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31.16 c 8.88 31.14 l 8.71 32.47 l 8.69 32.67 8.65 32.87 8.61 33.01 c 8.78 33.04 9.18 33.12 9.27 33.15 c 9.32 33.01 l 8.87 32.85 8.83 32.78 8.89 32.28 c 8.93 31.96 l 8.93 31.92 8.96 31.91 9.01 31.91 c 9.81 32.01 l 9.87 32.01 9.87 32.02 9.87 32.13 c 9.85 32.23 l 9.8 32.61 9.74 32.63 9.48 32.63 c 9.47 32.78 l 9.59 32.8 9.69 32.8 9.87 32.82 c 10.01 32.84 10.17 32.87 10.27 32.88 c 10.28 32.73 l 10.03 32.67 9.98 32.61 10.01 32.34 c 10.04 32.1 l 10.04 32.05 10.06 32.04 10.11 32.04 c 11 32.15 l 11.05 32.16 11.07 32.18 11.07 32.22 c 11 32.82 l 10.96 33.11 10.88 33.17 10.64 33.22 c 10.39 33.26 l 10.41 33.43 l 10.61 33.41 10.95 33.41 11.1 33.42 c 11.34 31.44 l 11.19 31.42 l h f 10.02 35.1 m 10.02 35.13 10.01 35.15 10.01 35.15 c 9.98 35.15 9.95 35.13 9.92 35.12 c 9.04 34.77 l 9.96 34.43 l 9.98 34.42 10 34.41 10.02 34.41 c 10.03 34.41 10.04 34.43 10.04 34.45 c 10.02 35.1 l h 10.92 33.6 m 10.89 33.87 10.81 33.92 10.5 34.03 c 8.95 34.62 l 8.69 34.72 8.62 34.75 8.49 34.78 c 8.49 34.97 l 8.6 34.98 8.79 35.05 8.9 35.1 c 10.61 35.84 l 10.84 35.93 10.88 35.96 10.87 36.26 c 11.02 36.26 l 11.04 35.04 l 10.89 35.04 l 10.87 35.4 10.84 35.43 10.75 35.43 c 10.67 35.43 10.28 35.27 10.24 35.24 c 10.22 35.23 10.21 35.22 10.21 35.2 c 10.2 35.11 10.2 34.93 10.2 34.57 c 10.21 34.35 10.23 34.34 10.31 34.31 c 10.52 34.22 10.71 34.17 10.75 34.17 c 10.85 34.18 10.88 34.21 10.9 34.55 c 11.05 34.55 l 11.07 33.6 l 10.92 33.6 l h f 10.89 36.34 m 10.89 36.68 10.89 36.7 10.79 36.72 c 10.67 36.74 10.39 36.76 9.84 36.81 c 9.3 36.86 9.01 36.88 8.89 36.88 c 8.79 36.88 8.78 36.86 8.72 36.53 c 8.57 36.54 l 8.67 37.68 l 8.82 37.67 l 8.82 37.33 8.82 37.31 8.92 37.29 c 9 37.27 9.2 37.25 9.37 37.23 c 10.78 37.11 l 10.91 37.1 10.94 37.14 10.95 37.24 c 10.98 37.65 l 11.01 37.99 10.91 38.05 10.43 38.29 c 10.5 38.45 l 10.62 38.4 11.03 38.31 11.21 38.29 c 11.04 36.33 l 10.89 36.34 l h f 11.12 38.68 m 11.16 39.06 11.16 39.08 11.06 39.11 c 10.99 39.13 10.87 39.16 10.66 39.2 c 9.05 39.47 l 8.99 39.07 l 8.96 38.95 9.05 38.88 9.44 38.67 c 9.37 38.51 l 9.24 38.57 9.05 38.63 8.73 38.7 c 8.75 38.76 8.77 38.83 8.78 38.9 c 8.81 38.96 8.82 39.03 8.83 39.1 c 9.04 40.31 l 9.06 40.45 9.08 40.59 9.08 40.72 c 9.4 40.68 9.6 40.67 9.74 40.67 c 9.75 40.51 l 9.32 40.43 9.21 40.4 