Series 1, Number 43 June 2005

Design and Operation of

the National Survey of

Children’s Health, 2003
Copyright information

All material appearing in this report is in the public domain and may be

reproduced or copied without permission; citation as to source, however, is

appreciated.

Suggested citation

Blumberg SJ, Olson L, Frankel MR, Osborn L, Srinath KP, Giambo P. Design

and operation of the National Survey of Children’s Health, 2003. National

Center for Health Statistics. Vital Health Stat 1(43). 2005.

For sale by the U.S. Government Printing Office

Superintendent of Documents

Mail Stop: SSOP

Washington, DC 20402-9328

Printed on acid-free paper.
National Center for Health Statistics

Edward J. Sondik, Ph.D., Director

Jennifer H. Madans, Ph.D., Acting Co-Deputy Director

Michael H. Sadagursky, Acting Co-Deputy Director

Jennifer H. Madans, Ph.D., Associate Director for Science

Lawrence H. Cox, Ph.D., Associate Director for Research

and Methodology

Edward L. Hunter, Associate Director for Planning, Budget,

and Legislation

Michael H. Sadagursky, Associate Director for

Management and Operations

Margot A. Palmer, Director for Information Technology

Phillip R. Beattie, Director for Information Services

Diane M. Makuc, Dr.P.H., Acting Associate Director for

Analysis and Epidemiology

Charles J. Rothwell, Director for Vital Statistics

Jane E. Sisk, Ph.D., Director for Health Care Statistics

Jane F. Gentleman, Ph.D., Director for Health Interview

Statistics

Clifford L. Johnson, Director for Health and Nutrition

Examination Surveys

Division of Health Interview Statistics

Jane F. Gentleman, Ph.D., Director

Anne K. Stratton, M.S., Associate Director for Planning and

Production

Eve Powell-Griner, Ph.D., Acting Associate Director for

Science

Susan S. Jack, M.S., Special Assistant for Data Quality and

User Services

Eve Powell-Griner, Ph.D., Chief, Data Analysis Branch

Marcie Cynamon, M.A., Chief, Survey Planning and Special

Surveys Branch

Anne K. Stratton, M.S., Acting Chief, Systems and

Programming Branch

Acknowledgments

The National Survey of Children’s

Health was sponsored and funded by the

Maternal and Child Health Bureau of

the Health Resources and Services

Administration. Additional support was

received from the Division of Viral

Hepatitis at the Centers for Disease

Control and Prevention’s (CDC)

National Center for Infectious Diseases,

using funds provided by the National

Vaccine Program Office.

The survey was conducted by

CDC’s National Center for Health

Statistics. The project director is Marcie

Cynamon. Design, production, and

analysis assistance for this project was

provided by Kathy O’Connor, Julian

Luke, Matthew Bramlett, and Terry

Richardson. CDC’s National

Immunization Program graciously

permitted the use of the National

Immunization Survey sampling frame

for this survey.

Abt Associates Incorporated and

their subcontractors conducted all

interviews for the project. Technical

assistance was contributed by Sergei

Rodkin, Seth Brady, Garrett James, and

Annabella Battaglia. David Hoaglin

provided editorial assistance. Mary Cay

Murray and Michael P. Battaglia

provided management support.

This report was edited by Klaudia

M. Cox and typeset by Jacqueline M.

Davis of the Information Design and

Publishing Staff, Office of Information

Services.

Finally, our appreciation is extended

to the tens of thousands of parents and

other family members who were willing

to share their stories. Their efforts made

this project a reality.
Contents

Abstract ................................................................................................. 1

Introduction ............................................................................................. 1

State and Local Area Integrated Telephone Survey Program ...................................................... 1

MCHB Goals and the National Survey of Children’s Health ..................................................... 2

Sampling Design ........................................................................................... 2

The National Immunization Survey Sampling Plan ............................................................. 2

NSCH Sample Design and Allocation ....................................................................... 3

Questionnaire ............................................................................................. 3

Content ................................................................................................ 4

CATI Programming ...................................................................................... 6

Interviewer Training ........................................................................................ 7

Data Collection ............................................................................................ 7

Pretests................................................................................................. 7

Advance Letter .......................................................................................... 8

Toll-Free Telephone Number ............................................................................... 8

Informed Consent ........................................................................................ 8

Assurance of Confidentiality ............................................................................... 9

Respondent Selection ..................................................................................... 9

Spanish-Language Interviewing ............................................................................. 9

Interview Length ........................................................................................ 9

Interview Breakoffs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

Cases Pending at Close of Data Collection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

Incentive Effort . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

Response Rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

Efforts to Maximize Response Rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

Quality Control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

Weighting and Estimation Procedures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

Base Sampling Weight . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

Adjustment for Households with Multiple Telephone Lines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

First Form of Nonresponse: Unknown Household Status . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

Second Form of Nonresponse: Unknown Household Eligibility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

Adjustment for Households with More than One Child . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

Poststratification of the Child Weight . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

Adjustment for Noncoverage of Households Without Telephones . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

Truncation of Large Weights . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

Quality Control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

Data Files . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

Editing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

Missing Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

Edits to Protect Confidentiality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

Other Derived Variables . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

Dummy Variables . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

iii
Additional Data Notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

Quality Control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

Estimation and Hypothesis Testing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

Variables Used for Variance Estimation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

Variance Estimation Using SUDAAN or STATA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

Variance Estimation for Subsets of the Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21

Weighted Frequencies, Prevalence Estimates, and Standard Errors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21

Guidelines for Data Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22

Appendix I

Sampling and Weighting Technical Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24

Drawing the NIS Sample . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24

NSCH Sampling Design and Allocation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

Sampling Weights . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

National Estimates. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30

Standard Errors of Estimates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30

Appendix II

Description of the Incentive Effort. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32

Pretest. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32

Expanded Incentive Effort . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33

Impact of the Incentive Effort . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33

Appendix III

Questionnaire . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35

Appendix IV

Summary of Questionnaire Changes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100

Appendix V

Procedures for Assigning Household Poverty Status . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101

Appendix VI

Letters Sent to Sampled Households . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111

Advance Letter for January–March 2003 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111

Advance Letter for April–December 2003 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112

Advance Letter When Incentives Were Offered (Group A) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113

Advance Letter When Incentives Were Offered (Group B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 114

Advance Letter When Incentives Were Offered (Group D) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115

Advance Letter When Incentives Were Offered (Group E). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 116

Thank You Letter (Group A) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117

Thank You Letter (Groups B and C) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 118

Thank You Letter (Group D) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 119

Thank You Letter (Groups E and F) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 120

Appendix VII

Disposition Code Frequencies and Response Rate Calculations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121

Appendix VIII

Prevalence Estimates and Weighted Frequencies for Respondent-Assessed Health Status . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123

iv
Objectives

This report presents the

development, plan, and operation of the

National Survey of Children’s Health

(NSCH), a module of the State and

Local Area Integrated Telephone

Survey, conducted by the Centers for

Disease Control and Prevention’s

(CDC) National Center for Health

Statistics. This survey was designed to

produce national and State-specific

prevalence estimates for a variety of

physical, emotional, and behavioral

health indicators and measures of

children’s experiences with the health

care system. The survey also includes

questions about the family (e.g.,

parents’ health status, stress and

coping behaviors, family activities) and

about respondents’ perceptions of the

neighborhoods where their children live.

Primary funding for this survey was

provided by the Maternal and Child

Health Bureau, Health Resources and

Services Administration. Additional

support was received from the CDC’s

National Center for Infectious Diseases,

using funds provided by the National

Vaccine Program Office.

Methods

A random-digit-dial sample of

households with children under 18

years of age was selected from each of

the 50 States and the District of

Columbia. One child was randomly

selected from all children in each

identified household to be the subject of

the survey. The respondent was the

parent or guardian who knew the most

about the child’s health and health care.

Results

A total of 102,353 interviews were

completed from January 2003 to July

2004. The weighted overall response

rate was 55.3%. A data file has been

released that contains demographic

information on the selected child,

substantive health and well-being data

for the child and his/her family, and

sampling weights. Estimates based on

the sampling weights generalize to the

noninstitutionalized population of

children in each State and nationwide.

Keywords: child health c child

well-being c access to care c medical

home c family functioning c health

surveys c needs assessment

Design and Operation of the

National Survey of Children’s

Health, 2003

Stephen J. Blumberg, Ph.D., Centers for Disease Control and

Prevention; Lorayn Olson, Ph.D., Abt Associates Inc.; Martin R.

Frankel, Ph.D., Baruch College, City University of New York and Abt

Associates Inc.; Larry Osborn, M.P.H.; K.P. Srinath, Ph.D.; and

Pamela Giambo, M.S., Abt Associates Inc.

Introduction

For nearly a century, the Maternal

and Child Health Bureau (MCHB) of

the Health Resources and Services

Administration (HRSA) has been

charged with the primary responsibility

for promoting and improving the health

of the Nation’s mothers and children.

The mission of MCHB is to ensure the

continued improvement in the health,

safety, and well-being of America’s

women, infants, children, adolescents,

and their families (1,2).

MCHB relies on data from

population-based systems to evaluate

progress toward its mission. Nationallevel data on child health and well-being

are available from a number of ongoing

surveys. However, valid and reliable

State-level statistical estimates cannot be

made from these national datasets for all

States. One source of valid and reliable

State-level estimates for children’s risk

behaviors is the Youth Risk Behavior

Survey, but these data are only available

for adolescents in grades 9–12. For

younger children, some States conduct

their own State-specific, populationbased surveys with health and

well-being questions, but varying design

strategies make comparisons of

estimates among States impossible.

Recognizing the need for health and

well-being data that could be

meaningfully compared across States

and nationally for all children under 18

years of age, MCHB utilized the State

and Local Area Integrated Telephone

Survey (SLAITS) program to sponsor

the National Survey of Children’s

Health (NSCH).

State and Local Area

Integrated Telephone

Survey Program

The SLAITS program, conducted

by the Centers for Disease Control and

Prevention’s (CDC) National Center for

Health Statistics (NCHS), is a

broad-based, ongoing surveillance

system available at the State and local

level for tracking and monitoring the

health and well-being of children and

adults. SLAITS uses the sampling frame

of the National Immunization Survey

(NIS), which is conducted jointly by

NCHS and CDC’s National

Immunization Program (3). NIS is a

large-scale random-digit-dialed (RDD)

telephone survey that screens for the

presence of young children in selected

households and collects immunization

history information for eligible children.

The size of the NIS sampling frame

provides an economical opportunity for

SLAITS projects to survey other

populations in addition to the rare

population that eventually screens into

the NIS itself. Through the NIS

sampling frame, SLAITS modules enjoy

cost savings by avoiding some of the

expense of frame development, sample

selection, and screening.

The National Survey of Children’s

Health is the third SLAITS survey to

Page 1
produce national estimates concerning

the health of children. It is the second

SLAITS survey to take full advantage of

the NIS sampling frame to produce

children’s health estimates at the State

level.

SLAITS began in 1997 with a pilot

test in two States (Iowa and

Washington) of a series of questions on

health, including issues of access to

care, health status, and insurance. In

1998, a SLAITS module concerning

child well-being and welfare issues was

implemented using three samples: a

Texas RDD sample, known Medicaid

program participants seeded into the

Texas RDD sample, and known

Medicaid or MinnesotaCare participants

in Minnesota. The first national SLAITS

survey was fielded in 2000. The

National Survey of Early Childhood

Health collected data from a national

sample regarding parents’ perceptions of

their children’s pediatric care and

examined relationships between the

promotion of health in the pediatric

office and promotion of health in the

home (4). Then, from late 2000 to early

2002, the SLAITS program conducted

the National Survey of Children with

Special Health Care Needs to produce

national and State-level estimates of the

prevalence of special health care needs,

describe the types of services that

children with special health care needs

(CSHCN) need and use, and assess

shortcomings in the system of care for

these children (5).

In 2003 and 2004, SLAITS fielded

the National Asthma Survey, which was

developed to help understand the health,

socioeconomic, behavioral, and

environmental factors that relate to

better control of asthma, as well as to

determine detailed prevalence rates by

various demographic characteristics on a

national level. Data from the National

Asthma Survey will be released this

year.

MCHB Goals and the

National Survey of

Children’s Health

According to its vision statement,

the MCHB strives ‘‘for a society where

children are wanted and born with

optimal health, receive quality care, and

are nurtured lovingly and sensitively as

they mature into healthy, productive

adults.’’ MCHB also seeks to ensure that

‘‘there is equal access for all to quality

health care in a supportive, culturally

competent, family and community

setting’’ (1,2). This effort is achieved by

providing block grants that are matched

by State funds.

This survey was conducted to assess

how well each State and the Nation as a

whole are meeting MCHB’s strategic

plan goals and national performance

measures, which include: providing

national leadership for maternal and

child health; promoting an environment

that supports maternal and child health;

eliminating health barriers and

disparities; improving the health

infrastructure and systems of care;

assuring quality care; working with

States and communities to plan and

implement policies and programs to

improve the social, emotional, and

physical environment; and acquiring the

best available evidence to develop and

promote guidelines and practices to

assure a social, emotional, and physical

environment that supports the health and

well-being of women and children. The

results from this survey support these

goals by providing a basis for Federal

and State program planning and

evaluation efforts.

The content of the NSCH is broad,

addressing a variety of physical,

emotional, and behavioral health

indicators and measures of children’s

health experiences with the health care

system. The survey includes an

extensive battery of questions about the

family, including parental health, stress

and coping behaviors, family activities,

and parental concerns about their

children. The NSCH also asks

respondents for their perceptions of the

child’s neighborhood. No other survey

provides this breadth of information

about children, families, and

neighborhoods with sample sizes

sufficient for State-level analyses in

every State, collected in a manner that

allows comparison among States and

nationally (6).

It is anticipated that Maternal and

Child Health programs in each State and

MCHB at the Federal level will use

data from the NSCH to characterize

children’s health status, understand their

families and communities, and identify

the challenges they face in navigating

the health care system. Federal and State

Title V programs should find the data

invaluable for planning and evaluating

programs. Researchers and public policy

analysts at State and Federal levels will

also use these data to assess issues such

as the prevalence of uninsured children,

the relationship of family health to

children’s health, and the impact of

State programs on children’s health and

well-being. Finally, the data will also

provide baseline estimates for several

MCHB companion objectives for

Healthy People 2010 (7,8).

Sampling Design

As noted earlier, SLAITS studies

benefit from the large number of

screening calls required for the NIS.

Telephone numbers for the NSCH were

initially selected from the telephone

numbers randomly generated for the

NIS screening effort. Therefore, the

procedures for drawing the NIS sample

were the first steps in the procedures for

drawing NSCH sample.

The next two sections describe the

basic NIS sample design and serve as a

nontechnical description of the NSCH

sample design and allocation procedures.

‘‘Appendix I’’ of this report includes a

more technical description. For more

detail on the NIS sample design, readers

are encouraged to obtain chapter 3 of

the NIS Annual Methodology Report (9),

which is available from NCHS. Further

information regarding the NIS can be

found in National Immunization Survey:

The Methodology of a Vaccination

Surveillance System (10).

The National

Immunization Survey

Sampling Plan

NIS was established in 1994 to

monitor immunization levels of very

young children within 78 geographic

areas called Immunization Action Plan

(IAP) areas. These 78 nonoverlapping

Page 2 [ Series 1, No. 43
areas (including the District of

Columbia and 27 other urban areas)

encompass the entire United States, and

each IAP area (except the District of

Columbia) is within the borders of a

single State. Every 3 months (or

calendar quarter), NIS selects a

random sample of telephone numbers in

each IAP area. NIS screens over 1

million households per year, but

interviews only a small portion of them

(those containing children aged 19–35

months, who are the primary targets of

immunization programs). Because less

than 5% of households in the United

States contain children in this age range,

a large number of households are

screened to identify households with

NIS-eligible children. Households

identified as having any children under

18 years of age were eligible for the

NSCH.

In the United States, telephone

numbers consist of an area code (3

digits), a prefix or exchange (3 digits),

and a suffix (4 digits). A random sample

of telephone numbers can be chosen by

randomly selecting an area code and

prefix combination currently in use and

appending a randomly chosen four-digit

number between 0000 and 9999. For

NIS, prior to the selection of the sample

of telephone numbers, banks of 100

consecutive numbers in the same area

code and prefix combination that

contain zero directory-listed residential

telephone numbers—that is, banks of

100 numbers that have a low probability

of containing working residential

numbers—are deleted from the sampling

frame. For this step, the GENESYS

Sampling System (a proprietary product

of Marketing Systems Group) uses a file

of directory-listed residential numbers

from Donnelley Marketing Information

Services. A random sample of 10-digit

telephone numbers is then drawn from

the retained banks of 100 numbers.

Identified business and nonworking

telephone numbers are removed from

this sample prior to dialing.

Each remaining telephone number is

then called by an interviewer. If the

telephone call reaches a household, the

person answering the telephone is asked

whether any children aged 19–35

months are living or staying in the

household. If the household contains an

NIS-eligible child or children, a

household respondent is interviewed

about each age-eligible child’s

immunization history and the

demographic characteristics of the

household. The NIS interviewer also

asks for permission to contact the

immunization providers of the children

to obtain vaccination information from

each child’s medical record.

NSCH Sample Design and

Allocation

The goal of the NSCH was to select

representative samples of children under

18 years of age in each State. The target

number of interviews was set at 2,000

per State to permit reasonably precise

estimates of the characteristics of

children in each State. Sufficient

precision was defined as a maximum

relative standard error of 5% for point

estimates of 20%. This same level of

precision can alternatively be defined as

a 95% confidence interval no wider than

5 percentage points for all point

estimates.

The target number of completed

interviews in each IAP area within a

State was determined by allocating the

total of 2,000 interviews among the IAP

areas within the State in proportion to

the total number of households with

children in each IAP area. To achieve

the given number of completed NSCH

interviews in each IAP area, the number

of households to be screened (i.e., to

determine if children live in the

household) was calculated using the

expected proportion of households with

children. Next, the number of telephone

numbers that needed to be called for the

NSCH was computed using the expected

working residential number rate. This

number of telephone numbers was then

increased to compensate for the fact that

not all respondents would agree to

participate. Finally, these numbers were

randomly selected from the pool of

telephone numbers selected to be called

for the NIS. In other words, telephone

numbers selected for the NIS were

assigned to be either NIS-only telephone

numbers or NIS/NSCH telephone

numbers in such proportion that the

required number of completed NSCH

interviews could be achieved.

When NIS/NSCH telephone

numbers were called, they were initially

screened for residential status and for

the presence of NIS age-eligible

children. NIS interviews were conducted

if NIS age-eligible children lived in the

household. If NIS age-eligible children

did not live in the household,

interviewers asked if there were any

children under age 18 living in the

household. Then, regardless of whether

an NIS interview was conducted, if

children were in the household, one

child was randomly sampled for the

NSCH interview.

Although the initial study plan

called for 2,000 completed interviews

per State, this plan was subsequently

revised. Not all States had sufficient

NIS sample available within the data

collection period to obtain the full

number of interviews, and a decision

was made not to draw more telephone

numbers from the GENESYS Sampling

System than was needed for the NIS. In

addition, a monetary incentive was

implemented part way through the data

collection period to increase response.

This incentive was implemented

differentially by State. (A detailed

description of the design for the

incentive effort appears in ‘‘Appendix

II.’’) Thus, the number of completed

interviews varied by State, ranging from

1,848 in New Mexico to 2,241 in

Louisiana and Ohio, with an average of

2,007. One State—Utah—was outside

the range noted above, with only 1,483

interviews completed. Compared with

other States, a substantially larger

proportion of Utah households are

NIS-eligible, thus decreasing the number

of telephone numbers called to complete

the NIS within the State. As a result of

the smaller screener sample available,

fewer NSCH interviews were conducted

in Utah. Table A details the total number

of interviews completed by State.

Questionnaire

The framework for the NSCH was

initially discussed on September 10,

2001. A National Expert Panel

consisting of State and Federal MCHB

program directors, representatives of

family organizations, child health

Series 1, No. 43 [ Page 3
services researchers, and survey design

experts met to recommend the content

domains for the survey. (See table B for

a list of panel members.) The eight

recommended domains, selected for

their epidemiological and policy

importance, included demographics,

physical and mental health status, health

insurance, health care utilization and

access to health care, medical home,

family functioning, parents’ health, and

neighborhood characteristics. In

addition, age-specific modules were

recommended to capture the

developmentally appropriate aspects of

child health and well-being.

A subset of the National Expert

Panel was selected to comprise a

Technical Expert Panel, which would

guide the development and testing of

specific questionnaire items. The initial

meeting of this panel was suspended

due to the events of September 11,

2001. Further meetings were conducted

by teleconference over the next 15

months. Where possible, questions from

existing surveys were used for the

NSCH to permit comparisons with those

surveys and to reduce the need for

extensive pretesting. Surveys reviewed

by the Technical Expert Panel included

(but was not limited to):

+ National Health Interview Survey

(NHIS), conducted annually by

NCHS;

+ National Survey of Children with

Special Health Care Needs,

sponsored by MCHB and conducted

by NCHS;

+ Consumer Assessment of Health

Plans Survey (CAHPS), sponsored

by the Agency for Healthcare

Research and Quality;

+ The National Survey of America’s

Families, sponsored by the Annie E.

Casey Foundation and other funders

and conducted by the Urban

Institute;

+ The Promoting Healthy

Development Survey and the Living

with Illness Survey, developed by

the Child and Adolescent Health

Measurement Initiative and the

Foundation for Accountability; and

+ Youth Risk Behavior Survey

(YRBS), conducted biennially by

CDC.

Questionnaire items recommended

for inclusion by the Technical Expert

Panel were assessed through reviews by

outside experts and selected members of

the community of potential data users.

Comments were also solicited from

State Maternal and Child Health

agencies. MCHB management made the

final decisions regarding the content of

the survey.

Content

The NSCH questionnaire was

designed to immediately follow a

completed NIS interview in households

with an NIS-eligible child or the NIS

screener in households without an

NIS-eligible child. The questionnaire

was divided into 11 sections,

summarized below.

1. Age-Eligibility Screening and

Demographic Characteristics—This

section consists of the introduction to

the interview and a question to

determine if any children under the age

of 18 years were living in the

household. All children living in the

household were rostered by age, and one

child was randomly sampled for the

detailed NSCH interview.

In this section, respondents were

asked questions about their relationship

to the sampled child, the number of

people living in their household, the

highest education attained by anyone in

the household, and the primary language

spoken in the household. Respondents

were also asked to identify the sex of

the sampled child.

2. Health and Functional Status—

The questions in this section were asked

to determine whether the sampled child

had acute or chronic physical, mental,

behavioral, learning, or developmental

conditions and, when present, the impact

of these conditions upon the child’s life.

Respondents were asked additional

specific questions (from the National

Health Interview Survey) to determine

the presence of various acute and

chronic health conditions.

This section included the CSHCN

Screener (11), a screening tool

developed by the Child and Adolescent

Health Measurement Initiative to

identify special health care needs in

children. The CSHCN Screener includes

five stem questions on health care needs

that could be the consequence of

chronic health conditions. If a child

currently experiences one of those

consequences, followup questions

determine whether this health care need

Table A. Number of completed interviews

by State

State

Number of

completed

interviews

All States . . . . . . . . . . . . . 102,353

Alabama . . . . . . . . . . . . . . 2,167

Alaska . . . . . . . . . . . . . . . 1,904

Arizona. . . . . . . . . . . . . . . 1,919

Arkansas . . . . . . . . . . . . . 1,878

California . . . . . . . . . . . . . 2,223

Colorado. . . . . . . . . . . . . . 1,855

Connecticut . . . . . . . . . . . . 2,146

Delaware . . . . . . . . . . . . . 2,156

District of Columbia . . . . . . . 2,049

Florida . . . . . . . . . . . . . . . 2,116

Georgia . . . . . . . . . . . . . . 1,864

Hawaii . . . . . . . . . . . . . . . 2,021

Idaho . . . . . . . . . . . . . . . . 1,861

Illinois . . . . . . . . . . . . . . . 2,158

Indiana . . . . . . . . . . . . . . . 1,874

Iowa . . . . . . . . . . . . . . . . 1,949

Kansas. . . . . . . . . . . . . . . 1,849

Kentucky. . . . . . . . . . . . . . 1,953

Louisiana . . . . . . . . . . . . . 2,241

Maine. . . . . . . . . . . . . . . . 1,920

Maryland. . . . . . . . . . . . . . 2,128

Massachusetts . . . . . . . . . . 2,114

Michigan . . . . . . . . . . . . . . 2,191

Minnesota . . . . . . . . . . . . . 1,864

Mississippi. . . . . . . . . . . . . 2,035

Missouri . . . . . . . . . . . . . . 2,220

Montana . . . . . . . . . . . . . . 1,941

Nebraska . . . . . . . . . . . . . 1,874

Nevada . . . . . . . . . . . . . . 2,064

New Hampshire . . . . . . . . . 1,925

New Jersey . . . . . . . . . . . . 2,113

New Mexico. . . . . . . . . . . . 1,848

New York . . . . . . . . . . . . . 2,021

North Carolina . . . . . . . . . . 2,084

North Dakota . . . . . . . . . . . 1,955

Ohio . . . . . . . . . . . . . . . . 2,241

Oklahoma . . . . . . . . . . . . . 1,937

Oregon. . . . . . . . . . . . . . . 1,969

Pennsylvania . . . . . . . . . . . 2,200

Rhode Island . . . . . . . . . . . 2,019

South Carolina . . . . . . . . . . 2,157

South Dakota . . . . . . . . . . . 1,868

Tennessee. . . . . . . . . . . . . 1,922

Texas. . . . . . . . . . . . . . . . 2,179

Utah . . . . . . . . . . . . . . . . 1,483

Vermont . . . . . . . . . . . . . . 1,902

Virginia. . . . . . . . . . . . . . . 2,179

Washington . . . . . . . . . . . . 1,932

West Virginia . . . . . . . . . . . 2,022

Wisconsin . . . . . . . . . . . . . 1,970

Wyoming . . . . . . . . . . . . . 1,893

Page 4 [ Series 1, No. 43
is the result of a medical, behavioral, or

other health condition that has lasted or

is expected to last for 12 months or

longer. Those with affirmative answers

to the stem and the followup questions

are considered to have special health

care needs. This screener was also used

for the National Survey of CSHCN (5).

This section also includes a

question on children’s difficulties with

emotions, concentration, behavior, or

being able to get along with other

people. This question and its followup

were drawn from the impact supplement

to the Strengths and Difficulties

Questionnaire (SDQ) (12). Due to an

inadvertent error in the questionnaire

development process, the choices of

answers for the followup question do

not match the answer choices for the

copyrighted SDQ. Analysts should use

caution when comparing estimates

derived from the NSCH followup

question to estimates derived from the

proper SDQ impact question used in

other surveys (e.g., the NHIS).

3. Health Insurance Coverage—The

focus of this section is on establishing

whether the sampled child had any type

of private or public health care coverage

in the 12 months prior to the interview.

4. Health Care Access and

Utilization—The questions in this

section address the availability of

medical services for the sampled child

within the 12 months prior to the

interview and the degree to which these

services were needed and used during

that time period. A battery of questions

also assessed Hepatitis A vaccination

status for children aged 2 and over. The

Hepatitis A vaccination questions were

sponsored by the Division of Viral

Hepatitis at CDC’s National Center for

Infectious Diseases, using funding from

the National Vaccine Program Office.

5. Medical Home—The main goal of

this section was to determine whether

the sampled child had a primary health

care provider and to assess the quality

of care for, and communication with, the

sampled child and his/her parents or

guardians. The questions in this section

were also designed to determine whether

the child received special services such

as physical therapy, medical equipment,

special educational services, or

counseling, and whether the child’s

primary health care provider coordinated

care received from various providers

and services. Together, the items in this

section permit an assessment of whether

children have access to a ‘‘medical

home,’’ which is defined by the

American Academy of Pediatrics as

primary care that is accessible,

continuous, comprehensive, family

centered, coordinated, compassionate,

and culturally effective (13).

6. Early Childhood (0–5 years)—This

section, administered if the sampled

child was 5 years old or younger,

included questions about learning,

development, behavior, child care

arrangements, and the occurrence of

accidental injuries and poisonings in the

12 months prior to the interview. This

section included questions from the

Parent’s Evaluation of Developmental

Status (PEDS). The PEDS is a tool to

identify children at risk for

developmental, behavioral, or social

delays (14). Therefore, it was used in

this section as a risk assessment tool to

Table B. National Expert Panel members (September 2001)

Name Affiliation (in 2001)

Henry Bernstein, D.O. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Harvard University

Christina Bethell, Ph.D., M.B.A., M.P.H.1 . . . . . . . . . . . . . . . . . . . . . . . The Foundation for Accountability

Stephen Blumberg, Ph.D.1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . National Center for Health Statistics, CDC2

Claire Brindis, Dr.P.H.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . University of California at San Francisco

James Collins, Jr., M.D., M.P.H. . . . . . . . . . . . . . . . . . . . . . . . . . . . . Northwestern University

James Crall, D.D.S., Sc.D. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Columbia University

Marcie Cynamon, M.A.1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . National Center for Health Statistics, CDC2

Denise Dougherty, Ph.D.................................. Agency for Healthcare Research and Quality

Paula Duncan, M.D.1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . University of Vermont

V. Jeffrey Evans, Ph.D., J.D. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . National Institute for Child Health and Human Development, NIH3

Floyd Fowler, Jr., Ph.D.1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . University of Massachusetts, Boston

Katherine Grimes, M.D., M.P.H. . . . . . . . . . . . . . . . . . . . . . . . . . . . . Harvard University

Neal Halfon, M.D., M.P.H. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . University of California at Los Angeles

David Heppel, M.D.1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Maternal and Child Health Bureau, HRSA4

Donald Hernandez, Ph.D. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . State University of New York at Albany

Solomon Iyasu, M.D. ................................... Centers for Disease Control and Prevention

Michael Kogan, Ph.D.1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Maternal and Child Health Bureau, HRSA4

Cassie Lauver, A.C.S.W.1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Maternal and Child Health Bureau, HRSA4

Kristin Anderson Moore, Ph.D.1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . Child Trends

Paul Newacheck, Dr.P.H., M.P.P.1 (chairperson) . . . . . . . . . . . . . . . . . . University of California at San Francisco

Kerry Nesseler, R.N., M.S.N.1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Maternal and Child Health Bureau, HRSA4

Matthew Stagner, Ph.D. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The Urban Institute

Ruth Stein, M.D.1 ..................................... Yeshiva University

Betty Thompson, M.S.N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Metropolitan Health Department (Nashville)

Peter van Dyck, M.D., M.P.H.1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Maternal and Child Health Bureau, HRSA4

Michael Weitzman, M.D. ................................. Center for Child Health Research

Jerry West, Ph.D. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . National Center for Education Statistics

Cindy White . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Family Voices

1This denotes the person was also a member of the Technical Expert Panel (TEP).

2CDC is Centers for Disease Control and Prevention.

2NIH is National Institutes of Health.

4HRSA is Health Resources and Services Administration.

Series 1, No. 43 [ Page 5
identify children who either have or are

more likely to have problems.

Researchers interested in analyzing the

PEDS data should consult the PEDS

documentation for scoring instructions

(15). (Health care providers wishing to

use PEDS in practice to assess risk

status or to make decisions about

developmental status for individual

children must use the clinical version of

the test, which can be obtained from

Ellsworth & Vandermeer Press, LLC

(14). It was not used for the NSCH.)

National data on the PEDS are also

available from the 2000 National Survey

of Early Childhood Health (4).

7. Middle Childhood and Adolescence

(6–17 years) —This section,

administered if the sampled child was

aged 6 years or over, focused on school

performance, activities outside school,

and behaviors exhibited by the child.

Respondents were also asked about their

attendance at the sampled child’s events

and activities; whether they had met all,

some, or none of the sampled child’s

friends; and the amount of time the

sampled child spent caring for himself

or herself.

This section includes a series of

questions about social competence,

behavior problems, and depression.

Several of these questions (S7Q41,

S7Q44, S7Q45, S7Q48, S7Q56, S7Q62,

and S7Q63) were drawn from the

Behavior Problems Index (16). S7Q52

was from the Positive Behaviors Scale

(17). Others were developed by

researchers from Child Trends for use in

this survey. In collaboration with

researchers at the U.S. Census Bureau

and Child Trends, NCHS is in the

process of validating scales based on

these questions and producing scaled

scores for public release. Contact

SLAITS staff (slaits@cdc.gov) for more

information.

8. Family Functioning—The goal of

this section was to determine the

number of recreational outings and

religious services attended by the

sampled child, the level of parental

involvement with the sampled child, and

the level of stress on the family

resulting from the demands of parenting.

Four of the parental stress questions

(S8Q07–10) comprise the Aggravation

in Parenting Scale, which was derived

from the Parental Stress Index (18) and

the Parental Attitudes about Childrearing

scale (19). It has been used previously

in the Panel Survey of Income

Dynamics, the Survey of Income and

Program Participation, and the Survey of

Program Dynamics. Analysts should

note that prior research revealed that the

Aggravation in Parenting Scale has

limited cultural validity among

Spanish-speaking Latino parents (20).

Removal of a single question (S8Q09)

from the scale improved the measure for

this group.

This section also includes several

questions about how families deal with

serious disagreements. These questions

were drawn from the National Survey of

Families and Households and from the

Early Childhood Longitudinal Survey.

They were modified slightly to refer to

all household members.

9. Parental Health—Questions in this

section were designed to obtain the

number and type of parents (or people

acting as parents) who lived inside or

outside the sampled child’s household

and to assess the physical, mental, and

emotional health, and insurance status of

the parents living in the household (or

of the respondent if he or she was not

the child’s parent).

10. Neighborhood Characteristics—

The primary goal of this section was to

ascertain the respondents’ perceptions of

their neighborhoods and to determine

the degree to which the respondents

believed their children were safe in the

neighborhood and in school. Four of the

questions in this section (S10Q01–03,

S10Q05) consider parents’ perceived

level of neighborhood social capital,

focusing specifically on positive aspects

of social capital relating to children

(21). This concept, alternatively called

‘‘social support,’’ is similar to the

concept of ‘‘social cohesion and trust,’’

which is related to variations in violence

among inner-city neighborhoods (22).

These questions were originally

developed for the Longitudinal Studies

of Child Abuse and Neglect and have

also been used for the Survey of Income

and Program Participation.

11. Additional Demographic

Characteristics—In this section,

respondents were asked a series of

demographic questions, including the

number of times the family had moved

since the child was born, household

utilization of assistance from county

welfare programs, and the household’s

ZIP code. Additional questions

determined the race and ethnicity of the

child and whether the child and his or

her parents were born in the United

States.

This section also included questions

on family income. The annual family

income was mapped to Department of

Health and Human Services (HHS)

Federal Poverty Guidelines for

households. This mapping made it

possible to determine whether the

family’s income was below the

household poverty level and, if so, to

quantify its poverty status.

‘‘Appendix III’’ includes a copy of

the NSCH questionnaire, ‘‘Appendix

IV’’ provides a list of changes made in

the questionnaire over the course of the

study, and ‘‘Appendix V’’ has the HHS

Federal Poverty Guidelines tables used

to determine household poverty status

during interview administration and a

description of the process for assigning

poverty status to households.

CATI Programming

The NSCH was conducted using a

computer-assisted telephone

interviewing (CATI) system. The CATI

data collection software presents the

questionnaire on computer screens to

each interviewer. The program guides

the interviewer through the

questionnaire, automatically routing the

interviewer to appropriate questions

based on answers to previous questions.

Interviewers enter survey responses

directly into the computer; the CATI

program determines whether the selected

response is within an allowable range,

checks it for consistency against other

data collected during the interview, and

saves the responses in a survey data file.

Online help facilities are available to aid

interviewers. This data collection

technology reduces the time required for

transferring, processing, and releasing

data, and promotes data accuracy.

The NSCH questionnaire was

programmed as a module of the NIS,

integrating the two surveys into a single

interview. The instrument made full use

Page 6 [ Series 1, No. 43
of the CATI system’s ability to check

whether a response was within a

legitimate range, to follow skip patterns,

to fill State-specific information in

questions as applicable (for example,

names of State health insurance

programs), and to employ ‘‘pick lists’’

for response categories. Certain

household and demographic questions

were identical in the NIS and the NSCH

portions of the interview. If a respondent

answered these questions during NIS

administration, the system was

programmed so that the questions were

not repeated in the NSCH. Instead, the

answers to these questions in the NIS

were copied to the data file for the

NSCH, as appropriate. Once initial

programming was completed, the

instrument underwent rigorous testing to

ensure correct functioning of the CATI

system.

Interviewer Training

Abt Associates Incorporated and

their subcontractors conducted all

interviews for the NIS and NSCH. The

initial NIS and NSCH data collection

staff was recruited from among

experienced NIS interviewers during

December 2002. To offset interviewer

attrition, interviewer recruitment and

training continued throughout 2003.

Interviewer training was conducted in

Abt Associates’ telephone centers in

Chicago, Illinois; Las Vegas, Nevada;

and Amherst, Massachusetts. The use of

several telephone centers made it

possible to maintain the level of

interviewer coverage needed to call such

a large sample in multiple time zones.

(Interviews were conducted from 9 a.m.

to 9 p.m. in each of the six time zones

covered by the 50 States.) The numbers

of interviewers who completed training

each month in each location are shown

in table C.

Training sessions began with an

explanation of the goals of the study, its

sponsors, why the study was being

conducted, and what it was designed to

accomplish, as well as a description of

the target for the number of completed

interviews and the expected time frame

for data collection. Next, trainers

discussed how the NSCH was designed

to seamlessly follow the NIS screening

(and interview for age-eligible children),

including information about the

age-eligibility ranges for the two studies,

the length of time required to conduct

both surveys, and the procedures to be

followed for gaining cooperation for

each study.

Mock interviews were conducted to

acquaint interviewers with the

questionnaire and to provide them with

the project knowledge and refusal

aversion skills necessary to conduct an

interview. Two types of mock interviews

were performed: trainer-led interviews

in which the trainer played the role of

the respondent and the interviewers

conducted the interview using the CATI

system, and dual-trainee interviews in

which one trainee performed the role of

the interviewer and another acted as the

respondent. Emphasis was placed on the

skills necessary to display project

knowledge and gain cooperation,

including in-class practice of answers to

questions frequently asked by

respondents and refusal aversion

techniques along with role-playing

exercises.

Final review exercises at the

conclusion of each training session

consisted of a question-and-answer

discussion summarizing the topics

taught during the session and an

interactive review modeled on a gameshow format in which interviewers split

into two teams and competed for points

based on project knowledge and refusal

aversion techniques.

A final test mock interview and

written evaluation were administered at

the end of each training session. The

final mock interview was standardized,

thus allowing interviewers to be

evaluated against the same standard on

their ability to navigate through CATI,

gain cooperation, and display project

knowledge. The written evaluation was

administered to reinforce what was

learned during the training sessions.

Each trainer received a written

evaluation answer guide to rate the

proficiency level of the interviewer.

Interviewers had to successfully

complete both evaluations before they

were permitted to collect data for the

NSCH.

Data Collection

Telephone interviewing began on

January 29, 2003, and was completed on

July 1, 2004, resulting in a total of

102,353 interviews. Table D shows the

total number of interviews completed by

month. Because 87% of the interviews

had been completed by the end of 2003,

this survey is referred to as the 2003

National Survey of Children’s Health.

Pretests

Two NSCH pretests were fielded.

The first was designed to assess

respondent comprehension of interview

questions and to provide an estimate of

questionnaire length. The second

incorporated questionnaire revisions

based on the first pretest and was

designed to ensure that all systems were

working properly prior to beginning the

main study.

Table C. Number of interviewers trained by month and telephone center location

Month Chicago Las Vegas Amherst Total

All months . . . . . . . . . . . . . . . . . . . . . . . . . 514 331 308 1,153

January 2003 . . . . . . . . . . . . . . . . . . . . . . . 196 58 25 279

February 2003 . . . . . . . . . . . . . . . . . . . . . . 31 25 12 68

March 2003 . . . . . . . . . . . . . . . . . . . . . . . . 39 56 16 111

April 2003 . . . . . . . . . . . . . . . . . . . . . . . . . 45 20 46 111

May 2003 . . . . . . . . . . . . . . . . . . . . . . . . . 44 0 28 72

June 2003 . . . . . . . . . . . . . . . . . . . . . . . . 28 39 38 105

July 2003 . . . . . . . . . . . . . . . . . . . . . . . . . 33 43 59 135

September 2003 . . . . . . . . . . . . . . . . . . . . . 9 12 22 43

October 2003 . . . . . . . . . . . . . . . . . . . . . . . 56 60 31 147

November 2003 . . . . . . . . . . . . . . . . . . . . . 33 18 31 82

Series 1, No. 43 [ Page 7
The first pretest, conducted between

June 12 and June 26, 2002, in 15 States

(Arkansas, Connecticut, Delaware,

Georgia, Indiana, Kansas, Kentucky,

Louisiana, Maine, Maryland, North

Dakota, Pennsylvania, Vermont,

Virginia, Washington) and the District of

Columbia, resulted in 922 completed

interviews. The administration time for

the interview was longer than

anticipated, at approximately 41 minutes

on average. Based on these results, the

questionnaire was substantially

shortened. A particular focus was placed

on eliminating items that, based on

observations of the interviews and an

evaluation of the resulting data, seemed

difficult for respondents to comprehend

or did not appear to elicit the desired

information. In addition, a number of

enhancements to question text and

ordering were made.

The second pretest, conducted

between December 10, 2002, and

February 25, 2003, in four States

(California, Florida, Illinois, and Texas),

resulted in 119 completed interviews.

The questionnaire incorporated revisions

based on the results of the first pretest

and included a battery of new questions

designed to assess Hepatitis A

vaccination coverage among children

aged 2 years and over. In late

December, the objective of the second

pretest (to ensure that all systems were

ready for the main study) had been met.

However, because this pretest was

implemented using an NIS sample, data

collection continued throughout the NIS

data collection period, thus overlapping

with main study data collection for the

NSCH.

Few changes were made to the

questionnaire following the second

pretest. Still, no data collected during

the pretests have been included in the

publicly released data files for the

NSCH.

Advance Letter

Advance letters have been shown to

decrease nonresponse by increasing

study legitimacy (23). An advance letter

(‘‘Appendix VI’’) was mailed prior to

any telephone calls and was mailed

when a mailing address could be

identified for a sampled telephone

number. Letters were mailed for 67.4%

of the telephone numbers dialed by the

interviewers, which was 39.5% of the

telephone numbers randomly generated.

(Some known business and nonworking

telephone numbers are removed from

the sample of randomly generated

telephone numbers prior to dialing.)

In the letter, recipients were asked

to participate in a voluntary study on the

immunization status of their children

and the types of health and related

services that their children need and use.

The letter advised recipients that their

telephone numbers had been chosen

randomly and indicated that they might

be called in the next few weeks. A

toll-free telephone number was provided

for those who wished to participate

immediately or to learn more about the

study.

Toll-Free Telephone

Number

A toll-free telephone number was

provided in the advance letter, in

answering machine messages, and by

interviewers at the request of

respondents. Potential respondents could

use this number to alert interviewers

that there were no children in the

study’s age range living or staying in

their household, to ask questions about

the study, or to complete an interview.

During the course of data collection,

9,209 calls were received on this line.

(This figure excludes calls received

during the incentive effort. Calls

received during that effort are described

in ‘‘Appendix II’’.) Of these 9,209 calls,

75.6% indicated that the household did

not have a child eligible for the study. A

total of 1,248 respondents who called

the toll-free telephone number

completed an interview.

Informed Consent

Consent for participation in the

study was obtained from NSCH

respondents as soon as it was

determined that their household

contained an age-eligible child.

Respondents were informed about the

voluntary nature of the survey, the

authorizing legislation, and

confidentiality of data collected. In

addition, the informed consent script

provided information about the content

of the survey and the expected duration.

The informed consent process also

ensured that the person most

knowledgeable about the sampled

child’s health had received the consent

information and agreed to participate. In

accordance with HHS regulations (45

CFR 46), these procedures were

reviewed by the NCHS Research Ethics

Review Board (ERB) and the Abt

Associates Institutional Review Board

(IRB). Approval for data collection was

Table D. Number of interviews completed by month

Month Number1 Percent

All months ......................... 102,353 100.00

January 2003 . . . . . . . . . . . . . . . . . . . . . . . 6 0.01

February 2003 . . . . . . . . . . . . . . . . . . . . . . 4,822 4.71

March 2003 . . . . . . . . . . . . . . . . . . . . . . . . 7,118 6.95

April 2003 . . . . . . . . . . . . . . . . . . . . . . . . . 6,471 6.32

May 2003 . . . . . . . . . . . . . . . . . . . . . . . . . 8,163 7.98

June 2003 . . . . . . . . . . . . . . . . . . . . . . . . 8,038 7.85

July 2003 . . . . . . . . . . . . . . . . . . . . . . . . . 8,102 7.92

August 2003 . . . . . . . . . . . . . . . . . . . . . . . 10,058 9.83

September 2003 . . . . . . . . . . . . . . . . . . . . . 6,616 6.46

October 2003 . . . . . . . . . . . . . . . . . . . . . . . 8,784 8.58

November 2003 . . . . . . . . . . . . . . . . . . . . . 12,153 11.87

December 2003 . . . . . . . . . . . . . . . . . . . . . 8,986 8.78

January 2004 . . . . . . . . . . . . . . . . . . . . . . . 5,166 5.05

February 2004 . . . . . . . . . . . . . . . . . . . . . . 1,383 1.35

March 2004 . . . . . . . . . . . . . . . . . . . . . . . . 3,801 3.71

April 2004 . . . . . . . . . . . . . . . . . . . . . . . . . 782 0.76

May 2004 . . . . . . . . . . . . . . . . . . . . . . . . . 448 0.44

June 2004 . . . . . . . . . . . . . . . . . . . . . . . . 1,443 1.41

July 2004 . . . . . . . . . . . . . . . . . . . . . . . . . 13 0.01

1Number of completed interviews includes all interviews completed through the first question on family functioning (Section 8).

