You Don't Want to Belong To This 1%

The average American incurred $5,006 in medical expenses in 2016, according to the federal government's Medical Expenditure Panel Survey. But an unlucky few spent much more than average. Just 5 percent of the population accounted for half of all medical spending in 2016. Here is the average health care spending incurred per person in 2016 at selected percentiles of spending...

Average spending per person by percentile of health care spending, 2016
Top 1 percent of spending: $110,003
Top 5 percent of spending: $50,077
Top 10 percent of spending: $33,053
Top 50 percent of spending: $9,735
Bottom 50 percent of spending: $276

Not surprisingly, people aged 65 or older were the largest share (43 percent) of those in the top 1 percent of medical spending, and 45-to-64-year-olds accounted for another 34 percent.

Medicare was a big source of payment for those in the top 1 percent, covering 36 percent of their health care costs. Private insurance paid another 37 percent of their costs. The top 1 percent paid 5.5 percent of its health care bills out-of-pocket.

Source: Medical Expenditure Panel Survey, Concentration of Health Expenditures and Selected Characteristics of High Spenders, U.S. Civilian Noninstitutionalized Population, 2016

More Evidence of Census Concerns

The public is feeling uneasy about the 2020 census. A Census Bureau survey of attitudes toward the 2020 census found only 68 percent of the public reporting that they would be very or extremely likely to answer the census. This figure is considerably smaller than the 86 percent who felt that way in a survey prior to the 2010 census. And that's not all. A recent Public Religion Research Institute (PRRI)/Atlantic survey probed the public's attitude toward the census with two questions—one about whether the census would be used to check people's immigration status and the other about how the potential citizenship question would affect the census count. The public's answers raise alarm bells.

Question 1: "Do you think the government will use...Census records to check on an individual's immigration status, or do you think this information will only be used for counting the population?"

39% said they don't know how census records will be used
33% said census records would be used to check immigration status
just 26% said census records would be used only to count the population

Question 2: "For the first time, the 2020 Census may include a new question that asks individuals if they are legal citizen of the United States. In your opinion, how likely do you think it is that the Census will NOT get an accurate count because some people will be worried about answering this question?"

53% said it would be very likely that the census would not be accurate
23% said it would be somewhat likely the census would not be accurate
11% said they didn't know how it would affect the count
only 10% said it was somewhat/very unlikely that the census count would not be accurate

Interestingly, Republicans and Democrats are in agreement about the harm of a citizenship question —81 percent of Republicans and 77 percent of Democrats believe it is somewhat/very likely to result in an inaccurate count. Let's hope the Supreme Court has the same concern when it hears arguments about the citizenship question later this year.

Source: PRRI/The Atlantic 2018 Pluralism Survey, American Democracy in Crisis: The Fate of Pluralism in a Divided Nation

Feelings of Discrimination Linked to Income

Feelings of perceived discrimination are linked to income for both whites and blacks, according to an analysis of survey data by Ana Hernåndez Kent of the Federal Reserve Bank of St. Louis. Examining data from two surveys—the American Identity and Representation Survey (Resource Center for Minority Data) and the Americans' Changing Lives survey (National Institute on Aging), Kent compared the household incomes of whites and blacks after controlling for feelings of racial discrimination. While her analysis confirmed the fact that whites typically have higher household incomes than blacks, the within-race income comparisons offered some surprises...

• Whites who thought they had been discriminated against because of their race had a lower household income than whites who did not feel discriminated against, according to the results of the American Identity Survey. In fact, the "whites who did feel they were discriminated against had a median range of household income equivalent to the typical black who also felt discrimination," reports Kent. But the second survey—Changing Lives—showed no difference in the household incomes of whites based on perceived discrimination.
• The black pattern was different. "The pattern of results for blacks in both surveys turned these findings on their head," says Kent. "Blacks who felt they were discriminated against because of their race actually had higher median incomes than blacks who didn't feel racial bias."

"Looking at only blacks, felt discrimination appears to be related to improved financial outcomes," Kent concludes.

