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 >  Learn About the NSCH > NSCH Guide to Topics & Questions > 2021 NSCH Guide to Topics and Questions

Guide to Topics & Questions Asked - 2021

2021 National Survey of Children's Health

The National Survey of Children’s Health (NSCH) is funded and directed by the U.S. Department of Health a¬nd Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau (HRSA MCHB), and is administered by the U.S. Census Bureau. Between June 2020 and January 2021, participants were mailed an invitation to complete an online household screener followed by a child-level questionnaire using a secure and confidential website. Additionally, participants were provided the opportunity to complete a mailed, paper version of the household screener and questionnaire instead of the web-based materials. See the NSCH Methodology Report and Sampling and Administration Diagram for more information. Below is a guide to the questions asked on the household screener and the child-level topical questionnaires. As in previous editions of the surveys, some variables in the public use file may be recoded to ensure consistency and ease of use. These recoded variables will appear in the public use file but will not appear in the table below.

KEY
^    Denotes that survey item is new to the 2021 NSCH (vs. 2020 NSCH). New items are noted in purple font.
*    Denotes that item content has substantively changed in the 2021 NSCH (vs. 2020 NSCH) or data are not comparable with the 2020 NSCH due to changes in question wording or response options; these are noted in red font. See box below for more information on the criteria used for content changes.
α     Denotes that response option for the survey item has changed in the 2021 NSCH (vs. 2020 NSCH).
•     Indicates a list of questions under one question stem.  
{}   Complex skip patterns are explained in brackets.
x    No number was assigned to this survey question. This question is nested within another survey item. 
-     Question does not exist in this version of the survey
       No symbol: Indented questions represent question sequences and are used if the respondent answered “yes” or gave a response other than “no” or “0” to the primary, non-indented question. 

Reasons for changes to content in 2021 NSCH
  1. To be consistent with other Federal policy/programs
  2. To reflect an updated understanding of a topic/question
  3. To focus on updated Maternal and Child Health Bureau priorities
  4. To reflect emerging priorities as identified by stakeholders

Note:
Items with minor wording changes are not indicated here. Survey items listed herein from the 2021 NSCH can be found in the full survey instruments which are available at the HRSA MCHB website.

CLICK on the question numbers in blue text below to view the full text of the question and its response options.

  SECTION 1: Initial Screener
  SECTION 2: Survey Questions  

SECTION 1: Pre-Survey Screener (Completed prior to full survey)

The screener is administered in advance of the full survey. It begins by asking an adult in the household if there are any children 0-17 years old in the home, how many children there are (TOTKIDS_R), what primary language is spoken (HHLANGUAGE), and and if the house, apartment, or mobile home is owned with or without a mortgage or loan, rented, or occupied without rent (TENURE). The # sign following each question number indicates which child in the household the response is referencing when there is more than one child in the household.

The following questions are then asked about each of the four youngest children living in the home:

  1. How old is this child? (C#_AGE_YEARS)
  2. What is this child’s sex? (C#_SEX)
  3. Is this child of Hispanic, Latino, or Spanish origin? (C#_HISPANIC_R)
  4. What is this child's race? [Mark one or more boxes] (C#_RACE_R)
  5. How well does this child speak English? [only asked of children 4+ years old] (C#_ENGLISH)
  6. Does this child CURRENTLY need or use medicine prescribed by a doctor, other than vitamins? (C#_K2Q10, C#_K2Q11, C#_K2Q12)
  7. Does this child need or use more medical care, mental health, or educational services than is usual for most children of the same age? (C#_K2Q13, C#_K2Q14, C#_K2Q15)
  8. Is this child limited or prevented in any way in his or her ability to do the things most children of the same age can do? (C#_K2Q16, C#_K2Q17, C#_K2Q18)
  9. Does this child need or get special therapy, such as physical, occupational, or speech therapy? (C#_K2Q19, C#_K2Q20, C#_K2Q21)
  10. Does this child have any kind of emotional, developmental, or behavioral problem for which he or she needs treatment or counseling? (C#_K2Q22, C#_K2Q23)

If YES to any of items 6-9, two follow up questions are asked:

  • Is this because of ANY medical, behavioral, or other health condition?
  • Is this a condition that has lasted or is expected to last 12 months or longer?

If YES to 10, one follow-up question is asked:

  • Has his or her emotional, developmental, or behavioral problem lasted or is it expected to last 12 months or longer?
 

Respondents are also asked to provide basic information (age and sex) about up to six additional children in the household.  These data are used for statistical purposes only and are not released.


Once information on all children is gathered via the screener, one child from the household is randomly selected. The remaining questions of the survey pertain only to this randomly selected child.

SECTION 2: Survey Questions

Survey Questions (variable name in public use data file) Survey Question Number
0-5 Years Survey 6-11 Years Survey 12-17 Years Survey
A. This Child's Health
In general, how would you describe this child’s health? (K2Q01) A1 A1 A1
How would you describe the condition of this child’s teeth? (K2Q01_D) A2 A2 A2
DURING THE PAST 12 MONTHS, has this child had FREQUENT or CHRONIC difficulty with any of the following? A3 A3 A3
  • Breathing or other respiratory problems (such as wheezing or shortness of breath) (BREATHING)
    		•   A3a  A3a  A3a
  • Eating or swallowing because of a health condition (SWALLOWING)
    		•   A3b  A3b  A3b
  • Digesting food, including stomach/intestinal problems, constipation, or diarrhea (STOMACH)
    		•   A3c  A3c  A3c
  • Repeated or chronic physical pain, including headaches or other back or body pain (PHYSICALPAIN)
    		•   A3d  A3d  A3d
  • Using their hands (HANDS)
    		•   A3e  -  -
  • Coordination or moving around (COORDINATION)
    		•   A3f  -  -
  • Toothaches (TOOTHACHES)
    		•   A3g  A3e  A3e
  • Bleeding gums (GUMBLEED)
    		•   A3h  A3f  A3f
  • Decayed teeth or cavities (CAVITIES)
    		•   A3i  A3g  A3g
    Does this child have any of the following? A4 A4 A4
  • Serious difficulty concentrating, remembering, or making decisions because of a physical, mental, or emotional condition (MEMORYCOND)
    		•   -  A4a  A4a
  • Serious difficulty walking or climbing stairs (WALKSTAIRS)
    		•   -  A4b  A4b
  • Difficulty dressing or bathing (DRESSING)
    		•   -  A4c  A4c
  • Difficulty doing errands alone, such as visiting a doctor’s office or shopping, because of a physical, mental, or emotional condition (ERRANDALONE)
    		•   -  -  A4d
  • Deafness or problems with hearing (K2Q43B)
    		•   A4a  A4d  A4e
  • Blindness or problems with seeing, even when wearing glasses (BLINDNESS)
    		•   A4b  A4e  A4f
    Has a doctor or other health care provider EVER told you that this child has:


