Click here to go to Table of Contents Copyrightinformation Permissionhasbeenobtainedfromthecopyright holderstoreproducecertainquotedmaterialinthis report.Furtherreproductionofthismaterialis prohibitedwithoutspecificpermissionofthe copyrightholder.Allothermaterialcontainedinthis reportisinthepublicdomainandmaybeusedand reprintedwithoutspecialpermission;citationasto source,however,isappreciated. Suggestedcitation NationalCenterforHealthStatistics Health,UnitedStates,2006 WithChartbookonTrendsintheHealthofAmericans Hyattsville,MD:2006 LibraryofCongressCatalogNumber76–641496. ForsalebySuperintendentofDocuments U.S.GovernmentPrintingOffice Washington,DC20402 Preface Health,UnitedStates,2006 isthe30threportonthehealth statusoftheNationandissubmittedbytheSecretaryofthe DepartmentofHealthandHumanServicestothePresident andCongressoftheUnitedStatesincompliancewithSection 308ofthePublicHealthServiceAct.Thisreportwas compiledbytheNationalCenterforHealthStatistics(NCHS), CentersforDiseaseControlandPrevention(CDC).The NationalCommitteeonVitalandHealthStatisticsservedina reviewcapacity. The Health,UnitedStates seriespresentsnationaltrendsin healthstatistics.Eachreportincludesanexecutivesummary, highlights,achartbook,trendtables,extensiveappendixes, andanindex. Chartbook The ChartbookonTrendsintheHealthofAmericans updates andexpandsinformationfrompreviouschartbooksand introducesthisyear’sspecialfeatureonpain.Painaffects physicalandmentalfunctioning,affectsqualityoflife,reduces productivity,andisamajorreasonforhealthcareutilization. ThechartbookassessestheNation’shealthbypresenting trendsandcurrentinformationonselecteddeterminantsand measuresofhealthstatusandutilizationofhealthcare.Many measuresareshownseparatelyforpersonsofdifferentages becauseofthestrongeffectofageonhealth.Selected figuresalsohighlightdifferencesindeterminantsand measuresofhealthstatusandutilizationofhealthcareby suchcharacteristicsassex,race,Hispanicorigin,education, andpovertystatus. TrendTables Thechartbooksectionisfollowedby147trendtables organizedaroundfourmajorsubjectareas:healthstatusand determinants,healthcareutilization,healthcareresources, andhealthcareexpenditures.Amajorcriterionusedin selectingthetrendtablesisavailabilityofcomparablenational dataoveraperiodofseveralyears.Thetablespresentdata forselectedyearstohighlightmajortrendsinhealthstatistics. Earliereditionsof Health,UnitedStates maypresentdatafor additionalyearsthatarenotincludedinthecurrentprinted report.Wherepossible,theseadditionalyearsofdataare availableinExcelspreadsheetfilesonthe Health,United States website.Tableswithadditionaldatayearsarelistedin AppendixIII. RacialandEthnicData Manytablesin Health,UnitedStates presentdataaccording toraceandHispanicoriginconsistentwithDepartment-wide emphasisonexpandingracialandethnicdetailwhen presentinghealthdata.Trenddataonraceandethnicityare presentedinthegreatestdetailpossibleaftertakinginto accountthequalityofdata,theamountofmissingdata,and thenumberofobservations.Standardsforclassificationof federaldataonraceandethnicityaredescribedinAppendix II,Race. EducationandIncomeData Manytablesin Health,UnitedStates presentdataaccording tosocioeconomicstatus,usingeducationandpovertylevelas proxymeasurescationandincomedataaregenerally obtaineddirectlyfromsurveyrespondents,andarenot generallyavailablefromrecords-baseddatacollection systemsincludingtheNationalHealthCareSurvey(see AppendixI).Statevitalstatisticssystemscurrentlyreport mother’seducationonthebirthcertificateand,basedon informationfromaninformant,decedent’seducationonthe deathcertificate.SeeAppendixII,Education;Familyincome; Poverty. DisabilityData Disabilityisacomplexconceptandcanincludepresenceof physicalormentalimpairmentsthatlimitaperson’sabilityto performanimportantactivity,anduseoforneedfor accommodationsorinterventionsrequiredtoimprove functioningrmationondisabilityintheU.S.populationis criticaltohealthplanningandpolicy.Althoughsome informationiscurrentlyavailablefromfederaldatacollection systems,theinformationislimitedbyalackofstandard definitionsandsurveyquestionsondisability.Severalcurrent initiativesareunderwaytocoordinateandstandardize measurementofdisabilityacrossfederaldatasystems.Until suchstandardizedinformationisavailable, Health,United States includesthefollowingdisability-relatedinformationfor theciviliannoninstitutionalizedpopulation:prevalenceof limitationsofactivityduetochronicconditions(Table58), Health,UnitedStates,2006 iii P re fa c e