Source: Federal Reserve Bank of St. Louis, Perceived Bias and Income Patterns Differ by Race

Bored Teenagers

What is the single most commonly shared feeling among today's teens? Boredom, according to a Pew Research Center survey. Fully 40 percent of teens aged 13 to 17 say they feel bored every day or almost every day. Another 44 percent say they feel bored "sometimes." Boredom is far more common among teens than feeling tense or nervous, with a smaller 29 percent of teens saying they feel tense or nervous every day or almost every day.

When teens are asked about the personal pressures they face, the biggest by far is pressure to get good grades. The 61 percent majority of teens say they feel a lot of pressure to do well in school. Few teens feel pressure to be sexually active, drink alcohol, or use drugs. In fact, most teens say they feel no pressure at all to engage in those activities.

Percent of teens who feel "a lot" of pressure
61% to get good grades
29% to look good
28% to fit in socially
21% to be involved in extracurricular activities
13% to help family financially
8% to participation in religious activities
8% to be sexually active
6% to drink alcohol
4% to use drugs

Source: Pew Research Center, Most U.S. Teens See Anxiety and Depression as a Major Problem among Their Peers

42% of New Mothers Have a Bachelor's Degree

More than 40 percent of women who gave birth in 2017 had a bachelor's degree or more education, according to the National Center for Health Statistics. The 41.7 percent of of new mothers with at least a bachelor's degree in 2017 is nearly twice the 22.8 percent of 1997.

The percentage of new mothers with a bachelor's degree or more education varies by race and Hispanic origin...

Percentage of new mothers with at least a bachelor's degree, 2017
67.9% of Asians
51.3% of non-Hispanic Whites
24.6% of Blacks
18.9% of Hispanics
13.2% of Native Hawaiians, other Pacific Islanders
12.7% of American Indians, Alaska Natives

Source: National Center for Health Statistics, Educational Attainment of Mothers Aged 25 and Over: United States, 2017

Most Whites Do Not Perceive Local Discrimination

When Americans are asked whether Blacks in their community are treated less fairly than Whites, attitudes are strikingly different depending on whether the respondent is Black or White, according to a Gallup survey. The majority of Blacks think Blacks are treated less fairly than Whites in a variety of local situations. Few Whites agree or perhaps are unaware of local problems. Here are the percentages who Blacks and Whites who think Blacks are treated less fairly than Whites in their community by type of situation...

Dealing with police, such as traffic incidents
Blacks: 77%
Whites: 45%

On the job or at work
Blacks: 60%
Whites: 22%

In stores downtown or the shopping mall
Blacks: 59%
Whites: 25%

In restaurants, bars, theaters or other entertainment places
Blacks: 50%
Whites: 22%

In getting healthcare from doctors and hospitals
Blacks: 49%
Whites: 17%

In neighborhood shops
Blacks: 48%
Whites: 22%

Source: Gallup, Americans Less Satisfied with Treatment of Minority Groups

32% of Americans Are Financially Insecure

Despite the robust job market, many Americans are financially insecure—a substantial 32 percent of the nation's adults in 2017, according to the Urban Institute. This estimate comes from the The Well-Being and Basic Needs Survey, a new effort by the Urban Institute to measure financial insecurity.

The Urban Institute classified survey respondents as financially insecure if they had experienced at least one of three things in the past 12 months: 1) they were not sure they could come up with $400 for an unexpected expense; 2) they had missed a credit card or nonmortgage loan payment; and/or 3) they had been contacted by a debt collector. Fully 32 percent of adults were found to be financially insecure—22 percent were not confident they could come up with $400 for an unexpected expense, 14 percent had been contacted by debt collector; and 13 percent missed a loan payment. Here are some of the demographics of financial insecurity...

• Financial insecurity does not vary much by age, with 27 percent of 50-to-64-year-olds, 34 percent of 35-to-49-year-olds, and 36 percent of 18-to-34-year-olds financially insecure. 
• Race has more of an impact on financial insecurity, with Blacks most likely to be insecure (52 percent), followed by Hispanics (40 percent), and non-Hispanic Whites (27 percent). 
• Education matters even more than race. Fully 51 percent of people with less than a high school education and 38 percent of those with a high school diploma/some college were financially insecure. Among college graduates, the figure was a much smaller 17 percent. 
• Income matters a bit more than education. Among people with household incomes below poverty level, 58 percent were financially insecure. Among those with household incomes above 400 percent of poverty level, the figure was 14 percent. 