  • Allergies (including food, drug, insect, or other)? (ALLERGIES)
    		•   A5  A5  A5
  • Arthritis? (ARTHRITIS)
    		•   A6  A6  A6
  • Asthma? (K2Q40A)
    		•   A7  A7  A7
  • Cerebral Palsy? (K2Q61A)
    		•   A8  A8  A8
  • Diabetes? (K2Q41A)
    		•   A9  A9  A9
  • Epilepsy or Seizure Disorder? (K2Q42A)
    		•   A10  A10  A10
  • Heart condition? (HEART)
    		•   A11  A11  A11
    If yes, was this child born with the condition. (HEART_BORN)
  • Frequent or severe headaches, including migraine? (HEADACHE)
    		•   A12  A12  A12
  • Tourette Syndrome? (K2Q38A)
    		•   A13  A13  A13
  • Anxiety problems? (K2Q33A)
    		•   A14  A14  A14
  • Depression? (K2Q32A)
    		•   A15  A15  A15
    If YES to any of the items from A5 (0-17 yrs) to this point, two follow up questions are asked:


    Does this child CURRENTLY have the condition? (variable name differs based on condition)  x  x  x
    If YES, is it Mild, Moderate, or Severe? (variable name differs based on condition)  x  x  x
    Has a doctor or other health care provider EVER told you that this child has:


  • Down Syndrome? (DOWNSYN)
    		•   A16  A16  A16
  • Blood Disorders (such as Sickle Cell Disease, Thalassemia, or Hemophilia)? (BLOOD)
    		•   A17  A17  A17
  • Cystic Fibrosis? (CYSTFIB)
    		•   A18  A18  A18
  • Other genetic or inherited condition? (GENETIC) (if yes, specify)
    		•  A19  A19  A19
    If YES to above question under A17 (0-17 yrs), a follow up question is asked:


    Is it Mild, Moderate, or Severe? (BLOOD_DESC)  x  x  x
    Was this child diagnosed with Sickle Cell Disease, Thalassemia, Hemophilia, Other Blood Disorders? (SICKLECELL, THALASSEMIA, HEMOPHILIA, BLOOD_OTHER)  x  x  x
    Were any of these blood disorders identified through a blood test done shortly after birth? These tests are sometimes called newborn screening. (BLOOD_SCREEN)  x  x  x
    If YES to any of the items from A18 and A19 (0-17 yrs), follow up questions are asked:


    If YES, is it Mild, Moderate, or Severe? (CYSTFIB_DESC, GENETIC_DESC)  x  x  x
    Was this condition identified through a blood test done shortly after birth? (These tests are sometimes called newborn screening) (BLOOD_SCREEN, CYSTFIB_SCREEN, GENETIC_SCREEN)  x  x  x
    Has a doctor, other health care provider, or educator EVER told you that this child has:


  • Behavioral or conduct problems? (K2Q34A)
    		•  A20 A20 A20
  • Developmental Delay? (K2Q36A)
    		•  A21 A21 A21
  • Intellectual Disability (formerly known as Mental Retardation)? (K2Q60A)
    		•  A22 A22 A22
  • Speech or other language disorder? (K2Q37A)
    		•  A23 A23 A23
  • Learning Disability? (K2Q30A)
    		•  A24 A24 A24
    If YES to any of the items from A20 to A24 (0-17 yrs) to this point, two follow up questions are asked:


