TIME Research

More Than a Quarter of American Adults Have Untreated Tooth Decay

American oral health could use a brush-up

New data on tooth decay and cavities among American adults reveal the sad state of our pearly whites. More than 25% of American adults ages 20 to 64 have untreated tooth decay, and 91% have one tooth — or more — that has been treated for tooth decay or needs to be.

The latest findings published Wednesday from the U.S. Centers for Disease Control and Prevention’s National Center for Health Statistics show that while tooth decay and complete tooth loss have dropped among Americans since the 1960s, disparities still remain, and there’s room for improvement in our oral health.

MORE: The Sugar Industry Shaped Government Advice on Cavities, Report Finds

The data span 2011–2012 and reveal that Hispanic and black adults had more untreated cavities compared with white and Asian adults ages 20 to 64. Black adults had the highest rate at 42%.

About 1 in 5 adults age 65 and older had untreated tooth decay; American adults ages 20 to 39 were twice as likely to have all their teeth, compared with adults ages 40 to 64.

Though the current report only looks at adults, cavities are common among young people too. Even though cavities are preventable, tooth decay is four times more common than asthma in teens ages 14 to 17. It’s the most common chronic disease among kids and adolescents ages 6 to 19.

TIME Aging

Why More Older Americans Are Suffering From Fatal Falls

55% of unintentional injury deaths among seniors come from falling

One of the fastest growing killers of older Americans isn’t a disease or a disability. It’s the accidental fall.

A new CDC report finds the rate of Americans aged 65 or over who die as a result of unintentional falls has nearly doubled since 2000; 55% of older citizens who die of unintentional injuries do so from falls, up from 33% in 2000. The death rate from falls increased from 29.6 per 100,000 in 2000 to 56.7 per 100,000 in 2013.

There’s no single reason for the steep increase in deaths from falls, and it’s far from clear what may be behind the rise, says the National Center for Health Statistics’ Ellen Kramarow, the report’s co-author. She notes the report is based on death certificate data, and there may be better reporting on underlying causes of death than in the past. But one factor some researchers point to is the continuing increase in overall life expectancy.

“People are living longer and living longer with conditions that make them frail and vulnerable to fall,” Kramarow says.

Before the growth in end-of-life care, assisted living facilities, medications, and hospital procedures designed to extend our lives, many people died from diseases or ailments that previously couldn’t be cured or treated in a way that made them manageable. Today, older Americans can often stave off death from something like heart disease or diabetes with medication that can prolong life longer than ever before. U.S. life expectancy is now at a record high of 78.8.

But as we live longer, often with diseases that once might have killed us, we get more frail — and consequently, researchers say, more likely to suffer fatal injuries from a fall.

Rates for other fatal accidental injuries like car crashes, suffocation, poisoning and fire-related deaths have remained steady over the last decade, according to the CDC. The death rate among seniors due to vehicle accidents actually went down in 2013 to about 15 per 100,000 people from 20 per 100,000 in 2000.

Overall, unintentional injuries resulted in almost 46,000 deaths for those 65 and older, making it the eighth leading cause of death. Unintentional injuries comprised 85% of all fatal injuries in 2012-2013 with suicide and homicide accounting for 15%.

TIME Research

Here’s What Time of Day Babies Are Born

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Just in time for Mother's Day, a new report shows when babies are most likely to be born

According to new data, American mothers-to-be aren’t having too many late night surprises. A new report shows the highest percentage of U.S. births in 2013 (the most recent data available) happened during morning and midday hours.

The new study from the U.S. Centers for Disease Control and Prevention (CDC)’s National Center for Health Statistics looked at 2013 birth certificate data from the National Vital Statistics System (NVSS), and found that the highest percentage of births took place occurred during the hours of 8:00 a.m. and noon. Less than 3% of babies were born during each hour from midnight to 6:59 a.m.

Though most births happen during the day, the latest findings report that when babies are born on a Saturday or Sunday, they are more likely to happen in the late evening or overnight—11:00 p.m. through 5:59 a.m.—compared to births that happen between Monday to Friday.

When it comes to how women gave birth, there were also some distinct patterns in timing. The researchers reported that compared to with induced and non-induced vaginal deliveries, cesarean deliveries were the least likely to occur during evening and early morning. Non-induced vaginal births were more likely to happen in the early morning compared to cesarean and induced vaginal births. Births in out-of-hospital settings were most likely to happen in the early morning hours starting at 1:00 a.m.

“As the use of medical interventions for childbirth (i.e., induction of labor and cesarean delivery) has increased during the last few decades, an increasing proportion of deliveries occur during regular daytime hours,” the study authors write. Understanding when women are most likely giving birth and what types of births are occurring when, can help hospitals better prepare to ensure mother and child are healthy.