Page 8 [ Series 1, No. 43
received in April 2002 from the NCHS

ERB and in May 2002 from the Abt

Associates IRB.

Assurance of

Confidentiality

Participation in surveys conducted

by NCHS is voluntary, and information

collected on individuals is confidential.

For the NSCH, assurance of

confidentiality was given to potential

respondents as part of the informed

consent procedures. In the CATI system,

interviewers acknowledged that they had

read the following script to potential

respondents:

Before we get to questions about

the health of [CHILD], I’d like you

to know that your answers will be

kept strictly private, as required by

the U.S. Public Health Service Act.

Your participation in this research

is voluntary. You may choose not to

answer any question you don’t want

to answer or stop at any time

without penalty.

If a respondent requested more

information on the U.S. Public Health

Service Act, the interviewer read the

following:

The Public Health Service Act is

Volume 42 of the U.S. Code, Section

242k. The collection of information

in this survey is authorized by

Section 306 of this Act. The

confidentiality of your responses is

assured by Section 308d of this Act.

Section 308d of the Public Health

Service Act (42 U.S.C. 242m) states

that:

No information, if an establishment

or person supplying the information

or described in it is identifiable,

obtained in the course of activities

undertaken or supported under

section. . .306. . .may be used for

any purpose other than the purpose

for which it was supplied unless

such establishment or person has

consented (as determined under

regulations of the Secretary) to its

use for such other purpose and in

the case of information obtained in

the course of health statistical or

epidemiological activities under

section . . .306, such information

may not be published or released in

other form if the particular

establishment or person supplying

the information or described in it is

identifiable unless such

establishment or person has

consented (as determined under

regulations of the Secretary) to its

publication or release in other form.

Strict procedures are used to prevent

disclosure of confidential data in survey

operations and data dissemination.

Respondent Selection

The respondent for the NSCH was

the adult in a household who was most

knowledgeable about the sampled

child’s health and health care. In over

95% of households, the respondent was

the child’s mother/female guardian or

father/male guardian. Table E shows the

frequency distribution of the relationship

of study respondents to the sampled

child. If any children in the household

were eligible for the NIS, the respondent

for the NSCH was almost always the

same as the respondent for the NIS.

Spanish-Language

Interviewing

NSCH interviews were administered

in Spanish as well as in English. A

professional translator with extensive

experience in the translation of health

surveys produced a Spanish-language

version of the NSCH questionnaire. A

team of experienced Spanish-language

telephone interviewers and supervisors

reviewed the translation and evaluated it

for accuracy and cultural

appropriateness. Issues raised during this

review were resolved in consultation

with the original translator, and a

Spanish-language CATI instrument

reflecting the final translation was

produced.

When a monolingual interviewer

contacted someone who seemed to only

speak Spanish, the interviewer assigned

the telephone number to a special

calling queue. A CATI flag indicated

such cases. Cases with this flag were

then delivered, via the CATI system, to

bilingual interviewers who were

specially trained to conduct interviews

in both Spanish and English. A total of

12,793 households in the Spanishlanguage queue were screened, resulting

in 6,035 Spanish-language detailed

interviews. These cases account for

2.5% of all screened households and

5.9% of all detailed interviews

completed.

Interview Length

Mean and median interview length

varied by NIS eligibility because some

demographic and household questions

necessary for both the NIS and the

NSCH were administered as part of the

NIS interview and not repeated during

the NSCH interview. The average

interview length for NIS-ineligible

households was 28 minutes and 53

seconds, and the median time was 27

minutes and 27 seconds. For NISeligible households, the average

interview length (excluding the NIS

interview itself) was 23 minutes and 25

seconds, and the median time was 21

minutes and 48 seconds. Mean and

median interview lengths, by section and

NIS eligibility, appear in table F.

Table E. Number and percent of respondents by relationship to sampled child

Relationship of respondent to sampled child Number Percent

Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . 102,353 100.0

Mother or female guardian. . . . . . . . . . . . . . . 80,472 78.6

Father or male guardian . . . . . . . . . . . . . . . . 17,736 17.3

Grandparent . . . . . . . . . . . . . . . . . . . . . . . 2,823 2.8

Aunt or uncle . . . . . . . . . . . . . . . . . . . . . . . 589 0.6

Sister or brother . . . . . . . . . . . . . . . . . . . . . 479 0.5

Other family member . . . . . . . . . . . . . . . . . . 106 0.1

Other nonrelative. . . . . . . . . . . . . . . . . . . . . 91 0.1

In-law of any type . . . . . . . . . . . . . . . . . . . . 32 <0.1

Don’t know/refused/missing . . . . . . . . . . . . . . 25 <0.1

Series 1, No. 43 [ Page 9
Interview Breakoffs

In cases where an interview was

begun but not completed, specially

trained interviewers attempted refusal

conversion. By the end of the data

collection period, 9,507 interviews were

completed with households that had

originally refused to participate (9.3% of

completed interviews).

There remained 43,552 identified

households with children (2.3% of the

initial sample) in which an interview

was not completed. Of these households,

2,918 broke off during administration of

the NIS interview, which preceded the

NSCH interview. For the remaining

40,634 breakoff cases, the vast majority

stopped during one of the three early

stages of the NSCH interview: during

the child rostering and sampling process

(38.9% of such cases), during the

process of identifying the most

knowledgeable respondent for the

sampled child (12.0%), or during the

informed consent process (37.5%).

Among the 4,714 cases that stopped the

interview after a child had been sampled

and the correct respondent identified

(11.6% of the breakoff cases; 0.3% of

the initial sample), there was little

commonality in breakoff location.

Cases Pending at Close of

Data Collection

The mean number of calls made to

complete an interview was eight, with a

median of five calls. Most of the cases

pending at the end of the data collection

period were ones in which the telephone

number had not yet been resolved as

residential or nonresidential (67.2% of

the pending cases and 15.7% of the

initial sample). A smaller number of

cases had been identified as residential

households without determining if a

child was living in the household, and a

similarly small number of households

with a child did not complete the

interview (2.0% and 2.3% of the initial

sample, respectively).

Incentive Effort

During NSCH data collection, study

response rates were lower than would be

expected from the rates observed in the

earlier SLAITS projects. A review of the

NSCH rates made it clear that

increasing the interview completion rate

(the percentage of completed interviews

among eligible households) would have

the most impact on the overall response

rate. Therefore, known households with

children in which an interview was not

completed became part of an incentive

effort designed to increase response. An

initial pretest was mounted to test the

effect of cash incentives on response.

Because of the success of this pretest,

the use of incentives was substantially

expanded. ‘‘Appendix II’’ discusses the

methodology and results of the incentive

effort.

Response Rates

Response rates provide one measure

of the potential for nonresponse

bias—that is, the possibility that the

sample interviewed differs from the

actual population in some meaningful

way. Weighted response rates were

calculated for the NSCH to reflect the

potential for nonresponse bias nationally

and in each State (table G). These

response rates, based on the Council of

American Survey Research

Organizations (CASRO) guidelines,

were produced and calculated in

accordance with the American

Association for Public Opinion

Research’s Standard Definitions: Final

Dispositions of Case Codes and

Outcome Rates for Surveys (24). The

calculation used the assumptions for

Response Rate #3 detailed by

Ezzati-Rice et al. (25) with one

exception. Based on recent research to

estimate the percentage of residential

telephone numbers among unresolved

numbers that had been finalized as

‘‘ring-no-answer at all attempts,’’ such

ring-no-answer cases were redistributed:

20.4% were categorized as known

households and 79.6% were categorized

as out-of-scope (26). Response rates

reflect this adjustment.

The interview completion rate, a

measure of the proportion of completed

interviews among known households

with children, was 68.8%. The screener

completion rate, which measures the

proportion of known households where

a resident reported whether a child lived

in the household, was 87.8%. The

resolution rate, indicating the proportion

of telephone numbers that could be

positively identified as residential or

nonresidential, was 91.6%. The overall

response rate (the product of these three

rates) was 55.3%. State response rates

ranged from 49.6% in New Jersey to

64.4% in South Dakota, with 32 States

achieving overall response rates above

55%.

The final disposition of the NSCH

sample is shown in table H. More

detailed information on final sample

disposition and unweighted national

response rate calculations are in

‘‘Appendix VII.’’

Table F. Mean and median length of the National Survey of Children’s Health interview by

National Immunization Survey eligibility (in minutes and seconds)

NIS-eligible

households

NIS-ineligible

households

Mean Median Mean Median

Overall length. . . . . . . . . . . . . . . . . . . . . . . 23:25 21:48 28:53 27:27

Screener. . . . . . . . . . . . . . . . . . . . . . . . . . 1:44 0:58 2:26 1:36

Section 1: Age Eligibility Screening

and Demographic Characteristics . . . . . . . . . . 0:30 0:23 0:43 0:37

Section 2: Health and Functional Status . . . . . . 3:44 3:24 4:22 4:01

Section 3: Health Insurance Coverage . . . . . . . 0:43 0:39 0:44 0:40

Section 4: Health Care Access and Utilization . . . 2:02 1:52 2:08 1:57

Section 5: Medical Home. . . . . . . . . . . . . . . . 2:17 2:15 2:22 2:19

Section 6: Early Childhood . . . . . . . . . . . . . . 3:12 3:00 3:19 3:07

Section 7: Middle Childhood and Adolescence . . 6:10 6:28 7:28 6:54

Section 8: Family Functioning . . . . . . . . . . . . . 2:50 2:37 2:52 2:40

Section 9: Parental Health . . . . . . . . . . . . . . . 1:45 1:37 1:50 1:42

Section 10: Neighborhood and Community

Characteristics . . . . . . . . . . . . . . . . . . . . . 1:26 1:19 1:29 1:22

Section 11: Additional Demographics . . . . . . . . 2:18 1:55 3:39 3:16

Page 10 [ Series 1, No. 43
Because of the repeated quarterly

selection of NIS sample in each IAP

area, some telephone numbers were

selected more than once over the course

of the NSCH data collection period.

Such numbers were not contacted a

second time for the study. Instead, these

cases were automatically finalized.

Response rates reflect the final

disposition of a telephone line from its

original sampling.

Efforts to Maximize

Response Rates

Approaches used to maximize

response rates included:

+ Thorough pretesting of the survey

instrument to ensure that it was

clear to respondents and not unduly

burdensome.

+ An advance mailing to households

having directory-listed telephone

numbers to establish the legitimacy

of the study, increase rapport prior

to the first contact, and convey

information about the strict

confidentiality protections.

+ A toll-free telephone number to

allow respondents to contact

interviewers, obtain information

about the study, establish study

eligibility, or voice any concerns.

+ A Spanish-language version of the

survey instrument to reduce

nonresponse bias among Spanishspeaking households.

+ A sample management plan that

ensured the correct number of cases

were in the field at any given time

and provided daily review of the

status of appointment and refusal

cases to ensure timely recontact.

+ Flexible calling schedules to permit

respondents to complete the

interview at their convenience.

+ An interviewer training program in

refusal aversion to reduce the

number of unresolved cases and

refusals from eligible respondents.

+ Refusal conversion attempts by

specially trained interviewers, who

Table G. Weighted response rates by State

State

Resolution

rate

Screener

completion

rate

Interview

completion

rate

CASRO1

rate

National . . . . . . . . . . . . . . . . . . . . . . . . . . 91.6 87.8 68.8 55.3

Alabama . . . . . . . . . . . . . . . . . . . . . . . . . . 90.4 88.5 70.7 56.5

Alaska . . . . . . . . . . . . . . . . . . . . . . . . . . . 96.0 88.4 71.2 60.4

Arizona. . . . . . . . . . . . . . . . . . . . . . . . . . . 92.0 88.0 64.8 52.5

Arkansas . . . . . . . . . . . . . . . . . . . . . . . . . 93.6 90.7 66.3 56.3

California . . . . . . . . . . . . . . . . . . . . . . . . . 91.1 86.3 66.2 52.1

Colorado. . . . . . . . . . . . . . . . . . . . . . . . . . 93.1 88.1 71.2 58.4

Connecticut . . . . . . . . . . . . . . . . . . . . . . . . 90.0 87.9 68.9 54.5

Delaware . . . . . . . . . . . . . . . . . . . . . . . . . 88.8 86.4 69.8 53.5

District of Columbia . . . . . . . . . . . . . . . . . . . 93.1 81.8 68.6 52.3

Florida . . . . . . . . . . . . . . . . . . . . . . . . . . . 89.4 87.0 65.6 51.0

Georgia . . . . . . . . . . . . . . . . . . . . . . . . . . 91.3 87.4 65.2 52.1

Hawaii . . . . . . . . . . . . . . . . . . . . . . . . . . . 93.0 89.1 61.0 50.5

Idaho . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93.7 90.5 71.7 60.8

Illinois . . . . . . . . . . . . . . . . . . . . . . . . . . . 91.7 86.9 68.8 54.8

Indiana . . . . . . . . . . . . . . . . . . . . . . . . . . . 92.3 89.6 66.8 55.2

Iowa . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94.0 90.0 66.9 56.5

Kansas. . . . . . . . . . . . . . . . . . . . . . . . . . . 93.3 90.0 70.4 59.1

Kentucky. . . . . . . . . . . . . . . . . . . . . . . . . . 92.6 89.7 72.0 59.9

Louisiana . . . . . . . . . . . . . . . . . . . . . . . . . 91.9 87.3 69.2 55.5

Maine. . . . . . . . . . . . . . . . . . . . . . . . . . . . 89.9 88.1 69.9 55.3

Maryland. . . . . . . . . . . . . . . . . . . . . . . . . . 90.1 85.8 68.5 53.0

Massachusetts . . . . . . . . . . . . . . . . . . . . . . 91.0 87.5 67.3 53.6

Michigan . . . . . . . . . . . . . . . . . . . . . . . . . . 92.3 87.8 72.6 58.9

Minnesota . . . . . . . . . . . . . . . . . . . . . . . . . 93.8 90.3 69.6 58.9

Mississippi. . . . . . . . . . . . . . . . . . . . . . . . . 91.0 87.5 67.3 53.6

Missouri . . . . . . . . . . . . . . . . . . . . . . . . . . 93.0 90.1 73.1 61.2

Montana . . . . . . . . . . . . . . . . . . . . . . . . . . 94.4 91.9 71.4 62.0

Nebraska . . . . . . . . . . . . . . . . . . . . . . . . . 94.3 91.1 71.8 61.6

Nevada . . . . . . . . . . . . . . . . . . . . . . . . . . 90.3 87.0 68.4 53.7

New Hampshire . . . . . . . . . . . . . . . . . . . . . 90.2 87.8 64.7 51.3

New Jersey . . . . . . . . . . . . . . . . . . . . . . . . 88.7 83.0 67.3 49.6

New Mexico. . . . . . . . . . . . . . . . . . . . . . . . 93.5 88.2 71.4 58.8

New York . . . . . . . . . . . . . . . . . . . . . . . . . 91.2 87.0 67.2 53.3

North Carolina . . . . . . . . . . . . . . . . . . . . . . 91.4 89.0 72.9 59.3

North Dakota . . . . . . . . . . . . . . . . . . . . . . . 94.5 91.1 69.1 59.5

Ohio . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92.1 89.3 73.4 60.4

Oklahoma . . . . . . . . . . . . . . . . . . . . . . . . . 92.8 89.4 66.2 54.9

Oregon. . . . . . . . . . . . . . . . . . . . . . . . . . . 93.4 90.4 68.1 57.5

Pennsylvania . . . . . . . . . . . . . . . . . . . . . . . 91.6 88.1 71.4 57.7

Rhode Island . . . . . . . . . . . . . . . . . . . . . . . 90.0 89.4 71.0 57.1

South Carolina . . . . . . . . . . . . . . . . . . . . . . 90.4 87.7 70.0 55.5

South Dakota . . . . . . . . . . . . . . . . . . . . . . . 95.3 91.9 73.5 64.4

Tennessee. . . . . . . . . . . . . . . . . . . . . . . . . 91.4 88.5 64.6 52.2

Texas. . . . . . . . . . . . . . . . . . . . . . . . . . . . 92.1 87.2 70.6 56.7

Utah . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94.4 88.7 76.4 64.0

Vermont . . . . . . . . . . . . . . . . . . . . . . . . . . 93.3 90.6 71.5 60.4

Virginia. . . . . . . . . . . . . . . . . . . . . . . . . . . 91.2 87.3 71.1 56.7

Washington . . . . . . . . . . . . . . . . . . . . . . . . 92.6 89.2 65.4 54.0

West Virginia . . . . . . . . . . . . . . . . . . . . . . . 90.4 90.2 69.2 56.4

Wisconsin . . . . . . . . . . . . . . . . . . . . . . . . . 93.0 90.2 65.9 55.3

Wyoming . . . . . . . . . . . . . . . . . . . . . . . . . 94.3 91.2 69.7 60.0

1CASRO is Council of American Survey Research Organizations. The CASRO rate is the product of the resolution rate, the

screener completion rate, and the interview completion rate.

Table H. Final disposition of the National

Survey of Children’s Health sample

Final Disposition

Number of

Selected

Telephone

Lines

Total . . . . . . . . . . . . . . . . . . . . . 1,872,194

Not resolved as residential/

nonresidential............... 294,200

Out of scope (i.e., business,

nonworking). . . . . . . . . . . . . . . . 1,025,036

Known household, age eligibility not

determined . . . . . . . . . . . . . . . . 37,520

Screened household, no child in age

range .................... 367,087

Screened eligible household,

language barrier . . . . . . . . . . . . . 2,446

Screened eligible household,

interview not completed . . . . . . . . 43,552

Screened eligible household, partially

completed interview . . . . . . . . . . . 1,047

Completed interview ........... 101,306

NOTE: The 1,047 partially completed interviews noted above

were determined to have sufficient data to include them in the

final data file, bringing the total number of completed

interviews in the file to 102,353.

Series 1, No. 43 [ Page 11
prepared case-specific strategies for

each conversion call based on call

history.

+ Monetary incentives for respondents

who had eligible children, but who

did not initially participate.

Quality Control

The prepared sample of telephone

numbers was checked to ensure that it

met the sample design specifications.

The sample was monitored on a daily

basis to ensure that the pace of data

collection was consistent across the data

collection period and to prevent the

release of excess cases to the telephone

centers. Daily analyses of the dynamics

in the sample were produced to assist in

timely sample management decisionmaking.

Telephone center supervisors were

available to interviewing staff at all

times to resolve any questions or

concerns about a case. Supervisors

regularly observed the data collection

process to informally monitor

interviewers. In addition, supervisory

staff used remote telephone and

computer monitoring technologies to

evaluate whether the interviewers were

performing according to project

specifications. They focused on whether

introductory materials were properly

read, item wording and sequence of the

questionnaire were followed correctly,

respondent questions were answered

properly, and any vague responses were

properly probed. Computer monitoring

also allowed supervisors to ascertain

whether answers were entered accurately

into the CATI system.

Supervisory staff monitored 5% of

all NSCH calls made. Selection of

interviewers for monitoring was

automated using an algorithm that

ensured newly trained interviewers were

monitored more often than experienced

interviewers. Experienced interviewers

were prioritized for monitoring based

upon the length of time since their last

monitoring session and recent

monitoring scores. Each interviewer was

typically monitored at least once a

week, but some interviewers were

monitored more often.

The CATI system was programmed

to help ensure complete and accurate

data collection, using automated data

checking techniques, such as responsevalue range checks and consistency

edits, during the interview process.

These features enabled interviewers to

obtain needed clarifications while still

on the telephone with the respondent.

Throughout the data collection

period, modified versions of the

programs that were ultimately used to

clean the final data produced weekly

checks of the interview data. These

programs identified any out-of-range

values and incorrect skip logic, and also

looked for missing data elements and

inconsistency among data fields. If any

data were missing from the CATI

system, the cases were recontacted, and

data were recorded on a hard copy of

the survey. The additional data were

entered manually into the CATI system,

with review by project staff to ensure

correctness.

Weighting and

Estimation Procedures

To obtain population-based

estimates, each sampled child for whom

an interview was completed is assigned

a sampling weight. This weight should

be used for all analyses. The sampling

weight is composed of a base sampling

weight, an adjustment for multiple

telephone lines within a household, and

various adjustments for nonresponse.

The final, adjusted weight is

poststratified so that the sum of the

weights for each State equals the

number of children in the State, as

determined from the July 2003 U.S.

Census Bureau estimates and the 5%

Public Use Microdata Sample (PUMS)

files from Census 2000.

The various steps in the production

of the sampling weight are described

below. This section is intended as a

nontechnical overview of NSCH

weighting procedures. A more detailed

technical description is in ‘‘Appendix

I.’’

Base Sampling Weight

The goal of the NSCH was to

complete approximately 2,000

interviews in each State. First, the total

number of telephone lines required to

obtain this number of completed

interviews was estimated. Then, an NIS

sample adequate to obtain the requisite

number of completed cases for the

NSCH for each quarter was selected.

The telephone lines selected to be

screened represent a random sample of

all possible telephone lines in each

geographic area. The probability that

any given telephone line will be selected

from the population of all possible

telephone lines can be calculated.

If there were 1,000 total telephone

lines in a given area and 100 of those

lines were selected for the study, the

probability that any single telephone line

would be selected is 100/1000, or 0.10.

Thus, each telephone line selected

represents some larger number of

telephone lines in the geographic area.

This number can be calculated as the

reciprocal of the probability of selection

for any single telephone line.

If the probability of selection for

any single telephone line was 0.10, then

each telephone line selected represents

1/0.10, or 10, telephone lines in the

geographic area. This number—the

reciprocal of the probability of selection

for any single telephone line—is the

base sampling weight for each

completed interview in that geographic

area. The base sampling weight varied

by geographic area, but was the same

for every completed interview within

that geographic area. Because the

population of telephone numbers did not

change much by quarter, the base

sampling weight was calculated for the

overall survey and not separately for

each quarter.

Adjustment for Households

with Multiple Telephone

Lines

If a household has multiple

voice-use telephone lines, it has a

greater chance of being included in the

survey than does a household with only

Page 12 [ Series 1, No. 43
a single voice-use telephone line.

Because the NSCH is a survey of

households with children, each

household should have an equal

probability of being in the sample. To

adjust for the increased probability of

multiple-telephone households being

included in the sample, the base

sampling weight is divided by the

number of voice-use telephone lines in

the household to a maximum of three

lines.

If a household had two voice-use

telephone lines, it could be included in

the sample two times. If it were

included twice and its base sampling

weight was 10, the household would

represent 10 (base sampling weight) x 2

(number of telephone lines) = 20

households. To adjust the weight so that

a multiple-line household in the sample

represents the same number of

households in the geographic area as

does a single-line household in the

sample, the base sampling weight (10) is

divided by the number of telephone

lines (2). With an adjusted weight of 5,

this household (had it been selected

twice) would still represent only 10

households (5x2= 10).

First Form of

Nonresponse: Unknown

Household Status

When selected telephone lines are

called, three results are possible:

1) It is determined that the telephone

line belongs to a household.

2) It is determined that the telephone

line is not a working residential

number, but is a business number or

a nonworking number.

3) The status is not determined because

the telephone rings without an

answer, the person answering the

telephone hangs up immediately, or

the telephone-answering device does

not indicate whether the telephone

line belongs to a household.

This third category includes some

household telephone lines, but the exact

number is unknown. Still, the completed

household interviews must represent the

households in this ‘‘unknown’’ category.

When the number of households in the

unknown category is large, the weight

for each completed household interview

must be increased substantially. When

the number of households in the

unknown category is small, the weight

for each completed household interview

must be increased only slightly. This

proportional adjustment is the first unit

nonresponse adjustment.

The size of the adjustment is based

on the size of the ‘‘unknown’’ category

and on previous research in which

telephone company business offices

reported on the number of households

among the ‘‘unknown’’ numbers. This

adjustment varies by geographic area,

telephone area code, and whether the

telephone line was directory-listed.

When many telephone numbers in a

geographic area and area code go

unanswered and most of these numbers

are highly likely to be households, the

weights for completed interviews in that

geographic area and area code are

increased greatly. When few telephone

numbers in a geographic area and area

code go unanswered or few of these

numbers are likely to be households, the

weights for completed interviews in that

geographic area and area code are

increased only slightly.

In other words, based on the

frequency of the nonresponse in a given

area, this nonresponse is compensated

by proportionately increasing the

weights for those interviews that could

be completed in that area. The

completed interviews, therefore,

represent the households in the

‘‘unknown’’ category.

Second Form of

Nonresponse: Unknown

Household Eligibility

When a household has been

identified, three results are possible:

1) It is determined that the household

includes a child and is, therefore,

eligible for an interview.

2) It is determined that the household

does not include a child and is,

therefore, not eligible.

3) Screening is not completed, and the

eligibility of the household is

unknown.

This third category includes some

eligible households. The exact number

of eligible households in this category is

unknown. Still, the completed household

interviews must represent the eligible

households in this ‘‘unknown’’ category.

When the number of eligible households

in the unknown category is large, the

weight for each completed household

interview must be increased

substantially. When the number of

eligible households in the unknown

category is small, the weight for each

completed household interview must be

increased only slightly. This proportional

adjustment is the second unit

nonresponse adjustment.

The size of the adjustment is based

on the size of the first two categories.

That is, the proportion of eligible

households in the unknown category is

assumed to be the same as the

proportion of eligible households among

all households where the screening

interview for children was completed.

This adjustment varies by geographic

area. When the eligibility for many

households in a geographic area is

unknown and a high proportion of the

completed eligibility interviews in that

area identify eligible children, the

weights for completed interviews in that

geographic area and sample are

increased greatly. When the eligibility

for only a few households in a

geographic area and sample is unknown

or few of the completed eligibility

interviews in that area identify eligible

children, the weights for completed

interviews in that geographic area and

sample are increased only slightly.

In other words, based on the

frequency of nonresponse to the

screening interview in a given area and

in a given sample, this nonresponse is

compensated by proportionately

increasing the weights for those

interviews that could be completed in

that area. The completed interviews,

therefore, represent the eligible

households in the ‘‘unknown’’ category.

Adjustment for Households

with More than One Child

One child was randomly selected

for interview from among all children

Series 1, No. 43 [ Page 13
living in the household. In households

with multiple children, the randomly

selected child represents all of the

unselected children in the household.

Therefore, the sampling weight for this

completed interview must be increased

to reflect the fact that this completed

interview ‘‘represents’’ multiple children

in that household. This adjustment

simply multiplies the child weight by

the number of eligible children living in

the household.

Poststratification of the

Child Weight

Despite the weighting efforts and

the nonresponse adjustments, the

estimated number of children is unlikely

to match the total number of children in

the population. Any discrepancies are

likely due to random sampling error and

nonrandom response biases such as

increased nonresponse based on age,

sex, or race of the child.

Poststratification adjusts the weights to

match population control totals for key

demographic variables obtained from an

independent source.

For the NSCH child weight, the

initial source for population control

totals was the July 2003 Census Bureau

State-level estimates of the number of

male and female children in three age

groups. The number of children

according to the Census Bureau in the

resulting six ‘‘age by sex’’ categories

includes institutionalized children.

Because the NSCH was a survey of

noninstitutionalized children, these

numbers had to be adjusted to reflect

that population. The Census 2000 5%

Public Use Microdata Sample (PUMS)

files were used to estimate the

proportion of children in each ‘‘age by

sex’’ category who were institutionalized

in each State.

Next, the number of

noninstitutionalized children of various

race and ethnic backgrounds in each

‘‘age by sex’’ category was estimated.

The number of race and ethnic

categories varied by State. Categories in

which the percentage of children in a

State was less than 4.5% were merged;

if the resulting category was still less

than 4.5% of the child population, it

was merged with the largest race/

ethnicity category in the State.

The 2000 5% PUMS data were also

used to determine the proportion of

children in households with fewer than

two adults and with two or more adults;

the proportion of children in households

with one child, two children, and three

or more children; and the proportion of

children in households in which the

highest-educated person has a high

school diploma or less and in which the

highest-educated person has more than a

high school diploma.

Based on these population control

totals and estimates, the NSCH child

weights were adjusted so that the sum

of the weights equals the July 2003

Census Bureau estimates for the number

of children in each ‘‘age by sex by

race/ethnicity’’ group in each State, and

further adjusted so that the State-specific

weighted proportion of children in each

household size and educational

attainment group in the NSCH matches

the corresponding State-specific

proportion for that group from the 2000

census.

Adjustment for

Noncoverage of Households

Without Telephones

The poststratification process also

includes an adjustment for the potential

bias that may exist because the NSCH,

as a telephone survey, could not select

households without a telephone at the

time of the survey. This adjustment was

based on State-level estimates of the

proportion of children in households

without telephones from the 2000 5%

PUMS and from the 2003 Current

Population Survey (CPS) Annual

Demographic Supplement. It

incorporated information about

households with interrupted telephone

service from the NSCH itself. Evidence

suggests that households with telephones

at the time of the survey, but with

interruptions in telephone service during

the year, are more similar to households

with no telephone service at the time of

the survey than households with

uninterrupted telephone service during

the year (27–30). Therefore,

nonresponse by households without

telephones can be somewhat

compensated by proportionately

increasing the weights for those

interviews that could be completed in

households with interrupted service. In

this way, completed interviews in

households with interrupted service

represent the households without

telephone service at the time of the

interview.

Truncation of Large

Weights

Extremely large weights were

truncated to prevent a small number of

cases with large weights from having

undue influence on the estimates.

‘‘Appendix I’’ describes how the

weights were truncated.

Quality Control

Staff compared the formulas for the

weights and adjustments developed by

the sampling statistician with the actual

weights and adjustments constructed by

the statistical programmer. The variables

delivered by the data collection staff to

the statistical programmer were used in

independent calculations of the weights

to check the programmer’s

implementation of the statistician’s

weighting specifications.

In addition to this independent

check, univariate statistics were

produced and reviewed for the

adjustments and weights. Reviewers

used general knowledge about the size

of the population and expectations for

IAP area-specific response. For example,

interview cooperation rates are typically

lower in certain IAP areas (e.g., urban

centers) than others (e.g., States in the

South and Midwest). This tendency was

present in the NSCH. In addition, the

sums of the various weights were

compared to ensure that differences

between the sums were in the expected

direction.

Data Files

A SAS (v8) data file contains one

record for each interview completed at

least through the first question on family

Page 14 [ Series 1, No. 43
functioning (Section 8). There are

102,353 records in this file. Of these,

101,306 are cases that completed the

entire interview, and 1,047 are partially

completed interviews. Each record

contains all interview data for the

sampled child and the household in

which the child resides.

Editing

Concurrent with the development of

the CATI questionnaire, a detailed plan

was developed to check and edit the

data using the CATI software. The

intention was to design into the CATI

software consistency checks across data

elements, valid range codes, and a

method to identify incorrect codes

entered by interviewers. To the extent

that the CATI software could be

developed to perform these tasks, the

need for postsurvey data cleaning and

processing is reduced.

The CATI system was designed to

perform edits as an interviewer enters

data into the computer system. These

edits dealt with errors that could be

reconciled while the respondent was on

the telephone and focused, in particular,

on items critical to the conduct of the

study. The CATI edit specifications were

designed to correct respondent errors

during the interview (for example, a

respondent saying two children lived in

the household, but providing only one

child’s age) and to identify and correct

data-entry error by interviewers (for

example, a child is reported to have

seen a doctor four times in the past

year, but the interviewer attempts to

enter 44 times). To the extent possible

without making the CATI system overly

complicated, out-of-range and

inconsistent responses resulted in a

warning screen for the benefit of the

interviewer, who was trained to correct

errors as they occurred. These messages

were designed primarily to prevent data

entry and respondent errors and not to

challenge respondents who gave

logically inconsistent responses.

The two main types of CATI edits

were range checks and consistency

checks. A range violation would result

in visual notification to the CATI

interviewer (a pop-up box). In most

cases, the interviewer would have to

enter a valid response to continue the

interview. However, some extreme

responses would produce a warning, and

the interviewer would be instructed to

verify the answer provided by the

respondent. If the respondent confirmed

the unusually small or unusually large

value, the interviewer was allowed to

continue. A consistency violation would

also result in a pop-up box indicating

that an inconsistency between two

responses had been detected. The

interviewer would then have the

opportunity to change one or both of the

values entered. In some cases, the

interviewer had the option to proceed if

the respondent confirmed the

inconsistent values. There are trade-offs

between incorporating every possible

type of error check into a CATI system

and overall performance of the CATI

system and the use of development

resources. To reconcile this trade-off,

post-CATI edits were developed to

resolve problems that did not require

access to the respondent. Any problems

that could not be resolved without

contacting the respondent were left

inconsistent.

After the preprogrammed edits were

run, the first step in the data cleaning

process was verification of the valid

number of cases in the data file. After

verifying the number of cases, initial

data frequencies were produced and

reviewed. Each variable’s range of

permissible values was examined for

any additional invalid values or unusual

distributions. Invalid values, where they

occurred, were deleted. Nested variables

(i.e., variables that are only asked based

on a response to a previous question)

were linked to their root variables, and

questionnaire paths were traced. If blank

values already existed for a variable,

they were checked to see whether they

were allowable (e.g., due to legitimate

skip patterns in the questionnaire) or

missing in error. Records that were

missing responses for unknown reasons

were left missing.

Missing Data

The CATI system is designed to

minimize missing data. However, some

cases still resulted in missing data for a

variety of reasons. Most analysts ignore

records with missing data regardless of

the reasons for the missing data.

However, for analysts who may wish to

differentiate between different types of

missing values, SAS provides a

mechanism to do so. The following key

provides a description of the various

codes that were used to represent

missing data in the file.

(.N) Not in universe (sample

logic)—Respondents skipped entire

section of questions based on eligibility

criteria. For the NSCH, sampled

children ages 0–5 years were not

eligible for Section 7 of the survey, and

children ages 6–17 years were not

eligible for Section 6 of the survey.

(.L) Legitimate skip (question

logic—Respondents skipped one or

more questions within a section because

of an answer selected for a root

question.

(.P) Partially completed case—The

question was not answered because the

respondent broke off the interview prior

to completing this question. Partially

completed interviews, or ‘‘partial

completes,’’ are those interviews that

were completed through the point where

at least the first question on family

functioning (Section 8) was answered.

These cases have interview records and

are treated as ‘‘completes,’’ although

data are missing for questions that were

asked late in the interview. The coding

of partially completed interviews was

slightly different for cases that also

completed the NIS than for cases that

were ineligible for the NIS. Cases that

were ineligible for the NIS received a

code of ‘‘.P’’ for all missing data from

the point where they ended the NSCH

interview. However, if the case was

NIS-eligible, then applicable data (e.g.,

income) that was captured in the NIS

interview was transferred to the NSCH

data file. For these NIS-eligible cases,

actual data and missing value codes of

‘‘.L’’ were used where appropriate. Thus,

the NIS-eligible partial completes might

have a mixture of actual data and

missing value codes of ‘‘.L’’ and ‘‘.M,’’

as well as missing value codes of ‘‘.P’’

from the point where respondents ended

the NSCH interview.

(.M) Missing in error—A response

should have been captured for this

question, but was not. Data may be

Series 1, No. 43 [ Page 15
missing in error if records were not

properly transferred or stored after a

case was finished, the rules for returning

to a previous question were not properly

followed by an interviewer, or the

recorded answer was determined to be

invalid.

(.A) Added question—This question

was added after the start of data

collection and the respondent was

interviewed before the question was

added to the interview. For example,

question S9Q11B (concerning smoking

by household members) originally was

not asked when the child was younger

than 6 years of age, but was added later

for this group of respondents.

Because SAS treats all of the above

codes similarly in statistical analyses

(i.e., as missing data), analysts using

SAS who are not interested in the

reasons for the missing data may

continue to analyze data as usual.

It is important to note that derived

variables (i.e., variables whose response

was not directly provided by the

respondent) do not include the detailed

coding of missing data. All missing

values for derived variables received an

‘‘.M’’ code regardless of the reason for

the missing data. Similarly, ‘‘.M’’ was

used when derived variables were

suppressed to protect the confidentiality

of the survey participants.

Data missing because the

respondent did not know the answer or

refused to provide the answer have been

treated differently. Rather than assigning

a missing value to these records, a

numeric code was used to identify these

responses. Typically, unknown answers

are coded as ‘‘6,’’ ‘‘96,’’ or ‘‘996.’’

Refused responses are coded as ‘‘7,’’

‘‘97,’’ or ‘‘997.’’ However, the codes

may be different for specific variables.

Therefore, analysts are encouraged to

consult the data documentation and

frequency lists to identify the correct

codes for each variable. Failure to do so

may result in inappropriate calculations,

especially for variables measured using

ordinal, interval, or ratio scales.

Edits to Protect

Confidentiality

NCHS takes extraordinary measures

to ensure that the identity of survey

subjects cannot be disclosed. The risk of

inadvertent disclosure of confidential

information regarding individual

respondents is higher with a publicly

released data set having detailed

geography variables, a detailed and

extensive set of survey observations, and

a sizeable proportion of the total

population of interest. Coarsening a data

set by suppressing survey variables,

collapsing multiple variables into one,

collapsing response categories for other

variables, and/or introduction of noise in

the data are common techniques to

reduce the risk of inadvertent disclosure.

In these data files, household

income has been suppressed, but a

measure of income relative to the

Federal poverty level has been included.

The date of the interview and the child’s

age (in months) have been suppressed,

but the child’s age (in years) has been

reported. The relationship of the

respondent to the child has been

suppressed when the respondent was not

the parent of the child. The length of

time that the child or parent has been

living in the United States has also been

suppressed.

Geography

Geographic information that would

identify the specific IAP area in States

with multiple IAP areas has been

suppressed. However, State identifiers

are included in all files. In addition, an

indicator identifying whether the

household resides inside or outside a

metropolitan statistical area (MSA) has

been included for some States. This

indicator, called MSA_STAT, was

suppressed whenever the sum total

population for all MSA areas in a given

State was less than 500,000 persons or

whenever the sum total population for

all the non-MSA areas in a given State

was less than 500,000 persons. This

resulted in the suppression of the MSA

identifier in 16 States. The MSA

identifier was suppressed in Connecticut,

Delaware, Hawaii, Massachusetts,

Maryland, New Hampshire, Nevada, and

Rhode Island because fewer than

500,000 persons lived in

nonmetropolitan areas. The MSA

identifier was suppressed in Idaho,

Maine, and Montana because fewer than

500,000 persons lived in metropolitan

areas. The MSA identifier was

suppressed in Alaska, North Dakota,

South Dakota, Vermont, and Wyoming

because the non-MSA population size

and the MSA population size were both

below the 500,000 threshold.

Race

Question S11Q02 asked about the

sampled child’s race. Respondents were

permitted to identify all possible

categories that described the child’s

race. If a race other than one of the

seven existing categories was indicated,

then a verbatim response was captured.

Verbatim responses were reviewed and

matched against a database of

alternative race terminology maintained

by the U.S. Census Bureau. Where

possible, ‘‘other’’ race responses were

backcoded into one of the seven existing

categories. Once all possible verbatim

responses were backcoded, a new race

variable was created by collapsing the

seven categories into one of six

categories: white, black or AfricanAmerican, American Indian or Alaska

Native, Asian, Native Hawaiian or

Pacific Islander, and multiple race.

‘‘Multiple race’’ was reserved for cases

where more than one of the other five

categories applied.

To protect the confidentiality of

individual respondents and children,

responses for the race variable were

further collapsed to four categories:

white only, African-American or black

only, other race, and multiple race. The

‘‘other race’’ category includes children

for whom only one of the other three

categories (Asian, Native American or

Alaska Native, and Native Hawaiian or

Pacific Islander) was reported. Children

for whom more than one race was

identified (e.g., Asian and Native

Hawaiian) were included in the

‘‘multiple race’’ category. If no race was

reported—because the respondent did

not know or refused to provide the race,

or because the verbatim response could

not be backcoded and no other race was

reported—then race was coded as ‘‘.M’’

for all States except Hawaii. (For

Hawaii, if the verbatim response could

not be backcoded and no other race was

reported, then race was coded as

‘‘other.’’) This new derived race variable

(called RACER) is the only

Page 16 [ Series 1, No. 43
classification available for all 50 States

and the District of Columbia.

In several States, however, minority

group populations are sufficiently large

that the release of additional race

categories was possible while still

protecting the confidentiality of the

respondents and children. To identify

these States, data from the decennial

2000 census were examined to identify

minority groups that comprise at least

5% of the total population of children in

a specific State. Based on this criterion,

the data files identify American Indian

and Alaskan Native children in Alaska,

Arizona, Montana, New Mexico, North

Dakota, Oklahoma, and South Dakota.

(This race classification variable is

called RACEAIAN.) Asian children’s

race is reported for children in

California, New Jersey, New York, and

Washington. (This race classification

variable is called RACEASIA.) The data

files identify both Asian children and

Native Hawaiian and Pacific Islander

children in Hawaii. (This race

classification variable is called

RACE_HI.)

Language

Question S1Q06 collected data on

the primary language spoken in the

household. To protect confidentiality,

Spanish-language households could not

be distinguished from other nonEnglish-language households in the data

file. Of the 7,912 children living in

households with a non-English language

as the primary language

(PLANGUAGE), 83.3% (n = 6,591)

lived in Spanish-language households.

Because Spanish-language households

were not identified in the data file,

language of interview was also

suppressed.

Height and Weight

Question S2Q02 permitted

respondents to report the child’s height

in either feet and inches or in

centimeters. Height reported in

centimeters was recoded into inches

(S2Q02R). Question S2Q03 permitted

respondents to report the child’s weight

in either pounds or kilograms. Weight

reported in kilograms was recoded into

pounds (S2Q03R).

To protect the confidentiality of

individual children, very short or very

tall heights and very low and very high

weights have been suppressed. Extreme

values were identified within each

single-year age group and were recoded

to less extreme values. For example, for

11-year-old children, all reported heights

shorter than 43 inches were recoded to

43 inches, and all reported heights taller

than 68 inches were recoded to 68

inches. Two flags (HGHT_FLG and

WGHT_FLG) have been added to the

dataset to enable analysts to determine

whether the values were reported or

assigned.

Because suppression of height and

weight variables may hinder calculations

of body mass index (BMI), a variable

identifying underweight and overweight

children (BMICLASS) has been added

to the dataset. Children aged 2–17 years

have been identified as either

underweight (BMI-for-age is in the 5th

percentile or lower), at risk for

overweight (BMI-for-age is in the 85th

percentile or greater but lower than the

95th percentile), and overweight

(BMI-for-age is in the 95th percentile or

greater). Percentiles are based on sex

and age (see http://www.cdc.gov/

nccdphp/dnpa/bmi/bmi-for-age.htm). The

95th percentile means that compared to

children of the same sex and age, 95%

have a lower BMI. Percentiles were

determined using the 2000 CDC growth

charts and a SAS program provided

online by CDC (http://www.cdc.gov/

nccdphp/dnpa/growthcharts/sas.htm).

However, this program relies on the

child’s age in months. Because age was

only reported in years for this survey,

children were assumed to be at the

midpoint of the age-year (i.e., a

10-year-old was assumed to be 126

months of age) for purposes of

calculating BMI-for-age. It should be

recognized that height and weight were

based on the parents’ reports and were

not independently measured.

Family Structure

To protect the confidentiality of

individual children whose families have

unique structural characteristics, a single

measure of family structure

(FAMSTRUCT) was created from

S1Q02, S9Q00–02. The family structure

variable refers to parents living in the

household. This variable has four levels:

1) two-parent household, which

includes both a biological or

adoptive mother and a biological or

adoptive father;

2) two-parent household with both a

mother and a father that includes at

least one step-parent;

3) one-parent household with a

biological, step, foster, or adoptive

mother and no father of any type

present;

4) all other family structures.

Any of these four family structures

may include other people who act as

parents, such as grandparents, aunts,

uncles, or unmarried partners of the

parents. Legal guardians were not

considered to be mothers or fathers.

On July 16, 2003, the CATI

instrument wording for S9Q02 was

refined to clarify that respondents were

not supposed to count themselves as a

parent-type in this question. Prior to that

date, if the same response was provided

for the relationship of the respondent to

the child (S1Q02) as for the relationship

of the other parent-type to the child

(S9Q02), it was not clear whether the

respondent was counting himself/herself,

or whether there was an additional

person of the same parent-type in the

household. Households identified as

having two mothers of the same type

(biological, step, foster, or adoptive)

have been classified as ‘‘other family

structure;’’ However, because of this

ambiguity about whether the respondent

was also counted as another parent in

the household, these households may

actually be ‘‘single mother’’ households.

Other households with ambiguous

structure (e.g., where a father refused to

indicate whether he was the biological

father) were also coded as ‘‘other family

structure.’’

