As part of SHADAC’s State Alternatives for Health Data Continuity project, we have developed our Survey Data Finder tool for people to identify the health topic domains that can be found in more than a dozen federal surveys that focus on health or include landmark health-related data. However, just because multiple surveys contain data on a particular domain does not mean they are perfectly comparable.
For instance, many of the surveys listed in the Survey Data Finder include questions on vaccines, but most only ask a few vaccine questions at most (e.g., did you get a flu shot in the past year?). However, the National Immunization Surveys focus entirely on vaccinations, asking detailed questions about which vaccines children have received and on what schedule. The implication is that the National Immunization Surveys are uniquely useful for providing detailed data on kids’ routine immunizations, while other federal health surveys are more limited.
As a complement to our Survey Data Finder, this blog provides very brief, one- or two-paragraph summaries of each of the surveys included to help users of the tool better understand the main focus and specifics that may make them particularly well-suited to certain uses in comparison to other surveys.
American Community Survey (ACS)
The American Community Survey, conducted by the U.S. Census Bureau, is a mandatory survey (individuals are required to respond under law) with a large sample size, collecting data from about 3.5 million households. It is an annual survey designed to be representative of the entire U.S. population and to produce representative estimates for all 50 states.
It can also be used to produce estimates at a sub-state geographic level, especially when combining multiple years of data. While it is not a health-focused survey, it does include questions on respondents’ health insurance coverage, including the type of health insurance coverage they have (e.g., Medicaid, employer-sponsored coverage, no health insurance). It is also used to develop estimates of the U.S. population that are commonly used in weighting other surveys to ensure they are representative of the population. SHADAC’s State Health Compare features measures that use the ACS, including detailed health insurance coverage and people who pay rents that are unaffordable.
Behavioral Risk Factor Surveillance System (BRFSS)
The Behavioral Risk Factor Surveillance System (BRFSS) is a set of surveys conducted annually in all 50 states and the District of Columbia, focused exclusively on adults age 18 and older. While it is sponsored by the U.S. Centers for Disease Control and Prevention (CDC), the surveys are administered individually by each state using a core set of questions used by all states and an additional menu of optional question sets.[1] After the surveys are conducted, the CDC then combines the data from all of the state surveys into a single data file, allowing for cross-state analysis.
The BRFSS is primarily focused on people’s health status and factors that can influence individuals’ health in positive or negative ways, such as exercise and diet, substance use behaviors, and exposure to health risks. However, the survey also asks limited questions on other topics, such as health insurance coverage, access, and utilization. It has also included an optional module used by a subset of states to collect information on sexual orientation and gender identity. SHADAC’s State Health Compare features several measures that use the BRFSS, including adults who forgo needed medical care, consume excessive amounts of alcohol, and report having certain chronic diseases, among others.
Current Population Survey – Annual Social and Economic Supplement (CPS – ASEC)
The Current Population Survey (CPS) is jointly sponsored by the U.S. Census Bureau and the Bureau of Labor Statistics, and it serves as one of the federal government’s main sources of data on the U.S. labor market. An additional component of the CPS, the Annual Social and Economic Supplement (ASEC), asks more-detailed economic and social questions (including those used to produce annual federal poverty rate estimates), including a limited set of health-related questions on topics including health insurance coverage, health care access, and utilization of health care services. These are available for all 50 states. SHADAC’s State Health Compare features measures that use the CPS, including high medical costs and food insecurity, among others.
Health and Retirement Study (HRS)
The Health and Retirement Study (HRS) is conducted once every other year by the University of Michigan and funded by the U.S. Social Security Administration and the National Institute on Aging. While the survey collects data on a relatively broad set of health-related domains, it is limited only to adults age 50 and older. The HRS has a complex design, aiming to produce nationally representative estimates, but is not designed to produce estimates for all 50 states.
Medical Expenditure Panel Survey – Household Component (MEPS-HC)
The Medical Expenditure Panel Survey – Household Component (MEPS-HC) is conducted annually by the U.S. Agency for Healthcare Research and Quality. The survey is primarily designed to collect data on individuals' utilization and spending on health care services, though it also asks questions on other related health domains, such as health status and conditions. While the MEPS-HC does not support state-level estimates for all 50 states, it does provide them for a subset of the largest population states (the exact states and number of them vary year-to-year).
National Health and Nutrition Examination Survey (NHANES)
The National Health and Nutrition Examination Survey (NHANES) is conducted each year by the U.S. Centers for Disease Control and Prevention’s National Center for Health Statistics, though data are typically released as two-year files (e.g., 2019-2020). The NHANES is unusual in that it includes health examinations and labs (e.g., blood tests) to measure individuals’ health in addition to asking respondents questions across many health domains. It is not designed to produce state-level estimates.
National Health Interview Survey (NHIS)
The National Health Interview Survey (NHIS) is conducted annually by the U.S. Centers for Disease Control and Prevention’s National Center for Health Statistics. It is a relatively broad health survey, asking questions on a variety of health-related domains, including health coverage, access, utilization, and detailed health conditions and functional limitations. It is one of the few federal health surveys that has collected information on sexual orientation. The public use files for the NHIS do not contain state identifiers to allow the production of state-level estimates. SHADAC’s State Health Compare features several measures that use the NHIS, including people who saw a mental health professional and people who made changes to their prescription drugs because of cost, among others.