TIME Addiction

Health Officials Worry as HIV Cases in Indiana Grow

TIME.com stock photos Health Syringe Needle
Elizabeth Renstrom for TIME

Health officials say families are using drugs together

The number of new HIV infections in Scott County, Indiana, has risen to 142, prompting local and state officials to call it a public-health emergency.

A new report released by the federal and state health officials on Friday reveals disturbing trends in injection drug use in a county of only 4,200 people. Scott County has historically reported less than five new cases of HIV each year, making the new tally of 142 all the more alarming. Health experts say the recent outbreak is reflective of a growing drug epidemic nationwide.

“There are children, and parents and grandparents who live in the same house who are injecting drugs together sort of as a community activity,” said Dr. Joan Duwve, the chief medical consultant for the Indiana State Department of Health, at a press briefing. “This community, like many rural communities, especially those along the Ohio River and Kentucky and West Virginia, has really seen a lot of prescription opioids flooding the market. With few resources [and] not a lot to do, the use and abuse has been occurring for at least a decade and probably longer.”

Health officials note that like many other rural counties in the U.S., Scott County has high unemployment, high rates of adults who have not completed high school and a large proportion of residents living in poverty with limited health care access. The report underlines the fact that the county consistently ranks among the lowest in Indiana for health and life expectancy.

“The outbreak highlights the vulnerability of many rural, resource-poor populations to drug use, misuse and addiction,” said Duwve.

The ages of the men and women diagnosed with HIV in Scott County range between ages 18 and 57. The health officials report that no infants have tested positive, though a small number of pregnant women have. Ten women in the cluster were identified to be sex workers. Around 84% of the patients have also been infected with hepatitis C. Eighty percent of the patients with HIV have reported injection drug use and among those people, all of them have reported dissolving and injecting tablets of oxymorphone. Some also reported using methamphetamine and heroin.

Dr. Jonathan Mermin, who runs the CDC’s National Center for HIV/AIDS, reminded reporters that the United States is facing an epidemic of prescription opioid abuse. “An estimated two million people are dependent on or abuse prescription opioids nationally. So while opioid pain relievers can play an important role in the management of some types of pain, the overprescribing of these powerful drugs has created a national epidemic of drug abuse and overdose,” he said.

The CDC estimates that nationwide about 3,900 new HIV infections each year are attributable to injection-drug use, which is down nearly 90% from a peak of about 35,000 in the late 1980s, says Mermin. He adds that opioid poisoning deaths in the United States have nearly quadrupled from 1999 to 2011. This epidemic has already played a major role in a growing epidemic of viral hepatitis among people who inject drugs with a 150% increase in reports of acute hepatitis C nationwide between 2010 and 2013.

State health officials and the CDC are working together to control the outbreaks of HIV and hepatitis C. The state has launched a public health campaign to notify residents of the support available to them: lab testing and treatment, referrals to addiction services and employment, and help with insurance registration. The state initially declared a 30-day public health emergency for Scott County on March 26, but expanded the executive order another 30 days. “I want to assure everyone [that] the state of Indiana will not abandon this community once the executive order is over,” said Dr. Jerome M. Adams, the Indiana State Health Commissioner.

The CDC also released a health advisory on Friday, and is asking states to look closely at their most recent data on HIV and hepatitis C diagnoses, overdose deaths, admissions for drug treatments, and drug arrests in order to help identify communities that could be at high risk for unrecognized clusters of the infections.

“We must act now to reverse this trend and to prevent this from undoing progress in HIV prevention to date,” said Mermin.

TIME Innovation

Five Best Ideas of the Day: April 16

The Aspen Institute is an educational and policy studies organization based in Washington, D.C.

1. Go ahead and start a new career in your fifties. It’s easier than you think.

By Donna Rosato in Money

2. This is what sex-ed would look like if it took place entirely on social media.

By Kate Hakala in Mic

3. Here’s why the FDA doesn’t really know what’s in our food.

By Erin Quinn and Chris Young at the Center for Public Integrity

4. What critical resource helps the sharing economy make billions? People trusting people.

By the editorial board of the Christian Science Monitor

5. Could a continent-wide CDC for Africa stop the next Ebola outbreak?

By Jim Burress at National Public Radio

The Aspen Institute is an educational and policy studies organization based in Washington, D.C.

TIME Ideas hosts the world's leading voices, providing commentary and expertise on the most compelling events in news, society, and culture. We welcome outside contributions. To submit a piece, email ideas@time.com.

TIME Infectious Disease

African CDC to Open in 2015

The goal for the agency is to support the continent with active disease surveillance and response

Secretary of State John Kerry signed an agreement Monday to help establish a Centers for Disease Control and Prevention (CDC) in Africa.

