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IntroductionKey FindingsNational InsightsOverviewAccess to Health CareImmunizationsChronic Disease PreventionInequity InsightsAccess to Health Care: Dedicated Health Care ProviderImmunizations: Pneumococcal VaccinationChronic Disease Prevention: Colorectal Cancer ScreeningState Insights: OverallState Insights: Access to Health CareState Insights: ImmunizationsState Insights: Chronic Disease PreventionAppendix 1Appendix 2Footnotes
Looking at each of the three key Prevention categories—Access to Health Care, Immunizations, and Chronic Disease Prevention—at the national level illuminates some insights about the country’s prevention performance, including:
Access to Health Care
On a national level, a higher percentage of Americans report having health insurance and a dedicated health care provider compared with those who visited the dentist in the past year.
1. Data Source: Centers for Disease Control and Prevention (CDC). Behavioral Risk Factor Surveillance System Survey Data, 2014.
The relatively higher percentage of Americans reporting having health insurance coverage compared to having a dedicated health care provider or an annual dental visit may suggest that having insurance is an important pre-requisite for further engagement with the health care system.
Immunizations
Among the three categories of prevention, the immunizations category presents the largest geographic variations. Some states are exceeding national HP2020 goals in childhood and long-established adolescent vaccination coverage, indicating that national goals are attainable.
Nationwide, 71.6% of children aged 19 to 35 months completed the recommended series of childhood immunizations. While this falls below the HP2020 target of 80%, the top four states (Maine, North Carolina, New Hampshire, and Nebraska) in childhood immunization coverage exceed the national goal. Immunization coverage for tetanus, diphtheria, and acellular pertussis (Tdap), long established as a vaccine required for teens aged 13 to 17, is 87.6%, exceeding the national goal.[3] In adults, only 40.4% of adults received an influenza vaccination while the national level of pneumococcal vaccination coverage for adults aged 65 years and older is 69.5%,4 both well below national goals.
Adolescent immunization coverage levels vary widely by type of vaccine and by state. The largest variation among states is in meningococcal conjugate vaccine (MCV4) coverage, with 95.2% of adolescents aged 13 to 17 years receiving the vaccine in Pennsylvania compared to only 46.0% of adolescents in Mississippi. Nationally, 79.3% of adolescents received MCV4.
Coverage levels of the human papilloma virus (HPV) vaccine, first recommended for females in 2009 and males in 2011, are 39.7% for females and 21.6% for males, much lower than the other recommended adolescent immunizations.
2. Centers for Disease Control (CDC). National Immunization Survey Data, 2014. 3. Centers for Disease Control (CDC). National Immunization Survey—Teen Data, 2014. 4. Centers for Disease Control & Prevention (CDC). Behavioral Risk Factor Surveillance System Survey Data, 2014.
Chronic Disease Prevention
Nationally, 31.4% of adults report they have high blood pressure. Many people with high blood pressure are not aware of their condition. Reducing high blood pressure reduces the risk for stroke and heart attack.
Nationally, a greater proportion of eligible adults have had a cholesterol check in the past 5 years compared with those who have received recommended colorectal cancer screening.
5. Centers for Disease Control and Prevention (CDC). Behavioral Risk Factor Surveillance Data, 2013. 6. Centers for Disease Control and Prevention (CDC). Behavioral Risk Factor Surveillance Data, 2014.
Table 1 displays national values for each prevention measure, the number of adults impacted, and the national Healthy People 2020 targets where data are available.
Table 1: National Value, Number Impacted, and Healthy People 2020 Target by Prevention Measure 
*HP2020 target includes persons aged 2 and older, so it is not directly comparable to dental visits, annual. **NA—Not available. National Immunization Survey Data does not include population estimates.
1. Data Source: Centers for Disease Control and Prevention (CDC). Behavioral Risk Factor Surveillance System Survey Data, 2014. 2. Centers for Disease Control (CDC). National Immunization Survey Data, 2014. Centers for Disease Control & Prevention (CDC). Behavioral Risk Factor Surveillance System Survey Data, 2014.