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Survey Items: Survey instrument item number for children 0-5 years: E4; for children 6-11 years: E4; for children 12-17 years: E4 Variable in public use data file: INSTYPE (derived)
Denominator: Children age 0-17 years
Numerator: Children with only public health insurance; Children with only private health insurance; Children with public and private health insurance; Children whose insurance coverage type is unknown; Children with no current insurance coverage
Revisions and Changes: In 2017, this measure did not change from the 2016 NSCH. In 2017, the category “Insured, type unknown” was dropped from INSTYPE derived variable. Due to changes in the administration and sampling for the NSCH, results from surveys prior to 2016 are not directly comparable and should not be used to conduct trend analyses. In the 2011/12 NSCH, public insurance was defined as "Medicaid or the State Children's Health Insurance Program, SCHIP" -- and named the Medicaid and/or SCHIP programs within the state the child resided in. Children who were insured but did not have public insurance were coded as having private insurance coverage. In the 2016 and 2017 NSCH, parents who indicated that their child is currently covered by any kind of health insurance/coverage were able to select the type of insurance from a list, with an open-ended field for “other insurance type”. Responses to the open-ended field were recoded to “other public insurance”, “other private insurance”, “coverage through the Affordable Care Act” and a “religious health share”. These recoded types of health insurance coverage were grouped into existent insurance categories when appropriate.
Additional Notes: This measure was derived using the constructed INSTYPE variable provided in both the 2016 and 2017 NSCH public use data file. The INSTYPE variable was constructed from two questions: whether the child was currently insured (CURRCOV); and the child’s type of insurance. “Public insurance” is defined as "Medicaid, Medical Assistance, or any kind of government assistance plan for those with low incomes or a disability." Private insurance is defined as "Insurance through a current or former employer or union", "Insurance purchased directly from an insurance company", or “TRICARE or other military health care” or coverage through the Affordable Care Act or other private insurance. Children identified as only having Indian Health Services or a religious health share as an insurance type were considered to have “no current insurance coverage".
Treatment of Unknown Values: Missing values due to non-response or a “don’t know” response are not included in the denominator when calculating prevalence estimates and weighted population counts displayed in the 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.). If missing cases are handled in any other way, details can be found in the "Additional notes" section above.
History and Development: The Health Resources and Services Administration’s (HRSA) Maternal and Child Health Bureau (MCHB) funds and directs the National Survey of Children’s Health (NSCH), and 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. The U.S. Census Bureau conducts the survey, oversees the sampling, and produces a final data set of survey results. Respondents’ cognitive understanding of the survey questions was assessed during the pretest phase of the survey redesign and reassessed after the 2016 survey; subsequent revisions were made. Previously validated questions and scales are used when available. The manuscript “The Design and Implementation of the 2016 National Survey of Children’s Health”, provides detailed information about the redesign of the NSCH, administration of the first redesigned survey (2016), and the sampling and administration changes for the 2017 NSCH. Prior to 2016, the NSCH and the National Survey of Children with Special Health Care Needs were each conducted three times as interviewer-assisted telephone surveys using random digit dial sampling. In 2016, the two surveys were combined into a single annual self-administered questionnaire. Due to decline in the number of households with landline telephones, the NSCH now utilizes an addressed based sampling method to select participating households, thus all invitations are sent by mail. Participants may choose to complete the survey either online using a secure website or a mailed paper version of the survey. All final data components are verified by the Census Bureau, HRSA/MCHB and CAHMI/DRC staff prior to public release. 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.
Indicator 3.3: What type of health insurance coverage, if any, did the child have at the time of the survey?
Notes: Click on the Column Header to sort the results by ascending or descending order. To get a detailed explanation of the data HOVER over the text in the table.
Select a Response Category: Public health insurance only Private health insurance only Public and private insurance Currently uninsured
Required citation: Child and Adolescent Health Measurement Initiative. 2016-2017 National Survey of Children’s Health (NSCH) data query. Data Resource Center for Child and Adolescent Health supported by Cooperative Agreement U59MC27866 from the U.S. Department of Health and Human Services, Health Resources and Services Administration’s Maternal and Child Health Bureau (HRSA MCHB). Retrieved [mm/dd/yy] from www.childhealthdata.org. CAHMI: www.cahmi.org.