    If yes, does this child CURRENTLY have the condition? (variable name differs based on condition)  x  x  x
    If YES, is it Mild, Moderate, or Severe? (variable name differs based on condition)  x  x  x
    Has a doctor or other health care provider EVER told you that this child has Autism or Autism Spectrum Disorder (ASD)? Include diagnoses of Asperger’s Disorder or Pervasive Developmental Disorder (PDD). (K2Q35A) A25 A25 A25
    If yes, does this child CURRENTLY have the condition? (K2Q35B)
    If yes, is it Mild, Moderate, or Severe? (K2Q35C)
    How old was this child when a doctor or other health care provider FIRST told you that they had Autism, ASD, Asperger’s Disorder or PDD?(K2Q35A_1_YEARS)  A26  A26  A26
    What type of doctor or other health care provider was the FIRST to tell you that this child had Autism, ASD, Asperger’s Disorder or PDD? (K2Q35D)  A27  A27  A27
    Is this child CURRENTLY taking medication for Autism, ASD, Asperger’s Disorder or PDD? (AUTISMMED) A28 A28 A28
    At any time DURING THE PAST 12 MONTHS, did this child receive behavioral treatment for Autism, ASD, Asperger’s Disorder or PDD, such as training or an intervention that you or this child received to help with their behavior? (AUTISMTREAT) A29 A29 A29
    Has a doctor or other health care provider EVER told you that this child has Attention Deficit Disorder or Attention Deficit/Hyperactivity Disorder, that is, ADD or ADHD? (K2Q31A) A30 A30 A30
    If yes, does this child CURRENTLY have the condition? (K2Q31B)
    If yes, is it Mild, Moderate, or Severe? (K2Q31C)
    Is this child CURRENTLY taking medication for ADD or ADHD? (K2Q31D)  A31  A31  A31
    At any time DURING THE PAST 12 MONTHS, did this child receive behavioral treatment for ADD or ADHD, such as training or an intervention that you or this child received to help with their behavior? (ADDTREAT)  A32  A32  A32
    Do you think this child has EVER had a concussion or brain injury? (CONCUSSION)  A33  A33  A33
    If yes, did you seek medical care from a doctor or other health care provider? (SEEKCARE)
    If yes, did a doctor or other health care provider tell you that your child had a concussion or brain injury? (CONFIRMINJURY)
    DURING THE PAST 12 MONTHS, how often have this child’s health conditions or problems affected their ability to do things other children their age do? (HCABILITY) A34 A34 A34
    To what extent do this child’s health conditions or problems affect their ability to do things? (HCEXTENT) A35 A35 A35
    B. This Child as an Infant
    Was this child born more than 3 weeks before his or her due date? (K2Q05) B1 B1 B1
     What month and year was this child born? (BIRTH_YR) B2 B2 B2
    How much did they weigh when born? (BIRTHWT_OZ_S) B3 B3 B3
    What was the age of the mother when this child was born? (MOMAGE) B4 B4 B4
    Was this child EVER breastfed or fed breast milk? (K6Q40) B5 - -
    If yes, how old was this child when they COMPLETELY stopped breastfeeding or being fed breast milk? (BREASTFEDEND) (K6Q41R_STILL) B6 - -
    How old was this child when they were FIRST fed formula? (FRSTFORMULA) (K6Q42R_NEVER) B7 - -
    How old was this child when they were FIRST fed anything other than breast milk or formula? (FRSTSOLIDS) (K6Q43R_NEVER) B8 - -
    C. Health Care Services
    Health Care Visits
    *DURING THE PAST 12 MONTHS, did this child see a doctor, nurse, or other health care professional for sick-child care, well-child checkups, physical exams, hospitalizations or any kind of medical care? Include health care visits done by video or phone. (S4Q01)
    		 C1 C1 C1
    If yes, at their LAST medical care visit, did this child have a chance to speak with a doctor or other health care provider privately, without you or another caregiver in the room? (DOCPRIVATE) - - C2
    If yes, DURING THE PAST 12 MONTHS, how many times did this child visit a doctor, nurse, or other health care professional to receive a PREVENTIVE check-up? (K4Q20R) C2 C2 C3
    Thinking about the LAST TIME you took this child for a PREVENTIVE check-up, about how long was the doctor or health care provider who examined this child in the room with you? (DOCROOM) C3 C3 C4
    Height and Weight
    What is this child’s CURRENT height? (HEIGHT) -  C4  C5
    How much does this child CURRENTLY weigh? (WEIGHT)
    [Data from the items on height and weight is not released individually, but they are combined to create a variable BMICLASS (10-17 years only) which is released. The questions have been removed from the 0-5 year old topic questionnaire]     		- C5 C6
    Are you concerned about this child’s weight? (WGTCONC) C4 C6 C7
    Has a doctor or other health care provider ever told you that his child is overweight? (OVERWEIGHT) C5  C7  C8
    Developmental Concerns & Screening
    DURING THE PAST 12 MONTHS, did this child’s doctors or other health care providers ask if you have concerns about this child’s learning, development, or behavior? (K6Q10)
    [If child is <9 months, skip to C10]    		 C6 - -
    DURING THE PAST 12 MONTHS, did a doctor or other health care provider have you or another caregiver fill out a questionnaire about observations or concerns you may have about this child’s development, communications, or social behaviors? (K6Q12) C7 - -
    If yes, [and child is 9-23 months], did the questionnaire ask about your concerns or observations about: x - -
  • How this child talks or makes speech sounds?  (K6Q13A)
    		•   x - - 
  • How this child interacts with you and others?  (K6Q13B)
    		•    x  -  - 
    If yes, [and child is 2-5 years], did the questionnaire ask about your concerns or observations about: x - -
  • Words and phrases this child uses and understands?  (K6Q14A)
    		•   x - -
  • How this child behaves and gets along with you and others?  (K6Q14B)
    		•   x - -
    Usual Source of Care
    Is there a place you or another caregiver USUALLY take this child when they are sick or you need advice about their health? (K4Q01) C8 C8 C9
    α If yes, where does this child USUALLY go first? (K4Q02_R) C9 C9 C10
    Is there a place that this child USUALLY goes when they need routine preventive care, such as a physical examination or well-child check-up? (USUALGO) C10 C10 C11
    If yes, is this the same place this child goes they are sick? (USUALSICK) C11 C11 C12
    Vision Testing
    ^Has this child EVER (0-5 years)/DURING THE PAST 2 YEARS, has this child (age 6-17 years) received a vision screening from a provider other than an eye doctor? (VISIONSCREENOTHER (0-5)), (VISIONSCREENOTHER (6-17))
    ^If yes, was it recommended that this child see an eye doctor or other eye care provider for an eye examination or additional vision service as a result of the vision screening? (VISIONEXAMREC)    		 C12 C12 C13
    ^Has this child EVER (0-5 years)/DURING THE PAST 2 YEARS (6-17 years) seen an eye doctor? (EYEDOCTOR (0-5)), (EYEDOCTOR (6-17))
    ^If yes, what care has this child received from the eye doctor? (EYECARE1_4)    		 C13 C13 C14
