DRC Frequently Asked Questions

About the DRC

• What is the Data Resource Center (DRC)?

  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 and youth, including those with special health care needs, and families in the United States. The DRC does this by providing hands-on access to national and state data findings from the National Survey of Children’s Health (NSCH), 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. The DRC prioritizes assisting Title V Maternal and Child Health Services Block Grant recipients and partners in the effective implementation of the Title V Block Grant Program by providing key technical support, interactive resources, and necessary training. To learn more visit our About the DRC/CAHMI page.

• Who sponsors the DRC?

  Our Sponsor

  The DRC is a project of the Child and Adolescent Health Measurement Initiative (CAHMI) and is supported by Cooperative Agreement U59MC27866 from the U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau (MCHB).

  Data Partners

  Starting in 2016, the United States (U.S.) Census Bureau collects the data for the NSCH on behalf of HRSA MCHB. Measures derived from this survey are developed collaboratively through a partnership between HRSA’s MCHB, a Technical Expert Panel on which the DRC is a member, the Census Bureau, and other federal partners who provide sponsorship for the NSCH. Several measures included in the NSCH were created through the collaborative efforts of MCHB, CAHMI and the National Center for Health Statistics.

  Dissemination Partners

  The DRC has longstanding collaborative relationships with Family Voices, the Association for Maternal and Child Health Programs (AMCHP), and many other organizations that work to transform healthcare and improve health for children and their families nationwide. Through this collaboration, CAHMI and the DRC work to promote data partnerships with family advocates, topical experts, and community leaders. The data collected through the NSCH are collected from families, and through these partnerships, we work to ensure that the data can be used by families in order to promote quality care and positive health outcomes for children.

Using the DRC website

• How can I get NSCH survey results?

  The DRC website lets you interactively browse NSCH data through the “Interactive Data Query” providing point-and-click access to NSCH survey results. These data can be viewed in tabular and graphical formats at the national and state level as well as by child and family demographic characteristics and other subgroups (where sample size permits). We provide US maps and comparison tables to compare data by state and to the nation. We also provide fully coded NSCH datasets, codebooks and resources to help with analyzing the data and learning about the NSCH on your own.

• Where are survey years prior to 2022?

  The Census Bureau, in partnership with MCHB, recreated weights for the NSCH survey and retroactively applied them to all surveys occurring before 2022. The newly adjusted weights better account for race and ethnicity data at the national and state levels. NSCH survey years 2016-2021 are now stored on the NSCH Data Archive page. Estimates from 2016-2021 on the DRC (which do not contain updated weights) should not be compared with estimates beginning with the 2022 single year data set (and the 2021-2022 combined year data set). Likewise, US maps and hotspotting tables from NSCH years 2016-2021 are also archived on separate pages and should not be compared with current estimates based on the new weights.
  

• Can I still access datasets from 2016-2021?

  Yes, the newly updated datasets are available directly from Census Bureau but do not contain the 350+ variables which are available on the DRC website. The DRC is currently working on updating the DRC constructed datasets for the 2016-2021 NSCH  For more information see the weighting revisions technical document.

• Are all survey data that are collected displayed on the DRC website?

  The DRC does not display all data from the NSCH due to data precision restrictions. The DRC Interactive Data Query alerts data users when estimates are suppressed or flagged as imprecise using the criteria set by HRSA MCHB.
  

  Which data are suppressed? 
  If the unweighted denominator < 30, the estimate is considered too unreliable for presentation.
  
  Which data receive an “interpret with caution” flag?           
  The DRC flags certain data that should be interpreted with caution if:

  • The absolute confidence interval (Cl) width > 20%, or
  • The relative Cl width > 120% (1.2 times the estimate), or
  • The estimate is 0% or 100%

  To learn more about the data suppression and data display criteria click here. 

• Where can I find resources for the NSCH?

  Detailed information about the NSCH - including Fast Facts and FAQs, Survey Sampling and Administration Diagrams, Guides to Topics and Questions, Survey Methodology, Survey Instruments, Survey Content Maps, Guides to Survey Changes Across Years, and SPSS, SAS, and Stata Codebooks - are available on the DRC website.
  
  The NSCH public use data file, along with FAQs, Methodology Reports, and other relevant background information and documentation, are located on the HRSA MCHB website and the U.S. Census Bureau website.

• Are the NSCH data files available to the public?

  Yes. Fully labeled datasets are available from the DRC at no cost. All NSCH survey data shown on the DRC website, including constructed MCHB Block Grant National Performance and Outcome Measures and Standardized Measures, child and family health measures, and demographic variables are available as SAS, SPSS, and Stata datasets on the Request a Dataset page. [See note above about availability of datasets from 2016-2021 based on new weights generated by the Census Bureau] Users can download datasets after submitting a User Form with a signed Data User Agreement.
  

