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Clinical Preventive Services

Latest Data

Explore the latest data for the LHI topic Clinical Preventive Services. 
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Where We’ve Been and Where We’re Going

From 2008 to 2013, the percentage of adults aged 50 to 75 years who had received a colorectal cancer screening based on the most recent guidelines increased 12%, from 52.1% (age adjusted) to 58.2%, moving toward the HP2020 target of 70.5%. 
 
Over the past decade, blood pressure control increased by 55% among adults aged 18 years and over with hypertension, from 31.6% (age adjusted) in 1999–2002 to 48.9% in 2009–12.  
 
Over the Healthy People 2020 tracking period there was no statistically significant change in the rate of poor glycemic control (HbA1c greater than 9%) among adults aged 18 years and over with diagnosed diabetes (18.0% in 2005–08 and 21.0% in 2009–12, age adjusted).
 
The percentage of children aged 19 to 35 months who had received the recommended doses of DTaP, polio, MMR, Hib, Hep B, varicella, and PCV vaccines increased 62%, from 44.3% in 2009 to 71.6% in 2014. In 2014, several population groups in specific demographic categories had the highest rates of receiving all recommended vaccinations, including children whose mothers had an advanced degree, those in families with incomes 400–599% of the poverty threshold, and those with private health insurance. 
 
 

Leading Health Indicators

Explore the latest data and disparities for each indicator.
Colorectal cancer screening (C-16)
Blood Pressure Control (HDS-12)
Poor Glycemic Control (D-5.1)
Fully Immunized Children (IID-8)

Colorectal cancer screening (C-16)

  • Healthy People 2020 objective C-16 tracks the proportion of adults aged 50–75 years who have had a blood stool test in the past year, sigmoidoscopy in the past 5 years and blood stool test in the past 3 years, or a colonoscopy in the past 10 years.
    • HP2020 Baseline: In 2008, 52.1% of adults aged 50–75 years received a colorectal cancer screening based on the most recent guidelines (age adjusted).
    • HP2020 Target: 70.5%, by modeling/projection.
    • Most Recent: In 2013, 58.2% of adults aged 50–75 years received a colorectal cancer screening based on the most recent guidelines (age adjusted).
  • Among racial and ethnic groups, the white non-Hispanic population had the highest rate of colorectal cancer screening based on the most recent guidelines in 2013, 60.5% of adults aged 50–75 years (age adjusted), whereas the Hispanic or Latino population had the lowest rate, 43.0%. The rate for the white non-Hispanic population was almost 1.5 times the rate for the Hispanic or Latino population.
  • In 2013, there was no statistically significant difference between females and males (59.1% versus 57.2%, age adjusted) aged 50–75 years who had received a colorectal cancer screening based on the most recent guidelines.
  • Among education groups for persons aged 50–75 years, those with an advanced degree had the highest rate of colorectal cancer screening based on the most recent guidelines, 72.9% (age adjusted) in 2013. Rates for other education groups were:
    • 42.6% among those with less than a high school education (lowest rate). The rate for those with an advanced degree was more than 1.5 times that for those with less than a high school education.
    • 53.3% among those with a high school education or GED. The rate for those with an advanced degree was almost 1.5 times that for those with a high school education or GED.
    • 57.7% among those with some college education. The rate for those with an advanced degree was almost 1.5 times that for those with some college education.
    • 63.6% among those with an associate degree.
    • 64.3% among those with a 4-year college degree.
  • Among income groups for persons aged 50–75 years, those with family incomes 600% of the poverty threshold or above had the highest rate of colorectal cancer screening based on the most recent guidelines, 70.1% (age adjusted) in 2013. Rates for other income groups were:
    • 44.3% among those with family incomes below the poverty threshold (lowest rate). The rate for those with a family income 600+% of the poverty threshold was more than 1.5 times that for those with family income below the poverty threshold. 
    • 47.8% among those with family incomes between 100% and 199% of the poverty threshold. The rate for those with family incomes 600+% of the poverty threshold was about 1.5 times that for those with family incomes between 100% and 199% of the poverty threshold.
    • 55.5% among those with family incomes between 200% and 399% of the poverty threshold. The rate for those with family incomes 600+% of the poverty threshold was almost 1.5 times that for those with family incomes between 200% and 399% of the poverty threshold.
    • 62.0% among those with family incomes between 400% and 599% of the poverty threshold.
  • In 2013, persons aged 50–64 years with private health insurance had the highest rate of colorectal cancer screening based on the most recent guidelines, 58.5%, among insurance groups. Those with public insurance and the uninsured had rates of 55.2% and 23.6%, respectively. The rate for those with private insurance was about 2.5 times that for those without insurance.