    Dental Health Care
    DURING THE PAST 12 MONTHS, did this child see a dentist or other oral health care provider for any kind of dental or oral health care? (K4Q30_R) C14 C14 C15
    If yes, DURING THE PAST 12 MONTHS, did this child see a dentist or other oral health care provider for preventive dental care, such as check-ups, dental cleanings, dental sealants, or fluoride treatments? (DENTISTVISIT) C15 C15 C16
    If yes, DURING THE PAST 12 MONTHS, what PREVENTATIVE dental services did this child receive? (DENTALSERV1-7) C16 C16 C17
    Mental Health Care and Other Types of Care
    DURING THE PAST 12 MONTHS, has this child received any treatment or counseling from a mental health professional? (K4Q22_R) C17 C17 C18
    How difficult was it to get the mental health treatment or counseling that this child needed? (TREATNEED) C18 C18 C19
    DURING THE PAST 12 MONTHS, has this child taken any medication because of difficulties with his or her emotions, concentration, or behavior? (K4Q23) C19 C19 C20
    DURING THE PAST 12 MONTHS, did this child see a specialist other than a mental health professional? (K4Q24_R) C20 C20 C21
    How difficult was it to get the specialist care that this child needed? (K4Q26) C21 C21 C22
    DURING THE PAST 12 MONTHS, did this child use any type of alternative health care or treatment? (ALTHEALTH) C22 C22 C23
    Forgone Health Care
    DURING THE PAST 12 MONTHS, was there any time when this child needed health care but it was not received? (K4Q27) C23 C23 C24
    If yes, which types of care were not received? (K4Q28X01-05, K4Q28X_EAR) C24 C24 C25
    Did any of the following reasons contribute to this child not receiving needed health services?: C25 C25 C26
  • This child was not eligible for the services (NOTELIG)
    		•  C25a C25a C26a
  • The services this child needed were not available in your area (AVAILABLE)
    		•  C25b C25b C26b
  • There were problems getting an appointment when this child needed one (APPOINTMENT)
    		•  C25c C25c C26c
  • There were problems with getting transportation or child care(TRANSPORTCC)
    		•  C25d C25d C26d
  • The clinic or doctor's office wasn’t open when this child needed care (NOTOPEN)
    		•  C25e C25e C26e
  • There were issues related to cost (ISSUECOST)
    		•  C25f C25f C26f
    DURING THE PAST 12 MONTHS, how often were you frustrated in your efforts to get services for this child? (C4Q04) C26 C26 C27
    ER Use
    DURING THE PAST 12 MONTHS, how many times did this child visit a hospital emergency room? (HOSPITALER) C27 C27 C28
    DURING THE PAST 12 MONTHS, was this child admitted to the hospital to stay for at least one night? (HOSPITALSTAY)  C28  C28 C29 
    Educational & Developmental Services
    Has this child EVER had a special education or early intervention plan? (K6Q15) C29 C29 C30
    If yes, how old was this child at the time of the FIRST plan? (SESPLANYR, SESPLANMO) C30 C30 C31
    Is this child CURRENTLY receiving services under one of these plans? (SESCURRSVC) C31 C31 C32
    Has this child EVER received special services to meet his or her developmental needs such as speech, occupational, or behavioral therapy? (K4Q36) C32 C32 C33
    If yes, how old was this child when they began receiving these special services? (K4Q37) C33 C33 C34
    Is this child CURRENTLY receiving these special services? (K4Q38) C34 C34 C35
    D. Experience with This Child's Health Care Providers
    Personal Doctor or Nurse
    Do you have one or more persons you think of as this child’s personal doctor or nurse? (K4Q04_R) D1 D1 D1
    Referrals for Care
    DURING THE PAST 12 MONTHS, did this child need a referral to see any doctors or receive any services? (K5Q10) D2 D2 D2
    How difficult was it to get referrals? (K5Q11) D3 D3 D3
    Family-Centered Care
    {Only answer questions D4-D12 if child had a health care visit in the past 12 months} DURING THE PAST 12 MONTHS, how often did this child’s doctors or other health care providers: D4
    		 D4 D4
  • Spend enough time with this child? (K5Q40)
    		•  D4a
    		 D4a
    		 D4a
  • Listen carefully to you? (K5Q41)
    		•  D4b D4b D4b
  • Show sensitivity to your family’s values and customs? (K5Q42)
    		•  D4c
    		 D4c
    		 D4c
  • Provide the specific information you needed concerning this child? (K5Q43)
    		•  D4d
    		 D4d
    		 D4d
  • Help you feel like a partner in this child’s care? (K5Q44)
    		•  D4e
    		 D4e
    		 D4e
    Shared Decision Making
    DURING THE PAST 12 MONTHS, did this child need any decisions to be made regarding his or her health care, such as whether to get prescriptions, referrals, or procedures? (DECISIONS) D5 D5 D5
    If yes, DURING THE PAST 12 MONTHS, how often did this child’s doctors or other health care providers: D6 D6 D6
  • Discuss with you the range of options to consider for his or her health care or treatment? (DISCUSSOPT)
    		•  D6a
    		 D6a
    		 D6a
  • Make it easy for you to raise concerns or disagree with recommendations for the child’s health care? (RAISECONC)
    		•  D6b
    		 D6b
    		 D6b
  • Work with you to decide together which health care and treatment choices would be best for this child? (BESTFORCHILD)
    		•  D6c
    		 D6c
    		 D6c
    Care Coordination
    DURING THE PAST 12 MONTHS, did anyone help you arrange or coordinate this child’s care among the different doctors or services that this child uses? (K5Q20_R)
    		 D7 D7 D7
    DURING THE PAST 12 MONTHS, have you felt that you could have used extra help arranging or coordinating this child’s care among the different health care providers or services? {If No, skip to D10} (K5Q21)  D8 D8 D8
    If yes, DURING THE PAST 12 MONTHS, how often did you get as much help as you wanted with arranging or coordinating this child’s health care? (K5Q22) D9 D9 D9
    DURING THE PAST 12 MONTHS, how satisfied were you with the communication among this child’s doctors and other health care providers? (K5Q30) D10 D10 D10
    DURING THE PAST 12 MONTHS, did this child’s health care provider communicate with the child’s school, child care provider, or special education program? (K5Q31_R) D11 D11 D11
    If yes, during this time, how satisfied were you with the health care provider’s communication with the school, child care provider, or special education program? (K5Q32) D12 D12 D12
    Transition to Adult Health Care 
    Do any of this child’s doctors or other health care providers treat only children? (TREATCHILD) - - D13
    If yes, have they talked with you about having this child eventually see doctors or other health care providers who treat adults? (TREATADULT) - - D14
    Has this child’s doctor or other health care provider actively worked with this child to: - - D15
  • Make positive choices about his or her heath? (POSCHOICE)
    		•  - - D15a
  • Gain skills to manage his or her health and health care? (GAINSKILLS)
    		•  - - D15b
  • Understand the changes in health care that happen at age 18? (CHANGEAGE)
    		•  - - D15c