Detailed information about parents

living outside the household also poses

a risk to confidentiality. To protect

confidentiality while still permitting

analysts to work with information about

contact with noncustodial biological

parents, questions S9Q05 and S9Q05A

have been combined into a single

Series 1, No. 43 [ Page 17
variable, S9Q05R. This new variable

indicates how often the child has seen

any biological parent living outside the

household. The assigned value was

based on the response to either S9Q05

(contact with noncustodial biological

mother) or S9Q05A (contact with

noncustodial biological father) that

indicated the greatest frequency of

contact. This new variable was assigned

a missing value code of ‘‘.L’’ if the

child lives with two adoptive parents or

with one biological parent and one

adoptive parent, to protect the

confidentiality of adopted children who

have contact with a biological parent. A

missing value code of ‘‘.L’’ may also

indicate that the child lives with both

biological parents or that the respondent

did not report that the child has any

biological parents who do not live with

the child.

Other Top-Coded Variables

Several other frequency variables

have been top-coded to suppress outliers

at the high end of the distribution of

responses. Due to their unusual

characteristics, records including these

outliers might have been more readily

identifiable.

+ For the total number of children

living in the household

(TOTKIDS4), four or more children

is the maximum reported.

+ For the total number of adults living

in the household (TOTADULT3),

three or more adults is the

maximum reported.

+ For the number of visits to a doctor,

nurse, or other health care professional

for preventative medical care in the

past year (S4Q03R), 20 or more visits

is the maximum reported.

+ For the number of hospital

emergency room visits in the past

year (S4Q04R), five or more visits

is the maximum reported.

+ For the number of hospital

emergency room visits in the past

year due to accident, injury, or

poisoning (S4Q05R), five or more

visits is the maximum reported.

+ For the number of visits to a doctor,

nurse, or other health care

professional for sick care in the past

year (S4Q06R), 20 or more visits is

the maximum reported.

+ For the age of the child when

breastfeeding stopped (S6Q60R),

1,095 days or older (i.e., 3 years or

over) is the maximum reported.

+ For the number of days of school

missed due to illness or injury in the

past year (S7Q02R), 40 or more

days is the maximum reported.

+ For the number of times that a

family member took the child on an

outing in the past week (S8Q01R),

20 or more outings is the maximum

reported.

+ For the frequency that the child

attended religious services in the

past year (S8Q02R), ‘‘daily’’ is the

maximum frequency reported.

+ For the number of times that the

child ever moved to a new address

(S11Q06R), 12 or more times is the

maximum reported.

Data Perturbations

Despite the modifications detailed

above, there was lingering concern that

the dataset may include children with

unique combinations of identifiable

characteristics. To investigate this

concern, the Census 2000 5% Public

Use Microdata Sample (PUMS) files

were used to calculate the ratio between

the number of children with various

combinations of observable demographic

characteristics in the NSCH sample and

the number of children with those

combinations of characteristics in the

general population. When the ratio was

large and/or the population size was

small, some of the identifiable

characteristics in the NSCH data file

were changed.

+ For five children, the race variable

was set to missing.

+ For 91 children, the poverty level

variable was modified by randomly

increasing or decreasing the poverty

level by one category (e.g., the

poverty level indicator for children

in households with incomes at

150%–185% of the Federal Poverty

Level was randomly changed to

either 133%–150% or 185%–200%).

+ For 10 children, the education

variable was set to ‘‘don’t know.’’

+ For two children, the number of

children living in the household was

reduced by one.

+ For nine children, the number of

adults living in the household was

reduced by one.

+ For four children whose fathers

were not born in the United States,

this variable was set to ‘‘born in the

U.S.’’

+ For 13 children who were not born

in the United States, this variable

was set to ‘‘born in the U.S.’’

+ For 84 children living with a

biological, step, foster, or adoptive

mother and no father of any type

present, and for 46 children living in

a two-parent household that includes

at least one step-parent, the family

structure variable was set to

‘‘other.’’

Analysts interested in working with

data that were suppressed to protect

confidentiality may access unmodified

data files through the NCHS Research

Data Center (RDC). This facility,

designed for the researcher outside of

NCHS, is located in Hyattsville,

Maryland. Data files housed in the RDC

may also be accessed remotely via

e-mail. For more information about how

to apply for access, analysts may visit

the NCHS Web site at http://

www.cdc.gov/nchs/r&d/rdc.htm.

Other Derived Variables

AGEYR_CHILD—The child’s age

in years was recorded when the child

was first identified as the sampled child

(which may have been prior to the date

that the actual interview was

completed). Valid values for age are 0

through 17, where ‘‘0’’ means younger

than 1 year.

TOTKIDS4—This variable

represents the total number of children

17 years of age or under living in the

household. As noted previously, this

variable was topcoded at four or more

children to protect confidentiality.

AGEPOS4—This variable

represents the age of the sampled child,

relative to the ages of the other children

17 years of age or under living in the

household. Because it is not known if

the sampled child was related to the

other children living in the household, if

the child has siblings who do not live in

the household, or if the child has

Page 18 [ Series 1, No. 43
siblings older than 17 years of age, this

variable should not be interpreted as

birth order.

RELATION—Information collected

in question S1Q02 regarding the

relationship of the respondent to the

sampled child has been collapsed into

three categories.

TOTADULT3—The total number of

adults in the household was derived by

subtracting the total number of children

in the household from the total number

of persons in the household (S1Q05).

During data collection, the CATI system

did not reconcile the total number of

persons reported as living in the

household with the total number of

children reported in that household.

Therefore, total number of persons

reported as living in the household

could be fewer than the total number of

children in a household plus one. When

this occurred, the total number of adults

was assigned a missing value code (.M).

EDUCATIONR—The highest level

of education attained by anyone in the

household was derived from S1Q05A.

PLANGUAGE—The primary

language spoken in the household was

derived from S1Q06.

POVERTY_LEVELR—This

indicator was created using total

household members (S1Q05) and the

household income value. If data for

either of these two components were

missing, refused, or had a ‘‘don’t know’’

response, this measure was assigned a

missing value code. The household

income value was the actual dollar

amount reported by respondents who

reported an exact household income

(C11Q01). However, when respondents

did not supply a specific dollar amount

for household income, it was necessary

to go through a series of questions

asking respondents whether the

household income was below, exactly at,

or above threshold amounts (W9Q02

through W9Q12A). If respondents did

not complete the income cascade either

because they refused or did not know

the answer to one of the cascade

questions, this measure was assigned a

missing value code. Once an income-tohousehold-size measure was computed,

it was compared with DHHS Federal

Poverty Guidelines. More detail about

the development of this poverty

indicator is available in ‘‘Appendix V.’’

Dummy Variables

When respondents were permitted

to provide multiple answers for the

same question, a variable was created

for each possible answer. The values for

these new dummy variables are ‘‘yes,

this answer was given,’’ and ‘‘no, this

answer was not given.’’ When

respondents could not or did not provide

an answer to the question, a value of

‘‘don’t know’’ or ‘‘refused’’ is reported

for each of the dummy variables.

+ S2Q55 is represented by S2Q55X01

to S2Q55X12.

+ S4Q08 is represented by S4Q08X01

to S4Q08X16.

+ S4Q14 is represented by S4Q14X01

to S4Q14X16.

+ S4Q18 is represented by S4Q18X01

to S4Q18X16.

+ S6Q56 is represented by S6Q56X01

to S6Q56X03.

Additional Data Notes

For the question about the number

of days during the past week that the

child participated in clubs,

organizations, or sports teams (S7Q12),

a CATI program error led to 1,707

missing values. This error was corrected

on February 20, 2003.

For the questions about whether the

child received all needed prescription

medications (S4Q17) and the reasons

why all prescription medications were

not received (S4Q18), an erroneous

CATI logic check resulted in missing

values for 125 cases. The problem was

corrected on May 27, 2003.

For the question about whether

anyone in the household smokes

(S9Q11B), an oversight in survey

planning resulted in 12,549 missing

values for children under 6 years of age.

This error was corrected on July 15,

2003.

For the question about whether

doctors provided information to address

concerns about learning, development,

or behavior (S6Q29), a CATI program

error led to 156 missing values. This

error was corrected on July 30, 2003.

For the question about the receipt of

free or reduced-cost breakfasts or

lunches in school (C11Q11B), a CATI

program error led to 1,103 missing

values. This error was corrected on

September 23, 2003.

A CATI program error during the

first wave of the incentive effort

resulted in 158 cases with missing data

for the income variables and all

subsequent variables. The problem was

corrected on March 22, 2004.

For the question on children’s

difficulties with emotions, concentration,

behavior, or being able to get along with

other people (S2Q59) and its followup

question (S2Q60), an inadvertent error

in the questionnaire development

process resulted in answer choices that

do not match the answer choices for the

copyrighted Strengths and Difficulties

Questionnaire (12). Analysts should use

caution when comparing estimates

derived from S2Q59 and S2Q60 to

estimates derived from the proper

answer choices used in other surveys.

Quality Control

A lead programmer was responsible

for cleaning data at the end of the data

collection period. The lead programmer

was also responsible for modifying the

cleaning programs for use as data

monitoring programs of the interview

data during each quarter of data

collection. A second programmer was

responsible for reviewing the work of

the lead programmer and signing off on

each completed task. The cleaned data

file was also thoroughly checked by

project staff. Below is a brief summary

of the steps involved in producing the

final data file.

Using the CATI questionnaire

specifications as a base, the lead

programmer followed detailed cleaning

specifications and produced a series of

cleaning programs. The programmer

annotated each cleaning program so that

results could be replicated and reviewed

by others. These programs were created

to check for duplicate cases across

NSCH data collection quarters, verify

the valid number of completed and

partially completed cases in the data

file, check that all data elements for a

Series 1, No. 43 [ Page 19
completed case were present, apply any

final data corrections based on data

recovery, check that values were within

specified ranges and that skip patterns

were followed, create derived variables

from existing variables, and assign

special codes to reflect missing data of

various kinds.

A second programmer produced an

independent set of programs to serve as

a quality control check of the cleaned

data. These quality control programs

performed three main checks. First, they

identified any out-of-range values and

incorrect skip logic. Second, derived

variables were independently created

and cross-checked against variables

created by the programmer. Any

discrepancies were flagged and reported

to the programmer. Third, the programs

checked for the correct assignment of

the special codes denoting the various

types of missing data.

Nested variables (i.e., variables that

are only asked based on a response to a

previous question) were linked to their

root variables, and questionnaire paths

were traced. Variables that should

correspond with earlier variable values

were compared with those values, using

cross tabulations, and reconciled with

them. Applicable variable frequencies

were checked for expected distributions.

Variables with anomalous distributions

were reviewed individually. Variable

labels and statements were checked to

ensure that they were consistent with the

data documentation provided.

The quality control programs were

run on each new version of the data

files until no problems were identified.

The quality control reviewer then signed

off on the data file. The final step of the

quality control process involved review

of the file by senior project

management.

Estimation and

Hypothesis Testing

The NSCH data were obtained

through a complex sample design

involving clustering of children within

households and stratification of

households within States. To produce

estimates that are representative of

children nationally and within each

State, sampling weights must be used.

These sampling weights were developed

to account for complex sample design

and include adjustments for multipletelephone households, unit nonresponse,

and noncoverage of nontelephone

households, as well as adjustments to

known population control estimates.

As described earlier, a single

sampling weight (WEIGHT_I) has been

developed for the NSCH. This weight

should be used for both national and

State-level analyses.

Variables Used for

Variance Estimation

Because of the complex design of

the NSCH, the interview records have

unequal weights. Therefore, statistical

software programs that assume simple

random sampling will most often

compute standard errors that are too

low. Tests of statistical hypotheses may

then suggest statistically significant

differences or associations that are

misleading. However, computer

programs are available that provide the

capability of variance estimation for

complex sample designs (e.g.,

SUDAAN, STATA, WesVar). To provide

the user with the capability of

estimating the complex sample variances

for the NSCH data, we have provided

stratum identifiers and primary sampling

unit (PSU) codes on the data files.

These variables and the sample weights

are necessary for the calculation of

variances.

It should be noted that the stratum

identifiers reported on the data set are

not identical to the strata used for

drawing the sample. In States with

multiple Immunization Action Plan

(IAP) areas, independent samples were

selected from each IAP area in

proportion to the total number of

households with children in each IAP

area. Therefore, these IAP areas should

be considered strata for variance

estimation. However, disclosure of the

specific IAP area for each child (even if

the code were scrambled) could increase

the risk of disclosure of a respondent’s

identity. For example, the IAP area with

the lowest frequency of responses in

New Jersey would be readily

identifiable as Newark. In the absence

of IAP-specific identifiers, data users

should use the State identifier (STATE)

as the stratum identifier. By using the

State identifier rather than the

suppressed IAP identifier, the standard

errors for national and State estimates

with key variables are affected only

slightly and not in a consistent direction.

The PSU for the NSCH is the

household. Each household is

represented by only one child.

Therefore, the PSU is represented on the

data sets by the unique household

identifier, IDNUMR.

The overall number of persons in

this survey is sufficient for most

statistical inference purposes. However,

analyses of some rare responses and

analyses of subclasses can lead to

estimators that are unreliable. Small

sample sizes used in the variance

calculations may also produce unstable

estimates of the variances.

Consequently, these analyses require that

the user pay particular attention to the

coefficient of variation for the estimates

of means, proportions, and totals.

Variance Estimation Using

SUDAAN or STATA

Standard errors for the NSCH can

be obtained using the Taylor-series

approximation method, available in

software such as SUDAAN and STATA.

As noted previously, the State should be

identified as the stratum variable and the

household should be identified as the

primary sampling unit.

The simplifying assumption that

PSUs have been sampled with

replacement allows most complex

survey sample design computer

programs to calculate Taylor-series

standard errors in a straightforward way.

This method requires no recoding of

design variables, but is statistically less

efficient (and therefore more

conservative) than some other methods

because the PSU unit is treated as being

sampled with replacement within the

stratum unit.

For SUDAAN, the data file needs

to be sorted by stratum (STATE) and

Page 20 [ Series 1, No. 43
PSU (IDNUMR) prior to invoking

SUDAAN. The following SUDAAN

design statements are used for analyses:

PROC . . . DESIGN = WR;

NEST STATE IDNUMR;

WEIGHT WEIGHT_I.

For STATA, the following design

statements are used:

svyset strata STATE;

svyset psu IDNUMR;

svyset pweight WEIGHT_I;

svyset.

It should be noted that other

variance estimation procedures are also

applicable to the NSCH. Specifically,

the jackknife method with replicate

weights and the bootstrap resampling

method with replicate weights can also

be used (via software such as WesVar)

to obtain standard errors that fully

reflect the impact of the weighting

adjustments on standard errors.

Variance Estimation for

Subsets of the Data

Most analyses of the NSCH data

will focus on specific population

subgroups such as children in only one

State or children living in poverty. Some

analysts will therefore be tempted to

delete all records outside of the domain

of interest so they may work with

smaller data files and run computer jobs

more quickly. This procedure of keeping

only select records and deleting other

records from the list is called

‘‘subsetting the data.’’ Subsetted data

that are appropriately weighted can be

used to generate correct point estimates

(e.g., estimates of population subgroup

frequencies or means), but most

software packages that analyze complex

survey data will incorrectly compute

standard errors for subsetted data. When

complex survey data are subsetted, the

sample design structure is often

compromised because the complete

design information is not available.

Subsetting the data can delete important

design information needed for variance

estimation (e.g., deleting all records for

certain subgroups may result in entire

PSUs being removed from the design

structure).

The NSCH was designed to provide

independent data sets for each of the 50

States and the District of Columbia.

Subsetting the survey data to a

particular State does not compromise the

design structure of the survey. That is,

standard errors calculated in SUDAAN

for a particular State will not be affected

if the data set has been subsetted to that

particular State. However, subsetting to

specific population subgroups (within or

across States) can result in incorrect

standard errors. For example, subsetting

the data to those children who live in

poverty within a specific State will

result in incorrectly calculated standard

errors. Typically, the standard errors for

subsetted data will be inflated, resulting

in a higher probability of type-II error

(i.e., failing to detect significant

differences that do exist). SUDAAN has

a SUBPOPN option that allows for the

targeting of specific subpopulations for

analysis while retaining the full

unsubsetted data set that includes the

full sample design information. Analysts

interested in specific population

subgroups should use SUBPOPN instead

of subsetting the data sets.

Weighted Frequencies,

Prevalence Estimates, and

Standard Errors

Weighted State-specific frequencies

of the number of children with excellent

or very good health (as assessed by the

respondent) appear in ‘‘Appendix VIII.’’

Prevalence estimates and standard errors

are also provided. Analysts may wish to

replicate this table to determine if they

are using the weights correctly.

Weighted frequencies, prevalence

estimates, and standard errors for other

survey measures will be available from

the National Survey of Children’s

Health Data Resource Center. This

online center is led by the Child and

Adolescent Health Measurement

Initiative at the Oregon Health and

Science University and is sponsored by

the Office of Data and Program

Development at the Maternal and Child

Health Bureau. When available, the data

resource center will be accessible at

http://www.nschdata.org or http://

www.childhealthdata.org.

Guidelines for Data

Use

With the goal of mutual benefit,

NCHS requests that recipients of data

files cooperate in certain actions related

to their use.

Any published material derived

from the data should acknowledge

NCHS as the original source. The

suggested citation, ‘‘Data Source:

Centers for Disease Control and

Prevention, National Center for Health

Statistics, State and Local Area

Integrated Telephone Survey, National

Survey of Children’s Health, 2003,’’

should appear at the bottom of all

tables. It should also include a

disclaimer that credits any analyses,

interpretations, or conclusions reached to

the author (recipient of the file) and not

to NCHS, which is responsible only for

the initial data. Consumers who wish to

publish a technical description of the

data should make a reasonable effort to

ensure that the description is not

inconsistent with that published by

NCHS.

The Public Health Service Act

(Section 308d) provides that data

collected by NCHS may be used only

for the purpose of health statistical

reporting and analysis. Any effort to

determine the identity of any reported

case is prohibited by this law. NCHS

does all it can to ensure that the identity

of data subjects cannot be disclosed. All

direct identifiers, as well as any

characteristics that might lead to

identification, are omitted from the data

files. Any intentional identification or

disclosure of a person or establishment

violates the assurances of confidentiality

given to the providers of the

information. Therefore, users must:

+ Use the data in this data file for

statistical reporting and analysis

only.

+ Make no use of the identity of any

person discovered, inadvertently or

otherwise, and advise the Director,

NCHS, of any such discovery

(301–458-4500).

+ Not link this data file with

individually identifiable data from

Series 1, No. 43 [ Page 21
any other NCHS or non-NCHS data

files.

Use of the data signifies users’

agreement to comply with the

above-stated statutory-based

requirements.

References

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stratplan03–07.htm.

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Blumberg SJ, Madans JH. Use of an

existing sampling frame to collect

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annual methodology report. Cambridge,

MA: Abt Associates Inc. 2002.

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Wright RA. National immunization

survey: The methodology of a

vaccination surveillance system. Public

Health Rep 115:65–77. 2000.

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developmental status: a method for

detecting and addressing developmental

and behavioral problems in children.

Nashville, TN: Ellsworth &

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using parent’s evaluation of

developmental status to detect and

address developmental and behavioral

problems. Nashville, TN: Ellsworth &

Vandermeer Press, LLC. 1998.

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on parental report [working paper].

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Press, Inc. 1997.

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al. The Aggravation in Parenting Scale:

Language application issues among

Spanish-speaking Latino families living

in Los Angeles County. Paper presented

at the Academy of Health Annual

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structure, and child well-being:

Indicators from the SIPP. Population

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multilevel study of collective efficacy.

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23. Camburn DP, Lavrakas PJ, Battaglia

MP, et al. Using advance respondent

letters in random-digit-dialing telephone

surveys. Paper presented at annual

research meeting of the American

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Opinion Research. Standard definitions:

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outcome rates for surveys. Ann Arbor,

MI: American Association for Public

Opinion Research. 2004.

25. Ezzati-Rice TM., Frankel MR, Hoaglin

DC, et al. An alternative measure of

response rate in random-digit-dialing

surveys that screen for eligible

subpopulations. J Econ Soc Meas

26:99–109. 2000.

26. Frankel MR, Battaglia MP, Kulp DW,

et al. The impact of ring-no-answer

telephone numbers on response rates in

random-digit-dialing surveys. Paper

presented at the 2003 Joint Statistical

Meetings. 2003.

27. Brick JM, Waksberg J, Keeter S. Using

data on interruptions in telephone

service as coverage adjustments.

Survey Methodology 22:185–97. 1996.

28. Frankel MR, Srinath KP, Battaglia MP,

et al. Using data on interruptions in

telephone service to reduce

nontelephone bias in a random-digitdialing survey. Proceedings of the

Section on Survey Research Methods,

pp. 647–52. Alexandria, VA: American

Statistical Association. 2000.

29. Frankel MR, Srinath KP, Hoaglin DC,

et al. Adjustments for nontelephone

bias in random-digit-dialling surveys.

Stat Med 22:1611–26. 2003.

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noncoverage bias with a telephone

survey. Public Opinion Quarterly

59:196–217. 1995.

31. Abt Associates Inc. The National

Immunization Survey (NIS): 1998

annual methodology report. Cambridge,

MA: Abt Associates Inc. 2001.

32. Shapiro G, Battaglia M, Camburn D, et

al. Calling local telephone company

business offices to determine the

residential status of a wide class of

unresolved telephone numbers in a

random-digit-dialing sample.

Proceedings of the Section on Survey

Research Methods, pp. 975–80.

Alexandria, VA: American Statistical

Association, 1995.

33. Lohr S. Sampling design and analysis.

Pacific Grove, CA: Duxbury Press.

1999.

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hotdeck imputation procedure.

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Research Methods, pp. 721–6.

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Alexandria, VA: American Statistical

Association. 1980.

35. Smith PJ, Srinath KP, Battaglia MP, et

al. Issues relating to the use of

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Series 1, No. 43[ Page 23
Appendix I

Sampling and Weighting

Technical Summary

The basic design objective of the

National Survey of Children’s Health

(NSCH) was to select a sample of

children under 18 years of age to obtain

2,000 completed interviews in each

State and the District of Columbia. This

sample was selected by identifying

households with children under age 18

years by screening a larger sample of

households and then selecting one child

for a detailed interview from each

age-eligible household. The sample of

households selected for screening for the

NSCH was a subsample of the

households screened for the National

Immunization Survey (NIS), a

continuous list-assisted random-digitdialing (RDD) survey administered in

each of the 50 States and 28

metropolitan Immunization Action Plan

(IAP) areas. Therefore, the sampling

design for the selection of households in

the NSCH was essentially the same as

in the NIS.

Drawing the NIS Sample

A brief description of the procedure

for the selection of households in the

NIS is given below. For more detail on

the NIS sample design, readers are

encouraged to obtain chapter 3 of the

NIS Annual Methodology Report (9),

which is available from NCHS. Further

information regarding the NIS can be

found in National Immunization Survey:

The Methodology of a Vaccination

Surveillance System (10).

Associating Telephone Numbers with

IAP Areas

To draw a sample of telephone

numbers in an IAP area, one must, in

effect, compile a list of all telephone

numbers that belong to that area. For

some IAP areas, this step is

straightforward. For example, when the

IAP area is a State with a single area

code, the list consists of all telephone

numbers within the central-office codes

that are in service in that area code.

(Combined, an area code and a

central-office code form a ‘‘prefix area.’’

For example, when a telephone number

is 617–555-1234, 617–555 is the prefix

area corresponding to the 555 central

office in the 617 area code.)

For other IAP areas, however, the

step encounters a number of

complications. When the IAP area is a

city, county, or combination of counties,

some prefix areas may cover part of the

IAP area and part of an adjacent IAP

area. In such situations, the NIS applies

a plurality rule: if at least 50% of the

directory-listed households in a prefix

area fall inside an IAP area, the prefix

area is assigned to that IAP area.

Drawing the Initial NIS Sample

The sample frame for an IAP area

consists of banks of 100 consecutive

telephone numbers within the prefix

areas assigned to the IAP area. For

example, the numbers from 617–555-

7100 to 617–555-7199 constitute a

working bank in the 617–555 prefix

area. Banks that contain zero

directory-listed residential telephone

numbers are excluded from the frame

because they have very little chance of

containing working residential numbers.

For this preliminary step, the GENESYS

Sampling System (a proprietary product

of Marketing Systems Group) uses a file

of directory-listed residential numbers

from Donnelley Marketing Information

Services (DMIS). The result is a file

that lists the remaining banks (the ‘‘1+

working banks’’). From the 1+ working

banks, a random sample of complete

10-digit telephone numbers is drawn for

each quarter in such a way that each

number has a known and equal

probability of being selected. Within

each IAP area, the sample is then

segmented into replicates, or

representative subsamples, with each

replicate containing sample telephone

numbers from each of the 78 IAP areas.

Segmenting the sample into replicates

allows for the release of telephone

numbers over time in a controlled

manner.

Updating the NIS Sampling Frame

The set of telephone banks with at

least one directory-listed residential

telephone number changes over time. As

a result, the sampling frame of 1+

working banks also needs to be updated.

The recent phenomenon of frequent

area-code splits has produced additional

changes to the sampling frame. The

GENESYS database reflects those

changes in a quarterly update. Marketing

Systems Group (MSG) has developed a

separate sampling frame for each IAP

area. The database is examined quarterly

to determine whether currently included

banks should be assigned to different

IAP areas and to assign newly included

banks to IAP areas. The rules for

assignment are the same as in the initial

definitions of the IAP areas. After all

modifications have been made to the

GENESYS database, a number of

checks ensure that all changes have

been applied correctly and that the new

database produces samples that are

consistent with those produced prior to

the changes. These checks compare the

number of active banks and RDDselectable lines in each IAP area before

and after the update. In parallel, the

actual exchanges assigned to each IAP

area before and after the update are

compared. Small changes are

expected—new banks are put into

service as new numbers are assigned. If

a major discrepancy occurs in any of

these checks, MSG is notified of the

difference and asked to provide

documentation of the reasons for the

change.

Forming NIS Sample Replicates

The total size of the initial sample

for an IAP area is calculated according

to the formula:

Total Sample Size = (1.5)T/(AC), where:

T is the quarterly target number of

completed interviews for the IAP

area (this target number of

completes ranged from 95 to 126 in

2003);

A is the proportion of telephone

numbers that remain after

identifiable business and

nonworking numbers have been

removed (as discussed below); and

C is the proportion of telephone

numbers sent to the telephone center

that result in a completed interview.

Page 24 [ Series 1, No. 43
In the formula, A and C are specific to

the IAP area. They are adjusted each

quarter, taking into account the results

from prior quarters. The target, T, may

also reflect the results in the previous

quarters; for example, if the three

previous quarters have not produced

their target total of completes, T is

raised accordingly. Likewise, if the three

previous quarters have exceeded their

target total of completes, T is reduced

accordingly. The factor 1.5 allows for

variation in actual performance among

IAP areas and among quarters.

The total sample selected is then

randomly divided into replicates. (In the

first quarter of 2003, the number of

replicates was 36; the first 26 were

equal in size, and the last 10 were half

that size. For the second and third

quarters, the number of replicates was

30; 24 full-size and 6 half-size. For the

fourth quarter, the number of replicates

was 31; 27 full-size and 4 half-size.)

This procedure permits smoother release

of the sample (at the rate of one or two

replicates per week) for each IAP area

separately, as needed. Toward the end of

the quarter, the half-size replicates allow

tighter control over the total amount of

sample released. The aim is to produce

an even distribution of work in the

telephone center over the course of a

quarter and to give all cases an equal

probability of being completed.

Removing Business and Nonworking

Numbers

In a traditional RDD survey, all

sampled telephone numbers are given to

interviewers for dialing. Because over

one-half of all selected telephone

numbers are businesses, modem lines, or

are unassigned, a large part of the

interviewers’ efforts may be directed

simply to identifying and removing

these numbers from the active sample.

MSG has produced companion products

to their GENESYS Sampling System

that can quickly and accurately reduce

the size of this task.

First, the selected sample is

matched against a GENESYS data file

containing telephone numbers that are

directory-listed in a business Yellow

Pages and are not directory-listed in a

residential White Pages. Any business

numbers that are identified are removed

from the sample.

Second, numbers listed in

residential White Pages are identified

and temporarily set aside.

Third, a hardware system,

GENESYS-IDplus, screens the

remaining sample to remove a portion

of the nonworking numbers. Using

personal computers with special

hardware and software, this system (the

‘‘auto-dialer’’) automatically dials the

telephone numbers to detect nonworking

and modem numbers. This is indicated

by the familiar tri-tone signal for

out-of-service numbers, by an extended

period of silence, or by continuous noise

on the line. If the telephone number

being dialed starts to ring, an attendant

responds if the telephone is answered.

(On a national basis, approximately

15%–20% of the numbers are

answered.) The GENESYS-IDplus

equipment is operated only during

daytime hours on weekdays in an

attempt to reduce the number of

answered calls. In addition, the White

Pages directory-listed numbers identified

in step two are not dialed. These

residential White Pages directory-listed

numbers are combined with those that

were not removed by the auto-dialer to

produce the sample to be dialed by NIS

interviewers. Together, these steps cull

out approximately 40% of the sampled

lines in the NIS sample.

Obtaining Addresses for Advance

Letters

To obtain addresses that correspond

to telephone numbers in the sample, the

numbers for each replicate are sent to a

company that provides this matching

service. This computerized name-andaddress-locating service uses a large

database of residential and business

telephone numbers, including

unpublished telephone numbers. In some

instances, by customer preference, a

listing may not contain a street address.

The resulting file contains both numbers

with and without listing matches.

Matched listings contain a business or

residential identifier.

‘‘Do Not Call’’ Requests

The NIS maintains a file containing

telephone numbers of people who have

requested that they not be called. Each

quarter’s sample is compared with this

file, and numbers in the ‘‘Do Not Call

List’’ are not included in the quarterly

sample of numbers loaded into the CATI

system.

Duplicate Telephone Numbers

Because of the repeated quarterly

selection of the sample in each IAP

area, it is possible that some telephone

numbers will be selected more than

once. To avoid respondent problems

created by recontacts for the same

survey, a further step of processing

identifies duplicate numbers. Each

complete replicate sample file is

compared with all sample files released

during the four prior quarters (taking

into account area code splits). For the

NIS, identified duplicates are processed

as follows:

If GENESYS-IDplus removes an

identified duplicate number, that result

supersedes the disposition of that

sampled number from the original

quarter in which it was sampled.

Otherwise, the processing depends on

whether the number was sampled in the

immediately preceding quarter.

Duplicates from earlier quarters are

mailed advance letters and called with

their assigned replicate. Duplicates from

the immediately preceding quarter are

not mailed advance letters (because they

might have received such a letter very

recently). If they are released before the

immediately preceding quarter was

finished, they are put on hold until

household data collection for that

quarter has closed (to ensure that they

do not receive calls simultaneously for

two quarters). Numbers that have certain

types of refusals (e.g., ‘‘take me off the

calling list’’ cases) as their final

disposition in the earlier quarter are

counted as refusals in the current

quarter. Certain final outcomes from the

immediately preceding quarter are

counted in the current quarter. For

example, if the case is called for the

preceding quarter in a month when data

collection for the current quarter is also

open, and the final outcome is

‘‘nonworking number,’’ ‘‘no child in

range,’’ or ‘‘complete,’’ the outcome is

counted for both quarters, and the data

are copied for the current quarter.

Series 1, No. 43 [ Page 25
Because of the repeated quarterly

selection of an NIS sample in each IAP

area, some telephone numbers were

selected more than once over the course

of the NSCH data collection period.

Such numbers were not contacted a

second time for the NSCH. Instead,

these cases were automatically finalized.

Response rates reflect the final

disposition of a telephone line from its

original sampling.

NSCH Sampling Design and

Allocation

The number of children required to

be selected in each IAP area within a

State with multiple IAP areas was

determined by allocating the total of

2,000 children in the State among the

IAP areas in proportion to their total

number of households with children

under 18 years of age. Then, the number

of households that needed to be

screened in each IAP area was

calculated using the expected proportion

of households with children in the

eligible age range. State-level estimates

of the proportion of households with

age-eligible children were obtained from

the Current Population Survey (CPS)

and applied to all IAP areas within a

State. The number of telephone numbers

that needed to be called was then

computed, using the expected working

residential telephone number rate. The

number of telephone numbers that

needed to be called was then increased

to compensate for a degree of

nonresponse because not all respondents

will agree to participate.

A random subsample of the

telephone numbers to be called for the

NIS in each IAP area was selected to

become the NIS/NSCH sample. The size

of this subsample was equivalent to the

number of telephone numbers

determined necessary to achieve the

required number of NSCH-completed

interviews. These NIS/NSCH numbers

were called in an attempt to first

identify NIS-eligible households, and

then to identify households that were

eligible for the NSCH. Any household

with at least one child under 18 years of

age was considered eligible for the

NSCH, and all households that were

NIS-eligible were also NSCH-eligible.

One child under 18 years of age was

selected at random from each NSCH

age-eligible household. The selection of

the sample was spread over four

quarters of NIS data collection (Quarters

1–4 of 2003). The split of the total

sample among quarters varied across

IAP areas.

Sampling Weights

To produce population-based

estimates, each respondent household

and child for whom complete data were

available was assigned a sampling

weight. These sampling weights

compensate for varying probabilities of

selection of households and children

because of stratification by IAP area and

clustering of children within households.

Also, the weights are needed to account

for nonresponding households and for

noncoverage of households without

telephones (i.e., only households with

telephones were included in the

sampling frame).

The sampling weight combines (a)

the IAP area base weight, which reflects

the probability of selecting the

household telephone number; (b) an

adjustment for households with multiple

telephone numbers; and (c) adjustments

for unit nonresponse at various data

collection phases. A child-level

interview weight was determined for

responding children in each State. These

State weights allow the production of

State-level estimates. The national

estimate is obtained by aggregating the

State-level estimates. There is no

separate national weight. The method of

determining the overall weight for each

respondent child in the survey is

described below.

Base Sampling Weight

As mentioned, a sample of

telephone numbers was selected in each

IAP area, spread over four quarters of

NIS data collection. In the NIS, an

independent sample of telephone

numbers is selected each quarter. A

telephone number could have been

selected for the NSCH in any of the

four quarters of the data collection

period. Once a telephone number was

selected, it was not selected again for

data collection in subsequent quarters.

To compute the base sampling weight,

the overall probability of selection was

determined, considering the probabilities

of selection in the different quarters.

Let the number of quarters over

which the total sample is selected be q.

Let pi denote the probability of selecting

a telephone number in the ith quarter

and p the overall probability of selection

of the telephone number of the

household. Then

p = ∑

i = 1

q

pi

Since the sample was selected over four

quarters, we have:

p1 = n1

N1

for the first quarter, where n1 is the

number of telephone numbers selected

in the first quarter and N1 the number of

telephone numbers available for

selection;

p2 = (1 – n1

N1

)

n2

N2

for the second quarter, where n2 is the

number of telephone numbers selected

in the second quarter and N2 the number

of telephone numbers available for

selection;

p3 = (1 – n1

N1

) (1 – n2

N2

)

n3

N3

for the third quarter, where n3 is the

number of telephone numbers selected

in the third quarter and N3 the number

of telephone numbers available for

selection; and

p4 = (1 – n1

N1

) (1 – n2

N2

) (1 – n3

N3

)

n4

N4

for the fourth quarter, where n4 is the

number of telephone numbers selected

in the third quarter and N4 the number

of telephone numbers available for

selection.

The base sampling weight for a

household in a particular IAP area is

given by w =1/ p. Generally, this

weight is the same for all households

within an IAP area.

Because the selection of telephone

numbers uses simple random sampling,

the probability of selection in each IAP

area in each quarter is simply the

number of telephone numbers selected

divided by the total number of telephone

numbers available for selection.

Page 26 [ Series 1, No. 43
Households with Multiple Telephone

Lines

The base sampling weight of

eligible households that have multiple

voice-use telephone lines was adjusted

to compensate for the higher probability

of selection of these households. The

adjustment divides the base sampling

weight by the number of telephone lines

in that household. Let tk denote the

number of telephone lines in the kth

household in an IAP area. The adjusted

base sampling weight for that household

is given by

wk =

w

tk

If the household had only one telephone

line, then the adjusted weight is the

same as the base sampling weight.

Unit Nonresponse Adjustment 1

(Residential Status Unknown)

When a selected telephone number

is called, three results are possible: (a)

the number called is a household, (b)

the number called is not a working

residential number (it could be a

business number or nonworking

number), or (c) there is a nonresponse to

the screening attempt and the residential

status of the telephone number is

unknown. In the NSCH, a minimum of

10 call attempts were made before a

number was assigned unresolved status.

Adjustment of the base sampling

weight to account for possible

residential numbers in the third category

described above occurred in two steps.

First, unresolved telephone numbers that

had been finalized as ‘‘ring-no-answer at

all attempts’’ were redistributed as

follows: 20.4% were grouped with

known, unscreened households (the first

category above), and 79.6% were

grouped with nonresidential numbers

(the second category above). This

redistribution is based on recent research

in which national data were collected to

estimate the percentage of residential

telephone numbers among unresolved

numbers in the ‘‘ring-no-answer at all

attempts’’ group (26). Second,

adjustment of the base sampling weight

to account for nonresponse in the

remaining ‘‘category 3’’ numbers is the

same as the method used in the NIS.

This method is described in detail in the

1998 NIS Annual Methodology Report

(31). In the NIS, information external to

the survey is used to reallocate these

unknown numbers to either residential

or nonresidential numbers.

Among the n telephone numbers in

an IAP area, let the number of telephone

numbers in each of the three categories

mentioned above be n1, n2, and n3,

respectively. The first nonresponse

adjustment factor is

A1 =

n1 + n^31

n1

where n^31 is the estimated number of

households among the n3 in the ‘‘status

unknown’’ category. The procedure for

estimating the number of households in

the unknown category is based on a

study conducted in 1994 and 1995, in

which telephone company business

offices were asked to report on the

status of a sample of category 3

telephone numbers (32). The results of

the study showed that the proportion of

residential numbers varies according to

IAP area regional grouping, whether the

telephone number was directory-listed,

and the type of noncontact (e.g.,

ring-no-answer versus answering

machine). Therefore, the nonresponse

adjustment factor within each IAP area

was calculated for a set of numbers

defined by IAP area grouping, calling

disposition code, and whether the

number was directory-listed. To keep the

notation simple, the adjustment factor is

denoted by A1, although it could differ

among households within each IAP area.

The nonresponse-adjusted base sampling

weight after nonresponse adjustment 1

for the kth household in an IAP area is

given by

A1wk

The adjusted weight is for all known

households.

Unit Nonresponse Adjustment 2

(Households of Unknown Eligibility)

A second form of nonresponse may

occur because a household does not

complete the screener questions relating

to the eligibility of the household for the

survey. Therefore, for these telephone

numbers identified as belonging to a

household, there is no determination of

eligibility. A description of the

adjustment for this form of nonresponse

follows. The adjustment is done

separately within three urban setting

categories based on census-defined

metropolitan statistical areas (MSAs).

The three categories, from most urban to

most rural, used for the adjustment are

within a central city of an MSA; outside

of a central city, but still within an

MSA; and not within an MSA.

Let the number of households

(within each urban setting category)

screened to be eligible out of the n1

households contacted be q1. Let the

number of households screened to be

ineligible be q2. Let q3 denote the

number of households that are

nonrespondents to the eligibility

question. Then

n1 = q1 + q2 + q3

The nonresponse adjustment to the

sampling weight to account for not

being able to determine the eligibility of

q3 households is given by

A2 =

∑

k = 1

n1

A1wk

∑

k = 1

q1 + q2

A1wk

The adjustment given above is

algebraically equivalent to estimating

the weighted proportion of eligible

households among the q3 households

and redistributing that weight among the

q1 eligible households.

The nonresponse-adjusted base

sampling weight after nonresponse

adjustment 2 is given by

wak = A2A1wk

This adjusted weight is determined for

all eligible households in which a

screening interview was completed.

Child Interview Weight

In households with more than one

child, all children were rostered by age

and a single child was randomly

selected from among all children in the

household to be the focus of the

interview. In households with multiple

eligible children, the randomly selected

child represents all of the nonselected

children in the household. Therefore, the

Series 1, No. 43 [ Page 27
sampling weight for this completed

interview must be increased to reflect

the fact that this completed interview

represents multiple children in that

household. This adjustment simply

multiplies the child weight by the

number of eligible children in the

household. Let the number of children

in kth household in an IAP area be Nk.

One child was randomly selected

from every age-eligible household. The

sampling weight for the selected child is

wc

k = wak Nk

Poststratification Weight Adjustment

for Child Interview Weights

Despite the weighting efforts and

nonresponse adjustments, the estimated

number of children is unlikely to match

the total number of children in the

population. Any discrepancies are likely

to be due to random sampling error and

nonrandom response biases. These

biases include bias because of

nonresponse related to age, sex, or race

of the child. Poststratification adjusts the

weights to match population control

totals for key demographic variables

obtained from an independent source.

Through this process, the NSCH child

interview weight was further adjusted,

such that the sum of the weights over

all children agrees with population

control totals. The sample of

interviewed households was divided into

cells representing more-detailed

categories of selected variables.

Poststratification adjustments were not

done in each cell formed by the

cross-classification of the categories of

the stratification variables, because

control totals for each cell were not

available. Only the marginal population

control totals were determined.

Therefore, for adjusting the weights,

raking (33) was used. Raking iteratively

adjusts the weights so that they match

the marginal control totals.

For the NSCH child weight, the

initial source for population control

totals was the July 2003 Census Bureau

State-level estimates of the number of

male and female children in three age

groups (0–4 years, 5–13 years, 14–17

years). The number of children

according to the Census Bureau in the

resulting six ‘‘age by gender’’ categories

includes institutionalized children.

Because the NSCH was a survey of

noninstitutionalized children, these

numbers had to be adjusted to reflect

that population. To make this

adjustment, the total number of children

(including institutionalized children) in

each ‘‘age by gender’’ category in each

State was estimated from the Census

2000 5% Public Use MicroData Sample

(PUMS) files. Then, the number of

noninstitutionalized children in each

‘‘age by gender by race’’ category

(within each age by gender category)

was likewise estimated. The ratio of the

number of children in each ‘‘age by

gender by race’’ category to the total

number of children in the ‘‘age by

gender’’ category was computed. For

each ‘‘age by gender’’ category, there

were seven ratios because there were

seven race categories. (These ratios do

not add up to 1.0 because the

denominator includes the

institutionalized children whereas the

numerator only includes

noninstitutionalized children.) The

resulting 42 ratios were then applied to

the corresponding control totals for ‘‘age

by gender’’ to produce control totals of

noninstitutionalized children in each of

the ‘‘age by gender by race’’ categories

in each State. The total of all the 42

categories gave the overall total number

of children in the State, used in all the

raking margins. Various aggregations of

the 42 categories resulted in the

following dimensions for raking:

+ Number of male and female children

in three age groups.

+ Number of children of various racial

and ethnic backgrounds.

+ Number of male and female children

by race/ethnicity.

Poststratification control totals were

also produced, using 2000 5% PUMS

data, for the number of children in the

following three margins.

+ Number of children in households

with fewer than two adults and in

households with two or more adults.

+ Number of children in households

with one child, with two children,

and with three or more children.

+ Number of children in households in

which the highest-educated person

has a high school diploma or less

and in households in which the

highest-educated person has more

than a high school diploma.

For determining these totals, the

proportion of children in each category

was obtained from the 2000 5% PUMS

and applied to the total number of

children in each State as obtained from

aggregating, by State, the 42 control

totals described earlier.

The poststratification process also

includes an adjustment for the potential

bias that may exist because the NSCH,

as a telephone survey, could not select

households without a telephone at the

time of the survey. This adjustment

incorporated information about

households with interrupted telephone

service from the NSCH. The reason for

using households with interrupted

telephone service in the weighting

process is as follows. Evidence suggests

that households with telephones at the

time of the survey, but with

interruptions in telephone service during

the year, are more similar to households

with no telephone service at the time of

the survey than households with

uninterrupted telephone service during

the year (27–30). Therefore,

nonresponse by nontelephone

households can be somewhat

compensated by proportionately

increasing the weights for those

interviews that could be completed in

households with interrupted service. In

this way, completed interviews in

households with interrupted service

represent the incomplete interviews in

households without telephone service at

the time of the interview.

To make this adjustment, two

control totals were formed. The first is

the total number of children in

households with telephone service, but

with no interruptions in telephone

service during the past year. The second

is the total number of children in

households with telephones, but with

interruptions in telephone service and

children in households with no

telephone service during the past year.

To determine the control totals, the

proportion of children in telephone and

nontelephone households was first

determined from the 5% PUMS. Let ps

Page 28 [ Series 1, No. 43
denote the proportion of children in

telephone households in a state obtained

from the 5% PUMS. (1 – ps) denotes the

proportion of children in nontelephone

households. The proportion ps is

adjusted to reflect the national

proportions from the CPS. This is done

by multiplying the PUMS-derived

proportion for the state by the ratio of

the CPS national proportion of children

in telephone households to the

PUMS-derived national proportion. This

gives the adjusted proportion of children

in telephone households in the state. Let

pn denote the national proportion of

children in telephone households based

on the data from PUMS. Let p*

n denote

the national proportion of children in

telephone households obtained from the

2003 CPS March Supplement.

The adjusted state proportion of children

in telephone households is

ps

* = ps

pn

*

pn

.

The adjusted proportion of children in

nontelephone households is (1–p*

s).

These proportions were then applied

to the State control total of the number

of children to get the estimated numbers

of children in the State in telephone and

nontelephone households. Let Ns be the

total number of children in the State.

The number of children in telephone

households was estimated as

Ns

t

= Ns ps

*

The number of children in nontelephone

households in the state is Ns – Nt

s .

