Wireless Substitution: Semiannual Estimates from the NHIS ER Program

Centers for Disease Control and PreventionNational Center for Health Statistics

Stephen Blumbergsblumberg@cdc.gov

Julian Lukejluke@cdc.gov

http://www.cdc.gov/nchs/nhis.htm

0

5

10

15

20

25

30

35

40

1963 1970 1975 1980 1985-1986

Percentage of U.S. HouseholdsWithout Landline Telephones Based on National Health Interview Survey data

0

5

10

15

20

25

30

35

40

1963 1970 1975 1980 1985-1986

1997 2001 Early2003

Early2005

Early2007

Early2009

Late2011

Percentage of U.S. HouseholdsWithout Landline Telephones Based on National Health Interview Survey data

0

5

10

15

20

25

30

35

40

1963 1970 1975 1980 1985-1986

1997 2001 Early2003

Early2005

Early2007

Early2009

Late2011

Percentage of U.S. HouseholdsWithout Landline Telephones

34% of households have only wireless telephones

Based on National Health Interview Survey data

0

5

10

15

20

25

30

35

40

Jan–Jun2011

Jan–Jun2010

Jan–Jun2009

Jan–Jun 2008

Jan–Jun2007

Jan–Jun 2006

Jan–Jun 2005

Jan–Jun 2004

Jan–Jun2003

Percentages of adults and children living inhouseholds with only wireless telephone service or

no telephone service: United States, 2003–2011

Per

cent

Children withwireless service only

Adults withwireless serviceonly

Children with notelephone service

Adults with notelephone service

32.3

38.1

1.92.2

NOTE: Adults are aged 18 and over; children are under age 18.DATA SOURCE: CDC/NCHS, National Health Interview Survey.

Jul–Dec2011

Prevalence of Wireless-Only Adultsby Age

48.6% of 18-24

59.6% of 25-2950.9% of 30-34

0

10

20

30

40

50

60

Jan-Jun'03

Jul-Dec'03

Jan-Jun'04

Jul-Dec'04

Jan-Jun'05

Jul-Dec'05

Jan-Jun'06

Jul-Dec'06

Jan-Jun'07

Jul-Dec'07

Jan-Jun'08

Jul-Dec'08

Jan-Jun'09

Jul-Dec'09

Jan-Jun'10

Jul-Dec'10

Jan-Jun'11

Jul-Dec'11

36.8% of 35-44

23.8% of 45-64

8.5% of 65+

Prevalence of Wireless-Only Adultsby Home Ownership Status

56.0% of adults renting their home

21.2% of adults owning or buying their home

0

10

20

30

40

50

60

Jan-Jun'03

Jul-Dec'03

Jan-Jun'04

Jul-Dec'04

Jan-Jun'05

Jul-Dec'05

Jan-Jun'06

Jul-Dec'06

Jan-Jun'07

Jul-Dec'07

Jan-Jun'08

Jul-Dec'08

Jan-Jun'09

Jul-Dec'09

Jan-Jun'10

Jul-Dec'10

Jan-Jun'11

Jul-Dec'11

Prevalence of Wireless-Only Adultsby Household Structure

77.5% of adults living with roommates

41.3% of adults living alone35.4% of adults living with children

0

10

20

30

40

50

60

70

80

Jan-Jun'03

Jul-Dec'03

Jan-Jun'04

Jul-Dec'04

Jan-Jun'05

Jul-Dec'05

Jan-Jun'06

Jul-Dec'06

Jan-Jun'07

Jul-Dec'07

Jan-Jun'08

Jul-Dec'08

Jan-Jun'09

Jul-Dec'09

Jan-Jun'10

Jul-Dec'10

Jan-Jun'11

Jul-Dec'11

25.1% of adults living with related adults

Prevalence of Wireless-Only Adultsby Sex

33.7% of men30.9% of women

0

10

20

30

40

50

60

Jan-Jun'03

Jul-Dec'03

Jan-Jun'04

Jul-Dec'04

Jan-Jun'05

Jul-Dec'05

Jan-Jun'06

Jul-Dec'06

Jan-Jun'07

Jul-Dec'07

Jan-Jun'08

Jul-Dec'08

Jan-Jun'09

Jul-Dec'09

Jan-Jun'10

Jul-Dec'10

Jan-Jun'11

Jul-Dec'11

Prevalence of Wireless-Only Adultsby Race/Ethnicity

43.3% of Hispanic adults36.8% of Black nonHispanic adults29.0% of White nonHispanic adults