9.19 40.28 c 9.12 39.88 l 10.73 39.6 l 10.94 39.57 11.06 39.55 11.13 39.55 c 11.23 39.54 11.25 39.56 11.34 39.93 c 11.49 39.91 l 11.27 38.66 l 11.12 38.68 l h f 11.4 40.38 m 11.47 40.73 11.47 40.76 11.38 40.79 c 11.26 40.84 10.99 40.92 10.46 41.07 c 9.93 41.22 9.66 41.29 9.54 41.32 c 9.44 41.33 9.43 41.32 9.3 40.97 c 9.16 41.01 l 9.49 42.19 l 9.64 42.16 l 9.56 41.8 9.57 41.78 9.66 41.74 c 9.73 41.71 9.93 41.65 10.09 41.6 c 10.32 41.53 l 10.42 41.51 10.44 41.51 10.46 41.6 c 10.72 42.5 l 10.74 42.59 10.73 42.6 10.63 42.63 c 10.4 42.7 l 10.24 42.75 10.04 42.8 9.96 42.81 c 9.86 42.83 9.84 42.81 9.72 42.47 c 9.58 42.51 l 9.91 43.69 l 10.06 43.65 l 9.99 43.29 9.99 43.27 10.08 43.24 c 10.2 43.19 10.47 43.11 11 42.96 c 11.53 42.81 11.8 42.74 11.92 42.71 c 12.02 42.7 12.03 42.71 12.16 43.06 c 12.3 43.02 l 11.97 41.83 l 11.82 41.87 l 11.9 42.23 11.89 42.25 11.8 42.29 c 11.71 42.33 11.43 42.41 11.03 42.52 c 10.93 42.55 10.91 42.54 10.88 42.46 c 10.63 41.56 l 10.61 41.47 10.61 41.46 10.72 41.42 c 11.12 41.32 11.4 41.24 11.5 41.22 c 11.59 41.2 11.61 41.22 11.73 41.56 c 11.88 41.52 l 11.54 40.34 l 11.4 40.38 l h f 13 45.15 m 13.06 45.26 13.07 45.41 13.04 45.59 c 12.73 45.51 12.12 45.46 11.83 45.46 c 11.84 45.19 11.91 45.03 12.14 44.92 c 12.39 44.81 12.85 44.83 13 45.15 c 11.69 45.8 m 11.7 45.99 11.56 46.14 11.43 46.2 c 11.31 46.26 11.13 46.27 11.05 46.12 c 11.01 46.01 11.03 45.87 11.2 45.8 c 11.3 45.75 11.47 45.73 11.69 45.8 c 13.72 46.55 m 13.76 46.33 13.74 46.12 13.67 45.97 c 13.59 45.81 13.46 45.72 13.19 45.63 c 13.26 45.39 13.27 45.14 13.14 44.88 c 12.93 44.43 12.5 44.34 12.16 44.5 c 11.85 44.65 11.7 44.92 11.69 45.44 c 11.31 45.41 11.18 45.42 11.06 45.47 c 10.85 45.57 10.72 45.8 10.89 46.16 c 11.03 46.47 11.26 46.61 11.53 46.48 c 11.79 46.35 11.84 46.09 11.83 45.83 c 12.21 45.85 12.57 45.88 12.93 45.94 c 12.85 46.14 12.7 46.36 12.59 46.41 c 12.5 46.46 12.43 46.42 12.34 46.29 c 12.21 46.35 l 12.56 47.1 l 12.7 47.03 l 12.62 46.86 12.63 46.71 12.79 46.5 c 12.87 46.4 12.99 46.21 13.1 45.98 c 13.39 46.04 13.47 46.08 13.54 46.21 c 13.59 46.32 13.59 46.45 13.57 46.63 c 13.72 46.55 l h f 14.32 47.61 m 14.51 47.92 14.51 47.95 14.44 48.01 c 14.35 48.1 14.12 48.25 13.66 48.57 c 13.22 48.89 12.98 49.05 12.88 49.11 c 12.79 49.16 12.77 49.15 12.54 48.86 c 12.41 48.95 l 13.12 