    Did you and this child receive a summary of your child's medical history (for example, medical conditions, allergies, medications, immunizations)? (MEDHISTORY)  - -   D16
    Have this child’s doctors or other health care providers worked with you and this child to create a plan of care to meet his or her health goals and needs? (WRITEPLAN) - - D17
    If yes, do you and this child have access to this plan of care? (RECEIVECOPY) - - D18
    Does this plan of care address transition to doctors and other health care providers who treat adults? (PLANNEEDS_R) - - D19
    Eligibility for health insurance often changes in young adulthood. Do you know how this child will be insured as he or she becomes an adult? (HEALTHKNOW) - - D20
    If no, has anyone discussed with you how to obtain or keep some type of health insurance coverage as this child becomes an adult? (KEEPINSADULT) - - D21
    E. This Child's Health Insurance Coverage
    DURING THE PAST 12 MONTHS, was this child EVER covered by ANY kind of health insurance or health coverage plan? (K3Q04_R) {If child was covered all 12 months, skip to E4} E1 E1 E1
    Indicate whether any of the following is a reason this child was not covered by health insurance DURING THE PAST 12 MONTHS: E2 E2 E2
  • Change in employer or employment status (K12Q01_A)
    		•  E2a
    		 E2a
    		 E2a
  • Cancellation due to overdue premiums (K12Q01_B)
    		•  E2b
    		 E2b
    		 E2b
  • Dropped coverage because it was unaffordable (K12Q01_C)
    		•  E2c
    		 E2c
    		 E2c
  • Dropped coverage because benefits were inadequate (K12Q01_D)
    		•  E2d
    		 E2d
    		 E2d
  • Dropped coverage because choice of health care providers was inadequate (K12Q01_E)
    		•  E2e
    		 E2e
    		 E2e
  • Problems with application or renewal process (K12Q01_F)
    		•  E2f
    		 E2f
    		 E2f
  • Other, specify (K12Q01_G)
    		•  E2g
    		 E2g
    		 E2g
    Is this child CURRENTLY covered by ANY kind of health insurance or health coverage plan? {If child is not currently covered by any kind of health insurance or health coverage plan, skip to F1} (CURRCOV) E3 E3 E3
    Is this child CURRENTLY covered by any of the following types of health insurance or health coverage plans? E4 E4 E4
  • Insurance through a current or former employer or union (K12Q03)
    		•  E4a
    		 E4a
    		 E4a
  • Insurance purchased directly from an insurance company (K12Q04)
    		•  E4b
    		 E4b
    		 E4b
  • Medicaid, Medical Assistance, or any kind of government assistance plan for those with low incomes or a disability (K12Q12)
    		•  E4c
    		 E4c
    		 E4c
  • TRICARE or other military health care (TRICARE)
    		•  E4d
    		 E4d
    		 E4d
  • Indian Health Service (K11Q03R)
    		•  E4e
    		 E4e
    		 E4e
  • Other, specify (HCCOVOTH)
    		•  E4f
    		 E4f
    		 E4f
    How often does this child’s health insurance offer benefits or cover services that meet this child’s needs? (K3Q20) E5 E5 E5
    How often does this child’s health insurance allow him or her to see the health care providers he or she needs? (K3Q22) E6 E6 E6
    Thinking specifically about this child’s mental or behavioral health needs, how often does this child’s health insurance offer benefits or cover services that meet these needs? (MENBEVCOV) E7 E7 E7
    F. Providing for This Child's Health
    Including co-pays and amounts reimbursed from Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA), how much money did you pay for this child’s medical, health, dental, and vision care DURING THE PAST 12 MONTHS? (HOWMUCH) F1 F1 F1
    How often are these costs reasonable? (K3Q21B) F2 F2 F2
    DURING THE PAST 12 MONTHS, did your family have problems paying for any of this child’s medical or health care bills? (K3Q25) F3 F3 F3
    DURING THE PAST 12 MONTHS, have you or other family members: F4 F4 F4
  • Left a job or taken a leave of absence because of this child’s health or health conditions? (STOPWORK)
    		•  F4a
    		 F4a
    		 F4a
  • Cut down on the hours you work because of this child’s health or health conditions? (CUTHOURS)
    		•  F4b
    		 F4b
    		 F4b
  • Avoided changing jobs because of concerns about maintaining health insurance for this child? (AVOIDCHG)
    		•  F4c
    		 F4c
    		 F4c
    IN AN AVERAGE WEEK, how many hours do you or other family members spend providing health care at home for this child? (ATHOMEHC) F5 F5 F5
    IN AN AVERAGE WEEK, how many hours do you or other family members spend arranging or coordinating health or medical care for this child, such as making appointments or locating services? (ARRANGEHC) F6 F6 F6
    G. This Child's Learning (0-5 years)
    Is this child able to do the following... {if child is <1 year, skip to question G25} G1  - - 
  • Say at least one word, such as "hi" or "dog"? (ONEWORD)
    		•  G1a - -
  • Use 2 words together, such as "car go"? (TWOWORDS)
    		•  G1b - -
  • Use 3 words together in a sentence, such as, "Mommy come now."? (THREEWORDS)
    		•  G1c - -
  • Ask questions like "who," "what," "when," "where"? (ASKQUESTION)
    		• G1d - -
  • Ask questions like "why," and "how? (ASKQUESTION2)
    		•  G1e - -
  • Tell a story with a beginning, middle, and end? (TELLSTORY)
    		•  G1f - -
  • Understand the meaning of the word "no"? (UNDERSTAND)
    		• G1g - -
  • Follow a verbal direction without hand gestures, such as "Wash your hands."? (DIRECTIONS)
    		•  G1h - -
  • Point to things in a book when asked? (POINT)
    		•  G1i - -
  • Follow 2-step directions, such as "Get your shoes and put them in the basket."? (DIRECTIONS2)
    		•  G1j - -
  • Understand words such as "in," "on," and "under"? (UNDERSTAND2)
    		• G1k - -
    Is this child 3 years old or older? (SC_AGE_YEARS) {If child is <3 years, skip to question G25}  G2 -  - 
    Has this child started school? (STARTSCHOOL)  G3  -  -
    Are you concerned about how this child is learning to do things for him or herself? (K6Q08_R)  G4  -  -
    How confident are you that this child is ready to be in school? (CONFIDENT)  G5  -  -
    How often can this child recognize the beginning sound of a word? (RECOGBEGIN)  G6  -  -
    About how many letters of the alphabet can this child recognize? (RECOGABC)  G7  -  -
    Can this child rhyme words? (RHYMEWORD)  G8  -  -
    How often can this child explain things he or she has seen or done so that you get a very good idea what happened? (CLEAREXP)  G9  -  -
    How often can this child write his or her first name, even if some of the letters aren’t quite right or are backwards? (WRITENAME)  G10  -  -
    How high can this child count? (COUNTTO)  G11  -  -
    How often can this child identify basic shapes such as a triangle, circle, or square? (RECSHAPES)  G12  -  -
    Can this child identify the colors red, yellow, blue, and green by name? (COLOR)   G13  -  -
    How often is this child easily distracted? (DISTRACTED)  G14  -  -
    How often does this child keep working at something until he or she is finished? (WORKTOFIN)  G15  -  -
