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The NHIS-D was sponsored by the National Center for Health Statistics (NCHS), which sponsors the annual National Health Interview Survey. Data were collected by employees of the U.S. Bureau of the Census, using procedures developed by the NCHS. The NHIS-D was designed to collect data on multiple policy-relevant aspects of disability.
The survey was a nationally representative sample of the civilian, non-institutionalized U.S. population, both children and adults.
Unlike the annual NHIS, the NHIS-D was conducted only once beginning in 1994, in two phases. The Phase 1 Disability questionnaire was administered to respondents as a supplement to the regular annual NHIS (the "core") in 1994-5.
It elicited information on disability for members of each household surveyed, and was used a screening device for Phase 2, the "Disability Followback Survey" (DFS). The DFS was administered to people who were identified as having disabilities through the Phase 1 NHIS-D and also by their responses to disability-related questions in the core NHIS. Phase II was conducted several months after the core NHIS and Phase 1 interviews and lasted from 1994 through 1997.
In an initial visit to each sampled household, the core NHIS interview and the Phase I Disability Supplement were completed for all members in the selected households. Questions were answered by any available adult in the household who was knowledgeable about the health of other household members.
In the second phase, interviewers returned to households that included members with disabilities. Interviews were usually face-to-face but sometimes were done by telephone. In most cases, the individual with the disability completed the Phase 2 interviews by themselves or with assistance, but proxy interviewees responded for about 12% of adults and most of the children.
The NHIS-D, Phase I, collected information on 202,560 respondents of all ages, representing a 93% response rate. A sample of 32,788 individuals was re-interviewed for Phase II.
The Phase I NHIS-D asked about:
The Phase I questionnaire also had three additional sections specifically for children:
There are four Phase 2 (DFS) questionnaires: one for adults, one for children, one for elderly persons (over age 69) without any indication of disability (also called the Supplement on Aging or SOA), and one for persons with a past history of polio.
For adults, the Phase II questionnaire collected information on:
For children in Phase II, additional information was collected on use and need for health services, participation in special education, functional assessment (including emotional and behavioral development), and the impact of the child's disability on the family.
The Supplement on Aging (SOA) questionnaire was given to people over age 69 who had no indication of disability. It included a number of items identical or similar to those on the Adult DFS questionnaire because, since disabilities increase with age. many of the Adult DFS topics are very relevant to the elderly population.
The Polio Questionnaire collected additional information about the symptoms and impact of the illness at the time of initial diagnosis of polio and at various times after the diagnosis. Information on current health problems was also obtained.
A complex set of eligibility criteria was used to identify the Phase 2 sample based on individuals' responses to the Phase I questionnaire and the core NHIS. "Disability" was a multifaceted concept for Phase 2, involving 227 variables and 24 combinations of variables (termed "Disability Hit Flags"). These "flags" included, among other variables, specified medical conditions; receipt of or application for disability benefits; use of assistive devices or prostheses; and ADL, IADL, or functional limitations.
Based on these flags, people were selected as belonging to one of 14 "Policy Groups":
The largest proportion of the adult sample (41%) were those with ADL/IADL/functional limitations. and 24 % percent of the sample were identified as mentally ill. Those with sensory impairments made up 15.3%, followed by SSDI applicants (13.5%).
Among children, those with special education needs made up the largest group (50%), followed by children with high levels of health care use or active health problems (44%). About 40% of children in Phase 2 had activity limitations.
The survey was conducted only with the non-institutionalized population, and thus did not capture data on people in nursing homes, state hospitals, board and care homes, and other institutional settings.
News Releases and Fact Sheets
Data analysis--Variance Estimation: Using SUDAAN
Public-use Data Files (Micro-data)
Downloadable data files via ftp
Downloadable documentation via ftp
Web site address: http://www.cdc.gov/nchs/about/major/nhis_dis/nhis_dis.htm