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Children's Health, the Nation's Wealth: Assessing and Improving Child Health (2004)

Chapter: Appendix B: Gaps Analysis of Measures of Children's Health and Influences on Children's Health in Select National Surveys

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Suggested Citation:"Appendix B: Gaps Analysis of Measures of Children's Health and Influences on Children's Health in Select National Surveys." National Research Council and Institute of Medicine. 2004. Children's Health, the Nation's Wealth: Assessing and Improving Child Health. Washington, DC: The National Academies Press. doi: 10.17226/10886.
×

Appendix B
Gaps Analysis of Measures of Children’s Health and Influences on Children’s Health in Select National Surveys

INTRODUCTION AND PURPOSE

This appendix examines selected national surveys to assess the current status of children’s health measurement and monitoring at the national level. This review is intended to inform an assessment of the current national approaches to measuring children’s health using survey methods. We examined 12 national surveys that collect information on children’s health and both its social and medical influences. Specifically, we gathered data on the design and reach of the surveys (Table B-1) and on the following aspects of child health:

  • Health conditions (Table B-2)

  • Children’s health status, functioning, and health potential (Table B-3)

  • Influences on children’s health (Table B-4)

The surveys that we reviewed encompass the vast majority of large, nationally representative, and publicly available efforts to collect information about children’s health and the individual, social, economic, and medical care influences of health as defined broadly. The review incorporates both public and private initiatives; one-time and ongoing surveys (only the most current version); longitudinal and cross-sectional designs; and surveys focusing on different child age groups. While many other nationally representative studies have been conducted by individual researchers and organizations, most of these are not publicly available and are limited to very narrow topics, making them less useful for monitoring national child health issues over the long term. While these surveys or data collec-

Suggested Citation:"Appendix B: Gaps Analysis of Measures of Children's Health and Influences on Children's Health in Select National Surveys." National Research Council and Institute of Medicine. 2004. Children's Health, the Nation's Wealth: Assessing and Improving Child Health. Washington, DC: The National Academies Press. doi: 10.17226/10886.
×

tion systems are important sources of child health information, they are not comprehensive enough to allow for detailed examination of patterns, trends, and disparities in health.

The surveys are ordered from left to right according to the design and frequency of the survey. Organized from left to right are ongoing cross-sectional national surveys of children’s health, followed by shorter duration or paneled longitudinal design surveys, and then small one-time specialty surveys. For each survey, we summarize key aspects of the design, including the frequency, origin date, sponsor, research design, sample size, age-group focus, and respondent (Table B-1). We then review, in Tables B-2 through B-4, the child health measures and influences on child health. Each child health topic is coded with a somewhat arbitrary system that indicates whether the topic is measured “comprehensively” (defined as three or more questions), “adequately” (defined as one or two questions), through a biological or physical mechanism (e.g., blood test), using data from a birth certificate, or not at all. The variables examined in the tables are organized and correspond with the structure of the report. Note: Some questions included in the tables (e.g., MEPS) are asked only of specific age groups (e.g., ages 5-17).

SUMMARY RESULTS OF THE REVIEW

The review identifies patterns of health topics that are commonly covered in national health surveys as well as gaps in which topics have rarely or never been addressed. We discuss the results with respect to whether the survey was a one-time endeavor or an ongoing initiative in order to analyze the consistency of data on specific topics. We also briefly discuss the measurement of race and ethnicity across surveys because of the national focus on eliminating racial and ethnic disparities in health.

Measurement of Children’s Health Conditions

Many of the national surveys ask parents to report on specific health conditions that are common among children and adolescents. The most common conditions are asthma, mental disorders (measured broadly), infectious diseases, pregnancy among teens, and child injuries. These conditions, however, were measured in no more than half of all the surveys. While the National Health Interview Survey (NHIS) and the National Health and Nutrition Examination Survey (NHANES) assess the greatest breadth of conditions, NHANES collects the most comprehensive and detailed information on specific conditions. Because NHANES collects biological samples from children (usually a blood test) to assess the presence of certain conditions, it also has the potential to collect things such as biomarkers.

Despite the comprehensiveness of NHIS and NHANES, there remain some gaps in the measurement of children’s health conditions across surveys. Among

Suggested Citation:"Appendix B: Gaps Analysis of Measures of Children's Health and Influences on Children's Health in Select National Surveys." National Research Council and Institute of Medicine. 2004. Children's Health, the Nation's Wealth: Assessing and Improving Child Health. Washington, DC: The National Academies Press. doi: 10.17226/10886.
×

the newer morbidities are mental health conditions such as Attention Deficit Disorder and Attention Deficit Hyperactivity Disorder (ADD/ADHD) and depression, and these conditions (though commonly diagnosed) are usually not included in national surveys of child health. Difficulty in identifying and measuring these conditions (beyond parent report of diagnosis) is likely to be a barrier to more frequent inclusion in large national surveys. Screening for the presence of a condition, such as depression or ADHD, often involves the use of 10 or more questions, which can take up a relatively large amount of scarce interview time. There are other nonsurvey data sources, however, that exist for monitoring child health conditions, including the annual National Ambulatory Medical Care Survey that collects data from medical offices about patient symptoms, diagnoses, and ambulatory care provided.

Measures of Child Health Status, Functioning, and Health Potential

Nearly every national survey assesses some aspect of a child’s physical health. The majority of the measures currently in national surveys relate to aspects of physical functioning and impairments or deficits in mobility, ability to do usual activities, or more specific deficits in hearing, vision, or speech. Some more recent surveys have tended to adopt broader perspectives on children’s health, evaluating aspects of cognitive, emotional, and even social functioning. The broader perspective of what constitutes health is not routinely included in ongoing surveys but is rather the focus of more detailed and topic-specific one-time surveys.

The largest apparent gaps in the assessment of children’s health are in the evaluation of health potential (or rather more positive aspects of development and functioning). While many surveys asked about impairments in functioning, only a handful of one-time studies actually incorporated questions about positive developmental and functional trajectories, such as positive personal affect or self-sufficiency. Refined understandings of health and well-being recognize that health is more than merely the absence of illness, although this is yet to be reflected in ongoing national surveys of children’s health.

Measures of Family and Community Influences on Health

National surveys of child health have made tremendous steps in recognizing the importance of family determinants on child development. Nearly every survey measures race and ethnicity and some aspect of socioeconomic status (most commonly income and education) of the family. Many of the one-time special surveys have also recognized the contribution of family composition to children’s health and the threats to development that are potentially associated with family disruptions (such as divorce), parent health status, and aspects of parenting (such as discipline and providing rich learning environments). Of particular interest is the recent attention given to the role of child care (both formal and informal) in

Suggested Citation:"Appendix B: Gaps Analysis of Measures of Children's Health and Influences on Children's Health in Select National Surveys." National Research Council and Institute of Medicine. 2004. Children's Health, the Nation's Wealth: Assessing and Improving Child Health. Washington, DC: The National Academies Press. doi: 10.17226/10886.
×

national surveys. For example, the Early Childhood Longitudinal Study—Birth Cohort (ECLS-B) not only asks a series of questions to parents about their child care needs and beliefs, but also interviews the care providers and directors of the child care centers themselves. Interestingly, the ECLS-B also incorporates direct observation of child care practices to assess the quality of care that is provided.