Despite the improving economy of 2017, concludes the Urban Institute, "many Americans are facing financial distress and struggle to keep up with their bills and cover unexpected expenses."

Source: Urban Institute, Financial Distress among American Families: Evidence from the Well-Being and Basic Needs Survey

Occupations that Grew Faster than Projected, 2006–16

In 2006, the Bureau of Labor Statistics projected that occupational employment would grow 10.4 percent by 2016. Boy, were they wrong. The actual growth during those years was just 3.6 percent, thanks to the Great Recession. When the BLS produces labor force projections, it assumes full employment. Employment was anything but full during and in the aftermath of the Great Recession.

But the BLS got a lot of things right. It correctly projected which occupations would grow or decline 75 percent of the time, according to its Occupational Projections Evaluations. (Yes, the BLS periodically evaluates its own projections for accuracy.) It projected which occupations would grow faster than the economy as a whole 54 percent of the time.

The Bureau projected especially rapid growth in the 2006 to 2016 time period for a number of occupations that ended up growing even faster than forecast—despite the ravages of the Great Recession. Here are some of those occupations, along with their actual and projected growth from 2006 to 2016...

Computer software engineers, applications
Actual growth: 64%
Projected growth: 45%

Mental health counselors
Actual growth: 58%
Projected growth: 30%

Personal financial advisors
Actual growth: 54%
Projected growth: 41%

Veterinary technologists/technicians
Actual growth: 43%
Projected growth: 41%

Pharmacy technicians
Actual growth: 41%
Projected growth: 32%

Source: Bureau of Labor Statistics, The 2006–16 Projections: How Did Fast-Growing Occupations Fare?

Millennials: The College Divide

A lot has been written about the struggles of Millennials. The generation had the misfortune to enter the job market in the midst of the Great Recession, an economic setback that has been throwing shade on them for more than a decade. But some in the generation are doing better than others, according to a Pew Research Center analysis that compares the wellbeing of Millennials to that of older generations at the same age (the 25-to-37 age group was used for the analysis). The dividing line between Millennial Haves and Have Nots is the bachelor's degree. Millennials with a bachelor's degree are doing as well or better than Gen Xers, Boomers, or older Americans (the Silent Generation) at the same age. Millennials without a bachelor's degree are doing worse.

Among Millennials who work full-time, those with at least a bachelor's degree earned a median of $56,000 in 2017, according to Pew. This was about the same as college-educated Gen Xers earned when they were aged 25 to 37, and it was more than college-educated Boomers or older Americans earned as young adults. The opposite is true for Millennials without a college degree. Those with only some college earned a median of $36,000 in 2017, less than their older counterparts at the same age. Millennials with no more than a high school diploma earned just $31,300 in 2017, also less than equally-educated Gen Xers, Boomers, or the Silent Generation when they were young adults.

The rising fortunes of Millennial college graduates and the declining fortunes of Millennials without a college degree have resulted in a growing gap in the median household income of young adults by educational attainment. Millennials with at least a bachelor's degree had an (adjusted for household size) median household income of $105,000 in 2017 versus $49,000 for those with no more than a high school diploma—a gap of $56,000. The gap was $54,000 for Gen Xers at the same age, $41,000 for Late Boomers, $29,000 for Early Boomers, and just $20,000 for the Silent Generation.

Source: Pew Research Center, Millennial Life: How Young Adulthood Today Compares with Prior Generations

Everyday Newspaper Readers Are Disappearing

Only 20 percent of Americans aged 16 or older say they read the newspaper every day, according to the 2016 General Social Survey. This figure is likely even lower today. In 2000, more than one-third (37 percent) of the public read the newspaper every day. In 1990, more than half (53 percent) were daily newspaper readers. Here is the percentage of Americans by generation who were daily newspaper readers in 2016...

Read a newspaper every day
Millennials: 10%
Gen Xers: 15%
Boomers: 30%
Older: 38%

A substantial 48 percent of Millennials, 39 percent of Gen Xers, 28 percent of Boomers, and 22 percent of older Americans say they never read the newspaper.

