Vital and Health Statistics. Series 2, Data Evaluation and Methods Research

Background Linking health survey data to administrative records expands the analytic utility of survey participant responses, but also creates the potential for new sources of bias when not all participants are eligible for linkage. Residual differences-bias-can occur between estimates made using the full survey sample and the subset eligible for linkage. Objective To assess linkage eligibility bias and provide examples of how bias may be reduced by changes in questionnaire design and adjustment of survey weights for linkage eligibility...

Over the past two decades, a steady decline in response rates on national face-to-face surveys has been documented, with steeper declines observed in recent years. The impact of nonresponse on survey estimates is inconsistent and depends on the correlation between response propensity and the survey estimates. To better understand the impact of declining response rates on the 2017-2018 National Health and Nutrition Examination Survey (NHANES), potential nonresponse bias (NRB) was investigated. NRB was assessed using three approaches: (a) studying variation within the respondent set; (b) benchmarking and comparisons to external data; and (c) comparing alternative weighting adjustments...

Background The purpose of the National Health and Nutrition Examination Survey (NHANES) is to produce national estimates representative of the total noninstitutionalized civilian U.S. population. The sample for NHANES is selected using a complex, four-stage sample design. NHANES sample weights are used by analysts to produce estimates of the health-related statistics that would have been obtained if the entire sampling frame (i.e., the noninstitutionalized civilian U.S. population) had been surveyed. Sampling errors should be calculated for all survey estimates to aid in determining their statistical reliability...

Objective This report compares five methods of waist circumference (WC) measurements: 1) the National Heart, Lung, and Blood Institute (NHLBI-WC); 2) the World Health Organization (WHO-WC); 3) the Multi-Ethnic Study of Atherosclerosis (MESA-WC) using Gulick II Plus tape; 4) the Multi-Ethnic Study of Atherosclerosis (MESA-WC) using Lufkin tape; and 5) assisted self-measurement over clothes (MESA-assisted). Method During 2016, measurements were obtained from 2,297 participants aged 20 and over, who participated in the National Health and Nutrition Examination Survey (NHANES)...

Statistically reliable, abridged, period life tables were produced for 88.7% of U.S. census tracts (65,662). A battery of tests revealed that the census-tract life table functions followed expected patterns; their distribution about state and U.S. values showed no aberrations; and their weighted mean values compared well with state- and national-level estimates. The weighted mean life expectancy at birth for the 65,662 census tracts was 78.7 years compared with the official U.S. estimate of 78.8 years in midyear 2013...

To describe methodological issues that arise in the construction and design-based estimation of multidimensional indices that aggregate state-specific inequalities in core health measures, using data from the National Health Interview Survey (NHIS).

Many reports present analyses of trends over time based on multiple years of data from National Center for Health Statistics (NCHS) surveys and the National Vital Statistics System (NVSS). Trend analyses of NCHS data involve analytic choices that can lead to different conclusions about the trends. This report discusses issues that should be considered when conducting a time trend analysis using NCHS data and presents guidelines for making trend analysis choices. Trend analysis issues discussed include: choosing the observed time points to include in the analysis, considerations for survey data and vital records data (record level and aggregated), a general approach for conducting trend analyses, assorted other analytic issues, and joinpoint regression...

Dietary recommendations are intended to be met based on dietary intake over long periods, as associations between diet and health result from habitual intake, not a single eating occasion or day of intake. Measuring usual intake directly is impractical for large population-based surveys due to the respondent burden associated with reporting habitual intake over longer periods. Therefore, analytical techniques were developed to estimate usual intake using as few as 2 days of 24-hour dietary recall data. With National Health and Nutrition Examination Survey (NHANES) data, this report demonstrates how to estimate usual intake using the National Cancer Institute (NCI)...

This report describes the methods used to create NHANES 2011-2014 sample weights and variance units for the public-use data files, including sample weights for selected subsamples, such as the fasting subsample. The impacts of sample design changes on estimation for NHANES 2011-2014 and the addition of the NHANES National Youth Fitness Survey (NNYFS) 2012 are described. Approaches that data users can employ to modify sample weights when combining survey cycles or when combining subsamples are also included.

Objective This report examines ways to improve National Ambulatory Medical Care Survey (NAMCS) data on practice and physician characteristics in multispecialty group practices. Methods From February to April 2013, the National Center for Health Statistics (NCHS) conducted a pilot study to observe the collection of the NAMCS physician interview information component in a large multispecialty group practice. Nine physicians were randomly sampled using standard NAMCS recruitment procedures; eight were eligible and agreed to participate...

