Health Outcomes Measure Definitions

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Arthritis Among Adults
Population All Adults
Model-based measure A multi-level regression and post-stratification approach was applied to BRFSS and ACS data to compute a detailed probability of having arthritis (reporting ‘yes’ to the question: “Have you ever been told by a doctor or other health professional that you have some form of arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia?”) The probability was then applied to the detailed population estimates at the appropriate geographic level to generate the prevalence. The 95% confidence interval was derived using Monte Carlo simulation. Detailed methods are available here.
Measure Type Prevalence (crude and age-adjusted)
Time Period of Case Definition Lifetime
Summary An estimated 58.5 million U.S. adults aged ≥18 years have arthritis, 25.7 million of whom report an arthritis-attributable activity limitation (1). Projections suggest that by 2040, an estimated 78 million adults will have arthritis (2). Arthritis has a profound economic, personal, and societal impact in the United States. In 2013, the total national arthritis-attributable medical care costs and earnings losses among adults with arthritis were $303.5 billion (3). Monitoring the burden of arthritis is important for estimating the state-specific need for interventions that reduce symptoms, improve physical function, and improve the quality of life for people with arthritis.
Notes Doctor-diagnosed arthritis is self-reported and is not confirmed by a health care provider or objective monitoring.
Related Objectives or Recommendations None
  1. Theis KA, Murphy LB, Guglielmo D, et al. Prevalence of arthritis and arthritis-attributable activity limitation — United States, 2016–2018. MMWR Morb Mortal Wkly Rep. 2021;70(40):1401–1407 doi: https://doi.org/10.15585/mmwr.mm7040a2.
  2. Hootman JM, Helmick CG, Barbour KE, Theis KA, Boring MA. Updated projected prevalence of self-reported doctor-diagnosed arthritis and arthritis-attributable activity limitation among U.S. adults, 2015–2040. Arthritis Rheumatol. 2016;68(7):1582–1587. doi: https://doi.org/10.1002/art.39692.
  3. Murphy LB, Cisternas MG, Pasta DJ, Helmick CG, Yelin EH. Medical expenditures and earnings losses among U.S. adults with arthritis in 2013. Arthritis Care Res (Hoboken). 2018;70(6):869–876. doi: https://doi.org/10.1002/acr.23425.
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Current asthma among adults
Population All Adults
Model-based measure A multi-level regression and post-stratification approach was applied to BRFSS and ACS data to compute a detailed probability of having current asthma (reporting ‘yes’ to both of the questions, “Have you ever been told by a doctor, nurse, or other health professional that you have asthma?” and the question, “Do you still have asthma?”). The probability was then applied to the detailed population estimates at the appropriate geographic level to generate the prevalence. The 95% confidence interval was derived using Monte Carlo simulation. Detailed methods are available here.
Measure Type Prevalence (crude and age-adjusted)
Time Period of Case Definition Calendar year
Summary Overall, the number of U.S. adults who currently have asthma increased from 14.0 million (6.9%) in 2001 (1) to 21.0 million (8.4%) in 2020 (2). In 2020, the prevalence of current asthma was highest among adults below 100% of the poverty threshold (13.1%) (2). The prevalence of current asthma was highest among non-Hispanic multiracial adults (14.4%) followed by non-Hispanic Black persons (11.4%) (3). Among states and territories, estimates of adult current asthma prevalence in 2020 ranged from 5.0% in Guam to 12.4% in West Virginia (2). Compared to persons without asthma, persons with asthma are more likely to report depression (4-7), be unemployed, spend more days sick in bed, and have limitations or inability to conduct normal work (8). There is no cure for asthma, and it requires ongoing medical management (9-10).
Notes Physician-diagnosed asthma is self-reported and was not confirmed by a healthcare provider or objective monitoring.
Related Objectives or Recommendations None
  1. National Center for Environmental Health. National Health Interview Survey (NHIS) Data (2022). Centers for Disease Control and Prevention; 2001. https://www.cdc.gov/asthma/nhis/default.htm.
  2. National Center for Environmental Health (2022). Most Recent National Asthma Data. Centers for Disease Control and Prevention
    https://www.cdc.gov/asthma/most_recent_data_states.htm.