  
  In addition, the original, non-coded, SAS and Stata versions of the NSCH can be found at the U.S. Census Bureau’s website. These data files include the household screener file, child-level topical file, and poverty implicate file.

   

• What can I expect when I request a DRC constructed dataset?

  Visit our “Request a Dataset” page here. Once we have received a completed User Form and Data Use Agreement, we will send you an e-mail with links to download all datasets and accompanying codebooks.  

• Can I get a list of publications that have used the surveys hosted on the DRC?

  The Papers, Publications and Briefs 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 should also search PubMed for additional articles. We are also happy to post articles from users who utilize NSCH data; please email us a link to your article for display.

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

  The DRC is funded by a cooperative agreement with HRSA MCHB to create the Interactive Data Query tool, as well as the key indicator dataset and codebook. The data results, data comparison tables, US maps and other documents on our website all have a citation at the bottom of the pages. Please use this context-specific citation information whenever possible. If a citation is not included on a screen, then please use the following general citation:

  Child and Adolescent Health Measurement Initiative. [Title of the document] [Insert name and year of survey]. Data Resource Center for Child and Adolescent Health supported by Cooperative Agreement from the U.S. Department of Health and Human Services, Health Resources and Services Administration's Maternal and Child Health Bureau (HRSA's MCHB). Retrieved [mm/dd/yy] from [www.childhealthdata.org].

  Please use the following citation when you report data findings obtained from the DRC interactive data query:
  Child and Adolescent Health Measurement Initiative. [Insert year and name of survey] data query. Data Resource Center for Child and Adolescent Health, supported by Cooperative Agreement from the U.S. Department of Health and Human Services, Health Resources and Services Administration’s Maternal and Child Health Bureau (HRSA's MCHB). Retrieved [mm/dd/yy] from [website address].

  Please use the following citation when you use resources obtained from the DRC website:
  Child and Adolescent Health Measurement Initiative [(Publication Year)]. “Title of the document” Data Resource Center for Child and Adolescent Health, supported by Cooperative Agreement from the U.S. Department of Health and Human Services, Health Resources and Services Administration’s Maternal and Child Health Bureau (HRSA's MCHB). Available at www.childhealthdata.org. Retrieved mm/dd/yyyy.
  

  Please use the following citation for datasets:
  Child and Adolescent Health Measurement Initiative (CAHMI) [(Publication Year)]. [Year and name of survey, SAS/SPSS/Stata] Indicator Data Set. Data Resource Center for Child and Adolescent Health supported by Cooperative Agreement from the U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau (MCHB). Retrieved [mm/dd/yy] from www.childhealthdata.org. .
  

  Please the following citation for codebooks:
  Child and Adolescent Health Measurement Initiative (CAHMI) [(Publication Year)]. [Year and name of survey]: Child and Family Health Measures and Subgroups, [format eg. SAS/SPSS] Codebook, Version [insert version], Data Resource Center for Child and Adolescent Health supported by Cooperative Agreement from the U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau (MCHB). Retrieved [mm/dd/yy] from www.childhealthdata.org.
  

  It would be very helpful to us if you informed us of publications, presentations, posters, or reports in which you used DRC resources so that we can track usage of the site and to share your work through the DRC website.

• How do I receive assistance if I am having a hard time interpreting output from the surveys?

  The DRC makes it easy to receive technical assistance for questions related to our website or interpreting data from the national surveys hosted here. Just follow the link to the Ask Us a Question page. We ask that you first review the resources listed there for information related to your inquiry. If you still do not find the information you need, please submit the “Ask Us a Question” form. Once we receive your question, we will review it within 48 hours. Due to limited capacity, we prioritize questions submitted by Title V leaders, families, and family organizations. As our team is able, our goal is to provide quick replies to all questions and requests for information. The DRC staff makes every effort to respond to your email within 2 to 3 business days.

• Is it possible to access data for two subgroups of children at the same time in the Interactive Data Query?

  The DRC Interactive Data Query features the ability to look at only one subgroup at a time at the national or state level. In order to analyze more than one subgroup simultaneously, you will need to request a dataset. Keep in mind that due to sample size, the response for selected demographic variables or questions might not be reliable because of an inflated standard error value. Also, make sure you review the survey methodology and other technical documents and codebooks to learn more about how to analyze the NSCH data.

• What internet browsers are supported by the DRC website?

  The DRC supports Microsoft Internet Explorer, Google Chrome, Mozilla Firefox, and Safari. If you do not have any of these browsers, visit the Microsoft Internet Explorer site, Google Chrome site, the Mozilla Firefox site, or the Safari site to download a free copy. The DRC is also accessible via mobile phone.

• How can I link to your site?

