United Health Foundation - Doing Your Part to Stay Healthy

National Changes from 1990

The 18-year perspective provided by this report, allows us to view health over time. During the past 18 years, this report has tracked our nation’s 18.4 percent improvement in overall health (Graph 1). This national success stems from improvements in the reduction of infant mortality, infectious disease, prevalence of smoking, cardiovascular deaths, violent crime, children in poverty and occupational fatalities, and an increase in immunization coverage and prenatal care. However, success has eluded us in four measures due to a rapid increase in the prevalence of obesity, an increase in the rate of uninsured population and an increase in both poor mental and physical health days in the last month (Table 4).

Graph 1: Improvements Since 1990

Table 4 - National Measures of Successes and Challenges: Long-Term

MEASURE	EDITION TO EDITION CHANGES
Successes
Infectious Disease	45 percent decrease in the incidence of infectious disease from 40.7 cases in 1990 to 22.5 cases per 100,000 population in 2007.
Infant Mortality	33 percent decrease in the infant mortality rate from 10.2 deaths in 1990 to 6.8 deaths per 1,000 live births in 2007.
Prevalence of Smoking	32 percent decline in the prevalence of smoking from 29.5 percent in 1990 to 20.1 percent of the population in 2007.
Violent Crime	22 percent decline in the violent crime rate from 609 offenses in 1990 to 474 offenses per 100,000 population in 2007.
Cardiovascular Deaths	22 percent decline in the rate of deaths from cardiovascular disease from 406.3 deaths in 1990 to 317.5 deaths per 100,000 population in 2007.
Children in Poverty	16 percent decline in the percentage of children in poverty from 20.6 percent in 1990 to 17.4 percent of persons under age 18 in 2007.
Occupational Fatalities	39 percent decline in the occupational fatalities rate from 8.7 deaths in 1990 to 5.3 deaths per 100,000 workers in 2007.
Immunization Coverage	46 percent increase in immunization coverage from 55.1 percent in 1996 to 80.6 percent of children ages 19 to 35 months receiving complete immunizations in 2007.
Prenatal Care	Approximately 10 percent improvement to 75.4 percent of pregnant women receiving adequate prenatal care in 2007.
High School Graduation	Slight increase in rate of high school graduation in last few years —74.3 percent of incoming ninth graders now graduate within four years.
Premature Death	A decline from 8,716 to 7,411 years of potential life lost before age 75 per 100,000 population since 1990.
Challenges
Prevalence of Obesity	116 percent increase in the prevalence of obesity from 11.6 percent in 1990 to 25.1 percent of the population in 2007.
Lack of Health Insurance	18 percent increase in the rate of uninsured population from 13.4 percent in 1990 to 15.8 percent in 2007.
Poor Mental Health Days	In the last eight years, the number of poor mental health days per month increased from 3.0 to 3.4 days in the last 30 days.
Poor Physical Health Days	In the last eight years, the number of poor physical health days per month increased from 3.2 to 3.6 days in the last 30 days.

Graph 1 shows that the rate of improvement in the health of the United States’ population has ceased. During the 1990s, health improved at an average annual rate of 1.5 percent per year. During the first half of this decade, the annual rate of improvement slipped to an average of 0.3 percent per year. In the last three years, it has stagnated. The overall health of the population in the United States is no longer improving. Special concern surrounds the decline in health determinants, as those measures point to the future health of the population.

Graph 2 - Prevalence of Smoking Since 1990

The United States has the potential to return to the rates of improvement typical of the 1990s. However, to do so, it must address the drivers of declining health more directly while focusing on reducing important risk factors. For example, while there has been an overall 32 percent decrease in the prevalence of smoking - from 29.5 percent of the population in 1990 to 20.1 percent of the population in 2007 - most of this decrease occurred in the early 1990s. Reductions in the rate of smoking have stagnated in the last three years (Graph 2).

Graph 3 - Prevalence of Obesity Since 1990

Unprecedented and unchecked growth in the prevalence of obesity has also dramatically impacted the overall health of the United States. The prevalence of obesity has exploded from 11.6 percent of the population in 1990 to 25.1 percent of the population in 2007. Now, one in four people is considered obese – a category that the Centers for Disease Control and Prevention reserves for those who are significantly over the suggested body weight given their height. This alarming rate of increase shows no evidence of slowing (Graph 3).

Graph 4 - Lack of Health Insurance: 2002-2007

The lack of health insurance coverage increased from 14.1 percent in 2002 to 15.8 percent of the population in 2007 (Graph 4). Lack of health insurance not only inhibits people from getting the proper care when needed but also reduces necessary preventive care to curtail or minimize future illnesses.

While there continue to be improvements since 1990, these worsening influences have caused and will continue to cause slower rates of improvement than in the 1990s.