    When this child is paying attention, how often can he or she follow instructions to complete a simple task? (SIMPLEINST)  G16  -  -
    How does this child usually hold a pencil? (USEPENCIL)  G17  -  -
    How often does this child play well with others? (PLAYWELL)  G18  -  -
    How often does this child become angry or anxious when going from one activity to another? (NEWACTIVITY)  G19  -  -
    How often does this child show concern when others are hurt or unhappy?(HURTSAD)  G20  -  -
    When excited or all wound up, how often can this child calm down quickly?(CALMDOWN)  G21  -  -
    How often does this child lose control of his or her temper when things do not go his or her way? (TEMPER)  G22  - -
    Compared to other children his or her age, how much difficulty does this child have making or keeping friends? (MAKEFRIEND)  G23  -  -
    Compared to other children his or her age, how often is this child able to sit still? (SITSTILL)  G24  -  -
    How often  G25  -  -
  • Is this child affectionate and tender with you? (K6Q70_R)
    		• G25a - -
  • Does this child bounce back quickly when things do not go their way? (K6Q73_R)
    		• G25b - -
  • Does this child show interest and curiosity in learning new things? (K6Q71_R)
    		• G25c - -
  • Does this child smile and laugh? (K6Q72_R)
    		• G25d - -
    G. This Child's Schooling and Activities (6-17 years)
    DURING THE PAST 12 MONTHS, about how many days did this child miss school because of illness or injury? (K7Q02R_R)  -  G1  G1
    DURING THE PAST 12 MONTHS, how many times has this child’s school contacted you or another adult in your household about any problems he or she is having with school? (K7Q04R_R)  -  G2  G2
    SINCE STARTING KINDERGARTEN, has this child repeated any grades? (REPEATED)  -  G3  G3
    DURING THE PAST 12 MONTHS, how often did you attend events or activities that this child participated in? (K7Q33) -  G4 G4 
    DURING THE PAST 12 MONTHS, did this child participate in:  -  G5  G5
  • A sports team or did he or she take sports lessons after school or on weekends? (K7Q30)
    		•   -  G5a  G5a
  • Any clubs or organizations after school or on weekends? (K7Q31)
    		•   -  G5b  G5b
  • Any other organized activities or lessons, such as music, dance, language, or other arts? (K7Q32)
    		•   -  G5c  G5c
  • Any type of community service or volunteer work at school, church, or in the community? (K7Q37)
    		•   -  G5d  G5d
  • Any paid work, including regular jobs as well as babysitting, cutting grass, or other occasional work? (K7Q38)
    		•   -  G5e  G5e
    DURING THE PAST WEEK, on how many days did this child exercise, play a sport, or participate in physical activity for at least 60 minutes? (PHYSACTIV)  -  G6  G6
    Compared to other children his or her age, how much difficulty does this child have making or keeping friends? (MAKEFRIEND)  -  G7  G7
    DURING THE PAST 12 MONTHS, how often was this child bullied, picked on, or excluded by other children? (BULLIED_R)  -  G8  G8
    DURING THE PAST 12 MONTHS, how often did this child bully others, pick on them, or exclude them? (BULLY)  -  G9  G9
    How often does this child  -  G10  G10
  • Show interest and curiosity in learning new things? (K6Q71_R)
    		• - G10a G10a
  • Work to finish tasks they start? (K7Q84_R)
    		• - G10b G10b
  • Stay calm and in control when faced with a challenge? (K7Q85_R)
    		• - G10c G10c
  • Care about doing well in school? (K7Q82_R)
    		• - G10d G10d
  • Care about doing well in school? (K7Q83_R)
    		• - G10e G10e
  • Argue too much? (K7Q70_R)
    		• - G10f G10f
    H. About You and This Child
    Was this child born in the United States? (If yes, skip to H3} (BORNUSA) H1 H1 H1
    If no, how long has this child been living in the United States? (LIVEUSA_YR/LIVEUSA_MO) H2 H2 H2
    How many times has this child moved to a new address since he or she was born? (K11Q43R) H3 H3 H3
    How often does this child go to bed at about the same time on weeknights? (BEDTIME) H4 H4 H4
    DURING THE PAST WEEK, how many hours of sleep did this child get [during an average day (count both nighttime sleep and naps) (HOURSLEEP05)/ on most weeknights]? (HOURSLEEP) H5 H5 H5
    In which position do you most often lay this baby down to sleep now? {<12 months old only} (SLEEPPOS) H6 - -
    ^DURING THE PAST WEEK, how many times did this child drink sugary drinks such as soda, fruit drinks, sport drinks, or sweet tea? (SUGARDRINK) H7 - -
    ^DURING THE PAST WEEK, how many times did this child eat vegetables? (VEGETABLES) H8 - -
    ^DURING THE PAST WEEK, how many times did this child eat fruit? (FRUIT) H9 - -
    ^ON MOST WEEKDAYS, how much time does this child spend playing outdoors? (OUTDOORSWKDAY) H10 - -
    ^ON AN AVERAGE WEEKEND DAY, how much time does this child spend playing outdoors? (OUTDOORSWKEND) H11 - -
    ON MOST WEEKDAYS, about how much time does this child usually spend in front of a TV, computer, cellphone or other electronic device watching programs, playing games, accessing the internet or using social media? (Do not include time spent doing schoolwork.) (SCREENTIME) H12 H6 H6
    DURING THE PAST WEEK, how many days did you or other family members read to this child? (K6Q60_R) H13 - -
    DURING THE PAST WEEK, how many days did you or other family members tell stories or sing songs to this child? (K6Q61_R) H14 - -
    How well can you and this child share ideas or talk about things that really matter? (K8Q21) - H7 H7
    How well do you think you are handling the day-to-day demands of raising children? (K8Q30) H15 H8 H8
    DURING THE PAST MONTH, how often have you felt:  H16 H9 H9
  • That this child is much harder to care for than most children his or her age? (K8Q31)
    		•  H16a
    		 H9a
    		 H9a
  • That this child does things that really bother you a lot? (K8Q32)
    		•  H16b
    		 H9b
    		 H9b
  • Angry with this child? (K8Q34)
    		•  H16c
    		 H9c
    		 H9c
    DURING THE PAST 12 MONTHS, was there someone that you could turn to for day-to-day emotional support with parenting or raising children? (K8Q35) H17 H10 H10
    If yes, did you receive emotional support from:  H18 H11 H11
  • Spouse or domestic partner? (EMOSUPSPO)
    		•  H18a
    		 H11a
    		 H11a
  • Other family member or close friend? (EMOSUPFAM)
    		•  H18b
    		 H11b
    		 H11b
  • Health care provider? (EMOSUPHCP)
    		•  H18c
    		 H11c
    		 H11c
  • Place of worship or religious leader? (EMOSUPWOR)
    		•  H18d
    		 H11d
    		 H11d
  • Support or advocacy group related to specific health condition? (EMOSUPADV)
    		•  H18e
    		 H11e
    		 H11e
  • Peer support group? (EMOSUPPEER)
    		•  H18f
    		 H11f
    		 H11f
  • Counselor or other mental health professional? (EMOSUPMHP)
    		•  H18g
    		 H11g
    		 H11g
  • Other person, specify (EMOSUPOTH)
    		•  H18h
    		 H11h
    		 H11h
    Does this child receive care for at least 10 hours per week from someone other than his or her parent or guardian? (K6Q20) H19 - -
