Description of 2017 Supplements

Attachment 3b - Summary Description of 2017 Supplementary Questions
A summary of the 2017 supplementary questions follows, and is presented in table form in Attachment 3c.
New and Returning Supplements
Alternative and integrative medicine: Sponsored by the National Institute for Complementary and Integrative
Health (NICCIH, NIH), these questions are repeated in modified form from a much longer battery that was
included on the 2012 NHIS. They assess the use of alternative and integrative or complementary medicine
practices among adults and children.
Cultural Competence: Sponsored by the Office of Minority Health (OMH, HHS) and new to NHIS, this battery of
five questions assesses respondents’ sense of their health care providers’ compliance with the national
standards for culturally and linguistically appropriate services (CLAS).
Epilepsy: Sponsored by the National Center For Chronic Disease Prevention and Health Promotion (NCCDPHP,
CDC), this set of five questions returns from 2015 to monitor the Healthy People 2020 objectives around
epilepsy. The purpose of the epilepsy questions is to:

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Monitor the prevalence of epilepsy in adults
Determine whether medication is taken for epilepsy
Find out the frequency of epileptic seizures, and whether epilepsy or its treatment interferes with
work/school/social activities.

Cognitive Disability: Sponsored by NCHS and new to NHIS, a question on the cause of cognitive disability,
follows the core family disability item on difficulty concentrating, remembering, or making decisions. Possible
causes of cognitive disability include intellectual disability, dementia, mental illness, and chronic health
conditions. This question is designed to provide national prevalence estimates on the cause for cognitive
disability among the adult U.S. population.
Heart Disease and Stroke: Sponsored by the National Center For Chronic Disease Prevention and Health
Promotion (NCCDPHP, CDC), this battery of fifteen questions is repeated from 2014 to allow monitoring of the
nation’s progress toward meeting the Healthy People 2020 objectives in these areas:
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Time since last blood pressure/cholesterol check
Identify symptoms of a heart attack/stroke and the importance of calling 911 in the event of a related
emergency

Continuing Supplements
Affordable Care Act: A number of questions on access and utilization of health care were added in 2011 to the
Family, Sample Adult and Sample Child Modules. These included questions on expansion of health care coverage
for young adults, access to health care providers, health information technology use, and direct purchase of
health insurance. In October 2013, a few questions were added about income-based health insurance premiums
for private plans (in the Family Module) and whether the respondent had looked into purchasing health
insurance through the Health Insurance Marketplace (in the Sample Adult Module). A few additional premiumrelated questions similar to those added in October 2013 were added in 2014 for Medicaid, state-sponsored
health plans, and other government health plans, located in the Family Module. For the 2015 NHIS,

approximately 25 supplemental ACA questions were dropped from the survey, due to funding constraints. For
2017, the 2016 version of the health care coverage questions continues.
Chronic Pain: Sponsored by the National Institute on Neurological Disorders and Stroke (NINDS) and the
National Center For Chronic Disease Prevention and Health Promotion (NCCDPHP, CDC), this set of questions is
on the NHIS to establish the prevalence of chronic pain and its impact on daily life for adults. They continue from
2016.
Diabetes: Sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK, NIH) and
the National Center For Chronic Disease Prevention and Health Promotion (NCCDPHP, CDC), this set of questions
was newly-developed for and underwent extensive cognitive testing prior to their addition to the 2016
questionnaire. They ask respondents about their risk factors for diabetes, medication use for those with
diabetes, gestational diabetes, and participation in diabetes prevention programs.
Disability and Functioning: Two sets of disability items continue for 2017. The first set is a six-item series that
closely approximates the disability questions that appear on the American Community Survey (ACS). As part of a
larger test of these questions, comparisons of responses will be made between the NHIS and the ACS. The items
cover difficulty hearing, seeing, recall, mobility, dressing/bathing, and doing errands. The second set was
developed by the United Nations Washington Group on Disability Statistics. The questions are asked in national
health surveys in multiple countries in order to better understand and compare functional limitations across
many cultures. These data will allow us to compare levels of social participation (for example, employment,
education or family life) between persons with disabilities and persons without disabilities.
Family Food Security: A ten question set of items on food security sponsored by the United States Department
of Agriculture (USDA) that have been on the survey since 2011 continues for 2017. These questions assess
whether the family has been able to afford adequate food for all adults during the previous 30 days.
ABCS of Heart Disease and Stroke Prevention: Beginning in 2012, four questions on aspirin use were embedded
in the Sample Adult Conditions Sections (ACN) to address the CDC ABCS initiative (A=Aspirin use, B=Blood
pressure control, C=Cholesterol control, S=Smoking). In 2015, items on medication use for high blood pressure
and cholesterol were added. The same battery of questions continues for 2017.
Immunizations: A set of questions to measure vaccination coverage for hepatitis, tetanus, shingles (adults), and
influenza immunizations for Sample Adults and Children continue for 2017. They are sponsored by the National
Center for Immunization and Respiratory Diseases (NCIRD, CDC) and have appeared on the NHIS since 1997.
Smokeless Tobacco and E-Cigarettes: Questions pertaining to use of non-cigarette tobacco products and nontobacco electronic nicotine delivery products (also called e-cigarettes) are retained from the discontinued 2015
NHIS Cancer Control Module. They are located in the Adult Behaviors core module. Developed in collaboration
with the Food and Drug Administration (FDA), the Office of Smoking and Health (CDC), and the National Cancer
Institute (NIH), the supplemental questions measure the prevalence and frequency of using non-cigarette
products such as cigars, pipes, and smokeless tobacco as well as e-cigarettes.
Vision: Sponsored by the National Eye Institute (NEI, NIH), this battery of questions, which was last on the NHIS
in 2008 and continuing from 2016, asks questions for adults and children about conditions of the eye, visual
acuity, and use of protective eye wear. These questions measure Healthy People 2020 objectives.
Children’s Mental Health: Six items to measure mental strengths and difficulties for children age 4-17 continue
in 2017. These items have been on the NHIS in some form since 2001.