school: 1-3 yaars ................................................

High school: 4 years ........ ........ ...................................

Collega: 13years ....... ............. ......... ...... ....................

College: 4 years or more .............................................

Labor force status

Not in labor force ....................... .................... ............

In labor force ..............................................................

Working full.time .... .............. ...... .. ...... ...................

Working pati.time ........................ ...... ...... .. ............

Not working .......... .. ............ ..................................

Poverty level income

Below poverty income ...... .............. ........ .............. ......

100-149 percent poverty income .... ....................... .....

150 percent poverty income or more ..........................

Religion and religious participation

Protestant ... .............. ........ ............................ ..............

More frequant ............. .. ...................... .............. .....

Less frequent ... ............ ..................... .....................

Roman Catholic ............................................... ...... .....

More frequent .............................. ...................... ....

Less frequent ... ....... ............................ ...................

Jewish .................... ....................................... .......... ....

Other or none ............. ................ ............................ ....

Age at first marriage

Under 18 years ............ .............. .................................

18-19 years .... ........................ .....................................

20-21 years .................. ........................ .......................

22-24 years ...... .................. ......... ...... ..........................

25-29 years ............ .............................. .......................

30 or more years ......................... ............................. ..

Timing of first birth

Before marriage ..... .................................................... .

After marriage ..................................... .. ...... .............. .

O-7 months ...................................... ..................... .

8-14 months .. .... ...................... .. ............................

15 or more months .............. .................... ..............

No live births ............ ..................................................

Contraceptive status

Noncontraceptors ...~ .. ................................................

Pregnant, post partum, seeking pregnancy .............

Sterile .......................................... ..........................

Other .............................. .......................................

Contraceptors .............................................................

Sterilization ................................................ ...........

Pill, IUD ........... ............................ ...... ...................

Other methods .............. ...................... .. .................

Total

2,783

3,403

2,741

3,6B6

3,148

2,669

2,544

2,302

2,942

2,560

2,511

2,730

2,410

3,501

3,564

2,645

2,710

2,782

2,644

3,057

3,225

2,840

2,356

2,257

3,219

2,862

2,654

2,551

2,291

1,901

3,672

2,973

3,226

3,250

2,693

1,717

2,740

2,727

2,897

2,627

2,801

3,328

2,563

2,752

Age in years

* I 25-29I

30-34 35-39 404’4

Total births expected

2,376

2,886

2,324

2,715

2,262

2,393

2,365

. . .

2,397

2,335

2,398

2,213

●1,455

2,466

2,319

2,366

2,246

2,338

2,182

2,790

2,804

2,782

*3 ,040

2,020

2,347

2,413

. . .

. . .

. . .

. . .

2,358

2,381

2,294

2,538

2,401

2,376

2,543

2,635

. . .

2,200

2,251

*1$12

2,214

2,450

2,810

2,279

3,134

2,559

2,276

2,109

1,931

2,479

2,116

2,132

2,227

1,508

2,641

2,363

2,273

2/260

2,381

2,195

2,514

2,626

2,403

1,569

2,117

2,528

2,283

2,254

2,194

. . .

. . .

3,13?

2,406

2,435

2,466

2,346

2,073

2,589

2,665

*409

2,411

2,202

2,311

2,184

2,233

2,445

3,258

2,394

3,279

2,877

2,380

2,297

2,115

2,634

2,147

2,128

2265

1,961

3,098

3,230

2,332

2,402

2,468

2,341

2,650

2,725

2,563

2,094

2,002

2,953

2,527

2,318

2,253

2,039

. . .