  The DRC encourages users to link to our site. Please use the URL http://www.childhealthdata.org. We suggest the following text to describe our work:
  “The Data Resource Center for Child and Adolescent Health, a project of the Child and Adolescent Health Measurement Initiative (CAHMI), provides online access to survey data from the National Survey of Children’s Health. The DRC site allows users to compare state, regional, and nationwide results, and to access additional resources and personalized assistance for interpreting and reporting findings.”

Defintions and Measure Development

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

  Every child health indicator in the DRC Interactive 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. This information can also be found in the survey codebook, which is available for download on the NSCH Codebook page.

• Have NSCH questions been validated or cognitively tested?

  The Maternal and Child Health Bureau, the US Census Bureau, and a national Technical Expert Panel (TEP; comprised of representatives from other federal agencies, state Title V leaders, family organizations, and child health researchers) lead indicator development, and previously validated questions are used when available. Cognitive testing was conducted on each of the items; reports are not publicly available.

• What criteria are used to create the race/ethnicity categories?

  The child race/ethnicity groups available on this website are standard categories constructed according to guidelines established by the Office of Management and Budget (OMB) and used in U.S. Department of Health and Human Services surveys. The NSCH asks 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.
  
  The DRC website provides three race and/or ethnicity groupings for NSCH: the Child and Family Health Measures have four and five category grouping options while the National Performance and Outcome Measures have four and seven category grouping options. Children are assigned to one of seven 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.
  • ASIAN: Non-Hispanic children with Asian as the only reported race category.
  • American Indian/Alaska Native: Non-Hispanic children with American Indian/Alaska Native as the only reported race category. 
  • Native Hawaiian/Other Pacific Islander: Non-Hispanic children with Native Hawaiian/Other Pacific Islander as the only reported race category.
  • Multiple race: non-Hispanic children reported two or more race categories.

  To learn more about the race and/or ethnicity groupings, click here.

  Please note that state sample sizes for Black, Asian, American Indian/Alaska Native, Native Hawaiian/Other Pacific Islander and Hispanic Origin are too small (n<30) in some states and should not be used to derive population estimates. This varies by survey year, and information can be found in the Methodology Report for the specified survey year.
  
  Additional information about how data about children’s race/ethnicity were collected and processed for the NSCH is available on the U.S. Census Bureau website in the Methodology Report and the HRSA MCHB website containing NSCH supporting documents. See also the updated report on why race and ethnicity weights were retroactively updated to better represent estimates at the national and state levels.

• I see references to HRSA regions in the NSCH DRC Interactive Data Query. What is a HRSA region?

  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 U.S. territories are each assigned to a specific HRSA region.

  HRSA is an agency of the U.S. Department of Health and Human Services. It is the primary Federal agency for improving access to healthcare services for people who are uninsured, isolated, or medically vulnerable.

  The ten standard federal regions were established by OMB 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, Federated States of Micronesia, Guam, Marshall Islands, Northern Mariana Islands, Palau
  • REGION X: AK, ID, OR, WA
• How are unknown or missing values handled in the DRC Interactive Data Query results?

  Missing values may be due to non-response (i.e. a skipped item) or a “don’t know” response. The way these items are handled can vary by measure. For National Performance and Outcome Measures, having missing values for all items in an indicator will lead to the case being given a missing value on the overall measure. For some other measures, if there is a missing value on any of the items, the case will be set to missing. How missing values are handled is documented in the "Additional notes" field when required.
  
  Missing values are not included in the denominator when calculating prevalence estimates and weighted population counts displayed in the Interactive Data Query results table. In the majority of cases, the proportion of missing values is less than 2%. Exceptions are noted in the form of a Data Alert at the bottom of a results table. The exclusion of these values does not change the prevalence estimates (%) and only marginally affects the weighted population counts (Pop. Est.). To learn about the impact of the missing values on the population count estimates, click here.

• What does it mean that the data from NSCH are “parent-reported”? Is parent-reported data valid? What is the accuracy of using parental responses?

  “Parent-reported” data means that the surveys are completed by a parent, guardian, or other adult familiar with the child’s health. This differs from electronic medical record data or other clinical data reported by hospitals, clinicians, or administrators. Data from parents and caregivers are critical to having a full understanding of the broad spectrum of child health. Questions included in the survey instrument are deemed appropriate to be reported by parents. Data from parents, who know their children better than anyone, are critical to having a full understanding of the broad spectrum of child health. Below are relevant publications on the validity of parent response:

  1. Gordon NP, Mellor, RG. Accuracy of parent-reported information for estimating prevalence of overweight and obesity in a race-ethnically diverse pediatric clinic population aged 3 to 12. BMC Ped. 2015 15(5). DOI: 10.1186/s12887-015-0320-0.
  

