Frequently Asked Questions

About the DRC

What is the Data Resource Center (DRC)?

Who sponsors the DRC?

About the Surveys

What is the National Survey of Children's Health (NSCH)?

What is the National Survey of Children with Special Health Care Needs (NS-CSHCN)?

Who sponsors the NSCH and the NS-CSHCN?

How are data for the surveys collected?

Why are the surveys sometimes called “SLAITS”?

Where can I find information about the sampling and administration methods used for the NSCH and the NS-CSHCN?

What topics are asked about in the NSCH and NS-CSHCN?

Will the NSCH and NS-CSHCN be collected again?

Are the NSCH and NS-CSHCN data files available to the public?

Is county or city-level data available from either the NSCH or the NS-CSHCN?

What is new in the 2011 NSCH survey?

Definitions and Measure Development

How can I find out which questions were used to develop a specific child health indicator?

Why aren’t there any data on this website for Asian, American Indian, Alaska Native, or Native Hawaiian/Pacific Islander children?

How are the race/ethnicity categories created which appear in the data query search feature on this website?

What is a HRSA region?

What is a "medical home"?

How are unknown or missing values handled in the DRC interactive data query results?

What is the Children with Special Health Care Needs (CSHCN) Screener?

Why are there sometimes different estimates of CSHCN in different surveys?

Using the DRC and the Surveys

Is it possible to get a list of publications that have used the NSCH or the NS-CSHCN?

Is there a standard format for citing information from the DRC website in an academic paper?

How do I receive assistance if I am having a hard time interpreting output from the NSCH or NS-CSHCN?

Is it possible to look at two subgroups of children at the same time?

What internet browsers are supported by the DRC website?

How can I link to your site?

About the DRC

What is the Data Resource Center (DRC)?

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The purpose of the Data Resource Center for Child and Adolescent Health (DRC) is to advance the effective use of public data on the health and health-related services for children, youth, and families in the United States. The DRC does this by providing hands-on access to national, state, and regional data findings as well as offering technical assistance on the interpretation and use of these data by policymakers, program leaders, advocates and researchers in order to inform and advance key child and youth health goals. To learn more visit our About the DRC page.

Who Sponsors the DRC?

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Our Sponsors

The Data Resource Center for Child and Adolescent Health is a project of the Child and Adolescent Health Measurement Initiative (CAHMI) supported by Cooperative Agreement 1-U59-MC06980-01 from the U.S. Department of Health and Human Services , Health Resources and Services Administration (HRSA) , Maternal and Child Health Bureau (MCHB). With funding and direction from MCHB, these surveys were conducted by the Centers for Disease Control and Prevention’s National Center for Health Statistics. CAHMI is responsible for the analyses, interpretations, presentations and conclusions included on this site.

Our Partners

In addition to our partnership with the Maternal and Child Health Bureau, the DRC partners with the National Center for Health Statistics at the Centers for Disease Control and Prevention (NCHS) to provide this data. NCHS collects the data for both the National Survey of Children’s Health and the National Survey of Children with Special Health Care Needs. Measures which derive from both surveys are developed collaboratively through a partnership between the Maternal and Child Health Bureau, the National Center for Health Statistics and a Technical Expert Panel, in which the Data Resource Center is a member.

About the Surveys

What is the National Survey of Children's Health (NSCH)?

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The National Survey of Children's Health is a national survey that was conducted by telephone in English and Spanish for the first time in 2003-2004. A second survey was fielded in 2007-2008 and the third was conducted in 2011/12. The survey provides a broad range of information about children's health and well-being collected in a manner that allows for comparisons between states and at the national level. Telephone numbers are called at random to identify households with one or more children under 18 years old. In each household, one child was randomly selected to be the subject of the interview. The survey results are weighted to represent the population of non-institutionalized children 0-17 nationally and in each of the 50 states plus the District of Columbia.

Refer to Fast Facts about the Surveys for more information.

What is the National Survey of Children with Special Health Care Needs (NS-CSHCN)?