3,279

2,610

2,691

2,851

2,453

1,633

2,542

2,685

2,118

2,146

2,406

2,806

2,338

2,307

2,879

3,395

2,854

3,658

3,365

2,839

2,568

2,317

3,032

2,633

2,519

2,836

2,766

3,738

3,930

2,719

2,798

2,810

2,787

3,138

3,284

2,929

2,058

2,553

3,629

3,038

2,786

2,432

2,225

1,434

3,889

2,992

3,493

3,216

2,630

1,022

2,680

2,734

2,520

2,729

2,948

3,195

2,851

2,839

3,183

3,840

3,118

3,861

3,565

3,065

2,971

2,385

3,348

2,866

3,028

2,907

2,760

4,203

4,477

2,960

3,088

3,129

3,034

3,476

3,630

3,251

2,583

2,680

3,704

3,430

3,199

2,831

2,273

1,767

4,140

3,275

4,049

3,525

2,880

654

2,987

3,084

3,152

2,727

3,267

3,544

3,439

2,859

3,297

3,840

3,267

4,214

3,654

3,023

“3,1 60

2,898

3,480

38074

3,021

3,314

2,791

4,692

4,799

3,080

3,198

3,090

3,324

3,632

3,795

3,330

2,771

2,586

3,767

3,671

3,019

3,064

2,638

2,274

4,481

3,456

4,678

3,771

3,009

276

2,956

3,144

3,044

2,802

3,503

3,796

3,508

3,257
8 achancedata

Table 3. Number of total births expected and children ever born per 1,000 currently married women 1544 vears old bv age and by selected characteristics: United States, 1973–con.

Selected characteristics

All women ....... ....................... ...... .. ..................

Origin

,Spanish ..................... .. ................ ........ ........................

Other ... .. ........................ ........ .....................................

Education

Less than high school ................................................. .

High school: 1-3 years ......... .. ................ .......... ...........

High school: 4 years .... .......... .....................................

College: 13 years ............... ........ ........ ........................

College: 4 years or more ............................. ................

Labor force status

Not in labor force ........... ...................................... ......

In labor force .................... ...... .. ..................................

Working full-time ......................................... ..........

Working part-time ....................... ...........................

Not working ...................... ....................................

Povertv level income

Balow poverty income. ...............................................

100-149 percent poverty income .. ........................ ......

150 percent poverty income or more .... ......................

Religion and religious participation

Protestant ...... .............................................................

More frequent ............ ...........................................

Less frequent .................... .. ...................................

Roman Catholic .... .................. ........ ............................

More frequent ........ .................. ........ ........ ..............

Less frequent ................... ........ .............................-

Jewish ............... .......... .................. ...... ........ .... ............

Other or none ............. ............... .................... ...... .......

Age at first marriage

Under 18 years ....... ....................................................

18-19 years .. ............ ...................................................

20-21 years .......... ...o...... .........c...................................

22-24 years ................... ..............................................

25-29 years .. .......................................... .....................

30 or more years .........................................................

Timing of first birth

Before marriage ......................... .................................

After marriage ................................. ...... .................... .

0-7 months ............. ...............................................

8-14 months .................. .. ......................................

15 or more months.. ..............................................

No live births ............ ..................................................

Contraceptive status

Noncontraceptors .... ........................ ...... .......... ........ ...

Pregnant, post partum, seeking pregnancy ........ .....

Sterile .... .................. .................. ............................

Other ..................... .......................................... .....-

Contraceptors ....................................... ......................

Sterilization .................................. .. ................ .......

Pill, IUD .... .................. ................................... .......

Other methods .......................................................

Age in years

Total

15-19 20-24 25-29 30-34 35-39 40-44

2,180

—.

2,641

2,149

3,210

2,707

2,072

1,812

1,470

2,395

1,877

1,731

2,239

1,931

2,734

3,099

2,043

2,158

2,287

2,039

2,359

2,525

2,144

1,914

1,467

2,778

2,266

1,999

1,825

1,657

1,284

3,186

2,626

2,842

2,966

2,317

. . .

1,825

1,056

2,897

2,166

2,335

3,328

1,832

2,322

479

’674

459

810

587

342

---

---

557

324

282

’455

*89

579

791

407

482

551

434

’471

*283

*589

‘ 540

*479

687

“21 8

. . .

. . .

. . .

. . .

1,123

1,154

1,128

1,139

1,228

. . .

’305

348

..-

*93

611

*1,912

621

* 503

Children ever born

921

1,268

897

1,832

1,694

835

473

“155

1,207

580

498

937

*514

1,150

1,410

837

928

959

912

888

677

1,089

“314

1,035

1,653

1,007

512

*279

. . .