While substantial progress has been made with the evaluation of family influences on health, few national surveys incorporate questions about community factors that may influence children’s health and development. Add Health is one of the few surveys to ask questions about community socioeconomic level, community unemployment rates, physical safety in the community (e.g., school and housing safety), and aspects of the social organization of the neighborhood (e.g., social cohesion, diversity, and social networks). Uniquely, Add Health further incorporates the use of direct observation of neighborhoods to note the safety of the neighborhood, housing adequacy, and other factors. While these community factors are increasingly known to influence children’s health, they are rarely included in ongoing national surveys.

Measurement of Health System Influences on Health

National surveys of child health also frequently assess the influences of health systems on children’s health and development, most often incorporating measures of access to care and health service use. Ongoing surveys also seem to focus on childhood immunizations in order to support national efforts to monitor children’s immunization status. Health insurance is covered in all but three of the surveys.

Measures of quality of health care, particularly those examining more qualitative aspects of care (e.g., patient-provider interpersonal factors), are underrepresented in the ongoing national surveys. Coordination of care is nearly non-existent in the surveys, with the exception of the National Survey of Children with Special Health Care Needs, which examines experiences of children with special health care needs. Relatively little information is provided on the content of care, particularly the receipt of childhood preventive services other than immunizations. The National Survey of Early Childhood Health (NSECH) comprehensively asks parents about preventive services they have received, and uniquely ascertains whether the parents who did not receive the services would have found them helpful. This allows for some analyses of missed opportunities to provide needed preventive care. The NSECH is a one-time endeavor, but it may serve as a model for incorporation of preventive care questions into ongoing national surveys.

CONCLUSION AND FUTURE CONSIDERATIONS

When considered together, this collection of national surveys covers a very large number of domains of children’s health and many family, community, and

Suggested Citation:"Appendix B: Gaps Analysis of Measures of Children's Health and Influences on Children's Health in Select National Surveys." National Research Council and Institute of Medicine. 2004. Children's Health, the Nation's Wealth: Assessing and Improving Child Health. Washington, DC: The National Academies Press. doi: 10.17226/10886.
×

medical influences on their health and development. When considered individually (because information from across surveys can rarely be combined), there remain substantial gaps in what is measured for children, particularly regarding positive functioning or health potential for children, family, or parenting processes, neighborhood and community influences, and aspects of health care quality. Moreover, with the exception of preventive care, there is almost no attempt to tailor measures to appropriate age groups or make them age-specific.

While recurrent surveys such as NHIS are well established and structured to routinely collect standard information about child health, their established nature makes them somewhat resistant to change other than through special supplements. The NHANES is, perhaps, one exception because it already collects biological samples from children, and these could be used to easily screen for additional biomarkers. Despite these gaps in measurement, a number of one-time surveys have successfully collected data on measures at the forefront of children’s health issues. Collection of these data not only demonstrates that these issues can be successfully measured, but also serves as a testing ground for the validity and reliability of the measures, easing their transition into other ongoing national surveys.

Suggested Citation:"Appendix B: Gaps Analysis of Measures of Children's Health and Influences on Children's Health in Select National Surveys." National Research Council and Institute of Medicine. 2004. Children's Health, the Nation's Wealth: Assessing and Improving Child Health. Washington, DC: The National Academies Press. doi: 10.17226/10886.
×



TABLES B-1 THROUGH B-4 FOLLOW

Suggested Citation:"Appendix B: Gaps Analysis of Measures of Children's Health and Influences on Children's Health in Select National Surveys." National Research Council and Institute of Medicine. 2004. Children's Health, the Nation's Wealth: Assessing and Improving Child Health. Washington, DC: The National Academies Press. doi: 10.17226/10886.
×

TABLE B-1 Descriptive Characteristics of 12 National Surveys of Children’s Health

Descriptive Characteristics

NHIS

NHANES

MEPSa

YRBS

NLSYb

Add Health

Year

2002

1994–2004

2002

2003

1997

2001–2002

Origination

1957

1971

1996

1991

1997

1994–1995

Sponsor(s)

NCHS/ CDC

NCHS/ CDC

AHRQ

NCHS/ CDC

DOL

NICHD

Frequency

Annual

Annual since 1999

Annual

2 years

Various

3 waves, 1 and 6 years

Design

CS

CS

CS panels

CS

L

L

Sample size

N = 12,524; 26,191 children in person file

N = 5085 <20 years, 4,880 adults

N = 11,500 children/ year

N = 13,000 adolescents

N = 8,984 adolescents

N = 20,745 adolescents

Age group

All ages

All ages

<18 years

14–17 years

12–16 years

<18 years

Respondent

Adult

Adult

Household respondent

Adolescent

Adolescent and adult

Adolescent and adult

NHIS = National Health Interview Survey; NHANES = National Health and Nutrition Examination Survey; MEPS = Medical Expenditure Panel Survey; YRBS = Youth Risk Behavior Survey; NLSY = National Longitudinal Survey of Youth; Add Health = National Longitudinal Survey of Adolescent Health; NSFH = National Survey of Families and Households; ECLS-K = Early Childhood Longitudinal Study Kindergarten Class; ECLS-B = Early Childhood Longitudinal Study-Birth Cohort; NHES = National Household Education Surveys; NSECH = National Survey of Early Childhood Health; NSCSHCN = National Survey of Children with Special Health Care Needs

Suggested Citation:"Appendix B: Gaps Analysis of Measures of Children's Health and Influences on Children's Health in Select National Surveys." National Research Council and Institute of Medicine. 2004. Children's Health, the Nation's Wealth: Assessing and Improving Child Health. Washington, DC: The National Academies Press. doi: 10.17226/10886.
×

NSFH

ECLS-K

ECLS-B

NHES

NSECH

NS-CSHCN

2001–2002

2002

2001

2003

2000

2000–2002

1987–1988

1998–1999

2001

1991

2000

2000–2002

NICHD/ NIA

NCES

NCES

NCES

CDC/AAP

MCHB

3 waves: 5 and 8 years

Fall and Spring K and 1st. Spring 3rd and 5th.

5 waves: 9 months to 6 years

Approx. every 2 years

One time

One time

L

L

L

CS

CS

CS

N = 2,500 children

N = 22,000 children

N = 10,700 children

Varies: N = 7,000–

N = 2,068 children

N = 37,500 children

 

22,000

 

 

 

 

<18 years

5–10 years

9 months to 6 years

Varies: but always includes <18 years

4–35 months

<18 years

Child and adult

Adult, child, school records

Adult, child, child care provider, observation, and birth certificate

Adult and adolescent

Adult

Adult

CS = Cross-sectional study design

L = Longitudinal study design

aPrior to 1996, the MEPS was conducted in 1977 and 1987.

bThe NSLY was started in 1979 with an original cohort of 12,686 children ages 14–22 that was interviewed annually until 1994. In this review, we focus only on a more recent and separate NSLY cohort study that began in 1997.