Persons Receiving a Recommended Colorectal Cancer Screening by Insurance Status, 2013

Colorectal Screening Web Graphic

Data source: National Health Interview Survey (NHIS), CDC/NCHS.

Endnotes:

  • All disparities described are statistically significant at the 0.05 level of significance. To maintain comparability across indicators, disparities are computed using adverse events.
  • Data are age adjusted to the 2000 standard population using the age groups 50–64 and 65–75 years. Age-adjusted rates are weighted sums of age-specific rates.
  • Data for this measure are available periodically and come from the National Health Interview Survey (NHIS), CDC/NCHS.
  • U.S. Preventative Services Task Force (USPSTF) guidelines recommend screening for colorectal cancer using fecal occult blood testing annually, sigmoidoscopy every 5 years with fecal occult blood testing every 3 years, or colonoscopy every 10 years for persons aged 50–75 years.

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Blood Pressure Control (HDS-12)

  • Healthy People 2020 objective HDS-12 tracks the proportion of adults with hypertension whose blood pressure is under control (systolic blood pressure <140 mmHg and diastolic blood pressure <90 mmHg).
    • HP2020 Baseline: In 2005–08, 43.7% of adults aged 18 years and over with hypertension had it under control (age adjusted). 
    • HP2020 Target: 61.2%, a 40% improvement over the baseline. 
    • The percentage of adults aged 18 years and over with hypertension who had their blood pressure under control increased by 55% between 1999–2002 and 2009–12, from 31.6% to 48.9% (age adjusted).
  • Among racial and ethnic groups, the white non-Hispanic population had the highest rate of blood pressure control, 53.6% of persons aged 18 years and over with hypertension (age adjusted) in 2009–12, whereas the Hispanic or Latino population had a rate of 37.9% (age adjusted) in 2009–12 and the black non-Hispanic population had a rate of 44.1% (age adjusted). The rate for the white non-Hispanic population was almost 1.5 times that for the Hispanic or Latino population.  
  • Females aged 18 years and over with hypertension had a higher (better) rate of blood pressure control than males (56.6% versus 43.1%, age adjusted) in 2009–12. The rate for females was almost 1.5 times the rate for males.  

Controlled High Blood Pressure by Sex, 2009-12

Hypertension Web Graphic

Data source: National Health and Nutrition Examination Survey (NHANES), CDC/NCHS.

  • Persons aged 20 years and over with hypertension with activity limitations had a higher (better) rate of blood pressure control than persons without activity limitations (63.1% versus 45.3%, age adjusted) in 2009–12. The rate for persons with activity limitations was almost 1.5 times that for persons without activity limitations.  
  • Persons aged 45–64 years with hypertension had the highest rate of blood pressure control, 56.6% in 2009–12, among broad age groups. Rates for the other age groups were:
    • 39.1% among persons aged 18–44. The rate for persons aged 45–64 years was about 1.5 times that for persons aged 18–44 years.
    • 52.5% among persons aged 65 years and over (not significantly different than the best group rate)
  • When further refining the age groups, persons aged 65–74 years with hypertension had the highest rate of blood pressure control, 58.5% in 2009–12. Rates for the other age groups were:
    • 41.3% among persons aged 25–44 years. The rate for persons aged 65–74 years was almost 1.5 times that for persons aged 25–44 years.
    • 57.9% among persons aged 45–54 years (not significantly different than the best group rate)
    • 55.7% among persons aged 55–64 years (not significantly different than the best group rate)
    • 52.3% among persons aged 75–79 years (not significantly different than the best group rate)
    • 41.5% among persons aged 80 years and over. The rate for persons aged 65–74 years was almost 1.5 times that for persons aged 80 years and over.
  • Adults aged 18 years and over with hypertension born in the US had a higher (better) rate of blood pressure control than persons born outside the US (50.2% versus 41.2%, age adjusted) in 2009–12.  
  • Among health insurance status groups, persons aged 18–64 years with hypertension with public health insurance had the highest rate of blood pressure control, 54.6% (age adjusted) in 2009–12, whereas persons with private insurance had a rate of 51.4% (not significantly different than the best group rate) and persons with no health insurance had a rate of 30.9%. The rate for persons with public health insurance was nearly twice the rate for persons with no health insurance.  
  • In 2009–12, adults aged 18 years and over with hypertension with diabetes had a higher (better) rate of blood pressure control than those without diabetes (67.2% versus 45.9%, age adjusted).  The rate for persons with diabetes was about 1.5 times the rate for persons without diabetes.  
  • In 2009–12, adults aged 20 years and over with hypertension who were obese had a higher (better) rate of blood pressure control than persons who were not obese (54.8% versus 42.4%, age adjusted). The rate for persons who were obese was almost 1.5 times that for persons who were not obese.  
 
