DOI: 10.3886/icpsr39205.v1
title: National Survey of Health Attitudes, [United States], 2023
title: Version 1

description: Since 2013, the Robert Wood Johnson Foundation (RWJF) has led the development of a pioneering national action framework to advance a "culture that enables all in our diverse society to lead healthier lives now and for generations to come." Accomplishing these principles requires a national paradigm shift from a traditionally disease and health care-centric view of health toward one that focuses on well-being. Recognizing that paradigm shifts require intentional actions, RWJF worked with RAND researchers to design an actionable path to fulfill the Culture of Health (CoH) vision. A central piece of this work is the development of measures to assess constructs underlying a CoH.
The National Survey of Health Attitudes (NSHA) is a survey that RWJF and RAND analysts developed and conducted as part of the foundation's CoH strategic framework. The foundation undertook this survey to measure key constructs that could not be measured in other data sources. Thus, the survey was not meant to capture the full action framework that informs CoH, but rather just selected measure areas. The questions in this survey primarily addressed the action area: making health a shared value. The survey covers a variety of topics, including views regarding what factors influence health, such as the notion of health interdependence (peer, family, neighborhood, and workplace drivers of health), values related to national and community investment for health and well-being; behaviors around health and well-being, including civic engagement on behalf of health, and the role of community engagement and sense of community in relation to health attitudes and values.
This study includes the results from the 2023 RWJF National Survey of Health Attitudes. The 2023 survey is the third wave of the NSHA. The first wave was conducted in 2015 (ICPSR 37405) and the second wave in 2018 (ICPSR 37633). The 2023 report complements the overview of the 2015 survey described in the RAND report Development of the Robert Wood Johnson Foundation National Survey of Health Attitudes (Carman et al., 2016), and its subsequent topline 2018 Survey of National Health Attitudes: Description and Top-Line Summary (Carman et al., 2019) and is organized similarly for consistency. A companion set of longitudinal surveys during the COVID-19 pandemic was fielded between 2020 and 2021 and is further described in four top-line reports, COVID-19 and the Experiences of Populations at Greater Risk (Carman et al., 2020-2021).
The questions in the 2023 survey uniquely capture aspects of American mindset about health, health equity, structural racism, and wellbeing in ways that are not present in other surveys. This version of the NSHA can be viewed in three main sections: (1) individual health experiences, perspectives, and knowledge (making health a shared value); (2) health equity perspectives; and (3) community wellbeing, including climate views and barriers to community engagement. Insights from the surveys referenced above, including this one, have established a baseline and set of cross-sectional pulse checks on where the American public is regarding their recognition of social determinants of health, their understanding of health inequities including structural racism, their willingness to address those inequities and their indication of who in society should be responsible for solving health inequities.
description: For many of Robert Wood Johnson Foundation's Culture of Health action areas, data were available to guide the RWJF and RAND's work in those areas. For one, making health a shared value, little or no data were available. The National Survey of Health Attitudes was designed to collect data on public perceptions of health as a shared value.
description: The researchers designed the first wave of the survey to measure constructs that could not be assessed using existing data. In some cases, existing data were out of date or collected only in small samples that were not nationally representative. Existing literature informed the survey design. Where possible, the researchers used questions drawn from available survey instruments. For following waves, existing questions were modified or new questions were developed to address new gaps in knowledge.
description: Variables include what factors influence health, how the United States and individual communities should invest in health, what priorities communities should have regarding health, what social supports the respondent experiences in their neighborhood, the respondent's experience as a caretaker of those who cannot manage their own health, as well as questions about the respondent's health and health attitudes.
description: To make the sample representative of the overall population, the principle investigator (PI) used weighting, a statistical adjustment. To create weights to match the distribution of characteristics in the sample as closely
as possible to that of the population from the 2022 Current Population Survey (CPS), the PI used a raking algorithm, following the methods described in Deming (1943) and Deville, Särndal, and Sautory (1993). The PI aimed to match population proportions on interactions of gender and race
and ethnicity, gender and education, and gender and age, as well as household income interacted
with household size. This study's weighting procedure treated observations from the American Life Panel and KnowledgePanel as equivalent.
description: Response Rates: RAND American Life Panel - 77.2 percent participation rate
Ipsos KnowledgePanel - 61.8 percent participation rate
description: Presence of Common Scales: The survey included several Likert-type scales and binary response options.
description: Respondents for the KnowledgePanel (now part of Ipsos, previously GfK) and the RAND American Life Panel (ALP) were recruited using probability-based methods (such as Address Based Sampling and Random Digit Dialing).
The ALP sample was limited to panel members who had both participated in the 2015 survey and remained active in the ALP system. The ALP also included an oversample of vulnerable populations based on geographic areas with lower per capita incomes and larger proportions of native Spanish speakers.
description: Datasets: 
DS1: National Survey of Health Attitudes, [United States], 2023
description: Adults in the United States. Smallest Geographic Unit: Census region
description: web-based surveyThis study features the third wave of the National Survey of Health Attitudes (NSHA). The first wave was conducted in 2015 and can be found at the National Survey of Health Attitudes, [United States], 2015 (ICPSR 37405) website. The second wave was conducted in 2018 and can be found at the National Survey of Health Attitudes, [United States], 2018 (ICPSR 37633) website.