  3. National Center for Environmental Health. Behavioral Risk Factor Surveillance System (BRFSS) Surveillance Data (2022). Centers for Disease Control and Prevention; 2001. https://www.cdc.gov/asthma/brfss/default.htm.
  4. King ME. Serious psychological distress and asthma. In: Preedy VR. Scientific Basis of Healthcare. Science Publishers; 2012:86-107.
  5. Strine TW, Mokdad AH, Balluz LS, et al. Depression and anxiety in the United States: findings from the 2006 Behavioral Risk Factor Surveillance System. Psychiatr Serv. 2008;59:1383-1390.
  6. Chapman DP, Perry GS, Strine TW. The vital link between chronic disease and depressive disorders. Prev Chronic Dis. 2005;2:A14.
  7. Scott KM, Von Korff M, Ormel J, et al. Mental disorders among adults with asthma: results from the World Mental Health Survey. Gen Hosp Psychiatry. 2007;29(2):123-33. doi: https://dor.org/10.1016/j.genhosppsych.2006.12.006.
  8. Sullivan PW, Ghushchyan VH, Slejko JF, et al. The burden of adult asthma in the United States: evidence from the Medical Expenditure Panel Survey. J Allergy Clin Immunol. 2011 Feb;127(2):363-369.e1-3. doi: https://doi.org/10.1016/j.jaci.2010.10.042.
  9. Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma. National Asthma Education and Prevention Program, US Department of Health and Human Services; 2007.
  10. Cloutier MM, Baptist AP, Blake KV, et al. 2020 focused updates to the asthma management guidelines: a report from the national asthma education and prevention program coordinating committee expert panel working group. J Allergy Clin Immunol. 2020;146(6):1217-1270. Erratum in: J Allergy Clin Immunol. 2021;147(4):1528-1530. doi: https://doi.org/10.1016/j.jaci.2020.10.003.
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High blood pressure among adults
Population All Adults
Model-based measure A multi-level regression and post-stratification approach was applied to BRFSS and ACS data to compute a detailed probability among adults who report ever having been told by a doctor, nurse, or other health professional that they have high blood pressure. Women who were told they had high blood pressure only during pregnancy and those who were told they had borderline hypertension are not included. The probability was then applied to the detailed population estimates at the appropriate geographic level to generate the prevalence. The 95% confidence interval was derived using Monte Carlo simulation. Detailed methods are available here.
Measure Type Prevalence (crude and age-adjusted)
Time Period of Case Definition Past 12 months
Summary According to the American College of Cardiology/American Heart Association (ACC/AHA) 2017 hypertension guideline, hypertension is defined as a blood pressure ≥130/≥80 mmHg (1). An estimated 116 million American adults (47.3%) have hypertension—nearly 1 in 2 adults 18 years of age and older (2). Of those with hypertension, an estimated 62.0% are aware they have hypertension (3). The financial costs are significant with an estimated $52.2 billion dollars annually in 2018-2019 (3). High blood pressure is the number one modifiable risk factor for stroke. In addition to stroke, high blood pressure also contributes to heart attacks, heart failure, kidney failure, and atherosclerosis. Evidence-based interventions can be implemented, adapted, and expanded in diverse settings across the United States to avert the negative health effects of high blood pressure (3).
Notes Indicator does not measure the proportion of adults who currently have undiagnosed high blood pressure and thus likely results in an underestimate of the prevalence of high blood pressure. Indicator is based on having been told that one has high blood pressure and is subject to recall and actually having been told. Additionally, reports are not validated against actual blood pressure measurements or medical records. Survey questions are part of the BRFSS Rotating Core (odd years).
Related Objectives or Recommendations Healthy People 2030 objective: HDS-04. Reduce the proportion of adults with high blood pressure.
  1. Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on clinical practice guidelines. Hypertension. 2018;71(6):1269–1324. doi: https://doi.org/10.1161/HYP.0000000000000066.
  2. Division for Heart Disease and Stroke Prevention. Estimated Hypertension Prevalence, Treatment, and Control Among U.S. Adults. Centers for Disease Control and Prevention; Accessed February 24, 2022. https://millionhearts.hhs.gov/data-reports/hypertension-prevalence.html.