    DURING THE PAST 12 MONTHS, 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 this child? (K6Q27) H20 - -
    I. About Your Family and Household
    DURING THE PAST WEEK, on how many days did all the family members who live in the household eat a meal together? (K8Q11) I1 I1 I1
    Does anyone living in your household use cigarettes, cigars, or pipe tobacco? (K9Q40) I2 I2 I2
    If yes, does anyone smoke inside your home? (K9Q41) I3 I3 I3
    SINCE THIS CHILD WAS BORN, how often has it been very hard to cover the basics, like food or housing, on your family’s income? (ACE1) I4 I4 I4
    Which of these statements best describes your household’s ability to afford the food you need DURING THE PAST 12 MONTHS? (FOODSIT) I5 I5 I5
    At any time DURING THE PAST 12 MONTHS, even for one month, did anyone in your family receive: I6 I6 I6
  • Cash assistance from a government welfare program? (K11Q60)
    		•  I6a
    		 I6a
    		 I6a
  • Food Stamps or Supplemental Nutrition Assistance Program benefits (SNAP) (K11Q61)?
    		•  I6b
    		 I6b
    		 I6b
  • Free or reduced-cost breakfasts or lunches at school? (K11Q62)
    		•  I6c
    		 I6d
    		 I6c
  • Benefits from the Women, Infants, and Children (WIC) Program? (S9Q34)
    		•  I6d
    		 I6c
    		 I6d
    In your neighborhood, is/are there:  I7 I7 I7
  • Sidewalks or walking paths? (K10Q11)
    		•  I7a
    		 I7a
    		 I7a
  • A park or playground? (K10Q12)
    		•  I7b
    		 I7b
    		 I7b
  • A recreation center, community center, or boys’ and girls’ club? (K10Q13)
    		•  I7c
    		 I7c
    		 I7c
  • A library or bookmobile? (K10Q14)
    		•  I7d
    		 I7d
    		 I7d
  • Litter or garbage on the street or sidewalk? (K10Q20)
    		•  I7e
    		 I7e
    		 I7e
  • Poorly kept or rundown housing? (K10Q22)
    		•  I7f
    		 I7f
    		 17f
  • Vandalism such as broken windows or graffiti? (K10Q23)
    		•  I7g
    		 I7g
    		 I7g
    To what extent do you agree with these statements about your neighborhood or community? I8 I8 I8
  • People in this neighborhood help each other out (K10Q30)
    		•  I8a
    		 I8a
    		 I8a
  • We watch out for each other’s children in this neighborhood (K10Q31)
    		•  I8b
    		 I8b
    		 I8b
  • This child is safe in our neighborhood (K10Q40_R)
    		•  I8c
    		 I8c
    		 I8c
  • When we encounter difficulties, we know where to go for help in our community (GOFORHELP)
    		•  I8d
    		 I8d
    		 I8d
  • This child is safe at school (K10Q41_R )
    		•  - I8e
    		 I8e
    Other than you or other adults in your home, is there at least one other adult in this child’s school, neighborhood, or community who knows this child well and who he or she can rely on for advice or guidance? (K9Q96) - I9 I9
    To the best of your knowledge, has this child EVER experienced any of the following?  I9 I10 I10
  • Parent or guardian divorced or separated (ACE3)
    		•  I9a
    		 I10a
    		 I10a
  • Parent or guardian died (ACE4)
    		•  I9b
    		 I10b
    		 I10b
  • Parent or guardian served time in jail (ACE5)
    		•  I9c
    		 I10c
    		 I10c
  • Saw or heard parents or adults slap, hit, kick punch one another in the home (ACE6)
    		•  I9d
    		 I10d
    		 I10d
  • Was a victim of violence or witnessed violence in neighborhood (ACE7)
    		•  I9e
    		 I10e
    		 I10e
  • Lived with anyone who was mentally ill, suicidal, or severely depressed (ACE8)
    		•  I9f
    		 I10f
    		 I10f
  • Lived with anyone who had a problem with alcohol or drugs (ACE9)
    		•  I9g
    		 I10g
    		 I10g
  • Treated or judged unfairly because of his or her race or ethnic group (ACE10)
    		•  I9h
    		 I10h
    		 I10h
  • Treated or judged unfairly because of their sexual orientation or gender identity (ACE12)
    		•  -
    		 I10i
    		 I10i
  • ^Treated or judged unfairly because of a health condition or disability (ACE11)
    		•  19i I10j
    		 I10j
    When your family faces problems, how often are you likely to do each of the following? I10 I11 I11
  • Talk together about what to do (TALKABOUT)
    		•  I10a
    		 I11a
    		 I11a
  • Work together to solve our problems (WKTOSOLVE)
    		•  I10b
    		 I11b
    		  I11b
  • Know we have strengths to draw on (STRENGTHS)
    		•  I10c
    		 I11c
    		 I11c
  • Stay hopeful even in difficult times (HOPEFUL)
    		•  I10d
    		 I11d
    		 I11d
    Impact of the Coronavirus Pandemic
    ^DURING THE PAST 12 MONTHS, has this child had any health care visits by video or phone? (VIDEOPHONE)
    ^If yes, were any of this child's health care visits by video or phone because of the coronavirus pandemic? (VIDEOPHONECOVID)    		 I11 I12 I12
    ^DURING THE PAST 12 MONTHS, did this child miss, delay or skip any PREVENTATIVE check-ups because of the coronavirus pandemic? (COVIDCHECKUPS) I12 I13 I13
    ^DURING THE PAST 12 MONTHS, have any of this child's regular childcare arrangements been closed or unavailable at any time because of the coronavirus pandemic? (COVIDARRANGE_0-5), (COVIDARRANGE_6-11) I13 I14 -
    J. Child's Caregivers
    *The questions are first asked of the respondent (“About you”) and then asked for a second adult if “Yes” to J13 “Does this child have another parent or adult caregiver who lives in this household?”. In 2021, the second adult (if any) is referred to as “other parent or caregiver in the household”.
    How are you/this other caregiver related to this child? (A1_RELATION) (A2_RELATION) .... J1/J14 J1/J14
    		 J1/J14
    What is your/this caregiver's sex? (A1_SEX) (A2_SEX) J2/J15 J2/J15
    		 J2/J15
    What is your/this caregiver's age? (A1_AGE) (A2_AGE) J3/J16 J3/J16
    		 J3/J16
    Where were you/this caregiver born? (A1_BORN) (A2_BORN) J4/J17 J4/J17
    		 J4/J17
    {If outside of the U.S.} When did you/this caregiver come to live in the United States? (A1_LIVEUSA) (A2_LIVEUSA) J5/J18 J5/J18
    		 J5/J18
    What is the highest grade or year of school you/this caregiver have completed? (A1_GRADE) (A2_GRADE) J6/J19 J6/J19
    		 J6/J19
    What is your/this caregiver's marital status? (A1_MARITAL) (A2_MARITAL) J7/J20 J7/J20
    		 J7/J20
    In general, how is your/this caregiver's physical health? (A1_PHYSHEALTH) (A2_PHYSHEALTH) J8/J21 J8/J21
    		 J8/J21
    In general, how is your/this caregiver's mental or emotional health? (A1_MENTHEALTH) (A2_MENTHEALTH) J9/J22 J9/J22
    		 J9/J22
    Which of the following best describes your/this caregiver’s current employment status? (A1_EMPLOYED) (A2_EMPLOYED) J10/J23 J10/J23
    		 J10/J23
    Have you/this caregiver ever served on active duty in the U.S. Armed forces, Reserves, or the National Guard? (A1_ACTIVE) (A2_ACTIVE)  J11/J24   J11/J24  J11/J24
    Were you/this caregiver deployed at any time during this child’s life? (A1_DEPLSTAT) (A2_DEPLSTAT)  J12/J25   J12/J25 J12/J25  
    K. Household Information
    How many people are living or staying at this address? (HHCOUNT) K1 K1 K1
    How many of these people in your household are family members? (FAMCOUNT) K2 K2 K2

