2019 NHIS Questionnaire Redesign

Overview

The National Health Interview Survey (NHIS) collects and analyzes health data to monitor the health of people across the country—the U.S. population. In 2019, the National Center for Health Statistics (NCHS) redesigned NHIS to better meet data users' needs. NCHS redesigned NHIS to—

• Improve how health topics are measured
• Shorten the length of the health interviews
• Establish a long-term survey structure, with topics covered every year and topics regularly rotated in and out of the survey of ongoing and periodic topics
• Ensure consistency with topics also covered by other federal health surveys
• Ensure content has a strong link to public health, like health behaviors and health care access
• Make use of advances in survey methods and practices
• Align with U.S. Department of Health and Human Services agency goals, strategic plans, or initiatives

NCHS estimates that NHIS will provide data from 27,000 sample adult and 9,000 sample child interviews for analysis each year. The redesign allows data users to combine two or more years of samples to produce reliable estimates for population subgroups.

NHIS was previously redesigned in 1997.

Questionnaire structure

The 2019 NHIS redesigned adult and child sample questionnaires include four components.

1. Annual core questions

Annual core questions are questions that appear on the survey every year. These core questions focus on:

• Demographic characteristics. like age, marital status, race, and ethnicity
• Health insurance coverage
• Chronic conditions
• Healthcare access and use
• Health-related behaviors, like smoking and other tobacco use
• Ability to perform daily activities (functioning) and disability

2. Rotating core questions

Rotating core questions are included in the survey on a regular schedule but are not included every year. Rotating questions cover topics like—

• Mental health, including negative feelings and emotions (psychological distress)
• Use of health services, including services to identify and prevent health problems (preventive services)
• Health-related behaviors, like physical activity and sleep
• Injuries and chronic pain
• Allergies

3. Sponsored content

Other federal agencies fund (or sponsor) some NHIS questions. Agencies can sponsor content every year for multiple years. This kind of content does not necessarily include the same questions every year. Agencies also can sponsor content to be included in the survey multiple times but not every year.

Sponsored content has included questions about—

• Access to and ability to afford food (food security)
• Exams and tests to identify cancer before symptoms appear (cancer screening)
• Diverse medical products and practices used in addition to or instead of standard medical care (complementary and alternative medicine)
• Heart disease and stroke prevention

The National Cancer Institute's website offers a proposed schedule of rotating sponsored questions about cancer is available on its website.

4. Emerging content

NCHS may add questions about new topics of growing interest. For example, in 2019, NHIS collected information about opioid use and pain management. Similarly, in 2020 and 2021, NHIS included questions about concussions.

Proposed content schedule

These sample questionnaires outline NHIS topics that will be included in each year's survey from 2019 through 2027.

• Sample Adult Content Schedule
• Sample Child Content Schedule