Core Content
The Child Conditions, Limitation of Activity, and Health Status Section (CHS) contains information on conditions, limitations of activity, health status, and mental health. The CHS includes questions about whether the sample child ever had the following health conditions: intellectual disability, also known as mental
retardation; developmental delays; attention-deficit/hyperactivity disorder (ADHD); Down syndrome; cerebral palsy; muscular dystrophy; cystic fibrosis; sickle cell anemia; autism; diabetes; arthritis; congenital and other heart disease; asthma; allergies; colitis; anemia; ear infections; seizures; headaches; stuttering or stammering. A question about whether the sample child still has asthma is included. This section also contains a question used to determine the number of school-loss days reported during the 12 months prior to the interview. In addition, respondents were asked about hearing and vision loss; if a health problem requires the sample child to use special equipment such as a brace, wheelchair, or hearing aid; whether the sample child’s health is better, worse, or the same compared with 12 months ago; and whether the sample child currently has a problem that has required prescription medication for at least three months.
U.S. Department of Health and Human Services ● Centers for Disease Control and Prevention ● National Center for Health Statistics The CHS section also includes questions about head colds, chest colds, and intestinal illnesses that started during the 2 weeks prior to the interview. It should be noted that these questions intentionally are measuring fairly broad symptoms and illnesses that may be a result of either acute or chronic conditions (e.g., irritable bowel syndrome or respiratory allergies).
This section also includes questions about the sample child’s height and weight. It is important to note that in the NHIS, the Sample Child respondent (usually a parent) is asked to report the sample child’s birth weight, current height, and current weight. No physical measurements were taken. National estimates based on physical measurements, such as those available from NCHS’ National Health and Nutrition Examination Survey (NHANES), may differ from those available from the NHIS, which are respondent-reported.
Supplemental Questions
In 2013, sixteen supplemental asthma questions sponsored by the National Heart, Lung, and Blood Institute (NHLBI, NIH) were embedded in the CHS section in order to provide enhanced information about the treatment and management of asthma. The variables based on the responses to these questions include data about hospital stays because of asthma (CASMHSP1), days of school or work missed because of asthma (CWZMSWK1), use of prescription inhaler or medication (CASMPMED1, CASMTYP, CASMCAN1, CASMDTP2), asthma
management (CASWMP1, CASCLASS, CAS_REC, CAS_RES, CAS_MON, CAPENVLN), number of times for routine asthma checkup (CAROUTIN), how often doctors or other health professionals asked about asthma symptoms and management (CASYMPT, CARESCUE, and CAACTLIM). Several of these questions, fielded previously in 2003 and/or 2008, have new universes or new wording to the question lead-in in 2013. Since these differences may impact the ability to examine trends, thorough review of the survey documentation for 2003 and 2008 is strongly recommended.
Several questions pertaining to child behavior for children aged 2–3 years that are derived from the Child Behavior Checklist were included: whether male sample children (aged 2–3 years) had been uncooperative, had trouble sleeping, had speech problems, or had been unhappy or depressed in the past 2 months, and whether female sample children (aged 2–3 years) had temper tantrums, had speech problems, had been nervous or high- strung, or had been unhappy or depressed in the past 2 months.
In 2012, there were 29 condition questions embedded in the CHS section in order to provide additional information for analysis of the Child Alternative Health supplement (CAL) data. These questions were dropped from the survey in 2013.
Major Recodes
Birth weight was collected in pounds and ounces or in grams. Recodes were created to provide information about total birth weight in ounces (TOTOZ_P) and total birth weight in grams (BWTGRM_P), regardless of the units of measurement originally provided. Current height for children aged 12–17 years was collected in feet and inches or in meters and centimeters. A recode was created to provide total current height in inches (CHGHT_TC), regardless of the units of measurement originally provided. Additionally, these recoded variables, as well as a variable about current weight (CWGHT_TC), were top and bottom-coded in order to protect the confidentiality of those who had extreme values in height and/or weight.
The CHS section includes several questions pertaining to child behavior for children aged 2–3 years that are derived from the Child Behavior Checklist. The data based on these questions are used to create recodes
U.S. Department of Health and Human Services ● Centers for Disease Control and Prevention ● National Center for Health Statistics regarding the child’s mental health (MHIBOY2, MHIGRL2); only the recodes are included in the Sample Child File. The items were chosen from the Checklist for their ability to discriminate between young children who have not received mental health services in the preceding 12 months and those who have, by using demographically- matched normative and clinical samples for boys and girls. More information on the scale derived from the Child Behavior Checklist is included in Appendix VI of this document.
Technical Notes
Beginning in 2008, questions about children’s current height and weight were limited to children aged 12–17 years. This limitation was introduced because of serious concerns about the reporting accuracy of height and weight information for younger children due to the rapid growth of children at younger ages. At the same time, an internal consistency check for the height and weight variables was added to the survey instrument to improve data quality. Extreme values for these height and weight variables triggered a request for interviewer verification of data entry and re-asking height and weight questions, if appropriate. In addition, body mass index (BMI) was calculated within the instrument, with extreme BMI values also triggering interviewer verification of height and weight. These consistency checks were solely within the survey instrument and are not reflected in the published questionnaire, documentation, or data file. See the 2012 NHIS Survey Description, CHS section, for more information about children’s height, weight, and BMI on the NHIS.