Endnotes:
  • Unless otherwise stated, all comparisons described are statistically significant at the 0.05 level of significance.
  • Data for this measure are available biennially and come from the National Health and Nutrition Examination Survey (NHANES), CDC/NCHS. Preferably 4 years of data are pooled for analysis when available.  
  • The terms “Hispanic or Latino” and “Hispanic” are used interchangeably in this report.  
  • Data (except those by disability status, education status, health insurance coverage, obesity status, and age group) are age adjusted to the 2000 standard population using the age groups 18–49, 50–59, 60–69, 70–79, and 80 years and over. Data by disability and obesity status are adjusted using the age groups 20–49, 50–59, 60–69, 70–79, and 80 years and over. Data by education status are adjusted using the age groups 25–49, 50–59, 60–69, 70–79, and 80 years and over. Data by health insurance coverage are adjusted using the age groups 18–49, 50–59, and 60–64 years. Data by age group are not age adjusted. Age-adjusted rates are weighted sums of age-specific rates. 
  • Blood pressure control is defined as an average systolic blood pressure <140 mmHg and an average diastolic blood pressure <90 mmHg among adults with hypertension. Hypertension is defined as an average systolic blood pressure ≥140 mmHg, an average diastolic blood pressure ≥90 mmHg, or self-reported current use of blood pressure–lowering medication. Pregnant women are excluded from analyses.

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Poor Glycemic Control (D-5.1)

  • Healthy People 2020 (HP2020) objective D-5.1 tracks the proportion of adults with diagnosed diabetes who have poor glycemic control (HbA1c greater than 9%).
    • HP2020 Baseline: In 2005–08, 18.0% of adults aged 18 years and over with diagnosed diabetes had poor glycemic control (age adjusted).  
    • HP2020 Target: 16.2%, a 10% improvement over the baseline. 
    • Most Recent: In 2009–12, 21.0% of adults aged 18 years and over with diagnosed diabetes had poor glycemic control (age adjusted).  
  • Among adults aged 18 years and over with diagnosed diabetes, females had a lower rate of poor glycemic control than males in 2009–12 (16.8% versus 24.6% age adjusted).
  • Among racial and ethnic groups with diagnosed diabetes, the white non-Hispanic population had the lowest rate of poor glycemic control, 15.3% of persons aged 18 years and over (age adjusted) in 2009–12. Rates for other race/ethnicity groups were nearly twice the best group rate (age adjusted):
    • 28.5% among the black non-Hispanic population
    • 28.1% among the Hispanic or Latino population
  • Persons with diagnosed diabetes aged 65 years and over had the lowest rate of poor glycemic control among age groups, 8.0% in 2009–12. Rates for the other age groups were:
    • 14.4% among persons aged 45–64 years; nearly twice the best group rate
    • 30.3% among persons aged 18–44 years; nearly 4 times the best group rate

Poor Glycemic Control by Age, 2009-12

Glycemic Control by Age Web Graphic

Data source: National Health and Nutrition Examination Survey (NHANES), CDC/NCHS.