From the NSCH, the weighted

proportion of children in telephone

households having an interruption in

telephone service of at least 1 week

during the past 12 months was

computed. This proportion was then

applied to the number of children in

telephone households to estimate the

number of children in telephone

households with interruption.

Let the weighted proportions of

children in households with an

interruption in telephone service in the

state be pIt

s. The number of children in

telephone households with interruptions

in telephone service is given by

NIt

s = Nts pIts . The number of children in

telephone households without

interruptions in telephone service is

given by Nt

s – NIts .

Based on these calculations, two

control totals, as described earlier, were

produced:

These were Nt

s – NIts and NIts +

(Ns – Nt

s).

The final child interview weight for

the responding child in household k in

an IAP area is denoted by wc

kf.

Imputation of Missing Values of

Poststratification Variables

Missing values for variables

required for poststratification were

imputed using Weighted Sequential

Hotdeck (34). Details regarding the

imputation appear in table I. Only 2.6%

of the 102,353 cases required imputation

of any variable and no single variable

required imputation in more than 1.3%

of cases.

Trimming Weights

In sample surveys, very large or

extreme sampling weights are often

truncated or ‘‘trimmed’’ as large

variation in weights can result in large

sampling variances of the survey

estimates. This is especially true if the

sampling weights are not correlated with

the values or characteristics of interest.

In such cases, the few observations

having very large weights may

contribute unduly to the overall

estimate. Sometimes, large variation in

weights is a result of a design in which

the probabilities of selection of sampling

units are positively correlated with

values of observations on those units.

Large weights can also be a result of

sample selection procedures and

adjustments for unit nonresponse.

Although a trimming procedure

reduces the variance of the estimates, it

may result in increased bias in the

estimates. The objective of trimming is

to reduce the variance so that the

reduction more than compensates for the

increase in bias, resulting in a smaller

mean squared error than before

trimming. Therefore, it is advisable to

minimize trimming as much as possible.

No strict rules or procedures for

defining extreme weights or trimming

such weights exist, and various methods

of weight trimming are practiced. In

some surveys that employ weighting,

the size of the nonresponse and other

adjustments to the base sampling

weights are restricted to avoid large

final weights altogether. Other surveys

examine the distribution of the final

weights to identify extreme weights and

propose trimming rules. This method is

more common because it is easier to

identify extreme weights by looking at

the entire distribution of the weights.

Some common procedures for

trimming weights are (a) to identify any

sampling weight larger than four or five

times the mean weight as an outlier

weight and trim that weight by making

it equal to the limit; (b) to identify any

weight larger than the median weight

plus five or six times the interquartile

range of the final weights and trim the

weight by making it equal to the limit;

and (c) to truncate weights above a

certain percentile (e.g., 95 or 99) in the

distribution of weights. The standard

deviation of weights is not used to guide

trimming because it is affected by

extreme weights.

Table I. Variables with imputed values

Variable

Number of

missing

values

Donor pool for weighted

hotdeck imputation

Sex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80 State

Number of adults. . . . . . . . . . . . . . . . . . . . . 184 State

Highest education . . . . . . . . . . . . . . . . . . . . 423 Race/ethnicity group within State

Ethnicity . . . . . . . . . . . . . . . . . . . . . . . . . . 1,092 State

Number of telephone lines . . . . . . . . . . . . . . . 1,139 Household size within Immunization

Action Plan area

Race (for non-Hispanic children only) . . . . . . . . 1,268 State

Interrupted telephone service . . . . . . . . . . . . . 1,298 Income group (<$30,000 or ‘‘don’t

know,’’ $30,000+ or ‘‘refused’’) within

State

Series 1, No. 43 [ Page 29
Typically, once trimming has been

done, the weights of those observations

with untrimmed weights are increased

so that the sum of the new weights

equals the sum of the weights before

trimming.

The NSCH examined the

distribution of the final weights to

identify extreme weights. If the overall

nonresponse adjustment factor exceeded

2.0, then it was trimmed to keep the

maximum value of the factor at 2.0.

A decision was made to define a

final weight as extreme if it exceeded

the median plus five times the

interquartile range to avoid undue

trimming. Using the final, poststratified

child interview weight as an example, a

formal description of the trimming

process applied is given below.

Let wkhf

c denote the final

poststratified sampling weight for the

responding child in the kth household in

stratum h in the sample. Let the number

of respondent children in the sample

with a final sampling weight be n. Let

wm be the median of these n weights.

Let the interquartile range be qr . Any

weight exceeding the value wm + 5qr is

truncated and set equal to wm + 5qr.

Assume that we have trimmed k

weights. The sum of the original

weights is ∑

i = 1

n

wikhf

c where

wc

ikhf is the weight for the i

th responding

child in the sample. The sum of the new

weights is ∑

i = 1

n–k

wikhf

c + k(wm + 5qr).

The two sums should be equal.

Therefore, the untrimmed weights are

adjusted by a factor equal to



i = 1

n

wikhf

c – k(wm + 5qr)

∑

i = 1

n – k

wikhf

c

This adjustment is done as part of

raking the weights such that the sum of

the weights agrees with various control

totals in the other margins. A final round

of raking occurs after trimming is

complete.

National Estimates

Descriptive statistics for the State

sampling weights are provided in

table II. The State sampling weights are

used to obtain estimates for each State.

To obtain national estimates of totals,

State estimates should be aggregated.

For computing national estimates of

ratios (e.g., the proportion of children

with health insurance coverage), the

ratio of the estimated number of

children with health care coverage in the

Nation is produced by aggregating the

State estimates and dividing this number

by the total number of children in the

United States, again by aggregating the

State totals.

Standard Errors of Estimates

Because of the complex design of

the NSCH, the interview records have

unequal weights. Therefore, statistical

software programs that assume simple

random sampling will most often

compute standard errors that are too

low. Tests of statistical hypotheses may

then suggest statistically significant

differences or associations that are

misleading. However, computer

programs are available that provide the

capability of variance estimation for

complex sample designs (e.g.,

SUDAAN, STATA, WesVar). To provide

the user with the capability of

estimating the complex sample variances

for the NSCH data, stratum identifiers

and primary sampling unit (PSU) codes

have been provided on the data files.

These variables and the sample weights

are necessary for calculating variances.

It should be noted that the stratum

identifiers reported on the data set are

not identical to the strata used for

drawing the sample. In States with

multiple Immunization Action Plan

(IAP) areas, independent samples were

selected from each IAP area in

proportion to the total number of

households with children in each IAP

area. Therefore, these IAP areas should

be considered strata for variance

estimation. However, disclosure of the

specific IAP area for each child (even if

the code were scrambled) could increase

the risk of disclosure of a respondent’s

identity. For example, the IAP area with

the lowest frequency of responses in

New Jersey would be readily

identifiable as Newark. In the absence

of IAP-specific identifiers, data users

should use the State identifier (STATE)

as the stratum identifier. By using the

State identifier rather than the

suppressed IAP identifier, the standard

errors for national and State estimates

with key variables are affected only

slightly and not in a consistent direction.

The PSU for the NSCH is the

household, represented on the data sets

by the unique household identifier,

IDNUMR.

Standard errors for the NSCH can

be obtained using the Taylor-series

approximation method, which is

available in software such as SUDAAN,

SAS, and STATA. The simplifying

assumption that PSUs have been

sampled with replacement allows most

complex survey sample design computer

programs to calculate Taylor-series

standard errors in a straightforward way.

This method requires no recoding of

design variables, but is statistically less

efficient (and therefore more

conservative) than some other methods

because the PSU unit is treated as being

sampled with replacement within the

stratum unit.

It should be noted that Taylor-series

approximation methods assume that the

weights are fixed. That is, in repeated

samples of households and children, the

weights attached to each child in an IAP

area are assumed to be constant. But the

final weights are obtained after various

adjustments to the base sampling

weight. These adjustments depend on

the sample selected. Therefore, the

variance estimates do not reflect the

sampling variability of the weights.

Thus, to a certain extent, there is

underestimation of variance. In addition,

there is a slight overestimation of

variance because of the assumption of

with-replacement sampling of

households when households were

actually selected without replacement.

The extent of underestimation depends

on the variability in weights in repeated

samples.

The underestimation may not be

severe as the weights have been raked

to multiple control totals and, therefore,

Page 30 [ Series 1, No. 43
may not be highly variable in repeated

samples. An alternative method of

variance estimation would use a

jackknife technique or a resampling

procedure such as bootstrap estimation.

For the NIS, jackknife variance

estimates of vaccination coverage rates

were computed, but were found to be

very similar to the estimates obtained

using Taylor-series approximation (35).

Table II. Summary statistics for interview weights for children, by State

State

Unweighted

sample size

Minimum

weight

Maximum

weight

Mean

weight

Median

weight

Sum of

weights

Alabama. . . . . . . . . . . . . . . . . . . 2,167 55.4 2,156.0 509.5 404.2 1,104,146

Alaska . . . . . . . . . . . . . . . . . . . . 1,904 12.1 453.4 98.9 85.9 188,239

Arizona . . . . . . . . . . . . . . . . . . . 1,919 123.6 3,163.8 788.3 671.8 1,512,819

Arkansas . . . . . . . . . . . . . . . . . . 1,878 26.6 1,610.9 361.5 319.7 678,939

California . . . . . . . . . . . . . . . . . . 2,223 650.7 17,611.3 4,218.7 3,166.8 9,378,237

Colorado . . . . . . . . . . . . . . . . . . 1,855 92.3 2,659.6 618.8 563.9 1,147,831

Connecticut . . . . . . . . . . . . . . . . . 2,146 42.6 1,469.8 387.7 346.9 832,105

Delaware . . . . . . . . . . . . . . . . . . 2,156 11.3 404.7 92.0 83.6 198,401

District of Columbia . . . . . . . . . . . . 2,049 4.3 233.1 52.5 37.0 107,485

Florida . . . . . . . . . . . . . . . . . . . . 2,116 196.5 6,954.8 1,846.7 1,464.0 3,907,632

Georgia . . . . . . . . . . . . . . . . . . . 1,864 119.7 6,213.1 1,227.0 1,094.8 2,287,060

Hawaii . . . . . . . . . . . . . . . . . . . . 2,021 17.4 688.3 146.5 111.1 269,099

Idaho. . . . . . . . . . . . . . . . . . . . . 1,861 36.9 897.5 199.0 203.3 370,344

Illinois . . . . . . . . . . . . . . . . . . . . 2,158 162.9 6,955.1 1,492.5 1,366.7 3,220,883

Indiana. . . . . . . . . . . . . . . . . . . . 1,874 131.1 4,002.7 852.1 753.8 1,596,856

Iowa . . . . . . . . . . . . . . . . . . . . . 1,949 58.3 1,675.8 353.9 349.2 689,667

Kansas . . . . . . . . . . . . . . . . . . . 1,849 48.5 1,663.6 374.7 338.8 692,847

Kentucky . . . . . . . . . . . . . . . . . . 1,953 52.3 2,218.3 506.9 434.2 990,015

Louisiana . . . . . . . . . . . . . . . . . . 2,241 59.1 2,246.1 523.3 423.7 1,172,697

Maine . . . . . . . . . . . . . . . . . . . . 1,920 22.4 735.6 148.7 140.7 285,571

Maryland . . . . . . . . . . . . . . . . . . 2,128 54.2 2,920.1 645.3 543.4 1,373,206

Massachusetts . . . . . . . . . . . . . . . 2,114 107.4 3,129.3 700.6 618.8 1,481,121

Michigan. . . . . . . . . . . . . . . . . . . 2,191 140.6 5,179.9 1,153.7 968.6 2,527,842

Minnesota. . . . . . . . . . . . . . . . . . 1,864 108.1 3,275.2 667.6 584.7 1,244,377

Mississippi . . . . . . . . . . . . . . . . . 2,035 42.1 1,673.9 372.1 294.0 757,175

Missouri . . . . . . . . . . . . . . . . . . . 2,220 101.6 2,766.1 631.3 553.1 1,401,584

Montana. . . . . . . . . . . . . . . . . . . 1,941 16.1 471.0 110.4 103.3 214,360

Nebraska . . . . . . . . . . . . . . . . . . 1,874 32.7 1,087.0 233.9 208.3 438,253

Nevada . . . . . . . . . . . . . . . . . . . 2,064 45.2 1,187.0 280.5 243.2 579,030

New Hampshire . . . . . . . . . . . . . . 1,925 26.3 679.5 158.6 157.8 305,278

New Jersey . . . . . . . . . . . . . . . . . 2,113 115.9 4,024.2 1,005.8 847.6 2,125,387

New Mexico . . . . . . . . . . . . . . . . 1,848 47.7 1,177.5 270.5 218.6 499,905

New York . . . . . . . . . . . . . . . . . . 2,021 298.7 10,318.9 2,228.2 1,842.0 4,503,196

North Carolina . . . . . . . . . . . . . . . 2,084 112.1 4,197.4 998.4 893.7 2,080,668

North Dakota . . . . . . . . . . . . . . . . 1,955 11.4 348.2 74.8 71.6 146,143

Ohio . . . . . . . . . . . . . . . . . . . . . 2,241 190.5 5,853.3 1,252.9 1,119.3 2,807,666

Oklahoma . . . . . . . . . . . . . . . . . . 1,937 52.0 1,973.2 451.6 396.2 874,700

Oregon . . . . . . . . . . . . . . . . . . . 1,969 65.7 1,765.0 429.4 434.5 845,439

Pennsylvania . . . . . . . . . . . . . . . . 2,200 182.8 5,909.3 1,279.8 1,063.9 2,815,445

Rhode Island . . . . . . . . . . . . . . . . 2,019 15.4 512.3 120.2 106.8 242,682

South Carolina . . . . . . . . . . . . . . . 2,157 63.7 2,125.0 472.4 437.8 1,019,067

South Dakota. . . . . . . . . . . . . . . . 1,868 13.5 530.6 103.1 90.5 192,623

Tennessee . . . . . . . . . . . . . . . . . 1,922 83.4 2,948.8 722.5 573.2 1,388,714

Texas . . . . . . . . . . . . . . . . . . . . 2,179 332.0 10,960.5 2,853.3 2,447.1 6,217,276

Utah . . . . . . . . . . . . . . . . . . . . . 1,483 84.3 2,186.9 498.8 413.6 739,705

Vermont . . . . . . . . . . . . . . . . . . . 1,902 10.7 318.9 72.0 63.9 137,011

Virginia . . . . . . . . . . . . . . . . . . . 2,179 94.7 3,634.4 822.6 736.5 1,792,362

Washington . . . . . . . . . . . . . . . . . 1,932 119.3 3,510.0 771.9 708.1 1,491,391

West Virginia . . . . . . . . . . . . . . . . 2,022 33.9 838.6 192.5 161.9 389,291

Wisconsin . . . . . . . . . . . . . . . . . . 1,970 104.1 3,180.5 674.0 611.1 1,327,839

Wyoming . . . . . . . . . . . . . . . . . . 1,893 7.2 269.8 63.6 60.5 120,356

Series 1, No. 43 [ Page 31
Appendix II

Description of the

Incentive Effort

Introduction

During data collection for the

SLAITS National Survey of Children’s

Health (NSCH), it became clear that

response rates were lower than would be

expected from the rates observed in the

earlier SLAITS National Survey of

Children with Special Health Care

Needs, which also sampled children

under the age of 18. A review of the

NSCH rates made it clear that

increasing the interview completion rate,

the percentage of completed interviews

among eligible respondents, would have

the most impact on the overall response

rate.

The methods considered for

increasing the study’s completion rate

included paid incentives, which have

increased response in such studies as the

Medical Expenditure Panel Survey and

the National Survey of America’s

Families. A pretest was implemented to

examine the impact of a paid incentive

on NSCH response in known

households with children that had not

completed an interview. Based on the

results of the pretest, the use of

incentives was substantially expanded.

This appendix describes the

methodology used for the NSCH

incentive effort and its resulting impact

on response rates.

Pretest

Known households with children

that had not completed an interview

were eligible for the incentive effort.

The sample included both

nonrespondents who had refused to

participate and those who were not

reached within the data collection period

despite multiple attempts. Two types of

households were excluded from the

sample: those that gave a ‘‘hostile’’

refusal and those that asked to be

removed from the calling list.

The pretest sample included

households with children who were

initially called in April, May, or June of

2003 (n = 10,904). These cases were

divided into two groups. The first group

could receive $15, and the second group

could receive $25. The two groups were

further divided so that half received an

initial $5 of the payment enclosed with

a letter sent prior to any new call

attempts. The letter notified these

nonrespondents of the additional $10 or

$20 payment in appreciation for

completing the interview. The other half

of the sample in each group was mailed

a letter without an initial payment. This

letter notified nonrespondents of the full

$15 or $25 payment in appreciation for

completing the interview. In cases where

an address could not be matched to a

sampled telephone number, no letter

could be mailed to the household.

Instead, the household was called, and

the full payment was offered at that

time.

In summary, the varying payment

amounts, payment schemes, and letter

conditions produced a total of six

treatment groups (table III). Copies of

the letters used in the incentive effort

appear in ‘‘Appendix VI.’’ All payments

after completion of an interview were

mailed with a thank-you letter, which is

also included in ‘‘Appendix VI.’’

All letters appeared on National

Center for Health Statistics (NCHS)

letterhead and were mailed using 3-day

Federal Express service. A signature was

required for delivery, but the delivery

person’s signature was accepted to

minimize respondent burden. Calling

rules were similar to those used for

NSCH data collection in general (i.e.,

cases were finalized after two verbal

refusals, three hang-ups during the

introduction, or a combination of one

verbal refusal and two hang-ups during

the introduction). The sole exception to

the usual rules was that a single refusal

by the identified respondent for the

sampled child resulted in the case being

immediately finalized. Prior to each

interview, informed consent information

was again read to ensure that all

respondents had received it.

The pretest was designed to address

a number of issues related to the impact

of incentives in general and the impact

of the incentive amounts and payment

methods, including:

a) Does either incentive amount

produce a significant increase in

the response rate?

b) Does the larger incentive amount

($25) produce a greater increase

than the smaller amount ($15)?

c) Does sending an initial $5

payment with the advance letter

have a significant effect on the

response rate?

d) Does re-contacting eligible

nonrespondents lead to a

substantial number of complaints

(e.g., to the NCHS Research

Ethics Review Board)?

Data collection for the pretest began

on November 21, 2003. After the first

few weeks, preliminary results were

reviewed to determine whether it was

possible to refine procedures for the

remainder of the test. Table IV shows

preliminary response rates for each of

the six treatments based on replicates

(or subsamples) released at the

beginning of the pretest. The completion

rates shown are calculated by dividing

the number of completed interviews by

the total number of cases released for

each treatment.

Table III. Characteristics of treatment groups for the National Survey of Children’s Health

incentive effort

Selected characteristic

$25 incentive $15 incentive

Group

A

Group

B

Group

C

Group

D

Group

E

Group

F

Advance mailing . . . . . . . . . . . . . . Yes Yes No Yes Yes No

Amount of payment included with

advance mailing . . . . . . . . . . . . . $ 5 $ 0 ... $ 5 $ 0 ...

Amount of payment upon completion

of interview . . . . . . . . . . . . . . . . $ 20 $ 25 $ 25 $ 10 $ 15 $ 15

. . . Category not applicable.

Page 32 [ Series 1, No. 43
Analyses of these preliminary

results showed a statistically significant

difference between completion rates for

the groups that received an initial $5

payment (A and D) and those that

received only a letter with a promise of

full payment upon interview completion

(B and E). Thus, Group B ($0/$25) was

merged with Group A ($5/20), and

Group E ($0/$15) was merged with

Group D ($5/10) in the last of the test

mailings. Hence, all remaining

address-matched cases received an

initial mailing that included a $5

prepayment. Preliminary differences by

incentive amount (Groups A–C vs.

Groups D–F) were not statistically

significant, so it was decided to continue

pretest data collection using both

amounts. Response rates in Groups C

and F lagged behind the other groups as

might be expected because they did not

receive an advance mailing to alert them

of the incentive for interview

completion.

Pretest data collection ended on

March 24, 2004, with 3,790 completed

interviews. Final pretest results (table V)

echoed those from the preliminary

analyses, with no statistically significant

difference by incentive amount.

Expanded Incentive Effort

The pretest results made it clear that

incentives had a positive impact on

survey response, but that the amount of

the incentive produced no significant

difference in response. Further,

re-contacting eligible nonrespondents

resulted in very few complaints from

contacted households. Therefore, the

incentive effort was substantially

expanded to include other cases from

NSCH data collection (i.e., those

initially called from January to March

and July to December 2003). These

nonresponding households with children

were offered a total of $15, with an

initial payment of $5 enclosed in a letter

sent prior to any new call attempts if an

address was known.

The number of remaining cases to

be fielded was based on a reduced target

of 1,850 completed interviews in most

States, with incentive cases released

selectively, as needed, to reach that

target. However, in States that had an

especially low response rate (i.e., an

interview completion rate below 62.0%),

all eligible incentive cases were fielded

although the release of all such cases

was likely to result in more than 2,000

interviews completed in those States.

This plan took advantage of incentive

use in the geographic areas where it

would have the most impact on the

overall weighted response rate for the

study.

Data collection for the expanded

incentive effort began on February 25,

2004 (prior to the end of the pretest)

and ended on July 1, 2004. A total of

24,222 cases were fielded, resulting in

6,800 completed interviews. Combining

these 6,800 interviews with the 3,790

completed during the pretest, a total of

10,590 interviews were completed as

part of the incentive effort. Of the

10,590 interviews, 1,697 (16.0%) were

completed with respondents who called

the project’s toll-free telephone number

in order to participate.

Impact of the Incentive Effort

The NSCH incentive effort

increased the number of completed

interviews from 91,763 to 102,353. The

study’s weighted interview completion

rate increased from 60.7% to 68.8%,

with a resulting increase in the overall

weighted response rate from 48.8% to

55.3% (table VI).

Table VII shows overall weighted

response rates by State prior to and after

implementation of incentives. The

increase in the overall response rate

after incentives ranged from

1.6 percentage points in Maine to

10.0 percentage points in Ohio. The

average increase was 5.5 percentage

points, with 31 States having an increase

of at least 5.0 percentage points.

Table IV. Preliminary response rates and sample sizes for the incentive pretest, by

treatment group

Rate and size

$25 incentive $15 incentive

Group

A

Group

B

Group

C

Group

D

Group

E

Group

F

Completion rate . . . . . . . . . . . . . . 47.9 37.5 18.5 43.9 36.5 16.3

Sample size . . . . . . . . . . . . . . . . 1,125 1,111 611 1,093 1,110 606

Table V. Final incentive effort response rates by treatment group

Rate and size

$25 incentive $15 incentive

Group

A

Group

B

Group

C

Group

D

Group

E

Group

F

Completion rate . . . . . . . . . . . . . . 44.9 37.5 18.3 39.8 36.5 16.7

Sample size . . . . . . . . . . . . . . . . 3,155 1,111 1,193 3,135 1,110 1,195

Series 1, No. 43 [ Page 33
Table VI. Impact of the incentive effort on number of completed interviews and study

response rates

Selected characteristic

Prior to

incentive effort

After

incentive effort

Number of completed interviews . . . . . . . . . . . 91,763 102,353

Interview completion rate. . . . . . . . . . . . . . . . 60.7 68.8

CASRO response rate1. . . . . . . . . . . . . . . . . 48.8 55.3

1CASRO is Council of American Survey Research Organizations. The CASRO rate is the product of the resolution rate, the

screener completion rate, and the interview completion rate.

Table VII. Weighted overall response rates by State prior to and after incentive effort

State

Rate prior to

incentive effort

Rate after

incentive effort

National . . . . . . . . . . . . . . . . . . . . . . . . . . 48.8 55.3

Alabama . . . . . . . . . . . . . . . . . . . . . . . . . . 48.3 56.5

Alaska . . . . . . . . . . . . . . . . . . . . . . . . . . . 58.6 60.4

Arizona. . . . . . . . . . . . . . . . . . . . . . . . . . . 50.6 52.5

Arkansas . . . . . . . . . . . . . . . . . . . . . . . . . 53.7 56.3

California . . . . . . . . . . . . . . . . . . . . . . . . . 45.3 52.1

Colorado. . . . . . . . . . . . . . . . . . . . . . . . . . 53.0 58.4

Connecticut . . . . . . . . . . . . . . . . . . . . . . . . 47.8 54.5

Delaware . . . . . . . . . . . . . . . . . . . . . . . . . 46.7 53.5

District of Columbia . . . . . . . . . . . . . . . . . . . 46.2 52.3

Florida . . . . . . . . . . . . . . . . . . . . . . . . . . . 44.2 51.0

Georgia . . . . . . . . . . . . . . . . . . . . . . . . . . 50.1 52.1

Hawaii . . . . . . . . . . . . . . . . . . . . . . . . . . . 45.3 50.5

Idaho . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56.5 60.8

Illinois . . . . . . . . . . . . . . . . . . . . . . . . . . . 47.5 54.8

Indiana . . . . . . . . . . . . . . . . . . . . . . . . . . . 52.2 55.2

Iowa . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53.7 56.5

Kansas. . . . . . . . . . . . . . . . . . . . . . . . . . . 54.7 59.1

Kentucky. . . . . . . . . . . . . . . . . . . . . . . . . . 51.0 59.9

Louisiana . . . . . . . . . . . . . . . . . . . . . . . . . 46.3 55.5

Maine. . . . . . . . . . . . . . . . . . . . . . . . . . . . 53.7 55.3

Maryland. . . . . . . . . . . . . . . . . . . . . . . . . . 46.0 53.0

Massachusetts . . . . . . . . . . . . . . . . . . . . . . 47.4 53.6

Michigan . . . . . . . . . . . . . . . . . . . . . . . . . . 49.5 58.9

Minnesota . . . . . . . . . . . . . . . . . . . . . . . . . 53.3 58.9

Mississippi. . . . . . . . . . . . . . . . . . . . . . . . . 45.1 53.6

Missouri . . . . . . . . . . . . . . . . . . . . . . . . . . 51.4 61.2

Montana . . . . . . . . . . . . . . . . . . . . . . . . . . 59.2 62.0

Nebraska . . . . . . . . . . . . . . . . . . . . . . . . . 56.2 61.6

Nevada . . . . . . . . . . . . . . . . . . . . . . . . . . 47.4 53.7

New Hampshire . . . . . . . . . . . . . . . . . . . . . 49.5 51.3

New Jersey . . . . . . . . . . . . . . . . . . . . . . . . 42.7 49.6

New Mexico. . . . . . . . . . . . . . . . . . . . . . . . 55.4 58.8

New York . . . . . . . . . . . . . . . . . . . . . . . . . 46.2 53.3

North Carolina . . . . . . . . . . . . . . . . . . . . . . 50.1 59.3

North Dakota . . . . . . . . . . . . . . . . . . . . . . . 55.8 59.5

Ohio . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50.4 60.4

Oklahoma . . . . . . . . . . . . . . . . . . . . . . . . . 52.8 54.9

Oregon. . . . . . . . . . . . . . . . . . . . . . . . . . . 55.1 57.5

Pennsylvania . . . . . . . . . . . . . . . . . . . . . . . 48.9 57.7

Rhode Island . . . . . . . . . . . . . . . . . . . . . . . 48.8 57.1

South Carolina . . . . . . . . . . . . . . . . . . . . . . 47.8 55.5

South Dakota . . . . . . . . . . . . . . . . . . . . . . . 59.2 64.4

Tennessee. . . . . . . . . . . . . . . . . . . . . . . . . 50.3 52.2

Texas. . . . . . . . . . . . . . . . . . . . . . . . . . . . 49.1 56.7

Utah . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55.4 64.0

Vermont . . . . . . . . . . . . . . . . . . . . . . . . . . 58.4 60.4

Virginia. . . . . . . . . . . . . . . . . . . . . . . . . . . 48.5 56.7

Washington . . . . . . . . . . . . . . . . . . . . . . . . 52.1 54.0

West Virginia . . . . . . . . . . . . . . . . . . . . . . . 49.7 56.4

Wisconsin . . . . . . . . . . . . . . . . . . . . . . . . . 53.2 55.3

Wyoming . . . . . . . . . . . . . . . . . . . . . . . . . 57.3 60.0

Page 34 [ Series 1, No. 43
Series 1, No. 43 □ Page 35

NATIONAL SURVEY OF CHILDREN’S HEALTH, 2003 

Health Resources and Services Administration 

Maternal and Child Health Bureau 

Centers for Disease Control and Prevention 

National Center for Health Statistics 

State and Local Area Integrated Telephone Survey 

INTERVIEW SECTIONS 1-11

OMB Control Number 

Public reporting burden of this collection of information is estimated to average 25 minutes per response, including 

the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and 

completing and reviewing the collection of information. An agency may not conduct or sponsor, and a respondent is 

not required to respond to, a collection of information unless it displays a currently valid OMB control number. 

Send comments regarding this burden estimate or any other aspect of this collection of information, including 

suggestions for reducing this burden, to CDC/ATSDR Reports Clearance Officer, 1600 Clifton Road, MS D-24, 

Atlanta, GA 30333, ATTN: PRA (0920-0406). Do not return the completed form to this address. 

OMB Control Number: 0920-0406 

Expiration Date: November 30, 2007 

Confidentiality 

Information contained on this form which would permit identification of any individual or establishment has been 

collected with a guarantee that it will be held in strict confidence by CDC and its contractors, will be used only for 

purposes stated in this study, and will not be disclosed or released to anyone other than authorized staff of CDC 

without the consent of the individual or establishment in accordance with Section 308(d) of the Public Health 

Service Act (42 U.S.C. 242). 
Page 36 □ Series 1, No. 43 

Screening and Sampling Section

 

NIS INTRODUCTION AND SCREENER

Hello, my name is [INTERVIEWER NAME]. I’m calling on behalf of the Centers for Disease 

Control and Prevention. We’re conducting a nationwide immunization study to find out how 

many children under 4 years of age are receiving all of the recommended vaccinations for 

childhood diseases. Your number has been selected at random to be included in the study. 

Am I speaking to someone who lives in this household who is over 17 years old? 

IF YES, PROCEED. 

How many children between the ages of 12 months and 3 years old are living or staying in your 

household? 

IF ONE OR MORE, CONDUCT NIS INTERVIEW AND THEN PROCEED TO 

S_UNDR18. 

 

 IF NONE, PROCEED TO S_UNDR18. 

S_UNDR18 How many people less than 18 years old live in this household? 

 

 00 PEOPLE 

 01 PERSON 

 02 PEOPLE 

 03 PEOPLE 

 04 PEOPLE 

 05 PEOPLE 

 06 PEOPLE 

 07 PEOPLE 

 08 PEOPLE 

 09 PEOPLE 

 

 (96) DON’T KNOW [TERMINATE] 

 (97) REFUSED [TERMINATE] 

IF SUNDR18 > 01 [SKIP TO AGE GRID] 

ELSE IF SUNDR18 =00 [SKIP TO NOCHILD] 

NOCHILD Those are all the questions I have. I’d like to thank you on behalf of the Centers for Disease 

Control and Prevention for the time and effort you’ve spent answering these questions. 

[TERMINATE] 
Series 1, No. 43 □ Page 37

AGE GRID CATI INSTRUCTIONS (AGE GRID): APPLY THIS FILL INSTRUCTION TO EACH OF 

THE INTRODUCTIONS BELOW: IF ONE CHILD UNDER 18 IN THE HOUSEHOLD, 

FILL “age” and “child.” IF MORE THAN ONE CHILD FILL “ages” AND “children.” 

INTRODUCTION #1 (DISPLAYED FOR NIS-INELIGIBLE HOUSEHOLDS): 

Many of my questions are for children of certain ages. So, I’ll know which questions to 

ask, please tell me the [age/ages] of the [child/children] less than 18 years old living in 

this household. FOR ALL SUBSEQUENT ROWS OF AGE GRID, DISPLAY: (Please 

tell me the age of the next child who lives in this household.) 

INTRODUCTION #2: (DISPLAYED FOR NIS-ELIGIBLE HOUSEHOLDS): 

Would you please tell me the [age/ages] of the other [child/children] living in this 

household? FOR ALL SUBSEQUENT ROWS OF AGE GRID DISPLAY: (Please 

tell me the age of the next child who lives in this household.) 

 YEARS MONTHS

SCQ03A1 __ __ SCQ03B1 __ __ 

SCQ03A2 __ __ SCQ03B2 __ __ 

SCQ03A3 __ __ SCQ03B3 __ __ 

SCQ03A4 __ __ SCQ03B4 __ __ 

SCQ03A5 __ __ SCQ03B5 __ __ 

SCQ03A6 __ __ SCQ03B6 __ __ 

SCQ03A7 __ __ SCQ03B7 __ __ 

SCQ03A8 __ __ SCQ03B8 __ __ 

SCQ03A9 __ __ SCQ03B9 __ __ 

HELP SCREEN (S1Q05): EACH CHILD IN THE HOUSEHOLD MUST BE A CURRENT 

RESIDENT OF THE HOUSEHOLD. A CURRENT RESIDENCE IS DEFINED AS A PLACE 

WHERE THE CHILD IS STAYING FOR MORE THAN TWO MONTHS AT THE TIME OF THE 

SURVEY CONTACT. IF A CHILD HAS NO PLACE WHERE HE OR SHE USUALLY STAYS, 

THE CHILD SHOULD BE CONSIDERED A CURRENT RESIDENT REGARDLESS OF THE 

LENGTH OF THE CURRENT STAY. 

CHILDREN AWAY FROM THEIR RESIDENCE FOR TWO MONTHS OR LESS, WHETHER 

TRAVELING OR IN THE HOSPITAL, ARE CONSIDERED “IN RESIDENCE.” 

CHILDREN AWAY FROM THEIR RESIDENCE FOR MORE THAN TWO MONTHS ARE 

CONSIDERED “NOT IN RESIDENCE” UNLESS THE CHILD IS AWAY AT SCHOOL (I.E., 

BOARDING SCHOOL, MILITARY ACADEMY, OR PREP SCHOOL, ETC.). 

CHILDREN WHO ONLY LIVE PART-TIME IN THE HOUSEHOLD BECAUSE OF CUSTODY 

ISSUES SHOULD BE INCLUDED IF THEY ARE STAYING THERE WHEN CONTACT WITH 

THE HOUSEHOLD IS MADE.
Page 38 □ Series 1, No. 43 

RANDOM SELECTION PROCESS: 

A FOCAL CHILD MUST BE SELECTED FOR THE REST OF THE INTERVIEW FROM ALL 

CHILDREN ROSTERED. 

ONE CHILD

IF ONLY ONE CHILD UNDER 18 YEARS OLD (AGE GRID HAS 1 CHILD LISTED) THAT CHILD IS 

THE FOCAL CHILD [CHILD] FROM THIS POINT. 

MORE THAN ONE CHILD

IF THERE IS MORE THAN ONE CHILD UNDER THE AGE OF 18 (AGE GRID HAS > 1 CHILD 

LISTED) ONE OF THESE CHILDREN SHOULD BE RANDOMLY SAMPLED AND THAT CHILD IS 

THE FOCAL CHILD [CHILD] FROM THIS POINT.

 

SCQ05 The rest of the survey will be about the health and health care of [S.C.]. We need to talk to the 

parent or guardian who lives in this household who knows the most about the health and health 

care of [S.C.]. Who would that be? 

 (1) MYSELF [SL_INTRO] 

 (2) SOME ONE ELSE [SKIP TO SCQ06]

SCQ06 ____________ [MKP NAME] [SKIP TO SCQ07] 

SCQ07 May I speak with [MKP NAME] now? 

 (1) YES [SKIP TO NEW_RESP] 

(2) NO [SCHEDULE APPOINTMENT] 

NEW_RESP Hello, my name is [interviewer name]. I am calling on behalf of the Centers for Disease Control 

and Prevention. We are doing a survey about the health of children and teenagers in [name of 

state], and I was told that you were the person to talk with about the health of [SC]. 

SL_INTRO INFORMED CONSENT SCRIPT:

 Before we get to questions about the health of [S.C.], I’d like you to know that your answers will 

be kept strictly private, as required by the U.S. Public Health Service Act. Your participation in 

this research is voluntary. You may choose not to answer any question you don’t want to answer 

or stop at any time without penalty. The survey will take about 25 minutes. In order to evaluate 

my performance, my supervisor may record and listen as I ask the questions. I’d like to continue 

now unless you have any questions. 

 

 HELP SCREEN: The Public Health Service Act is Volume 42 of the US Code, Section 242k. 

The collection of information in this survey is authorized by Section 306 of this Act. The 

confidentiality of your responses is assured by Section 308d of this Act. 
Series 1, No. 43 □ Page 39

Section 1: Initial Demographics

S1Q01 Is [CHILD] male or female? 

 (1) MALE 

 (2) FEMALE 

 (6) DON’T KNOW 

 (7) REFUSED 

 NOTE: ANSWER TO S1Q01 DETERMINES SUBSEQUENT GENDER 

 PRONOUN FILLS. 

S1Q02 What is your relationship to [CHILD]? 

(01) MOTHER (BIOLOGICAL, STEP, FOSTER, ADOPTIVE) 

(02) FATHER (BIOLOGICAL, STEP, FOSTER, ADOPTIVE) 

(03) SISTER (STEP/FOSTER/HALF/ADOPTIVE) 

(04) BROTHER (STEP/FOSTER/HALF/ADOPTIVE) 

(05) IN-LAW OF ANY TYPE 

(06) AUNT 

(07) UNCLE 

(08) GRANDPARENT 

(09) OTHER FAMILY MEMBER 

(10) OTHER NON-RELATIVE 

(11) FEMALE GUARDIAN 

(12) MALE GUARDIAN 

(96) DON’T KNOW 

 (97) REFUSED 
Page 40 □ Series 1, No. 43 

S1Q05 Please tell me how many people live in this household, including all children and anyone who 

normally lives here even if they are not here now, like someone who is away traveling or in a 

hospital. 

 ____ ____ [RANGE CHECK: 02-18] 

 (96) DON’T KNOW 

 (97) REFUSED 

 

HELP SCREEN (S1Q05): EACH CHILD IN THE HOUSEHOLD MUST BE A CURRENT 

RESIDENT OF THE HOUSEHOLD. A CURRENT RESIDENCE IS DEFINED AS A PLACE 

WHERE THE CHILD IS STAYING FOR MORE THAN TWO MONTHS AT THE TIME OF THE 

SURVEY CONTACT. IF A CHILD HAS NO PLACE WHERE HE OR SHE USUALLY STAYS, 

THE CHILD SHOULD BE CONSIDERED A CURRENT RESIDENT REGARDLESS OF THE 

LENGTH OF THE CURRENT STAY. 

CHILDREN AWAY FROM THEIR RESIDENCE FOR TWO MONTHS OR LESS, WHETHER 

TRAVELING OR IN THE HOSPITAL, ARE CONSIDERED “IN RESIDENCE.” 

CHILDREN AWAY FROM THEIR RESIDENCE FOR MORE THAN TWO MONTHS ARE 

CONSIDERED “NOT IN RESIDENCE” UNLESS THE CHILD IS AWAY AT SCHOOL (I.E., 

BOARDING SCHOOL, MILITARY ACADEMY, OR PREP SCHOOL, ETC.). 

CHILDREN WHO ONLY LIVE PART-TIME IN THE HOUSEHOLD BECAUSE OF CUSTODY 

ISSUES SHOULD BE INCLUDED IF THEY ARE STAYING THERE WHEN CONTACT WITH 

THE HOUSEHOLD IS MADE. 

S1Q05A What is the highest level of education attained by anyone in your household? 

 __ __ ENTER NUMBER YEARS [RANGE CHECK: 01-24] 

(41) NEVER ATTENDED 

(51) ELEMENTARY 

(61) HIGH SCHOOL 

(71) COLLEGE 

(81) GRADUATE SCHOOL 

(96) DON'T KNOW 

(97) REFUSED 

HELP SCREEN (S1Q05A): THE HIGHEST LEVEL OF EDUCATION ATTAINED 

MEEANS THE NUMBER OF YEARS COMPLETED. YOU MAY NEED TO PROBE 

FOR MORE INFORMATION. FOR EXAMPLE, IF A RESPONDENT SAYS THAT 

SOMEONE IN THE HOUSEHOLD HAD “SOME COLLEGE,” PROBE TO DETERMINE 

HOW MANY YEARS WERE COMPLETED. 

S1Q06 What is the primary language spoken in your home? 

 [READ RESPONSES ONLY IF NECESSARY] 

 (1) English 

 (2) Spanish 

(3) Any other language 

(6) DON’T KNOW 

(7) REFUSED 
Series 1, No. 43 □ Page 41

Section 2: Health and Functional Status

S2Q01 In general, how would you describe [CHILD]’s health? Would you say [his/her] health is 

excellent, very good, good, fair, or poor? 

(1) Excellent 

(2) Very good 

(3) Good 

(4) Fair 

(5) Poor 

(6) DON’T KNOW 

(7) REFUSED 

S2Q02 

NOTE: HEIGHT CAN BE ENTERED IN FEET AND INCHES, OR IN CENTIMETERS. 

 How tall is [CHILD] now? 

 S2Q02 ___ ___ FEET [RANGE CHECK 00-08] 

 

(96) DON’T KNOW 

 (97) REFUSED 

S2Q02A ___ ___ INCHES [RANGE CHECK 00-72] 

 

(96) DON’T KNOW 

 (97) REFUSED 

S2Q02B ___ ___ ___CENTIMETERS [RANGE CHECK 015-250] 

 (996) DON’T KNOW 

 (997) REFUSED 

S2Q03 

NOTE: WEIGHT CAN BE ENTERED IN POUNDS OR KILOGRAMS. 

 How much does [CHILD] weigh now? 

S2Q03 ___ ___ ___ POUNDS [RANGE CHECK: 001-500] 

 

(996) DON’T KNOW 

(997) REFUSED 

S2Q03A ___ ___ ___ KILOGRAMS [RANGE CHECK: 001-230] 

 (996) DON’T KNOW 

(997) REFUSED 
Page 42 □ Series 1, No. 43 

INTRODUCTION

 The next questions are about any kind of health problems, concerns, or conditions that may affect 

[CHILD]’s behavior, learning, growth, or physical development. 

 

S2Q04 Does [CHILD] currently need or use medicine prescribed by a doctor, other than vitamins? 

(0) NO [SKIP TO S2Q07] 

(1) YES 

(6) DON’T KNOW [SKIP TO S2Q07] 

(7) REFUSED [SKIP TO S2Q07] 

HELP SCREEN (S2Q04): This only applies to medications prescribed by a doctor. Overthe-counter medications such as cold or headache medication, or other vitamins, minerals, 

or supplements purchased without a prescription are not included. 

S2Q05 Is [his/her] need for prescription medicine because of ANY medical, behavioral, or other health 

condition? 

(0) NO [SKIP TO S2Q07] 

(1) YES 

(6) DON’T KNOW [SKIP TO S2Q07] 

(7) REFUSED [SKIP TO S2Q07] 

S2Q06 Is this a condition that has lasted or is expected to last 12 months or longer? 

 

(0) NO 

(1) YES 

(6) DON’T KNOW 

(7) REFUSED 

S2Q07 Does [CHILD] need or use more medical care, mental health, or educational services than is usual 

for most children of the same age? 

(0) NO [SKIP TO S2Q10] 

(1) YES 

(6) DON’T KNOW [SKIP TO S2Q10] 

(7) REFUSED [SKIP TO S2Q10] 

HELP SCREEN (S2Q07): The child requires more medical care, the use of more mental 

health services, or the use of more educational services than most children the same age. 

S2Q08 Is [his/her] need for medical care, mental health or educational services because of ANY medical, 

behavioral, or other health condition? 

(0) NO [SKIP TO S2Q10] 

(1) YES 

(6) DON’T KNOW [SKIP TO S2Q10] 

(7) REFUSED [SKIP TO S2Q10] 
Series 1, No. 43 □ Page 43

S2Q09 Is this a condition that has lasted or is expected to last 12 months or longer? 

 

(0) NO 

(1) YES 

(6) DON’T KNOW 

(7) REFUSED 

S2Q10 Is [CHILD] limited or prevented in any way in [his/her] ability to do the things most children of 

the same age can do? 

(0) NO [SKIP TO S2Q13] 

(1) YES 

(6) DON’T KNOW [SKIP TO S2Q13] 

(7) REFUSED [SKIP TO S2Q13] 

HELP SCREEN (S2Q10): A child is limited or prevented when there are things the child 

can’t do as much or can’t do at all that most children the same age can. 

S2Q11 Is [his/her] limitation in abilities because of ANY medical, behavioral, or other health condition? 

(0) NO [SKIP TO S2Q13] 

(1) YES 

(6) DON’T KNOW [SKIP TO S2Q13] 

(7) REFUSED [SKIP TO S2Q13]

S2Q12 Is this a condition that has lasted or is expected to last 12 months or longer? 

 

(0) NO 

(1) YES 

(6) DON’T KNOW 

(7) REFUSED 

S2Q13 Does [CHILD] need or get special therapy, such as physical, occupational, or speech therapy? 

[SPECIAL THERAPY INCLUDES PHYSICAL, OCCUPATIONAL, OR SPEECH THERAPY. 

DO NOT INCLUDE PSYCHOLOGICAL THERAPY.] 

 

(0) NO [SKIP TO S2Q16] 

(1) YES 

(6) DON’T KNOW [SKIP TO S2Q16] 

(7) REFUSED [SKIP TO S2Q16] 

S2Q14 Is [his/her] need for special therapy because of ANY medical, behavioral, or other health 

condition? 

