CHILD HEALTH SUPPLEMENT
                                 NOTES


The Child Health file contains the part of the 1991 National Health
Interview Survey of Health Promotion and Disease Prevention (NHIS-HPDP)
related to child safety and health.  For this section of the survey,
information was collected on one randomly selected child (17 years and
younger) from each family with children who participated in the NHIS.  A
responsible adult (usually a parent or guardian) provided the
information about the selected sample child.

The Child Health survey covered several different topic areas:

      1.  Childhood Immunizations - This information was collected for
          children under 6 years of age.  Analysts interested in this
          data are STRONGLY encouraged to review the questionnaire for
          this part of the survey.  Four vaccine types were asked about:
          DTP, Polio, Measles or MMR, and Hemophilus type B or HIB.
          When possible, information was abstracted directly from
          vaccination records maintained by the family.  Respondents who
          were able to provide vaccination records were also asked about
          additional shots that may have been received but were not
          listed on the records.  Respondents who were unable to provide
          records were asked the ages at which the child received each
          of the four vaccines.  Ages at vaccination were recoded for
          each of the four vaccine types.  When a respondent knew the
          number of shots received but not the ages, the age at
          vaccination was recoded as "99" for the appropriate number of
          shots; when neither the ages nor the number of shots received
          was known, a recoded age of "77" was entered.  For each
          vaccine type, the total number of shots received and the total
          received by 24 months for children 2 years and older were also
          calculated and included as recodes.

          Estimation of immunization coverage levels (i.e. the percentage
          of children who are "up-to-date" for a particular vaccine type or
          a series of vaccines) is complicated.  The Division of Immuniza-
          tion at the Centers for Disease Control and Prevention is respon-
          sible for calculating the official Public Health Service coverage
          level estimates.  Analysts who wish to make these types of 
          estimates can contact the Division of Immunization (404-639-1884)
          for technical assistance.  

      2.  Information on diarrhea, middle ear infection and participation 
          in child care arrangements with more than 6 children were collected 
          for children under 6 years.

      3.  Information on use of safety seats and/or seat belt use was
          collected for all children.

      4.  For children 7 years and older, participation in nine organized 
          sports was ascertained.  Information on use of mouth guards and 
          head gear was collected for sports participants.

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      5.  Bottle feeding, use of bottles at bedtime (children 6 months -
          5 years), and visits to a dentist in past year (children 2-6
          years) was collected.

      6.  A series of questions on functional limitations in daily
          activities (such as walking, bathing, and dressing) was asked
          for children 5 years and older.

The response rate to the Child Health portion of the NHIS-HPDP was 93.2
percent and was calculated as follows:

      The response rate to the NHIS Core questionnaire was 95.7 percent.
      Of the eligible families from the CORE, 97.4 percent responded to
      the Child Health section.  Multiplying these two response rates
      together yields the overall response rate to the Child Health
      section (93.2 percent).

Each record included in the Child Health contains a final weight (file
locations 207-212).  Weights must be used to make accurate estimates
based on this data file.  Because the Child Health survey included only
one child per NHIS family, the weight on this file is different from the
weight for the same child on the NHIS Core Person file.  Most of the
weights for records on the Child Health file are between 2000 and 8000.
However, due to the design of the NHIS and the weighting procedure,
there are 65 records on the Child Health file which have very large
weights (greater than 20,000); 10 of these have weights of 30,000 or
more.  Analyses involving fairly small sample numbers may be heavily
impacted by the inclusion of these records with extremely large weights.
Analysts are encouraged to look at the distribution of weights for
records being analyzed to decided how to handle these weighting outliers. 
























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