Immunization information system progress--United States, 2004

One of the national health objectives for 2010 is to increase to at least 95% the proportion of children aged <6 years who participate in fully operational, population-based immunization registries (objective no. 14-26). Immunization registries are confidential, computerized information systems that collect and consolidate vaccination data from multiple health-care providers, generate reminder and recall notifications, and assess vaccination coverage within a defined geographic area. A registry with added capabilities, such as vaccine management, adverse event reporting, lifespan vaccination histories, and linkages with electronic data sources, is called an immunization information system (IIS). This report summarizes data from CDC's 2004 IIS Annual Report, a survey of 56 grantees in 50 states, five cities, and the District of Columbia (DC) that receive funding under section 317b of the Public Health Service Act. The findings indicate that approximately 48% of U.S. children aged <6 years participated in an IIS. Moreover, 76% of public vaccination provider sites and 39% of private vaccination provider sites submitted immunization data to an IIS during the last 6 months of 2004. Overcoming challenges and barriers to increasing the number of provider sites and the percentage of children aged <6 years participating in an IIS is critical to achieving the national health objective. CDC has developed a plan of action to address those challenges. Major components of the plan include, but are not limited to, a multiyear IIS business plan for each grantee and enhanced technical assistance to grantees with unresolved challenges.     

Racial/ethnic disparities in prevalence, treatment, and control of hypertension--United States, 1999-2002

High blood pressure (HBP) is a major risk factor for heart disease and stroke, end-stage renal disease, and peripheral vascular disease and is a chief contributor to adult disability. Approximately one in four adults in the United States has hypertension. Although effective therapy has been available for more than 50 years, most persons with hypertension do not have their blood pressure (BP) under control. National health objectives for 2010 include reducing the proportion of adults with HBP to 16% (baseline: 28%), increasing the proportion of adults with hypertension who are taking action to control it to 95% (baseline: 82%), and increasing the proportion of adults with controlled BP to 50% (baseline: 18%). During 1990-2000, the prevalence of hypertension, the percentage of those with hypertension who were aware of their condition, and treatment and control of hypertension increased among non-Hispanic whites, non-Hispanic blacks, and Hispanics. CDC analyzed data from the National Health and Nutrition Examination Surveys (NHANES) for 1999-2002. This report summarizes the results of that analysis, which determined that racial/ethnic disparities in awareness of, treatment for, and control of hypertension persist. If national health objectives are to be met, public health efforts must continue to focus on the prevention of HBP and must improve awareness, treatment, and control of hypertension among minority populations.     

Health disparities experienced by black or African Americans--United States

In the 2000 census, 36.4 million persons, approximately 12.9% of the U.S. population, identified themselves as Black or African American; 35.4 million of these persons identified themselves as non-Hispanic. For many health conditions, non-Hispanic blacks bear a disproportionate burden of disease, injury, death, and disability. Although the top three causes and seven of the 10 leading causes of death are the same for non-Hispanic blacks and non-Hispanic whites (the largest racial/ethnic population in the United States), the risk factors and incidence, morbidity, and mortality rates for these diseases and injuries often are greater among blacks than whites. In addition, three of the 10 leading causes of death for non-Hispanic blacks are not among the leading causes of death for non-Hispanic whites: homicide (sixth), human immunodeficiency virus (HIV) disease (seventh), and septicemia (ninth). This week's MMWR is the third in a series focusing on racial/ethnic health disparities. Eliminating these disparities will require culturally appropriate public health initiatives, community support, and equitable access to quality health care.     

Tobacco use among students aged 13-15 years--Philippines, 2000 and 2003

Tobacco use is one of the major preventable causes of premature death and disease in the world. A disproportionate share of the global tobacco burden falls on developing countries, where an estimated 84% of the world's 1.3 billion current smokers live. The Global Youth Tobacco Survey (GYTS), part of the Global Tobacco Surveillance System (GTSS) initiated by the World Health Organization (WHO) and CDC, was developed to monitor youth tobacco use, attitudes about tobacco, and exposure to tobacco smoke, and has been completed by approximately 1.4 million students in 133 countries. A key goal of GTSS is for countries to conduct the GYTS every 4 years. This report presents findings from the GYTS conducted in the Philippines in 2000 and 2003, which revealed substantial declines in the proportions of students aged 13-15 years who currently smoked cigarettes, currently used other tobacco products, were likely to start smoking in the next year, or were exposed to secondhand smoke in public places. The findings also indicated an increase in the proportion of students who supported bans on smoking in public places, had learned about the dangers of tobacco use in school, and had seen antitobacco messages in media and advertising. Public health authorities in the Philippines should evaluate their current tobacco-control programs and enhance or expand them to further reduce youth smoking.     