(0) NO [SKIP TO S2Q16] 

(1) YES 

(6) DON’T KNOW [SKIP TO S2Q16] 

(7) REFUSED [SKIP TO S2Q16]
Page 44 □ Series 1, No. 43 

S2Q15 Is this a condition that has lasted or is expected to last 12 months or longer? 

 

(0) NO 

(1) YES 

(6) DON’T KNOW 

(7) REFUSED 

S2Q16 Does [CHILD] have any kind of emotional, developmental, or behavioral problem for which 

[he/she] needs treatment or counseling? 

(0) NO [SKIP TO S2Q18] 

(1) YES 

(6) DON’T KNOW [SKIP TO S2Q18] 

(7) REFUSED [SKIP TO S2Q18] 

HELP SCREEN (S2Q16): These are remedies, therapy, or guidance a child may receive for 

his/her emotional, developmental, or behavioral problem. 

S2Q17 Has [his/her] emotional, developmental or behavioral problem lasted or is it expected to last 12 

months or longer? 

(0) NO 

(1) YES 

(6) DON’T KNOW 

(7) REFUSED 

S2Q18 (IF AGE OF CHILD < 36 MONTHS, SKIP TO S2Q19)

Has a doctor, health professional, teacher, or school official ever told you [CHILD] has a learning 

disability? 

(0) NO 

(1) YES 

(6) DON’T KNOW 

(7) REFUSED 
Series 1, No. 43 □ Page 45

INTRODUCTION

[Has a doctor or health professional ever told you that [CHILD] has any of the following 

conditions]? 

 

S2Q19 Asthma? 

(0) NO (1) YES (6) DK (7) REFUSED 

HELP SCREEN (S2Q19): IF THE RESPONDENT NEVER HEARD OF THE 

MEDICAL CONDITION OR DOES NOT KNOW WHAT THE CONDITION IS, 

THEN A DOCTOR OR HEALTH PROFESSIONAL PROBABLY HAS NOT 

TOLD THE RESPONDENT THAT THE CHILD HAS THE CONDITION. IF A 

DOCTOR OR HEALTH PROFESSIONAL HAS NOT TOLD THE RESPONDENT 

THAT THE CHILD HAS THE CONDITION, BUT THE RESPONDENT INSISTS 

THAT THE CHILD HAS THE CONDITION, WE STILL NEED TO CODE THE 

ANSWER AS “NO.” 

S2Q20 (IF AGE OF CHILD < 24 MONTHS, SKIP TO S2Q24)

Hearing problems or vision problems that cannot be corrected with glasses or contact 

lenses? 

(0) NO (1) YES (6) DK (7) REFUSED 

S2Q21 Attention Deficit Disorder or Attention Deficit Hyperactive Disorder, that is, ADD or 

ADHD? 

 (0) NO (1) YES (6) DK (7) REFUSED 

 

S2Q22 Depression or anxiety problems? 

 (0) NO (1) YES (6) DK (7) REFUSED 

 

S2Q23 Behavioral or conduct problems? 

 (0) NO (1) YES (6) DK (7) REFUSED 

 

S2Q24 Bone, joint, or muscle problems? 

 (0) NO (1) YES (6) DK (7) REFUSED 

 

S2Q26 Diabetes? 

 (0) NO (1) YES (6) DK (7) REFUSED 

 

S2Q35 Autism? 

 (0) NO (1) YES (6) DK (7) REFUSED 

 

S2Q37 Any developmental delay or physical impairment? 

 (0) NO (1) YES (6) DK (7) REFUSED 
Page 46 □ Series 1, No. 43 

INTRODUCTION

The next set of questions asks about conditions [CHILD] may have had over the past 12 months. 

QUESTION STEM: During the past 12 months, that is since [FILL CURRENT MONTH, 

AND CURRENT YEAR - 1)] have you been told by a doctor or other health care professional 

that [he/she] had any of the following conditions? 

 

S2Q38 Hay fever or any kind of respiratory allergy? 

 (0) NO (1) YES (6) DK (7) REFUSED 

 

S2Q39 Any kind of food or digestive allergy? 

 (0) NO (1) YES (6) DK (7) REFUSED 

 

S2Q40 Eczema or any kind of skin allergy? 

(0) NO (1) YES (6) DK (7) REFUSED 

HELP SCREEN (S2Q40): Eczema is skin condition characterized by redness, 

itching and dry, flaky, scaly skin. 

S2Q41 (IF AGE OF CHILD < 36 MONTHS, SKIP TO S2Q47)

Frequent or severe headaches, including migraines? 

 (0) NO (1) YES (6) DK (7) REFUSED 

S2Q42 Stuttering, stammering, or other speech problems? 

 (0) NO (1) YES (6) DK (7) REFUSED 

HELP SCREEN (S2Q42): A speech problem is any condition that interferes with the 

formation of words. 

S2Q44 Three or more ear infections? 

(0) NO (1) YES (6) DK (7) REFUSED 
Series 1, No. 43 □ Page 47

S2Q47 (IF SAMPLED CHILD HAS NO CONDITIONS OR LIMITATIONS—I.E., S2Q10, S2Q19-

S2Q44 HAVE NO VALUES EQUAL TO 1— SKIP TO S2Q49)

You said that [CHILD] [has/had/has or has had] [NAMES OF CONDITIONS]. Would you 

describe [his/her] health condition(s) as minor, moderate, or severe? 

(1) MINOR 

(2) MODERATE 

(3) SEVERE 

(6) DON’T KNOW 

(7) REFUSED 

HELP SCREEN: IF THE RESPONDENT ASKS WHICH HEALTH CONDITION TO 

CONSIDER IF THE CHILD HAS MULTIPLE CONDITIONS, INSTRUCT THE 

RESPONDENT TO CONSIDER [CHILD]’s MOST SEVERE CONDITION.

 

S2Q49 (IF SAMPLED CHILD DOES NOT HAVE ASTHMA—I.E., S2Q19 IN (0, 6, 7)— SKIP TO 

S2Q54) 

Does [CHILD] still have asthma? 

(0) NO [SKIP TO S2Q52] 

(1) YES 

(6) DON’T KNOW [SKIP TO S2Q52] 

(7) REFUSED [SKIP TO S2Q52] 

S2Q50 Would you describe the health difficulties caused by [his/her] asthma as minor, moderate, or 

severe? 

(1) MINOR DIFFICULTIES 

(2) MODERATE DIFFICULTIES 

(3) SEVERE DIFFICULTIES 

(6) DON’T KNOW 

(7) REFUSED 

S2Q51 Overall, would you say [his/her] asthma puts a burden on your family a great deal, a medium 

amount, a little, or not at all? 

(1) A GREAT DEAL 

(2) A MEDIUM AMOUNT 

(3) A LITTLE 

(4) NOT AT ALL 

(6) DON’T KNOW 

(7) REFUSED 
Page 48 □ Series 1, No. 43 

S2Q52 How long has it been since [he/she] last took asthma medication? 

[READ RESPONSES ONLY IF NECESSARY]. 

(01) Less than one day ago 

(02) 1-6 days ago 

(03) 1 week to less than 3 months ago 

(04) 3 months to less than 1 year ago 

(05) 1 year to less than 3 years ago 

(06) 3 years to 5 years ago 

(07) More than 5 years ago 

(08) Has never used medication 

(96) DON’T KNOW 

(97) REFUSED 

S2Q52A During the past 12 months, has [CHILD] had an episode of asthma or an asthma attack? 

 (0) NO 

(1) YES 

 (6) DON’T KNOW 

 (7) REFUSED 

HELP SCREEN (S2Q52A): Asthma attacks, sometimes called episodes, refer to periods of 

worsening asthma symptoms that make the respondent limit his/her activity more than 

usual, or makes him/her seek medical care. 

 

S2Q53 During the past 12 months, has [CHILD] stayed overnight in a hospital because of [his/her]

asthma? 

(0) NO 

(1) YES 

 (6) DON’T KNOW 

(7) REFUSED 

HELP SCREEN (S2Q53): IF THE CHILD IS IN THE HOSPITAL FOR ASTHMA AND 

OTHER REASONS THE CORRECT ANSWER CHOICE IS YES. 

 

S2Q54 (IF AGE OF CHILD IS < 12 MONTHS, SKIP TO S2Q62)

The next questions are about dental health. How would you describe the condition of [CHILD]’s 

teeth: excellent, very good, good, fair, poor? 

(01) Excellent [SKIP TO S2Q56] 

(02) Very good [SKIP TO S2Q56]

(03) Good [SKIP TO S2Q56] 

(04) Fair 

(05) Poor 

(06) HAS NO NATURAL TEETH [SKIP TO S2Q59] 

(96) DON’T KNOW [SKIP TO S2Q56] 

(97) REFUSED [SKIP TO S2Q56] 
Series 1, No. 43 □ Page 49

S2Q55 INDEX [What specific problems does [CHILD] have with [his/her] teeth?] 

[MARK ALL THAT APPLY. ONLY READ RESPONSES IF NECESSARY]. 

 N Y D R 

S2Q55X01 Pain 0 1 6 7 

S2Q55X02 Cavities 0 1 6 7 

S2Q55X03 Broken front tooth, or teeth that need repair 0 1 6 7 

S2Q55X04 Crooked teeth, or teeth that need braces 0 1 6 7 

S2Q55X05 Other 0 1 6 7 

S2Q55X06 Hygiene (plaque/doesn't brush regularly/needs cleaning etc.) 0 1 6 7 

S2Q55X07 Discoloration (staining/yellow teeth/blackened teeth etc.) 0 1 6 7 

S2Q55X08 Enamel problems (poor enamel/no enamel etc.) 0 1 6 7 

S2Q55X09 Gum problems (gingivitis/gum disease/bleeding gums etc.) 0 1 6 7 

S2Q55X10 Teeth problems (grinding/soft teeth/teeth pulled/teeth falling out etc) 0 1 6 7 

S2Q55X11 Nerves (Root Canal/nerve problems etc.) 0 1 6 7 

S2Q55X12 No problems with teeth 0 1 6 7 

 

 *RESPONSE CATEGORIES 

 (0) NO 

 (1) YES 

 (6) DON’T KNOW 

 (7) REFUSED 

HELP SCREEN (S2Q55): USE PRESET CATEGORIES AS MUCH AS POSSIBLE. THE 

“OTHER” CATEGORY SHOULD ONLY BE USED WHEN YOU ARE UNABLE TO 

CODE THE RESPONSE INTO ONE OF THE PRESENT CATEGORIES. 

S2Q55_OS READ IF NECESSARY: What kind of other problems? 

[IF RESPONDENT WILL NOT GIVE A VERBATIM ANSWER ENTER: “NO ANSWER 

GIVEN”] 

RECORD VERBATIM RESPONSE________ 

S2Q56 About how long has it been since [he/she] last saw a dentist? Include all types of dentists, such as 

orthodontists, oral surgeons, and all other dental specialists. 

 

(01) NEVER 

(02) 6 MONTHS OR LESS 

(03) MORE THAN 6 MONTHS, BUT NOT MORE THAN 1 YEAR AGO 

(04) MORE THAN 1 YEAR, BUT NOT MORE THAN 2 YEARS AGO 

(05) MORE THAN 2 YEARS, BUT NOT MORE THAN 5 YEARS AGO 

(06) MORE THAN 5 YEARS AGO 

(96) DON’T KNOW 

(97) REFUSED 
Page 50 □ Series 1, No. 43 

S2Q59 (IF AGE OF CHILD < 36 MONTHS SKIP TO S2Q62)

Overall, do you think that [CHILD] has difficulties with one or more of the following areas: 

emotions, concentration, behavior, or being able to get along with other people? 

(0) NO 

(1) YES 

(6) DON’T KNOW 

(7) REFUSED 

 

S2Q60 (IF CHILD HAS ADD/ADHD—S2Q21 = 1—AND S2Q59 IN (0,6,7), SKIP TO S2Q62) 

(IF ADD/ADHD NOT PRESENT—S2Q21 IN (0, 6, 7)—AND S2Q59 IN (0, 6, 7), SKIP TO 

S3Q01) 

Would you describe these difficulties as minor, moderate, or severe? 

 

(1) Minor 

(2) Moderate 

(3) Severe 

(6) DON’T KNOW 

(7) REFUSED 

S2Q61 Overall, would you say [CHILD]’s mental and emotional health puts a burden on your family a 

great deal, a medium amount, a little, or not at all? 

(1) A great deal 

(2) A medium amount 

(3) A little 

(4) Not at all 

(6) DON’T KNOW 

(7) REFUSED 

S2Q62 (IF ADD/ADHD NOT PRESENT—I.E., S2Q21 IN (0, 6, 7)—SKIP TO S3Q01) 

Earlier, you said [CHILD] had Attention Deficit Disorder or Attention Deficit Hyperactive 

Disorder, that is, ADD or ADHD. Is [CHILD] currently taking medication for ADD or ADHD? 

(0) NO 

(1) YES 

(6) DON’T KNOW 

(7) REFUSED 
Series 1, No. 43 □ Page 51

Section 3: Health Insurance Coverage

INTRODUCTION

The next questions are about health insurance. 

S3Q01 Does [CHILD] have any kind of health care coverage, including health insurance, prepaid plans 

such as HMOs, or government plans such as Medicaid? 

 

(0) NO [SKIP TO S3Q05] 

(1) YES 

(6) DON’T KNOW 

(7) REFUSED 

HELP SCREEN (S3Q01): Medicaid refers to a medical assistance program that provides 

health care coverage to low-income and disabled persons. The Medicaid program is a joint 

federal-state program that is administered by the states. 

Private health insurance refers to any type of health insurance, including Health 

Maintenance Organizations (HMOs), other than public programs. These plans may be 

provided in part or fully by the person’s employer or union, or purchased directly by the 

individual. 

S3Q02 CATI INSTRUCTION (S3Q02): IF S3Q01 = 1 THEN FILL “Is that coverage.” ELSE, fill “Is 

[he/she] insured by.” 

[Is that coverage,/Is [he/she] insured by] Medicaid or the State Children’s Health Insurance 

Program, S-CHIP? In this state, the program is sometimes called [FILL MEDICAID NAME, 

SCHIP NAME]. 

(0) NO 

(1) YES 

(6) DON’T KNOW 

(7) REFUSED 

HELP SCREEN: S-CHIP is a type of state-sponsored health insurance coverage that a child 

may have. The name of the plan may vary from state-to-state. 

 

S3Q04 (IF S3Q01 IN (6, 7) AND S3Q02 IN (2, 6, 7), SKIP TO S3Q05) 

[During the past 12 months/Since [his/her] birth], was there any time when [he/she] was not 

covered by ANY health insurance? 

(0) NO [SKIP TO S3Q03]

(1) YES [SKIP TO S3Q03] 

(6) DON’T KNOW [SKIP TO S3Q03]

(7) REFUSED [SKIP TO S3Q03]
Page 52 □ Series 1, No. 43 

S3Q05 [During the past 12 months/Since [his/her] birth] has [he/she] had health coverage? 

(0) NO 

(1) YES 

(6) DON’T KNOW 

(7) REFUSED 

S3Q03 Does [CHILD] have insurance that helps pay for any routine dental care including cleanings, xrays and examinations? 

(0) NO 

(1) YES 

(6) DON’T KNOW 

(7) REFUSED 

RECORD TIMESTAMP. 
Series 1, No. 43 □ Page 53

Section 4: Health Care Access And Utilization

S4Q01 [During the past 12 months/Since [his/her] birth], did [CHILD] see a doctor, nurse, or other 

health care professional for any kind of medical care, including sick-child care, well-child checkups, physical exams, and hospitalizations? 

(0) NO 

(1) YES [SKIP TO S4Q03] 

 (6) DON’T KNOW 

 (7) REFUSED 

S4Q02 [During the past 12 months/Since [his/her] birth], was there any time when [he/she] needed any 

kind of medical care? 

[INCLUDE SICK-CHILD CARE, WELL-CHILD CHECK-UPS, PHYSICAL EXAMS, AND 

HOSPITALIZATIONS] 

(0) NO [SKIP TO S4Q09] 

(1) YES [SKIP TO S4Q08] 

(6) DON’T KNOW [SKIP TO S4Q09] 

(7) REFUSED [SKIP TO S4Q09]

S4Q03 [During the past 12 months/Since [his/her] birth], how many times did [CHILD] see a doctor, 

nurse, or other health care professional for preventive medical care such as a physical exam or 

well-child check-up? 

 ___ ___ ___ TIMES [RANGE CHECK: 000 – 995]

 (996) DON’T KNOW 

 (997) REFUSED 

 

S4Q04 [During the past 12 months/Since [his/her] birth], how many times did [CHILD] go to a hospital 

emergency room about [his/her] health? This includes emergency room visits that resulted in a 

hospital admission. 

___ ___ ___ TIMES [RANGE CHECK: 000 – 995]

 (996) DON’T KNOW 

 (997) REFUSED 

IF S4Q04 = 000, [SKIP TO S4Q06]

ELSE IF S4Q04=001, [SKIP TO S4Q04A] 

ELSE, [SKIP TO S4Q05] 

S4Q04A Was this visit because of an accident, injury, or poisoning? 

 (0) NO [SKIP TO S4Q06] 

(1) YES [SKIP TO S4Q06]

 (6) DON’T KNOW [SKIP TO S4Q06]

 (7) REFUSED [SKIP TO S4Q06] 
Page 54 □ Series 1, No. 43 

S4Q05 How many emergency room visits were because of an accident, injury, or poisoning? 

 

 ___ ___ ___ TIMES [RANGE CHECK: 000 – 995] 

 

(996) DON’T KNOW 

 (997) REFUSED 

 

 

S4Q06 Excluding emergency room visits, hospitalizations, and well-child care, how many times [during 

the past 12 months/Since [his/her] birth], did [he/she] see a doctor, nurse, or other health care 

professional for sick-child care? 

 ___ ___ ___ TIMES [RANGE CHECK: 000 – 995]

 (996) DON’T KNOW 

 (997) REFUSED 

S4Q07 [During the past 12 months/Since [his/her] birth], did [CHILD] receive all the medical care 

[he/she] needed? 

 (0) NO 

(1) YES [SKIP TO S4Q09] 

 (6) DON’T KNOW [SKIP TO S4Q09]

 (7) REFUSED [SKIP TO S4Q09]

S4Q08 INDEX Why did [CHILD] not get all the medical care that [he/she] needed? 

 [MARK ALL THAT APPLY. READ RESPONSES ONLY IF NECESSARY.] 

 N Y D R 

 S4Q08X01 Cost too much 0 1 6 7 

 S4Q08X02 No insurance 0 1 6 7 

 S4Q08X03 Health plan problem 0 1 6 7 

 S4Q08X04 Can’t find doctor who accepts child’s insurance 0 1 6 7 

 S4Q08X05 Not available in area/transport problems 0 1 6 7 

 S4Q08X06 Not convenient times/could not get appointment 0 1 6 7 

 S4Q08X07 Doctor did not know how to treat or provide care 0 1 6 7 

 S4Q08X08 Dissatisfaction with doctor 0 1 6 7 

 S4Q08X09 Did not know where to go for treatment 0 1 6 7 

 S4Q08X10 Child refused to go 0 1 6 7 

 S4Q08X11 Treatment is ongoing 0 1 6 7 

 S4Q08X12 Vaccine shortage 0 1 6 7 

 S4Q08X13 Other 0 1 6 7 

 S4Q08X14 No referral 0 1 6 7 

 S4Q08X15 Lack of resources at school 0 1 6 7 

 

 *RESPONSE CATEGORIES 

 (0) NO 

 (1) YES 

 (6) DON’T KNOW 

 (7) REFUSED 

 IF S4Q08X13 = 1, [SKIP TO S4Q08_OS]
Series 1, No. 43 □ Page 55

S4Q08_OS [FILL VERBATIM RESPONSE]_______________________________ 

[IF RESPONDENT WILL NOT GIVE A VERBATIM ANSWER ENTER: “NO ANSWER 

GIVEN”] 

 

S4Q09 (IF AGE OF CHILD < 12 MONTHS, SKIP TO S4Q15) 

(IF CHILD HAS NO NATURAL TEETH—S2Q54 = 06—SKIP TO S4Q13) 

(IF CHILD HAS NOT SEEN DENTIST IN 1 YEAR OR MORE—I.E., S2Q56 IN (01, 04, 05, 

06)—SKIP TO S4Q10) 

During the past 12 months/Since [his/her] birth], did [CHILD] see a dentist for any routine 

preventive dental care, including check-ups, screenings, and sealants? Include all types of dentists, 

such as orthodontists, oral surgeons, and all other dental specialists. 

 (0) NO 

(1) YES [SKIP TO S4Q13] 

 (6) DON’T KNOW 

 (7) REFUSED 

 

S4Q10 [During the past 12 months/Since [CHILD]’s birth], was there any time when [CHILD] needed 

routine preventive dental care? 

 (0) NO [SKIP TO S4Q15]

(1) YES 

 (6) DON’T KNOW [SKIP TO S4Q15] 

 (7) REFUSED [SKIP TO S4Q15] 

 

HELP SCREEN (S4Q10): Include check-ups, screenings, and sealants. 

S4Q13 [During the past 12 months/Since [his/her] birth], did [he/she] receive all the routine preventive 

dental care [he/she] needed? 

 (0) NO 

(1) YES [SKIP TO S4Q15] 

 (6) DON’T KNOW [SKIP TO S4Q15] 

 (7) REFUSED [SKIP TO S4Q15]
Page 56 □ Series 1, No. 43 

S4Q14 INDEX Why did [CHILD] not get all the dental care that [he/she] needed? 

 [MARK ALL THAT APPLY. READ RESPONSES ONLY IF NECESSARY.] 

 

 N Y D R 

 S4Q14X01 Cost too much 0 1 6 7 

 S4Q14X02 No insurance 0 1 6 7 

 S4Q14X03 Health plan problem 0 1 6 7 

 S4Q14X04 Can’t find dentist who accepts child’s insurance 0 1 6 7 

 S4Q14X05 Not available in area/transport problems 0 1 6 7 

 S4Q14X06 Not convenient times/could not get appointment 0 1 6 7 

 S4Q14X07 Dentist did not know how to treat or provide care 0 1 6 7 

 S4Q14X08 Dissatisfaction with dentist 0 1 6 7 

 S4Q14X09 Did not know where to go for treatment 0 1 6 7 

 S4Q14X10 Child refused to go 0 1 6 7 

 S4Q14X11 Treatment is ongoing 0 1 6 7 

 S4Q14X13 Other 0 1 6 7 

 S4Q14X14 No referral 0 1 6 7 

 S4Q14X15 Lack of resources at school 0 1 6 7 

 

 *RESPONSE CATEGORIES 

 (0) NO 

 (1) YES 

 (6) DON’T KNOW 

 (7) REFUSED 

 

S4Q14_OS [FILL VERBATIM RESPONSE]___________________________________ 

 

[IF RESPONDENT WILL NOT GIVE A VERBATIM ANSWER ENTER: “NO ANSWER 

GIVEN”] 

(99999996) DON’T KNOW 

(99999997) REFUSED 

S4Q15 (IF CHILD CURRENTLY NEEDS/USES PRESCRIPTION MEDICATION—I.E., S2Q04 = 

1—SKIP TO S4Q17)

During the past 12 months/Since [his/her] birth], did [CHILD] use any prescription medication? 

 (0) NO 

(1) YES [SKIP TO S4Q17] 

 (6) DON’T KNOW [SKIP TO S4Q17]

 (7) REFUSED [SKIP TO S4Q17] 

S4Q16 [During the past 12 months/Since [his/her] birth], was there any time when [he/she] needed 

prescription medication? 

 (0) NO [SKIP TO S4Q23] 

(1) YES 

 (6) DK [SKIP TO S4Q23]

 (7) REFUSED [SKIP TO S4Q23]
Series 1, No. 43 □ Page 57

S4Q17 CATI INSTRUCTION (S4Q17): IF CHILD CURRENTLY NEEDS/USES PRESCRIPTION 

MEDICATION—I.E., S2Q04 = 1— FILL: “Earlier you told me your child currently uses or needs 

prescription medication.” 

[FILL] [During the past 12 months/Since [his/her] birth], did [CHILD] receive all the prescription 

medication [he/she] needed? 

 (0) NO 

(1) YES [SKIP TO S4Q23] 

 (6) DON’T KNOW [SKIP TO S4Q23]

 (7) REFUSED [SKIP TO S4Q23] 

S4Q18 INDEX Why did [CHILD] not get all the prescription medication that [he/she] needed? 

 [MARK ALL THAT APPLY. READ RESPONSES ONLY IF NECESSARY] 

 N Y D R 

 S4Q18X01 Costs too much 0 1 6 7 

 S4Q18X02 No insurance 0 1 6 7 

 S4Q18X03 Health plan problem 0 1 6 7 

 S4Q18X04 Can’t find doctor who accepts child’s insurance 0 1 6 7 

 S4Q18X05 Not available in area/transport problems 0 1 6 7 

 S4Q18X06 Not convenient times/could not get appointment 0 1 6 7 

 S4Q18X07 Doctor did not know how to treat or provide care 0 1 6 7 

 S4Q18X08 Dissatisfaction with doctor 0 1 6 7 

 S4Q18X09 Did not know where to go for treatment 0 1 6 7 

 S4Q18X10 Child refused to go 0 1 6 7 

 S4Q18X11 Treatment is ongoing 0 1 6 7 

 S4Q18X13 Other 0 1 6 7 

 S4Q18X14 No referral 0 1 6 7 

 S4Q18X15 Lack of resources at school 0 1 6 7 

 *RESPONSE CATEGORIES 

 (0) NO 

 (1) YES 

 (6) DON’T KNOW 

 (7) REFUSED 

 IF S4Q18X13 =1 [SKIP TO S4Q18_OS] 

 

S4Q18_OS [FILL VERBATIM RESPONSE]___________________________________ 

[IF RESPONDENT WILL NOT GIVE A VERBATIM ANSWER ENTER: “NO ANSWER 

GIVEN”] 

 (99999996) DON’T KNOW 

 (99999997) REFUSED 
Page 58 □ Series 1, No. 43 

S4Q23 (IF AGE OF CHILD < 12 MONTHS, SKIP TO S4Q27). 

[During the past 12 months/Since [his/her] birth], did [CHILD] receive any mental health care or 

counseling? 

 (1) YES 

 (0) NO 

 (6) DON’T KNOW 

 (7) REFUSED 

S4Q27 (IF AGE OF CHILD <24 MONTHS, SKIP TO S5Q01) 

 (S4Q27-S4Q30 IS ASKED IN THE FOLLOWING STATES: AK, AR, AZ, CA, CO, ID, MO, 

MT, NV, NM, OK, OR, SD, TX, UT, WA, WY. IF STATE NOT LISTED, SKIP TO S5Q01) 

The hepatitis A vaccine is a shot that can be given to children who are over 2 years of age. It is 

different from a hepatitis B shot and it has only been available since 1995. Has [CHILD] ever 

received any hepatitis A vaccine shots? 

 

(0) NO [SKIP TO S4Q30] 

(1) YES 

(6) DON’T KNOW [SKIP TO S4Q30]

(7) REFUSED [SKIP TO S4Q30]

HELP SCREEN (S4Q27): IF RESPONDENT ASKS FOR THE NAME OF THE VACCINE: 

The vaccine for hepatitis A is called either Vaqta or Havrix. The vaccine for hepatitis B is 

called Recombivax or Engerix.

S4Q28 Please tell me how many hepatitis A vaccine shots [CHILD] has received. 

 

(1) ONE 

(2) TWO 

(3) THREE OR MORE 

(4) ALL THAT ARE RECOMMENDED 

(6) DON’T KNOW 

(7) REFUSED 

S4Q29 Where did [he/she] get [his/her] first hepatitis A vaccine shot? 

 [READ RESPONSES IF NECESSARY] 

(01) Doctor’s office [SKIP TO S5Q01] 

(02) School clinic [SKIP TO S5Q01]

(03) Community clinic [SKIP TO S5Q01]

(04) Head Start program or daycare [SKIP TO S5Q01]

(05) Health department [SKIP TO S5Q01]

(06) Pharmacy [SKIP TO S5Q01] 

(07) Some other place 

(08) Other hospital/medical center [SKIP TO S5Q01]

(09) Military hospital/military base/military clinic [SKIP TO S5Q01]

(10) WIC [SKIP TO S5Q01]

(96) DON’T KNOW [SKIP TO S5Q01]

(97) REFUSED [SKIP TO S5Q01]
Series 1, No. 43 □ Page 59

S4Q29_O Where did [CHILD] get [his/her] first hepatitis A vaccine shot? 

 ENTER VERBATIM TEXT ___________________________

[IF RESPONDENT WILL NOT GIVE A VERBATIM ANSWER ENTER: “NO ANSWER 

GIVEN”] 

S4Q30 Has a doctor or other health care professional ever recommended that [he/she] be vaccinated for 

hepatitis A? 

(0) NO 

(1) YES 

(6) DON’T KNOW 

(7) REFUSED 

RECORD TIMESTAMP 
Page 60 □ Series 1, No. 43 

Section 5: Medical Home

S5Q01 A personal doctor or nurse is a health professional who knows your child well and is familiar with 

your child’s health history. This can be a general doctor, a pediatrician, a specialist doctor, a nurse 

practitioner, or a physician assistant. Do you have one or more persons you think of as 

[CHILD]’s personal doctor or nurse? 

(0) NO [SKIP TO S5Q13] 

(1) YES 

(6) DON’T KNOW [SKIP TO S5Q13] 

(7) REFUSED [SKIP TO S5Q13] 

S5Q02 How often does [CHILD]’s personal doctor or nurse spend enough time with [him/her]? 

 Would you say never, sometimes, usually, or always? 

(1) Never 

(2) Sometimes 

(3) Usually 

(4) Always 

(6) DON’T KNOW 

(7) REFUSED 

S5Q04 CATI INSTRUCTION (S5Q04): IF AGE OF CHILD > 36 MONTHS, FILL “and [CHILD].” 

ELSE, NO FILL. 

How often does [CHILD]’s personal doctor or nurse explain things in a way that you [and 

[CHILD]] can understand? Would you say never, sometimes, usually, or always? 

 

 (1) Never 

 (2) Sometimes 

 (3) Usually 

 (4) Always 

 (6) DON’T KNOW 

 (7) REFUSED 

S5Q06 [During the past 12 months/Since [CHILD]’s birth], have you needed to call [his/her] personal 

doctor or nurse for help or advice over the phone? 

 (0) NO [SKIP TO S5Q07] 

(1) YES 

(6) DON’T KNOW [SKIP TO S5Q07] 

(7) REFUSED [SKIP TO S5Q07] 
Series 1, No. 43 □ Page 61

S5Q06A When you have called [CHILD]’s personal doctor or nurse for help or advice over the phone, how 

often were you able to get the help or advice you needed for [him/her]? Would you say never, 

sometimes, usually, or always? 

 (1) Never 

 (2) Sometimes 

 (3) Usually 

 (4) Always 

 (6) DON’T KNOW 

 (7) REFUSED 

S5Q07 [During the past 12 months/Since [CHILD]’s birth], has [he/she] needed care right away from 

[his/her] personal doctor or nurse for an illness or injury? 

 (0) NO [SKIP TO S5Q08A] 

(1) YES 

 (6) DON’T KNOW [SKIP TO S5Q08A] 

 (7) REFUSED [SKIP TO S5Q08A] 

S5Q07A When [CHILD] needed care right away for an illness or injury, how often did [he/she] get this 

care from [his/her] personal doctor or nurse as soon as you wanted? Would you say never, 

sometimes, usually, or always? 

 (1) Never 

 (2) Sometimes 

 (3) Usually 

 (4) Always 

 (6) DON’T KNOW 

 (7) REFUSED 

S5Q08A Preventive care visits include things like a well-child check-up, a routine physical exam, 

immunizations, or health screening tests. [During the past 12 months/Since [CHILD]’s birth], did 

[he/she] visit [his/her] personal doctor or nurse for preventive care? 

 

(0) NO 

(1) YES [SKIP TO S5Q09]

(6) DON’T KNOW [SKIP TO S5Q09] 

(7) REFUSED [SKIP TO S5Q09]

S5Q08B (IF AGE OF CHILD > 24 MONTHS, SKIP TO S5Q08B) 

 

During the past 24 months, did [he/she] visit [his/her] personal doctor or nurse for preventive 

care? 

(0) NO 

(1) YES 

(6) DON’T KNOW 

(7) REFUSED 
Page 62 □ Series 1, No. 43 

S5Q09 Specialists are doctors like surgeons, heart doctors, allergy doctors, psychiatrists, skin doctors, and 

others who specialize in one area of health care. [During the past 12 months/Since [CHILD]’s 

birth], did you or [CHILD]’s personal doctor or nurse think that [he/she] needed to see any 

specialist doctor or doctors? 

(0) NO [SKIP TO S5Q10]

(1) YES 

(6) DON’T KNOW [SKIP TO S5Q10] 

(7) REFUSED [SKIP TO S5Q10] 

S5Q09A How much of a problem, if any, was it to get the care from the specialist doctor or doctors? Would 

you say you had a big problem, moderate problem, small problem, or no problem at all? 

 (1) A big problem 

(2) A moderate problem 

(3) A small problem 

(4) No problem at all 

(6) DON’T KNOW 

(7) REFUSED 

S5Q09B Did [CHILD]’s personal doctor or nurse or someone from their office or clinic do anything to help 

you get the care from the specialist doctor or doctors? 

 

(0) NO 

(1) YES 

(6) DON’T KNOW 

(7) REFUSED 

S5Q09C How often did [CHILD]’s personal doctor or nurse talk with you about what happens during 

[his/her] visits to a specialist doctor or doctors? Would you say never, sometimes, usually, or 

always? 

 (1) Never 

 (2) Sometimes 

(3) Usually 

(4) Always 

(5) NO VISITS TO THE SPECIALIST DOCTOR 

 (6) DON’T KNOW 

 (7) REFUSED 

 

S5Q10 Children sometimes need other special types of services that they can’t get from their personal 

doctor or nurse. For example, children may need special services like physical therapy, medical 

equipment like wheelchairs, special educational services, or counseling. [During the past 12 

months/Since [his/her] birth], did [CHILD] need any type of special services, equipment, or other 

care for [his/her] health? 

 

(0) NO [SKIP TO S5Q13]

(1) YES 

(6) DON’T KNOW [SKIP TO S5Q13] 

(7) REFUSED [SKIP TO S5Q13] 
Series 1, No. 43 □ Page 63

S5Q10A How much of a problem, if any, did you have getting the special services, equipment, or other care 

[he/she] needed? Would you say you had a big problem, moderate problem, small problem, or no 

problem at all? 

 (1) A big problem 

(2) A moderate problem 

(3) A small problem 

(4) No problem at all 

(6) DON’T KNOW 

(7) REFUSED 

S5Q10B Did [CHILD]’s personal doctor or nurse or someone from their office or clinic do anything to help 

you get the special care or equipment that [he/she] needed? 

(0) NO 

(1) YES 

(6) DON’T KNOW 

(7) REFUSED 

 

S5Q10C How often did [CHILD]’s personal doctor or nurse talk with you about the special care or 

equipment that [he/she] gets? Would you say never, sometimes, usually, or always? 

 (1) Never 

 (2) Sometimes 

 (3) Usually 

 (4) Always 

 (5) NO SPECIAL CARE OR EQUIPMENT RECEIVED 

 (6) DON’T KNOW 

 (7) REFUSED 

S5Q13 (IF PRIMARY LANGUAGE OF HOUSEHOLD IS UNKNOWN OR ENGLISH—I.E., 

S1Q06 IN (1, 6, 7)—SKIP TO S6Q08) 

CATI INSTRUCTION (S5Q13): IF AGE OF CHILD >36 MONTHS, FILL [or[CHILD]]. 

An interpreter is someone who repeats what one person says in a language used by another person. 

[During the past 12 months/Since [CHILD]’s birth], did you [or [CHILD]] need an interpreter to 

help speak with his or her doctors or nurses? 

(0) NO [SKIP TO S6Q08]

(1) YES 

(6) DON’T KNOW [SKIP TO S6Q08] 

(7) REFUSED [SKIP TO S6Q08]
Page 64 □ Series 1, No. 43 

S5Q13A CATI INSTRUCTION (S5Q13): IF AGE OF CHILD >36 MONTHS, FILL [or [CHILD]]. 

 

When you [or [CHILD]] needed an interpreter, how often were you able to get someone other 

than a family member to help you speak with the doctors or nurses? Would you say never, 

sometimes, usually, or always? 

 (1) Never 

 (2) Sometimes 

 (3) Usually 

 (4) Always 

 (6) DON’T KNOW 

 (7) REFUSED 
Series 1, No. 43 □ Page 65

Section 6: Early Childhood (0-5 Years)

NOTE: THIS SECTION ADMINISTERED IF AGE OF CHILD IS 00-71 MONTHS.

S6Q08 Do you have any concerns about [CHILD]’s learning, development, or behavior? 

 

(0) NO 

(1) YES 

(6) DON’T KNOW 

(7) REFUSED 

(IF AGE OF CHILD IS < 3 MONTHS, SKIP TO S6Q28) 

INTRODUCTION

The next section asks about specific concerns some parents may have. Please tell me if you are currently 

concerned a lot, a little, or not at all about the following. 

QUESTION STEM FOR S6Q09-S6Q27: [Are you concerned a lot, a little, or not at all about] 

(1) A lot 

(2) A little 

(3) Not at all 

(6) DON’T KNOW 

(7) REFUSED 

(IF AGE OF CHILD 4 - 9 MONTHS, ASK VERSION I, S6Q09 - S6Q12) 

(IF AGE OF CHILD 10 - 17 MONTHS, ASK VERSION II, S6Q13 - S6Q19) 

(IF AGE OF CHILD 18 – 71 MONTHS, ASK VERSION III, S6Q20 - S6Q27) 

Age-Specific Question Sequence 

Version I Version II Version III 

4-9 Months Old 10-17 Months Old 18-71 Months

S6Q09 How [CHILD] makes 

speech sounds?

S6Q10 How [he/she] 

understands what you 

say? 

S6Q11 How [he/she] uses 

[his/her] hands and 

fingers to do things? 

S6Q12 How [he/she] uses 

[his/her] arms and legs? 

S6Q13 How [CHILD] talks and makes 

speech sounds?

S6Q14 How [he/she] understands what 

you say?

S6Q15 How [he/she] uses [his/her] hands 

and fingers to do things? 

S6Q16 How [he/she] uses [his/her] arms 

and legs?

S6Q17 How [he/she] behaves? 

S6Q18 How [he/she] gets along with 

others?

 

S6Q19 How [he/she] is learning to do 

things for (himself/herself)? 

S6Q20 How [CHILD] talks and makes speech 

sounds?

S6Q21 How [he/she] understands what you 

say?

S6Q22 How [he/she] uses [his/her] hands and 

fingers to do things?

S6Q23 How [he/she] uses [his/her] arms and 

legs? 

S6Q24 How [he/she] behaves? 

 

S6Q25 How [he/she] gets along with others? 

S6Q26 How [he/she] is learning to do things 

for (himself/herself)? 

S6Q27 How [he/she] is learning pre-school or 

school skills? 
Page 66 □ Series 1, No. 43 

S6Q28 (IF CHILD HAS NOT SEEN DOCTOR OR HEALTH PROFESSIONAL IN LAST 12 

MONTHS—I.E., S4Q01 IN (0, 6, 7)—SKIP TO S6Q48) 

[During the past 12 months/Since [CHILD]’s birth], did [CHILD]’s doctors or other health care 

professionals ask if you have concerns about [his/her] learning, development, or behavior? 

 

(0) NO 

(1) YES 

(6) DON’T KNOW 

(7) REFUSED 

S6Q29 (S6Q29 ASKED IF ANY PARENT CONCERNS EXPRESSED IN S6Q08-S6Q27. IF NO VALUES 

PARENT CONCERNS EXPRESSED—I.E., S6Q08-S6Q27 NOT EQUAL TO 1, SKIP TO S6Q48) 

[During the past 12 months/Since [CHILD]’s birth], did [his/her] doctors or other health care 

professionals give you specific information to address your concerns about [his/her] learning, 

development, or behavior? 

(0) NO 

(1) YES 

(6) DON’T KNOW 

(7) REFUSED 

S6Q48 QUESTION STEM (S6Q48-S6Q52): During the past month, did [CHILD] regularly attend:

S6Q48 A child care center? 

[DO NOT INCLUDE FAMILY-BASED CHILD CARE OUTSIDE THE HOME] 

 (0) NO (1) YES (6) DON’T KNOW (7) REFUSED 

HELP SCREEN (S6Q48): By “regularly,” I mean at least once a week during the 

past month.

S6Q49 Family-based child care outside of your home? 

 (0) NO (1) YES (6) DON’T KNOW (7) REFUSED 

HELP SCREEN (S6Q49): By “regularly,” I mean at least once a week during the 

past month.

S6Q50 Child care in your home provided by a nanny or relative other than a parent or guardian 

(0) NO (1) YES (6) DON’T KNOW (7) REFUSED 

HELPSCREEN (S6Q50): By “regularly,” I mean at least once a week during the 

past month.

THIS CAN INCLUDE CHILD-CARE IN THE HOME THAT IS PART OF A 

HOME DAY CARE CENTER RUN BY THE PARENTS.” 

S6Q51 (IF AGE OF SCQ03 < 36 MONTHS, SKIP TO S6Q52)

Nursery school, preschool, or kindergarten 

 (0) NO (1) YES (6) DON’T KNOW (7) REFUSED 

HELP SCREEN (S6Q51): By “regularly,” I mean at least once a week during the 

past month.
Series 1, No. 43 □ Page 67

S6Q52 Head Start or Early Start program? 

 (0) NO (1) YES (6) DON’T KNOW (7) REFUSED 

HELP SCREEN (S6Q52): By “regularly,” I mean at least once a week during the 

past month. 

Head Start or Early Start programs are usually school-based programs that 

sometimes provide care for the child either before or after the school day and are 

usually operated only during the school year. 

S6Q53 During the past month, how many times have you had to make different arrangements for childcare at the 

last minute because your usual plans changed due to circumstances beyond your control? 

 

___ ___ ___ NUMBER OF TIMES [RANGE CHECK: 000-995] 

(996) DON’T KNOW 

(997) REFUSED 

HELP SCREEN (S6Q53): EXAMPLES OF CIRCUMSTANCES BEYOND ONE’S CONTROL 

INCLUDE A CHILD BECOMING ILL, OR A CHILDCARE PROVIDER CHANGING HIS/HER 

PLANS OR SCHEDULE SUDDENLY.

S6Q54 [During the past 12 months/Since [CHILD]’s birth], did you or anyone in the family have to quit a job, 

not take a job, or greatly change your job because of problems with child care for [CHILD]? 

(0) NO 

(1) YES 

(6) DON’T KNOW 

(7) REFUSED 

S6Q55 [During the past 12 months/Since [CHILD]’s birth], has [CHILD] been injured and required medical 

attention? 

(0) NO [SKIP TO S5Q57] 

(1) YES 

(6) DON’T KNOW [SKIP TO S5Q57]

(7) REFUSED [SKIP TO S5Q57]

HELP SCREEN (S6Q55): MEDICAL ATTENTION HERE IS NOT LIMITED TO EMERGENCY 

ROOM VISITS, OR ATTENTION THAT REQUIRES A DOCTOR. THIS INCLUDES 

SITUATIONS WHERE THE PARENT IS ABLE TO PROVIDE THE MEDICAL ATTENTION 

THEMSELVES, OR WHERE A CALL IS PLACED TO A DOCTOR, BUT THE CARE IS 

ADMINISTERED BY THE PARENT, ETC. 
Page 68 □ Series 1, No. 43 

S6Q56-INDEX Did the injury occur at home, at child-care, or some other place? [MARK ALL THAT APPLY] 

 N Y D R 

S6Q56X01 Home 0 1 6 7 

S6Q56X02 Child-care 0 1 6 7 

S6Q56X03 Some other place 0 1 6 7 

 *RESPONSE CATEGORIES 

 (0) NO 

 (1) YES 

 (6) DON’T KNOW 

 (7) REFUSED 

 

S6Q57 [During the past 12 months/Since [CHILD]’s birth], has [CHILD] been poisoned by accident and 

required medical attention? 

(0) NO [SKIP TO S6Q59] 

(1) YES 

(6) DON’T KNOW [SKIP TO S6Q59] 

(7) REFUSED [SKIP TO S6Q59]

HELP SCREEN (S6Q57): MEDICAL ATTENTION HERE IS NOT LIMITED TO EMERGENCY 

ROOM VISITS, OR ATTENTION THAT REQUIRES A DOCTOR. THIS INCLUDES 

SITUATIONS WHERE THE PARENT IS ABLE TO PROVIDE THE MEDICAL ATTENTION 

THEMSELVES, OR WHERE A CALL IS PLACED TO A POISON CONTROL CENTER, BUT 

THE CARE IS ADMINISTERED BY THE PARENT, ETC. 

S6Q58-INDEX Did the poisoning occur at home, at child-care, or some other place? [MARK ALL THAT APPLY] 

 N Y D R 

S6Q58X01 Home 0 1 6 7 

S6Q58X02 Child-care 0 1 6 7 

S6Q58X03 Some other place 0 1 6 7 

 *RESPONSE CATEGORIES 

 (0) NO 

 (1) YES 

 (6) DON’T KNOW 

 (7) REFUSED 

S6Q59 Was [CHILD] ever breastfed or fed breast milk? 