The National Center for Health Statistics (NCHS) disseminates information on a broad range of health topics through diverse publications. These publications must rely on clear and transparent presentation standards that can be broadly and efficiently applied. Standards are particularly important for large, cross-cutting reports where estimates cannot be individually evaluated and indicators of precision cannot be included alongside the estimates. This report describes the NCHS Data Presentation Standards for Proportions...

The 2014 Native Hawaiian and Pacific Islander National Health Interview Survey (NHPI NHIS) is the first federal survey designed exclusively to measure the health of the noninstitutionalized civilian NHPI population of the United States.

Background California is the most populated state and Los Angeles County is the most populated county in the United States. National Health and Nutrition Examination Survey (NHANES) sample weights and variance units were developed for these places to obtain subnational estimates. Objective This report describes the California and Los Angeles County NHANES 1999-2006 and 2007-2014 samples, including the creation of the sample weights and variance units and descriptions of the resulting data files. Some analytic guidelines are provided...

Objectives This report presents the findings of an updated study of the validity of race and Hispanic-origin reporting on death certificates in the United States, and its impact on race- and Hispanic origin-specific death rates. Methods The latest version of the National Longitudinal Mortality Study (NLMS) was used to evaluate the classification of race and Hispanic origin on death certificates for deaths occurring in 1999–2011 to decedents in NLMS. To evaluate change over time, these results were compared with those of a study based on an earlier version of NLMS that evaluated the quality of race and ethnicity classification on death certificates for 1979–1989 and 1990–1998...

BACKGROUND: The National Ambulatory Medical Care Survey (NAMCS) is an annual, nationally representative sample survey of physicians and of visits to physicians. Two major changes were made to the 2012 NAMCS to support reliable state estimates. The sampling design changed from an area sample to a fivefold-larger list sample of physicians stratified by the nine U.S. Census Bureau divisions and 34 states. At the same time, the data collection mode changed from paper forms to laptop-assisted data collection and from physician or office staff abstraction of medical records to predominantly Census interviewer abstraction using automated Patient Record Forms (PRFs)...

BACKGROUND: The National Health and Nutrition Examination Survey's 9NHANES) biospecimena program was formed to manage the collection of biospecimena (including serum, plasma, urine, and DNA) from NHANES cycles, the storage of biospecimens in NHANES biospecimens, accessing of biospecimens by researchers and the providing of resulting data to future researchers. Data from biospeceimen research can be combined with existing NHANES data. OBJECTIVE: This report provides background on the development of NHANES biorepositories and describes the collection, processing, and storing of biospecimens; ethical considerations and informed consent; and the proposal process for accessing biospecimens and resulting data...

Objective-This report presents a set of quality analyses of sexual orientation data collected in the 2013 National Health Interview Survey (NHIS). NHIS sexual orientation estimates are compared with those from the National Survey of Family Growth (NSFG) and the National Health and Nutrition Examination Survey (NHANES). Selected health outcomes by sexual orientation are compared between NHIS and NSFG. Assessments of item nonresponse, item response times, and responses to follow-up questions to the sexual orientation question are also presented...

BACKGROUND: The National Health and Nutrition Examination Survey's (NHANES) National Youth Fitness Survey (NNYFS) was conducted in 2012 by the Centers for Disease Control and Prevention's National Center for Health Statistics (NCHS). NNYFS collected data on physical activity and fitness levels to evaluate the health and fitness of children aged 3-15 in the United States. The survey comprised three levels of data collection: a household screening interview (or screener), an in-home personal interview, and a physical examination...

BACKGROUND: National survey data linked with state cancer registry data has the potential to create a valuable tool for cancer prevention and control research. A pilot project-developed in a collaboration of the Centers for Disease Control and Prevention's National Center for Health Statistics (NCHS) and the Florida Cancer Data System (FCDS) at the University of Miami -links the records of the 1986-2009 National Health Interview Survey (NHIS) and the 1981-2010 FCDS. The project assesses the feasibility of performing a record linkage between NCHS survey data and a state-based cancer registry, as well as the value of the data produced...

OBJECTIVES: This report details development of the 2013 National Center for Health Statistics' (NCHS) Urban-Rural Classification Scheme for Counties (update of the 2006 NCHS scheme) and applies it to health measures to demonstrate urban-rural health differences. METHODS: The methodology used to construct the 2013 NCHS scheme was the same as that used for the 2006 NCHS scheme, but 2010 census-based data were used rather than 2000 census-based data. All U.S. counties and county-equivalent entities are assigned to one of six levels (four metropolitan and two nonmetropolitan) based on: 1) their February 2013 Office of Management and Budget designation as metropolitan, micropolitan, or noncore; 2) for metropolitan counties, the population size of the metropolitan statistical area (MSA) to which they belong; and 3) for counties in MSAs of 1 million or more, the location of principal city populations within the MSA...