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Cancer (non-skin) or melanoma among adults
Population All Adults
Model-based measure A multi-level regression and post-stratification approach was applied to BRFSS and ACS data to compute a detailed probability of having arthritis (reporting ‘yes’ to the question: “Have you ever been told by a doctor, nurse, or other health professional that you had melanoma or any other types of cancer?” and “no” to the question, “Have you ever been told by a doctor, nurse, or other health professional that you had skin cancer that is not melanoma?”). The probability was then applied to the detailed population estimates at the appropriate geographic level to generate the prevalence. The 95% confidence interval was derived using Monte Carlo simulation. Detailed methods are available here.
Measure Type Prevalence (crude and age-adjusted)
Time Period of Case Definition Past year
Summary Malignant neoplasms (ICD-10: C00-C97) accounted for 605,213 deaths (17.5 % of total deaths) among US adults in 2021. (1) Overall cancer death rates continued to decline among men, women, children, and adolescents and young adults in every major racial and ethnic group in the United States from 2015 to 2019. (2) Among people who develop cancer, more than 69% will be alive in 5 years. (3) Yet, cancer remains a leading cause of death in the United States, second only to heart disease. (1)
Notes Doctor-diagnosed cancer is self-reported and is not confirmed by a healthcare provider or objective monitoring. This measure is not specific to cancer type.
Related Objectives or Recommendations Healthy People 2030 objectives C-01, C-02, C-04, C-06, and C-08. (4)
  1. Curtin SC, Tejada-Vera B, Bastian BA. Deaths: Leading causes for 2021. National Vital Statistics Reports, Vol. 73, No. 4, April 8, 2024 Hyattsville, MD: National Center for Health Statistics. 2024. https://www.cdc.gov/nchs/data/nvsr/nvsr73/nvsr73-04.pdf.
  2. Cronin KA, Scott S, Firth AU, et al. Annual report to the nation on the status of cancer, part 1: National cancer statistics. Cancer. 2022; 128(24): 4251-4284. doi: https://dor.org/10.1002/cncr.34479.
  3. National Cancer Institute, Surveillance, Epidemiology, and End Results Program. Cancer Statistic Explore Network. All Cancer Sites Combined SEER 5-Year Relative Survival Rates, 2014-2020 Bethesda, MD: National Cancer Institute. Accessed May 29, 2024.
  4. Office of Disease Prevention and Health Promotion. (n.d.). Cancer. Healthy People 2030. U.S. Department of Health and Human Services. Accessed May 29, 2024. https://health.gov/healthypeople/search?query=Cancer.
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High cholesterol among adults who have ever been screened
Population All Adults
Model-based measure A multi-level regression and post-stratification approach was applied to BRFSS and ACS data to compute a detailed probability among adults who report having ever been screened for high cholesterol and told by a doctor, nurse, or other health professional that they had high cholesterol. The probability was then applied to the detailed population estimates at the appropriate geographic level to generate the prevalence. The 95% confidence interval was derived using Monte Carlo simulation. Detailed methods are available here.
Measure Type Prevalence (crude and age-adjusted)
Time Period of Case Definition Lifetime
Summary In 2017–2020, about 10% of adults ages 20 and older had total cholesterol above 240 mg/dL, and about 17% had high-density lipoprotein (HDL, or “good”) cholesterol levels below 40 mg/dL (1). Slightly more than half of U.S. adults (54.5%, or 47 million people) who could benefit from cholesterol medicine are currently taking it (2). High cholesterol commonly has no symptoms, so many people don’t know that their cholesterol is too high. Having high blood cholesterol raises the risk for heart disease, the leading cause of death, and for stroke, the fifth leading cause of death in 2021. Lifestyle changes and medications can reduce cholesterol and prevent heart disease among people with elevated serum cholesterol (3).
Notes This measure does not include people with high cholesterol who have not had their blood cholesterol checked. Survey questions are part of the BRFSS Rotating Core (odd years).
Related Objectives or Recommendations Healthy People 2030 objective: HDS-06. Reduce cholesterol in adults.