(0) NO [SKIP TO S6Q62] 

(1) YES 

(6) DON’T KNOW [SKIP TO S6Q62]

(7) REFUSED [SKIP TO S6Q62]
Series 1, No. 43 □ Page 69

S6Q60 How old was [he/she] when [he/she] completely stopped breastfeeding or being fed breast milk? 

___ ___ ___ [ENTER NUMBER] [RANGE CHECK: 000-994] 

(995) STILL BREASTFEEDING 

(996) DON’T KNOW 

(997) REFUSED 

S6Q60A (IF S6Q60 IN (995, 996, 997), SKIP TO S6Q62) 

[MARK PERIOD] 

(1) DAYS 

(2) WEEKS 

(3) MONTHS 

(4) YEARS 

(6) DON’T KNOW 

(7) REFUSED 

S6Q62 During the past week, how many days did you or other family members read stories to [CHILD]? 

____NUMBER OF DAYS [RANGE CHECK: 00–07]

(96) DON’T KNOW 

(97) REFUSED 

HELP SCREEN (S6Q62): STORIES INCLUDE BOOKS WITH WORDS OR PICTURES BUT 

NOT BOOKS READ BY OR WITH THE ASSISTANCE OF AN AUDIO TAPE, RECORD, CD, 

OR COMPUTER. 
Page 70 □ Series 1, No. 43 

Section 7: Middle Childhood and Adolescence (6-17 Years) 

NOTE: THIS SECTION ADMINISTERED IF AGE OF CHILD IS 72-215 MONTHS.

S7Q01 USE THIS VERSION DURING SCHOOL MONTHS: What kind of school is [CHILD] currently 

enrolled in? Is it a public school, private school, or home-school? 

USE THIS VERSION DURING SUMMER MONTHS: During the last school year, what kind of 

school was [CHILD] enrolled in? Is it a public school, private school, or home-school? 

 (1) Public [SKIP TO S7Q02] 

(2) Private [SKIP TO S7Q02]

(3) Home-schooled [SKIP TO S7Q02] 

(4) [CHILD] IS NOT ENROLLED IN SCHOOL. 

(6) DON’T KNOW [SKIP TO S7Q02] 

(7) REFUSED [SKIP TO S7Q02]

HELP SCREEN (S7Q01): IF THE CHILD WAS ENROLLED IN MORE THAN ONE TYPE OF 

SCHOOL DURING THE CURRENT OR LAST SCHOOL YEAR, LIST THE TYPE OF 

SCHOOL THAT THE CHILD HAS MOST RECENTLY ATTENDED. 

S7Q01F During the past 12 months, was [CHILD] enrolled in a public school, a private school, or home school? 

 (0) NO [SKIP TO S7Q09]

 (1) YES 

(6) DON’T KNOW [SKIP TO S7Q09]

 (7) REFUSED [SKIP TO S7Q09]

S7Q02 During the past 12 months that is, since [FILL: CURRENT MONTH, 1 YEAR AGO] about how many 

days did [CHILD] miss school because of illness or injury? 

___ ___ ___ DAYS [RANGE CHECK: 000-240] 

(000) NONE 

(240) ENTIRE SCHOOL YEAR 

(994) HOME SCHOOLED 

(995) DID NOT GO TO SCHOOL 

(996) DON’T KNOW 

(997) REFUSED 
Series 1, No. 43 □ Page 71

S7Q04 (IF NOT ENROLLED OR HOME SCHOOLED—I.E., [(S7Q01F IN (0, 6, 7) AND (S7Q01 = 4)] OR 

(S7Q02 = 994, 995) OR (S7Q01 = 3—SKIP TO S7Q09)

During the past 12 months, how many times has [CHILD]’s school contacted you or another adult in 

your household about any problems [he/she] is having with school? 

(0) Never 

(1) Once 

(2) More than once 

(6) DON’T KNOW 

(7) REFUSED 

HELP SCREEN (S7Q04): [THIS INCLUDES SCHOOL-RELATED PROBLEMS, BUT NOT 

MINOR OR TYPICAL HEALTH-RELATED PROBLEMS SUCH AS A SCHOOL NURSE 

INFORMING AN ADULT THAT A STUDENT IS ILL] 

S7Q09 Since starting kindergarten, has [he/she] repeated any grades? 

(0) NO 

(1) YES 

(6) DON’T KNOW 

(7) REFUSED 

S7Q10 During the past 12 months, was [CHILD] on a sports team or did [he/she] take sports lessons after school 

or on weekends? 

[INCLUDE SCHOOL AND COMMUNITY SPORTS]. 

(0) NO 

(1) YES 

(6) DON’T KNOW 

(7) REFUSED 

S7Q11 During the past 12 months, did [he/she] participate in any clubs or organizations after school or on 

weekends, such as Scouts, a religious group, or [Boy/Girl]’s club? 

(0) NO 

(1) YES 

(6) DON’T KNOW 

(7) REFUSED 

 

S7Q11A (IF NO PARTICIPATION IN AFTER SCHOOL ACTIVITIES/ORGANIZATIONS INDICATED 

IN S7Q10 AND S7Q11—I.E., S7Q10 AND S7Q11 IN (0, 6, 7) SKIP TO S7Q11A) 

During the past 12 months, did [he/she] participate in any other organized events or activities? 

 

(0) NO 

(1) YES 

(6) DON’T KNOW 

(7) REFUSED 
Page 72 □ Series 1, No. 43 

S7Q12 (IF NO PARTICIPATION IF AFTER SCHOOL ACTIVITIES/ORGANIZATIONS INDICATED 

IN S7Q10, S7Q11, S7Q11A—I.E., ALL VALUES IN (0, 6, 7)—SKIP TO S7Q14) 

During the past week, how many days did [CHILD] participate in clubs, organizations, or sports teams? 

 ___ ___NUMBER OF DAYS [RANGE CHECK: 00-07] 

(96) DON’T KNOW 

(97) REFUSED 

HELP SCREEN (S7Q12): Include any teams run by your child’s school or community groups. 

S7Q13 During the past 12 months, how often did you attend events or activities that [CHILD] and [his/her] 

friends participated in? Would you say never, sometimes, usually or always? 

(1) Never 

(2) Sometimes 

(3) Usually 

(4) Always 

(6) DON’T KNOW 

(7) REFUSED 

S7Q14 Regarding [CHILD]’s friends, would you say that you have met all of [his/her] friends, most of [his/her]

friends, some of [his/her] friends, or none of [his/her] friends? 

(1) All of [his/her] friends 

(2) Most of [his/her] friends 

(3) Some of [his/her] friends 

(4) None of [his/her] friends 

(5) CHILD HAS NO FRIENDS 

(6) DON’T KNOW 

(7) REFUSED 

S7Q15 (IF AGE OF CHILD > 143 MONTHS, SKIP TO S7Q17) 

Sometimes children spend time caring for themselves, either at home or somewhere else, without an adult 

or older child responsible for them. During the past week, did [CHILD] spend time caring for 

[himself/herself] for even a small amount of time? 

(0) NO [SKIP TO S7Q20] 

(1) YES 

(6) DON’T KNOW [SKIP TO S7Q20]

(7) REFUSED [SKIP TO S7Q20]

 

HELP SCREEN (S7Q15): INCLUDE ALL TIMES WHEN A CHILD IS NOT IN THE DIRECT 

SUPERVISION OF AN ADULT OR OLDER CHILD. AN ADULT OR OLDER CHILD MAY OR 

MAY NOT BE AT HOME OR NEARBY. 
Series 1, No. 43 □ Page 73

S7Q16 During the past week, how many hours did [S.C] take care of [himself/herself]? 

__ __ __ NUMBER OF HOURS [RANGE CHECK: 001-168]

(995) MORE THAN ZERO, LESS THAN 1 HOUR 

(996) DON’T KNOW 

(997) REFUSED 

S7Q17 During the past 12 months, has [CHILD] been involved in any type of community service or volunteer 

work at school, church, or in the community? 

 

(0) NO 

(1) YES 

(6) DON’T KNOW 

(7) REFUSED 

S7Q19 (IF AGE OF CHILD < 143 MONTHS, SKIP TO S7Q20)

During the past week, how many hours did [CHILD] work for pay? 

__ __ __ NUMBER OF HOURS [RANGE CHECK: 000-168]

(995) MORE THAN ZERO, LESS THAN 1 HOUR 

(996) DON’T KNOW 

(997) REFUSED 

HELP SCREEN (S7Q19): WORK FOR PAY INCLUDES ONLY WORK OUTSIDE THE HOME. 

S7Q20 During the past week, on how many nights did [CHILD] get enough sleep for a child [his/her] age? 

____NUMBER OF DAYS [RANGE CHECK: 00-07]

(96) DON’T KNOW 

(97) REFUSED 

HELP SCREEN (S7Q20): “Enough sleep” is whatever you define it as for this child. 

S7Q21 During the past week, on how many days did [CHILD] exercise or participate in physical activity for at 

least 20 minutes that made [him/her] sweat and breathe hard, such as basketball, soccer, running, 

swimming laps, fast bicycling, fast dancing, or similar aerobic activities? 

 

____NUMBER OF DAYS [RANGE CHECK: 00-07]

(96) DON’T KNOW 

(97) REFUSED 

HELP SCREEN (S7Q21): Include active sports such as baseball, softball, basketball, swimming, 

soccer, tennis, or football; riding a bike or rollerskating; walking or jogging; jumping rope; 

gymnastics; and active dance such as ballet. 
Page 74 □ Series 1, No. 43 

S7Q22 During the past 12 months, has [CHILD] ridden a bike, scooter, skateboard, roller skates, or rollerblades? 

(0) NO [SKIP TO S7Q26]

(1) YES 

(6) DON’T KNOW [SKIP TO S7Q26]

(7) REFUSED [SKIP TO S7Q26]

S7Q23 How often does [he/she] wear a helmet when riding a bike, scooter, skateboard, roller skates, or 

rollerblades? Would you say never, sometimes, usually or always? 

 

(1) Never 

(2) Sometimes 

(3) Usually 

(4) Always 

(6) DON’T KNOW 

(7) REFUSED 

S7Q26 (IF NOT ENROLLED IN SCHOOL, OR HOME SCHOOLED—I.E., [(S7Q01F IN (0, 6, 7) AND 

(S7Q01 = 4)] OR (S7Q02 = 995)—SKIP TO S7Q29)

On an average school day, about how much time does [he/she] usually spend reading for pleasure? 

INCLUDE TIME WHEN THE CHILD READS TO THEMSELVES OR IS READ TO BY SOMEONE 

ELSE. DO NOT INCLUDE TIME SPENT LISTENING TO BOOKS ON AUDIO TAPES, RECORDS, 

CDS OR A COMPUTER. 

___ ___ ___ HOURS [RANGE CHECK 000-994] 

(995) CHILD CANT READ 

(996) DON’T KNOW 

(997) REFUSED 

IF HOURS ARE THE CHOSEN TIME PERIOD, RANGE IS 001-012. 

IF MINUTES ARE THE CHOSEN TIME PERIOD, RANGE IS 001-720. 

HELP SCREEN (S7Q26): TIME SPENT READING INCLUDES THE TIME A CHILD SPENDS 

READING TO THEMSELVES OR BEING READ TO BY ANOTHER PERSON. IT DOES NOT 

INCLUDE TIME SPENT LISTENING TO BOOKS READ BY OR WITH THE ASSISTANCE OF 

AN AUDIO TAPE, RECORD, CD, OR COMPUTER. 

S7Q26A [MARK PERIOD] 

(1) HOURS 

(2) MINUTES 

(6) DON’T KNOW 

(7) REFUSED
Series 1, No. 43 □ Page 75

S7Q27 On an average school day, about how many hours does [CHILD] use a computer for purposes other than 

schoolwork? 

____NUMBER OF HOURS [RANGE CHECK: 00-24]

(25) MORE THAN 0, LESS THAN 1 HOUR 

(26) DON’T OWN COMPUTER 

(96) DON’T KNOW 

(97) REFUSED 

S7Q28 On an average school day, about how many hours does [CHILD] usually watch TV, watch videos, or 

play video games? 

____NUMBER OF HOURS [RANGE CHECK: 00-24]

(25) MORE THAN 0, LESS THAN 1 HOUR 

(26) DON’T OWN TELEVISION 

(96) DON’T KNOW 

(97) REFUSED 

 

S7Q29 (IF S7Q28 = 26, SKIP TO S7Q30) 

Are there family rules about what television programs [he/she] is allowed to watch? 

(0) NO 

(1) YES 

(6) DON’T KNOW 

(7) REFUSED 

INTRODUCTION 

The next section asks about specific concerns you may have about [CHILD]. Please tell me if you are 

currently concerned a lot, a little, or not at all about the following: 

QUESTION STEM (S7Q30-S7Q40): Are you currently concerned a lot, a little, or not at all about: 

 

 S7Q30 [CHILD]’s Achievement 

(1) A lot (2) A little (3) Not at all (6) DON’T KNOW (7) REFUSED 

HELP SCREEN (S7Q30): ACHIEVEMENT COULD BE EITHER ACADEMIC OR NONACADEMIC. 

THIS SERIES OF QUESTIONS ASKS ABOUT A NUMBER OF TOPICS THAT ARE OF 

CONCERN FOR MANY PARENTS. WHAT IS A CONCERN TO SOME PARENTS MAY NOT 

BE A CONCERN TO OTHERS. PLEASE IDENTIFY YOUR LEVEL OF CONCERN ABOUT 

THIS PARTICULAR TOPIC BASED ON HOW YOU WOULD DEFINE A ‘CONCERN’. 

 
Page 76 □ Series 1, No. 43 

 S7Q31 Having enough time with [CHILD]

(1) A lot (2) A little (3) Not at all (6) DON’T KNOW (7) REFUSED 

HELP SCREEN (S7Q31): THIS SERIES OF QUESTIONS ASKS ABOUT A NUMBER OF 

TOPICS THAT ARE OF CONCERN FOR MANY PARENTS. WHAT IS A CONCERN TO 

SOME PARENTS MAY NOT BE A CONCERN TO OTHERS. PLEASE IDENTIFY YOUR 

LEVEL OF CONCERN ABOUT THIS PARTICULAR TOPIC BASED ON HOW YOU WOULD 

DEFINE A ‘CONCERN’. 

 S7Q32 Your relationship with [him/her]

(1) A lot (2) A little (3) Not at all (6) DON’T KNOW (7) REFUSED 

HELP SCREEN (S7Q32): THIS SERIES OF QUESTIONS ASKS ABOUT A NUMBER OF 

TOPICS THAT ARE OF CONCERN FOR MANY PARENTS. WHAT IS A CONCERN TO 

SOME PARENTS MAY NOT BE A CONCERN TO OTHERS. PLEASE IDENTIFY YOUR 

LEVEL OF CONCERN ABOUT THIS PARTICULAR TOPIC BASED ON HOW YOU WOULD 

DEFINE A ‘CONCERN’. 

 S7Q33 [His/Her] self-esteem 

(1) A lot (2) A little (3) Not at all (6) DON’T KNOW (7) REFUSED 

HELP SCREEN (S7Q33): THIS SERIES OF QUESTIONS ASKS ABOUT A NUMBER OF 

TOPICS THAT ARE OF CONCERN FOR MANY PARENTS. WHAT IS A CONCERN TO 

SOME PARENTS MAY NOT BE A CONCERN TO OTHERS. PLEASE IDENTIFY YOUR 

LEVEL OF CONCERN ABOUT THIS PARTICULAR TOPIC BASED ON HOW YOU WOULD 

DEFINE A ‘CONCERN’. 

 

 S7Q34 How [he/she] copes with stressful things 

(1) A lot (2) A little (3) Not at all (6) DON’T KNOW (7) REFUSED 

HELP SCREEN (S7Q34): THIS SERIES OF QUESTIONS ASKS ABOUT A NUMBER OF 

TOPICS THAT ARE OF CONCERN FOR MANY PARENTS. WHAT IS A CONCERN TO 

SOME PARENTS MAY NOT BE A CONCERN TO OTHERS. PLEASE IDENTIFY YOUR 

LEVEL OF CONCERN ABOUT THIS PARTICULAR TOPIC BASED ON HOW YOU WOULD 

DEFINE A ‘CONCERN’. 

 S7Q35 Learning difficulties 

(1) A lot (2) A little (3) Not at all (6) DON’T KNOW (7) REFUSED 

HELP SCREEN (S7Q35): LEARNING DIFFICULTIES ARE NOT LIMITED TO THOSE THAT 

ARE OFFICIALLY DIAGNOSED. 

THIS SERIES OF QUESTIONS ASKS ABOUT A NUMBER OF TOPICS THAT ARE OF 

CONCERN FOR MANY PARENTS. WHAT IS A CONCERN TO SOME PARENTS MAY NOT 

BE A CONCERN TO OTHERS. PLEASE IDENTIFY YOUR LEVEL OF CONCERN ABOUT 

THIS PARTICULAR TOPIC BASED ON HOW YOU WOULD DEFINE A ‘CONCERN’.
Series 1, No. 43 □ Page 77

 S7Q36 Depression or anxiety 

(1) A lot (2) A little (3) Not at all (6) DON’T KNOW (7) REFUSED 

HELP SCREEN (S7Q36): DEPRESSION AND ANXIETY ARE NOT LIMITED TO THOSE 

ILLNESSES THAT ARE CLINICALLY DIAGNOSED. 

THIS SERIES OF QUESTIONS ASKS ABOUT A NUMBER OF TOPICS THAT ARE OF 

CONCERN FOR MANY PARENTS. WHAT IS A CONCERN TO SOME PARENTS MAY NOT 

BE A CONCERN TO OTHERS. PLEASE IDENTIFY YOUR LEVEL OF CONCERN ABOUT 

THIS PARTICULAR TOPIC BASED ON HOW YOU WOULD DEFINE A ‘CONCERN’. 

 

 S7Q37 Substance abuse 

(1) A lot (2) A little (3) Not at all (6) DON’T KNOW (7) REFUSED 

HELP SCREEN (S7Q37): THIS SERIES OF QUESTIONS ASKS ABOUT A NUMBER OF 

TOPICS THAT ARE OF CONCERN FOR MANY PARENTS. WHAT IS A CONCERN TO 

SOME PARENTS MAY NOT BE A CONCERN TO OTHERS. PLEASE IDENTIFY YOUR 

LEVEL OF CONCERN ABOUT THIS PARTICULAR TOPIC BASED ON HOW YOU WOULD 

DEFINE A ‘CONCERN’. 

 S7Q38 Eating disorders 

(1) A lot (2) A little (3) Not at all (6) DON’T KNOW (7) REFUSED 

HELP SCREEN (S7Q38): THIS SERIES OF QUESTIONS ASKS ABOUT A NUMBER OF 

TOPICS THAT ARE OF CONCERN FOR MANY PARENTS. WHAT IS A CONCERN TO 

SOME PARENTS MAY NOT BE A CONCERN TO OTHERS. PLEASE IDENTIFY YOUR 

LEVEL OF CONCERN ABOUT THIS PARTICULAR TOPIC BASED ON HOW YOU WOULD 

DEFINE A ‘CONCERN’. 

 S7Q39 Being ‘bullied’ by classmates 

(1) A lot (2) A little (3) Not at all (6) DON’T KNOW (7) REFUSED 

HELP SCREEN (S7Q39): THIS SERIES OF QUESTIONS ASKS ABOUT A NUMBER OF 

TOPICS THAT ARE OF CONCERN FOR MANY PARENTS. WHAT IS A CONCERN TO 

SOME PARENTS MAY NOT BE A CONCERN TO OTHERS. PLEASE IDENTIFY YOUR 

LEVEL OF CONCERN ABOUT THIS PARTICULAR TOPIC BASED ON HOW YOU WOULD 

DEFINE A ‘CONCERN’. 
Page 78 □ Series 1, No. 43 

 S7Q40 Violence in the home, school, or neighborhood 

(1) A lot (2) A little (3) Not at all (6) DON’T KNOW (7) REFUSED 

HELP SCREEN (S7Q40): THIS SERIES OF QUESTIONS ASKS ABOUT A NUMBER OF 

TOPICS THAT ARE OF CONCERN FOR MANY PARENTS. WHAT IS A CONCERN TO 

SOME PARENTS MAY NOT BE A CONCERN TO OTHERS. PLEASE IDENTIFY YOUR 

LEVEL OF CONCERN ABOUT THIS PARTICULAR TOPIC BASED ON HOW YOU WOULD 

DEFINE A ‘CONCERN’. 

THE RESPONDENT SHOULD INDICATE THE HIGHEST LEVEL OF CONCERN FOR ANY 

SINGLE LOCATION RATHER THAN TRYING TO AVERAGE THE LEVEL OF CONCERN 

ACROSS ALL LOCATIONS. 

FOR RESPONDENTS LIVING IN REMOTE OR RURAL AREAS, ‘NEIGHBORHOOD’ 

SHOULD BE UNDERSTOOD AS ONE'S COMMUNITY, TOWN, VILLAGE, OR COUNTY.

 

INTRODUCTION 

I am going to read a list of items that sometimes describe children. For each item, please tell me how 

often this is true for [CHILD] during the past month. Would you say never, sometimes, usually, or 

always? 

 S7Q56 [He/She] argues too much. 

(1) Never (2) Sometimes (3) Usually (4) Always (6) DON’T KNOW (7) REFUSED 

 S7Q45 [He/She] bullies, or is cruel or mean to others. 

(1) Never (2) Sometimes (3) Usually (4) Always (6) DON’T KNOW (7) REFUSED 

 S7Q53 [He/She] shows respect for teachers and neighbors. 

(1) Never (2) Sometimes (3) Usually (4) Always (6) DON’T KNOW (7) REFUSED 

 S7Q52 [He/She] gets along well with other children. 

(1) Never (2) Sometimes (3) Usually (4) Always (6) DON’T KNOW (7) REFUSED 

 S7Q44 [He/She] is disobedient. 

(1) Never (2) Sometimes (3) Usually (4) Always (6) DON’T KNOW (7) REFUSED 

 S7Q41 [He/She] is stubborn, sullen, or irritable. 

(1) Never (2) Sometimes (3) Usually (4) Always (6) DON’T KNOW (7) REFUSED 

 S7Q54 [He/She] tries to understand other people’s feelings. 

(1) Never (2) Sometimes (3) Usually (4) Always (6) DON’T KNOW (7) REFUSED 

 S7Q59 [He/She] tries to resolve conflicts with classmates, family, or friends. 

(1) Never (2) Sometimes (3) Usually (4) Always (6) DON’T KNOW (7) REFUSED 

 S7Q48 [He/She] feels worthless or inferior. 

(1) Never (2) Sometimes (3) Usually (4) Always (6) DON’T KNOW (7) REFUSED 

 S7Q62 [He/She] is unhappy, sad, or depressed. 

(1) Never (2) Sometimes (3) Usually (4) Always (6) DON’T KNOW (7) REFUSED 

 S7Q63 [He/She] is withdrawn, and does not get involved with others. 

(1) Never (2) Sometimes (3) Usually (4) Always (6) DON’T KNOW (7) REFUSED 
Series 1, No. 43 □ Page 79

Section 8: Family Functioning

S8Q01 (IF AGE OF CHILD > 71 MONTHS, SKIP TO S8Q03)

 

During the past week, how many times did you or any family member take [CHILD] on any kind of 

outing, such as to the park, library, zoo, shopping, church, restaurants, or family gatherings? 

 

___ ___ NUMBER OF TIMES [RANGE CHECK: 00-95] 

(96) DON’T KNOW 

(97) REFUSED 

S8Q03 During the past week, on how many days did all the family members who live in the household eat a meal 

together? 

 __ __ [RANGE CHECK: 00-07] 

(96) DON’T KNOW 

(97) REFUSED 

S8Q02 About how often does [CHILD] attend a religious service? 

__ __ __ [RANGE CHECK: 001-993] 

[ENTER NUMBER] 

(994) NEVER 

(996) DON’T KNOW 

(997) REFUSED 

S8Q02A [MARK PERIOD] 

(1) PER DAY 

(2) PER WEEK 

(3) PER MONTH 

(4) PER YEAR 

(6) DON’T KNOW 

(7) REFUSED 

S8Q04 (F CHILD <072 MONTHS, SKIP TO S8Q06)

Is your relationship with [CHILD] very close, somewhat close, not very close, not close at all? 

(1) Very close 

(2) Somewhat close 

(3) Not very close 

(4) Not close at all 

(6) DON’T KNOW 

(7) REFUSED 
Page 80 □ Series 1, No. 43 

S8Q05 How well can you and [CHILD] share ideas or talk about things that really matter? Would you say very 

well, somewhat well, not very well, or not well at all? 

(1) Very well 

(2) Somewhat well 

(3) Not very well 

(4) Not very well at all 

(6) DON’T KNOW 

(7) REFUSED 

S8Q06 CATI INSTRUCTION (S8Q06): IF S1Q02 = (1) MOTHER, OR (2) FATHER, FILL “parenthood.” 

ELSE FILL “raising children.” 

In general, how well do you feel you are coping with the day-to-day demands of [parenthood/raising 

children]? Would you say that you are coping very well, somewhat well, not very well, or not well at all? 

(1) Very well 

(2) Somewhat well 

(3) Not very well 

(4) Not well at all 

(6) DON’T KNOW 

(7) REFUSED 

S8Q07 During the past month, how often have you felt [CHILD] is much harder to care for than most children 

[his/her] age? Would you say never, sometimes, usually, or always? 

(1) Never 

(2) Sometimes 

(3) Usually 

(4) Always 

(6) DON’T KNOW 

(7) REFUSED 

S8Q08 During the past month, how often have you felt [he/she] does things that really bother you a lot? [READ 

RESPONSES AS NECESSARY] Would you say never, sometimes, usually, or always? 

(1) NEVER 

(2) SOMETIMES 

(3) USUALLY 

(4) ALWAYS 

(6) DON’T KNOW 

(7) REFUSED 

S8Q09 During the past month, how often have you felt you are giving up more of your life to meet [CHILD]’s 

needs than you ever expected? Would you say never, sometimes, usually, or always? 

(1) NEVER 

(2) SOMETIMES 

(3) USUALLY 

(4) ALWAYS 

(6) DON’T KNOW 

(7) REFUSED 
Series 1, No. 43 □ Page 81

S8Q10 During the past month, how often have you felt angry with [him/her]? Would you say never, sometimes, 

usually, or always? 

(1) NEVER 

(2) SOMETIMES 

(3) USUALLY 

(4) ALWAYS 

(6) DON’T KNOW 

(7) REFUSED 

S8Q11 CATI INSTRUCTION (S8Q11): IF RESPONDENT IS MOTHER OR FATHER—I.E., S1Q02 IN (01, 

02)—FILL “parenthood.” ELSE FILL “raising children.”

Is there someone that you can turn to for day-to-day emotional help with [parenthood/raising children]? 

 

(0) NO 

(1) YES 

(6) DON’T KNOW 

(7) REFUSED 

HELP SCREEN: THIS CAN BE ANY PERSON, INCLUDING THEIR SPOUSE. 

INTRODUCTION

There are various ways that families deal with serious disagreements. QUESTION STEM: [When you 

have a serious disagreement with your household members, how often do you [FILL S8Q12-S8Q15]. 

Would you say never, rarely, sometimes, usually or always?]

S8Q12 Just keep your opinions to yourself? 

[READ IF NECESSARY: Would you say never, rarely, sometimes, usually or always?] 

 (1) Never (2) Rarely (3) Sometimes (4) Usually (5) Always (6) DON’T KNOW (7) REFUSED 

S8Q13 Discuss your disagreements calmly? 

 [READ IF NECESSARY: Would you say never, rarely, sometimes, usually or always?] 

 (1) Never (2) Rarely (3) Sometimes (4) Usually (5) Always (6) DON’T KNOW (7) REFUSED 

 

S8Q14 Argue heatedly or shout? 

 [READ IF NECESSARY: Would you say never, rarely, sometimes, usually or always?] 

 (1) Never (2) Rarely (3) Sometimes (4) Usually (5) Always (6) DON’T KNOW (7) REFUSED 

S8Q15 End up hitting or throwing things? Would you say? 

[READ IF NECESSARY: Would you say never, rarely, sometimes, usually or always?] 

 (1) Never (2) Rarely (3) Sometimes (4) Usually (5) Always (6) DON’T KNOW (7) REFUSED 
Page 82 □ Series 1, No. 43 

Section 9: Parental Health

INTRODUCTION

The next few questions are about [CHILD]’s parents. Before I ask them, I need to know which parents 

live in this household with [CHILD].

S9Q00 (IF RESPONDENT IS MOTHER OR FATHER—I.E., S1Q02 = 1 OR 2—CONTINUE WITH 

S9Q00) 

Earlier you told me you are [CHILD]’s [mother/father]. Are you [CHILD]’s biological, adoptive, step, 

or foster [mother/father]? 

(01) BIOLOGICAL MOTHER 

(02) STEPMOTHER 

(03) FOSTER MOTHER 

(04) ADOPTIVE MOTHER 

(05) BIOLOGICAL FATHER 

(06) STEPFATHER 

(07) FOSTER FATHER 

(08) ADOPTIVE FATHER 

(09) OTHER 

(96) DON’T KNOW 

(97) REFUSED 

S9Q01 (IF ONLY ONE ADULT—I.E., TOTAL NUMBER IN HOUSEHOLD = NUMBER OF 

CHILDREN UNDER18 + 1, SKIP TO S9Q03) 

CATI INSTRUCTION (S9Q01): IF S1Q02 = (1) Mother OR (2) Father, FILL “other” and “Does”. 

ELSE, FILL “Earlier you told me you are [CHILD]’s [RELATION FROM S1Q02]” AND “Other than 

yourself, does” 

 

[FILL: Earlier you told me you are [CHILD]’s [ANSWER TO S1Q02)]. [Other than yourself 

does/Does] [S.C]. have any (other) parents, or people who act as [his/her] parents, living here? 

 

(0) NO [SKIP TO S9Q03] 

(1) YES 

(6) DON’T KNOW [SKIP TO S9Q03] 

(7) REFUSED [SKIP TO S9Q03] 
Series 1, No. 43 □ Page 83

S9Q02 INDEX What is their relationship to [CHILD]? [MARK ALL THAT APPLY] 

IF R RESPONDS “Mother” or “Father” PROBE: ‘Is that [his/her] biological, adoptive, step, or foster 

(FILL)?’] 

 N Y D R 

 S9Q02X01 BIOLOGICAL MOTHER 0 1 6 7 

S9Q02X02 STEPMOTHER 0 1 6 7 

S9Q02X03 FOSTER MOTHER 0 1 6 7 

S9Q02X04 ADOPTIVE MOTHER 0 1 6 7 

S9Q02X05 BIOLOGICAL FATHER 0 1 6 7 

S9Q02X06 STEPFATHER 0 1 6 7 

S9Q02X07 FOSTER FATHER 0 1 6 7 

S9Q02X08 ADOPTIVE FATHER 0 1 6 7 

S9Q02X09 SISTER OR BROTHER (STEP/FOSTER/HALF/ADOPTIVE) 0 1 6 7 

S9Q02X10 IN-LAW OF ANY TYPE 0 1 6 7 

S9Q02X11 AUNT/UNCLE 0 1 6 7 

S9Q02X12 GRANDMOTHER 0 1 6 7 

S9Q02X13 GRANDFATHER 0 1 6 7 

S9Q02X14 OTHER FAMILY MEMBER 0 1 6 7 

S9Q02X15 FEMALE GUARDIAN 0 1 6 7 

S9Q02X16 MALE GUARDIAN 0 1 6 7 

S9Q02X17 RESPONDENT’S PARTNER OR BOY/GIRLFRIEND 0 1 6 7 

S9Q02X18 OTHER NON-RELATIVE 0 1 6 7 

S9Q02X19 TWO OR MORE OF THE SAME RELATIONSHIP TYPE 0 1 6 7 

S9Q02X20 MOTHER TYPE UNKNOWN 0 1 6 7 

S9Q02X21 FATHER TYPE UNKNOWN 0 1 6 7 

S9Q02X22 OTHER RELATIONSHIP UNKNOWN 0 1 6 7 

 *RESPONSE CATEGORIES 

 (0) NO 

 (1) YES 

 (6) DON’T KNOW 

(7) REFUSED 

 IF S9Q02X19 = 1, [SKIP TO S9Q02_T]

S9Q02_T ENTER RELATIVE OR RELATIVES_______________________________. 

ENTER THE NUMBER AND TYPE OF PERSON REPORTED. FOR EXAMPLE: “2 

BROTHERS”. IF ONE OF THE RELATIVES IS ALREADY LISTED IN THE PICKLIST, DO 

NOT INCLUDE AGAIN HERE. 

 

S9Q03 (IF BIOLOGICAL MOTHER AND BIOLOGICAL FATHER LIVE IN THE HOUSEHOLD—

I.E., (S9Q00 = 01 AND S9Q02X05 = 1) OR (S9Q00 = 05 AND S9Q02X01 = 1)—SKIP TO S9Q08)

CATI INSTRUCTION (S9Q03): IF S1Q02 NE (01) Mother AND S9Q00 = (01) FILL “other.” 

 

Does [CHILD] have any (other) parents, or people who act as [his/her] parents, who do not live at this 

address? 

(0) NO [SKIP TO S9Q08] 

(1) YES 

(6) DON’T KNOW [SKIP TO S9Q08] 

(7) REFUSED [SKIP TO S9Q08]
Page 84 □ Series 1, No. 43 

S9Q04 INDEX What is their relationship to [CHILD]? [MARK ALL THAT APPLY] 

IF R RESPONDS “Mother” or “Father” PROBE: ‘Is that [his/her] biological, adoptive, step, or 

foster (FILL)?’] 

 

 N Y D R 

 S9Q04X01 BIOLOGICAL MOTHER 0 1 6 7 

S9Q04X02 STEPMOTHER 0 1 6 7 

S9Q04X03 FOSTER MOTHER 0 1 6 7 

S9Q04X04 ADOPTIVE MOTHER 0 1 6 7 

S9Q04X05 BIOLOGICAL FATHER 0 1 6 7 

S9Q04X06 STEPFATHER 0 1 6 7 

S9Q04X07 FOSTER FATHER 0 1 6 7 

S9Q04X08 ADOPTIVE FATHER 0 1 6 7 

S9Q04X09 SISTER OR BROTHER (STEP/FOSTER/HALF/ADOPTIVE) 0 1 6 7 

S9Q04X10 IN-LAW OF ANY TYPE 0 1 6 7 

S9Q04X11 AUNT/UNCLE 0 1 6 7 

S9Q04X12 GRANDMOTHER 0 1 6 7 

S9Q04X13 GRANDFATHER 0 1 6 7 

S9Q04X14 OTHER FAMILY MEMBER 0 1 6 7 

S9Q04X15 FEMALE GUARDIAN 0 1 6 7 

S9Q04X16 MALE GUARDIAN 0 1 6 7 

S9Q04X17 RESPONDENT’S PARTNER OR BOY/GIRLFRIEND 0 1 6 7 

S9Q04X18 OTHER NON-RELATIVE 0 1 6 7 

S9Q04X19 TWO OR MORE OF THE SAME RELATIONSHIP TYPE 0 1 6 7 

S9Q04X20 MOTHER TYPE UNKNOWN 0 1 6 7 

S9Q04X21 FATHER TYPE UNKNOWN 0 1 6 7 

S9Q04X22 OTHER RELATIONSHIP UNKNOWN 0 1 6 7 

IF S9Q04X19 = 1, [SKIP TO S9Q04_T]

S9Q04_T ENTER RELATIVE OR RELATIVE(S)_______________________________. 

S9Q05 (S9Q05 ASKED OF BIOLOGICAL MOTHER LIVING OUTSIDE THE HOUSEHOLD—I.E., 

S9Q04X01 = 1. IF NO BIOLOGICAL MOTHER OUTSIDE THE HOUSEHOLD, SKIP TO 

S9Q05A)

During the past 12 months, how often has [CHILD] seen [his/her] biological mother. 

(1) More than once a week 

(2) About once a week 

(3) 1 to 3 times a month 

(4) 1 to 11 times a year 

(5) Not at all 

(6) DON’T KNOW 

(7) REFUSED 
Series 1, No. 43 □ Page 85

S9Q05A (S9Q05 ASKED OF BIOLOGICAL FATHER LIVING OUTSIDE THE HOUSEHOLD—I.E., 

S9Q04X05 = 1. IF NO BIOLOGICAL FATHER OUTSIDE THE HOUSEHOLD, SKIP TO 

S9Q05B)

During the past 12 months, how often has [CHILD] seen his/her biological father? 

 

(1) More than once a week 

(2) About once a week 

(3) 1 to 3 times a month 

(4) 1 to 11 times a year 

(5) Not at all 

(6) DON’T KNOW 

(7) REFUSED 

S9Q08 (S9Q08 ASKED IF ANY MOTHER TYPE IS RESPONDENT, OR ANY MOTHER TYPE LIVES 

IN THE HOUSHOLD—I.E., S1Q02 = 01, OR ANY VALUE FOR S9Q02X01-S9Q02X04 = 1. IF 

NO MOTHER TYPE IN HOUSEHOLD, SKIP TO S9Q09)

Would you say that in general [[CHILD]’s MOTHER TYPE’s/your] health is excellent, very good, 

good, fair, or poor? 

(1) Excellent 

(2) Very good 

(3) Good 

(4) Fair 

(5) Poor 

(6) DON’T KNOW 

(7) REFUSED 

S9Q09 (S9Q09 ASKED IF ANY FATHER TYPE IS RESPONDENT, OR ANY FATHER TYPE LIVES 

IN THE HOUSHOLD—I.E., S1Q02 = 02 OR ANY VALUE FOR S9Q02X05-S9Q02X08 = 1. IF NO 

FATHER TYPE IN THE HOUSEHOLD, SKIP TO S9Q10)

Would you say that in general [[CHILD]’s FATHER TYPE’s/your] health is excellent, very good, 

good, fair, or poor? 

(1) Excellent 

(2) Very good 

(3) Good 

(4) Fair 

(5) Poor 

(6) DON’T KNOW 

(7) REFUSED 

S9Q10 (IF MOTHER TYPE OR FATHER TYPE IS RESPONDENT—I.E., S1Q02 IN (01, 02)—SKIP TO 

S9Q18)

Would you say that in general your health is excellent, very good, good, fair, or poor? 

(1) Excellent 

(2) Very good 

(3) Good 

(4) Fair 

(5) Poor 

(6) DON’T KNOW 

(7) REFUSED 
Page 86 □ Series 1, No. 43 

S9Q18 (S9Q18 ASKED IF ANY MOTHER TYPE IS RESPONDENT, OR ANY MOTHER TYPE LIVES 

IN THE HOUSHOLD—I.E., S1Q02 = 01 OR ANY VALUE FOR S9Q02X01-S9Q02X04 = 1. IF 

NO MOTHER TYPE IN THE HOUSEHOLD, SKIP TO S9Q19)

Would you say that in general [[CHILD]’s MOTHER TYPE’s/your] mental and emotional health is 

excellent, very good, good, fair, or poor? 

(1) Excellent 

(2) Very good 

(3) Good 

(4) Fair 

(5) Poor 

(6) DON’T KNOW 

(7) REFUSED 

S9Q19 (S9Q19 ASKED IF ANY FATHER TYPE IS RESPONDENT, OR ANY FATHER TYPE LIVES 

IN THE HOUSHOLD—I.E., S1Q02 = 1 OR ANY VALUE FOR S9Q02X05-S9Q02X08 = 1. IF NO 

FATHER TYPE IN THE HOUSEHOLD, SKIP TO S9Q20) 

Would you say that in general [[CHILD]’s FATHER TYPE’s/your] mental and emotional health is 

excellent, very good, good, fair, or poor? 

(1) Excellent 

(2) Very good 

(3) Good 

(4) Fair 

(5) Poor 

(6) DON’T KNOW 

(7) REFUSED 

 

S9Q20 (IF MOTHER TYPE OR FATHER TYPE IS RESPONDENT—I.E., S1Q02 IN (01, 02)—SKIP TO 

S9Q15) 

Would you say that in general your mental and emotional health is excellent, very good, good, fair, or 

poor? 

(1) Excellent 

(2) Very good 

(3) Good 

(4) Fair 

(5) Poor 

(6) DON’T KNOW 

(7) REFUSED 
Series 1, No. 43 □ Page 87

S9Q15 (S9Q15 ASKED IF ANY MOTHER TYPE IS RESPONDENT, OR MOTHER TYPE LIVES IN 

THE HOUSHOLD—I.E., S1Q02 = 01 OR ANY VALUE FOR S9Q02X01-S9Q02X04 = 1. IF NO 

MOTHER TYPE IN THE HOUSEHOLD, SKIP TO S9Q15A)

During the past month, did [you/[CHILD]’s MOTHER TYPE] regularly exercise or play sports hard 

enough to make [you/her] breathe hard, make [your/her] heart beat fast, or make [you/her] sweat for 20 

minutes or more? 

 

(0) NO 

(1) YES 

(6) DON’T KNOW 

(7) REFUSED 

S9Q15A (S9Q15A ASKED IF ANY FATHER TYPE IS RESPONDENT, OR ANY FATHER TYPE LIVES 

IN THE HOUSHOLD—I.E., S1Q02 = 02 OR ANY VALUE FOR S9Q02X05-S9Q02X08 = 1. IF NO 

FATHER TYPE IN THE HOUSEHOLD, SKIP TO S9Q15B)

CATI INSTRUCTION (S9Q15A): IF S1Q02 = 02 USE FILL # 2 WITH THESE PRONOUN FILLS: 

(1) you (2) you (3) your (4) you. ELSE, FILL (1)[CHILD]’s FATHER TYPE (2) his (3) his (4) his. 

IF S9Q15 NOT SKIPPED, USE FILL #1 AND DISPLAY FILL #2 WITH BRACKETS AROUND IT. 

ELSE USE FILL #2 ONLY. 

FILL #1: [And how about [CHILD]’s [FATHER TYPE]/YOU?]/ FILL #2: During the past month, did 

[you/[CHILD]’s FATHER TYPE] regularly exercise or play sports hard enough to make [you/him] 

breathe hard, make [your/his] heart beat fast, or make [you/him] sweat for 20 minutes or more?] 

 

(0) NO 

(1) YES 

(6) DON’T KNOW 

(7) REFUSED 

S9Q15B (IF MOTHER TYPE OR FATHER TYPE IS RESPONDENT—I.E., S1Q02 IN (01, 02)—SKIP TO 

S9Q15C) 

CATI INSTRUCTION (S9Q15B): IF S9Q20 ASKED, ASK S9Q15B. ELSE, SKIP TO S9Q15C. IF 

S9Q15 OR S9Q15 ANSWERED, USE FILL #1 AND DISPLAY FILL #2 WITH BRACKETS 

AROUND IT. ELSE, USE FILL #2. 

[FILL #1: And how about you?/ FILL#2: During the past month, did you regularly exercise or play sports 

hard enough to make you breathe hard, make your heart beat fast, or make you sweat for 20 minutes or 

more]? 

 

(0) NO 

(1) YES 

(6) DON’T KNOW 

(7) REFUSED 
Page 88 □ Series 1, No. 43 

S9Q15C (S9Q15C ASKED IF ANY MOTHER TYPE IS RESPONDENT, OR MOTHER TYPE LIVES IN 

THE HOUSHOLD—I.E., S1Q02 = 01 OR ANY VALUE FOR S9Q02X01-S9Q02X04 = 1. IF NO 

MOTHER TYPE IN THE HOUSEHOLD, SKIP TO S9Q15D) 

CATI INSTRUCTION (S9Q15C): IF S9Q18 ASKED, ASK S9Q15C. ELSE, SKIP TO S9Q15D. IF 

S1Q02 = 01, FILL “you.” ELSE, FILL (1) [CHILD]’s MOTHER TYPE.

[Do you/Does [CHILD]’s MOTHER TYPE] have any kind of health care coverage, including health 

insurance, prepaid plans such as HMOs, or government plans such as Medicare? 

 

 (0) NO 

 (1) YES 

(6) DON’T KNOW 

 (7) REFUSED 

S9Q15D (S9Q15D ASKED IF ANY FATHER TYPE IS RESPONDENT, OR ANY FATHER TYPE LIVES 

IN THE HOUSHOLD—I.E., S1Q02 = 02 OR ANY VALUE FOR S9Q02X05-S9Q02X08 = 1. IF NO 

FATHER TYPE IN THE HOUSEHOLD, SKIP TO S9Q15E) 

CATI INSTRUCTION (S9Q15D): IF S9Q19 ASKED, SKIP TO S9Q15D. ELSE, SKIP TO S9Q15E. 

IF S1Q02 = (1) Father, THEN FILL: you. 

ELSE DO: 

IF S9Q15 ANSWERED THEN FILL “Does (CHILD)’s father?” ONLY. 

ELSE IF S9Q15 NOT ANSWERED 

ELSE, FILL, “Does (CHILD)’s FATHER TYPE...

[Do you/Does [CHILD]’s FATHER TYPE] have any kind of health care coverage, including health 

insurance, prepaid plans such as HMOs, or government plans such as Medicare? 

 

 (0) NO 

 (1) YES 

(6) DON’T KNOW 

 (7) REFUSED 

S9Q15E (S9Q15E IS ASKED ONLY IF THERE ARE NO MOTHER TYPES OR FATHER TYPES IN 

THE HOUSEHOLD—I.E., IF S1Q02 NOT IN (01, 02) AND S9Q02X01-S9Q02X08 NE 1. IF ANY 

MOTHER TYPE OR FATHER TYPE IN THE HOUSEHOLD, SKIP TO S9Q11B) 

Do you have any kind of health care coverage, including health insurance, prepaid plans such as HMOs, 

or government plans such as Medicare? 