  2. Gutierrez SJ, Fagnano M, Wiesenthal E, Koehler AD, Halterman JS. Discrepancies between medical record data and parent reported use of preventive asthma medications. J Asthma. 2014 May; 51(4): 446–450. 2014 Jan. 30. DOI: 10.3109/02770903.2013.878351
  

  3. Porter SC, Forbes P, Manzi S, Kalish LA. Patients providing the answers: narrowing the gap in data quality for emergency care. Qual Saf Health Care. 2010 May 27. [Epub ahead of print] PubMed PMID: 20511242.
  

  4. Bourgeois FT, Porter SC, Valim C, Jackson T, Cook EF, Mandl KD. The value of patient self-report for disease surveillance. J Am Med Inform Assoc. 2007 Nov-Dec;14(6):765-71. Epub 2007 Aug 21. PubMed PMID: 17712092; PubMed Central PMCID: PMC2213481.
  

  5. Porter SC, Kohane IS, Goldmann DA. Parents as partners in obtaining the medication history. J Am Med Inform Assoc. 2005 May-Jun;12(3):299-305. Epub 2005 Jan 31. PubMed PMID: 15684127; PubMed Central PMCID: PMC1090461.
  

  6. Porter SC. Patients as experts: a collaborative performance support system. Proc AMIA Symp. 2001:548-52. PubMed PMID: 11825247; PubMed Central PMCID: PMC2243331.
  

  7. Porter SC, Silvia MT, Fleisher GR, Kohane IS, Homer CJ, Mandl KD. Parents as direct contributors to the medical record: validation of their electronic input. Ann Emerg Med. 2000 Apr;35(4):346-52. PubMed PMID: 10736120.
  

  8. Porter SC, Mandl KD. Data quality and the electronic medical record: a role for direct parental data entry. Proc AMIA Symp. 1999:354-8. PubMed PMID: 10566380; PubMed Central PMCID: PMC2232794.
  

DRC Constructed Datasets

• What is included in the NSCH datasets?

  DRC constructed datasets for the NSCH survey include all content in the public use file plus National Performance Measures, National Outcome Measures, and dozens of other key Child and Family Health Indicator variables. These measures were developed collaboratively by the HRSA MCHB, CAHMI’s DRC, the National Center for Health Statistics, the U.S. Census Bureau, and a national Technical Expert Panel of child health researchers and policymakers.

• Do the datasets include local-level data?

  DRC constructed datasets provide state and national level data. The NSCH is designed to be representative at the national and state level only; however, it is possible to analyze county and zip code data on-site at the U.S. Census Bureau’s Research Data Centers. Interested researchers must first complete the process to receive Special Sworn Status to be able to gain access to the datafiles on-site. Go to https://ask.census.gov/support/case to submit your request to begin this process.

  The NSCH reports four geographic variables for some states in the public use file: FIPSST (State of Residence), CBSAFP_YN (Core-Based Statistical Area Status), METRO_YN (Metropolitan Statistical Area Status), and MPC_YN (Metropolitan Principal City Status). More information about the geographic variables can be found in the U.S. Census Bureau’s Methodology Report.

  Synthetic estimates are also a way in which you can obtain local estimates using national or state-level data. A synthetic estimate is a prevalence estimate for a local area that is calculated by applying state-level NSCH prevalence estimates by demographic characteristics (e.g., poverty level and/or race/ethnicity) to the demographic distribution for local areas obtained from an external source (e.g., American Community Survey). It is similar in concept to an indirect adjustment. A simple approach to this indirect adjustment can only accommodate two variables at one time and thus will not produce robust estimates found in multilevel approaches. For more information on creating straightforward synthetic estimates, view our Local Uses of National and State Data Brief. Although this approach has limitations, it offers an accessible alternative to direct estimation.

• How are DRC constructed datasets different from the U.S. Census Bureau public use data files?
  • The DRC constructed datasets include additional derived variables not available in the NSCH public use files, which are available from the Census Bureau.
  • The public use files from the Census Bureau are available in SAS and Stata formats. The DRC provides the datafile in SPSS format in addition to SAS and Stata.
  • Access to the DRC datasets significantly reduces the time and knowledge required to construct key indicators and advances the standardized use of these indicators in research, education, and policy.
    
• Where can I find out how derived variables in DRC datasets were conceptualized and how they are constructed in SPSS, SAS, or Stata?

  The DRC has published documentation for derived variables in the DRC constructed datasets and the DRC Interactive Data Query in the form of SPSS, SAS, and Stata codebooks. Download codebooks from the DRC website. We will ask you to provide your email (optional) if you would like to receive updates on codebooks and other DRC news. We will not contact you frequently.

• What if I have additional questions?

  If you have questions or need assistance, visit our site and ask us a question.