  1. Tsao CW, Aday AW, Almarzooq ZI, et al. Heart disease and stroke statistics—2023 update: a report from the American Heart Association. Circulation. 2023;147(8):e93–e621. doi: https://doi.org/10.1161/CIR.0000000000001123.
  2. Wall HK, Ritchey MD, Gillespie C, Omura JD, Jamal A, George MG. Vital Signs: Prevalence of key cardiovascular disease risk factors for Million Hearts 2022—United States, 2011–2016. MMWR Morb Mortal Wkly Rep. 2018;67(35):983–991.
  3. Grundy SM, Stone NJ, Bailey AL, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of blood cholesterol: a report of the American College of Cardiology/American Heart Association Task Force on clinical practice guidelines. Circulation. 2019;139(25):e1082–e1143. doi: https://doi.org/10.1161/cir.0000000000000625.
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Chronic kidney disease among adults
Discontinued in the 2024 release.
Population: All Adults
Model-based measure A multi-level regression and post-stratification approach was applied to BRFSS and ACS data to compute a detailed probability among adults aged 18 years and older who report ever having been told by a doctor, nurse, or other health professional that they have kidney disease. The probability was then applied to the detailed population estimates at the appropriate geographic level to generate the prevalence. The 95% confidence interval was derived using Monte Carlo simulation. Detailed methods are available here.
Measure Type Prevalence (crude and age-adjusted)
Time Period of Case Definition Lifetime (before 2022)
Summary Chronic kidney disease (CKD) is a condition in which the kidneys are damaged and can’t filter blood as well as they should. Because of this, excess fluid and waste remain in the body and may cause health problems such as heart disease (1). Kidney diseases are a leading cause of death in the U.S. (1). In 2019, treating Medicare beneficiaries with CKD cost $87.2 billion, and treating people with end-stage kidney disease cost an additional $37.3 billion (1). More than 1 in 7 US adults—about 35.5 million people, or 14%—are estimated to have CKD (2). As many as 9 in 10 adults with CKD do not know they have it, and about 1 in 3 adults with severe CKD do not know they have CKD (2). CKD is more common in people aged 65 years or older (34%) than in people aged 45–64 years (12%) or 18–44 years (6%), and slightly more common in women (14%) than men (12%) (2).
Notes The estimated prevalence of CKD in the U.S. population is likely to be an underestimate because BRFSS is a telephone survey that excludes the institutionalized population, in whom the prevalence is likely to be higher (3), and because the prevalence is based on self-report. Most persons with CKD are unaware of their condition (2). In addition, one data point is available. The following question was asked for the first time in the 2011 BRFSS core questionnaire: “Has a doctor, nurse, or other health professional EVER told you have kidney disease? Do NOT include kidney stones, bladder infection, or incontinence.” (4).
Related Objectives or Recommendations Healthy People 2030 objective CKD-1: Reduce the proportion of adults with chronic kidney disease.
  1. Centers for Disease Control and Prevention. Chronic Kidney Disease Basics. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention; 2023. Accessed June 7, 2024. https://www.cdc.gov/kidney-disease/about/index.html#cdc_disease_basics_overview-about-your-kidneys-and-ckd.
  2. Centers for Disease Control and Prevention. Chronic Kidney Disease in the United States, 2023. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention; 2023. Accessed June 7, 2024. https://www.cdc.gov/kidney-disease/php/data-research/index.html.
  3. McClellan WM, Resnick B, Lei L, et al. Prevalence and severity of chronic kidney disease and anemia in the nursing home population. J Am Med Dir Assoc 2010;11:33–41.
  4. Centers for Disease Control and Prevention. Behavioral Risk Factor Surveillance System: questionnaires. Atlanta, GA: U.S. Department of Health and Human Services, CDC.
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Chronic obstructive pulmonary disease among adults
Population All Adults
Model-based measure A multi-level regression and post-stratification approach was applied to BRFSS and ACS data to compute a detailed probability among adults who report having ever been told by a doctor, nurse, or other health professional they had chronic obstructive pulmonary disease (COPD), emphysema, or chronic bronchitis. The probability was then applied to the detailed population estimates at the appropriate geographic level to generate the prevalence. The 95% confidence interval was derived using Monte Carlo simulation. Detailed methods are available here.
