Before 2010, only about half of US adults utilized preventive services, such as screening for lipid disorders, despite the substantial benefits associated with early intervention, according to data published in the CDC’s Morbidity and Mortality Weekly Report.
“This report provides a snapshot of preventive services for US adults before 2010. As we look to the future, we can track how our nation’s health is progressing through better prevention in health care,” CDC Director Thomas R. Frieden, MD, MPH, said in a press release.
Improving heart health
“Cardiovascular disease (CVD) is the leading cause of preventable death in the United States, a major contributor to adult disability, and one of the most expensive conditions treated in US hospitals,” the researchers wrote. Many people, however, do not take the steps necessary for prevention.
Data from the National Health and Nutrition Examination Survey 2005-2008 showed that 88.7% of US adults aged 20 years and older should have been screened for high cholesterol, yet only 68.4% had been screened in the preceding 5 years.
Additionally, the US Preventive Services Task Force (USPSTF) guidelines for the prevention of hypertension claim that adults aged 18 years and older with hypertension should undergo a clinical treatment plan, including medications and monthly follow-up visits. However, hypertension is controlled in less than half (44%) of those with the condition, the researchers wrote.
Furthermore, of adults aged 18 years and older, 30% were not taking prescribed blood pressure medications between 2005 and 2008, and only 47% of patients with CVD were prescribed daily use of aspirin.
“Screening for lipid abnormalities is essential in detecting and properly managing lipid disorders early in the atherogenic process, thereby preventing the development of atherosclerotic plaques and minimizing existing plaques,” researchers said.
Disparities in diabetes
Between 2007 and 2010, approximately 12.9% of US adults with self-reported diabetes exhibited poor glycemic control (HbA1c >9%), according to NHANES data. Researchers also said a disproportionate number of young people and minorities were affected.
Researchers found that poor glycemic control was least common among patients aged 65 years or older (6.8%), and it was most common in patients aged 18 to 39 years (24.2%), they wrote.
“The sub-optimal glycemic control observed among young persons might reflect less interaction with the health system stemming from the vulnerable period of age-related transition between parents’ and independent health insurance coverage,” the researchers wrote.
Moreover, black and Hispanic patients were more likely to have HbA1c levels higher than 9% vs. white patients (18.7% and 18.8% vs. 10.1%). Similarly, when compared with insured patients, uninsured patients exhibited worse glycemic control.
The Affordable Care Act’s (ACA) provisions could affect future data. The new provisions will require new private health insurance plans to cover recommended preventive services, with no cost sharing. Additionally, the health care law will require coverage for a new annual wellness visit under Medicare and will eliminate cost sharing for recommended preventive services provided to Medicare beneficiaries, according to a press release from the CDC.
Financial incentives will be given to state Medicaid programs to cover preventive services for adults and will support initiatives to improve public knowledge about the benefits of preventive services.
The CDC said the ACA provided approximately 54 million Americans with at least one new free preventive service through their private health insurance plans in 2011.
According to the Rationale for Periodic Reporting on the Use of Selected Adult Clinical Preventive Services supplementation, “researchers have reported that increasing use of nine clinical preventive services to more optimal levels (ie, levels achieved by high-performing health plans) could prevent an estimated 50,000 to 100,000 deaths each year among adults aged <80 years.”
For more information:
Ali MK. MMWR. 2012;61(Suppl; June 15, 2012):32-37.
Coates RJ. MMWR. 2012;61(Suppl; June 15, 2012):3-10.
Gillespie CD. MMWR. 2012;61(Suppl; June 15, 2012):26-31.