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The National Survey of Children with Special Health Care Needs (NS-CSHCN) is a national survey that was conducted by telephone in English and Spanish for the first time in 2001. The survey was conducted a second time in 2005-2006 and for a third time in 2009-2010. The survey provides a broad range of information about the health and functional status of children with special health care needs collected in a manner that allows for comparisons between states and at the national level. Telephone numbers are called at random to identify households with one or more children under 18 years old. Each child in the household is screened for special health care needs using the CSHCN Screener. In each household, one child was randomly selected to be the subject of the interview. The survey results are weighted to represent the population of non-institutionalized children with special health care needs 0-17 nationally and in each of the 50 states plus the District of Columbia..

Refer to Fast Facts about the Surveys for more information.

Who sponsors the NSCH and the NS-CSHCN?

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The U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau provides the primary funding for the surveys. The National Center for Health Statistics of the Centers for Disease Control and Prevention conducts the survey, oversees the sampling and produces a final public use data set of the results.

Refer to Fast Facts about the Surveys for more information.

How are data for the surveys collected?

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The sampling and data collection for the National Survey of Children’s Health and the National Survey of Children with Special Health Care Needs are conducted using SLAITS. SLAITS is an acronym for the State and Local Area Integrated Telephone Survey, and is an approach developed by the National Center for Health Statistics to quickly and consistently collect information on a variety of health topics at the state and local levels. Other national surveys collect through the SLAITS program include the National Immunization Survey and the National Survey of Early Childhood Health.

Refer to Fast Facts about the Surveys for more information.

Where can I find information about the sampling and administration methods used for the NSCH and the NS-CSHCN?

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What questions are in the surveys? Can I see the final questionnaire that was used? Who is in the survey, how are they chosen? Are the results representative of US children? Answers to these questions can be found in the Survey Methods and Documentation section of our website.

Why are the surveys sometimes called “SLAITS”?

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The sampling and data collection for the NSCH and NS-CSHCN surveys were conducted using the “State and Local Area Integrated Telephone Survey” or SLAITS. This approach was developed by the NCHS to collect information on a variety of health topics at the state and local levels.

Refer to Fast Facts about the Surveys for more information.

What topics are asked about in the NSCH and NS-CSHCN?

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The topics in the NSCH include:

  • Child and family demographics
  • Children’s physical and mental health status
  • Health insurance status and type of coverage
  • Access and use of health care services
  • Medical home
  • Early childhood-specific information (0-5 years)
  • Middle childhood and adolescent-specific information (6-17 years)
  • Family health and activities
  • Parental health status
  • Parent’s perceptions of neighborhood characteristics

The topics in the NS-CSHCN include:

  • Child’s health and functional status; including current conditions and functioning limitations information added in 2005-2006
  • Child’s health insurance status and adequacy of coverage
  • Access to health care — including types of health care services needed and any unmet needs for care
  • Care coordination
  • Family-centeredness of child’s health care
  • Impact of child’s health on family

For a full look at all of the questions in the surveys, please see the Guide to Survey Topics and Questions.

Will the NSCH and NS-CSHCN be collected again?

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Collection of data for the National Survey of Children’s Health used to alternate with collection for the National Survey of Children with Special Health Care Needs so that new data are available every 2 years for one or other of the surveys and every 4 years for a particular survey. The 2011/12 NSCH was released in early  2013. The next fielding of these surveys are pending results from the current review and revision process, but  it is projected that data collection will commence in 2015. 

Are the NSCH and NS-CSHCN data files available to the public?

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Yes. Free, easy to use, fully cleaned and labeled data sets are available from the Data Resource Center by visiting our Request a Dataset page. All questions and data shown on the DRC website, including demographic and constructed health indicators, are available in SAS and SPSS formats by clicking on the Request a Dataset link. In most cases there is absolutely no cost associated with the Data Resource Center Indicator Data Sets. Exceptions may apply to for-profit organizations. The original SAS version of the data set (without constructed indicators) can also be downloaded at no cost from the NCHS website: www.cdc.gov/nchs.