Measure Type Prevalence (crude and age-adjusted)
Time Period of Case Definition Lifetime
Summary In 2021, more than 15 million Americans (6.4%) reported that they have been diagnosed with COPD (1). Major risk factors include tobacco smoking, occupational and environmental exposures, respiratory infections, and genetics (2). Although there is no cure for COPD, it can be treated and managed to slow declining lung function, improve exercise tolerance, and prevent and treat exacerbations (2).
Notes The measure is based on being diagnosed by a physician and respondent recall of the diagnosis and may underestimate the true prevalence.
Related Objectives or Recommendations None
  1. BRFSS Web Enabled Analysis Tool. Centers for Disease Control and Prevention. Accessed May 3, 2023. https://nccd.cdc.gov/weat/#/.
  2. Agustí A, Celli BR, Criner GJ, et al. Global Initiative for Chronic Obstructive Lung Disease 2023 Report: GOLD Executive Summary. Am J Respir Crit Care Med. 2023;207(7):819-837. doi: https://doi.org/10.1164/rccm.202301-0106PP.
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Coronary heart disease among adults
Population All Adults
Model-based measure A multi-level regression and post-stratification approach was applied to BRFSS and ACS data to compute a detailed probability among adults who report ever having been told by a doctor, nurse, or other health professional that they had angina or coronary heart disease. The probability was then applied to the detailed population estimates at the appropriate geographic level to generate the prevalence. The 95% confidence interval was derived using Monte Carlo simulation. Detailed methods are available here.
Measure Type Prevalence (crude and age-adjusted)
Time Period of Case Definition Lifetime
Summary Coronary heart disease (also called ischemic heart disease) is caused by plaque buildup on the arteries. These blockages can limit the amount blood and oxygen the heart receives causing cause chest pain or angina. Coronary heart disease may present as an acute myocardial infarction which happens when the blood flow to a part of the heart is blocked by plaque. Approximately 20.5 million adults aged ≥20 years have CHD (about 7.1%) (NHANES 2017–2020) with men (8.7%) more commonly affected than women (5.8%) (1). CHD is the largest category of heart disease mortality with 375,476 people killed in 2021 (2). The estimated direct and indirect cost of heart disease in 2018 to 2019 (average annual) was $239.9 billion (1). Timely, effective treatment for heart attacks can reduce the risk for long-term disability and death (3).
Notes The measure is based on being diagnosed by a physician and respondent recall of the diagnosis and might underestimate the true prevalence.
Related Objectives or Recommendations Healthy People 2030 objective HDS-2: Reduce coronary heart disease deaths.
  1. Tsao CW, Aday AW, Almarzooq ZI, et al. Heart disease and stroke statistics—2023 update: a report from the American Heart Association. Circulation. 2023;147(8):e93–e621. doi: https://doi.org/10.1161/CIR.0000000000001123.
  2. National Center for Health Statistics. Underlying Cause of Death, 2018-2021. CDC WONDER, Centers for Disease Control and Prevention, U.S. Dept of Health and Human services; https://wonder.cdc.gov/ucd-icd10-expanded.html.
  3. Division for Heart Disease and Stroke Prevention. Coronary Artery Disease (CAD). Centers for Disease Control and Prevention. Accessed December 9, 2022. https://www.cdc.gov/heartdisease/coronary_ad.htm.
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Depression among adults
Population All Adults
Model-based measure A multi-level regression and post-stratification approach was applied to BRFSS and ACS data to compute a detailed probability among adults who responded yes to having ever been told by a doctor, nurse, or other health professional they had a depressive disorder, including depression, major depression, dysthymia, or minor depression. The probability was then applied to the detailed population estimates at the appropriate geographic level to generate the prevalence. The 95% confidence interval was derived using Monte Carlo simulation. Detailed methods are available here.
Measure Type Prevalence (crude and age-adjusted)
Time Period of Case Definition Lifetime
Summary Depression is a common and serious mood disorder. It causes severe symptoms that affect how you feel, think, and handle daily activities, such as sleeping, eating, or working (1). In 2019, an estimated 47 million U.S. adults (19%) reported they had been told by a doctor they had a depressive disorder, including depression, major depression, dysthymia, or minor depression in their lifetime (2). In 2019, 7% of all U.S. adults experienced moderate or severe symptoms of depression within the past 2 weeks with women more likely than men and adults ages 18–29 more likely than adults 30 years and older to experience any level of severity of symptoms (3). Depression, even the most severe cases, can be treated. The earlier treatment begins, the more effective it is (1).
