Report Analysis by: Kelly Emrick MBA, Ph.D.

www.kellyemrick.com

The 2023 National Health Interview Survey report includes 22 health indicators. These indicators are grouped into several categories. The categories are health status, healthcare service use, healthcare access, health insurance coverage, and health behaviors. The data is segmented quarterly, providing insight into variations over time within the year 2023. https://www.cdc.gov/nchs/nhis/releases. hhtm

1. Health Status Indicators:
   • Disability Status: The percentage of adults reporting a disability varied slightly throughout the year, from 8.7% in Q1 to 9.5% in Q4, with an annual average of 9.4%. This indicator considers difficulties in six domains of functioning, including seeing, hearing, mobility, communication, cognition, and self-care.
   • Chronic Conditions: Regular chronic pain was reported by approximately 24.5% of adults, while the prevalence of diagnosed hypertension was about 27.6%. These conditions are consistent in their quarterly estimates, reflecting ongoing public health challenges related to chronic disease management.
2. Healthcare Service Use:
   • Doctor Visits: A high percentage of adults (around 84.6%) reported visiting a doctor in the past 12 months, showing little variation across quarters. This consistent utilization of healthcare services indicates stable access to and engagement with healthcare providers.
   • Mental Health Services: A mental health professional counseled about 13.3% of adults, showing a slight increase in Q4 (14.1%) compared to earlier quarters. This rise may reflect increased mental health needs or improved access to mental health services.
3. Healthcare Access:
   • Barriers to Care: Approximately 6.4% of adults did not receive needed medical care due to cost concerns, and 5.4% faced similar barriers for mental health care. These indicators highlight ongoing issues with healthcare affordability, which can significantly impact health outcomes.
   • Medication Adherence: The percentage of adults who did not take medication as prescribed to save money ranged from 7.2% to 8.3% throughout the year. This behavior can worsen chronic conditions and increase long-term healthcare costs.
4. Health Insurance Coverage:
   • Uninsured Rate: The uninsured rate among adults aged 18-64 remained relatively stable, with an annual average of 10.9%. This rate is essential to healthcare access and reflects the population’s vulnerability to medical expenses.
   • Private and Public Coverage: Private insurance coverage fluctuated around 68.1%, while public health plan coverage was approximately 23.0%. These figures suggest a stable but segmented insurance landscape, where a significant portion of the population relies on public health programs.
5. Health Behaviors:
   • Smoking and Vaping: The prevalence of current cigarette smoking was about 10.9%, while electronic cigarette use was 6.6%. These behaviors have significant public health implications, especially concerning respiratory health and the prevention of chronic diseases.

The report emphasizes that the estimates presented are preliminary, as the data have yet to undergo final editing and weighting. This early release format is intended to provide a timely snapshot of public health trends, which is critical for policymakers and healthcare providers responding to emerging health issues.

• Redesign of the NHIS Questionnaire: In January 2019, the NHIS implemented a redesigned questionnaire, which impacts the comparability of some indicators over time. The redesign included changes to sample weighting and new key health indicators. Researchers should be cautious when comparing these estimates to data from prior years.
• Data Collection and Representation: The estimates are derived from household interviews with a sample of the civilian non-institutionalized population. As with any survey-based research, there are limitations related to response bias and the accuracy of self-reported data. The use of confidence intervals helps to account for sampling variability, providing a more nuanced understanding of the data’s reliability.

The findings from this early-release report have several implications for public health policy and clinical practice:

1. Chronic Disease Management: The high prevalence of chronic conditions, such as hypertension and chronic pain, underscores the need for enhanced strategies to manage these conditions. This could include more robust patient education, improved access to preventive services, and targeted interventions for higher-risk populations.
2. Mental Health Services: The steady increase in adults receiving mental health counseling suggests a growing demand for mental health services. Expanding access to these services, particularly in underserved areas, should be a priority for healthcare systems.
3. Healthcare Affordability: The data on cost-related barriers to care and medication adherence highlight the persistent issue of healthcare affordability. Policymakers should consider measures to reduce out-of-pocket costs and improve insurance coverage to ensure that financial barriers do not prevent individuals from receiving necessary care.
4. Public Health Monitoring: The continued use of redesigned health indicators and interactive data tools by the NHIS will be crucial in monitoring public health trends in real-time. These tools can support data-driven decision-making by providing accessible and up-to-date information on health indicators.

The 2023 National Health Interview Survey’s early release report provides a valuable, albeit preliminary, overview of U.S. adults’ health status and healthcare access. The data presented reveal critical trends in chronic disease prevalence, healthcare service utilization, and barriers to care. These insights are instrumental in informing public health strategies and policies to improve health outcomes and reduce disparities in healthcare access. As final data become available, further analysis will be necessary to validate these findings and explore long-term trends.

References

Norris, T., Adjaye-Gbewonyo, D., & Bottoms-McClain, L. (2023). Early release of selected estimates based on data from the 2023 National Health Interview Survey. National Center for Health Statistics, U.S. Department of Health and Human Services. https://www.cdc.gov/nchs/nhis/releases.htm