Health, United States, 2005 is the 29th report on the health status of the Nation and is submitted by the Secretary of the Department of Health and Human Services to the President and Congress of the United States in compliance with Section 308 of the Public Health Service Act. This report was compiled by the National Center for Health Statistics (NCHS), Centers for Disease Control and Prevention (CDC). The National Committee on Vital and Health Statistics served in a review capacity.

The Health, United States series presents national trends in health statistics. Each report includes an executive summary, highlights, a chartbook, trend tables, extensive appendixes, and an index.


The fourth Chartbook on Trends in the Health of Americans updates and expands information from previous chartbooks and introduces this year's special feature on adults 55–64 years of age, a rapidly growing segment of the adult population. The economic and health status of this age group is of interest as the majority of its members are poised to enter retirement and to become eligible for Medicare. The chartbook assesses the Nation's health by presenting trends and current information on selected determinants and measures of health status and utilization of health care. Determinants of health considered in the chartbook include demographic factors, poverty, health insurance coverage, and health behaviors and risk factors, including obesity, cigarette smoking, and physical activity. Additional risk factors this year include teen seat belt use, drinking and driving, and multiple cardiovascular risk factors for adults. Measures of health status include prevalence of asthma attacks in children, headache and lower back pain in adults, limitation of activity due to chronic health conditions, and several measures of mortality. A new section on health care utilization includes use of mammography and Pap tests, visits to physician offices and outpatient departments, injury-related visits by children to emergency departments, and insertion of cardiac stents—an increasingly common hospital procedure for treatment of coronary artery disease, particularly for older persons. Many measures are shown separately for persons of different ages because of the strong effect of age on health. Selected figures also highlight differences in determinants and measures of health status and utilization of health care by such characteristics as sex, race, Hispanic origin, education, and poverty status.

Trend Tables

The chartbook section is followed by 156 trend tables organized around four major subject areas: health status and determinants, health care utilization, health care resources, and health care expenditures. A major criterion used in selecting the trend tables is availability of comparable national data over a period of several years. The tables present data for selected years to highlight major trends in health statistics. Earlier editions of Health, United States may present data for additional years that are not included in the current printed report. Where possible, these additional years of data are available in Excel spreadsheet files on the Health, United States Web site. Tables with additional data years are listed in Appendix III.

Racial and Ethnic Data

Many tables in Health, United States present data according to race and Hispanic origin consistent with Department-wide emphasis on expanding racial and ethnic detail when presenting health data. Trend data on race and ethnicity are presented in the greatest detail possible after taking into account the quality of data, the amount of missing data, and the number of observations. New standards for Federal data on race and ethnicity are described in Appendix II under Race.

Education and Income Data

Many tables in Health, United States present data according to socioeconomic status, using education and poverty level as proxy measures. Poverty level is based on family income data and number of persons in the household. Data are presented in the greatest detail possible after taking into account the quality of data, the amount of missing data, and the number of observations. Due to the complexity and sensitivity of collecting education and income information, only a few national data systems obtain data on education and income, including the National Health Interview Survey (NHIS), the National Health and Nutrition Examination Survey, and the National Survey of Family Growth. Education and income are obtained directly from survey respondents, and nonresponse rates, especially for income data, are particularly high. NCHS imputes missing family income data for the NHIS starting with data year 1990, and tables with NHIS data shown in Health, United States utilize the imputed poverty data. Education and income information are not generally available from records-based data collection systems including the National Health Care Surveys (see Appendix I). State vital statistics systems currently report mother's education on the birth certificate and, based on information from an informant, decedent's education on the death certificate. See Appendix II, Education; Family income; Poverty level.

Changes in This Edition

Each volume of Health, United States is prepared to maximize its usefulness as a standard reference source while maintaining its continuing relevance. Comparability is fostered by including similar trend tables in each volume. Timeliness is maintained by (1) adding new tables each year to reflect emerging topics in public health and (2) improving the content of ongoing tables. Health, United States, 2005 includes eight new trend tables on multiple births (table 5) based on birth certificate data; prevalence of respiratory conditions (table 56), headache and low back pain (table 57), hearing and vision limitations (table 59), leisure-time physical activity (table 72), and adult vaccinations (table 76), all based on National Health Interview Survey data; the nutritional status of the U.S. population based on National Health and Nutrition Examination Survey data (table 71); and factors that affect growth in personal health care expenditures (table 121) based on data from the Centers for Medicare & Medicaid Services.


Appendix I describes each data source used in the report and provides references for further information about the sources. Data sources are listed alphabetically within two broad categories: (1) Government Sources and (2) Private and Global Sources.

Appendix II is an alphabetical listing of terms used in the report. It also presents standard populations used for age adjustment (tables I, II, and III); ICD codes for causes of death shown in Health, United States from the Sixth through Tenth Revisions and the years when the Revisions were in effect (tables IV and V); comparability ratios between ICD–9 and ICD–10 for selected causes (table VI); ICD–9–CM codes for external cause-of-injury, diagnostic, and procedure categories (tables VII, IX, and X); industry codes according to the 2002 North American Industry Classification System (table VIII); National Drug Code (NDC) Therapeutic Class recodes of generic analgesic drugs (table XI); and sample tabulations of NHIS data comparing the 1977 and 1997 Standards for Federal data on race and Hispanic origin (tables XII and XIII).

Appendix III lists tables for which additional years of trend data are available electronically in Excel spreadsheet files on the Health, United States Web site and CD-ROM, described below under Electronic Access.


The Index to Trend Tables and Chartbook Figures is a useful tool for locating data by topic. Tables are cross-referenced by such topics as Child and adolescent health; Elderly population age 65 years and over; Women's health; Men's health; State data; American Indian, Asian, Black, and Hispanic origin populations; Education; Poverty status; Disability; and Metropolitan and nonmetropolitan data.

Electronic Access

Health, United States may be accessed in its entirety on the World Wide Web at From the Health, United States Web site, one may also register for the Health, United States electronic mailing list to receive announcements about release dates and notices of updates to tables.

Health, United States, 2005, the chartbook, and each of the trend tables are available as Acrobat .pdf files on the Web. Chartbook figures are available as downloadable PowerPoint® slides. Trend tables and chartbook data tables are available as downloadable Excel spreadsheet files. Trend tables listed in Appendix III include additional years of data not shown in the printed report or .pdf files. Both .pdf and spreadsheet files for selected tables will be updated on the Web if more current data become available near the time when the printed report is released. Readers who register with the electronic mailing list will be notified of these table updates. Previous editions of Health, United States and chartbooks, starting with the 1993 edition, also may be accessed from the Health, United States Web site.

Health, United States is also available on CD-ROM, where it can be viewed, searched, printed, and saved using Adobe Acrobat software on the CD-ROM.

Copies of the Report

Copies of Health, United States, 2005, and the CD-ROM can be purchased from the Government Printing Office (GPO) through links to GPO on the National Center for Health Statistics Web site, Publications and Information Products page.


For answers to questions about this report, contact:

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