Suggested Citation:"Appendix B: Gaps Analysis of Measures of Children's Health and Influences on Children's Health in Select National Surveys." National Research Council and Institute of Medicine. 2004. Children's Health, the Nation's Wealth: Assessing and Improving Child Health. Washington, DC: The National Academies Press. doi: 10.17226/10886.
×

TABLE B-2 Child Health Condition Categories (by ICD9 Code) with Selected Highlights

ICD9 Code

Health Conditions, Disorders, or Diseases

NHIS

NHANES

MEPS

001–139

Infectious and parasitic diseases

○●●

 

042: AIDS

 

 

 

079: Syphilis

 

○●

 

 

055: Measles

 

 

140–239

Neoplasms

 

●●

240–279

Endocrine, nutritional, metabolic

 

 

 

250: Diabetes mellitus

○●●

280–289

Blood and blood-forming organs

 

280: Iron-deficiency anemia

○●

 

 

984: Lead poisoning

 

○●

 

290–319

Mental disorders

●●

●●

●●

 

300: Depression

 

●●

 

314: ADD/ADHD

●●

 

315: Mental retardation

 

320–389

Nervous system & sense organs

●●

 

390–459

Circulatory system

 

460–519

Respiratory system

●●

●●

 

493: Asthma

●●

●●

520–579

Digestive system

 

521: Oral health (cavities, etc)

 

580–629

Genitourinary system

 

 

 

630–676

Pregnancy, childbirth, puerperium

 

○●

 

635: Abortion

 

 

 

680–709

Skin and subcutaneous tissue

○●●

710–739

Musculoskeletal/connective tissue

 

740–759

Congenital abnormalities

 

760–779

Conditions in perinatal period

 

 

 

 

765: Low birthweight

 

 

765: Very low birthweight

 

780–799

Symptoms/ill-defined conditions

 

800–999

Injury and poisoning

 

 

995: Child abuse

 

 

 

V01–V82

Supplemental influences on health

 

 

 

 

V22: Pregnancy

 

 

E800–E999

Supplemental injury, poisoning

 

 

 

E950–959: Suicide

 

 

 

 

Chronic condition (general measure)

 

 

 

NHIS = National Health Interview Survey; NHANES = National Health and Nutrition Examination Survey; MEPS = Medical Expenditure Panel Survey; YRBS = Youth Risk Behavior Survey; NLSY = National Longitudinal Survey of Youth; Add Health = National Longitudinal Survey of Adolescent Health; NSFH = National Survey of Families and Households; ECLS-K = Early Childhood Longitudinal Study Kindergarten Class; ECLS-B = Early Childhood Longitudinal Study-Birth Cohort; NHES = National Household Education Surveys; NSECH = National Survey of Early Childhood Health; NSCSHCN = National Survey of Children with Special Health Care Needs

Suggested Citation:"Appendix B: Gaps Analysis of Measures of Children's Health and Influences on Children's Health in Select National Surveys." National Research Council and Institute of Medicine. 2004. Children's Health, the Nation's Wealth: Assessing and Improving Child Health. Washington, DC: The National Academies Press. doi: 10.17226/10886.
×

YRBS

NLSY

Add Health

NSFH

ECLS-K

ECLS-B

NHES

NSECH

NS-CSHCN

 

 

 

 

 

 

 

 

 

●○

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

●●

 

 

 

 

 

 

 

 

 

 

 

 

●●

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

●●

 

bc

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

bc

 

 

 

 

 

 

 

bc

 

 

 

 

bc

 

 

 

 

bc

 

 

 

 

 

 

 

 

 

●●

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

●●

●● Construct is measured “comprehensively” (i.e., at least 3–4 questions used to gather information on a topic).

● Construct is measured “adequately” (i.e., only 1–2 questions used to gather information on a topic).

○ Construct is measured through a biological or physical mechanism (e.g., withdrawal of a blood sample or physical exam).

bc Construct is measured using data from birth certificates.

Suggested Citation:"Appendix B: Gaps Analysis of Measures of Children's Health and Influences on Children's Health in Select National Surveys." National Research Council and Institute of Medicine. 2004. Children's Health, the Nation's Wealth: Assessing and Improving Child Health. Washington, DC: The National Academies Press. doi: 10.17226/10886.
×

TABLE B-3 Child Health Status, Functioning, and Health Potential Measures

Health Measures

NHIS

NHANES

MEPS

I. Functioning

 

 

 

 

A. Physical functioning

 

 

 

1. Diseases

○●

 

 

2. Injuries

 

 

 

3. Impairments

 

 

 

 

Limitations in mobility

 

 

 

Impairments needing wheelchair, etc.

 

 

 

Gross and fine motor deficits

 

 

 

 

 

Hearing difficulty, deafness

 

●●

 

 

 

Vision difficulty, blindness

●●

○●

●●

 

 

 

Speech difficulty

 

 

 

 

 

Delays in growth or development

 

 

 

 

 

Measurement of height

 

 

 

 

Measurement of weight

●●

●●

 

 

 

Restriction of usual activities

●●

●●

●●

 

 

 

Limitations due to oral health

 

 

 

 

4. Symptoms

 

 

B. Psychological functioning

 

 

 

1. Cognitive functioning

 

 

 

 

Alertness problems

 

 

 

 

Confusion problems

 

●●

 

 

 

 

Inattentiveness

 

 

 

 

 

Concentration difficulty

 

 

 

 

 

Problem-solving deficits

 

 

 

 

Language use/comprehension deficits

 

 

 

 

Reading difficulty

 

 

 

 

Learning disability

●●

 

 

2. Emotional functioning

 

 

 

 

Limitations in usual activities

 

 

 

 

Attachment problems

 

 

 

 

Negative affect, mood, or depression

 

●●

 

 

 

Consideration of suicide

 

 

 

 

Infant temperament

 

 

 

 

Temperament problems

 

 

 

 

Anxious, nervous, or worrisome

 

 

 

 

Trouble with self-regulation

 

 

 

 

Poor self-esteem and self-perception

 

 

 

 

Negative body image

 

 

 

 

Self-sufficiency problems

 

 

 

 

Difficulty getting to sleep

 

 

 

C. Social functioning

 

 

 

 

Relational capacity deficits

 

 

 

 

Cooperation problems

 

 

 

 

 

Poor integration or connection

 

 

 

 

Conduct/delinquency problems

 

●●

 

 

 

 

Poor academic performance

 

 

 

 

School days missed

 

Suggested Citation:"Appendix B: Gaps Analysis of Measures of Children's Health and Influences on Children's Health in Select National Surveys." National Research Council and Institute of Medicine. 2004. Children's Health, the Nation's Wealth: Assessing and Improving Child Health. Washington, DC: The National Academies Press. doi: 10.17226/10886.
×

YRBS

NLSY

Add Health

NSFH

ECLS-K

ECLS-B

NHES

NSECH

NS-CSHCN

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

●●

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

●●

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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●●

 

 

 

 

 

 

 

 

 

 

 

 

●●

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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●●

 

 

 

 

 

 

 

●●

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●●

●●

●●

 

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●●

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Suggested Citation:"Appendix B: Gaps Analysis of Measures of Children's Health and Influences on Children's Health in Select National Surveys." National Research Council and Institute of Medicine. 2004. Children's Health, the Nation's Wealth: Assessing and Improving Child Health. Washington, DC: The National Academies Press. doi: 10.17226/10886.
×

