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Objective: This report highlights the health characteristics of four age groups of older adults-55-64 years, 65-74 years, 75-84 years, and 85 years and over-providing estimates by sex, race and Hispanic origin, poverty status, health insurance status, and marital status.

Methods: The estimates in this report were derived from the 2000-2003--National Health Interview Surveys' Family and Sample Adult questionnaires. Estimates are based on interviews with 39,990 sample adults aged 55 years and over.

Results: Overall, prevalence rates for fair or poor health, chronic health conditions (with the exception of diabetes), sensory impairments, and difficulties with physical and social activities increased with advancing age, doubling or even tripling between the age groups 55-64 and 85 years and over. About one in five adults aged 55-64 years were in fair or poor health, rising to about one-third of adults aged 85 years and over. Men and women were about equally likely to be in fair or poor health across the age groups studied, but women were more likely to have difficulty in physical or social activities. Sociodemographic variations in health were noted across the age groups studied, with the most consistent and striking results found for poverty status and health insurance coverage. Poor and near poor adults and those with public health insurance were, by far, the most disadvantaged groups of older adults in terms of health status, health care utilization, and health behaviors.

Conclusions: Health status, health care utilization, and health-promoting behaviors among adults aged 55 and over vary considerably by age and other sociodemographic characteristics. Identifying these variations can help government and private agencies pinpoint areas of greatest need and greatest opportunity for extending years of healthy life among the Nation's seniors.

Objective: This report presents national prevalence estimates of selected measures of physical health status and limitations, health care access and utilization, and mental health status among the civilian noninstitutionalized population of U.S.- and foreign-born adults aged 18 years and over in four race-ethnicity groups in the United States.

Methods: The estimates in this report were derived from the Family Core and Sample Adult components of the 1998-2003 National Health Interview Surveys, conducted annually by the Centers for Disease Control and Prevention's National Center for Health Statistics (NCHS). Estimates were generated and comparisons conducted using the SUDAAN statistical package to account for the complex survey sample design. Data were age adjusted to the 2000 U.S. standard population.

Results: In general, the foreign-born population was younger, less likely to have a high school diploma, more likely to be poor, heavily concentrated in the central cities of metropolitan areas, and more likely to live in large families, compared with their U.S.-born counterparts. Hispanic immigrants were the least likely to have health insurance or to have a usual source of health care compared with other immigrant groups. Non-Hispanic black and Hispanic adults, regardless of nativity, were more likely to be obese than non-Hispanic white and non-Hispanic Asian adults. However, non-Hispanic black and Hispanic immigrant adults were significantly less likely to be obese than their U.S.-born counterparts. Hispanic immigrants were more likely to be obese the longer they lived in the United States. Foreign-born nonHispanic black and Hispanic immigrant adults experienced fewer symptoms of serious psychological distress compared with their U.S.-born counterparts.

Conclusions: There are significant differences in physical health status and mental health status among U.S.-born and foreign-born adults. Foreign-born adults enjoy considerable advantages over their U.S.-born counterparts for many health measures despite limited access to health care and unfavorable sociodemographic characteristics. Differences in the impact of length of stay in the United States on immigrant health suggest that the role of acculturation in understanding immigrant health is complex and may differ for various race/ethnicity groups.

Objectives: This report presents estimates on the availability of pediatric services, expertise, and supplies for treating pediatric emergencies in U.S. hospitals.

Methods: The Emergency Pediatric Services and Equipment Supplement (EPSES) was a self-administered questionnaire added to the 2002-03 National Hospital Ambulatory Medical Care Survey (NHAMCS). NHAMCS samples non-Federal, short-stay and general hospitals in the United States. The EPSES content was based on the 2001 guidelines for pediatric services, medical expertise, small-sized supplies, and equipment for emergency departments (EDs) developed by the American Academy of Pediatrics (AAP) and the American College of Emergency Physicians (ACEP). Combined response rate for both years was 86 percent. Estimates were weighted to produce average annual estimates of pediatric services, expertise, and equipment availability in EDs.

Results: One-half of hospitals (52.9 percent) admitted pediatric patients, but did not have a specialized inpatient pediatric ward. One-third (38.3 percent) admitted pediatric patients and had a separate pediatric ward; the remainder did not admit pediatric patients. Among those that did not admit pediatric cases, 30.4 percent were in counties that had a children's hospital. One-quarter of EDs had access 24 hours and 7 days a week to a board-certified pediatric emergency medicine attending physician. Only 5.5 percent had all recommended pediatric supplies, but one-half had greater than 85 percent of recommended supplies. Most hospitals without pediatric trauma service (90.7 percent) or pediatric intensive care units (97.5 percent) transferred critical pediatric patients to hospitals with these services. EDs in hospitals with specialized inpatient facilities for children were more likely to meet the AAP and ACEP guidelines for pediatric ED services, expertise, and supplies.

Objectives: This report describes ambulatory care visits to hospital outpatient departments (OPDs) in the United States. Statistics are shown on selected hospital, clinic, patient, and visit characteristics, as well as selected trends in OPD visits since 1993. The report highlights variation in use across the major types of OPD clinics surveyed.

Methods: The data shown in this report were collected from the 2003 National Hospital Ambulatory Medical Care Survey (NHAMCS). NHAMCS is a national probability sample survey of visits to emergency and outpatient departments of non-Federal, short stay, and general hospitals in the United States. Sample data are weighted to produce annual national estimates.

