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Mixed model HMO is an HMO that combines features of
more than one HMO model.
(Also see Appendix II, Managed care; Preferred provider
organization [PPO].)
Health services and supplies expenditures—See
Appendix II, Health expenditures, national.
Health status, respondent-assessed—Health status was
measured in the National Health Interview Survey by asking
the family respondent about his or her health or the health
of a family member: ‘‘Would you say [person's] health in
general is excellent, very good, good, fair, or poor?’’
Hearing trouble—In the National Health Interview Survey,
information about hearing trouble is obtained by asking
respondents how well they hear without the use of hearing
aids. Prior to 2007 data, respondents were asked, ‘‘Which
statement best describes your hearing without a hearing
aid: good, a little trouble, a lot of trouble, or deaf?’’ In the
2007 data, the question was revised to expand the response
categories. Respondents were asked, ‘‘These next questions
are about your hearing WITHOUT the use of hearing aids or
other listening devices. Is your hearing excellent, good, [do
you have] a little trouble hearing, moderate trouble, a lot of
trouble, or are you deaf?’’ Starting with 2008 data,
respondents were asked, ‘‘WITHOUT the use of hearing aids
or other listening devices, is your hearing excellent, good,
[do you have] a little trouble hearing, moderate trouble, a lot
of trouble, or are you deaf?’’ Because of the expanded
response categories, 2007 and subsequent data are not
strictly comparable with earlier years and caution is urged
when interpreting trends. For example, in 2006, 3.5% of
adults (aged 18 and over) were classified as having hearing
difficulty (response categories: a lot of trouble or deaf). In
2007, 2.3% of adults (aged 18 and over) were classified as
having hearing difficulty (response categories: a lot of
trouble or deaf). This more than 30% decline from 2006 to
2007 in the estimate of those with hearing trouble is likely
attributable to the addition of the moderate trouble
response category, rather than changes in the prevalence of
hearing trouble. Although all age groups saw a decline in
the percentage reporting hearing trouble between 2006 and
2007, the amount of the decline varied. There was a 50%
decline in reported hearing trouble among adults aged
18–44 (from 0.8% in 2006 to 0.4% in 2007). Among adults
aged 45–64, the percentage that reported hearing trouble
declined 43%, from 3.5% in 2006 to 2.0% in 2007. Among
adults aged 65 and over, reported hearing trouble declined
24%, from 11.4% in 2006 to 8.7% in 2007.
For more information, see: Pleis JR, Lucas JW. Summary
health statistics for U.S. adults: National Health Interview
Survey, 2007. NCHS. Vital Health Stat 2009;10(240). Available
from: http://www.cdc.gov/nchs/data/series/sr_10/
sr10_240.pdf. (Also see Appendix II, Basic actions difficulty.)
Hispanic origin—Hispanic or Latino origin includes persons
of Mexican, Puerto Rican, Cuban, Central and South
American, and other or unknown Latin American or Spanish
origin. Persons of Hispanic origin may be of any race.
Birth file—The reporting area for an Hispanic-origin item
on the birth certificate expanded between 1980 and
1993 (when the Hispanic item was included on the birth
certificate in all states and D.C.). Trend data on births of
Hispanic and non-Hispanic parentage in Health, United
States are affected by expansion of the reporting areas,
which affects numbers of events, composition of the
Hispanic population, and maternal and infant health
characteristics.
In 1980 and 1981, information on births of Hispanic
parentage was reported on the birth certificate by the
following 22 states: Arizona, Arkansas, California,
Colorado, Florida, Georgia, Hawaii, Illinois, Indiana,
Kansas, Maine, Mississippi, Nebraska, Nevada, New
Jersey, New Mexico, New York, North Dakota, Ohio, Texas,
Utah, and Wyoming. In 1982 Tennessee, and in 1983 D.C.,
began reporting this information. Between 1983 and
1987, information on births of Hispanic parentage was
available for 23 states and D.C. In 1988, this information
became available for Alabama, Connecticut, Kentucky,
Massachusetts, Montana, North Carolina, and
Washington state, increasing the number of states
reporting information on births of Hispanic parentage to
30 states and D.C. In 1989, this information became
available from an additional 17 states, increasing the
number of Hispanic-reporting states to 47 and D.C. In
1989, only Louisiana, New Hampshire, and Oklahoma did
not report Hispanic parentage on the birth certificate.
With the inclusion of Louisiana in 1989 and Oklahoma in
1990 as Hispanic-reporting states, 99% of birth records
included information on mother's origin. Hispanic origin
of the mother was reported on the birth certificates of 49
states and D.C. in 1991 and 1992; only New Hampshire
did not provide this information. Starting in 1993,
Hispanic origin of mother was reported by all 50 states
and D.C.
Starting with 2003 data, some states began using the
2003 revision of the U.S. Standard Certificate of Live Birth.
Hispanic origin and race are collected separately on the
birth certificate. The Hispanic origin question on the
2003 revision of the birth certificate asks respondents to
select only one response. Occasionally, more than one
Hispanic origin response is given; that is, a specified
Hispanic origin group (Mexican, Puerto Rican, Cuban, or
Central and South American) in combination with one or
more other specified Hispanic origin groups. From 2003
through 2012, respondents who selected more than one
Hispanic origin on the birth certificate were classified as
other Hispanic. In 2012, 0.4% of births in the revisedstate
reporting area, plus Massachusetts (unrevised state
that also reported more than one Hispanic origin
response), were to women reporting more than one
416 Appendix II. Definitions and Methods Health, United States, 2014