Survey Results

Survey Items: Survey instrument item number for children 0-5 years: E1,E3,E4; for children 6-11 years: E1,E3,E4; for children 12-17 years: E1,E3,E4
Variable in public use data file: INSGAP (derived)

Denominator: Children age 0-17 years

Numerator: Children who have had continuous health insurance coverage during the past 12 months; Children who did not have health insurance or had periods of no coverage during the past 12 months

Revisions and Changes: In 2017, this measure did not change from the 2016 NSCH.
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, a question whether the child was currently insured was asked first. This was followed by a question about whether the child had periods with no insurance coverage. Children with gaps in their health insurance coverage were defined by combining responses to whether the child currently had health insurance coverage (K3Q01) and whether currently insured children had periods with no insurance (K3Q03) but did take into account the type of insurance. In the 2016 and 2017 NSCH, those children with only Indian Health Service or health care sharing ministry were set to missing (considered not to be currently insured).

Additional Notes: This measure is derived using the constructed variable INSGAP variable provided in both the 2016 and 2017 NSCH public use data files. The INSGAP variable was constructed from three questions: whether the child was covered by any kind of health insurance during the past 12 months (K3Q04_R), whether the child was covered with any health insurance at the time of the survey (CURRCOV), and type of insurance coverage. This measure combines the following responses to INSGAP: "Yes child had any kind of insurance, but had a gap in coverage" and "No, child did not have any insurance during the past 12 months", as “child did not have continuous coverage during the past 12 months”. It is important to note that consistency of the coverage was considered as missing if the child was currently insured but the type of coverage was ONLY Indian Health Service or health care sharing ministry.

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.