. .

2,218

1,474

1,602

1,561

1,325

. . .

824

780

’409

1,031

960

2,311

872

830

1,651

2,404

1,604

2,627

2,434

1,719

1,323

730

1,985

1,124

1,042

1,432

944

2,101

2,732

1,531

1,670

1,747

1,599

1,773

1,732

1,820

994

1,025

2,603

2,019

1,503

964

654

. . .

2,695

2,036

2,278

2,361

1,774

. . .

1,223

1,088

2,118

1,388

1,820

2,806

1,669

1,542

2,575

2,932

2,558

3,358

3,133

2,584

2,227

1,770

2,767

2,267

2,153

2,498

2,293

3,488

3,765

2,399

2,548

2,546

2,550

2,727

2,903

2,475

2,058

2,103

3,462

2,838

2,591

1,985

1,476

*333

3,441

2,761

3,387

3,039

2,309

. . .

1,985

1,401

2,520

2,474

2,779

3,195

2,647

2,558

3,054

3,612

2,998

3,640

3,424

2,959

2,892

2,220

3,197

2,865

2,908

2,836

2,670

3,975

4,388

2,836

2,993

3,040

2,932

3,273

3,425

3,051

2,510

2,471

3,628

3,361

3,106

2,675

1,963

1,108

3,957

3,181

3,952

3,419

2,806

. . .

2,628

1,822

3,152

2,521

3,236

3,544

3,390

2811

-

3,251

3,574

3,233

4,146

3,617 .

2,976

3,117

2,855

3,421

3,042

2,983

3,294

2,762

4,557

4,733

3,041

3,169

3,041

3,318

3,546

3,729

3,209

2,733

2,510

3,750

3,652

2,976

2,997

2,573

1,950

4,468

3,424

4,651

3,733

2,980

. . .

2,839

1,866

3,044

2,72%

3,498

3,796

3,506

3247 -
admmdaa9

TECHNICAL NOTES

DESIGN OF THE SURVEY: The National Survey of Family Growth (NSFG), initiated in

1971, is designed to provide data on fertility,

family planning, and related aspects of maternzd

and child health. Field work for Cycle I was

carried out by the National Opinion Research

Center in 1973 and early 1974 with September

13, 1973, as the midpoint of the interviewing.

A multistage probability sample of women

in the noninstitutional population of the conterminous United States was used. The sample

of women eligible for the NSFG was between

the ages of 15 to 44 years, incIusive, were currently married or previously married or were

never married but had natural children presently

living in the household. A detailed description of

the sample design will be presented in a forthcoming report “Sample Design, Estimation Procedures, and Variance Estimation for a National

~urvey of Family Growth. ”

RELIABILITY OF ESTIMATES: Since the statistics presented in this report are based on a

sample, they may differ somewhat from the figures that would have been obtained if a

complete census had been taken, using the same

questionnaires, instructions, interviewing personnel, and field procedures. This chance difference

between sample results and a complete count is

referred to as sampling error. In addition, the

resuIts are also subject to nonsampling error due

to respondent misreporting, data processing mistakes, and nonresponse. It is very difficuIt, if n~t

impossible, to obtain accurate measures of nonsampling errors. These types of errors were kept

to a minimum by the quality control procedures

and other methods incorporated into the survey

design and administration.

Sampling error, or the extent to which samples may differ by chance from a complete

count, is measured by a statistic called the standard error of estimate. Approximate standard

errors for estimated numbers and ratios from

this survey are shown in tables I and II.

The chances are about 68 out of 100 that an

:stimate from the sample would differ from a

complete census by less than the standard error.

The chances are about 95 out of 100 that the

differences between the sample estimate and a

Table 1. Approximate standard errors for estimated numbers of

white and total women: 1973 National Survey of Family

Growth

Size of estimate

50,000 ......... ..........................

100,000 ....... ..........................

200,000 .................................

500,000.................................

1,000,000..............................

2,000,000..............................

5,000,000..............................

10,000,000............................

20,000,000............................