The memorandum of cooperation, signed by Kerry and African Union Commission (AUC) Chairperson Nkosanzana Dlamini Zuma, makes formal the relationship between the United States CDC and AUC, and mandates the establishment of an African CDC. The new institute, set to launch in 2015, will work to prevent and respond to future outbreaks in the continent, like the Ebola epidemic.

“The West African Ebola epidemic reaffirmed the need for a public health institute to support African ministries of health and other health agencies in their efforts to prevent, detect, and respond to any disease outbreak,” said CDC director Dr. Tom Frieden, in a statement. “This memorandum solidifies the commitment by the United States to advance public health across Africa and global health security.”

The formation of an African CDC has been under development for a few years, and the physical launch of the health institute will happen later this year. An African Surveillance and Response Unit will be established with an emergency operations center. Five regional centers will also be identified with a coordinating center in Ethiopia’s capital, Addis Ababa. Like the U.S. CDC, there will be epidemiologists at the various locations who will perform disease surveillance, investigation and tracking of infection trends. The new unit will also provide response expertise during large outbreaks.

“With the African CDC in place, these volunteers and others can be organized to form a deployable force ready to serve Member States during future health emergency responses on the continent,” said a CDC statement.

TIME Sex/Relationships

Teens Aren’t Using the Most Effective Birth Control

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Photo Illustration by Mia Tramz for TIME; Corbis

A new CDC report reveals few teens use IUDs and implants

American teenagers are getting better at practicing safe sex, but a new federal report reveals very few teens are using the most effective forms of birth control.

In the new report, the Centers for Disease Control and Prevention (CDC) looked at 2005–2013 data from the Title X National Family Planning Program on teen contraceptive use and found that teen use of long-acting reversible contraception (LARC)—such as the intrauterine device (IUD) and the implant—are up but still very low. The numbers show that U.S. teen LARC use increased from under 1% in 2005 to 7% in 2013. Implants were used more than IUDs by women of all ages. The state with the highest use of LARC among its teens in 2013 was Colorado at 26%. All other states ranged from use of less than 1% to 20%.

Currently, teens are opting for methods like condoms and birth control pills, which while still good options, are less effective and more prone to incorrect or inconsistent use.

MORE: Why The Most Effective Form of Birth Control is the One No One Uses

The benefit of contraceptives like the IUD and implant are that they are low maintenance and highly effective. For example, the typical use failure rate of the IUD is 0.2% and for the implant it’s 0.05%. By comparison, the birth control pill and vaginal ring have a failure rate of 9% and condoms have a fail rate of 18%.

In 2012, the American Congress of Obstetricians and Gynecologists (ACOG), considered an authority on reproductive health, concluded that IUDs and implants are safe and appropriate for adolescents and teens. In 2014, the American Academy of Pediatrics (AAP) agreed and said it recommends LARC for adolescents.

“Long-acting reversible contraception is safe for teens, easy to use, and very effective,” said CDC principal deputy director Ileana Arias in a statement. “We need to remove barriers and increase awareness, access, and availability of long-acting reversible contraception such as IUDs and implants.”

CDC

According to the new CDC report, there are a variety of reasons why a young person may not opt for the IUD or implant. Many teens don’t know very much about them and they often think they are too young to use them. As TIME reported in June, some physicians may remember the IUDs of past, which caused severe problems for women and were discontinued. Modern-day IUDs are safe and appropriate but there are still misperceptions about the device that persist within the medical community. Many providers are also not properly trained on insertion or removal of the IUD and implant. However, a recent report showed that among female health care providers 42% use LARC, which is much higher than both the general population of teens and adult women.

Overall, the CDC report shows that American teens are waiting to have sex, and when they are sexually active, nearly 90% report using birth control. The teen pregnancy rate in the United States appears to be steadily dropping, though in 2013 over 273,000 babies were born to girls between ages 15 and 19. The CDC says encouraging young women to consider LARC is an important strategy for further reducing teen pregnancy.

TIME Infectious Disease

Travelers Are Bringing a Superbug into the United States

CDC

The bug is resistant to the antibiotics used to treat it

Some international travelers are bringing back and spreading a bacteria that’s resistant to the drugs used to treat it, the U.S. Centers for Disease Control and Prevention (CDC) reported on Thursday in an investigation published in the CDC’s Morbidity and Mortality Weekly Report.

The bug, called shigella sonnei, causes an estimated 500,000 cases of diarrhea in the U.S. each year, and the CDC reports that between May 2014 and February 2015, a drug-resistant strain infected 243 people in 32 states and Puerto Rico. When investigating clusters of shigellosis—the infection caused by shigella—in Massachusetts, California and Pennsylvania, the CDC discovered that 90% of the cases were resistant to an antibiotic called ciprofloxacin (Cipro), which is the drug of choice when treating shigellosis.

