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Public Health Rep. 2008 Sep-Oct; 123(5): 667–668.
PMCID: PMC2496942

NCHS Dataline

A new analysis from the National Center for Health Statistics (NCHS), Centers for Disease Control and Prevention tracks patterns in breastfeeding in the United States and shows a substantial increase—including an almost doubling among non-Hispanic black women—from 1993–1994 to 2005–2006. NCHS has just published a report with the latest data on pregnancy outcomes—births, abortions, and fetal losses. The report covers the more than 6 million pregnancies in 2004. Another new report examines the characteristics of the approximately 300,000 physicians in office-based practice in the U.S.

BREASTFEEDING RATES HAVE INCREASED

The percentage of infants who were ever breastfed increased from 60% among infants who were born in 1993–1994 to 77% among infants born in 2005–2006. The 2005–2006 level of breastfeeding exceeded the Healthy People 2010 target of 75%. This increase was driven to a large extent by the increase for non-Hispanic black infants who had the lowest rate but also experienced the greatest increase. The percent of non-Hispanic black infants who were breastfed increased from 36% in 1993–1994 to 65% for those born in 2005–2006. The breastfeeding rate for non-Hispanic white infants reached 79% in 2005–2006 and 80% for Mexican-American infants; these rates were not a statistically significant increase from the 1993–1994 period.

Data on breastfeeding are obtained in the National Health and Nutrition Examination Survey, a continuous survey of the health and nutritional status of the U.S. civilian, noninstitutionalized population. The survey produces estimates for the overall population and for non-Hispanic white, non-Hispanic black, and Mexican-American racial/ethnic groups. The survey is comprised of a standardized physical examination, laboratory tests, and medical history and health behaviors questionnaires and interviews. A proxy respondent, usually one of the child's parents, answered the breastfeeding and infant feeding questions. The data are presented by birth year cohort.

In addition to differences by race/ethnicity, the survey found significant differences by income, with breastfeeding rates higher among those in families with higher incomes (74%) compared with those in low-income families (57%). Older mothers were also more likely to breastfeed their infants. The breastfeeding rates of mothers who were younger than 20 years of age (43%) were lower compared with mothers who were 30 years of age and older (75%) or those aged 20 to 29 (65%). However, maternal age mattered less for Mexican-American infants. Mexican-American infants born to mothers younger than 20 years of age had a significantly higher breastfeeding rate (66%) compared with non-Hispanic white (40%) and non-Hispanic black (30%) infants.

These findings and more appear in “Breastfeeding in the United States: Findings from the National Health and Nutrition Examination Survey: 1999–2005,”1 which is available on the NCHS website at http://www.cdc.gov/nchs/data/databriefs/db05.htm.

PREGNANCY OUTCOMES STUDIED

“Estimated Pregnancy Rates by Outcome for the United States, 1990–2004”2 shows that there were almost 6.4 million pregnancies in 2004 among women of all ages, about 6% fewer than the nearly 6.8 million in 1990. The 2004 total included 4.11 million live births, 1.22 million induced abortions, and 1.06 million fetal losses. In 1990, there were 4.16 million live births, 1.61 million induced abortions, and 1.02 million fetal losses. Pregnancy rates for women younger than age 25, including teenagers, in the U.S. declined in 2004 compared with 1990. The report says nearly 38% of pregnancies in 2004 were to women younger than age 25, down from nearly 43% in 1990. The proportion of pregnancies among teens younger than age 20 dropped from 15% in 1990 to 12% in 2004. This latest pregnancy outcome report finds that there was little change in births and fetal loss numbers between 1990 and 2004; however, abortions fell 24% over this time period.