Notes The question only assesses lifetime, not necessarily current, depression, and does not assess the severity or duration of depression.
Related Objectives or Recommendations Healthy People 2030 objective MHMD-05: Increase the proportion of adults with depression who get treatment. Healthy People 2030 objective MHMD-08: Increase the proportion of primary care visits where adolescents and adults are screened for depression.
  1. National Institute of Mental Health. Depression. National Institutes of Health, U.S. Dept of Health and Human Services. Accessed October 14, 2022. https://www.nimh.nih.gov/health/topics/depression.
  2. National Center for Chronic Disease Prevention and Health Promotion. BRFSS Web Enabled Analysis Tool. Centers for Disease Control and Prevention, U.S. Dept of Health and Human Services. Accessed October 14, 2022. https://nccd.cdc.gov/weat/#/analysis.
  3. Villarroel MA, Terlizzi EP. Symptoms of depression among adults: United States, 2019. NCHS Data Brief. 2020;379.
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Diagnosed diabetes among adults
Population All Adults
Model-based measure A multi-level regression and post-stratification approach was applied to BRFSS and ACS data to compute a detailed probability among adults who report being told by a doctor or other health professional that they have diabetes (other than diabetes during pregnancy for female respondents). The probability was then applied to the detailed population estimates at the appropriate geographic level to generate the prevalence. The 95% confidence interval was derived using Monte Carlo simulation. Detailed methods are available here.
Measure Type Prevalence (crude and age-adjusted)
Time Period of Case Definition Lifetime
Summary In 2021 in the U.S., 8.5% of the U.S. adult population aged ≥ 18 years had diagnosed diabetes (1). For the same year, the overall median prevalence for all 50 states, the District of Columbia, and territories was 11.1% (2). Substantial differences in diabetes prevalence exist by age, race, and ethnicity (1-3). The burden of diabetes in the U.S. has increased with the growing prevalence of obesity (3). Multiple long-term complications of diabetes can be prevented by managing blood glucose, blood lipids, and blood pressure regularly, eating healthy foods, being physically active, and screening and early treatment for eye, foot, and kidney abnormalities (4).
Notes About one-fourth of U.S. adults with diabetes are undiagnosed (5). As self-awareness of having diabetes is low, the prevalence of diabetes may be underestimated.
Related Objectives or Recommendations Healthy People 2030 objective: D-01. Reduce the number of diabetes cases diagnosed yearly.
    1. United States Diabetes Surveillance System, Division of Diabetes Translation, Centers for Disease Control and Prevention. United States Diabetes Surveillance System. https://gis.cdc.gov/grasp/diabetes/diabetesatlas.html .
    2. Division of Population Health. BRFSS Prevalence & Trends Data: Explore BRFSS Data By Topic. Centers for Disease Control and Prevention. Accessed April 4, 2023. https://www.cdc.gov/brfss/brfssprevalence.
    3. Geiss LS, Cowie CC. Type 2 diabetes and persons at high risk of diabetes. In: Narayan KMV, eds. Diabetes Public Health: From Data to Policy. Online ed. Oxford Academic; 2011:15–32. https://academic.oup.com/book/6900/chapter/151124452.
    4. National Center for Chronic Disease Prevention and Health Promotion. Prevent Diabetes Complications. Centers for Disease Control and Prevention. Accessed April 21, 2023. https://www.cdc.gov/diabetes/managing/problems.html.
    5. Diabetes. National Diabetes Statistics Report: Prevalence of Both Diagnosed and Undiagnosed Diabetes. Centers for Disease Control and Prevention. Accessed April 4, 2023. https://www.cdc.gov/diabetes/data/statistics-report/diagnosed-undiagnosed-diabetes.html.
