Number of drugs per 100 population 4 Total number of drugs . . . . . . . . . . . . . . . . . . . . . . . . . . . 400.3 604.3 321.1 502.1 475.6 701.9 Antidepressants (depression and related disorders). . . . . . . 13.8 30.2 9.1 20.0 18.2 40.0 NSAID 6 (pain relief) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19.9 30.1 16.0 25.4 23.7 34.7 Antiasthmatics/bronchodilators (asthma, breathing) . . . . . . . 13.0 24.7 11.7 21.4 14.3 27.9 Hyperlipidemia (high cholesterol) . . . . . . . . . . . . . . . . . . . . 5.4 23.7 5.4 24.0 5.4 23.4 Hypertension control drugs, not otherwise specified (high blood pressure) . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.0 23.6 4.1 20.5 7.8 26.6 Nonnarcotic analgesics (pain relief) . . . . . . . . . . . . . . . . . . 14.4 23.6 13.0 21.9 15.7 25.3 Antihistamines (allergies) . . . . . . . . . . . . . . . . . . . . . . . . . 13.7 22.7 10.8 17.3 16.4 27.9 Acid/peptic disorders (gastrointestinal reflux, ulcers). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.0 21.4 9.8 18.3 14.1 24.3 Blood glucose/sugar regulators (diabetes) . . . . . . . . . . . . . 9.5 19.8 8.6 19.1 10.4 20.6 Vitamins/minerals (dietary supplements) . . . . . . . . . . . . . . . 9.2 16.8 3.4 10.3 14.8 23.1 ACE inhibitors (high blood pressure, heart disease). . . . . . . 9.6 16.8 9.0 16.5 10.2 17.0 Narcotic analgesics (pain relief) . . . . . . . . . . . . . . . . . . . . . 11.2 16.7 10.3 13.4 12.2 19.9 Diuretics (high blood pressure, heart disease). . . . . . . . . . . 10.2 16.6 7.8 13.4 12.6 19.6 Penicillins (bacterial infections) . . . . . . . . . . . . . . . . . . . . . 16.6 13.1 15.5 12.6 17.7 13.6 Estrogens/progestins (menopause, hot flashes) . . . . . . . . . . . . . . . . . . . . . 19.8 14.9

/pdf/health-united-states-2005-with-chartbook-on-trends-in-the-33t2w1py7x.pdf

Health, United States, 2005; with chartbook on trends in the health of Americans

Unintended pregnancy in the United States: incidence and disparities, 2006.

Background: The incidence of unintended pregnancy is among the most essential health status indicators in the field of reproductive health. One ongoing goal of the US Department of Health and Human Services is to reduce unintended pregnancy, but the national rate has not been estimated since 2001. Study Design: We combined data on women's pregnancy intentions from the 2006–2008 and 2002 National Survey of Family Growth with a 2008 national survey of abortion patients and data on births from the National Center for Health Statistics, induced abortions from a national abortion provider census, miscarriages estimated from the National Survey of Family Growth and population data from the US Census Bureau. Results: Nearly half (49%) of pregnancies were unintended in 2006, up slightly from 2001 (48%). The unintended pregnancy rate increased to 52 per 1000 women aged 15–44 years in 2006 from 50 in 2001. Disparities in unintended pregnancy rates among subgroups persisted and in some cases increased, and women who were 18–24 years old, poor or cohabiting had rates two to three times the national rate. The unintended pregnancy rate declined notably for teens 15–17 years old. The proportion of unintended pregnancies ending in abortion decreased from 47% in 2001 to 43% in 2006, and the unintended birth rate increased from 23 to 25 per 1000 women 15–44 years old. Conclusions: Since 2001, the United States has not made progress in reducing unintended pregnancy. Rates increased for nearly all groups and remain high overall. Efforts to help women and couples plan their pregnancies, such as increasing access to effective contraceptives, should focus on groups at greatest risk for unintended pregnancy, particularly poor and cohabiting women.

Original research article Unintended pregnancy in the United States: incidence and disparities, 2006

Abnormal placentation: twenty-year analysis.

Recent data show that gestational diabetes mellitus (GDM) prevalence has increased by ∼10–100% in several race/ethnicity groups during the past 20 years. A true increase in the prevalence of GDM, aside from its adverse consequences for infants in the newborn period, might also reflect or contribute to the current patterns of increasing diabetes and obesity, especially in the offspring. Therefore, the public health aspects of increasing GDM need more attention.

The frequency of GDM usually reflects the frequency of type 2 diabetes in the underlying population (1,2). Established risk factors for GDM are advanced maternal age, obesity, and family history of diabetes (3). Unquestionably, there are ethnic differences in the prevalence of GDM (4–15). In the U.S., Native Americans, Asians, Hispanics, and African-American women are at higher risk for GDM than non-Hispanic white women (4–6,8–11,13–15). In Australia, GDM prevalence was found to be higher in women whose country of birth was China or India than in women whose country of birth was in Europe or Northern Africa (7). GDM prevalence was also higher in Aboriginal women than in non-Aboriginal women (12). In Europe, GDM has been found to be more common among Asian women than among European women (16). The proportion of pregnancies complicated by GDM in Asian countries has been reported to be lower than the proportion observed in Asian women living in other continents (17). In India, GDM has been found to be more common in women living in urban areas than in women living in rural areas (18).

The trend toward older maternal age (19), the epidemic of obesity (20) and diabetes (21), and the decrease in physical activity (22) and the adoption of modern lifestyles in developing countries (23) may all …

https://care.diabetesjournals.org/content/diacare/30/Supplement_2/S141.full.pdf

Increasing prevalence of gestational diabetes mellitus: a public health perspective.

