Age-Related Subpopulations

In addition to gaps in the measurement of the health of subpopulations defined by current health and social adversity, there are also gaps associated with age and development, particularly a lack of data related to the middle childhood years. While the NHIS, NHANES, and other national data collection efforts include data on all children, sample size and response burden issues usually preclude the kind of detailed information that is necessary to assess the health of children relative to their developmental age and stage or membership in particular subgroup populations. The NHIS contains a few questions specific to young children, school-age children, and adolescents, and the new MCHB-sponsored NSCH will provide a few more questions relevant to age and developmental stage questions. However, neither of these surveys provides the information needed to develop a comprehensive picture of the health of young children, to better understand the role of various risk and protective factors during early childhood, to assess their access to personal or public health services, or to measure the impact of health care on health. Until the NSECH was piloted, there had not been a data collection effort targeted on the health, health care content, quality of health care, or home health behaviors of families with young children. Since the NSECH is not a part of the regular national survey series, there is no guarantee that there will be ongoing collection of such relevant early childhood health data (Halfon, Olson, Inkelas et al., 2002). Similarly, while there has been recent emphasis on the importance of early childhood and the first 5 years of life as well as considerable focus on adolescents, there has not been the same kind of focus on middle childhood. Relative to adolescents and early childhood, this is a vastly ignored developmental period with regard to the collection of information on health and health influences. Ongoing monitoring of health risk through state administration of the YRBS provides some information on health, although only for those ages 12 to 17 (Brown, 2001).

Addressing the Need for Data on Functioning and Positive Aspects of Health

Standard surveys often ask about whether children are limited in the amount of play (for children under 5 years), or school they experience, but there are few other assessments of their overall functioning. Since many children with even severe impairments are able to play, and most are able to attend school, especially under current policies, this is only a gross estimate of their overall functioning. There are currently few other attempts to assess the overall functioning of children on a population basis, in part because of the relative paucity of measures available to assess functioning, and in part because many of the existing measures require the administration of multi-item questionnaires or other assessments. More work is needed in developing tools that are efficient and valid in this domain.

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