Most shigella strains are already resistant to other drugs used to treat it, and public health experts have noted that a Cipro-resistant strain is spreading worldwide. The bacteria can spread very quickly and are commonly discovered in places like childcare centers and nursing homes, according to the report.

“Drug-resistant infections are harder to treat and because Shigella spreads so easily between people, the potential for more—and larger—outbreaks is a real concern,” said CDC director Dr. Tom Frieden in a statement. Frieden added that the recent outbreaks reveal a “troubling trend” of infections in the U.S.

The CDC was first alerted to a new strain of shigella in December 2014 and discovered in the lab that it was resistant to Cipro. The CDC then investigated several large clusters of shigella infections across the United States. Nearly 100 cases were from an outbreak among homeless people in San Francisco, and others were related to international travel. Infection can be common among people who travel to developing countries.

The CDC says international travelers should wash their hands “meticulously” and be cautious about food and water consumption. Travelers can download the CDC’s app, “Can I Eat This?” as a guide for what’s safe to eat while traveling.

Antibiotic resistance is becoming a growing global problem; in September 2014, President Obama signed an executive order to create a task force to tackle the issue of antibiotic-resistant bacteria.

TIME Addiction

A New Government Anti-Smoking Campaign Includes E-Cigs

Past campaigns have increased calls to quitlines by 80%

A new federal ad campaign against smoking features e-cigarettes for the first time.

The U.S. Centers for Disease Control and Prevention (CDC) released its latest ad in its ongoing “Tips From Former Smokers” campaign. The campaign features real Americans who have experienced serious health or social consequences from smoking. Often the ads are explicit. On March 30, the first ad about e-cigarettes, as opposed to traditional tobacco, will air.

The ad features a 35-year-old woman named Kristy who picked up e-cigarettes as a way to quit smoking. She ended up using both products. Eventually she had a collapsed lung and was diagnosed with lung disease. She’s a married mother of three who works as a truck driver.

Kristy's Tip Print Full Page Ad
CDC

“Nationally, about 3 in 4 adult e-cigarette users also smoke cigarettes,” the CDC says in a statement. “If you only cut down the number of cigarettes you smoke by adding another tobacco product, like e-cigarettes, you still face serious health risks.”

Other ads focus on side effects like vision loss and colorectal cancer.

In 2014, the CDC says the national quit line received 80% more calls when the ads were on the air, and since 2012 the ads have generated more than 500,000 additional calls. The ads will run for 20 weeks on TV, radio, online, billboards, in theaters and in magazines and newspapers. Kristy’s ads will be on the radio and in print.

The ads encourage smokers to call 1-800-QUIT-NOW or visit www.cdc.gov/tips.

Read next: These 4D Ultrasound Photos Show How Fetuses Respond to Their Mothers’ Smoking

Listen to the most important stories of the day.

TIME Research

High Blood Pressure Related Deaths Are Way Up: CDC

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Hypertension is a factor in many U.S. deaths

Deaths related to high blood pressure, have risen significantly over the last 13 years, according to new federal data.

A new report from the U.S. Centers for Disease Control and Prevention’s (CDC) National Center for Health Statistics shows the number of hypertension-related deaths increased 61.8%, from 2000 to 2013. The researchers analyzed national cause-of-death data files and defined hypertension-related death as any mention of hypertension on the death certificate. They found that over the 13 year period, the rate rose for both sexes age 45 and older.

But report also found that the proportion of deaths where heart disease was the underlying cause of death dropped by about 6%. The proportion of deaths where stroke was the underlying cause also dropped by about 5%.

“In the areas we’ve been focusing on for the last two to three decades we really have seen a reduction in deaths,” says Dr. Clyde Yancy chief of the division of cardiology at Northwestern University’s Feinberg School of Medicine. “The lens has to increase now. This is an important message to get out that there are multiple reasons you want to get rid of hypertension, not just reducing stroke and heart disease, but minimizing the impact on diabetes and reducing your risk for cancer.” Yancy was not involved in the research.

While it is generally accepted that high blood pressure can lead to heart-related problems, studies have also shown links between hypertension and other chronic diseases. For instance, prior data has shown that hypertension can increase the risk of dying from cancer and developing the disease in the first place. The researchers report that heart disease, stroke, cancer and diabetes accounted for 65% of all the deaths with a mention of hypertension in 2000 and 54% in 2013.

Overall, the report shows that one out of six hypertension-related deaths was due to high blood pressure as the underlying cause. In the other deaths, high blood pressure was listed as a contributing factor.

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