Note: In 2016, Millennials were aged 22 to 39; Generation Xers were aged 40 to 51; Baby Boomers were aged 52 to 70; older Americans were aged 71 or older.

Source: Demo Memo analysis of the General Social Survey

Giving Money Away in 2016

Forty-eight percent of American households gave money to persons or organizations outside the household in 2016, according to a Bureau of Labor Statistics' analysis of the Consumer Expenditure Survey. Among those who did, the average amount given was $4,298. Here is the percentage of households that gave money away during the year by type of recipient (and average amount given by donors)...

25.16% gave money to churches/religious organizations ($2,970)
16.54% gave cash gifts to family/friends outside the household ($2,391)
16.11% gave money to charitable organizations ($2,462)
  3.15% paid child support ($7,142)
  2.84% gave money to support students in college ($3,580)
  2.30% gave money to political organizations ($837)
  2.26% gave money to educational institutions ($2,716)
  0.46% paid alimony ($20,754)
  0.15% gave gifts of stocks/bonds/mutual funds to family/friends ($25,717)

Source: Bureau of Labor Statistics, The Relationship between Cash Contributions, Pretax Income, and Age

37% Retire Earlier than Planned

A substantial 37 percent of Americans retire before their planned retirement age, according to the Center for Retirement Research. The Center's researchers came to this conclusion after examining longitudinal data from the Health and Retirement Study for the years 1992 to 2012 to determine how many older Americans ended up retiring before their planned retirement age—one of the questions asked by the survey. The older the age at which people plan to retire, the more likely they are to retire before they planned...

Percent retiring earlier than planned
20% of those who planned to retire at age 61 or younger
26% of those who planned to retire at age 62
38% of those who planned to retire at ages 63 or 64
42% of those who planned to retire at age 65
55% of those who planned to retire at age 66 or older

What accounts for all these early retirements? Of the four factors considered by the researchers (health, employment, family, and financial), the most important is health. Absent health problems or a change in health status, the percentage who retire earlier than planned would drop from 37 to 32 percent, the researchers report. That's not much of a decline. In fact, the four factors considered by the researchers can explain only one-quarter of early retirements. What accounts for the rest? Perhaps "soft" factors, say the researchers, "like the lure of leisure time."

Source: Center for Retirement Research at Boston College, Retiring Earlier than Planned: What Matters Most?

19% Have Experienced Identity Theft

Millions of Americans have been the victims of identity theft, according to the Bureau of Justice Statistics. Nearly one in five (19.4 percent) people aged 16 or older has been a victim at least once in his or her lifetime, and 10 percent have been a victim in the past year. These findings come from the 2016 Identity Theft Supplement to the National Crime Victimization Survey.

Identity theft is not only common, but affects a growing share of the population. The 10 percent who were victims in 2016 is greater than the 7 percent measured in 2014. The Bureau of Justice Statistics defines identity theft as "fraud that is committed or attempted using a person's identifying information without authority." The three types of identity theft are the misuse of an existing credit card, bank, or other account; the opening of a new account in a person's name; and the misuse of personal information for fraudulent purposes—such as to get medical care.

The most common type of identity theft is misuse of an existing credit card account. In 2016, a substantial 4.3 percent of Americans aged 16 or older—or 11 million people—were the victims of credit card fraud. How did the victims discover the identity theft? Most were alerted to suspicious activity by a financial institution, the Bureau of Justice Statistics' reports. Only 7 percent of victims reported their identity theft to police, while 88 percent reported it to a credit card company or bank.

Actions taken by identity theft victims in the past 12 months
75.6% checked bank or credit statements
67.5% shredded documents with personal information
44.3% checked their credit report
36.8% changed passwords on financial accounts
16.2% used an identity-theft security program on a computer
11.7% purchased identity-theft insurance or credit monitoring service
4.7% purchased identity-theft protection

While the above list makes it look as though identity theft victims have learned their lesson and are getting serious about protecting their personal information, in fact the percentages who undertake these security enhancing activities are about the same for identity theft victims as they are for nonvictims.