Children and teens told by doctors that they were overweight--United States, 1999-2002

The percentage of children and teens aged 6-19 years in the United States who are overweight nearly tripled to 16% during 1980-2002. Overweight and obese children and teens are at greater risk for many comorbid conditions, both immediate and long-term. Their risk is approximately 10 times greater than that of normal weight children for hypertension in young adulthood, three to eight times greater for dyslipidemias, and more than twice as great for diabetes mellitus. To determine what percentage of overweight children (or their parents) and teens were ever told their weight status by doctors or other health-care professionals, CDC analyzed data from the 1999-2002 National Health and Nutrition Examination Survey (NHANES). This report summarizes the results of that analysis, which determined that 36.7% of overweight children and teens aged 2-19 years had been told by a doctor or other health-care professional that they were overweight, and teens aged 16-19 years were more likely to be told than parents of children aged 2-11 years. By discussing weight status with overweight patients and their parents, pediatric health-care providers might help these patients implement lifelong improvements in diet and physical activity.     

Cigarette smoking among adults--United States, 2003

One of the national health objectives for 2010 is to reduce the prevalence of cigarette smoking among adults to 12%. To assess progress toward this objective, CDC analyzed self-reported data from the 2003 National Health Interview Survey (NHIS). The results of that analysis indicated that, in 2003, approximately 21.6% of U.S. adults were current smokers. Although this prevalence is lower than the 22.5% prevalence among U.S. adults in 2002 and significantly lower than the 22.8% prevalence in 2001, the rate of decline is not sufficient to meet the national health objective for 2010. Comprehensive, sustained interventions that reduce the rate of smoking initiation and increase the rate of cessation are needed to further the decline in cigarette smoking among adults.     

Trends in leisure-time physical inactivity by age, sex, and race/ethnicity--United States, 1994-2004

Physical inactivity is associated with increased risk for certain chronic diseases, including cardiovascular disease, diabetes, and osteoporosis. Despite the benefits of physical activity, more than half of adults in the United States are not regularly active at the recommended levels. Trends in the proportion of adults who achieve the recommended levels of leisure-time physical activity have remained relatively stable over time. However, the proportion of adults from 35 states and the District of Columbia who reported that they did not engage in any leisure-time physical activity declined from 1996 to 2002. To further examine trends in no leisure-time physical activity by population subgroup, CDC analyzed data from the Behavioral Risk Factor Surveillance System (BRFSS) for the period 1994-2004. This report is the first analysis of BRFSS physical-inactivity trends that includes all 50 states and the District of Columbia (DC). State and local health departments should continue to create programs that encourage adults to be physically active during leisure time.     

Disparities in universal prenatal screening for group B streptococcus--North Carolina, 2002-2003

Group B streptococcus (GBS) is a leading cause of neonatal morbidity and mortality in the United States. Intrapartum antibiotics administered to women at risk for transmitting GBS to their newborns are effective in preventing perinatal GBS infection. In 2002, CDC, the American Academy of Pediatrics, and the American College of Obstetricians and Gynecologists recommended universal prenatal screening for vaginal and rectal GBS colonization at 35-37 weeks' gestation. To examine prenatal GBS screening among pregnant women in North Carolina, CDC analyzed 2002 and 2003 data from the North Carolina Pregnancy Risk Assessment Monitoring System (PRAMS). The proportions of women reporting prenatal screening for GBS were similar in 2002 and 2003 (70% and 74%, respectively); however, for both years, women of Hispanic ethnicity and women who received prenatal care at a hospital or health department clinic were less likely to report prenatal screening for GBS. These findings underscore the need to increase GBS-related education and prevention activities targeted to these populations.     

Seroprevalence of poliovirus antibodies among children in a Dominican community--Puerto Rico, 2002

Although the Region of the Americas was certified as polio-free in 1994, an outbreak of paralytic poliomyelitis associated with circulating vaccine-derived poliovirus (cVDPV) occurred during July 2000-July 2001 on the Caribbean island of Hispaniola. A total of 21 cases of paralytic polio associated with type 1 oral poliovirus vaccine (OPV) strain were reported in Haiti and the Dominican Republic (DR). Outbreaks from cVDPV occur among children in communities with low immunity levels to polioviruses and the absence of circulation of wild poliovirus (WPV). The U.S. territory of Puerto Rico (PR), located approximately 72 miles east of DR, has not had a case of paralytic polio since 1974. However, because of its proximity to DR and concerns that visitors and immigrants from DR (who tend to live in a separate community in PR) might not be fully vaccinated against polioviruses, the PR Department of Health (PRDH) and CDC assessed the seroprevalence of poliovirus antibodies among children aged 7-60 months in a predominantly DR community of PR. This report describes the results of that assessment, which indicated high levels of seropositivity for all three poliovirus serotypes. If vaccination rates remain high, the risk for a polio outbreak in this community is low. However, until all threats of poliovirus are eliminated globally, high rates of vaccination among preschool children must be ensured to prevent outbreaks of paralytic polio from any source (e.g., imported WPV, laboratory strains, or cVDPV) in the United States and its territories.