Health Measures

NHIS

NHANES

MEPS

 

 

 

School drop out

 

 

II. Health potential

 

 

 

 

A. Physical well-being

 

 

 

 

 

 

Self-assessed physical health

 

 

 

 

Self-assessed oral health

 

 

 

 

 

Changes in physical health status

 

 

 

Gross and fine motor coordination

 

 

 

 

 

 

Positive growth or development

 

 

 

 

 

 

Participation in usual activities

 

 

 

 

 

Developmental milestones

 

 

 

 

B. Psychological well-being

 

 

 

 

 

1. Cognitive well-being

 

 

 

 

 

 

Intelligence (IQ)

 

 

 

 

 

 

Alertness

 

 

 

 

 

 

Attentiveness

 

 

 

 

 

 

Problem-solving ability

 

 

 

 

 

 

Language use/comprehension ability

 

 

 

 

 

 

Reading level or frequency

 

 

 

 

 

 

Task persistence

 

 

 

 

 

Curiosity

 

 

 

 

 

 

Creativity

 

 

 

 

 

2. Emotional well-being

 

 

 

 

 

 

Obedience/compliance

 

 

 

 

 

Self-assessed mental health status

 

 

 

 

 

Independence

 

 

 

 

 

 

Positive personal affect or mood

 

 

 

 

 

Positive temperament

 

 

 

 

 

Impulse control

 

 

 

 

 

 

Self-esteem and self-perception

 

 

 

 

 

 

Positive body image

 

 

 

 

 

 

Self-sufficiency

 

 

 

 

C. Social well-being

 

 

 

 

 

 

Relational capacity (parents, peers)

 

 

 

 

 

Cooperativeness

 

 

 

 

 

 

Integration/connection (e.g. sports)

 

 

 

 

 

School readiness

 

 

 

 

 

 

Academic performance

 

 

 

 

 

High school completion

 

 

 

 

 

College plans/admission

 

 

 

 

D. Resilience (e.g., seldom gets sick)

 

 

●●

NHIS = National Health Interview Survey; NHANES = National Health and Nutrition Examination Survey; MEPS = Medical Expenditure Panel Survey; YRBS = Youth Risk Behavior Survey; NLSY = National Longitudinal Survey of Youth; Add Health = National Longitudinal Survey of Adolescent Health; NSFH = National Survey of Families and Households; ECLS-K = Early Childhood Longitudinal Study Kindergarten Class; ECLS-B = Early Childhood Longitudinal Study-Birth Cohort; NHES = National Household Education Surveys; NSECH = National Survey of Early Childhood Health; NSCSHCN = National Survey of Children with Special Health Care Needs

Suggested Citation:"Appendix B: Gaps Analysis of Measures of Children's Health and Influences on Children's Health in Select National Surveys." National Research Council and Institute of Medicine. 2004. Children's Health, the Nation's Wealth: Assessing and Improving Child Health. Washington, DC: The National Academies Press. doi: 10.17226/10886.
×

YRBS

NLSY

Add Health

NSFH

ECLS-K

ECLS-B

NHES

NSECH

NS-CSHCN

 

●●

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

●●

 

 

 

 

 

 

 

 

 

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●●

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

●●

 

 

 

 

 

 

●●

 

 

●●

 

 

 

 

●●

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

●●

●●

 

 

 

 

 

 

●●

●●

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

●●

●●

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

●●

●●

●●

 

 

 

 

 

●●

 

 

 

 

 

 

●●

●●

●●

 

●●

 

 

 

 

 

 

●●

 

●●

 

 

●●

●●

●●

●●

 

●●

 

 

 

●●

●●

●●

 

 

 

 

 

 

●●

 

●●

 

 

●●

 

 

 

 

●●

 

 

 

 

 

 

●● Construct is measured “comprehensively” (i.e., at least 3–4 questions used to gather information on a topic).

● Construct is measured “adequately” (i.e., only 1–2 questions used to gather information on a topic).

○ Construct is measured through a biological or physical mechanism (e.g., withdrawal of a blood sample or physical exam).

bc Construct is measured using data from birth certificates.

Suggested Citation:"Appendix B: Gaps Analysis of Measures of Children's Health and Influences on Children's Health in Select National Surveys." National Research Council and Institute of Medicine. 2004. Children's Health, the Nation's Wealth: Assessing and Improving Child Health. Washington, DC: The National Academies Press. doi: 10.17226/10886.
×

TABLE B-4 Influences on Children’s Health

Health Measures

NHIS

NHANES

MEPS

I. Children’s biology

 

 

 

 

 

1. Genetics

 

 

 

 

 

2. Body burdens

 

 

 

 

 

3. Biomarkers

 

 

 

 

4. Body composition

 

○●

 

 

 

5. Body anthropometry

 

 

 

 

6. Cardiovascular fitness

 

 

 

 

7. Blood pressure

 

○●

 

II. Children’s behavior

 

 

 

 

 

1. Child social behaviors

 

 

 

 

 

 

Peer contacts and support networks

 

 

 

 

 

 

Romantic relationships

 

 

 

 

 

 

Peer pressures/influences

 

 

 

 

 

 

Employment/volunteering

 

 

 

 

 

Civic involvement

 

 

 

 

 

2. Child health risk behaviors

 

 

 

 

 

 

Smoking/chewing tobacco

 

○●●

 

 

 

 

Alcohol use/riding drunk

 

●●

 

 

 

 

Drug use

 

●●

 

 

 

 

Overeating/undereating/dieting

 

●●

 

 

 

 

Excessive television watching

 

●●

 

 

 

 

High-risk sexual activity

 

●●

 

 

 

 

Carrying a weapon to school

 

 

 

 

 

 

Perceptions of risk

 

 

 

 

 

3. Child health promotion behaviors

 

 

 

 

 

 

Seat belt use

 

 

 

 

 

Exercise frequency/intensity

 

●●

 

 

 

 

Nutrition adequacy

 

●●○

 

 

 

 

Getting adequate sleep

 

 

 

 

 

 

Sunscreen use

 

●●

 

 

 

 

Use of bicycle/motorcycle helmets

 

 

 

 

 

 

Eye protection during sports

●(periodic)

 

 

 

 

4. Illness management behaviors

 

 

 

 

 

 

Belief in medical care

 

 

 

 

 

 

Compliance with treatments

 

 

 

 

 

 

Attendance of scheduled visits

 

 

 

 

 

 

Parent receipt of health education

 

 

 

 

 

 

Child receipt of health education

 

 

 

III. Social environment

 

 

 

 

A. Family

 

 

 

 

 

1. Family composition and size

 

 

 

 

 

 

Single vs. two-parent families

 

 

 

 

Family disruption (e.g., divorce)

 

 

 

 

Maternal age (e.g., teen birth)

 

 

 

 

 

Foster care/guardian

 

 

 

 

Number/spacing of children

 

 

 

 

 

 

Relocation and mobility

 

 