National Immunization Surveys (NIS)
The Centers for Disease Control and Prevention’s (CDC) National Center for Immunization and Respiratory Diseases conducts two recurring National Immunization Surveys (NIS): one for adolescents, age 13-17 (NIS-Teen), and one for younger children, age 19-35 months (NIS-Child). These annual NIS surveys contain by far the most detailed data on vaccinations of any federal health surveys; while many surveys ask one or a few questions about certain vaccines—particularly flu vaccines and COVID-19 vaccines—the NIS surveys ask detailed questions about many routine childhood vaccines that kids receive in the U.S., such as well as questions about vaccination schedule. The NIS surveys support the production of estimates for 50 states. SHADAC’s State Health Compare features a measure of whether children have received recommended vaccines that uses the NIS.
National Survey of Children’s Health (NSCH)
The National Survey of Children’s Health (NSCH) is a survey focused on children, age 17 and younger, sponsored by the U.S. Health Resources and Service’s Administration (HRSA). While the survey is conducted annually, state-level data are available only in two-year combined data files (e.g., 2020-2021, 2021-2022, 2022-2023). It is conducted with adult respondents (e.g., parents) answering questions about children in their care, on a variety of topics commonly asked in health-related surveys, as well as some less-common domains, such as exposure to special health care needs and services (e.g., special education); adverse childhood experiences (ACEs); parenting, family, and school activities. The NSCH supports the production of estimates for 50 states. SHADAC’s State Health Compare features a measure of adverse childhood experiences that uses the NSCH.
National Survey of Family Growth (NSFG)
The National Survey of Family Growth (NSFG) is a recurring survey sponsored by the U.S. National Center for Health Statistics (NSCH), with data from the past two decades are available from public use files that combine multiple years of survey data (e.g., 2015-2017, 2017-2019, 2022-2023). The survey is conducted using in-person interviews with men and women of reproductive age, 15-49 years old.
While the survey includes some common health domains found in other surveys, it is differentiated by relatively detailed questions related to sexual and reproductive behaviors and health, maternal-child health topics (e.g., pregnancy, breastfeeding), family structure, and parenting activities. The NSFG does not support state-level estimates.
National Survey on Drug Use and Health (NSDUH)
The National Survey on Drug Use and Health (NSDUH) is sponsored by the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA). It is conducted annually, but state-level estimates are only possible using files that combine two or more years of data (e.g., 2021-2022, 2022-2023), which can be obtained in three ways: 1) from tables of selected measures published by SAMHSA each year, 2) using an online tabulation tool that leverages restricted data files and automatically suppresses data that don’t meet the agency’s release standards based on reliability and confidentiality considerations, and 3) using restricted-access microdata files in federal Research Data Centers (RDC) located at various locations around the country, which requires a rigorous application and review process.
While some other federal surveys ask limited questions on substance use, the NSDUH offers the most detailed questions on substance use, treatment, and related issues of any federally sponsored survey. In addition, it also asks some mental health questions that exceed the level of detail generally found in other federal health surveys, and it has asked questions about sexual orientation. The tables published by SAMHSA include 50 state estimates for a select set of measures. The online tabulation tool supports the production of 50 state estimates for certain measures using files that combine two or more years of data. Additionally, identifiers to produce state-level estimates using microdata can be accessed through RDCs, but doing so generally requires combining multiple years of survey data, and the files must meet strict disclosure requirements designed to ensure privacy protections for survey respondents.
Pregnancy Risk Assessment Monitoring System (PRAMS)
The Pregnancy Risk Assessment Monitoring System (PRAMS) is dataset sponsored by the U.S. Centers for Disease Control and Prevention (CDC) that includes surveys with new mothers as well as associated vital statistics data abstraction from birth certificates. Prior to PRAMS data collection being placed on indefinite pause in 2025, a majority of states participated in the voluntary data collection initiative; while national-level PRAMS data are not released as public use files, data may be obtained by researchers through an application process with the CDC.
While other federal health surveys may include some questions on maternal-child health, the PRAMS is unique in the level of detail collected and the additional collection of data from administrative birth records. State-level data are available, but not all states participate in PRAMS.
Survey of Income and Program Participation (SIPP)
The Survey of Income and Program (SIPP), conducted by the U.S. Census Bureau, was first conducted more than 40 years ago, but it has been redesigned multiple times, most recently in 2014. Since then, it has been conducted annually since 2018. One of the most important differentiators of the SIPP in comparison with other federal surveys that include health-related questions is its longitudinal design, revisiting respondents for new surveys over a period of time.
Additionally, the SIPP collects detailed information on individuals’ income—including different sources of income—and participation in various public programs, such as Social Security benefits, as well as questions on certain health-related domains. The SIPP supports production of 50-state estimates.
Youth Risk Behavior Surveillance System (YRBSS)
The Youth Risk Behavior Surveillance System (YRBSS) is sponsored by the U.S. Centers for Disease Control and Prevention (CDC) and includes two components: The Youth Risk Behavior Survey (YRBS), which is a nationally representative survey of students in private and public high schools (grades 9 through 12), as well as a group of state-level surveys from a limited number of states that voluntarily participate to produce state-representative estimates.
The YRBSS is conducted every other year, and is similar to the adult-focused BRFSS, but it is limited to high school-age youth and is targeted more specifically on health risks, such as substance use and sexual behaviors. The YRBSS includes more-limited demographic data than many other federal health-related surveys because it excludes certain questions (including health insurance type) that youth may not be able to accurately answer, such as family income. While the YRBSS samples all 50 states to produce nationally representative estimates, state-representative estimates are only available for a subgroup of states.
Notes
[1] BRFSS: States may also add their own custom-made, self-funded questions to their BRFSS surveys.