    Income in 2020 (The public use file does not include the following individual variables# but are presented as an aggregate variable labeled FPL (if imputed FPL_I).

    		  K3  K3  K3
    Income in 2020. Mark Yes or No for each type of income this child’s family received, and give best estimate of the total amount in the last calendar year.
  • Wages, salary, commissions, bonuses, or tips from all jobs? (INCWAGES)#
    		• K3a
    		 K3a
    		 K3a
  • Self-employment income from own nonfarm businesses or farm businesses, including proprietorships and partnerships? (INCSELFEMP)#
    		• K3b
    		 K3b
    		 K3b
  • Interest, dividends, net rental income, royalty income, or income from estates and trusts? (INCINTDIV)#
    		• K3c
    		 K3c
    		 K3c
  • Social security or railroad retirement; retirement, survivor, or disability pensions? (INCSSRR)
    		•  K3d
    		 K3d
    		 K3d
  • Supplemental security income (SSI); any public assistance or welfare payments from the state or local welfare office? (INCSSIPA)#
    		• K3e
    		 K3e
    		 K3e
  • Any other sources of income received regularly such as Veterans’ (VA) payments, unemployment compensation, child support, or alimony? (INCOTHER)#
    		• K3f
    		 K3f
    		 K3f
    Think about your total combined family income IN THE LAST CALENDAR YEAR for all members of the family. What is that amount before taxes? (TOTINCOME)# K4 K4 K4
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