0

10

20

30

40

50

60

Jan-Jun'03

Jul-Dec'03

Jan-Jun'04

Jul-Dec'04

Jan-Jun'05

Jul-Dec'05

Jan-Jun'06

Jul-Dec'06

Jan-Jun'07

Jul-Dec'07

Jan-Jun'08

Jul-Dec'08

Jan-Jun'09

Jul-Dec'09

Jan-Jun'10

Jul-Dec'10

Jan-Jun'11

Jul-Dec'11

Prevalence of Wireless-Only Adultsby Household Poverty Status

51.4% of adults in poverty

39.6% of adults near poverty

28.9% of higher income adults

0

10

20

30

40

50

60

Jan-Jun'03

Jul-Dec'03

Jan-Jun'04

Jul-Dec'04

Jan-Jun'05

Jul-Dec'05

Jan-Jun'06

Jul-Dec'06

Jan-Jun'07

Jul-Dec'07

Jan-Jun'08

Jul-Dec'08

Jan-Jun'09

Jul-Dec'09

Jan-Jun'10

Jul-Dec'10

Jan-Jun'11

Jul-Dec'11

Prevalence of Wireless-Only Adultsby Employment Status Last Week

36.8% of adults working at a job

40.8% of adults going to school

32.7% of adults keeping house

0

10

20

30

40

50

60

Jan-Jun'03

Jul-Dec'03

Jan-Jun'04

Jul-Dec'04

Jan-Jun'05

Jul-Dec'05

Jan-Jun'06

Jul-Dec'06

Jan-Jun'07

Jul-Dec'07

Jan-Jun'08

Jul-Dec'08

Jan-Jun'09

Jul-Dec'09

Jan-Jun'10

Jul-Dec'10

Jan-Jun'11

Jul-Dec'11

22.3% of other adults (incl. unemployed)

Prevalence of Wireless-Only Adults byMetropolitan Statistical Area Status

33.6% of adults in MSAs

27.2% of adults not in MSAs

0

10

20

30

40

50

60

Jan-Jun'03

Jul-Dec'03

Jan-Jun'04

Jul-Dec'04

Jan-Jun'05

Jul-Dec'05

Jan-Jun'06

Jul-Dec'06

Jan-Jun'07

Jul-Dec'07

Jan-Jun'08

Jul-Dec'08

Jan-Jun'09

Jul-Dec'09

Jan-Jun'10

Jul-Dec'10

Jan-Jun'11

Jul-Dec'11

Prevalence of Wireless-Only Adultsby Geographic Region

20.6% in Northeast

35.9% in South35.2% in Midwest

0

10

20

30

40

50

60

Jan-Jun'03

Jul-Dec'03

Jan-Jun'04

Jul-Dec'04

Jan-Jun'05

Jul-Dec'05

Jan-Jun'06

Jul-Dec'06

Jan-Jun'07

Jul-Dec'07

Jan-Jun'08

Jul-Dec'08

Jan-Jun'09

Jul-Dec'09

Jan-Jun'10

Jul-Dec'10

Jan-Jun'11

Jul-Dec'11

33.0% in West

Percent Distribution of Households by Telephone Status, July-December 2011

Wireless Only: 34.0%

Landline with Wireless: 53.4%

LandlineOnly: 10.2%

Unknown: 0.2%Phoneless: 2.2%

Why did NCHS Begin Studying Whether Households have Wireless Telephones? In 2003, random-digit-dial telephone

surveys did not call wireless telephones As more people gave up their landline

telephones and lived only with wireless telephones, more people were excluded from RDD landline surveys

To understand the impact of this noncoverage and how to correct it, a personal visit survey was needed to monitor the growing size and characteristics of the wireless-only population

National Health Interview Survey In-person survey of the civilian

noninstitutionalized U.S. population with high annual household-level response rates

Includes questions on residential telephone numbers to permit recontact of participants 2003: Added questions on working cellular

telephones 2007: Added questions on relative frequency of

calls received on landlines and cell phones

Coverage Bias Two factors determine the degree of

coverage bias due to telephone ownership in a telephone survey: The percentage of persons without landline

telephones in the population of interest The magnitude of the difference between

persons with and without landline telephones for the variable of interest

Health Characteristics Examined Health-related behaviors

5+ alcoholic drinks in one day (past year) Smoking (current) Leisure-time physical activity (regularly)

Health status Excellent or very good health status Serious psychological distress (past 30 days) Obesity Asthma episode (past year) Diabetes (ever diagnosed)

Health care service use Has a usual place to go for medical care Received influenza vaccine (past year) Tested for HIV (ever) Financial barrier to needed care (past year) Uninsured (current)

For these 13 estimates, preliminary weighted data

were produced by theNHIS Early Release Program.