49.96 l 13.24 49.87 l 13.06 49.56 13.05 49.53 13.13 49.47 c 13.19 49.42 13.35 49.29 13.5 49.19 c 13.69 49.06 l 13.77 49 13.79 49 13.84 49.08 c 14.38 49.84 l 14.43 49.92 14.43 49.94 14.34 50 c 14.14 50.13 l 14.01 50.23 13.83 50.34 13.76 50.39 c 13.68 50.43 13.66 50.42 13.43 50.14 c 13.31 50.22 l 14.01 51.23 l 14.14 51.14 l 13.95 50.83 13.95 50.81 14.02 50.75 c 14.11 50.66 14.34 50.5 14.79 50.18 c 15.24 49.87 15.47 49.71 15.58 49.65 c 15.67 49.6 15.69 49.61 15.92 49.89 c 16.05 49.81 l 15.34 48.8 l 15.21 48.88 l 15.4 49.19 15.4 49.22 15.33 49.28 c 15.25 49.35 15.02 49.52 14.67 49.76 c 14.59 49.82 14.57 49.82 14.52 49.74 c 13.98 48.98 l 13.93 48.9 13.93 48.88 14.02 48.83 c 14.36 48.58 14.6 48.42 14.69 48.37 c 14.78 48.33 14.8 48.34 15.03 48.62 c 15.15 48.53 l 14.44 47.53 l 14.32 47.61 l h f 14.28 51.56 m 15.1 52.47 l 15.22 52.38 l 14.99 52.09 14.99 52.07 15.05 51.99 c 15.13 51.9 15.34 51.71 16.01 51.11 c 16.22 50.92 16.6 50.68 16.97 51.09 c 17.39 51.55 17.21 51.82 16.67 52.31 c 16.24 52.71 16.03 52.89 15.93 52.96 c 15.85 53.02 15.83 53.01 15.55 52.75 c 15.44 52.85 l 16.13 53.6 l 16.24 53.51 l 16.02 53.22 16.01 53.19 16.07 53.12 c 16.16 53.03 16.37 52.84 16.94 52.32 c 17.35 51.95 17.69 51.55 17.08 50.88 c 16.71 50.47 16.22 50.37 15.72 50.81 c 15.07 51.4 14.86 51.59 14.76 51.66 c 14.68 51.72 14.66 51.71 14.39 51.46 c 14.28 51.56 l h f 17.81 52.03 m 18.09 52.3 18.09 52.32 18.04 52.4 c 17.97 52.5 17.78 52.72 17.43 53.13 c 17.06 53.55 16.88 53.76 16.79 53.85 c 16.71 53.91 16.7 53.91 16.39 53.68 c 16.29 53.79 l 17.02 54.42 l 17.03 54.4 17.07 54.37 17.1 54.35 c 18.8 53.37 l 18.8 53.38 l 18.06 55.32 l 18.78 55.93 l 18.88 55.81 l 18.6 55.54 18.59 55.52 18.65 55.44 c 18.71 55.34 18.9 55.13 19.25 54.71 c 19.62 54.29 19.8 54.07 19.89 53.99 c 19.96 53.93 19.98 53.93 20.29 54.17 c 20.39 54.05 l 19.45 53.24 l 19.35 53.36 l 19.62 53.62 19.62 53.65 19.57 53.71 c 18.28 55.21 l 18.28 55.2 l 19.05 53.21 l 19.07 53.15 19.09 53.09 19.12 53.03 c 18.91 52.85 l 18.89 52.88 18.84 52.91 18.79 52.94 c 16.91 54.03 l 16.9 54.02 l 17.98 52.77 l 18.05 52.69 18.17 52.58 18.21 52.54 c 18.28 52.48 18.3 52.48 18.58 52.69 c 18.68 52.58 l 17.91 51.91 l 17.81 52.03 l h f 21.26 55.82 m 21.28 55.83 21.29 55.85 21.28 55.86 c 21.27 55.87 21.24 55.89 21.22 55.91 c 20.45 56.47 l 20.65 55.51 l 20.65 55.49 