OBJECTIVES: This report presents 2002 data on U.S. births according to a wide variety of characteristics. Data are presented for maternal demographic characteristics including age, live-birth order, race, Hispanic origin, marital status, and educational attainment; maternal characteristics (medical risk factors, weight gain, tobacco, and alcohol use); medical care utilization by pregnant women (prenatal care, obstetric procedures, complications of labor and/or delivery, attendant at birth, and method of delivery); and infant characteristics (period of gestation, birthweight, Apgar score, abnormal conditions, congenital anomalies, and multiple births). Also presented are birth and fertility rates by age, live-birth order, race, Hispanic origin, and marital status. Selected data by mother's State of residence are shown, as well as data on month and day of birth, sex ratio, and age of father. Trends in fertility patterns and maternal and infant characteristics are described and interpreted.

METHODS: Descriptive tabulations of data reported on the birth certificates of the 4.022 million births that occurred in 2002 are presented. Denominators for population-based rates are derived from the 2000 U.S. census. Rates for 1991-2001 may differ from those published previously based on the 1990 U.S. census.

RESULTS: There were 4,021,726 live births in 2002, essentially unchanged from 2001. The birth rate, fertility rate, and total fertility rates all declined 1 percent in 2002. The teenage birth rate dropped 5 percent, reaching another record low. The birth rates for women 20-24 years declined, whereas the rate for women 25-29 years was stable. The birth rate for women 30-34 years declined, but the rate for women 35-44 years continued to rise. Births to unmarried women changed very little. Smoking during pregnancy was down again. The timeliness of prenatal care continued to improve. The cesarean delivery rate climbed to the highest level ever reported in the United States (26.1 percent) and the rate of vaginal birth after previous cesarean plummeted 23 percent to 12.6 percent. Preterm and low birthweight levels both rose for 2002. The twin birth rate continued to climb, but the rate of triplet/+ births was down slightly.

Births: final data for 2002.

Objectives—This report presents 2003 data on U.S. births according to a wide variety of characteristics. Data are presented for maternal demographic characteristics including age, live-birth order, race, Hispanic origin, marital status, and educational attainment; maternal characteristics (medical risk factors, weight gain, and tobacco and alcohol use); medical care utilization by pregnant women (prenatal care, obstetric procedures, complications of labor and/or delivery, attendant at birth, and method of delivery); and infant characteristics (period of gestation, birthweight, Apgar score, abnormal conditions, congenital anomalies, and multiple births). Also presented are birth and fertility rates by age, live-birth order, race, Hispanic origin, and marital status. Selected data by mother’s State of residence are shown, as well as data on month and day of birth, sex ratio, and age of father. Trends in fertility patterns and maternal and infant characteristics are described and interpreted. Methods—Descriptive tabulations of data reported on the birth certificates of the 4.09 million births that occurred in 2003 are pre­ sented. Denominators for population-based rates are derived from the U.S. 2000 census. Results—In 2003 there were 4,089,950 live births reported in the United States, 2 percent more than the number in 2002. The crude birth rate (CBR) and general fertility rate (GFR) rose slightly. Childbearing among teenagers declined for the 12th straight year to another historic Figure 1. Birth rates by age of mother: United States, low. Birth rates for women aged 20–24 years also declined, whereas 1990–2003 rates for women aged 25–44 years increased 2–6 percent, reaching highs not reported since the mid- to late 1960s. All measures of unmarried childbearing increased considerably in 2003, but smoking during pregnancy continued to decline. Timely initiation of prenatal care Highlights improved slightly. The cesarean delivery rate jumped another 5 percent to another all-time high, and the rate of vaginal birth after previous + In 2003, 4,089,950 births were registered in the United States, cesarean dropped 16 percent, an all-time low. Key measures of birth 2 percent more than in 2002. Births increased among nonoutcome—the percentages of preterm and low birthweight (LBW) Hispanic white, Hispanic, American Indian, and Asian or Pacific births—rose. The twinning rate increased, but the rate of triplet and Islander (API) women but decreased among non-Hispanic black higher order multiple births was essentially stable. women.

/pdf/births-final-data-for-2003-4bkb5veo1e.pdf

Births: final data for 2003.

Objectives This report presents 2003 fetal and perinatal mortality data by a variety of characteristics, including maternal age, marital status, race, Hispanic origin, and state of residence; and by infant birthweight, gestational age, plurality, and sex. Trends in fetal and perinatal mortality are also examined. Methods Descriptive tabulations of data are presented and interpreted. Results The U.S. fetal mortality rate in 2003 was 6.23 fetal deaths of 20 weeks of gestation or more per 1,000 live births and fetal deaths. Fetal and perinatal mortality rates have declined slowly but steadily from 1990 to 2003. Fetal mortality rates for 28 weeks of gestation or more have declined substantially, whereas those for 20-27 weeks of gestation have not declined. Fetal mortality rates are higher for a number of groups, including non-Hispanic black women, teenagers, women aged 35 years and over, unmarried women, and multiple deliveries. Over one-half (51 percent) of fetal deaths of 20 weeks of gestation or more occurred between 20 and 27 weeks of gestation.

/pdf/fetal-and-perinatal-mortality-united-states-2003-4oupi2drae.pdf

Martha L Munson

Papers

Births: final data for 2002.

Births: final data for 2003.

Fetal and perinatal mortality, United States, 2003.