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Use of Clinical Preventive Services and Prevalence of Health Risk Factors Among Adults Aged 50–64

National and State-Level Racial/Ethnic, Socioeconomic, and Health Insurance Coverage Status Disparities

This report tracks national and state-level data on the use of preventive services and the prevalence of risk factors among adults aged 50 to 64.

Indicators and Analysis

It examines the use of four disease screenings, two immunizations, and two composite measures indicating individuals were up-to-date with select clinical preventive services, as well as the prevalence of five risk factors. This study also examines these 13 indicators across racial/ethnic groups, income levels, educational attainment, and health insurance coverage status, and across all 50 states and the District of Columbia.

The Value of Preventive Care at Midlife

For midlife adults, maintaining a healthy lifestyle along with having routine recommended screenings and immunizations is critical to healthy aging. Hundreds of thousands of lives would be saved each year if people quit using tobacco, lost weight, exercised routinely, and consumed a healthy diet. It has been estimated that 25,000 to 40,000 deaths per year among Americans under the age of 65 could be prevented through optimal use of nine recommended clinical preventive services.  Yet, Americans in this age group underuse preventive services and face considerable health challenges.

Summary of Results

This study reveals that fewer than 1 in 3 midlife adults were up-to-date with select recommended preventive services, 44 percent reported having high blood pressure ever, and 33 percent were obese.

Underuse of preventive services is an even greater problem for uninsured Americans, racial/ethnic minorities and those of low socioeconomic status. These vulnerable groups are also more likely to report risk factors for poor health. For example, it was found that over three times more insured women were up-to-date with select clinical preventive services than uninsured women (32.8% vs. 10%, respectively). Nearly three times more low-income adults reported physical inactivity than high income adults (42.2% vs. 15.5%, respectively).

The report also revealed that 7 out of 10 relevant national target rates for prevention activities (Healthy People 2020) were not met among the 50- to 64-year-old population by the majority of states. In particular, just 5 states met the target rate for colorectal cancer screening, only 1 state (Utah) met the target rate for smoking, and no states met the target rates for Pap test and influenza and pneumococcal vaccinations.

Differences in the use of preventive services and the prevalence of risk factors also varied across states, at time considerably. Southern states tended to have the highest prevalence of risk factors. Northeastern states tended to have the highest preventive service utilization rates. Idaho, Mississippi, and Montana were tied for the lowest-ranking state more often than any other state, reflecting some of the lowest preventive service utilization rates and highest prevalence of risk factors in the nation. Massachusetts ranked number one for highest rates of utilization for preventive services more often than any other state, potentially reflecting the success of the Massachusetts health care insurance reform law.

The Affordable Care Act took a number of steps to make preventive care more accessible and affordable, including eliminating coinsurance, copayments, and deductibles for recommended preventive services. This report highlights the need for supporting and promoting this new benefit given the evidence that reducing out-of-pocket costs increase disease screenings and immunizations. Read the report for more evidence-based strategies to increase uptake of preventive services and reduce health disparities.

Customize National and State-Level Data

Accompanying the report is an interactive Website that allows users to customize the data to rank states and examine disparities as well as compare state performance to national averages and national target rates.