20.66 55.47 20.67 55.46 c 20.67 55.44 20.7 55.45 20.71 55.46 c 21.26 55.82 l h 20.46 54.26 m 20.67 54.43 20.67 54.53 20.6 54.84 c 20.27 56.47 l 20.22 56.74 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[(:H)-35.78(GHWHUPLQHG)-35.78(WKH)-35.78(SHUFHQWDJH)-35.78(RI)-35.78(VWXGHQWV)-35.78(ZLWKRXW)-35.78(DFFHVV)-35.78(WR)-35.78(DQ\\)]TJ 0 g 0 Tw 0 Tc 1 0 0 1 30 666 Tm 0 0 0 rg 0.02529 Tw 0.01012 Tc [(FRPSHWLWLYH)-2.53(EHYHUDJHV)-2.53(WKH)-2.53(SHUFHQWDJH)-2.53(RI)-2.53(VWXGHQWV)-2.53(ZLWK)-2.53(DFFHVV)-2.53(RQO\\)]TJ 0 g 0 Tw 0 Tc 1 0 0 1 30 654 Tm 0 0 0 rg 0.27681 Tw 0.11072 Tc [(WR)-27.68(FRPSHWLWLYH)-27.68(EHYHUDJHV)-27.68(PHHWLQJ)-27.68(WKH)-27.68(VWDQGDUGV)-27.68(DQG)-27.68(WKH)-27.68()]TJ 0 g 0 0 0 rg (SHUFHQW)Tj 0 g 0 Tw 0 Tc 1 0 0 1 30 642 Tm 0 0 0 rg 0.51327 Tw 0.20531 Tc [(DJH)-51.33(RI)-51.33(VWXGHQWV)-51.33(ZLWK)-51.33(DFFHVV)-51.33(WR)-51.33(QRQFRPSOLDQW)-51.33(EHYHUDJHV)-51.33( IXUWKHU)]TJ 0 g 0 Tw 0 Tc 1 0 0 1 30 630 Tm 0 0 0 rg 0.4745 Tw 0.1898 Tc [(FODVVLI\\LQJ)-47.45(QRQFRPSOLDQW)-47.45(EHYHUDJHV)-47.45(DV)-47.45(66%V)-47.45(RU)]TJ 0 g 0 0 0 rg [-47.45(QRQ66%V\f)]TJ 0 g 0 0 0 rg [-47.45(:H)]TJ 0 g 0 Tw 0 Tc 1 0 0 1 30 618 Tm 0 0 0 rg 0.10439 Tw 0.04175 Tc [(WKHQ)-10.44(VXPPHG)-10.44(WKH)-10.44(QXPEHU)-10.44(RI)-10.44(VWXGHQWV)-10.44(DWWHQGLQJ)-10.44(HDFK)-10.44(VFKRRO)-10.44()]TJ 0 g 0 0 0 rg (FODVVL)Tj 0 g 0 Tw 0 Tc 1 0 0 1 30 606 Tm 0 0 0 rg 0.07162 Tw 0.02865 Tc [(ILHG)-7.16(LQWR)-7.16(HDFK)-7.16(RI)-7.16(WKHVH)-7.16()-7.16(FDWHJRULHV)-7.16(DQG)-7.16(GLYLGHG)-7.16(WKLV)-7.16(QXPEHU)-7.16(E\\)-7.16(WKH)]TJ 0 g 0 Tw 0 Tc 1 0 0 1 30 594 Tm 0 0 0 rg 0.11658 Tw 0.04663 Tc [(WRWDO)-11.66(QXPEHU)-11.66(RI)-11.66(VWXGHQWV)-11.66(HQUROOHG)-11.66(LQ)-11.66(%36)-11.66(VWUDWLILHG)-11.66(E\\)-11.66(JUDGH)-11.66(OHYHO)]TJ 0 g 0 Tw 0 Tc 1 0 0 1 30 582 Tm 0 0 0 rg 0.30754 Tw 0.12302 Tc [(:H)-30.75(XVHG)-30.75(6$6)-30.75(YHUVLRQ)-30.75()-30.75( 6$6)-30.75(,QVWLWXWH)-30.75(,QF\f)-30.75(WR)-30.75(FRQGXFW)-30.75(DOO)-30.75()]TJ 0 g 0 0 0 rg (DQD)Tj 0 g 0 Tw 0 Tc 1 0 0 1 30 570 Tm 0 0 0 rg 0.56815 Tw 0.22726 Tc [(O\\VHV)-56.82(7KLV)-56.82(VWXG\\)-56.82(ZDV)-56.82(GHWHUPLQHG)-56.82(WR)-56.82(EH)-56.82(H[HPSW)-56.82(E\\)-56.82(WKH)-56.82(+DUYDUG)]TJ 0 g 0 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0 g 0 Tw 0 Tc 1 0 0 1 30 384 Tm 0 0 0 rg 0.22654 