Suggested Citation:"Appendix B: Gaps Analysis of Measures of Children's Health and Influences on Children's Health in Select National Surveys." National Research Council and Institute of Medicine. 2004. Children's Health, the Nation's Wealth: Assessing and Improving Child Health. Washington, DC: The National Academies Press. doi: 10.17226/10886.
×

YRBS

NLSY

Add Health

NSFH

ECLS-K

ECLS-B

NHES

NSECH

NS-CSHCN

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

●●

●●

●●

 

 

 

 

 

●●

●●

●●

 

 

 

 

 

 

●●

●●

 

 

●●

 

 

 

●●

●●

●●

 

 

●●

 

 

 

 

●●

 

 

 

●●

 

 

●●

●●

●●

 

 

 

 

 

●●

●●

●●

 

 

 

 

 

●●

●●

●●

 

 

 

 

 

 

●●

●●

 

 

 

 

 

●●

●●

 

●●

●●

 

●●

●●

●●

 

 

 

 

 

●●

●●

 

 

 

 

 

 

 

●●

●●

 

 

 

 

 

 

 

 

 

 

 

 

●●

●●

●●

 

●●

 

 

 

 

●●

●●

 

 

 

 

 

●●

 

 

 

 

 

 

 

 

●●

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

●●

 

 

●●

 

 

 

 

 

 

 

●●

●●

●●

●●

 

●●

●●

●●

●●

 

 

 

●●

●●

●●

 

 

 

 

●●

●●

●●

 

 

●●

●●

●●

bc●

 

●●

●●

●●

 

Suggested Citation:"Appendix B: Gaps Analysis of Measures of Children's Health and Influences on Children's Health in Select National Surveys." National Research Council and Institute of Medicine. 2004. Children's Health, the Nation's Wealth: Assessing and Improving Child Health. Washington, DC: The National Academies Press. doi: 10.17226/10886.
×

Health Measures

NHIS

NHANES

MEPS

 

2. Socioeconomic status

 

 

 

 

 

Family income

●●

●●

●●

 

 

Difficulty paying for basic needs

 

 

 

 

Receipt of TANF

●●

●●

 

 

 

Receipt of SSI

 

●●

 

 

Receipt of WIC

 

 

 

Rental assistance/public housing

 

 

 

 

 

Food insecurity

●●

●●

 

 

 

Receipt of food stamps

 

 

 

Participation in early intervention

●●

 

 

 

Special education

●●

 

 

 

Individualized education program

 

 

 

 

 

Free or reduced price lunch

 

●●

 

 

 

Maternal/paternal education

●●

●●

 

 

Maternal/paternal employment

●●

●●

●●

 

4. Parent health, mental health, substance use

 

 

 

 

 

Parent health

●●

 

●●

 

 

Parent/partner support or arguing

 

 

 

 

 

Maternal depression

 

 

 

Maternal frustration

 

 

 

 

 

Maternal stress

 

 

 

 

 

Parent social support

 

 

 

 

 

Parent concerns about child health

 

 

 

 

 

Parent exercise behaviors

●●

 

 

 

Parent smoking

●●

●●

 

 

Parent alcohol and drug use

●●

●●

 

 

5. Pregnancy issues

 

 

 

 

 

Whether the pregnancy was wanted

 

 

 

 

 

Receipt of prenatal care

 

 

 

 

 

Prepregnancy weight

 

 

 

 

 

Supplement use during pregnancy

 

 

 

 

 

Use of fertility treatments

 

 

 

 

6. Parenting

 

 

 

 

 

Paternal involvement/closeness

 

 

 

 

 

Breastfeeding

 

●●

 

 

 

Routines for sleeping, feeding

 

 

 

 

 

Childrearing belief (age to toilet train)

 

 

 

 

 

Parenting style (authoritarian, etc.)

 

 

 

 

 

Time spent with children

 

 

 

 

 

Monitoring and supervision

 

 

 

 

 

Supportive nature

 

 

 

 

 

Discipline

 

 

 

 

 

Use of child care

 

 

 

 

7. Family learning environments

 

 

 

 

 

Home schooling

 

 

 

 

Reading to children

 

 

 

Suggested Citation:"Appendix B: Gaps Analysis of Measures of Children's Health and Influences on Children's Health in Select National Surveys." National Research Council and Institute of Medicine. 2004. Children's Health, the Nation's Wealth: Assessing and Improving Child Health. Washington, DC: The National Academies Press. doi: 10.17226/10886.
×

YRBS

NLSY

Add Health

NSFH

ECLS-K

ECLS-B

NHES

NSECH

NS-CSHCN

 

●●

●●

●●

●●

●●

 

 

 

●●

●●

 

●●

 

●●

 

 

 

 

●●

 

 

 

 

 

●●

 

●●

 

 

●●

 

 

 

 

 

 

 

 

 

 

●●

●●

 

 

 

●●

 

 

 

 

 

 

 

 

 

 

 

 

●●

 

 

 

 

 

 

●●

 

 

 

 

 

 

●●

 

●●

 

 

 

●●

●●

●●

●●

 

●●

●●

●●

●●

●●

 

 

●●

●●

●●

 

 

 

 

●●

 

 

●●

 

 

 

 

 

●●

●●

●●

 

●●

 

 

 

 

●●

 

 

 

 

 

 

 

●●

 

 

 

 

 

 

 

●●

●●

●●

 

 

 

 

 

 

 

 

 

●●

 

 

 

 

●●

 

 

 

 

 

 

 

●●

 

 

 

 

 

 

 

 

 

 

 

 

 

 

bc●●

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

●●

 

 

●●

 

 

 

 

 

●●

●●

●●

●●

 

 

 

 

 

 

●●

 

 

 

 

●●

●●

●●

●●

●●

●●

 

 

●●

●●

●●

●●

●●

 

 

●●

●●

●●

 

 

 

 

●●

●●

●●

●●

 

 

 

●●

●●

●●

●●

 

 

●●

 

●●

●●

●●

●●

●●

 

 

 

 

 

 

 

●●

 

 

 

 

 

●●

●●

●●

 

Suggested Citation:"Appendix B: Gaps Analysis of Measures of Children's Health and Influences on Children's Health in Select National Surveys." National Research Council and Institute of Medicine. 2004. Children's Health, the Nation's Wealth: Assessing and Improving Child Health. Washington, DC: The National Academies Press. doi: 10.17226/10886.
×

Health Measures

NHIS

NHANES

MEPS

 

 

 

Socialization and play

 

 

 

 

 

 

Participation in school activities

 

 

 

 

 

 

Providing learning opportunities

 

 

 

 

 

 

Assisting with homework/projects

 

 

 

 

 

 

Use of after school programs

 

 

 

 

 

 

Availability of a computer at home

 

 

 

 

 

8. Family provision of safe environments

●(periodic)

 

 

 

 

 

Car seats and seat belts

 

 

 

 

 

 

Use of smoke detectors

 

 

 

 

 

 

Reduce hot water temperature

 

 

 

 

 

 

Cabinet locks or safety latches

 

 

 

 

 

 

Covering electrical sockets

 

 

 

 

 

 

Baby gates and other barriers

 

 

 

 

 

 

Water safety supervision

 

 

 

 

 

 

Have syrup of Ipecac

 

 

 

 

 

 

Safe storage of firearms

 