Relative

standard

error

30.0

21.2

15.0

9.5

6.7

4.8

3.0

2.2

1.5

Standard

error

15,000

21,000

30,000

47,000

67,000

95,000

151,000

216,000

311,000

Table II. Estimated standard errors of the ratio of total births expected per 1,000 women: 1973 National Survey of Family

Growth

Base of ratio

20,000...............

50,000...............

100,000.............

200,000.............

500,000.............

1,000,000..........

2,000,000..........

5,000,000..........

10,000,000 ........

20,000,000........

Estimated ratio

n

I,000 2,000

232 531

147 336

104 238

74 168

47 107

33 76

24 54

16 35

12 26

9 20

1,000

826

523

370

262

166

118

84

54

40

30

!,000

1,121

709

502

355

225

160

114

74

54

41

5,000

1,416

896

634

448

284

202

144

93

68

51

complete count wouId be less than twice the

standard errclr. The relati~~e standard error is the

ratio of the standard error to the statistic being

estimated. In this report, numbers and percentages which have a standard error that is

more than 25 percent of the estimate itself are

considered “unrelial-de.” They are marked with

an asterisk tc> caution the user but may be combined to make other types of comparisons of

greater precision.

In this report, terms such as “similar” and

“the same “ mean that any observed difference

between twcl estimates being compared is not

statistically significant. Similarly, terms such as
10 advancedata

“greater,” “less,” “larger,” “smaller,” etc., indicate that the observed differences are statistically significant. The normal deviate test with a

0.5 level of significance was used to test all comDEFINITION

Children ever born. –The number of children

born alive to a woman.

Additional births expected. –The number of

children a woman expects to give birth to in the

future, including current pregnancy, if applicable. Women who were sterile or married to

sterile men were classified as expecting zero

additional births. Those physically able to have

births were asked whether they and their husbands intended to have any babies in the future

and, if so, how many. Women who did not know

whether they intended any future births, or did

not know a particular number they intended to

have, were asked for the smallest and largest

numbers they expect to have. Women who reported a particular number of children they intended to have were asked how sure they were

about having specifically that number. Those uncertain of having that specific number were

asked for the maximum and minimum numbers

they expect to have.

For each woman, there is a maximum, minimum and central number of additional births

expected. If a woman reported a specific

number she intended to have, that was considered the central number she expected. If she

was sure about it, that was also the minimum

and maximum number she expected. For a

woman who was not sure of having her intended

number, the smallest and largest numbers she

expected were her minimum and maximum numbers, respectively. For a woman who did not

report any specific number of intended future

births, the average of the smallest and the largest

numbers expected became her central expected

number. In this report, discussion of additional

births expected refers to the central number unless specifically identified otherwise. Further discussion of this topic will be given in a forthcoming report in Series 23 of Vital and Health

Statistics.

Total births expected. –The number of

children a woman expects to have by the time

parisons. Lack of comment in the text between

any two statistics does not mean the difference

was tested and found not to be significant.

OF TERMS

she completes her childbearing. This number is

the sum of the children ever born and the additional births expected. .Minimum, maximum and

central numbers of total births expected are calculated by using the minimum, maximum and

central additional births expected. Unless specified otherwise, references to total births expected refer to the central number.

Births desired. –The number of children a

woman would have if she could start life all over

again and have just the number of children shle

wanted, knowing other things would have

turned out just about the way they did for her

and her husband.

Age. –The respondent’s age at her last birthday before the interview.

Age at first marriage. –The woman’s age at

the time of her first marriage or commonlaw

union.

Con traceptive status. –Women were classified as “noncontraceptors” if they were pregnant, post partum (last pregnancy terminated

less than two months before interview) or they

and their husbands were not using contraceptives because she was trying to become pregnant, they or their husbands were sterile for other

than contraceptive reasons, or for some other

reason. Women were classified as “contraceptors”

if they or their husbands had had a sterilizing

operation at least partly for contraceptive reasons, if they were using the pill, the IUD, or

other methods of contraception.

Education. –The highest grade of regular

school the woman had completed at the survey

date.