 

 (0) NO 

 (1) YES 

(6) DON’T KNOW 

 (7) REFUSED 

S9Q11B Does anyone in the household use cigarettes, cigars, or pipe tobacco? 

 

(0) NO 

(1) YES 

(6) DON’T KNOW 

(7) REFUSED 
Series 1, No. 43 □ Page 89

Section 10: Neighborhood Characteristics

INTRODUCTION

 Now, for the next five questions, I am going to ask how much you agree or disagree with each of these 

statements about your neighborhood or community. 

S10Q01 “People in this neighborhood help each other out.” Would you say that you definitely agree, somewhat 

agree, somewhat disagree, or definitely disagree with this statement? 

(1) Definitely agree 

(2) Somewhat agree 

(3) Somewhat disagree 

(4) Definitely disagree 

(6) DON’T KNOW 

(7) REFUSED 

S10Q02 “We watch out for each other’s children in this neighborhood.” [READ ONLY WHEN NEEDED: 

Would you say that you definitely agree, somewhat agree, somewhat disagree, or definitely disagree with 

this statement?] 

 (1) Definitely agree 

(2) Somewhat agree 

(3) Somewhat disagree 

(4) Definitely disagree 

(6) DON’T KNOW 

(7) REFUSED 

S10Q03 “There are people I can count on in this neighborhood.” [READ ONLY WHEN NEEDED: Would you 

say that you definitely agree, somewhat agree, somewhat disagree, or definitely disagree with this 

statement?] 

(1) Definitely agree 

(2) Somewhat agree 

(3) Somewhat disagree 

(4) Definitely disagree 

(6) DON’T KNOW 

(7) REFUSED 

S10Q04 CATI INSTRUCTION (S10Q04): IF NUMBER OF CHILDREN IN HOUSEHOLD UNDER AGE 18 

= 1, THEN FILL “child,” ELSE FILL “children.” 

“There are people in this neighborhood who might be a bad influence on my [child/children].” [READ 

ONLY WHEN NEEDED: Would you say that you definitely agree, somewhat agree, somewhat disagree, 

or definitely disagree with this statement?] 

(1) Definitely agree 

(2) Somewhat agree 

(3) Somewhat disagree 

(4) Definitely disagree 

(6) DON’T KNOW 

(7) REFUSED 
Page 90 □ Series 1, No. 43 

S10Q05 “If my child were outside playing and got hurt or scared, there are adults nearby who I trust to help my 

child.” [READ ONLY WHEN NEEDED: Would you say that you definitely agree, somewhat agree, 

somewhat disagree, or definitely disagree with this statement?] 

 IF R SAYS THEIR CHILD IS TOO YOUNG TO PLAY OUTSIDE, SAY: "Please answer the question 

as IF your child were playing outside."

(1) Definitely agree 

(2) Somewhat agree 

(3) Somewhat disagree 

(4) Definitely disagree 

(6) DON’T KNOW 

(7) REFUSED 

S10Q06 How often do you feel [CHILD] is safe in your community or neighborhood? Would you say never, 

sometimes, usually, or always? 

(1) Never 

(2) Sometimes 

(3) Usually 

(4) Always 

(6) DON’T KNOW 

(7) REFUSED 

S10Q07 (IF AGE OF CHILD < 72 MONTHS, OR CHILD HOME-SCHOOLED/NOT ENROLLED—I.E., 

(S7Q01 =3) OR (S7Q01 = 4 AND S7Q01F IN (0, 6, 7)) OR (S7Q02 = 994, 995)—SKIP TO S10Q08) 

How often do you feel [he/she] is safe at school? Would you say never, sometimes, usually, or always? 

(1) Never 

(2) Sometimes 

(3) Usually 

(4) Always 

(6) DON’T KNOW 

(7) REFUSED 

S10Q08 How often do you feel [he/she] is safe at home? Would you say never, sometimes, usually, or always? 

(1) Never 

(2) Sometimes 

(3) Usually 

(4) Always 

(6) DON’T KNOW 

(7) REFUSED 
Series 1, No. 43 □ Page 91

Section 11: Additional Demographics

INTRODUCTION

Now I have a few more general questions about [CHILD] and your household. 

 

S11Q01 Is [CHILD] of Hispanic or Latino origin? 

 

 (0) NO 

(1) YES 

(6) DON’T KNOW 

 (7) REFUSED 

 

 

S11Q02 INDEX Now, I'm going to read a list of categories. Please choose one or more of the following categories to 

describe [CHILD]’s race. Is [CHILD] White, Black or African American, American Indian, Alaska 

Native, Asian, or Native Hawaiian or other Pacific Islander? [MARK ALL THAT APPLY] 

 N Y D R 

 S11Q02X01 WHITE 0 1 6 7 

 S11Q02X02 BLACK/AFRICAN-AMERICAN 0 1 6 7 

 S11Q02X03 AMERICAN INDIAN 0 1 6 7 

 S11Q02X04 ALASKA NATIVE 0 1 6 7 

 S11Q02X05 ASIAN 0 1 6 7 

 S11Q02X06 NATIVE HAWAIIAN 0 1 6 7 

 S11Q02X07 PACIFIC ISLANDER 0 1 6 7 

 

 *RESPONSE CATEGORIES 

 (0) NO 

 (1) YES 

 (6) DON’T KNOW 

 (7) REFUSED 

 

 

HELP SCREEN (S11Q02): BE SURE TO READ THE ENTIRE QUESTION AS WRITTEN 

(INCLUDING ALL RESPONSE CATEGORIES. 

RACE INFORMATION IS COLLECTED BY SELF-IDENTIFICATION. IT IS “WHATEVER 

RACE YOU CONSIDER YOURSELF TO BE.” DO NOT TRY TO EXPLAIN OR DEFINE ANY 

OF THE GROUPS. MULTIPLE RACES MAY BE SELECTED. 
Page 92 □ Series 1, No. 43 

S11Q03 (IF RESPONDENT IS NOT MOTHER—I.E., S1Q02 NOT EQUAL TO 01—AND NO MOTHER 

TYPE RESIDES IN THE HOUSEHOLD—I.E., NO VALUES FOR S9Q02X01-S9Q02X04 = 1—

SKIP TO S11Q04)

CATI INSTRUCTION (S11Q03): IF MOTHER IS RESPONDENT—I.E., S1Q02 = 01—FILL “Were 

you born in the United States?” ELSE IF MOTHER NOT RESPONDENT BUT FOSTER, ADOPTIVE 

OR STEP MOTHER RESIDES IN HOUSEHOLD—I.E., ONE OR MORE VALUES IN S9Q02X02-

S9Q02X04 = 1—THEN FILL FIRST AVAILABLE MOTHER TYPE FOR S9Q02INDEX. 

 Was [CHILD]’s [FILL FIRST MOTHER TYPE FROM S9Q02X01-S9Q02X04]/Were you born in 

the United States? 

 (0) No (1) Yes (6) DON’T KNOW (7) REFUSED 

S11Q04 (IF RESPONDENT IS NOT FATHER—I.E., S1Q02 NOT EQUAL TO 02—AND NO FATHER 

TYPE RESIDES IN THE HOUSEHOLD—I.E., NO VALUES FOR S9Q02X05-S9Q02X08 = 1—

SKIP TO S11Q05)

CATI INSTRUCTION S11Q04): IF FATHER IS NOT RESPONDENT—I.E., S1Q02 NOT EQUAL 

TO 02—AND S11Q03 ANSWERED, USE FILL #1. ELSE IF FATHER IS NOT RESPONDENT AND 

S11Q03 NOT ANSWERED, USE FILL #2. ELSE IF FATHER IS RESPONDENT—I.E., S1Q02 = 02, 

USE FILL #3. 

FILL #1: And how about [you/[CHILD]’s [FILL FIRST FATHER TYPE FROM S9Q02X05-

S9Q02X08]]? 

FILL #2: Was [CHILD]’s [FILL FIRST FATHER TYPE FROM S9Q02X05-S9Q02X08] born in the 

United States? 

FILL #3: Were you born in the United States? 

 (0) No (1) Yes (6) DON’T KNOW (7) REFUSED 

 

S11Q05 CATI INSTRUCTION S11Q04): IF S11Q03 ANSWERED, USE FILL #1, AND DISPLAY FILL #2 

IN BRACKETS. ELSE USE FILL #2. 

 FILL #1: And how about [CHILD]? 

 FILL #2: Was [CHILD] born in the United States? 

 (0) No (1) Yes (6) DON’T KNOW (7) REFUSED 

 

S11Q05A (S11Q05A IS ASKED OF MOTHER TYPE RESIDING IN THE HOUSHOLD THAT WERE 

BORN OUTSIDE OF THE UNITED STATES. IF MOTHER TYPE BORN IN THE UNITED 

STATES OR PLACE OF BIRTH UNKNOWN/REFUSED—I.E., S11Q03 NOT EQUAL TO 0—

SKIP TO S11Q05C) 

 

 How long [have you/has [CHILD’s] MOTHER TYPE FROM S9Q02X01-S9Q02X04] been in the 

United States? 

 ___ ____ ___ [RANGE CHECK: 001-993] 

(994) SHE HAS NEVER LIVED IN THE UNITED STATES 

(995) SHE IS DECEASED 

(996) DON’T KNOW 

(997) REFUSED 
Series 1, No. 43 □ Page 93

S11Q05B [MARK PERIOD] 

 (01) DAY(S) 

 (02) WEEK(S) 

 (03) MONTH(S) 

 (04) YEAR(S) 

 (96) DON’T KNOW 

 (97) REFUSED 

S11Q05C (S11Q05C IS ASKED OF FATHER TYPE RESIDING IN HOUSHOLD WHO WAS BORN 

OUTSIDE OF THE UNITED STATES. IF FATHER TYPE BORN IN THE UNITED STATES 

OR PLACE OF BIRTH UNKNOWN/REFUSED—I.E., S11Q04 NOT EQUAL TO 0—SKIP TO 

S11Q05E) 

 How long [have you/has [CHILD]’s [FILL FIRST FATHER TYPE FROM S9Q02X05-S9Q02X08]]

been in the United States? 

 ___ ____ ___ [RANGE CHECK: 001-993] 

(994) HE HAS NEVER LIVED IN THE UNITED STATES 

(995) HE IS DECEASED 

(996) DON’T KNOW 

(997) REFUSED 

S11Q05D [MARK PERIOD] 

 (01) DAY(S) 

 (02) WEEK(S) 

 (03) MONTH(S) 

 (04) YEARS 

 (96) DON’T KNOW 

 (97) REFUSED 

 

S11Q05E (S11Q05E IS ASKED OF SAMPLED CHILDREN BORN OUTSIDE OF THE UNITED STATES. 

IF CHILD WAS BORN IN THE UNITED STATES OR PLACE OF BIRTH 

UNKNOWN/REFUSED—I.E., S11Q05 NOT EQUAL TO 2—SKIP TO S11Q056) 

 “How long has [CHILD] been in the United States? 

 ___ ____ ___ [RANGE CHECK: 001-995] 

(996) DON’T KNOW 

(997) REFUSED 

S11Q05F [MARK PERIOD] 

 (01) DAY(S) 

 (02) WEEK(S) 

 (03) MONTH(S) 

 (04) YEARS 

 (96) DON’T KNOW 

 (97) REFUSED 
Page 94 □ Series 1, No. 43 

S11Q06 How many times has [CHILD] ever moved to a new address? 

 

 ___ ___ ___ MOVES [RANGE CHECK: 000-995] 

(996) DON’T KNOW 

(997) REFUSED 

HELP SCREEN (S11Q06): PLEASE INCLUDE ANY AND ALL TIMES A CHILD HAS 

CHANGED THEIR PRIMARY RESIDENCE. DO NOT INCLUDE TEMPORARY CHANGES 

IN RESIDENCE SUCH AS A CHILD VISITING ANOTHER RESIDENCE DURING SUMMER 

VACATION OR OTHER BREAKS IN THE SCHOOL YEAR. 

S11Q08 Was anyone in the household employed at least 50 weeks out of the past 52 weeks? 

 

 (0) NO 

 (1) YES 

 (6) DON’T KNOW 

(7) REFUSED 

C11Q01 Now I am going to ask you a few questions about your income. Please think about your total combined 

FAMILY income during (CATI: FILL LAST CALENDAR YEAR) for all members of the family. 

Include money from jobs, social security, retirement income, unemployment payments, public assistance, 

and so forth. Also, include income from interest, dividends, net income from business, farm, or rent, and 

any other money income received. Can you tell me that amount before taxes? 

RECORD INCOME $___________________ [SKIP TO C11Q11] 

DON’T KNOW (999999996) [SKIP TO W9Q02] 

 REFUSED (999999997) [SKIP TO W9Q02] 

HELP SCREEN: RESPONDENT MAY GIVE A RANGE AS AN ANSWER TO THIS 

QUESTION. BE PREPARED TO PROBE FOR A MORE ACCURATE ANSWER. 

 

W9Q02 You may not be able to give us an exact figure for your total combined family income, but was your total 

family income during (CATI: LAST CALENDAR YEAR) more or less than $20,000? 

 

(1) More than $20,000 [SKIP TO W9Q06] 

(2) $20,000 [SKIP TO C11Q11]

(3) Less than $20,000 [SKIP TO C11Q11] 

(6) DON’T KNOW [SKIP TO C11Q11] 

(7) REFUSED [SKIP TO C11Q11] 

W9Q03 Was the total combined FAMILY income more or less than $10,000? 

(1) More than $10,000 [SKIP TO W9Q05]

(2) $10,000 [SKIP TO C11Q11] 

(3) Less than $10,000 [SKIP TO C11Q11]

(6) DON’T KNOW [SKIP TO C11Q11] 

(7) REFUSED [SKIP TO C11Q11] 
Series 1, No. 43 □ Page 95

W9Q04 Was it more than $7,500? 

(0) No [SKIP TO W9Q12] 

(1) Yes [SKIP TO W9Q12]

(6) DON’T KNOW [SKIP TO C11Q11]

(7) REFUSED [SKIP TO C11Q11] 

W9Q05 Was it more than $15,000? 

 (0) No [SKIP TO W9Q05B] 

(1) Yes [SKIP TO C11Q11]

(6) DON’T KNOW [SKIP TO C11Q11]

(7) REFUSED [SKIP TO C11Q11] 

W9Q05A Was it more than $17,500? 

(0) No [SKIP TO W9Q12] 

(1) Yes [SKIP TO W9Q12]

(6) DON’T KNOW [SKIP TO C11Q11]

(7) REFUSED [SKIP TO C11Q11]

W9Q05B Was it more than $12,500? 

(0) No [SKIP TO W9Q12] 

(1) Yes [SKIP TO W9Q12]

(6) DON’T KNOW [SKIP TO C11Q11]

(7) REFUSED [SKIP TO C11Q11] 

W9Q06 Was the total combined FAMILY income more or less than $40,000? 

(1) More than $40,000 

(2) $40,000 [SKIP TO C11Q11]

(3) Less than $40,000 [SKIP TO W9Q07] 

(6) DON’T KNOW [SKIP TO C11Q11] 

(7) REFUSED [SKIP TO C11Q11]

W9Q06A Was the total combined FAMILY income more or less than $60,000? 

 

(1) More than $60,000 [SKIP TO W9Q08]

(2) $60,000 [SKIP TO C11Q11]

(3) Less than $60,000 [SKIP TO C11Q11] 

(6) DON’T KNOW [SKIP TO C11Q11]

(7) REFUSED [SKIP TO C11Q11] 

W9Q06B Was the total combined FAMILY income more or less than $50,000? 

 (1) More than $50,000 [SKIP TO W9Q12]

 (2) $50,000 [SKIP TO C11Q11]

 (3) Less than $50,00 [SKIP TO C11Q11]

(6) DON’T KNOW [SKIP TO C11Q11]

(7) REFUSED [SKIP TO C11Q11] 
Page 96 □ Series 1, No. 43 

W9Q06C Was the total combined FAMILY income more or less than $45,000? 

 (1) More than $45,000 [SKIP TO W9Q12] 

 (2) Less than $45,000 [SKIP TO W9Q12]

(6) DON’T KNOW [SKIP TO C11Q11]

(7) REFUSED [SKIP TO C11Q11]

W9Q07 Was the total combined FAMILY income more or less than $30,000? 

 

(1) More than $30,000 

(2) $30,000 [SKIP TO C11Q11]

(3) Less than $30,000 [SKIP TO W9Q07B] 

(6) DON’T KNOW [SKIP TO C11Q11] 

(7) REFUSED [SKIP TO C11Q11]

W9Q07A Was the total combined FAMILY income more or less then $35,000? 

(1) More than $35,000 [SKIP TO W9Q12]

(2) Less than $35,000 [SKIP TO W9Q12]

(6) DON’T KNOW [SKIP TO C11Q11]

(7) REFUSED [SKIP TO C11Q11]

W9Q07B Was the total combined FAMILY income more or less than $25,000? 

(1) More than $25,000 [SKIP TO W9Q12]

(2) Less than $25,000 [SKIP TO W9Q12]

(6) DON’T KNOW [SKIP TO C11Q11]

(7) REFUSED [SKIP TO C11Q11]

W9Q08 Was the total combined FAMILY income more or less than $75,000? 

(1) More than $75,000 

(2) $75,000 [SKIP TO C11Q11] 

(3) Less than $75,000 [SKIP TO C11Q11]

(6) DON’T KNOW [SKIP TO C11Q11]

(7) REFUSED [SKIP TO C11Q11]
Series 1, No. 43 □ Page 97

W9Q12 CATI INSTRUCTION (W9Q12): BASED ON THE RANGE ALREADY IDENTIFIED, THIS NEXT 

QUESTION WILL BE FILLED WITH A DOLLAR AMOUNT THAT FALLS WITHIN THE RANGE 

AND IS EQUIVALENT TO 50%, 100%, 133%, 150%, 185%, 200%, 300%, OR 400% OF THE 

FEDERAL POVERTY LEVEL BASED ON THE NUMBER OF FAMILY MEMBERS. IF THE 

RANGE IDENTIFIED IS NARROW ENOUGH THAT NONE OF THESE POVERTY LEVEL 

CUTOFFS FALL WITHIN THE RANGE, THEN SKIP TO W9Q12A. FOR A FEW RANGES, TWO 

ADDITIONAL QUESTIONS WILL BE NEEDED. REFER TO REFERENCE TABLES FOR 

CORRECT INCOME FILLS. 

Would you say this income was above or below [$REF]? 

 (1) MORE THAN [$REF] (WHEN INDICATED, ASK W9Q12A) 

 (2) EXACTLY [$REF] [SKIP TO C11Q11] 

 (3) LESS THAN [$REF] [SKIP TO C11Q11]

 (6) DON'T KNOW [SKIP TO C11Q11] 

 (7) REFUSED [SKIP TO C11Q11] 

W9Q12A Would you say this income was above or below [$REF]? 

(1) MORE THAN [$REF] [SKIP TO C11Q11] 

(2) EXACTLY [$REF] [SKIP TO C11Q11] 

(3) LESS THAN [$REF] [SKIP TO C11Q11]

(6) DON'T KNOW [SKIP TO C11Q11] 

(7) REFUSED [SKIP TO C11Q11] 

C11Q11 NOTE: IF HOUSEHOLD INCOME CANNOT BE DETERMINED, CATI HH POVERTY LEVEL 

IS ASSUMED TO BE GREATER THAN 300%. 

(IF HOUSEHOLD INCOME GREATER THAN OR EQUAL TO 300% POVERTY, SKIP TO 

C11Q14) 

 

At any time during the past 12 months, even for one month, did anyone in this household receive any 

cash assistance from a state or county welfare program, such as [state TANF name]? 

(0) No 

(1) Yes 

(6) DON’T KNOW 

(7) REFUSED 

C11Q11A During the past 12 months, did [[CHILD]/ any child in the household] receive Food Stamps? 

(0) No 

(1) Yes 

(6) DON’T KNOW 

(7) REFUSED 

C11Q11B (IF AGES OF ALL CHILDREN IN HOUSEHOLD ARE < 36 MONTHS, SKIP TO S9Q34)

During the past 12 months, [did any child in the household/[CHILD]] receive free or reduced-cost 

breakfasts or lunches at school? 

(0) NO 

(1) YES 

(6) DON’T KNOW 

(7) REFUSED 
Page 98 □ Series 1, No. 43 

S9Q34 Does anyone who lives in the household currently receive benefits from the Women, Infants, and 

Children (WIC) Program? 

(0) NO 

(1) YES 

(3) NEVER HEARD OF WIC 

(6) DON’T KNOW 

(7) REFUSED 

C11Q14 The next few questions are about the telephone numbers in your household. Do you have any other home 

phone numbers in addition to {area code and telephone number called}? Please do not include cellular 

phones in your answer. 

(0) NO [SKIP TO C11Q20] 

(1) YES 

(6) DON’T KNOW [SKIP TO C11Q20] 

(7) REFUSED [SKIP TO C11Q20] 

C11Q15 Is this second number for home use only, for business use only, or for both home and business use? 

(1) HOME ONLY 

(2) BUSINESS ONLY [SKIP TO C11Q17] 

(3) BOTH HOME AND BUSINESS 

(6) DON’T KNOW [SKIP TO C11Q17]

(7) REFUSED [SKIP TO C11Q17] 

C11Q16 Is this second number used only for computer or fax communications? 

(0) NO 

(1) YES 

(6) DON’T KNOW 

(7) REFUSED 

C11Q17 Do you have a third home phone number in addition to the two you have already told me about? Please 

do not include cellular phones in your answer. 

 (0) NO [SKIP TO C11Q20] 

(1) YES 

(6) DON’T KNOW [SKIP TO C11Q20] 

(7) REFUSED [SKIP TO C11Q20]

C11Q18 Is this third number for home use only, for business use only, or for both home and business use? 

(1) HOME ONLY 

 (2) BUSINESS ONLY [SKIP TO C11Q20] 

 (3) BOTH HOME AND BUSINESS 

(6) DON’T KNOW [SKIP TO C11Q20] 

 (7) REFUSED [SKIP TO C11Q20]
Series 1, No. 43 □ Page 99

C11Q19 Is this third number used only for computer or fax communications? 

 (0) NO 

(1) YES 

(6) DON’T KNOW 

 (7) REFUSED 

C11Q20 During the past 12 months, has your household been without telephone service for 1 week or more? 

Please do not include cellular phones in your answer. 

(0) NO [SKIP TO C11Q22] 

(1) YES 

(6) DON’T KNOW [SKIP TO C11Q22]

(7) REFUSED [SKIP TO C11Q22] 

 

C11Q21_A For how long was your household without telephone service in the past 12 months? 

 ENTER NUMBER ___ ___ ___ 

 (996) DON’T KNOW 

 (997) REFUSED 

 IF DAYS IS CHOSEN TIME PERIOD, RANGE IS 001-365. 

 IF WEEKS IS CHOSEN TIME PERIOD, RANGE IS 001-052. 

 IF MONTHS IS CHOSEN TIME PERIOD, RANGE IS 001-012. 

C11Q21 ENTER PERIOD. 

 ___ ___ 

 

(1) DAYS 

(2) WEEK(S) 

 (3) MONTH(S) 

 (6) DON’T KNOW 

 (7) REFUSED 

 

C11Q22 Please tell me your zip code. 

____ ____ ____ ____ ____ [RANGE 00001-99997] 

(00001-99995) 

 (99996) DON’T KNOW 

(99997) REFUSED 

CLOSING STATEMENT

 Those are all the questions I have. I’d like to thank you on behalf of the Centers for Disease Control and 

Prevention for the time and effort you’ve spent answering these questions. If you have any questions 

about this survey, you may call my supervisor toll-free at 1-800-290-1296. If you have questions about 

your rights as a survey participant, you may call the chairman of the Institutional Review Board at 

1-800-223-8118. Thanks again. 

 
Appendix IV

Summary of Questionnaire

Changes

1. On April 15, 2003, on-screen help

text was added to verbatim questions

S2Q55_OS, S4Q08_OS, S4Q18_OS,

and S4Q29_OS. This text directed

interviewers to type the phrase ‘‘NO

ANSWER GIVEN’’ when the

respondent was not able to provide a

specific answer.

2. Question S9Q01 is designed to

identify parents or people who act as

parents, other than the respondent.

During the course of data collection for

the National Survey of Children’s

Health, it became clear that some

respondents had been unintentionally

including themselves more than once in

their reports. To avoid this problem,

question S9Q01 was changed on May

12, 2003, from:

S9Q01 [FILL: Earlier you told me you

are (S.C.)’s (ANSWER TO S1Q02)].

Does S.C. have any (other) parents, or

people who act as (his/her) parents,

living here?

to:

S9Q01 [Fill: Earlier you told me you

are (S.C.)’s (ANSWER TO S1Q02)].

[Other than yourself, does/Does] S.C.

have any (other) parents, or people who

act as (his/her) parents, living here?

3. On May 27, 2003, a skip instruction

for questions S4Q15 and S4Q16 was

added to avoid redundancy with

question S2Q04. Question S4Q15,

which asks about the use of prescription

medication by the sampled child in the

past 12 months and question S4Q16

which asks about the sampled child’s

need for prescription medication in the

past 12 months, did not need to be

asked when the respondent provided a

positive response to question S2Q04

(‘‘Does your children currently need or

use medicine prescribed by a doctor,

other than vitamins?’’).

4. On June 16, 2003, an enhancement

was made to questions S11Q05A and

S11Q05C, and their respective follow-up

questions S11Q05B and S11Q05D. The

enhancement allowed interviewers to

indicate that a mother or father was

‘‘deceased’’ or ‘‘never lived in the

United States’’ immediately, without

having to first enter a value of ‘‘00’’ in

S11Q05A or S11Q05C.

5. On July 14, 2003, an inappropriate

age-related skip instruction for question

S9Q11B was removed. Prior to July

14th, the question about smoking in the

household was not asked when the age

of the sampled child was less than 72

months. From July 14th forward, the

question was asked in all households

regardless of the sampled child’s age.

6. On July 29, 2003, state-specific

S-CHIP program names that appeared in

question S3Q01 were updated to reflect

current information.

7. On August 5, 2003, an age-related

skip instruction was added for question

C11Q11B, which asked whether any

child in the household had received free

or reduced-cost meals at school within

the past year. The instruction stipulated

that the question be skipped in

households where all children were 36

months of age or younger. Previously

the question had been asked in all

households, regardless of the ages of the

resident children.

Page 100 [ Series 1, No. 43
Appendix V

Procedures for Assigning

Household Poverty Status

The Department of Health and

Human Services (DHHS) publishes

Federal Poverty Guidelines for the

determination of household poverty

status. These guidelines are produced

annually and developed separately for

the 48 contiguous States (plus the

District of Columbia), Alaska, and

Hawaii. The National Survey of

Children’s Health (NSCH) used DHHS

guidelines to assign household poverty

status. Year 2002 guidelines for 2001

income were used in interviews

conducted from January 29, 2003,

through March 4, 2003 (tables VIII–X).

On March 5, 2003, the newly released

2003 guidelines for 2002 income were

implemented for the remainder of the

data collection period (tables XI–XIII).

The tables were used to group

households into the following nine

poverty status categories:

+ Category AA — Below 50% of

poverty

+ Category A — 50% of poverty or

greater, but less than 100% of

poverty

+ Category B — 100% of poverty or

greater, but less than 133% of

poverty

+ Category C — 133% of poverty or

greater, but less than 150% of

poverty

+ Category D — 150% of poverty or

greater, but less than 185% of

poverty

+ Category E — 185% of poverty or

greater, but less than 200% of

poverty

+ Category F — 200% of poverty or

greater, but less than 300% of

poverty

+ Category G — 300% of poverty or

greater, but less than 400% of

poverty

+ Category H — 400% of poverty or

greater

Two variables were used to

determine a household’s poverty status:

the number of people residing in a

household and the household’s income

during the prior year. It was possible for

income data to be gathered using one of

three methods: a respondent could

provide an exact income, provide an

income range based on a closed-ended

series of questions, or provide an

income range using a set of cascading

questions revised to allow exact

determination of household poverty

status in cases where that would not

otherwise be possible. A brief

description of each of these methods

and the household poverty status

assignment process for each appears

below.

Respondent-reported exact

income—When a respondent reported an

exact income, poverty status was

assigned by comparing the number of

household members and the exact

income reported with the appropriate

guidelines table. For example, a

respondent living in the 48 contiguous

States reporting a household size of five

persons and an income of $34,000

would be classified into category D

(150% of poverty or greater, but less

than 185% of poverty) based on the

2002 guidelines in table VIII. A

respondent living in Hawaii reporting a

household size of three persons and an

income of $50,000 would be classified

into category F (200% of poverty or

greater, but less than 300% of poverty)

based on the 2002 guidelines in table X.

Respondent Reported Income Range

Based on a Closed-Ended Series of

Questions—When respondents did not

supply a specific dollar amount for

household income, it was necessary to

go through a series of questions asking

respondents whether the household

income was below, exactly at, or above

threshold amounts. A matrix was then

created to categorize responses to these

income cascade questions. Each cell in

the matrix was assigned to one of the

following income categories:

+ Less than $7,500

+ $7,500–$9,999

+ $10,000–$12,499

+ $12,500–$14,999

+ $15,000–$17,499

+ $17,500–$19,999

+ $20,000–$24,999

+ $25,000–$29,999

+ $30,000–$34,999

+ $35,000–$39,999

+ $40,000–$44,999

+ $45,000–$49,999

+ $50,000–$59,999

+ $60,000–$74,999

+ $75,000 or higher

Respondents who went through the

cascade of income questions were

assigned a household poverty status by

comparing the number of household

members and the assigned income

category with the appropriate guidelines

table. For example, a respondent living

in Alaska reporting a household size of

two persons and an income (based on

the cascade) of $30,000–$34,999 would

be classified into category F (200% of

poverty or greater, but less than 300%

of poverty) based on the 2002

guidelines in table IX. A respondent

living in the 48 contiguous States

reporting a household size of four

persons and an income of $75,000 or

higher would be classified into category

H (400% of poverty or greater) based

on the 2003 guidelines in table XI.

When respondents did not complete

the income cascade, either because they

refused or did not know the answer to

one of the cascade questions, household

poverty status could not be assigned.

However, such households were

assumed to be at or above 300% of

poverty to skip questions asked only of

those households that were known to be

less than 300% of poverty.

Respondent-reported income range

based on revised series of cascade

questions—In some cases, the income

categories described above encompassed

one or more income breaks for

determining household poverty status. In

such cases, additional income cascade

questions were asked to permit

definitively assigning poverty status. For

these questions, ‘‘customized’’ income

‘‘reference’’ values, based on household

size and State of residence, were used to

obtain a range that would fit into the

poverty-level table. For example, the

income break indicating that a

two-person household in the contiguous

48 States was below 50% of poverty,

using the 2003 guidelines, was $6,060.

This income break is encompassed in

the income category of ‘‘less than

Series 1, No. 43 [ Page 101
$7,500.’’ Therefore, for respondents who

went through the cascade and reported

income less than $7,500, an additional

cascade question asked whether the

household income was above, at, or

below $6,100 (based on rounding rules

described in the note at the bottom of

table XIV). If the household reported an

income below $6,100, the assigned

household poverty status would be

Category AA (below 50% of poverty).

Another scenario is: a respondent living

in the 48 contiguous States reporting a

household size of five persons and an

income (based on the cascade) of

$20,000–$24,999 would be asked

whether the household income was

above, at, or below $21,500 (based on

2003 guidelines and based on rounding

rules described in the note at the bottom

on table XIX). If the respondent

reported an income below $21,500, the

assigned household poverty status would

be category A (50% of poverty or

greater, but less than 100% of poverty).

Using DHHS guidelines, tables

were developed to provide reference

values for the additional income cascade

questions. Reference values using 2002

guidelines were used with 2001 income

from January 29, 2003, through March 4,

2003 (tables XIV–XVI). Reference

values using 2003 guidelines with 2002

income were implemented on March 5,

2003 (tables XVII–XIX).

Table VIII. Year 2002 guidelines for poverty ranges based on total family members for families in the 48 contiguous States and the

District of Columbia

Family size

Percent of Federal poverty level

50 100 133 150 185 200 300 400

2 . . . . . . . . . . . . . . . . . . . . . . . $ 5,970 $11,940 $15,880 $17,910 $ 22,089 $ 23,880 $ 35,820 $ 47,760

3 . . . . . . . . . . . . . . . . . . . . . . . $ 7,510 $15,020 $19,976 $22,530 $ 27,787 $ 30,040 $ 45,060 $ 60,080

4 . . . . . . . . . . . . . . . . . . . . . . . $ 9,050 $18,100 $24,073 $27,150 $ 33,485 $ 36,200 $ 54,300 $ 72,400

5 ....................... $10,590 $21,180 $28,169 $31,770 $ 39,183 $ 42,360 $ 63,540 $ 84,720

6 ....................... $12,130 $24,260 $32,265 $36,390 $ 44,881 $ 48,520 $ 72,780 $ 97,040

7 ....................... $13,670 $27,340 $36,362 $41,010 $ 50,579 $ 54,680 $ 82,020 $109,360

8 ....................... $15,210 $30,420 $40,458 $45,630 $ 56,277 $ 60,840 $ 91,260 $121,680

9 ....................... $16,750 $33,500 $44,555 $50,250 $ 61,975 $ 67,000 $100,500 $134,000

10. . . . . . . . . . . . . . . . . . . . . . . $18,290 $36,580 $48,651 $54,870 $ 67,673 $ 73,160 $109,740 $146,320

11. . . . . . . . . . . . . . . . . . . . . . . $19,830 $39,660 $52,747 $59,490 $ 73,371 $ 79,320 $118,980 $158,640

12. . . . . . . . . . . . . . . . . . . . . . . $21,370 $42,740 $56,844 $64,110 $ 79,069 $ 85,480 $128,220 $170,960

13. . . . . . . . . . . . . . . . . . . . . . . $22,910 $45,820 $60,940 $68,730 $ 84,767 $ 91,640 $137,460 $183,280

14. . . . . . . . . . . . . . . . . . . . . . . $24,450 $48,900 $65,037 $73,350 $ 90,465 $ 97,800 $146,700 $195,600

15. . . . . . . . . . . . . . . . . . . . . . . $25,990 $51,980 $69,133 $77,970 $ 96,163 $103,960 $155,940 $207,920

16. . . . . . . . . . . . . . . . . . . . . . . $27,530 $55,060 $73,229 $82,590 $101,861 $110,120 $165,180 $220,240

17. . . . . . . . . . . . . . . . . . . . . . . $29,070 $58,140 $77,326 $87,210 $107,559 $116,280 $174,420 $232,560

18. . . . . . . . . . . . . . . . . . . . . . . $30,610 $61,220 $81,422 $91,830 $113,257 $122,440 $183,660 $244,880

Table IX. Year 2002 guidelines for poverty ranges based on total family members for families in Alaska

Family size

Percent of Federal poverty level

50 100 133 150 185 200 300 400

2 . . . . . . . . . . . . . . . . . . . . . . . $ 7,465 $14,930 $ 19,856 $ 22,395 $ 27,621 $ 29,860 $ 44,790 $ 59,720

3 . . . . . . . . . . . . . . . . . . . . . . . $ 9,390 $18,780 $ 24,977 $ 28,170 $ 34,743 $ 37,560 $ 56,340 $ 75,120

4 . . . . . . . . . . . . . . . . . . . . . . . $11,315 $22,630 $ 30,097 $ 33,945 $ 41,866 $ 45,260 $ 67,890 $ 90,520

5 ....................... $13,240 $26,480 $ 35,218 $ 39,720 $ 48,988 $ 52,960 $ 79,440 $105,920

6 ....................... $15,165 $30,330 $ 40,338 $ 45,495 $ 56,111 $ 60,660 $ 90,990 $121,320

7 ....................... $17,090 $34,180 $ 45,459 $ 51,270 $ 63,233 $ 68,360 $102,540 $136,720

8 ....................... $19,015 $38,030 $ 50,579 $ 57,045 $ 70,356 $ 76,060 $114,090 $152,120

9 ....................... $20,940 $41,880 $ 55,700 $ 62,820 $ 77,478 $ 83,760 $125,640 $167,520

10. . . . . . . . . . . . . . . . . . . . . . . $22,865 $45,730 $ 60,820 $ 68,595 $ 84,601 $ 91,460 $137,190 $182,920

11. . . . . . . . . . . . . . . . . . . . . . . $24,790 $49,580 $ 65,941 $ 74,370 $ 91,723 $ 99,160 $148,740 $198,320

12. . . . . . . . . . . . . . . . . . . . . . . $26,715 $53,430 $ 71,061 $ 80,145 $ 98,846 $106,860 $160,290 $213,720

13. . . . . . . . . . . . . . . . . . . . . . . $28,640 $57,280 $ 76,182 $ 85,920 $105,968 $114,560 $171,840 $229,120

14. . . . . . . . . . . . . . . . . . . . . . . $30,565 $61,130 $ 81,302 $ 91,695 $113,091 $122,260 $183,390 $244,520

15. . . . . . . . . . . . . . . . . . . . . . . $32,490 $64,980 $ 86,423 $ 97,470 $120,213 $129,960 $194,940 $259,920

16. . . . . . . . . . . . . . . . . . . . . . . $34,415 $68,830 $ 91,543 $103,245 $127,336 $137,660 $206,490 $275,320

17. . . . . . . . . . . . . . . . . . . . . . . $36,340 $72,680 $ 96,664 $109,020 $134,458 $145,360 $218,040 $290,720

18. . . . . . . . . . . . . . . . . . . . . . . $38,265 $76,530 $101,784 $114,795 $141,581 $153,060 $229,590 $306,120

Page 102 [ Series 1, No. 43
Table X. Year 2002 guidelines for poverty ranges based on total family members for families in Hawaii

Family size

Percent of Federal poverty level

50 100 133 150 185 200 300 400

2 . . . . . . . . . . . . . . . . . . . . . . . $ 6,870 $13,740 $18,274 $ 20,610 $ 25,419 $ 27,480 $ 41,220 $ 54,960

3 . . . . . . . . . . . . . . . . . . . . . . . $ 8,640 $17,280 $22,982 $ 25,920 $ 31,968 $ 34,560 $ 51,840 $ 69,120

4 ....................... $10,410 $20,820 $27,690 $ 31,230 $ 38,517 $ 41,640 $ 62,460 $ 83,280

5 ....................... $12,180 $24,360 $32,398 $ 36,540 $ 45,066 $ 48,720 $ 73,080 $ 97,440

6 ....................... $13,950 $27,900 $37,107 $ 41,850 $ 51,615 $ 55,800 $ 83,700 $ 111,600

7 ....................... $15,720 $31,440 $41,815 $ 47,160 $ 58,164 $ 62,880 $ 94,320 $125,760

8 ....................... $17,490 $34,980 $46,523 $ 52,470 $ 64,713 $ 69,960 $104,940 $139,920

9 ....................... $19,260 $38,520 $51,231 $ 57,780 $ 71,262 $ 77,040 $115,560 $154,080

10. . . . . . . . . . . . . . . . . . . . . . . $21,030 $42,060 $55,939 $ 63,090 $ 77,811 $ 84,120 $126,180 $168,240

11. . . . . . . . . . . . . . . . . . . . . . . $22,800 $45,600 $60,648 $ 68,400 $ 84,360 $ 91,200 $136,800 $182,400

12. . . . . . . . . . . . . . . . . . . . . . . $24,570 $49,140 $65,356 $ 73,710 $ 90,909 $ 98,280 $147,420 $196,560

13. . . . . . . . . . . . . . . . . . . . . . . $26,340 $52,680 $70,064 $ 79,020 $ 97,458 $105,360 $158,040 $210,720

14. . . . . . . . . . . . . . . . . . . . . . . $28,110 $56,220 $74,772 $ 84,330 $104,007 $112,440 $168,660 $224,880

15. . . . . . . . . . . . . . . . . . . . . . . $29,880 $59,760 $79,480 $ 89,640 $110,556 $119,520 $179,280 $239,040

16. . . . . . . . . . . . . . . . . . . . . . . $31,650 $63,300 $84,189 $ 94,950 $117,105 $126,600 $189,900 $253,200

17. . . . . . . . . . . . . . . . . . . . . . . $33,420 $66,840 $88,897 $100,260 $123,654 $133,680 $200,520 $267,360

18. . . . . . . . . . . . . . . . . . . . . . . $35,190 $70,380 $93,605 $105,570 $130,203 $140,760 $211,140 $281,520

Table XI. Year 2003 guidelines for poverty ranges based on total family members for families in the 48 contiguous States and the District

of Columbia

Family size

Percent of Federal poverty level

50 100 133 150 185 200 300 400

2 . . . . . . . . . . . . . . . . . . . . . . . $ 6,060 $12,120 $16,119 $18,180 $ 22,422 $ 24,240 $ 36,360 $ 48,480

3 . . . . . . . . . . . . . . . . . . . . . . . $ 7,630 $15,260 $20,295 $22,890 $ 28,231 $ 30,520 $ 45,780 $ 61,040

4 . . . . . . . . . . . . . . . . . . . . . . . $ 9,200 $18,400 $24,472 $27,600 $ 34,040 $ 36,800 $ 55,200 $ 73,600

5 ....................... $10,770 $21,540 $28,648 $32,310 $ 39,849 $ 43,080 $ 64,620 $ 86,160

6 ....................... $12,340 $24,680 $32,824 $37,020 $ 45,658 $ 49,360 $ 74,040 $ 98,720

7 ....................... $13,910 $27,820 $37,000 $41,730 $ 51,467 $ 55,640 $ 83,460 $ 111,280

8 ....................... $15,480 $30,960 $41,176 $46,440 $ 57,276 $ 61,920 $ 92,880 $123,840

9 ....................... $17,050 $34,100 $45,353 $51,150 $ 63,085 $ 68,200 $102,300 $136,400

10. . . . . . . . . . . . . . . . . . . . . . . $18,620 $37,240 $49,529 $55,860 $ 68,894 $ 74,480 $ 111,720 $148,960

11. . . . . . . . . . . . . . . . . . . . . . . $20,190 $40,380 $53,705 $60,570 $ 74,703 $ 80,760 $121,140 $161,520

12. . . . . . . . . . . . . . . . . . . . . . . $21,760 $43,520 $57,881 $65,280 $ 80,512 $ 87,040 $130,560 $174,080

13. . . . . . . . . . . . . . . . . . . . . . . $23,330 $46,660 $62,057 $69,990 $ 86,321 $ 93,320 $139,980 $186,640

14. . . . . . . . . . . . . . . . . . . . . . . $24,900 $49,800 $66,234 $74,700 $ 92,130 $ 99,600 $149,400 $199,200

15. . . . . . . . . . . . . . . . . . . . . . . $26,470 $52,940 $70,410 $79,410 $ 97,939 $105,880 $158,820 $211,760

16. . . . . . . . . . . . . . . . . . . . . . . $28,040 $56,080 $74,586 $84,120 $103,748 $112,160 $168,240 $224,320

17. . . . . . . . . . . . . . . . . . . . . . . $29,610 $59,220 $78,762 $88,830 $109,557 $118,440 $177,660 $236,880

18. . . . . . . . . . . . . . . . . . . . . . . $31,180 $62,360 $82,938 $93,540 $115,366 $124,720 $187,080 $249,440

Series 1, No. 43 [ Page 103
Table XII. Year 2003 guidelines for poverty ranges based on total family members for families in Alaska

Family size

Percent of Federal poverty level

50 100 133 150 185 200 300 400

2 . . . . . . . . . . . . . . . . . . . . . . . $ 7,570 $15,140 $ 20,136 $ 22,710 $ 28,009 $ 30,280 $ 45,420 $ 60,560

3 . . . . . . . . . . . . . . . . . . . . . . . $ 9,535 $19,070 $ 25,363 $ 28,605 $ 35,280 $ 38,140 $ 57,210 $ 76,280

4 . . . . . . . . . . . . . . . . . . . . . . . $11,500 $23,000 $ 30,590 $ 34,500 $ 42,550 $ 46,000 $ 69,000 $ 92,000

5 ....................... $13,465 $26,930 $ 35,816 $ 40,395 $ 49,821 $ 53,860 $ 80,790 $107,720

6 ....................... $15,430 $30,860 $ 41,043 $ 46,290 $ 57,091 $ 61,720 $ 92,580 $123,440

7 ....................... $17,395 $34,790 $ 46,270 $ 52,185 $ 64,362 $ 69,580 $104,370 $139,160

8 ....................... $19,360 $38,720 $ 51,497 $ 58,080 $ 71,632 $ 77,440 $116,160 $154,880

9 ....................... $21,325 $42,650 $ 56,724 $ 63,975 $ 78,903 $ 85,300 $127,950 $170,600

10. . . . . . . . . . . . . . . . . . . . . . . $23,290 $46,580 $ 61,951 $ 69,870 $ 86,173 $ 93,160 $139,740 $186,320

11. . . . . . . . . . . . . . . . . . . . . . . $25,255 $50,510 $ 67,178 $ 75,765 $ 93,444 $101,020 $151,530 $202,040

12. . . . . . . . . . . . . . . . . . . . . . . $27,220 $54,440 $ 72,405 $ 81,660 $100,714 $108,880 $163,320 $217,760

13. . . . . . . . . . . . . . . . . . . . . . . $29,185 $58,370 $ 77,632 $ 87,555 $107,985 $116,740 $175,110 $233,480