Tw 0.09062 Tc [(VWDQGDUGV)-22.65( \b\f)-22.65(IROORZHG)-22.65(E\\)-22.65(PLGGOH)-22.65(VFKRROV)-22.65( \b\f)-22.65(DQG)-22.65(KLJK)]TJ 0 g 0 Tw 0 Tc 1 0 0 1 30 372 Tm 0 0 0 rg 0.57382 Tw 0.22953 Tc [(VFKRROV)-57.38( \b\f)-57.38($PRQJ)-57.38(HOHPHQWDU\\)-57.38(DQG)-57.38(PLGGOH)-57.38(VFKRROV)-57.38(PRVW)]TJ 0 g 0 Tw 0 Tc 1 0 0 1 30 360 Tm 0 0 0 rg 0.58006 Tw 0.23202 Tc [(PHW)-58.01(WKH)-58.01(VWDQGDUGV)-58.01(EHFDXVH)-58.01(QR)-58.01(FRPSHWLWLYH)-58.01(EHYHUDJHV)-58.01(ZHUH)-58.01(VROG)]TJ 0 g 0 Tw 0 Tc 1 0 0 1 30 348 Tm 0 0 0 rg 0.81266 Tw 0.32506 Tc [( \b)-81.27(RI)-81.27(HOHPHQWDU\\)-81.27(VFKRROV)-81.27(DQG)-81.27(\b)-81.27(RI)-81.27(PLGGOH)-81.27(VFKRROV\f)]TJ 0 g 0 Tw 0 Tc 1 0 0 1 30 336 Tm 0 0 0 rg 0.03444 Tw 0.01378 Tc [(&RPSHWLWLYH)-3.44(EHYHUDJHV)-3.44(ZHUH)-3.44(VROG)-3.44(DW)-3.44()-3.44(DFFHVV)-3.44(SRLQWV)-3.44(LQ)-3.44()-3.44(VFKRROV)]TJ 0 g 0 Tw 0 Tc 1 0 0 1 30 324 Tm 0 0 0 rg 0.01243 Tw 0.00497 Tc [(0RVW)-1.24(DFFHVV)-1.24(SRLQWV)-1.24(ZHUH)-1.24(YHQGLQJ)-1.24(PDFKLQHV)-1.24( )-1.24(RI)-1.24()-1.24(>\b@\f)-1.24(RU)-1.24(D)]TJ 0 g 0 Tw 0 Tc 1 0 0 1 30 312 Tm 0 0 0 rg 0.16026 Tw 0.06411 Tc [(OD)-16.03(FDUWH)-16.03(FDIHWHULD)-16.03(VDOHV)-16.03( )-16.03(RI)-16.03()-16.03(>\b@\f)-16.03( )]TJ 0 g 0 0 0 rg [(7DEOH)-16.03()]TJ 0 g 0 0 0 rg [(\f)-16.03(:H)-16.03(IRXQG)-16.03(QR)]TJ 0 g 0 Tw 0 Tc 1 0 0 1 30 300 Tm 0 0 0 rg 0.15318 Tw 0.06127 Tc [(GLIIHUHQFH)-15.32(LQ)-15.32(ZKHWKHU)-15.32(RU)-15.32(QRW)-15.32(FRPSHWLWLYH)-15.32(EHYHUDJHV)-15.32(PHW)-15.32(WKH)-15.32()]TJ 0 g 0 0 0 rg (VWDQG)Tj 0 g 0 Tw 0 Tc 1 0 0 1 30 288 Tm 0 0 0 rg (DUGVE\\W\\SHRIDFFHVVSRLQW)Tj 0 g ET BT 1 0 0 1 30 268 Tm /F1 10 Tf 0 0 0 rg 0.28621 Tw 0.11448 Tc [(2I)-28.62(WKH)-28.62()-28.62(VFKRROV)-28.62(LQ)-28.62(ZKLFK)-28.62(FRPSHWLWLYH)-28.62(EHYHUDJHV)-28.62(ZHUH)-28.62(VROG)-28.62(WKDW)]TJ 0 g 0 Tw 0 Tc 1 0 0 1 30 256 Tm 0 0 0 rg 0.00481 Tw 0.00193 Tc 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Articles focus on preventing and controlling chronic diseases and conditions, promoting health, and examining the biological, behavioral, physical, and social determinants of health and their impact on quality of life, morbidity, and mortality across the life span. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. 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