Labor Force Status. –A woman is categorized as being in the labor force if she was

working full-time or part-time, had a job but was

not at work because of temporary illness, vacation, or a strike, or if she was unemployed,

laid off, or looking for work. A woman is classified as working full-time if she works 35 or

more hours a week.
ackmxkm 11

Jfan”tal Status. –Marital status classifications

are married, widowed, divorced, separated, or

never married. Married persons include those

who reported themselves as married or as informally married, such as living with a partner or

commonlaw spouse. This classification includes

those who are temporarily separated for reasons

other than marital discord such as vacation, iHness, or Armed Forces. Persons who are separated legaHy or informally for reasons of marital discord are classified as separated. All tables

in this report are based upon currently married

women or others whose marital status at the

time of the interview was “married. ”

Poverty level. –The poverty index ratio was

calculated by dividing the total family income

by the weighted average threshold income of

nonfarm residents, head under 65, based. on the

poverty levels shown in the U.S. Bureau of the

Census, Cun-ent Population Reports, Series P-60,

No. 98, “Characteristics of the Low-Income

Population, 1973,” table A-3. This definition

takes into account the sex of the family head

and the number of persons in the family. Total

family income includes income from alI sources

for all members of the respondent’s famiIy.

Race. –Classification by race of the woman

interviewed, based on interviewer observation,

was reported as Negro, white, or other.

Religion (znd religious participation. –Women

were asked whether they were Protestant, Catholic, Jewish or something else. Protestant incIudes most of the Christian groups other than

Roman Catholic. The “other” category includes

non-Chnstian religions and no religion.

Protestant women are classified as having

more frequent religious participation if they attend religious services twice a month or more,

and having less frequent participation if attendance is once a month or less.

Catholic women are classified as having more

frequent religious participation if they receive

communion several times a year or more, and

less frequent participation if they receive communion once a year or less. Sample reliability

makes subclassification of Jewish or “other or

none” religious categories by participation impractical.

Spanish origin. –A respondent was classified

as being of Spanish origin if she reported her

origin or descent as Mexican, Chicano, Mexican

American, Puerto Rican, Cuban, or other

Spanish.

Timing oj’j’irst birth. –The first birth is classified as occurring before or after the first or

only marriage. First births occurring after marriage are further classified by the number of

months between marriage and the birth.
12

No. 1.

No. 2.

No. 3.

No. 4.

No. 5.

Previous issues of Advance Data From Vital and Health Statistics

Blood Pressure of Persons 6-74 Years No. 6. Dietary Intake of Persons 1-74 Years

of Age in the United States (Issued: of Age in the United States (Issued:

October 18, 197 6) March 30, 1977)

Hypertension: United States, 1974

(Issued: November 8, 1976)

No. 7. Total Serum

Adults 18-74

Height and Weight of Adults 18-74 United States

Years in the United States (Issued: May 25, 1977)

November 19, 1976)

Cholesterol Level of

Years of Age in the

in 1971-74 (Issued:

Prevalence of Dermatological Diseases

No. 8. Total Serum Cholesterol Level of

Among Persons 1-74 Years of Age,

Children 417 Years of Age in the

United States (Issued: January 26,

United States in 1971-74 (Issued:

1977)

July 11, 1977)

A Comparison of Levels of Serum No. 9. Wanted and Unwanted Births Reported

Cholesterol of Adults 18-74 Years of by Mothers 15-44 Years of Age in the

Age in the United States in 1960-62 United States in 1973 (Issued: August

and 1971-74 (Issued: February 22, 10, 1977)

1977)
Vital and Health Statistics

series descriptions

SERIES 1.

SERIES 2.

SERIES 3.

SERIES 4.

SERIES 5.

SERIES 6.

SERIES 10.

SERIES 11.

SERIES 12.

SERIES 13.

SERIES 14.

Programs and Collection Procedures— Reports describing

the general programs of the National Center for Health

Statistics and its offices and divisions and the data COIIaction methods used. They also Include definitions and

other material necessa~ for understanding the data.

Data Evaluation and Methods Research—Studies 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 data, and contributions to

statistical theory. Studies also include comparison of

U.S. methodology with those of other countries.