14. . . . . . . . . . . . . . . . . . . . . . . $31,150 $62,300 $ 82,859 $ 93,450 $115,255 $124,600 $186,900 $249,200

15. . . . . . . . . . . . . . . . . . . . . . . $33,115 $66,230 $ 88,085 $ 99,345 $122,526 $132,460 $198,690 $264,920

16. . . . . . . . . . . . . . . . . . . . . . . $35,080 $70,160 $ 93,312 $105,240 $129,796 $140,320 $210,480 $280,640

17. . . . . . . . . . . . . . . . . . . . . . . $37,045 $74,090 $ 98,539 $ 111,135 $137,067 $148,180 $222,270 $296,360

18. . . . . . . . . . . . . . . . . . . . . . . $39,010 $78,020 $103,766 $117,030 $144,337 $156,040 $234,060 $312,080

Table XIII. Year 2003 guidelines for poverty ranges based on total family members for families in Hawaii

Family size

Percent of Federal poverty level

50 100 133 150 185 200 300 400

2 . . . . . . . . . . . . . . . . . . . . . . . $ 6,970 $13,940 $18,540 $ 20,910 $ 25,789 $ 27,880 $ 41,820 $ 55,760

3 . . . . . . . . . . . . . . . . . . . . . . . $ 8,775 $17,550 $23,341 $ 26,325 $ 32,468 $ 35,100 $ 52,650 $ 70,200

4 ....................... $10,580 $21,160 $28,142 $ 31,740 $ 39,146 $ 42,320 $ 63,480 $ 84,640

5 ....................... $12,385 $24,770 $32,944 $ 37,155 $ 45,825 $ 49,540 $ 74,310 $ 99,080

6 ....................... $14,190 $28,380 $37,745 $ 42,570 $ 52,503 $ 56,760 $ 85,140 $113,520

7 ....................... $15,995 $31,990 $42,546 $ 47,985 $ 59,182 $ 63,980 $ 95,970 $127,960

8 ....................... $17,800 $35,600 $47,348 $ 53,400 $ 65,860 $ 71,200 $106,800 $142,400

9 ....................... $19,605 $39,210 $52,149 $ 58,815 $ 72,539 $ 78,420 $117,630 $156,840

10. . . . . . . . . . . . . . . . . . . . . . . $21,410 $42,820 $56,950 $ 64,230 $ 79,217 $ 85,640 $128,460 $171,280

11. . . . . . . . . . . . . . . . . . . . . . . $23,215 $46,430 $61,751 $ 69,645 $ 85,896 $ 92,860 $139,290 $185,720

12. . . . . . . . . . . . . . . . . . . . . . . $25,020 $50,040 $66,553 $ 75,060 $ 92,574 $100,080 $150,120 $200,160

13. . . . . . . . . . . . . . . . . . . . . . . $26,825 $53,650 $71,354 $ 80,475 $ 99,253 $107,300 $160,950 $214,600

14. . . . . . . . . . . . . . . . . . . . . . . $28,630 $57,260 $76,155 $ 85,890 $105,931 $114,520 $171,780 $229,040

15. . . . . . . . . . . . . . . . . . . . . . . $30,435 $60,870 $80,957 $ 91,305 $112,610 $121,740 $182,610 $243,480

16. . . . . . . . . . . . . . . . . . . . . . . $32,240 $64,480 $85,758 $ 96,720 $119,288 $128,960 $193,440 $257,920

17. . . . . . . . . . . . . . . . . . . . . . . $34,045 $68,090 $90,559 $102,135 $125,967 $136,180 $204,270 $272,360

18. . . . . . . . . . . . . . . . . . . . . . . $35,850 $71,700 $95,361 $107,550 $132,645 $143,400 $215,100 $286,800

Page 104 [ Series 1, No. 43
e table for additional income cascade questions for families in the 48 contiguous States and the District of Columbia

Reported range of household income

ss than

7,500

$7,500–

$9,999

$10,000–

$12,499

$12,500–

$14,999

$15,000–

$17,499

$17,500–

$19,999

$20,000–

$24,999

$25,000–

$29,999

$30,000–

$34,999

$35,000–

$39,999

$40,000–

$44,999

$45,000–

$49,999

$50,000–

$59,999

$60,000–

$74,999

$75,000

and over

6,000

AA/A) A

11,900

(A/B) B

15,900

(B/C) D

22,100/

23,900

(D/E/F) F F G G

47,800(G/H) H H H

AA A AABB

22,500

(C/D)

27,800

(D/E) F F F G G H H

AA

9,100

(AA/A) A A A

18,100

(A/B) B

27,200

(C/D)

33,500

(D/E)

36,200

(E/F) F F

54,300(F/G)

72,400

(G/H) H

AA AA

10,600(AA/A) A A A

21,200

(A/B)

28,200

(B/C)

31,800(C/D) D

42,400

(E/F) F F

63,500

(F/G)

85,000

(G/H)

AA AA AA A A A A B

32,300

(B/C)

36,400(C/D) D

48,500

(E/F) F

72,800

(F/G)

95,000

(G/H)

AA AA AA

13,700(AA/A) A A A

27,300

(A/B) B

36,400

(B/C)

41,000(C/D) D

54,700

(E/F) F

80,000/110,000(F/G/H)

AA AA AA AA A A A A B B C D

56,300

(D/E) F

90,000/120,000(F/G/H)

AA AA AA AA

16,800(AA/A) A A A

33,500

(A/B) B B C D

62,000/

67,000

(D/E/F)

100,000/135,000(F/G/H)

AA AA AA AA AA

18,300(AA/A) A A A

36,600

(A/B) B

48,700

(B/C)

54,900(C/D)

67,700/

73,200

(D/E/F)

110,000/145,000

(E/F/G)

AA AA AA AA AA AA A A A A B B

52,700

(B/C)

73,400

(D/E)

80,000/120,000

(E/F/G)

AA AA AA AA AA AA

21,400

(AA/A) A A A

42,700

(A/B) B

56,800

(B/C)

64,100

(C/D)

85,000/130,000

(E/F/G)

AA AA AA AA AA AA

22,900

(AA/A) A A A A B B

68,700

(C/D)

90,000/135,000

(E/F/G)

AA AA AA AA AA AA AA A A A A

48,900

(A/B) B

65,000/

73,400

(B/C/D)

100,000/145,000

(E/F/G)

AA AA AA AA AA AA AA

26,000(AA/A) A A A A

52,000

(A/B)

69,100

(B/C)

105,000/155,000

(E/F/G)

AA AA AA AA AA AA AA

27,500(AA/A) A A A A

55,100

(A/B)

73,200

(B/C)

110,000/165,000

(E/F/G)

AA AA AA AA AA AA AA AA A A A A

58,100

(A/B) B

115,000/175,000

(E/F/G)

AA AA AA AA AA AA AA AA A A A A A

61,200

(A/B)

120,000/

185,000

(E/F/G)

me was included with two or more poverty ranges, additional questions (W9Q12 and W9Q12A) were asked to determine the poverty range for the household. Values within the body of this table represent

income questions were asked with this value (‘‘Would you say this income was above or below (value)?’’) to identify the proper poverty range for the household. Values were rounded to the nearest $100 if

000 if income was over $75,000. When income was less than $20,000, the additional income questions were not asked if the value (i.e., the range border) was less than $900 from either endpoint of the

than values signify that the reported range of household income was entirely within one poverty range. The poverty range for each letter shown is listed in the first bulleted section under ‘‘Procedures for

V.’’

Series 1, No. 43 [ Page 105
table for additional income cascade questions for families in Alaska

Reported range of household income

ss than

7,500

$7,500–

$9,999

$10,000–

$12,499

$12,500–

$14,999

$15,000–

$17,499

$17,500–

$19,999

$20,000–

$24,999

$25,000–

$29,999

$30,000–

$34,999

$35,000–

$39,999

$40,000–

$44,999

$45,000–

$49,999

$50,000–

$59,999

$60,000–

$74,999

$75,000

and over

AA A A A B B

22,400

(C/D)

27,600

(D/E) F F F G G H H

AA

9,400

(AA/A) A A A

18,800

(A/B) B

28,200

(C/D) D

37,600

(D/E) F F

56,300

(F/G) G H

AA AA

11,300(AA/A) A A A

22,600

(A/B) B

33,900

(C/D) D

41,900(D/E) F F

67,900

(F/G)

90,000

(G/H)

AA AA AA

13,200(AA/A) A A A

26,500

(A/B) B C D

49,000(D/E)

53,000

(E/F) F

80,000/105,000(F/G/H)

AA AA AA AA A A A A B BC D

56,100

(D/E) F

90,000/120,000(F/G/H)

AA AA AA AA AA A A A A BB C

51,300(C/D)

63,200/

68,400

(D/E/F)

105,000/135,000(F/G/H)

AA AA AA AA AA

19,000(AA/A) A A A

38,000

(A/B) B B

57,000(C/D)

70,400

(D/E)

115,000/150,000(F/G/H)

AA AA AA AA AA AA AAAA

41,900

(A/B) B

55,700

(B/C)

62,800

(C/D)

85,000/125,000(F/G/H)

AA AA AA AA AA AA

22,900(AA/A) A A A A B B

68,600

(C/D)

90,000/135,000

(E/F/G)

AA AA AA AA AA AA AA A A A A A B

65,900

(B/C)

100,000/150,000

(E/F/G)

AA AA AA AA AA AA AA

26,700(AA/A) A A A A

53,400

(A/B)

71,100

(B/C)

105,000/160,000

(E/F/G)

AA AA AA AA AA AA AA

28,600(AA/A) A A A A

57,300

(A/B) B

115,000/170,000

(E/F/G)

AA AA AA AA AA AA AA AA A A A A A

61,100

(A/B)

120,000/185,000

(E/F/G)

AA AA AA AA AA AA AA AA

32,500(AA/A) A A A A

65,000

(A/B)

130,000/195,000

(E/F/G)

AA AA AA AA AA AA AA AA AA A A A A

68,800

(A/B)

140,000/205,000

(E/F/G)

AA AA AA AA AA AA AA AA AA

36,300(AA/A) A A A

72,700

(A/B)

145,000/220,000

(E/F/G)

AA AA AA AA AA AA AA AA AA

38,300(AA/A) A A A A

155,000/230,000

(E/F/G)

me was included with two or more poverty ranges, additional questions (W9Q12 and W9Q12A) were asked to determine the poverty range for the household. Values within the body of this table represent

income questions were asked with this value (‘‘Would you say this income was above or below (value)?’’) to identify the proper poverty range for the household. Values were rounded to the nearest $100 if

000 if income was over $75,000. When income was less than $20,000, the additional income questions were not asked if the value (i.e., the range border) was less than $900 from either endpoint of the

than values signify that the reported range of household income was entirely within one poverty range. The poverty range for each letter shown is listed in the first bulleted section under ‘‘Procedures for

V.’’

Page 106 [ Series 1, No. 43
e table for additional income cascade questions for families in Hawaii

Reported range of household income

ss than

7,500

$7,500–

$9,999

$10,000–

$12,499

$12,500–

$14,999

$15,000–

$17,499

$17,500–

$19,999

$20,000–

$24,999

$25,000–

$29,999

$30,000–

$34,999

$35,000–

$39,999

$40,000–

$44,999

$45,000–

$49,999

$50,000–

$59,999

$60,000–

$74,999

$75,000

and over

6,900

AA/A) A A

13,700

(A/B) B

18,300

(B/C) D

27,500

(E/F) F F

41,200

(F/G) G

55,000

(G/H) H H

AA

8,600

(AA/A) A A A B

23,000

(B/C) D

32,000

(D/E) F F F

51,800

(F/G)

69,100

(G/H) H

AA AA A AAAB

27,700

(B/C)

31,200

(C/D)

38,500

(D/E)

41,600

(E/F) F F

62,500

(F/G)

85,000

(G/H)

AA AA AA AAAAB

32,400

(B/C)

36,500(C/D) D

48,700

(E/F) F

73,100

(F/G)

95,000

(G/H)

AA AA AA

14,000(AA/A) A A A

27,900

(A/B) B

37,100

(B/C)

41,900(C/D) D

51,600/

55,800

(D/E/F) F

85,000/110,000(F/G/H)

AA AA AA AA

15,700(AA/A) A A A

31,400

(A/B) B

41,800

(B/C)

47,200(C/D)

58,200

(D/E)

62,900

(E/F)

95,000/125,000(F/G/H)

AA AA AA AA AA A A A AB B

46,500

(B/C)

52,500

(C/D)

64,700/

70,000

(D/E/F)

105,000/140,000(F/G/H)

AA AA AA AA AA

19,300(AA/A) A A A

38,500

(A/B) B B

51,200/

57,800

(B/C/D)

71,300

(D/E)

115,000/155,000(F/G/H)

AA AA AA AA AA AA

21,000(AA/A) A A A

42,100

(A/B) B

55,900

(B/C)

63,100

(C/D)

85,000/125,000

(E/F/G)

AA AA AA AA AA AA

22,800(AA/A) A A A A B B

68,400

(C/D)

90,000/135,000

(E/F/G)

AA AA AA AA AA AA AA A A A A A B

65,400/

73,700

(B/C/D)

100,000/145,000

(E/F/G)

AA AA AA AA AA AA AA

26,300(AA/A) A A A A

52,700

(A/B)

70,100

(B/C)

105,000/160,000

(E/F/G)

AA AA AA AA AA AA AA

28,100(AA/A) A A A A

56,200

(A/B) B

110,000/170,000

(E/F/G)

AA AA AA AA AA AA AA AA A A A A A B

120,000/180,000

(E/F/G)

AA AA AA AA AA AA AA AA

31,700(AA/A) A A A A

63,300

(A/B)

125,000/190,000

(E/F/G)

AA AA AA AA AA AA AA AA

33,400(AA/A) A A A A

66,800

(A/B)

135,000/200,000

(E/F/G)

AA AA AA AA AA AA AA AA AA A A A A

70,400

(A/B)

140,000/210,000

(E/F/G)

me was included with two or more poverty ranges, additional questions (W9Q12 and W9Q12A) were asked to determine the poverty range for the household. Values within the body of this table represent

income questions were asked with this value (‘‘Would you say this income was above or below (value)?’’) to identify the proper poverty range for the household. Values were rounded to the nearest $100 if

000 if income was over $75,000. When income was less than $20,000, the additional income questions were not asked if the value (i.e., the range border) was less than $900 from either endpoint of the

than values signify that the reported range of household income was entirely within one poverty range. The poverty range for each letter shown is listed in the first bulleted section under ‘‘Procedures for

V.’’

Series 1, No. 43 [ Page 107
e table for additional income cascade questions for families in the 48 contiguous States and the District of Columbia

Reported range of household income

ss than

7,500

$7,500–

$9,999

$10,000–

$12,499

$12,500–

$14,999

$15,000–

$17,499

$17,500–

$19,999

$20,000–

$24,999

$25,000–

$29,999

$30,000–

$34,999

$35,000–

$39,999

$40,000–

$44,999

$45,000–

$49,999

$50,000–

$59,999

$60,000–

$74,999

$75,000

and over

6,100

AA/A) A A B

16,100(B/C)

18,200

(C/D)

22,400

(D/E) F F

36,400

(F/G) G

48,500(G/H) H H H

AA A A A B B

22,900

(C/D)

28,200

(D/E) F F F G G

61,000

(G/H) H

AA

9,200

(AA/A) A A A

18,400

(A/B) B

27,600

(C/D)

34,000

(D/E)

36,800

(E/F) F F

55,200

(F/G)

73,600

(G/H) H

AA AA

10,800(AA/A) A A A

21,500

(A/B)

28,600

(B/C)

32,300

(C/D) D

43,100

(E/F) F F

64,600

(F/G)

85,000

(G/H)

AA AA AA A A A A B

32,800

(B/C)

37,000(C/D) D E F

74,000

(F/G)

100,000

(G/H)

AA AA AA

13,900(AA/A) A A A

27,800

(A/B) B

37,000

(B/C)

41,700(C/D) D

51,500/

55,600

(D/E/F) F

85,000/110,000(F/G/H)

AA AA AA AA A A A A

31,000

(A/B) B

41,200

(B/C)

46,400

(C/D)

57,300

(D/E)

61,900

(E/F)

95,000/125,000(F/G/H)

AA AA AA AA AA A A A AB B C

51,200

(C/D)

63,100/

68,200

(D/E/F)

100,000/135,000(F/G/H)

AA AA AA AA AA

18,600(AA/A) A A A

37,200

(A/B) B B

55,900

(C/D)

68,900

(D/E)

110,000/150,000(F/G/H)

AA AA AA AA AA AA A A A A B B

53,700

(B/C) D

80,000/120,000

(E/F/G

AA AA AA AA AA AA

21,800(AA/A) A A A

43,500

(A/B) B

57,900

(B/C)

65,300

(C/D)

85,000/130,000

(E/F/G)

AA AA AA AA AA AA

23,300(AA/A) A A A A

46,700

(A/B) B

62,100/

70,000

(B/C/D)

95,000/140,000

(E/F/G)

AA AA AA AA AA AA AA A A A A A B

66,200

(B/C)

100,000/150,000

(E/F/G)

AA AA AA AA AA AA AA

26,500(AA/A) A A A A

52,900

(A/B)

70,400

(B/C)

105,000/160,000

(E/F/G)

AA AA AA AA AA AA AA

28,000(AA/A) A A A A

56,100

(A/B) B

110,000/170,000

(E/F/G)

AA AA AA AA AA AA AA AA A A A A A B

120,000/180,000

(E/F/G)

AA AA AA AA AA AA AA AA

31,200(AA/A) A A A A

62,400

(A/B)

125,000/

185,000

(E/F/G)

me was included with two or more poverty ranges, additional questions (W9Q12 and W9Q12A) were asked to determine the poverty range for the household. Values within the body of this table represent

income questions were asked with this value (‘‘Would you say this income was above or below (value)?’’) to identify the proper poverty range for the household. Values were rounded to the nearest $100 if

000 if income was over $75,000. When income was less than $20,000, the additional income questions were not asked if the value (i.e., the range border) was less than $900 from either endpoint of the

than values signify that the reported range of household income was entirely within one poverty range. The poverty range for each letter shown is listed in the first bulleted section under ‘‘Procedures for

V.’’

Page 108 [ Series 1, No. 43
ue table for additional income cascade questions for families in Alaska

Reported range of household income

ss than

7,500

$7,500–

$9,999

$10,000–

$12,499

$12,500–

$14,999

$15,000–

$17,499

$17,500–

$19,999

$20,000–

$24,999

$25,000–

$29,999

$30,000–

$34,999

$35,000–

$39,999

$40,000–

$44,999

$45,000–

$49,999

$50,000–

$59,999

$60,000–

$74,999

$75,000

and over

AA A A A B B

22,700

(C/D)

28,000

(D/E) F F F G G H H

AA AA A A A

19,100

(A/B) B

28,600

(C/D) D

38,100

(E/F) F F

57,200

(F/G) G H

AA AA

11,500(AA/A) A A A

23,000

(A/B) B C D

42,600(D/E)

46,000

(E/F) F

69,000

(F/G)

90,000

(G/H)

AA AA AA

13,500(AA/A) A A A

26,900

(A/B) B C D D

53,900

(E/F) F

80,000/110,000(F/G/H)

AA AA AA AA A AAABB

41,000(B/C)

46,300(C/D)

57,100

(D/E)

61,700

(E/F)

95,000/125,000(F/G/H)

AA AA AA AA AA A A A A BB

46,300

(B/C)

52,200

(C/D)

64,400/

69,600

(D/E/F)

105,000/140,000(F/G/H)

AA AA AA AA AA

19,400(AA/A) A A A

38,700

(A/B) B B

51,500/

58,100

(B/C/D)

71,600

(D/E)

115,000/155,000(F/G/H)

AA AA AA AA AA AA

21,300(AA/A) A A A

42,700

(A/B) B

56,700/

58,100

(B/C)

64,000

(C/D)

85,000/130,000

(E/F/G)

AA AA AA AA AA AA

23,300(AA/A) A A A A

46,600

(A/B) B

62,000/

69,900

(B/C/D)

95,000/140,000

(E/F/G)

AA AA AA AA AA AA AA A A A A A B

67,200

(B/C)

100,000/150,000

(E/F/G)

AA AA AA AA AA AA AA

27,200(AA/A) A A A A

54,400

(A/B)

72,400

(B/C)

110,000/165,000

(E/F/G)

AA AA AA AA AA AA AA AA A A A A

58,400

(A/B) B

115,000/175,000

(E/F/G)

AA AA AA AA AA AA AA AA

31,200(AA/A) A A A A

62,300

(A/B)

125,000/185,000

(E/F/G)

AA AA AA AA AA AA AA AA

33,100(AA/A) A A A A

66,200

(A/B)

130,000/200,000

(E/F/G)

AA AA AA AA AA AA AA AA AA A A A A

70,200

(A/B)

140,000/210,000

(E/F/G)

AA AA AA AA AA AA AA AA AA

37,000(AA/A) A A A A

150,000/220,000

(E/F/G)

AA AA AA AA AA AA AA AA AA

39,000(AA/A) A A A A

155,000/235,000

(E/F/G)

me was included with two or more poverty ranges, additional questions (W9Q12 and W9Q12A) were asked to determine the poverty range for the household. Values within the body of this table represent

income questions were asked with this value (‘‘Would you say this income was above or below (value)?’’) to identify the proper poverty range for the household. Values were rounded to the nearest $100 if

000 if income was over $75,000. When income was less than $20,000, the additional income questions were not asked if the value (i.e., the range border) was less than $900 from either endpoint of the

than values signify that the reported range of household income was entirely within one poverty range. The poverty range for each letter shown is listed in the first bulleted section under ‘‘Procedures for

V.’’

Series 1, No. 43 [ Page 109
e table for additional income cascade questions for families in Hawaii

Reported range of household income

ss than

7,500

$7,500–

$9,999

$10,000–

$12,499

$12,500–

$14,999

$15,000–

$17,499

$17,500–

$19,999

$20,000–

$24,999

$25,000–

$29,999

$30,000–

$34,999

$35,000–

$39,999

$40,000–

$44,999

$45,000–

$49,999

$50,000–

$59,999

$60,000–

$74,999

$75,000

and over

A A A

13,900

(A/B) B

18,500(B/C) D

27,900

(E/F) F F

41,800

(F/G) G

55,800

(G/H) H H

AA

8,800

(AA/A) A A A B

23,300

(B/C)

26,300

(C/D)

32,500

(D/E) F F F

52,700

(F/G)

70,200

(G/H) H

AA AA

10,600(AA/A) A A A

21,200

(A/B)

28,100

(B/C)

31,700

(C/D) D

42,300

(E/F) F F

63,500

(F/G)

85,000

(G/H)

AA AA AA A A A A B

32,900

(B/C)

37,200(C/D) D E F F

100,000

(G/H)

AA AA AA

14,200(AA/A) A A A

28,400

(A/B) B

37,700

(B/C)

42,600(C/D) D

52,500/

56,800

(D/E/F) F

85,000/115,000(F/G/H)

AA AA AA AA

16,000(AA/A) A A A

32,000

(A/B) B

42,500

(B/C)

48,000(C/D) D

64,000

(E/F)

95,000/130,000(F/G/H)

AA AA AA AA AA A A A A B B

47,300

(B/C)

53,400

(C/D)

65,900/

71,200

(D/E/F)

105,000/140,000(F/G/H)

AA AA AA AA AA AA A A A A B B

52,100/

58,800

(B/C/D)

72,500

(D/E)

80,000/120,000(F/G/H)

AA AA AA AA AA AA

21,400(AA/A) A A A

42,800

(A/B) B

57,000

(B/C)

64,200

(C/D)

85,000/130,000(F/G/H)

AA AA AA AA AA AA

23,200(AA/A) A A A A

46,400

(A/B) B

61,800/

69,600

(B/C/D)

95,000/140,000(F/G/H)

AA AA AA AA AA AA AA A A A A A B

66,600

(B/C)

100,000/150,000(F/G/H)

AA AA AA AA AA AA AA

26,800(AA/A) A A A A

53,700

(A/B)

71,400

(B/C)

105,000/160,000(F/G/H)

AA AA AA AA AA AA AA

28,600(AA/A) A A A A

57,300

(A/B) B

115,000/170,000(F/G/H)

AA AA AA AA AA AA AA AA A A A A A B

120,000/185,000(F/G/H)

AA AA AA AA AA AA AA AA

32,200(AA/A) A A A A

64,500

(A/B)

130,000/195,000(F/G/H)

AA AA AA AA AA AA AA AA

34,000(AA/A) A A A A

68,100

(A/B)

135,000/205,000(F/G/H)

AA AA AA AA AA AA AA AA AA A A A A

71,700

(A/B)

145,000/215,000(F/G/H)

me was included with two or more poverty ranges, additional questions (W9Q12 and W9Q12A) were asked to determine the poverty range for the household. Values within the body of this table represent

income questions were asked with this value (‘‘Would you say this income was above or below (value)?’’) to identify the proper poverty range for the household. Values were rounded to the nearest $100 if

000 if income was over $75,000. When income was less than $20,000, the additional income questions were not asked if the value (i.e., the range border) was less than $900 from either endpoint of the

than values signify that the reported range of household income was entirely within one poverty range. The poverty range for each letter shown is listed in the first bulleted section under ‘‘Procedures for

V.’’

Page 110 [ Series 1, No. 43
Appendix VI

Letters Sent To Sampled Households

Advance Letter for January–March 2003

Series 1, No. 43 [ Page 111
Advance Letter for April–December 2003

Page 112 [ Series 1, No. 43
Advance Letter when Incentives were Offered (Group A)

 

 

 

 

 

 

Series 1, No. 43 [ Page 113
Advance Letter when Incentives were Offered (Group B)

 

 

 

 

 

 

Page 114 [ Series 1, No. 43
Advance Letter when Incentives were Offered (Group D)

 

 

 

 

 

 

Series 1, No. 43 [ Page 115
Advance Letter when Incentives were Offered (Group E)

 

 

 

 

 

 

Page 116 [ Series 1, No. 43
Thank You Letter (Group A)

 

 

 

 

 

 

Series 1, No. 43[ Page 117
Thank You Letter (Groups B and C)

 

 

 

 

 

 

Page 118 [ Series 1, No. 43
Thank You Letter (Group D)

 

 

 

 

 

 

Series 1, No. 43[ Page 119
Thank You Letter (Groups E and F)

 

 

 

 

 

 

Page 120 [ Series 1, No. 43
Appendix VII

Disposition Code

Frequencies and Response

Rate Calculations

Table XX. Frequencies of disposition codes for National Survey of Children’s Health

Disposition code by name

Disposition

category Frequency

Percent

of total

Total number of phone lines in sample . . . . . . . . . . . . . . . . . . . . . . . . 1,872,194 100.00

No contact . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . UH 147,257 7.87

3 or more fax/modem prior to any contact . . . . . . . . . . . . . . . . . . . . . . Z 28,275 1.51

2 or more temporarily not in service . . . . . . . . . . . . . . . . . . . . . . . . . Z 32,791 1.75

Nonworking number . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Z 111,916 5.98

Number changed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Z 8,290 0.44

Answering machine—known household . . . . . . . . . . . . . . . . . . . . . . . UO 2,916 0.16

Answering machine—nonresidential . . . . . . . . . . . . . . . . . . . . . . . . . . Z 13,504 0.72

Answering machine—residential status unknown . . . . . . . . . . . . . . . . . UH 42,620 2.28

Answering service—known household . . . . . . . . . . . . . . . . . . . . . . . . UO 3 <0.005

Answering service—nonresidential . . . . . . . . . . . . . . . . . . . . . . . . . . Z 172 0.01

Answering service—residential status unknown. . . . . . . . . . . . . . . . . . . UH 97 0.01

Spanish case—residential status unknown . . . . . . . . . . . . . . . . . . . . . UH 188 0.01

Other language case—residential status unknown . . . . . . . . . . . . . . . . UH 666 0.04

Physical/mental impairment case—residential status unknown . . . . . . . . . UH 1,148 0.06

Appointment at introduction—residential status unknown . . . . . . . . . . . . UH 7,379 0.39

Callback at introduction—residential status unknown . . . . . . . . . . . . . . . UH 213 0.01

Broken appointment at introduction—residential status unknown . . . . . . . . UH 1,738 0.09

Hang-up during introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . UH 32,633 1.74

Refusal at introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . UH 60,261 3.22

Callback—known household . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . UO 9,860 0.53

Appointment—known household . . . . . . . . . . . . . . . . . . . . . . . . . . . . UO 1,637 0.09

Broken appointment—known household . . . . . . . . . . . . . . . . . . . . . . . UO 1,632 0.09

Refusal—known household . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . UO 16,373 0.87

NIS-level callback . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . R 199 0.01

NIS-level appointment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . R 85 <0.005

NIS-level broken appointment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . R 43 <0.005

NIS-level refusal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . R 2,591 0.14

Not residential . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Z 58,324 3.12

Refusal prior to NSCH Item S_UNDR18 . . . . . . . . . . . . . . . . . . . . . . . UO 4,542 0.24

Callback prior to NSCH Item S_UNDR18 . . . . . . . . . . . . . . . . . . . . . . UO 265 0.01

Appointment prior to NSCH Item S_UNDR18 . . . . . . . . . . . . . . . . . . . . UO 79 <0.005

Refusal at or prior to NSCH Item S8Q1 . . . . . . . . . . . . . . . . . . . . . . . R 32,303 1.73

Callback at or prior to NSCH Item S8Q1 . . . . . . . . . . . . . . . . . . . . . . . R 5,406 0.29

Appointment at or prior to NSCH Item S8Q1 . . . . . . . . . . . . . . . . . . . . R 2,925 0.16

Refusal—partial interview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . P 144 0.01

Callback—partial interview. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . P 44 <0.005

Broken appointment—partial interview . . . . . . . . . . . . . . . . . . . . . . . . P 17 <0.005

Appointment—partial interview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . P 842 0.04

Other language case—known household, unknown age eligibility. . . . . . . . UO 213 0.01

Other language case—known age-eligible household . . . . . . . . . . . . . . . Y 2,446 0.13

Screened—emancipated minor household1 . . . . . . . . . . . . . . . . . . . . . R 633 0.03

Screened—no age-eligible children .......................... X 366,454 19.57

Completed household interview . . . . . . . . . . . . . . . . . . . . . . . . . . . . I 91,799 4.90

Converted household interview . . . . . . . . . . . . . . . . . . . . . . . . . . . . I 9,507 0.51

GENESYS IDplus-resolved numbers (nonworking, business,

and modem numbers) ................................. Z 771,764 41.22

1Interviews were not conducted in households in which no one over the age of 17 resided.

NOTE: NIS is National Immunization Survey. NSCH is National Survey of Children’s Health.

Series 1, No. 43 [ Page 121
Table XXI. Unweighted response rate calculations for National Survey of Children’s Health

Disposition categories

and response rates

Frequency or

calculated

rate

Code or

formula

Summary of disposition categories

Completed interviews at the household level .................... 101,306 I

Partial interviews at the household level . . . . . . . . . . . . . . . . . . . . . . . 1,047 P

Unknown residential status ............................... 294,200 UH

Known household, unknown age eligibility . . . . . . . . . . . . . . . . . . . . . . 37,520 UO

Refusal, screened and eligible household . . . . . . . . . . . . . . . . . . . . . . 44,185 R

Known household screened for age eligibility, no eligible child ......... 366,454 X

Known age-eligible household, other language . . . . . . . . . . . . . . . . . . . 2,446 Y

Out of scope (i.e., business, nonworking, fax/modem). . . . . . . . . . . . . . . 1,025,036 Z

Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,872,194

Calculation of response rates

Child-level interview completion rate (ICR). . . . . . . . . . . . . . . . . . . . . . 68.7 (I+P) / (I+P+R+Y)

Screener completion rate (SCR) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93.2 (I+P+R+X+Y) / (I+P+R+X+Y+UO)

Resolution rate (RR) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84.3 (I+P+R+X+Y+UO+Z) / (I+P+R+X+Y+UO+Z+UH)

Overall response rate. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54.0 (ICR)(SCR)(RR)

Page 122 [ Series 1, No. 43
Appendix VIII

Prevalence Estimates and

Weighted Frequencies for

Respondent-Assessed

Health Status

Table XXII. Unweighted and weighted estimates of the frequency and prevalence of children with excellent or very good health as assessed

by the survey respondent

State

Total

unweighted

number of

children

Total

weighted

estimate of

number of

children

Unweighted

number of

children with

excellent or

very good

health

Weighted

estimate of

number of

children with

excellent or

very good

health

Standard

error of

weighted

estimate of

number of

children with

excellent or

very good

health

Percent of

children

who have

excellent or

very good

health1

Standard

error of

percent of

children

who have

excellent or

very good

health

Total . . . . . . . . . . . . . . . . . . . . . 102,353 72,736,965 89,155 61,141,289.0 238,338.283 84.06 0.223

Alabama . . . . . . . . . . . . . . . . . . 2,167 1,104,146 1,870 916,159.3 17,343.196 82.97 1.101

Alaska . . . . . . . . . . . . . . . . . . . . 1,904 188,239 1,707 165,845.4 2,935.371 88.10 0.960

Arizona . . . . . . . . . . . . . . . . . . . 1,919 1,512,819 1,549 1,220,631.9 24,192.452 80.69 1.044

Arkansas . . . . . . . . . . . . . . . . . . 1,878 678,939 1,572 557,118.1 10,856.560 82.06 1.116

California . . . . . . . . . . . . . . . . . . 2,223 9,378,237 1,715 7,268,304.0 150,698.579 77.50 1.080

Colorado . . . . . . . . . . . . . . . . . . 1,855 1,147,831 1,624 994,202.3 17,718.060 86.62 0.934

Connecticut . . . . . . . . . . . . . . . . . 2,146 832,105 1,918 726,341.2 11,772.268 87.29 0.927

Delaware . . . . . . . . . . . . . . . . . . 2,156 198,401 1,857 169,066.4 2,888.884 85.21 0.939

District of Columbia . . . . . . . . . . . . 2,049 107,485 1,744 88,740.8 2,011.263 82.56 1.124

Florida . . . . . . . . . . . . . . . . . . . . 2,116 3,907,632 1,835 3,365,485.4 63,721.009 86.13 0.951

Georgia . . . . . . . . . . . . . . . . . . . 1,864 2,287,060 1,605 1,953,122.1 39,316.975 85.40 1.059

Hawaii . . . . . . . . . . . . . . . . . . . . 2,021 269,099 1,774 256,360.6 5,033.035 86.58 1.006

Idaho. . . . . . . . . . . . . . . . . . . . . 1,861 370,344 1,641 322,512.3 5,067.459 87.09 0.909

Illinois . . . . . . . . . . . . . . . . . . . . 2,158 3,220,883 1,848 2,682,017.6 47,904.027 83.27 1.053

Indiana. . . . . . . . . . . . . . . . . . . . 1,874 1,596,856 1,652 1,398,016.4 24,459.503 87.55 0.984

Iowa . . . . . . . . . . . . . . . . . . . . . 1,949 689,667 1,732 607,804.8 9,342.323 88.13 0.859

Kansas . . . . . . . . . . . . . . . . . . . 1,849 692,847 1,620 597,733.6 10,541.863 86.27 1.007

Kentucky . . . . . . . . . . . . . . . . . . 1,953 990,015 1,718 860,028.9 15,412.071 86.87 0.961

Louisiana . . . . . . . . . . . . . . . . . . 2,241 1,172,697 1,900 963,576.9 18,432.587 82.17 1.084

Maine . . . . . . . . . . . . . . . . . . . . 1,920 285,571 1,759 259,116.1 4,061.794 90.74 0.804

Maryland . . . . . . . . . . . . . . . . . . 2,128 1,373,206 1,886 1,206,110.6 20,393.539 87.83 0.887

Massachusetts . . . . . . . . . . . . . . . 2,114 1,481,121 1,905 1,313,987.5 21,122.101 88.72 0.889

Michigan. . . . . . . . . . . . . . . . . . . 2,191 2,527,842 1,907 2,148,036.4 34,582.449 84.98 0.982

Minnesota. . . . . . . . . . . . . . . . . . 1,864 1,244,377 1,699 1,124,432.0 18,784.082 90.36 0.827

Mississippi . . . . . . . . . . . . . . . . . 2,035 757,175 1,714 611,023.0 12,612.632 80.70 1.184

Missouri . . . . . . . . . . . . . . . . . . . 2,220 1,401,584 1,977 1,231,625.7 19,430.346 87.87 0.870

Montana. . . . . . . . . . . . . . . . . . . 1,941 214,360 1,757 193,141.3 3,039.925 90.10 0.832

Nebraska . . . . . . . . . . . . . . . . . . 1,874 438,253 1,643 378,828.4 6,587.097 86.44 1.001

Nevada . . . . . . . . . . . . . . . . . . . 2,064 579,030 1,665 460,819.6 8,188.231 79.59 1.048

New Hampshire . . . . . . . . . . . . . . 1,925 305,278 1,778 279,701.3 3,997.239 91.62 0.729

New Jersey . . . . . . . . . . . . . . . . . 2,113 2,125,387 1,815 1,793,562.2 31,149.604 84.39 1.002

New Mexico . . . . . . . . . . . . . . . . 1,848 499,905 1,535 409,326.1 8,770.659 81.88 1.123

New York . . . . . . . . . . . . . . . . . . 2,021 4,503,196 1,726 3,742,722.2 70,052.261 83.11 1.076

North Carolina . . . . . . . . . . . . . . . 2,084 2,080,668 1,800 1,777,942.8 31,249.104 85.45 0.968

North Dakota . . . . . . . . . . . . . . . . 1,955 146,143 1,777 132,650.8 2,131.636 90.77 0.765

Ohio . . . . . . . . . . . . . . . . . . . . . 2,241 2,807,666 2,003 2,497,255.1 38,182.740 88.94 0.814

Oklahoma . . . . . . . . . . . . . . . . . . 1,937 874,700 1,671 754,705.8 13,749.660 86.28 0.950

Oregon . . . . . . . . . . . . . . . . . . . 1,969 845,439 1,709 732,704.9 11,998.504 86.67 0.893

Pennsylvania . . . . . . . . . . . . . . . . 2,200 2,815,445 1,954 2,460,764.9 39,996.986 87.40 0.909

Rhode Island . . . . . . . . . . . . . . . . 2,019 242,682 1,751 210,634.5 3,918.896 86.79 0.919

South Carolina . . . . . . . . . . . . . . . 2,157 1,019,067 1,823 841,263.3 14,644.388 82.55 1.044

South Dakota. . . . . . . . . . . . . . . . 1,868 192,623 1,661 171,360.7 3,306.709 88.96 0.916

See footnotes at end of table.

Series 1, No. 43 [ Page 123
Table XXII. Unweighted and weighted estimates of the frequency and prevalence of children with excellent or very good health as assessed

by the survey respondent—Con.

State

Total

unweighted

number of

children

Total

weighted

estimate of

number of

children

Unweighted

number of

children with

excellent or

very good

health

Weighted

estimate of

number of

children with

excellent or

very good

health

Standard

error of

weighted

estimate of

number of

children with

excellent or

very good

health

Percent of

children

who have

excellent or

very good

health1

Standard

error of

percent of

children

who have

excellent or

very good

health

Tennessee . . . . . . . . . . . . . . . . . 1,922 1,388,714 1,675 1,186,178.0 22,587.762 85.42 1.035

Texas . . . . . . . . . . . . . . . . . . . . 2,179 6,217,276 1,735 4,797,216.0 85,827.667 77.16 1.105

Utah . . . . . . . . . . . . . . . . . . . . . 1,483 739,705 1,320 659,881.9 11,659.938 89.21 0.921

Vermont . . . . . . . . . . . . . . . . . . . 1,902 137,011 1,781 127,581.1 2,098.580 93.12 0.710

Virginia . . . . . . . . . . . . . . . . . . . 2,179 1,792,362 1,966 1,614,832.3 25,997.231 90.10 0.793

Washington . . . . . . . . . . . . . . . . . 1,932 1,491,391 1,689 1,303,469.0 22,213.131 87.40 0.879

West Virginia . . . . . . . . . . . . . . . . 2,022 389,291 1,734 327,861.9 5,532.279 84.22 1.025

Wisconsin . . . . . . . . . . . . . . . . . . 1,970 1,327,839 1,759 1,172,186.3 20,148.526 88.28 0.910

Wyoming . . . . . . . . . . . . . . . . . . 1,893 120,356 1,700 107,299.7 1,489.658 89.15 0.844

1Denominator includes children for whom health status was not reported, because the respondent did not know or refused to answer the health status question or because the question was

erroneously omitted from the interview.

Page 124 [ Series 1, No. 43
Vital and Health Statistics

series descriptions

SERIES 1. Programs and Collection Procedures—These reports

describe the data collection programs of the National Center

for Health Statistics. They include descriptions of the methods

used to collect and process the data, definitions, and other

material necessary for understanding the data.

SERIES 2. Data Evaluation and Methods Research—These reports

are studies of new statistical methods and include analytical

techniques, objective evaluations of reliability of collected

data, and contributions to statistical theory. These studies

also include experimental tests of new survey methods and

comparisons of U.S. methodology with those of other

countries.

SERIES 3. Analytical and Epidemiological Studies—These reports

present analytical or interpretive studies based on vital and

health statistics. These reports carry the analyses further than

the expository types of reports in the other series.

SERIES 4. Documents and Committee Reports—These are final

reports of major committees concerned with vital and health

statistics and documents such as recommended model vital

registration laws and revised birth and death certificates.

SERIES 5. International Vital and Health Statistics Reports—These

reports are analytical or descriptive reports that compare U.S.

vital and health statistics with those of other countries or

present other international data of relevance to the health

statistics system of the United States.

SERIES 6. Cognition and Survey Measurement—These reports are

from the National Laboratory for Collaborative Research in

Cognition and Survey Measurement. They use methods of

cognitive science to design, evaluate, and test survey

instruments.

SERIES 10. Data From the National Health Interview Survey—These

reports contain statistics on illness; unintentional injuries;

disability; use of hospital, medical, and other health services;

and a wide range of special current health topics covering

many aspects of health behaviors, health status, and health

care utilization. They are based on data collected in a

continuing national household interview survey.

SERIES 11. Data From the National Health Examination Survey, the

National Health and Nutrition Examination Surveys, and

the Hispanic Health and Nutrition Examination Survey—

Data from direct examination, testing, and measurement on

representative samples of the civilian noninstitutionalized

population provide the basis for (1) medically defined total

prevalence of specific diseases or conditions in the United

States and the distributions of the population with respect to

physical, physiological, and psychological characteristics, and

(2) analyses of trends and relationships among various

measurements and between survey periods.

SERIES 12. Data From the Institutionalized Population Surveys—

Discontinued in 1975. Reports from these surveys are

included in Series 13.

SERIES 13. Data From the National Health Care Survey—These

reports contain statistics on health resources and the public’s

use of health care resources including ambulatory, hospital,

and long-term care services based on data collected directly

from health care providers and provider records.

SERIES 14. Data on Health Resources: Manpower and Facilities—

Discontinued in 1990. Reports on the numbers, geographic

distribution, and characteristics of health resources are now

included in Series 13.

SERIES 15. Data From Special Surveys—These reports contain

statistics on health and health-related topics collected in

special surveys that are not part of the continuing data

systems of the National Center for Health Statistics.

SERIES 16. Compilations of Advance Data From Vital and Health

Statistics—Advance Data Reports provide early release of

information from the National Center for Health Statistics’

health and demographic surveys. They are compiled in the

order in which they are published. Some of these releases

may be followed by detailed reports in Series 10–13.

SERIES 20. Data on Mortality—These reports contain statistics on

mortality that are not included in regular, annual, or monthly

reports. Special analyses by cause of death, age, other

demographic variables, and geographic and trend analyses

are included.

SERIES 21. Data on Natality, Marriage, and Divorce—These reports

contain statistics on natality, marriage, and divorce that are

not included in regular, annual, or monthly reports. Special

analyses by health and demographic variables and

geographic and trend analyses are included.

SERIES 22. Data From the National Mortality and Natality Surveys—

Discontinued in 1975. Reports from these sample surveys,

based on vital records, are now published in Series 20 or 21.

SERIES 23. Data From the National Survey of Family Growth—These

reports contain statistics on factors that affect birth rates,

including contraception, infertility, cohabitation, marriage,

divorce, and remarriage; adoption; use of medical care for

family planning and infertility; and related maternal and infant

health topics. These statistics are based on national surveys

of women of childbearing age.

SERIES 24. Compilations of Data on Natality, Mortality, Marriage, and

Divorce—These include advance reports of births, deaths,

marriages, and divorces based on final data from the National

Vital Statistics System that were published as National Vital

Statistics Reports (NVSR), formerly Monthly Vital Statistics

Report. These reports provide highlights and summaries of

detailed data subsequently published in Vital Statistics of the

United States. Other special reports published here provide

selected findings based on final data from the National Vital

Statistics System and may be followed by detailed reports in

Series 20 or 21.

For answers to questions about this report or for a list of reports published

in these series, contact:

Information Dissemination Staff

National Center for Health Statistics

Centers for Disease Control and Prevention

3311 Toledo Road, Room 5412

Hyattsville, MD 20782

1-866-441-NCHS (6247)

E-mail: nchsquery@cdc.gov

Internet: www.cdc.gov/nchs
U.S. DEPARTMENT OF

HEALTH & HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics

3311 Toledo Road

Hyattsville, Maryland 20782

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