Refer to Fast Facts about the Surveys for more information.

Is county or city-level data available in either the NSCH or the NS-CSHCN?

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Currently, the public use data files for the surveys have state identifiers and a binominal variable identifying children living in the metropolitan statistical areas (MSA) with greater than 500,000 persons in each state. This indicator is suppressed whenever the population for the MSA or non-MSA area is less than 500,000 persons.

Zip codes are collected by the National Center for Health Statistics (NCHS), however, these data are not released in the public use data file due to confidentiality restrictions. It is possible to analyze these zipcode data on site at the NCHS’ Research Data Center in Hyattsville, MD. Interested researchers must first submit a proposal to the Research Data Center. Go to www.cdc.gov/rdc for more information about the Research Data Center and the proposal process.

Synthetic estimates are also a way in which you can obtain local estimates using national data. A synthetic estimate is a prevalence estimate for a local area that is calculated by using descriptive or demographic data for local areas combined with state prevalence values.  It is similar in concept to an indirect adjustment.  A local estimate is most likely to differ from a state estimate if the demographic distribution at the local area differs from that of the state and the prevalence of the indicator varies by the same demographic factor.  For more information on synthetic estimates, view our  Local Use of State Data and Synthetic Estimates Data Brief.

What is new in the 2011/12 NSCH survey?

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The 2011/12 NS-CSHCN includes new questions to better understand the following topics: 

  • Follow-up questions for children ever diagnosed with Autism or ASD
  • Premature birth
  • Age at diagnosis of several conditions
  • Flourishing (e.g. bonding, resilience, aspiration, joy)
  • Adverse family experiences (e.g. difficulty covering basic costs like food and housing, child witnessing violence, substance abuse)
  • WIC benefits
  • Additional questions on health insurance for uninsured children only

Definitions and Measure Development

How can I find out which questions were used to develop a specific child health indicator?

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Every child health indicator in the DRC data query has a pop-up box that displays pertinent information about the variable, including a list of the survey questions used to construct it. The pop-up box for a specific indicator or question can be viewed by clicking on the information icon next to questions and indicators on the browsing and results pages.

Why aren’t there any data on this website for Asian, American Indian, Alaska Native, or Native Hawaiian/Pacific Islander children?

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At the national level, children in these race categories are combined into a single group called OTHER. This is done because only a handful of States meet the National Center for Health Statistics’ confidentiality standards for releasing data to the public. The National Center for Health Statistics only includes individual level data for one of these groups in the publicly available data files when a group comprises 5% or more of the total child population in any given state. This standard is in place to protect against the chance of an individual child inadvertently being identified in states with relatively few children from these groups in their populations.

Both the NSCH and the NS-CSHCN ask a series of questions about the sample child’s race and Hispanic or Latino ethnicity. Respondents are allowed to answer affirmatively to one or more categories of race. There are a number of ways that the responses to these questions can be used to create different groupings of race and/or ethnicity. For the analytic purposes of this website, children were assigned to one of five distinct categories according to the following criteria:

  • For the NSCH and the NS-CSHCN, seven states have data in the publicly released data files for the race categories of American Indian or Native Alaskan (AK, AZ, NM, MT, ND, OK, SD). Only Hawaii has data released for the category Native Hawaiian/Pacific Islander. In the 2003 NSCH, and both NS-CSHCN datasets Asian-specific race data is publicly available for five states (CA, NJ, NY, WA, HI). In the 2007 NSCH these Asian-specific data are available for nine states (CA, MD, MA, NV, NJ, NY, VA, WA, HI).
  • It is important to note that when individual-level data for one or more of these race categories is not available in the publicly released survey data files for a specific state, it does not mean that the data were not collected. Rather, it indicates that one or more of these specific groups make up less than 5% of the total child population in that state. Researchers interested in analyzing the non-publicly released data for these minority groups in a state can submit a proposal to the Research Data Center (RDC) at the National Center for Health Statistics. The RDC provides access to detailed data files in a secure environment that does not jeopardize the confidentiality of respondents. For information about the RDC, click here.

