Survey Results

Survey Items: Survey instrument item number for children 0-5 years: E1,E3,E5,E6,E7,F1,F2; for children 6-11 years: E1,E3,E5,E6,E7,F1,F2; for children 12-17 years: E1,E3,E5,E6,E7,F1,F2
Variable name in public use data file: CURRINS (derived); INSGAP (derived); K3Q20; K3Q21B; K3Q22; HOWMUCH

Denominator: Children age 0-17 years

Numerator: Children, ages 0 through 17, who were reported to be continuously insured in the past year with adequate coverage

Revisions and Changes: In 2017, this measure did not change from the 2016 NSCH.
Due to changes in the survey’s mode of data collection and sampling frame, as well as adjustments to item wording for the NSCH, results from surveys prior to 2016 are not directly comparable and should not be used to conduct trend analyses. In 2011/12 NSCH, the denominator of this measure was restricted to those with current insurance and did not require reporting of consistent coverage. In 2016-2017, the measure included all children, and children who are uninsured or who had any gap in coverage during the past year are coded as lacking continuous and adequate coverage. For more information on content changes, click here .

Additional Notes: To qualify this measure the child should meet the following two criteria: 1) having continuous insurance in the past 12 months, and 2) having current insurance which is adequate for the child’s healthcare needs. The measure is only considered missing if both items are missing. Therefore, children with a valid, positive response to either portion of the measure and missing to the other portion are categorized as having adequate and continuous insurance.
In NSCH, survey item (K3Q04_R) asked whether the child was continuously insured during the past 12 months. If the child was not continuously insured, a question asked whether the child was currently covered by any health insurance. The child’s current insurance was considered adequate when the following criteria were met: 1) the child currently has health insurance coverage, AND 2) benefits usually or always meet child's needs, AND 3) the insurance usually or always allows the child to see needed providers, AND 4) the insurance either has no out-of-pocket expenses or out-of-pocket expenses are usually or always reasonable.

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:
Overview of the Title V Block Grant
The Title V Maternal and Child Health (MCH) Services Block Grant Program operates as a federal-state partnership in 59 states and jurisdictions to improve the health and well-being of MCH populations through the development of public health systems of care which are family-centered, community-based and culturally appropriate. To improve accountability and to more clearly demonstrate the impact of the Title V Block Grant Program, an updated national performance measure framework was introduced in 2015. This three-tiered framework includes National Outcome Measures (NOMs), National Performance Measures (NPM) and state-initiated Evidence-Based or –Informed Strategy Measures (ESMs). Updates to the Application/Annual Report Guidance released by HRSA in December 2017 retained the performance measure framework, but allowed greater flexibility for states in selecting national and state performance measures that align with their individual MCH priority needs. More information about the block grant can be obtained at the MCHB website.

About NSCH
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 address-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.