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Obesity among adults
Population All Adults
Model-based measure A multi-level regression and post-stratification approach was applied to BRFSS and ACS data to compute a detailed probability among respondents aged ≥18 years who have a body mass index (BMI) ≥30.0 kg/m² calculated from self-reported weight and height. Exclude the following:
  • Height: data from respondents measuring <3 ft or ≥8 ft
  • Weight: data from respondents weighing <50 lbs or ≥650 lbs
  • BMI: data from respondents with BMI <12 kg/m2 or ≥100 kg/m2
  • BMI: data from respondents with BMI <12 kg/m2 or ≥100 kg/m2

The probability was then applied to the detailed population estimates at the appropriate geographic level to generate the prevalence. The 95% confidence interval was derived using Monte Carlo simulation. Detailed methods are available here.
Measure Type Prevalence (crude and age-adjusted)
Time Period of Case Definition Current
Summary Many adults in the United States have obesity (1). Adults with obesity have higher risks for stroke, many types of cancer, premature death, and mental illness such as clinical depression and anxiety (2-5). Obesity-related stigma and discrimination can also lead to health problems. Evidence suggests that intensive behavioral interventions that use more than one strategy — like group sessions and changes in both diet and physical activity — are an effective way to address obesity (6).
Notes Self-reports of height and weight lead to lower BMI estimates compared to estimates obtained when height and weight are measured (7).
Related Objectives or Recommendations Healthy People 2030 objective: NWS-03. Reduce the proportion of adults with obesity.
  1. Centers for Disease Control and Prevention, Office of Disease Prevention and Health Promotion. Physical Activity. Healthy People 2030. U.S. Department of Health and Human Services; 2022. https://health.gov/healthypeople/objectives-and-data/browse-objectives/overweight-and-obesity.
  2. Bhaskaran K, Douglas I, Forbes H, dos-Santos-Silva I, Leon DA, Smeeth L. Body-mass index and risk of 22 specific cancers: a population-based cohort study of 5.24 million UK adults. Lancet. 2014;384(9945):755-765.
  3. Kasen S, Cohen P, Chen H, Must A. Obesity and psychopathology in women: a three decade prospective study. Int J Obes (Lond). 2008;32:558-566.
  4. Luppino FS, de Wit LM, Bouvy PF, et al.l. Overweight, obesity, and depression: a systematic review and meta-analysis of longitudinal studies. Arch Gen Psychiatry. 2010;67:220-229.
  5. National Heart, Lung and Blood Institute. Managing Overweight and Obesity in Adults: Systematic Evidence Review from the Obesity Expert Panel. NHLBI; 2013. https://www.nhlbi.nih.gov/sites/default/files/media/docs/obesity-evidence-review.pdf.
  6. United States Preventive Services Task Force. Weight Loss to Prevent Obesity-Related Morbidity and Mortality in Adults: Behavioral Interventions. USPSTF; 2022. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/obesity-in-adults-interventions.
  7. Hodge JM, Shah R, McCullough ML, et al. Validation of self-reported height and weight in a large, nationwide cohort of U.S. adults. PLoS ONE. 2020; 15(4): e0231229. doi: https://doi.org/10.1371/journal.pone.0231229.
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All teeth lost among adults aged ≥65 years
Population Adults aged 65 years and older
Model-based measure A multi-level regression and post-stratification approach was applied to BRFSS and ACS data to compute a detailed probability among adults aged 65 years and older who report having lost all of their natural teeth due to tooth decay or gum disease. The probability was then applied to the detailed population estimates at the appropriate geographic level to generate the prevalence. The 95% confidence interval was derived using Monte Carlo simulation. Detailed methods are available here.
Measure Type Prevalence (crude and age-adjusted)
Time Period of Case Definition Current
Summary Estimates from the Behavioral Risk Factor Surveillance System (BRFSS) indicated the prevalence of edentulism (i.e., having lost all natural teeth or complete tooth loss) among U.S. adults aged ≥ 65 years decreased from 16.2% in 2012 to 13.8% in 2020 (1). Despite improvement in tooth retention over the past decades, disparities remain across some populations, such as a higher prevalence of edentulism in adults with lower income and lower educational levels, and current smokers (2). Dental caries (tooth decay or cavities) and periodontal (gum) disease are leading causes of tooth loss. Complete tooth loss substantially limits food choices and eating and chewing ability and affects the quality of life (3). Older adults with chronic conditions (e.g., diabetes and heart disease) had a significantly higher prevalence of severe and complete tooth loss than those without the condition (4). Personal, professional, and population-based strategies to prevent and control gum disease and tooth decay can help ensure tooth retention (5, 6).