Percent of U.S. Adults with Various Health Characteristics, by Phone Status

Has a landline

telephone

Wireless-only

No telephone

5+ alcoholic drinks in 1 day 17.2 31.5 23.9Current smoker 15.3 24.4 26.7Psychological distress 2.8 4.1 4.5Health excellent / very good 59.9 63.9 57.3

July – December 2011

Percent of U.S. Adults with Various Health Characteristics, by Phone Status

Has a landline

telephone

Wireless-only

No telephone

Uninsured (when interviewed) 15.1 28.7 40.6Financial barriers to care 5.8 13.0 14.0Has a usual place for care 88.9 69.8 59.3Flu vaccination 39.0 73.3 70.6Ever tested for HIV 31.9 43.5 43.3

July – December 2011

American Journal of Public Health, October 2009, pp. 1806-1810

Why does NCHS Continue to Monitor Wireless Telephone Use? Most major survey research organizations

now include wireless telephone numbers when conducting RDD telephone surveys

Data on household telephone ownership and use are necessary to properly weight these dual-frame telephone surveys

Adding a Cell-Phone Frame

Landline Only Landline and Wireless

Wireless Only Phoneless

Landline Frame Wireless Frame

Landline Frame

Wireless Frame

National Health Interview Survey In-person survey of the civilian

noninstitutionalized U.S. population with high annual household-level response rates

Includes questions on residential telephone numbers to permit recontact of participants 2003: Added questions on working cellular

telephones 2007: Added questions on relative frequency of

calls received on landlines and cell phones

National Health Interview Survey In-person survey of the civilian

noninstitutionalized U.S. population with high annual household-level response rates

Includes questions on residential telephone numbers to permit recontact of participants

“Of all the calls that your family receives, are …(1) All or almost all calls received on cell phones?(2) Some received on cell phones and some on regular phones?(3) Very few or none received on cell phones?”

Percent Distribution of Households by Telephone Status, July-December 2011

Wireless Only: 34.0%

Landline with Wireless: 53.4%

LandlineOnly: 10.2%

Unknown: 0.2%Phoneless: 2.2%

Percent Distribution of Households by Telephone Status, July-December 2011

Wireless Only: 34.0%

LandlineOnly: 10.2%

Unknown: 0.2%Phoneless: 2.2%

WirelessMostly: 16.0%

Landline withSome Wireless: 37.4%

0

4

8

12

16

20

24

Jan-Jun2007

Jul-Dec2007

Jan-Jun2008

Jul-Dec2008

Jan-Jun2009

Jul-Dec2009

Jan-Jun2010

Jul-Dec2010

Jan-Jun2011

Jul-Dec2011

Percentage of Adults Living in Wireless-Mostly Households Based on National Health Interview Survey data

Prevalence of Wireless-Mostly Adultsby Home Ownership Status

13.5% of adults renting their home

19.9% of adults owning or buying their home

0

4

8

12

16

20

24

Jan–Jun 2007

Jul-Dec2007

Jan–Jun 2008

Jul-Dec2008

Jan–Jun 2009

Jul-Dec2009

Jan–Jun 2010

Jul-Dec2010

Jan–Jun 2011

Jul-Dec2011

Prevalence of Wireless-Mostly Adultsby Household Poverty Status

8.8% of adults inpoverty

13.5% of adults near poverty

21.9% of higher income adults

0

4

8

12

16

20

24

Jan–Jun 2007

Jul-Dec2007

Jan–Jun 2008

Jul-Dec2008

Jan–Jun 2009

Jul-Dec2009

Jan–Jun 2010

Jul-Dec2010

Jan–Jun 2011

Jul-Dec2011

Prevalence of Wireless-Only Adultsby Age

18.9% of 18-2415.8% of 25-29

21.2% of 30-44 19.9% of 45-64

8.9% of 65+

Jan–Jun 2007

Jul-Dec 2007

Jan–Jun 2008

Jul-Dec 2008

Jan–Jun 2009

Jul-Dec 2009

Jan–Jun 2010

Jul-Dec 2010

Jan–Jun 2011

Jul-Dec 2011

0

4

8

12

16

20

24

Prevalence of Wireless-Only Adultsby Age

21.2% of 30-44 19.9% of 45-64

8.9% of 65+

Jan–Jun 2007

Jul-Dec 2007

Jan–Jun 2008

Jul-Dec 2008

Jan–Jun 2009

Jul-Dec 2009

Jan–Jun 2010

Jul-Dec 2010

Jan–Jun 2011

Jul-Dec 2011

0

4

8

12

16

20

24

Percent Distribution of Households by Telephone Status, July-December 2011

Wireless Only: 34.0%

LandlineOnly: 10.2%

Unknown: 0.2%Phoneless: 2.2%

WirelessMostly: 16.0%

Landline withSome Wireless: 37.4%

Forthcoming Reports (Fall 2012) Wireless Substitution: State-level Estimates From

the NHIS, 2010-2011

Wireless Substitution: Early Release of Estimates From the NHIS, January-June 2012

Prevalence of Adults Living in Wireless-Only Households,July 2009 - June 2010

For More Information… Stephen J. Blumberg, Ph.D.

National Center for Health Statistics3311 Toledo Road, Room 2112Hyattsville, Maryland 20782 USA

sblumberg@cdc.gov