Additional information about how data about children’s race/ethnicity were collected and processed for the NSCH and the NS-CSHCN is available in the Survey Design and Operation Manuals.

What criteria are used to create the race/ethnicity categories on this website?

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The child race/ethnicity groups available on this website are standard categories constructed according to the same guidelines used by the National Center for Health Statistics.

Both the NSCH and the NS-CSHCN ask a series of questions about the sample child’s race and Hispanic or Latino ethnicity. Respondents are allowed to answer affirmatively to one or more categories of race. There are a number of ways that the responses to these questions can be used to create different groupings of race and/or ethnicity. For the analytic purposes of this website, children were assigned to one of five distinct categories according to the following criteria:

  • HISPANIC: Children identified as having Hispanic or Latino ethnicity, regardless of reported race.
  • WHITE: Non-Hispanic children with White as the only reported race category.
  • BLACK: Non-Hispanic children with Black as the only reported race category.
  • MULTI-RACIAL: Non-Hispanic children with two or more race categories reported.
  • OTHER: Non-Hispanic children identified by a single one of the following categories: Asian, American Indian, Alaska Native, or Native Hawaiian/Pacific Islander. See previous question for more information.

Additional information about how data about children’s race/ethnicity were collected and processed for the NSCH and the NS-CSHCN is available in the Survey Design and Operation Manuals.

What is a HRSA region?

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The term “HRSA region” refers to the ten standard federal regions through which the Health Resources and Services Administration (HRSA) organizes and conducts its administrative activities. The 50 States, the District of Columbia, and the US territories are each assigned to a specific HRSA region.

The Health Resources and Services Administration (HRSA) is an agency of the U.S. Department of Health and Human Services. It is the primary Federal agency for improving access to health care services for people who are uninsured, isolated or medically vulnerable. The Maternal and Child Health Bureau, which sponsors the NSCH and the NS-CSHCN, is one of five HRSA bureaus.

The ten standard Federal Regions were established by OMB (Office of Budget Management) Circular A-105, "Standard Federal Regions," in April, 1974. The Standard Federal Regions used by HRSA are:

  • REGION I: CT, ME, MA, NH, RI, VT
  • REGION II: NJ, NY, Puerto Rico, Virgin Islands
  • REGION III: DE, MD, PA, VA, WV
  • REGION IV: AL, FL, GA, KY, MS, NC, SC, TN
  • REGION V: IL, IN, MI, MN, OH, WI
  • REGION VI: AR, LA, NM, TX, OK
  • REGION VII: IA, KS, MO, NE
  • REGION VIII: CO, MT, ND, SD, UT, WY
  • REGION IX: AZ, CA, HI, NV (American Samoa, Guam, Northern Mariana Islands, Trust Territory of the Pacific Islands)
  • REGION X: AK, ID, OR, WA

What is a "medical home"?

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“Medical home” refers to medical care for infants, children, and adolescents that is accessible, continuous, comprehensive, family-centered, coordinated, compassionate, and culturally effective. The medical home concept was first proposed by the American Academy of Pediatrics (AAP) in a 1992 policy statement which was updated in 2002. The AAP definition of medical home emphasizes that a medical home is "not a building, house, or hospital, but rather an approach to providing continuous and comprehensive primary pediatric care from infancy through young adulthood, with availability 24 hours a day, 7 days a week, from a pediatrician or physician whom families trust."

The need for an ongoing source of health care—ideally a medical home—for all children has been identified as a priority for child health policy reform at the national and local level. The US Department of Health and Human Services' Healthy People 2010 and 2020 goals and objectives state that "all children with special health care needs will receive regular ongoing comprehensive care within a medical home" and multiple federal programs require that all children have access to an ongoing source of health care. The following links provide more information and background on the medical home concept:

Whether children do or do not experience receiving care within a medical home is measured in both the NSCH and the NS-CSHCN and the measure has been endorsed by the National Quality Forum. The DRC has produced a detailed manual outlining the concept and measurement of medical home through the two national surveys. Additional details about the survey items and scoring approaches used are available in the DRC Child Health Indicator SAS and SPSS codebooks for each survey.