Results: During 2003, an estimated 94.6 million visits were made to hospital OPDs in the United States, about 33.1 visits per 100 persons. This rate represents a 35-percent increase since 1993, although rates have been stable since 1999. Infants under 12 months of age had a visit rate of 88.7 visits per 100 persons, a rate that increased by 23 percent since 1993. Increasing trends in OPD visit rates were found for persons 50-64 years of age (up by 30 percent), 13-21 years of age (up by 32 percent), 22-49 years of age (up by 34 percent), and 1-12 years of age (up by 71 percent). Females had higher OPD visit rates than males (39.6 compared with 26.4 visits per 100 persons), and black or African American persons had higher OPD visit rates than white persons (59.7 compared with 29.9 visits per 100 persons). Medicaid and State Children's Health Insurance Program patients used OPDs for preventive care services more frequently than private pay patients. The preventive care visit rate by Hispanic and Latino patients was twice the rate by non-Hispanic patients. Diphtheria, tetanus, and acellular pertussis (DTaP) was the most frequently provided vaccine to children under age 18 years. Between 1993-94 and 2003, the proportion of visits involving only mid-level providers increased from 5.9 to 12.6 percent of visits.

Objective: This report presents national estimates of testing for Human immunodeficiency virus, or HIV, the virus that causes acquired immunodeficiency syndrome (AIDS). The objectives are to present nationally representative estimates of the degree of self-reported lifetime and recent HIV testing among persons 15-44 years of age in the United States. The report also contains data on sources of testing, reasons for tests, and whether HIV counseling was obtained.

Methods: Data from the 2002 NSFG, conducted by the Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), are based on interviews with a national sample of the household population of the United States. In-person, face-to-face interviews were conducted in the homes of 12,571 males and females 15-44 years of age in 2002. Most of the data used for this report were collected by an interviewer who asked the questions and entered the answers into a laptop computer.

Results: One-half of men and women 15-44 years of age in 2002 reported that they had been tested at least once (other than through blood donation), and 15.1 percent had been tested in the past 12 months, which is equivalent to 17-20 million tests per year among 15-44 year olds. Testing is more common in some population subgroups than others, for example, among African Americans and persons with increased risk for HIV. Private physicians and HMOs were the largest provider of tests, accounting for 45 percent of recent tests. Public sources accounted for 22 percent of tests. A minority of recently tested respondents (29 percent) reported talking with a health professional about the HIV test after being tested. Among women who had recently been pregnant, 69 percent reported being tested for HIV during prenatal care. Persons 15-44 years of age with increased risk for HIV, defined by drug-related or sex-related behavior, had higher reported testing during their lifetime and in the past 12 months than those not at higher risk. However, one-third of this higher risk group reported that they had never had an HIV test, equivalent to 4.1-5.5 million untested, at-risk persons aged 15-44 years, and a majority of higher risk persons had not been tested in the past year.

Objectives: This study examined the content of hospital terrorism preparedness emergency response plans; whether those plans had been updated since September 11, 2001; collaboration of hospitals with outside organizations; clinician training in the management of biological, chemical, explosive, and nuclear exposures; drills on the response plans; and equipment and bed capacity.

Methods: The National Hospital Ambulatory Medical Care Survey (NHAMCS) is an annual survey of a probability sample of approximately 500 non-Federal general and short-stay hospitals in the United States. A Bioterrorism and Mass Casualty Supplement was included in the 2003 survey and provided the data for this analysis.

Results: Almost all hospitals have plans for responding to natural disasters (97.3 percent). Most have plans for responding to chemical (85.5 percent), biological (84.8 percent), nuclear or radiological (77.2 percent), and explosive incidents (76.9 percent). About three-quarters of hospitals were integrated into community-wide disaster plans (76.4 percent), and 75.9 percent specifically reported a cooperative planning process with other local health care facilities. Despite these plans, only 46.1 percent reported written memoranda of understanding with these facilities to accept inpatients during a declared disaster. Hospitals varied widely in their plans for re-arranging schedules and space in the event of a disaster. Training for hospital incident command and smallpox, anthrax, chemical, and radiological exposures was ahead of training for other infectious diseases. The percentage of hospitals training their staff in any exposure varied from 92.1 percent for nurses to 49.2 percent for medical residents. Drills for natural disasters occurred more often than those for chemical, biological, explosive, nuclear, and epidemic incidents. More hospitals staged drills for biological attacks than for severe epidemics. Despite explosions being the most common form of terrorism, drills for these were staged by only one-fifth of hospitals. Hospitals collaborated on drills most often with emergency medical services, fire departments, and law enforcement agencies.

Objective: This report presents national estimates of several measures of sexual behavior among males and females 15-44 years of age in the United States in 2002, as collected in the 2002 National Survey of Family Growth (NSFG). These data are relevant to demographic and public health concerns, including fertility and sexually transmitted diseases among teenagers and adults. Data from the 2002 NSFG are compared with previous national surveys.

Methods: The 2002 NSFG was conducted by the Centers for Disease Control and Prevention's (CDC) National Center for Health Statistics (NCHS) and is based on in-person, face-to-face interviews with a national sample of 12,571 males and females in the household population of the United States. The measures of sexual behavior presented in this report were collected using Audio Computer-Assisted Self-Interviewing (ACASI), in which the respondent enters his or her own answers into a laptop computer without telling them to an interviewer.

Results: Among adults 25-44 years of age, 97 percent of men and 98 percent of women have had vaginal intercourse; 90 percent of men and 88 percent of women have had oral sex with an opposite-sex partner; and 40 percent of men and 35 percent of women have had anal sex with an opposite-sex partner. About 6.5 percent of men 25-44 years of age have had oral or anal sex with another man. Based on a differently worded question, 11 percent of women 25-44 years of age reported having had a sexual experience with another woman. The public health significance of the findings is described.