Health Status

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Frequent mental distress 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 aged ≥ 18 years who report that their mental health (including stress, depression, and problems with emotions) was not good for 14 or more days during the past 30 days. 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 30 days
Summary In 2021, 14.7% of US adults reported frequent mental distress (FMD), defined as 14 or more mentally unhealthy days during the past 30 days where the person has experienced poor mental health because of stress, depression, or problems with emotions (1) FMD estimates are higher for women than men (1). FMD is also negatively associated with life expectancy and positively associated with behavioral and metabolic risk factors (2). Mentally unhealthy days are one of the CDC’s health-related quality of life measures (CDC HRQOL-4). FMD is used to identify individuals with more severe or persistent health problems in the previous month (1). Many chronic diseases can impact general health status, including mental distress. Practicing healthy behaviors (e.g., not smoking, eating healthy, being active, and limiting drinking) can reduce the likelihood of getting a chronic disease and improve the odds of staying well, feeling good, and living longer (3).
Notes Although this measure is based on self-assessment, the number of days has been demonstrated to have good reliability, validity, and responsivenes.
Related Objectives or Recommendations None
  1. United Health Foundation. America’s Health Rankings. Accessed 2023. https://www.americashealthrankings.org.
  2. Zahran HS, Kobau R, Moriarty DG, et al. Health-related quality of life surveillance–United States, 1993-2002. MMWR Surveill Summ. 2005;54(4):1–35.
  3. National Center for Chronic Disease Prevention and Health Promotion. How You Can Prevent Chronic Diseases. Centers for Disease Control and Prevention, US Dept of Health and Human Services. Accessed November 30, 2022. https://www.cdc.gov/chronicdisease/about/prevent/index.htm.
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Frequent physical distress 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 reported 14 or more days, during the past 30 days, that their physical health (including physical illness and injury) was not good. 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 30 days
Summary Physically unhealthy days, one of CDC’s health-related quality of life measures (CDC HRQOL-4), is defined as a person’s perceived physical health over time (1). Physically unhealthy days asked about the number of days in the past 30 days a respondent experienced poor physical health because of physical illness or injury. Frequent physical distress (FPD), defined as 14 or more physically unhealthy days during the past 30 days, is used to identify individuals with more severe or chronic health problems in the previous month (2). FPD is also negatively associated with life expectancy (2,3). In 2021, 11% of US adults reported FPD with estimates higher for women than men (4). Many chronic diseases can impact general health status, including physical distress. Practicing healthy behaviors (e.g., not smoking, eating healthy, being active, and limiting drinking) can reduce the likelihood of getting a chronic disease and improve the odds of staying well, feeling good, and living longer (5).
Notes None
Related Objectives or Recommendations None
  1. Moriarty DG, Zack MM, Kobau R. The Centers for Disease Control and Prevention’s Healthy Days Measures – population tracking of perceived physical and mental health over time. Health Qual Life Outcomes. 2003;1:37. doi: https://doi.org/10.1186/1477-7525-1-37.
  2. Zahran HS, Kobau R, Moriarty DG, et al. Health-related quality of life surveillance–United States, 1993-2002. MMWR Surveill Summ. 2005;54(4):1–35.
  3. Dwyer-Lindgren L, Mackenbach JP, van Lenthe FJ, Mokdad AH. Self-reported general health, physical distress, mental distress, and activity limitation by US county, 1995-2012. Popul Health Metr. 2017;15(1):16. doi: https://doi.org/10.1186/s12963-017-0133-5.
  4. America’s Health Rankings. Frequent Physical Distress in depth. United Health Foundation. Accessed May 4, 2023. https://www.americashealthrankings.org/explore/measures/Physical_distress.
  5. National Center for Chronic Disease Prevention and Health Promotion. How You Can Prevent Chronic Diseases. Centers for Disease Control and Prevention, US Dept of Health and Human Services. Accessed November 30, 2022. https://www.cdc.gov/chronicdisease/about/prevent/index.htm.
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Fair or poor self-rated health status 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 their general health status as “fair” or “poor”. 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 Health status is a measure of how people perceive their health and is considered a good global assessment of a person’s well-being (1). Furthermore, it is a predictor of important health outcomes including mortality, morbidity, and functional status (2). Health status is also used to measure healthy life expectancy at the population level (3). In 2019, 15.3% of adults assessed their health as fair or poor. Substantial differences in the prevalence of fair or poor self-reported health status exist by age group, race, education level, urbanization level, and poverty status (4,5). Monitoring health status can inform individual- and population-level interventions and demonstrate improvements over time.
Notes: This measure is based on self-assessment only and does not include an objective health component.
Related Objectives or Recommendations Healthy People 2030 objective: OHM-8. Respondent-assessed health status — in good or better health.
  1. World Health Organization. International Classification of Functioning, Disability and Health (ICF). World Health Organization. https://www.who.int/classifications/international-classification-of-functioning-disability-and-health.
  2. DeSalvo KB, Bloser N, Reynolds K, He J, Muntner P. Mortality prediction with a single general self-rated health question. A meta-analysis. J Gen Intern Med. 2006;21(3):267–275. doi: https://doi.org/10.1111/j.1525-1497.2005.00291.x.
  3. Zhang YS, Shim H, Crimmins EM. Life expectancy and health expectancy. In: Rattan SI. Encyclopedia of Biomedical Gerontology. Academic Press; 2020:313–325.
  4. National Vital Statistics System (NVSS). Percentage of fair or poor health status for adults aged 18 and over, United States, 2019—2021. National Health Interview Survey, Centers for Disease Control and Prevention, US Dept of Health and Human Services. https://wwwn.cdc.gov/NHISDataQueryTool/SHS_adult/index.html.
  5. Centers for Disease Control and Prevention. QuickStats: Percentage of adults aged ≥18 years with fair or poor health, by urbanization level and age group — National Health Interview Survey, United States, 2019. MMWR Morb Mortal Wkly Rep. 2021;70:1048. doi: https://doi.org/10.15585/mmwr.mm7030a3.
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