Notes Questions are part of the rotating core, currently collected in even years.
Related Objectives or Recommendations Healthy People 2030 objective: OH-05. Reduce the proportion of adults aged 45 years and over who have lost all their teeth.
  1. Centers for Disease Control and Prevention, Division of Oral Health. Oral Health Data. Centers for Disease Control and Prevention; 2020. https://www.cdc.gov/oralhealthdata/.
  2. Centers for Disease Control and Prevention, Division of Oral Health. Oral Health Surveillance Report: Trends in Dental Caries and Sealants, Tooth Retention, and Edentulism, United States, 1999–2004 to 2011–2016. Centers for Disease Control and Prevention; 2019. https://www.cdc.gov/oralhealth/publications/OHSR-2019-index.html.
  3. Griffin SO, Jones JA, Brunson D, Griffin PM, Bailey WD. Burden of oral disease among older adults and implications for public health priorities. Am J Public Health. 2012;102(3):411-8.
  4. Parker ML, Thornton-Evans G, Wei L, Griffin SO. Prevalence of and changes in tooth loss among adults aged ≥50 years with selected chronic conditions — United States, 1999–2004 and 2011–2016. MMWR Morb Mortal Wkly Rep. 2020;69(21):641-6.
  5. Centers for Disease Control and Prevention, Division of Oral Health. Oral Health Conditions. Centers for Disease Control and Prevention; 2022. https://www.cdc.gov/oralhealth/conditions.
  6. National Institutes of Health. Oral Health in America: Advances and Challenges. U.S. Department of Health and Human Services, National Institutes of Health, National Institute of Dental and Craniofacial Research; 2021. https://www.ncbi.nlm.nih.gov/pubmed/35020293.
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Stroke among adults
Population All Adults
Model-based measure A multi-level regression and post-stratification approach was applied to BRFSS and ACS data to compute a detailed probability among adults who report ever having been told by a doctor, nurse, or other health professional that they have had a stroke. The probability was then applied to the detailed population estimates at the appropriate geographic level to generate the prevalence. The 95% confidence interval was derived using Monte Carlo simulation. Detailed methods are available here.
Measure Type Prevalence (crude and age-adjusted).
Time Period of Case Definition Lifetime
Summary Ischemic stroke occurs when a blood vessel leading to the brain is blocked by a clot. Hemorrhagic stroke occurs when a blood vessel within the brain ruptures. Based on data from 1999, approximately 9.4 million American adults have had a stroke (3.3%) (NHANES 2017–2020) (1). Approximately 795,000 people or 1 person on average every 40 seconds has a stroke each year in the United States (1). On average, 1 American dies from a stroke every 3 minutes 14 seconds (2). Stroke was the fifth leading cause of death in the United States in 2021 (2). Timely, effective treatment for strokes can reduce the risk for long-term disability and death (3).
Notes The measure is based on being diagnosed by a physician and respondent recall of the diagnosis and might underestimate the true prevalence.
Related Objectives or Recommendations Healthy People 2030 Objective HDS-3: Reduce stroke deaths.
  1. Tsao CW, Aday AW, Almarzooq ZI, et al. Heart disease and stroke statistics—2023 update: a report from the American Heart Association. Circulation. 2023;147(8):e93–e621. doi: https://doi.org/10.1161/CIR.0000000000001123.
  2. National Center for Health Statistics. Underlying Cause of Death, 2018-2021.. CDC WONDER, Centers for Disease Control and Prevention, U.S. Dept of Health and Human services; Accessed January 13, 2022 and February 21, 2022 https://wonder.cdc.gov/ucd-icd10-expanded.html.
  3. National Center for Chronic Disease Prevention and Health Promotion, Division for Heart Disease and Stroke Prevention. About Stroke. Centers for Disease Control and Prevention, U.S. Dept of Health and Human services; Accessed December 9, 2022. https://www.cdc.gov/stroke/about.htm.
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