Source: Bureau of Justice Statistics, Victims of Identity Theft, 2016

E-Cigarette Use: Young Adults by State, 2017

Young adults are the biggest users of e-cigarettes but their use varies by state, according to the CDC's Behavioral Risk Factor Surveillance System. Here are the five states in 2017 with the largest percentages of 18-to-24-year-olds who use e-cigarettes...

States with largest percentage of 18-to-24-year-olds who use e-cigarettes
1. Oklahoma: 15.4%
2. Wyoming: 15.2%
3. Arkansas: 14.7%
4. Tennessee: 14.5%
5. Missouri: 13.9%

Maryland had the smallest percentage of 18-to-24-year-olds who use e-cigarettes, with only 5.4 percent doing so in 2017. Vermont (6.1 percent) and California (6.4 percent) followed.

Source: CDC, BRFSS Prevalence and Trends Data

Median Household Income Stable in December 2018

Median household income in December 2018 was stable at $63,517, according to Sentier Research. This was not significantly different from the November 2018 median, after adjusting for inflation. The December 2018 median was 2.7 percent higher than the December 2017 median. Sentier's estimates are derived from the Census Bureau's Current Population Survey and track the economic wellbeing of households on a monthly basis. 

Median household income in December was 15.4 percent higher than the post-Great Recession low reached in June 2011 ($55,051)—a bottom hit two years after the official end of the Great Recession.

Sentier's Household Income Index in December 2018 was 104.3 (January 2000 = 100.0). To stay on top of these trends, look for the next monthly update from Sentier.

Source: Sentier Research, Household Income Trends: December 2018

More People Aged 65-Plus Are at Work

Two decades ago, the percentage of older men and women in the labor force was negligible. Marketers could safely ignore them and target only retirees in their messages to the 65-plus age group. Not so anymore. More than one-third of men aged 65 to 69 and one-fourth of those aged 70 to 74 are still working. More than one in four women aged 65 to 69 has a job...

Labor force participation rate of people aged 65-or-older, 1998 and 2018

	2018	1998
Men
Aged 65 or older	24.0%	16.5%
Aged 65 to 69	37.6	28.0
Aged 70 to 74	23.8	16.5
Aged 75 or older	11.9	7.5
Women
Age 65 or older	15.9%	8.6%
Aged 65 to 69	28.9	17.8
Aged 70 to 74	15.8	9.3
Aged 75 or older	6.4	2.9

Between 1998 and 2018, the number of workers aged 65 or older more than doubled (up 161 percent) because of the double whammy of rising labor force participation rates and the aging of the baby-boom generation. These increases will continue, according to the Bureau of Labor Statistics. The labor force participation rate of men aged 65 or older is projected to rise to 25.9 percent by 2026, and women's rate should climb to 18.3 percent. The number of workers aged 65 or older will expand by another 46 percent between 2018 and 2026.

Source: Demo Memo analysis of the Bureau of Labor Statistics' Labor Force Statistics from the Current Population Survey

The 6 Most Commonly Purchased Groceries

During an average week, nearly every household spends money on groceries. But shopping carts are disproportionately filled with only a handful of items. These are the 6 items purchased by at least one-third of households during the average week of 2017...

Percent of households buying item in an average week
1. Fresh fruit: 56%
2. Fresh vegetables: 56%
3. Milk: 47%
4. Bread: 44%
5. Cheese: 39%
6. Prepared food from the supermarket deli: 38%

Bananas are the most frequently purchased fruit (34 percent). Tomatoes are the most frequently purchased vegetable (22 percent). During an average week, nonwhite bread is added to more shopping carts (40 percent) than white bread (35 percent).

Source: Demo Memo analysis of the 2017 Consumer Expenditure Survey

Only 5.0% of Workers Have More than One Job

Really? If we are to believe the Bureau of Labor Statistics, which collects monthly employment figures through the Current Population Survey, then only 5.0 percent of workers had two or more jobs during an average week of 2018. But there is growing evidence that this number is way too low.