 

 

 

B. Community

 

 

 

 

 

1. Neighborhood demographics and SES

 

 

 

 

 

 

Geographic setting (e.g., rural)

 

 

 

 

 

 

Community socioeconomic level

 

 

 

 

 

 

Unemployment rates

 

 

 

 

 

 

Relative income distribution

 

 

 

 

 

 

Affordable housing

 

 

 

 

 

2. Neighborhood institutions

 

 

 

 

 

 

Preschool availability and use

 

 

 

 

 

Head Start availability and use

 

 

 

 

 

Schools and class size

 

 

 

 

 

 

Social (e.g., library/community centers)

 

 

 

 

 

 

Child care programs

 

 

 

 

 

 

Police protection

 

 

 

 

 

3. Social organization of neighborhood

 

 

 

 

 

 

Social cohesion (trust and values)

 

 

 

 

 

 

Social control (monitoring)

 

 

 

 

 

 

Social connection (e.g., to school)

 

 

 

 

 

 

Social interaction and networks

 

 

 

 

C. Culture

 

 

 

 

 

 

Race/ethnicity

●●

●●

 

 

 

English-language proficiency

 

●●

 

 

 

Culture, beliefs, practices

 

 

 

 

 

 

Citizenship or immigration status

 

 

 

Acculturation

●●

 

D. Discrimination

 

 

 

 

 

 

Diversity and segregation

 

 

 

 

 

 

Racism, classicism, etc.

 

 

 

Suggested Citation:"Appendix B: Gaps Analysis of Measures of Children's Health and Influences on Children's Health in Select National Surveys." National Research Council and Institute of Medicine. 2004. Children's Health, the Nation's Wealth: Assessing and Improving Child Health. Washington, DC: The National Academies Press. doi: 10.17226/10886.
×

YRBS

NLSY

Add Health

NSFH

ECLS-K

ECLS-B

NHES

NSECH

NS-CSHCN

 

 

●●

●●

●●

●●

●●

 

 

●●

●●

●●

 

 

 

 

 

●●

●●

●●

●●

●●

 

 

 

●●

 

●●

 

 

 

 

 

 

●●

 

●●

 

 

 

 

●●

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

●●

 

 

 

 

 

 

 

●●

 

 

 

 

●●

 

 

 

 

 

 

●●

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

●●

 

 

 

 

 

 

●●

●●

 

 

 

 

●●

 

 

 

 

 

 

 

 

●●

 

 

 

 

 

 

 

 

 

 

 

 

●●

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

●●

●●

 

●●

●●

 

 

 

 

●●

 

●●

 

 

 

●●

●●

●●

●●

 

●●

 

●●

 

 

●●

 

 

 

 

 

 

●●

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Suggested Citation:"Appendix B: Gaps Analysis of Measures of Children's Health and Influences on Children's Health in Select National Surveys." National Research Council and Institute of Medicine. 2004. Children's Health, the Nation's Wealth: Assessing and Improving Child Health. Washington, DC: The National Academies Press. doi: 10.17226/10886.
×

Health Measures

NHIS

NHANES

MEPS

IV. Physical environment

 

 

 

 

A. Micro-environment

 

 

 

 

 

1. Prenatal exposures

 

 

 

 

 

 

Nonconcurrent exposures

 

 

 

 

 

 

Concurrent exposures (e.g., smoking)

 

 

 

 

2. Postnatal exposures

 

 

 

 

 

 

Air pollutants

 

●●

 

 

 

 

Water pollutants

 

 

 

 

 

 

Food contaminants

 

 

 

 

 

 

Infectious agents

 

 

 

 

 

Chemicals (e.g., lead) and pesticides

 

○●●

 

 

 

 

Noise

 

 

 

 

 

 

Radiation (UV and Ionizing)

 

 

 

 

B. Macro-environment

 

 

 

 

 

1. Physical exposures

 

 

 

 

 

 

Noise and unwanted sound

 

 

 

 

 

 

Environmental air pollution/ozone

 

 

 

 

 

2. Physical safety and security

 

 

 

 

 

 

Housing adequacy

 

●●

 

 

 

 

Housing safety (e.g., lead paint)

●(periodic)

●●

 

 

 

 

School safety (e.g., playground)

 

 

 

 

 

 

Recreational safety (e.g., parks)

 

 

 

 

 

 

Pedestrian safety (e.g., crosswalks)

 

 

 

 

 

 

Vehicle accidents (e.g., car, bike)

 

 

 

 

 

 

Community/school safety (violence)

 

 

 

V. Services (health services)

 

 

 

 

A. Structure

 

 

 

 

 

1. Health insurance coverage and type

●●

●●

●●

 

 

 

Public vs. private sponsorship

●●

●●

●●

 

 

 

Comprehensiveness of benefits

 

 

 

 

 

Cost-sharing requirements

 

●●

●●

 

 

 

Gaps in coverage

●●

 

 

2. Managed care plan restrictions

 

 

 

 

 

 

Gatekeeping restrictions

●●

●●

●●

 

 

 

Network restrictions

●●

●●

●●

 

 

 

Provider incentives

 

 

 

 

 

3. Regular source/provider of care

 

 

 

Specialty and training

 

 

 

 

Demographics (gender, race, or age)

 

 

●●

 

 

 

Language

 

 

 

 

4. Setting of care

 

 

 

 

 

 

Clinic vs. private office

 

 

 

Health center (e.g., CHC)

 

 

 

 

 

Staffing and resources

 

 

 

 

 

 

Geographic location

 

 

 

 

 

 

Service capacity

 

 

 

Suggested Citation:"Appendix B: Gaps Analysis of Measures of Children's Health and Influences on Children's Health in Select National Surveys." National Research Council and Institute of Medicine. 2004. Children's Health, the Nation's Wealth: Assessing and Improving Child Health. Washington, DC: The National Academies Press. doi: 10.17226/10886.
×

YRBpS

NLSY

Add Health

NSFH

ECLS-K

ECLS-B

NHES

NSECH

NS-CSHCN

 

 

 

 

 

●●

 

 

 

 

 

●●

 

 

●●

 

 

 

 

 

●●

 

 

 

 

 

 

 

●●

 

●●

 

●●

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

●●

●●

●●

 

 

 

 

 

●●

●●

●●

 

 

●●

●●

 

 

 

 

 

 

 

 

 

 

 

 

 

 

●●

●●

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Suggested Citation:"Appendix B: Gaps Analysis of Measures of Children's Health and Influences on Children's Health in Select National Surveys." National Research Council and Institute of Medicine. 2004. Children's Health, the Nation's Wealth: Assessing and Improving Child Health. Washington, DC: The National Academies Press. doi: 10.17226/10886.
×

Health Measures

NHIS

NHANES

MEPS

 

B. Process of care

 

 

 

 

 

1. Accessibility

 

●●

 

 

 

Waiting time for/at appointment

 

 

 

 

 

Distance/transportation to office

 

 

 

 

 

Phone contact with provider

 

 

 

 

Delayed or missed care/prescriptions

 

 

 

Difficulty obtaining referrals

 

 

 

 

2. Continuity of crare

 

 

 

 

 

 

Same provider for sick and well care

 