Analytical and Epidamiological Studies-Reports presenting analytical or interpretive studies based on vital

and health statistics, carrying the analysts further than

the expository types of raports in the other series.

Documents and Committee Reports-Final reports of

major committees concerned with vital and health statistics and documents such as recommended mod’el vital

registration laws and revisad birth and death certificates.

Comparative International Vital and Haalth Statistics

Reports-Analytical and descriptive reports comparing

U.S. vital and health statistics with those of other countries.

Cognition and Survey Measuremant— Reports from the

National Laboratory for Collaborative Research in Cognition and Survey Measurement using methods of cognitive

science to dasign, evaluate, and test survey instruments.

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.

Data From the National Health Examination Survey and

the National Health and Nutrition Examination Survey—

Data from direct examination, testing, and measurement

of national samples of the civilian noninstitutionalized

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 raspect to physical, physiological, and psychological characteristics and (2) analysis of relationships

among the various measurements without reference to

an explicit finite universe of pereons.

Data From the Institutionalized Population Surveys-Discontinued in 1975. Reports from these surveys are included in Series 13.

Data on Health Resources Utilization—Statistics on the

utilization of health manpower and facilities providing

long-term care, ambulatory care, hospital care, and family

planning services.

Data on Health Resources: Manpower and Facilities—

Statistics on the numbers, geographic dwtribution, and

characteristics of health resources including physicians,

dentists, nurses, other health occupations, hospitals,

nursing homes, and outpatient facilities.

SERIES 15.

SERIES 16,

SERIES 20.

SERIES 21.

SERIES 22,

SERIES 23.

SERIES 24.

Data From Special Surveys-Statistics on health and

health-related topics collected in special surveys that

are not a part of the continuing data systems of the

National Center for Health Statistics.

Compilations of Advance Data From Vital and Health

Statistics—These reports provide early release of data

from the National Center for Health Statistics’ health and

demographic surveys. Many of these releases are followed

by detailed reports in the Vital and Health Statistics

Series.

Data on Mortality-Various statistics on mortality other

than as included in regular annual or monthly reports.

Special analyses by cause of death, age, and other demographic variables; geographic and time series analyses;

and statistics on characteristics of deaths not availab[e

from the vital records based on sample suweys of those

records.

Data on Natality, Marriage, and Divorca—Various statistics on natality, marriage, and divorce other than as

included m regular annual or monthly reports. Special

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 tha National Mortality and Natality Survays—

Discontinued in 1975. Reports from these sample surveys

based on vital records are included in Series 20 and 21,

respectively.

Data From the National Survay of Family Growth—

Statwtics on fertility, family formation and dissolution,

family planning, and related maternal and infant health

topics derived from a periodic survey of a nationwide

probability sample of women 15-44 years of age.

Compilations of Data on Natality, Mortality, Marriage,

Divorce, and Induced Terminations of Pregnancy—Advance reports of births, deaths, marriages, and divorces

are based on final data from the National vital Statistics

System and are published annually as supplements to the

Monthly Vital Statistics Report (MVSR). These reports are

followed by the publication of detailed data in Vital Statistics of the United States annual volumes. Other reports

including induced terminations of pregnancy issued periodically as supplements to the MVSR provide selected findings based on data from the National Vital Statistics

System and may be followed by detailed reports in Vital

and Health Statistics Series.

For answers to questions about this report or for a list of titles of

reports published in these series, contacti

Scientific and Technical Information Branch

National Center for Health Statistics

Centers for Disease Control

Public Health Setvice

Hyattwille, Md. 20782

301-436-8500
US DEPARTMENT OF HEALTH AND

HUMAN SERVICES

Pubhc Health Service

Centers for Disease Control

National Center for Health Statlstlcs

3700 East-West Highway

Hyattsville, Maryland 20782

OFFICIAL BUSINESS

PENALTY FOR PRIVATE USE, $300

BULK RATE

POSTAGE & FEES PAID

PHS/NCHS

PERMIT NO. G–281

DHHS Publication No. (PHS) 89-1860, Series 16, No. 1