How are unknown or missing values handled in the DRC interactive data query results?

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Unknown values (responses coded as "refused", "don't know", or missing) are not included in the denominator when calculating prevalence estimates and weighted population counts displayed in the results tables. The proportion of unknown values is less than 1% for most of the survey items. In nearly all cases, the exclusion of these values does not affect the prevalence estimates (%) and only marginally affects the weighted population counts (Pop. Est.). Income, race/ethnicity and BMI-for-age are notable exceptions. See the survey SAS and SPSS codebooks for more information. Please click here if you have further questions.

Why are there sometimes different estimates of CSHCN in different surveys?

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Both the NS-CSHCN and NSCH surveys use the same CSHCN Screener but apply and administer it differently. We at the Data Resource Center think this difference leads to a more concentrated/robust group of CSHCN for the NS-CSHCN and a larger group of CSHCN for the NSCH. Read more about the variation across surveys in CSHCN prevalence in this article from the Maternal and Child Health Journal.

What is the CSHCN Screener?

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The CSHCN Screener is a five-item parent-reported tool designed to identify children across the range and diversity of childhood chronic conditions and special needs. You can learn more by reading CSHCN Screener Fast Facts, or visit the Children with Special Health Care Needs section of the CAHMI website. Learn more about who CSHCN are by reading our two-page brief called "Who are CSHCN?"

Using the DRC and the Surveys

Is it possible to get a list of publications that have used the NSCH or the NS-CSHCN?

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The Articles page on our website is your best resource for a list of current publications. There you will find dozens of articles that have used the surveys. We do our best to keep the articles section of our website updated, however you can also try searching in PubMed for additional articles.

Is there a standard format for citing information from the DRC website in an academic paper?

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Each data results or state data snapshot page on our website has a citation at the bottom of the results. Please use this context-specific citation information whenever possible. If a citation is not included on a screen then please use the following more general citation:
[Insert name and year of survey]. Child and Adolescent Health Measurement Initiative, Data Resource Center on Child and Adolescent Health website. Retrieved [mm/dd/yy] from [website address].

How do I receive assistance if I am having a hard time interpreting output from the NSCH or NS-CSHCN?

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The DRC makes it easy to receive technical assistance for questions related to understanding data and using our website or data from the two national surveys. Just follow the link to the Ask Us a Question page and type your question into the query box. The DRC Staff makes every effort to respond to your email within 2 to 3 business days.

Is it possible to look at two subgroups at the same time?

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Yes. More complicated queries can be completed by using the Ask Us a Question link to email us with the topic and subgroups of interest.

In addition, we do offer the full NSCH and NS-CSHCN datasets in both SPSS and SAS formats with all the publicly released variables plus all the indicator variables and MCHB core outcomes available on our website. Also included in the dataset are relevant socio-demographic and health stratifiers. The first step is to request a copy so we can send you a Data Request and Data Use Agreement forms by visiting the Request a Dataset page.

Keep in mind that due to sample size, the response for some specific demographic variables or specific questions might not be reliable because of an inflated standard error value.

What browsers does the DRC support?

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The DRC supports Microsoft Internet Explorer, Mozilla Firefox and Safari. If you do not have any of these browsers, visit the Microsoft Internet Explorer site, the Mozilla Firefox site, or the Safari site to download a free copy.

How can I link to your site?

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The DRC encourages users to link to our site. Please use the URL http://www.childhealthdata.org to the DRC and we suggest the following text to describe our work:

“The Data Resource Center for Child and Adolescent Health provides online access to survey data from the National Survey of Children’s Health and the National Survey of Children with Special Health Care Needs. Our site allows users to compare state, regional, and nationwide results – plus access additional resources and personalized assistance for interpreting and reporting findings.”

Please visit the Contact Us page for more information.