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2018 Questionnaire Redesign

The content and structure of the National Health Interview Survey (NHIS) will be updated in 2018 to better meet the needs of data users. Aims of the redesign are to improve the measurement of covered health topics, to reduce respondent burden by shortening the length of the questionnaire, to harmonize overlapping content with other federal health surveys, to establish a long-term structure of ongoing and periodic topics, and to incorporate advances in survey methodology and measurement.

In general, topics under consideration for NHIS must meet the following criteria: (1) be relevant to monitoring public health, (2) be measured in a manner consistent with other federal health surveys, and (3) be a content area that can be accurately measured with the survey methods used.

Content areas with relevance to monitoring public health include:

  • Leading causes of morbidity/mortality
  • Health insurance coverage
  • Health care access and utilization
  • Targets of major federal health promotion initiatives
  • Behavioral risk or protective factors for the above relevant content areas
  • Other factors that identify populations most at risk for or protected from the above relevant content areas (e.g., family income)
  • Intermediate health outcomes for the above relevant content areas

A measure was considered to be consistent with other federal health surveys if the measure on NHIS is used by other surveys for calibration; the measure is consistent with another federal survey when that other survey is the data source for monitoring progress towards national objectives; and the measure does not duplicate the detail collected in targeted federal health surveys. Furthermore, the measure needed to have reasonable accuracy in a cross-sectional sample design using self-report and face-to-face interviews.

In 2014 and 2015, NCHS conducted multiple waves of information gathering and outreach with survey sponsors and agency partners. In October 2015, the first call for public comment was released. In late 2015, the redesigned NHIS structure and lists of topics for consideration were developed. After completing the first phase of content review and engagement with data users and partners, we determined the following will be features of the new design:

  • Questions will focus on the health of one sample adult and one sample child per household.
  • Information about other individuals in the household will be limited to that which is needed for selection of the sample adult and sample child and for weighting (age, sex, race, armed forces status).
  • A fixed core questionnaire will be used for the sample adult and sample child annually. Additional core areas will rotate on and off the questionnaire with a pre-established periodicity.
  • Content sponsored by federal partners (which may be as short as one question or comprise a battery of topically-related questions) will be limited to no more than 5 minutes per year on a given topic.

In February 2016, another wave of outreach to gather public comment was launched, with specific calls for comment on the proposed list of topics for the sample adult.  A detailed outline of topics under consideration for the sample adult interview [PDF - 226 KB] can be downloaded.

NCHS staff are reviewing and considering each of the comments received during the most recent public comment period. During this call for comments, we received a number of form letters that raise general concern about the proposed change in structure. These letters emphasize that important demographic and socioeconomic data currently collected in the family questionnaire would no longer be available. While it is impossible to substantially reduce the length of the interview without cutting any content, many of the topics found in the current family questionnaire will still be collected in the redesigned sample adult and sample child questionnaires. A page on the Impact of the Proposed NHIS Redesign on Family Questionnaire Content has more detail on how existing family-level content will (or will not) change in the redesign. A page on the Proposed Elimination of the Family Questionnaire has more detail specifically related to the collection of data on family context, health insurance, and health disparities in the redesigned survey.

The next version of the adult questionnaire and the first outline of the child questionnaire will be available at this website in the spring. A listserv announcement will be made when the materials are ready for comment. Please join the NHIS listserv for this notification.

If you have questions or comments about the NHIS redesign, you may send an email.