  • Comparisons for 2009–12 among educational attainment, family income, country of birth, disability status, health insurance status, marital status, and obesity status groups were not statistically significant.
Endnotes:
  • Unless otherwise stated, all comparisons described are statistically significant at the 0.05 level of significance.
  • Data for this measure are available biennially and come from the National Health and Nutrition Examination Survey (NHANES), CDC/NCHS. Preferably 4 years of data are pooled for analysis when available.  
  • The terms “Hispanic or Latino” and “Hispanic” are used interchangeably in this report.  
  • Data (except those by education status, health insurance coverage, obesity status, marital status, disability status, and age group) are age adjusted to the 2000 standard population using the age groups 18–49, 50–59, 60–69, 70–79, and 80 years and over. Data by education status are adjusted using the age groups 25–49, 50–59, 60–69, 70–79, and 80 years and over. Data by health insurance coverage are adjusted using the age groups 18–49, 50–59, and 60–64 years. Data by obesity status, disability status, and marital status are age adjusted using the groups 20–49, 50–59, 60–69, 70–79, and 80 years and over. Data by age group are not age adjusted. Age-adjusted rates are weighted sums of age-specific rates. 
  • The age distribution of the year 2000 standard population used for age adjustment may not be sufficiently similar to the age distribution for the population with diagnosed diabetes. 
  • Diagnosed diabetes is self-reported based on the question “Have you ever been told by a doctor or other health professional that you have diabetes or sugar diabetes?” Women who reported having diabetes only during pregnancy and persons who report being diagnosed as having “borderline” diabetes are excluded. Women who are pregnant at the time of the exam are also excluded.

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Fully Immunized Children (IID-8)

  • Healthy People 2020 (HP2020) objective IID-8 tracks the proportion of children aged 19–35 months who have received the recommended doses of diphtheria, tetanus, and pertussis (DTaP); polio; measles, mumps, and rubella (MMR); Haemophilus influenzae type b (Hib); hepatitis B (Hep B); varicella; and pneumococcal conjugate vaccine (PCV) vaccines.
    • HP2020 Baseline: In 2009, 44.3% of children aged 19–35 months had received the recommended doses of DTaP, polio, MMR, Hib, Hep B, varicella, and PCV vaccines.
    • HP2020 Target: 80%, consistent with national programs.
    • Most Recent: In 2014, 71.6% of children aged 19–35 months had received the recommended doses of DTaP, polio, MMR, Hib, Hep B, varicella, and PCV vaccines.
  • Among racial and ethnic groups, American Indian or Alaska Native children aged 19–35 months had the highest rate of receiving all recommended vaccinations, 75.9% in 2014, whereas black non-Hispanic children had the lowest rate, 65.4%. 
  • Girls aged 19–35 months had a slightly higher rate of receiving all recommended vaccinations (73.0%) than boys (70.4%) in 2014. 
  • In 2014, children aged 19–35 months whose mothers (aged 25 years and over) had an advanced degree had the highest rate of receiving all recommended vaccinations (80.9%) among education groups, while children aged 19–35 months whose mothers (aged 25 years and over) had less than a high school education had the lowest rate (68.0%).
  • Children aged 19–35 months in families with incomes 400–599% of the poverty threshold had the highest rate of receiving all recommended vaccinations (80.6%) among income groups in 2014. Rates for children in other income groups were:
    • 66.2% for those with family incomes under the poverty threshold
    • 70.4% for those with family incomes 100% to 199% of the poverty threshold
    • 74.0% for those with family incomes 200% to 399% of the poverty threshold
    • 78.3% for those with family incomes 600+% of the poverty threshold (not significantly different than the best group rate) 
  • Children aged 19–35 months with private health insurance had the highest rate of receiving all recommended vaccinations (76.1%) among insurance groups in 2014. Rates for children in other insurance groups were:
    • 68.9% for those with public insurance
    • 46.5% for those without insurance.  The rate for children aged 19–35 months with private health insurance was more than 1.5 times the rate of those without health insurance.

Children Receiving All Recommended Vaccinations by Insurance Status, 2014

Fully Immunized Children Web Graphic

Data source: National Immunization Survey (NIS), CDC/NCIRD and CDC/NCHS.

 
Endnotes:
  • Unless otherwise stated, all comparisons described are statistically significant at the 0.05 level of significance.
  • Data for this measure are available annually and come from the National Immunization Survey (NIS), CDC/NCIRD and CDC/NCHS.
  • Public and private insurance are not mutually exclusive. About 5% of children with health insurance are included in both categories. 
  • Receipt of all recommended vaccinations for children aged 19–35 months is defined as receipt of the following recommended doses of each of the following vaccines: 4 DTap, 3 polio, 1 MMR, 3 or 4 Hib (depending on product type received, including primary series plus the booster dose), 3 Hep B, 1 varicella, and 4 PCV.
  • Some children in the baseline (2009) NIS sample were affected by the Hib vaccine shortage and thus not recommended to get the full Hib series. 

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