A National Bureau of Economic Research study by economists Lawrence F. Katz and Alan B. Krueger raises serious doubts about the 5.0 percent figure. Not only do Katz and Krueger think the number is too low, they are also skeptical of Current Population Survey data that show a decline in multiple job holding over the years—from a peak of 6.2 percent in 1996 to the 5.0 percent of today. So they designed an experiment to test the accuracy of the CPS's multiple jobs question.

Using a sample of Amazon Mechanical Turk participants, many of whom are multiple job holders, Katz and Kreuger asked their sample the standard Current Population Survey question about multiple jobs ("Last week did you have more than one job or business, including part time, evening or weekend work?") to see how many said yes. They also probed the sample about any additional work they did in the past week ("Did you work on any other... small paid jobs last week that you did not include in your response to the previous question?")

Among those who reported having only one job on the CPS question, fully 61 percent said they had failed to report another small job they had done in the reference week. Among those who reported having multiple jobs on the CPS question, an additional 38 percent reported having even more work than was captured by the CPS.

"The MTurk sample is highly non-representative," the authors note, "but this survey experiment demonstrates that the standard multiple job holding question in the basic monthly CPS is susceptible to underreporting." Interestingly, the Bureau of Labor Statistics agrees. While the BLS disputes the notion that its surveys have missed the rise of the gig economy, it admits that the CPS may undercount multiple job holders. For more on this, see the Monthly Labor Review article, Measuring Labor Market Activity Today: Are the Words Work and Job too Limiting for Surveys?

Source: National Bureau of Economic Research, Understanding Trends in Alternative Work Arrangements in the United States, Working Paper 25425 ($5)

State-to-State Student Migration

Among high school graduates who enroll in a four-year institution within 12 months of receiving their high school diploma, most enroll in a school in their home state. Fully 74 percent of students choose an in-state school, according to 2016 data collected by the National Center for Education Statistics. But the rate ranges from lows of 39 percent in New Hampshire and 42 percent in Connecticut to highs of 89 percent in West Virginia and 90 percent in Utah.

The net migration of first-year four-year college students also varies greatly by state. Most states gain from student migration, but 13 states lose more students to other states than they attract to their schools. Here are the five states with the biggest net migration streams, both positive and negative...

States with the biggest net gain of first-year college students
Pennsylvania: 15,525
Indiana: 9,656
Alabama: 8,532
Arizona: 7,361
Iowa: 7,358

States with the biggest net loss of first-year college students
New Jersey: –27,262
Illinois: –19,171
California: –14,164
Texas: –12,059
Maryland: –8,564

Other states that lose more first-year four-year college students than they gain are Alaska, Connecticut, Hawaii, Minnesota, Nevada, New Mexico, Washington, and Wyoming.

Source: National Center for Education Statistics, Digest of Education Statistics 2017

Homicides at the Nation's Schools

Hundreds of children have been murdered while at school over the past few decades, according to a grim study by the CDC. Nearly 400 children (393) were murdered in single-death incidents while at school from 1994 to 2016. Another 121 children were murdered in multiple-death incidents from 1994 to 2018. There are differences in these two types of crimes, according to the study findings...

Sex of victims and perpetrators: The victims in single-death incidents were mostly male (77 percent), while the victims in multiple-death incidents were evenly split between males and females. Males were the great majority of perpetrators in both types of incidents, with the proportion reaching as high as 98 percent in multiple-death incidents.

Race of victims: Blacks were a much larger share of victims in single-death (53 percent) than multiple-death incidents (12 percent). Non-Hispanic Whites were a much larger share of victims in multiple-death incidents (69 percent) than single-death incidents (23 percent).

Age of victims: Fully 78 percent of victims in single-death incidents were aged 15 to 18, another 19 percent were aged 10 to 14, and 3 percent were aged 5 to 9. In multiple-death incidents, a smaller 54 percent of victims were in the 15-to-18 age group, 23 percent were aged 10 to 14, and 23 percent were aged 5 to 9.

Cause of death: Firearms were the cause of death in 63 percent of single-death incidents. Stabbing accounted for another 24 percent. In multiple-death incidents, fully 95 percent of deaths were caused by firearms.

Source: CDC, Characteristics of School-Associated Youth Homicides—United States, 1994–2018