 

 

 

Same provider seen regularly

 

 

 

 

 

Length of time with same provider

 

 

 

 

 

3. Interpersonal manner

 

 

 

 

 

 

Duration of medical visit

 

 

 

 

 

 

Enough time to ask questions

 

 

 

 

 

Provider listens/answers questions

 

 

 

 

 

Support and partnership in care

 

 

●●

 

 

4. Comprehensiveness of services

 

 

 

 

 

 

Developmental assessment

 

 

 

 

 

 

Use of reminders for immunizations

 

 

 

 

 

 

Anticipatory guidance

 

 

●●

 

 

 

Injury prevention guidance

 

 

●●

 

 

 

Psychosocial counseling

 

 

 

 

 

 

Lead poisoning screening

 

 

 

 

 

 

Reproductive counseling/screening

 

 

 

 

 

5. Coordination of care

 

 

 

 

 

 

Need for coordination

 

 

 

 

 

 

Type of care coordinator

 

 

 

 

 

 

Actions of the provider/coordinator

 

 

 

 

 

Communication among providers

 

 

 

 

 

 

Communication with school/teacher

 

 

 

 

 

 

Receipt of Title V services

 

 

 

 

 

6. Family-centered care

 

 

 

 

 

7. Cultural competence

 

 

 

C. Utilization/receipt of care

 

 

 

 

 

1. Primary care

 

 

 

 

 

 

Well-child/routine checkup visits

 

 

 

 

Physician visits

 

 

 

Vision visits

 

 

 

 

Dental visits

●●

 

 

 

Prescription medication (use)

 

 

2. Up-to-date immunization schedule

 

 

 

 

 

Hepatitis A

○●

 

 

 

 

Hepatitis B

○●

 

 

 

 

DTP (diphtheria, tetanus, pertussis)

 

 

 

 

 

MMR (measles, mumps, rubella)

 

 

 

 

IPV (inactivated polio)

 

 

Suggested Citation:"Appendix B: Gaps Analysis of Measures of Children's Health and Influences on Children's Health in Select National Surveys." National Research Council and Institute of Medicine. 2004. Children's Health, the Nation's Wealth: Assessing and Improving Child Health. Washington, DC: The National Academies Press. doi: 10.17226/10886.
×

YRBS

NLSY

Add Health

NSFH

ECLS-K

ECLS-B

NHES

NSECH

NS-CSHCN

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

●●

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

●●

 

 

 

 

 

 

 

 

●●

 

 

 

 

 

 

 

 

●●

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

●●

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Suggested Citation:"Appendix B: Gaps Analysis of Measures of Children's Health and Influences on Children's Health in Select National Surveys." National Research Council and Institute of Medicine. 2004. Children's Health, the Nation's Wealth: Assessing and Improving Child Health. Washington, DC: The National Academies Press. doi: 10.17226/10886.
×

Health Measures

NHIS

NHANES

MEPS

 

 

 

Hib (Haemophilus influenzae)

 

 

 

 

 

Varicella

 

 

 

 

Influenza

 

 

 

 

 

Pneumococcal

 

 

 

3. Specialty and tertiary care

 

 

 

 

 

 

Specialist visits

 

 

 

 

Mental health visits

 

 

 

Receipt of special therapy

 

 

●●

 

 

 

Hospitalization admission

 

 

 

Emergency department visit

 

 

 

Surgical procedures

 

 

 

 

Home care from professional

 

NHIS = National Health Interview Survey; NHANES = National Health and Nutrition Examination Survey; MEPS = Medical Expenditure Panel Survey; YRBS = Youth Risk Behavior Survey; NLSY = National Longitudinal Survey of Youth; Add Health = National Longitudinal Survey of Adolescent Health; NSFH = National Survey of Families and Households; ECLS-K = Early Childhood Longitudinal Study Kindergarten Class; ECLS-B = Early Childhood Longitudinal Study-Birth Cohort; NHES = National Household Education Surveys; NSECH = National Survey of Early Childhood Health; NSCSHCN = National Survey of Children with Special Health Care Needs

Suggested Citation:"Appendix B: Gaps Analysis of Measures of Children's Health and Influences on Children's Health in Select National Surveys." National Research Council and Institute of Medicine. 2004. Children's Health, the Nation's Wealth: Assessing and Improving Child Health. Washington, DC: The National Academies Press. doi: 10.17226/10886.
×

YRBS

NLSY

Add Health

NSFH

ECLS-K

ECLS-B

NHES

NSECH

NS-CSHCN

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

●● Construct is measured “comprehensively” (i.e., at least 3–4 questions used to gather information on a topic).

● Construct is measured “adequately” (i.e., only 1–2 questions used to gather information on a topic).

○ Construct is measured through a biological or physical mechanism (e.g., withdrawal of a blood sample or physical exam).

bc Construct is measured using data from birth certificates.

