Wireless Substitution: Early Release of Estimates from the National Health Interview Survey, July-December, 2016

Questions for Stephen Blumberg, Ph.D., Health Scientist and Lead Author of “Wireless Substitution: Early Release of Estimates From the National Health Interview Survey, July-December, 2016”

Q:  What does cell phone use have to do with Americans’ health?

SB:  The National Center for Health Statistics (NCHS) does not monitor cell phone ownership in the United States because of any concerns about the impact of cell phones on health. Rather, NCHS monitors cell phone ownership because of concerns about the impact of cell phones on health surveys. Many health surveys are conducted using telephone data collection, and it is important to know the size and characteristics of the wireless-only population to ensure that they are adequately represented in telephone-based health surveys.

Q:  What do you think is the most striking finding in your report?

SB:  The change in the balance of landline-phone and cell-phone-only households is quite striking. We’ve been monitoring telephone ownership in the United States since 2003, and we have seen a steady increase over time in the number of households that have cut-the-cord and become wireless-only. The second half of 2016, however, is the first time we have observed that more than 50% of households are wireless-only. Households with landlines are now in the minority in the United States.

Q:  What characteristics are most strongly associated with the types of telephones households use?

SB:  The strongest predictor of whether an adult lives in a wireless-only household is the adult’s age. Younger adults are more likely to be wireless-only than older adults. For example, about two-thirds of adults under 45 are wireless-only, whereas only about one-third of adults 45 and over are wireless-only. After age, home ownership is the next strongest predictor. Adults who rent their homes are more likely to be wireless-only than adults who own their homes. We see this difference regardless of the adult’s age. Finally, we also see that where people live predicts whether they still have a landline. Adults living in the Northeast – and especially home owners in the Northeast – are much less likely to be wireless-only than adults living in other regions of the United States.

Q:  What is the take-home message of your report?

SB:  I think the take-home message is how important it is for telephone-based surveys to include adequate numbers of cell-phone-only households. The prevalence of wireless-only households continues to increase. We see no evidence that this trend is slowing. And adults who live in wireless-only households are different from adults who live in households with landlines. Not only are they younger on average, but they are also more likely to drink alcohol in excess, more likely to smoke, and less likely to have health insurance coverage. For these reasons, it remains important that telephone-based health surveys include adequate numbers of wireless-only households to ensure that their survey estimates are valid.