Survey Results

Survey Items: Survey instrument item number for children 0-5 years: A3a-d(2019), G25a-d(2020); for children 6-11 years: A3a(2019), G10a(2020); for children 12-17 years: A3a(2019), G10a(2020);
Variables in public use data file: K6Q70_R ; K6Q73_R ; K6Q71_R ; K6Q72_R

Denominator: Children age 6 months-5 years

Numerator: Meets 0-2 flourishing items; Meets 3 flourishing items; Meets all 4 flourishing items

Revisions and Changes: There have been changes in this measure since 2016. Changes could be in the way the item was worded, in the response options provided, or in other areas such as a skip pattern change, question placement changes, etc. For more information about the changes, click here.

Additional Notes: For children age 0-5 years, four questions were asked that aimed to capture curiosity and discovery about learning, resilience, attachment with parent, and contentment with life. The survey questions asked, "How often: (1) is this child affectionate and tender, (2) does this child bounce back quickly when things do not go his/her way, (3) does this child show interest and curiosity in learning new things, and (4) does this child smile and laugh?" The "Always" or "Usually" responses to the question indicate the child meets the flourishing item criteria. Questions were developed based on a review of positive health indicators by a Technical Expert Panel (TEP). This TEP includes a representative group of experts in the field of survey methodology, children's health, community organizations, and family leaders. Additionally, there was a public comment period, which yielded more interest in this concept.

Treatment of Unknown Values: 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 NPMs and NOMs, 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 above 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.

History and Development: The National Survey of Children’s Health (NSCH), funded and directed by the Health Resources and Services Administration’s (HRSA) Maternal and Child Health Bureau (MCHB), is designed to provide annual national and state-level information on the health and well-being of children ages 0-17 years in the United States. The U.S. Census Bureau administers the survey, oversees the sampling, and produces a final data set of survey results. HRSA’s Maternal and Child Health Bureau (MCHB) develops survey content in collaboration with the U.S. Census Bureau and a Technical Expert Panel. The Technical Expert Panel consists of experts in survey methodology and children’s health, federal and state stakeholders, clinicians and researchers. In 2016, the NSCH underwent a significant redesign which combined content from both the NSCH and the National Survey of Children with Special Health Care Needs (NS-CSHCN). Further information on that redesign can be found in “The Design and Implementation of the 2016 National Survey of Children’s Health”.
The NSCH is conducted as a household survey, and one child per household is selected to be the subject for the detailed age-specific questionnaire. The respondent to this questionnaire is a parent or guardian who is living in the home and has knowledge of the sampled child. Survey participants complete either web-based or self-administered paper-and-pencil questionnaires. Data from the NSCH is used for scientific research, federal policy and program development, and state-level planning and performance reporting. Information is collected on factors related to the health and well-being of children, including access to and utilization of health care, receipt of care in a medical home, systems of care for CSHCN, family interactions, parental health, school and after-school experiences, and neighborhood characteristics.
More information about the survey can be found in the “About the National Survey of Children's Health” section of this website and HRSA’s MCHB website.