Preventive Services, 65+

Dashboard-City Average

Why do we measure preventive services?

Preventive care, which a person receives before showing signs of a disease, is an important aspect of clinical care that can reduce the risk for diseases, disabilities, and death.1 Preventive services, including vaccinations and cancer screenings, like colonoscopies or mammograms, help medical providers detect chronic and infectious diseases early and provide treatment. Yet, each year, millions of people do not receive the preventive services recommended by national experts for their age group, and only about half of older adults receive full preventive services.1,2

People with lower incomes and those without health insurance are less likely to use preventive services than other groups.3,4 However, Black and Hispanic populations today are more likely to receive preventive services than the White population– possibly due to health care providers’ growing awareness of the higher risk that some groups have for certain health conditions.3,5 Overall, it is essential to increase access to preventive services in order to improve health and well-being and to reduce national disease rates.2,6

How do we measure preventive services?

This metric includes adults, age 65 years or older, who report being up to date on a core set of clinical preventive services.

Strengths and Limitations

Strengths of Metric

Limitations of Metric

• This metric focuses on adults aged 65 or older, which is important as the proportion of the U.S. population in this age group continues to rise.

• This metric is available broken down by race and ethnicity, which can help target resources and interventions for groups that historically have been underrepresented.

• The metric does not take preventive services received by those younger than 65 into account.

• The preventive services metric does not provide insight into why individuals are not receiving recommended care.

• The metric is self-reported and depends on the accuracy of the person surveyed.

• Race and ethnicity data are often collected using discrete options that may not account for all or multiple identities, leading to undercounting of those who are more likely to select “other.”

Calculation

Preventive services are calculated by the following formula for both men and women. These values are then averaged to achieve the total population estimate.

Preventive Services Calculation

Preventive services for women include an influenza vaccination in the past year; a pneumococcal vaccination (PPV) ever; either a fecal occult blood test (FOBT) within the past year, a sigmoidoscopy within the past five years and a FOBT within the past three years, or a colonoscopy within the previous 10 years; and a mammogram in the past two years. Preventive services for men include an influenza vaccination in the past year, a PPV ever, and either a FOBT within the past year, a sigmoidoscopy within the past five years and a FOBT within the past three years, or a colonoscopy within the past 10 years.

For more information on the calculation, please refer to the City Health Dashboard Technical Documentation.

Data Source

Estimates for this metric are from one year modeled PLACES Project Data (formerly 500 Cities Project) from the Centers for Disease Control and Prevention. Multi-year data are available for this metric. For more information, please refer to Using Multi-Year Data: Tips and Cautions.

Years of Collection

Calculated by the Dashboard Team using data from 2020, 1 year modeled estimate.

References

1. Healthy People 2030. Preventive Care. https://health.gov/healthypeople/objectives-and-data/browse-objectives/preventive-care. Accessed June 15, 2023

2. Shenson D, Anderson L, Slonim A, Benson W. Vaccinations and preventive screening services for older adults: opportunities and challenges in the USA. Perspectives in public health. 2012;132(4):165-170.

3. Vaidya V, Partha G, Howe J. Utilization of preventive care services and their effect on cardiovascular outcomes in the United States. Risk Management and Healthcare Policy. 2011;4:1-7.

4. Abdus S, Selden TM. Preventive services for adults: how have differences across subgroups changed over the past decade? Medical care. 2013;51(11):999-1007.

5. Holden CD, Chen J, Dagher RK. Preventive care utilization among the uninsured by race/ethnicity and income. Am J Prev Med. 2015;48(1):13-21.

6. Farley TA, Dalal MA, Mostashari F, Frieden TR. Deaths preventable in the U.S. by improvements in use of clinical preventive services. Am J Prev Med. 2010;38(6):600-609.

Last updated: July 26, 2023