Other findings of the report include:

  • Nearly half (45%) of the 6.4 million pregnancies in 2004 occurred among unmarried women. Pregnancy totals among unmarried women increased from more than 2.7 million in 1990 to more than 2.8 million in 2004, whereas pregnancy totals among married women declined from 4.1 million in 1990 to 3.5 million in 2004.
  • The average U.S. woman is expected to have 3.2 pregnancies in her lifetime at current pregnancy rates; black and Hispanic women are expected to have 4.2 pregnancies each, compared with 2.7 for non-Hispanic white women.
  • Three out of four pregnancies among married women (75%) ended in a live birth in 2004, while 19% ended in fetal loss, and 6% ended in abortion. For unmarried women, slightly more than half of pregnancies (51%) ended in live birth, an increase from 43% in 1990. Thirty-five percent of these pregnancies ended in abortion and 13% ended in fetal loss.
  • More than two-thirds of pregnancies for non-Hispanic white (69%) and Hispanic (67%) women and half of pregnancies to non-Hispanic black women ended in live birth.
  • More than a third (37%) of pregnancies for black women ended in abortion compared with 12% for non-Hispanic white women and 19% for Hispanic women.

Copies of the report can be viewed or downloaded from the NCHS website at http://www.cdc.gov/nchs/data/nvsr/nvsr56/nvsr56_15.pdf.

SURVEY OF OFFICE-BASED PHYSICIANS

The latest report from the National Ambulatory Medical Care Survey (NAMCS) profiles the characteristics of office-based physicians and their medical practices in the U.S. The NAMCS is a national probability survey of non-federal physicians who see patients in an office setting in the U.S. The survey collects nationally representative data on patients, patient characteristics, diagnoses, and treatments as well as characteristics of physicians and medical practices. The survey was conducted on an annual basis from 1973 to 1981, conducted again in 1985, and resumed an annual schedule in 1989. The report, entitled “Characteristics of Office-Based Physicians and Their Medical Practices: United States, 2005–2006,”3 covers the latest data and presents comparisons with the 2001–2002 period.

The survey found that during 2005–2006, a mean of 308,900 office-based physicians practiced in an estimated 163,000 medical practices. In 2005–2006, nearly one in 10 medical practices were multispecialty groups and accounted for 20.3% of all physicians. In 2006, 11.5% of practices employed at least one mid-level provider and about one-third of medical practices performed electrocardiogram tests and lab tests onsite. Between 2001–2002 and 2005–2006, the percentage of physicians not accepting new Medicaid patients increased by 16% and the percentage not accepting new charity cases increased by 23%.

In 2005–2006, the overall rate of 105.5 physicians per 100,000 people has remained stable since 2001 2003. One-third of physicians were aged 45 to 54 years at the time of the survey. Since 2001–2002, mean physician age has increased from 49.7 years to 50.4 years. About one in four office-based physicians were female. Since 2001–2002, the percentage of office-based physicians who were female increased by 24%, from 19.4% to 24.1% in 2005–2006. During 2005–2006, 23.0% of physicians were graduates of medical schools outside the U.S., about the same percent as in 2001–2002. In 2005–2006, more physicians practiced in the South than in other regions, and the great majority (almost 90%) practiced in urban areas.

Regarding medical practice characteristics, between 2003–2004 and 2005–2006, use of full or partially electronic medical records by medical practices increased by 46% from 15.0% in 2003–2004 to 21.9% in 2005–2006. During 2005–2006, 83.2% of physicians reported having at least one managed care contract. Private insurance accounted for about one-half of office revenue and Medicare accounted for 29.7% of revenue.

This report and earlier studies from the NAMCS are available from: URL: http://www.cdc.gov/nchs.

Footnotes

NCHS Dataline was prepared by Sandra S. Smith, MPH, Communications Consultant at the National Center for Health Statistics (NCHS), Centers for Disease Control and Prevention, and Jeffrey H. Lancashire, Acting Associate Director for Health Communications at NCHS.

REFERENCES

1. McDowell MM, Wang C-Y, Kennedy-Stephenson J. NCHS Data Briefs, No. 5. Hyattsville (MD): National Center for Health Statistics; 2008. Breastfeeding in the United States: findings from the National Health and Nutrition Examination Survey, 1999–2005.
2. Ventura S, Abma J, Mosher W. Estimated pregnancy rates by outcome for the United States, 1990–2004. Natl Vital Stat Rep. 2008 Apr 14;56:1–26. [PubMed]
3. Hing E, Burt C. Vital Health Stat 13. 2002. Characteristics of office-based physicians and their medical practices: United States, 2005–2006. (168) [PubMed]

Articles from Public Health Reports are provided here courtesy of SAGE Publications