Suggested Citation:"Appendix B: Gaps Analysis of Measures of Children's Health and Influences on Children's Health in Select National Surveys." National Research Council and Institute of Medicine. 2004. Children's Health, the Nation's Wealth: Assessing and Improving Child Health. Washington, DC: The National Academies Press. doi: 10.17226/10886.
×
Page 262
Suggested Citation:"Appendix B: Gaps Analysis of Measures of Children's Health and Influences on Children's Health in Select National Surveys." National Research Council and Institute of Medicine. 2004. Children's Health, the Nation's Wealth: Assessing and Improving Child Health. Washington, DC: The National Academies Press. doi: 10.17226/10886.
×
Page 263
Suggested Citation:"Appendix B: Gaps Analysis of Measures of Children's Health and Influences on Children's Health in Select National Surveys." National Research Council and Institute of Medicine. 2004. Children's Health, the Nation's Wealth: Assessing and Improving Child Health. Washington, DC: The National Academies Press. doi: 10.17226/10886.
×
Page 264
Suggested Citation:"Appendix B: Gaps Analysis of Measures of Children's Health and Influences on Children's Health in Select National Surveys." National Research Council and Institute of Medicine. 2004. Children's Health, the Nation's Wealth: Assessing and Improving Child Health. Washington, DC: The National Academies Press. doi: 10.17226/10886.
×
Page 265
Suggested Citation:"Appendix B: Gaps Analysis of Measures of Children's Health and Influences on Children's Health in Select National Surveys." National Research Council and Institute of Medicine. 2004. Children's Health, the Nation's Wealth: Assessing and Improving Child Health. Washington, DC: The National Academies Press. doi: 10.17226/10886.
×
Page 266
Suggested Citation:"Appendix B: Gaps Analysis of Measures of Children's Health and Influences on Children's Health in Select National Surveys." National Research Council and Institute of Medicine. 2004. Children's Health, the Nation's Wealth: Assessing and Improving Child Health. Washington, DC: The National Academies Press. doi: 10.17226/10886.
×
Page 267
Suggested Citation:"Appendix B: Gaps Analysis of Measures of Children's Health and Influences on Children's Health in Select National Surveys." National Research Council and Institute of Medicine. 2004. Children's Health, the Nation's Wealth: Assessing and Improving Child Health. Washington, DC: The National Academies Press. doi: 10.17226/10886.
×
Page 268
Suggested Citation:"Appendix B: Gaps Analysis of Measures of Children's Health and Influences on Children's Health in Select National Surveys." National Research Council and Institute of Medicine. 2004. Children's Health, the Nation's Wealth: Assessing and Improving Child Health. Washington, DC: The National Academies Press. doi: 10.17226/10886.
×
Page 269
Suggested Citation:"Appendix B: Gaps Analysis of Measures of Children's Health and Influences on Children's Health in Select National Surveys." National Research Council and Institute of Medicine. 2004. Children's Health, the Nation's Wealth: Assessing and Improving Child Health. Washington, DC: The National Academies Press. doi: 10.17226/10886.
×
Page 270
Suggested Citation:"Appendix B: Gaps Analysis of Measures of Children's Health and Influences on Children's Health in Select National Surveys." National Research Council and Institute of Medicine. 2004. Children's Health, the Nation's Wealth: Assessing and Improving Child Health. Washington, DC: The National Academies Press. doi: 10.17226/10886.
×
Page 271
Suggested Citation:"Appendix B: Gaps Analysis of Measures of Children's Health and Influences on Children's Health in Select National Surveys." National Research Council and Institute of Medicine. 2004. Children's Health, the Nation's Wealth: Assessing and Improving Child Health. Washington, DC: The National Academies Press. doi: 10.17226/10886.
×
Page 272
Suggested Citation:"Appendix B: Gaps Analysis of Measures of Children's Health and Influences on Children's Health in Select National Surveys." National Research Council and Institute of Medicine. 2004. Children's Health, the Nation's Wealth: Assessing and Improving Child Health. Washington, DC: The National Academies Press. doi: 10.17226/10886.
×
Page 273
Suggested Citation:"Appendix B: Gaps Analysis of Measures of Children's Health and Influences on Children's Health in Select National Surveys." National Research Council and Institute of Medicine. 2004. Children's Health, the Nation's Wealth: Assessing and Improving Child Health. Washington, DC: The National Academies Press. doi: 10.17226/10886.
×
Page 274
Suggested Citation:"Appendix B: Gaps Analysis of Measures of Children's Health and Influences on Children's Health in Select National Surveys." National Research Council and Institute of Medicine. 2004. Children's Health, the Nation's Wealth: Assessing and Improving Child Health. Washington, DC: The National Academies Press. doi: 10.17226/10886.
×
Page 275
Suggested Citation:"Appendix B: Gaps Analysis of Measures of Children's Health and Influences on Children's Health in Select National Surveys." National Research Council and Institute of Medicine. 2004. Children's Health, the Nation's Wealth: Assessing and Improving Child Health. Washington, DC: The National Academies Press. doi: 10.17226/10886.
×
Page 276
Suggested Citation:"Appendix B: Gaps Analysis of Measures of Children's Health and Influences on Children's Health in Select National Surveys." National Research Council and Institute of Medicine. 2004. Children's Health, the Nation's Wealth: Assessing and Improving Child Health. Washington, DC: The National Academies Press. doi: 10.17226/10886.
×
Page 277
Suggested Citation:"Appendix B: Gaps Analysis of Measures of Children's Health and Influences on Children's Health in Select National Surveys." National Research Council and Institute of Medicine. 2004. Children's Health, the Nation's Wealth: Assessing and Improving Child Health. Washington, DC: The National Academies Press. doi: 10.17226/10886.
×
Page 278
Suggested Citation:"Appendix B: Gaps Analysis of Measures of Children's Health and Influences on Children's Health in Select National Surveys." National Research Council and Institute of Medicine. 2004. Children's Health, the Nation's Wealth: Assessing and Improving Child Health. Washington, DC: The National Academies Press. doi: 10.17226/10886.
×
Page 279
Suggested Citation:"Appendix B: Gaps Analysis of Measures of Children's Health and Influences on Children's Health in Select National Surveys." National Research Council and Institute of Medicine. 2004. Children's Health, the Nation's Wealth: Assessing and Improving Child Health. Washington, DC: The National Academies Press. doi: 10.17226/10886.
×
Page 280
Suggested Citation:"Appendix B: Gaps Analysis of Measures of Children's Health and Influences on Children's Health in Select National Surveys." National Research Council and Institute of Medicine. 2004. Children's Health, the Nation's Wealth: Assessing and Improving Child Health. Washington, DC: The National Academies Press. doi: 10.17226/10886.
×
Page 281
Suggested Citation:"Appendix B: Gaps Analysis of Measures of Children's Health and Influences on Children's Health in Select National Surveys." National Research Council and Institute of Medicine. 2004. Children's Health, the Nation's Wealth: Assessing and Improving Child Health. Washington, DC: The National Academies Press. doi: 10.17226/10886.
×
Page 282
Suggested Citation:"Appendix B: Gaps Analysis of Measures of Children's Health and Influences on Children's Health in Select National Surveys." National Research Council and Institute of Medicine. 2004. Children's Health, the Nation's Wealth: Assessing and Improving Child Health. Washington, DC: The National Academies Press. doi: 10.17226/10886.
×
Page 283
Suggested Citation:"Appendix B: Gaps Analysis of Measures of Children's Health and Influences on Children's Health in Select National Surveys." National Research Council and Institute of Medicine. 2004. Children's Health, the Nation's Wealth: Assessing and Improving Child Health. Washington, DC: The National Academies Press. doi: 10.17226/10886.
×
Page 284
Suggested Citation:"Appendix B: Gaps Analysis of Measures of Children's Health and Influences on Children's Health in Select National Surveys." National Research Council and Institute of Medicine. 2004. Children's Health, the Nation's Wealth: Assessing and Improving Child Health. Washington, DC: The National Academies Press. doi: 10.17226/10886.
×
Page 285
Suggested Citation:"Appendix B: Gaps Analysis of Measures of Children's Health and Influences on Children's Health in Select National Surveys." National Research Council and Institute of Medicine. 2004. Children's Health, the Nation's Wealth: Assessing and Improving Child Health. Washington, DC: The National Academies Press. doi: 10.17226/10886.
×
Page 286
Suggested Citation:"Appendix B: Gaps Analysis of Measures of Children's Health and Influences on Children's Health in Select National Surveys." National Research Council and Institute of Medicine. 2004. Children's Health, the Nation's Wealth: Assessing and Improving Child Health. Washington, DC: The National Academies Press. doi: 10.17226/10886.
×
Page 287
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Children's health has clearly improved over the past several decades. Significant and positive gains have been made in lowering rates of infant mortality and morbidity from infectious diseases and accidental causes, improved access to health care, and reduction in the effects of environmental contaminants such as lead. Yet major questions still remain about how to assess the status of children's health, what factors should be monitored, and the appropriate measurement tools that should be used.

Children's Health, the Nation's Wealth: Assessing and Improving Child Health provides a detailed examination of the information about children's health that is needed to help policy makers and program providers at the federal, state, and local levels. In order to improve children's health -- and, thus, the health of future generations -- it is critical to have data that can be used to assess both current conditions and possible future threats to children's health. This compelling book describes what is known about the health of children and what is needed to expand the knowledge. By strategically improving the health of children, we ensure healthier future generations to come.

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