Health Status

Mental health not good for ≥14 days among adults aged ≥18 years
Demographic group Resident adults aged ≥18 years.
Numerator Respondents aged ≥18 years who report 14 or more days during the past 30 days during which their mental health was not good.
Denominator Respondents aged ≥18 years who report or do not report the number of days during the past 30 days during which their mental health was not good (excluding those who refused to answer, had a missing answer, or answered “don’t know/not sure”).
Measures of frequency Annual prevalence: crude and age adjusted (standardized by the direct method to the year 2000 standard U.S. population, distribution 9 [1]) with 95% confidence intervals and by demographic characteristics when feasible.
Time period of case definition Current.
Background Only about 17% of US adults are considered to be in a state of optimal mental health. (2)  In 2010, 79.1% of US adults self-reported having good or better mental health. (3)
Significance Evidence has shown that mental disorders, especially depressive disorders, are strongly related to the occurrence, successful treatment, and course of many chronic diseases including diabetes, cancer, cardiovascular disease, asthma, and obesity (4) and many risk behaviors for chronic disease; such as, physical inactivity, smoking, excessive drinking, and insufficient sleep.  Mental health is an important component of Health-related quality of life (HRQOL), a multi-dimensional concept that focuses on the impact of health status on quality of life.
Limitations of indicator This measure is based on self-assessment only and does not include an objective health component. Self-rated health status is a subjective measure; therefore, assessing the reliability and validity is difficult.
Data resources Behavioral Risk Factor Surveillance System (BRFSS).
Limitations of data resources As with all self-reported sample surveys, BRFSS data might be subject to systematic error resulting from noncoverage, nonresponse, or measurement bias. In an effort to address noncoverage issues related to phone use, BRFSS began including cell phone interviews in the 2011 data collection. Due to changes in sampling and weighting methodology, 2011 is a new baseline for BRFSS, and comparisons with prior year data are inappropriate.
Related recommendations Healthy People 2020 objective HRQOL/WB-1.2: Increase the proportion of adults who self-report good or better mental health.
  1. Klein RJ, Schoenborn CA. Age adjustment using the 2000 projected U.S. population. Healthy people 2010 statistical notes, no. 20 pdf icon[PDF–122 KB]. Hyattsville, MD: US Department of Health and Human Services, CDC, National Center for Health Statistics; 2001.
  2. U.S. Department of Health and Human Services. Mental Health: A Report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services; Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health, 1999.
  3. CDC. National Health Interview Survey (NHIS), 2010.
  4. Chapman DP, Perry GS, Strine TW.The vital link between chronic disease and depressive disorders. Prev Chronic Dis 2005;2(1):A14.

Physical health not good for ≥14 days among adults aged ≥18 years
Demographic group Resident adults aged ≥18 years.
Numerator Respondents aged ≥18 years who report 14 or more days during the past 30 days during which their physical health was not good.
Denominator Respondents aged ≥18 years who report or do not report the number of days during the past 30 days during which their physical health was not good (excluding those who refused to answer, had a missing answer, or answered “don’t know/not sure”).
Measures of frequency Annual prevalence: crude and age adjusted (standardized by the direct method to the year 2000 standard U.S. population, distribution 9 [1]) with 95% confidence intervals and by demographic characteristics when feasible.
Time period of case definition Current.
Background In 2010, 78.8% of US adults self-reported having good or better physical health. (2)
Significance Physical health is an important component of Health-related quality of life (HRQOL), a multi-dimensional concept that focuses on the impact of health status on quality of life.
Limitations of indicator This measure is based on self-assessment only and does not include an objective health component. Self-rated health status is a subjective measure; therefore, assessing the reliability and validity is difficult.
Data resources Behavioral Risk Factor Surveillance System (BRFSS).
Limitations of data resources As with all self-reported sample surveys, BRFSS data might be subject to systematic error resulting from noncoverage, nonresponse, or measurement bias.  In an effort to address noncoverage issues related to phone use, BRFSS began including cell phone interviews in the 2011 data collection. Due to changes in sampling and weighting methodology, 2011 is a new baseline for BRFSS, and comparisons with prior year data are inappropriate.
Related recommendations Healthy People 2020 objective HRQOL/WB-1.1: Increase the proportion of adults who self-report good or better physical health.
  1. Klein RJ, Schoenborn CA. Age adjustment using the 2000 projected U.S. population. Healthy people 2010 statistical notes, no. 20 pdf icon[PDF–122 KB]. Hyattsville, MD: US Department of Health and Human Services, CDC, National Center for Health Statistics; 2001.
  2. CDC. National Health Interview Survey (NHIS), 2010.

Fair or poor self-rated health status among adults aged ≥18 years
Demographic group Resident adults aged ≥18 years.
Numerator Respondents aged ≥ 18 years who report their general health status as “fair” or “poor.”
Denominator Respondents aged ≥ 18 years who report their general health status as “excellent,” “very good,” “good,” “fair,” or “poor” (excluding unknowns and refusals).
Measures of frequency Annual prevalence (percentage), crude and age adjusted (standardized by the direct method to the year 2000 standard U.S. population, distribution 9 (1)) with 95% confidence intervals and by demographic characteristics when feasible.
Time period of case definition Current.
Background In 2019, 15.3% of adults assessed their health as fair or poor. Substantial differences in the prevalence of fair or poor reported health status exist by age group, race, education level, urbanization level, and poverty status (2,3).
Significance Self-assessed health status is a strong measure of overall health status and has been demonstrated to correlate with subsequent health service use, functional status, and mortality (4).
Limitations of indicator This measure is based on self-assessment only and does not include an objective health component. Self-rated health status is a subjective measure; therefore, assessing the reliability and validity is difficult.
Data resources Behavioral Risk Factor Surveillance System (BRFSS)
Limitations of data resources As with all self-reported sample surveys, BRFSS data might be subject to systematic error resulting from noncoverage, nonresponse, or measurement bias. To address noncoverage issues related to phone use, BRFSS began including cell phone interviews in the 2011 data collection. Due to changes in sampling and weighting methodology, 2011 is a new baseline for BRFSS, and comparisons with prior year data are inappropriate.
Related recommendations Healthy People 2030 objective OHM-8: Respondent-assessed health status – in good or better health (5)
  1. Klein RJ, Schoenborn CA. Age adjustment using the 2000 projected U.S. population. Healthy People Statistical Notes, no. 20. Hyattsville, Maryland: National Center for Health Statistics. 2001. http://www.cdc.gov/nchs/data/statnt/statnt20.pdf pdf icon[PDF – 121 KB]
  2. National Center for Health Statistics. Percentage of fair or poor health status for adults aged 18 and over, United States, 2019. National Health Interview Survey. Generated interactively: Jul 23, 2021 from https://wwwn.cdc.gov/NHISDataQueryTool/SHS_adult/index.html
  3. 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: http://dx.doi.org/10.15585/mmwr.mm7030a3external icon
  4. Centers for Disease Control and Prevention. Measuring Healthy Days. Atlanta, Georgia: 2000. https://www.cdc.gov/hrqol/pdfs/mhd.pdf pdf icon[PDF – 913 KB]
  5. U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. Healthy People 2030: Overall Health and Well-Being Measures. Accessed July 30, 2021. https://health.gov/healthypeople/objectives-and-data/overall-health-and-well-being-measuresexternal icon