Officials: Health survey needs to slim
Refusal rates go up as 1,200 questions prove to be offputting
NEW YORK — When the government launched what would become most influential survey to monitor the nation’s public health, there were just 75 questions — and 95 percent of those asked agreed to sit for it.
But that was nearly 60 years ago, and the National Health Interview Survey has mushroomed along with the government and its interests. There are now 1,200 potential questions, and the average family takes more than 90 minutes to complete the survey.
Not surprisingly, the refusal rate has gone up, as well: Thirty percent are refusing to take part. And that has raised concerns that the survey — conducted in people’s homes — has gotten too big.
“If you tell them it’s going to take an hour and it could be longer... right away people are going to say no,” said Joseph Paysen, who oversees the survey in the New York City area.
These and other issues have prompted plans for dramatic changes. But as government officials embark on a redesign, they’re contending with bureaucratic obstacles and pleas from researchers who want more questions asked, not less.
U.S. Census Bureau workers conduct the survey every year, on behalf of another federal agency, the Centers for Disease Control and Prevention. It’s a $30 million annual project, and somewhere around 50,000 people answer the survey’s questions each year.
Their answers have shaped our understanding of topics ranging from how common arthritis is to how many people get X-rays to what proportion of U.S. children suffers seizures. The responses also are the foundation of how we measure the nation’s progress (or backslide) on problems like obesity and smoking.
Tellingly, the CDC recently added questions to it about use of electronic cigarettes — even though other surveys already asked about that subject — because the agency wants a new, unimpeachable statistical baseline on the controversial topic.
“It’s been kind of the gold standard” for continuous, nationally-representative information on the American public’s health, said Lynn Blewett, a University of Minnesota expert on health data.
The survey’s data became the basis for measuring the nation’s progress in fighting disease. It spurred funding for a CDC arthritis program, and shaped the agency’s policy on cervical cancer screening. It was the first federal household survey to track the growing popularity of cell phones. And it’s been a primary measuring stick for how many people are gaining health insurance under the 2010 Affordable Care Act, better known as Obamacare.
But now it’s just one data source in a crowded field. The CDC has conducted or funded hundreds of surveys designed to improve researchers’ understanding of peoples’ health and health behaviors. That includes roughly 20 ongoing surveys of all or parts of the U.S. public. Many are focused on specific topics, like HIV or teen smoking.
“The shorter it is,” Paysen said, “the easier it will be.”