The National Association of County and City Health Officials' (NACCHO) Forces of Change Survey is an evolution of NACCHO's Job Losses and Program Cuts Surveys (also known as the Economic Surveillance Surveys) which measured the impact of the economic recession on local health departments' (LHD) budgets, staff, and programs. The Forces of Change Survey continues to measure changes in LHD budgets, staff, and programs and assess more broadly the impact of forces affecting change in LHDs, such as health reform and accreditation. More specifically, the survey collected information about LHD staffing levels, workforce reductions, and changes in budget sizes; provided services or functions; changes in the level of service delivery; billing for clinical services; efforts to help people enroll in health insurance from exchanges under the Affordable Care Act; awareness of and involvement in the State Innovation Models Initiative; participation in the Public Health Accreditation Board's national accreditation program for LHDs; and whether LHDs are part of a combined health and human services agency. The collection is comprised of the restricted-use version (Restricted-Use Level 2) of the Forces of Change 2014 dataset, and includes 140 variables for 648 cases, with demographic variables related to LHD budgets, governance type, and number of employees.

Overview

The Associated Press is sharing data from the COVID Impact Survey, which provides statistics about physical health, mental health, economic security and social dynamics related to the coronavirus pandemic in the United States.

Conducted by NORC at the University of Chicago for the Data Foundation, the probability-based survey provides estimates for the United States as a whole, as well as in 10 states (California, Colorado, Florida, Louisiana, Minnesota, Missouri, Montana, New York, Oregon and Texas) and eight metropolitan areas (Atlanta, Baltimore, Birmingham, Chicago, Cleveland, Columbus, Phoenix and Pittsburgh).

The survey is designed to allow for an ongoing gauge of public perception, health and economic status to see what is shifting during the pandemic. When multiple sets of data are available, it will allow for the tracking of how issues ranging from COVID-19 symptoms to economic status change over time.

The survey is focused on three core areas of research:

• Physical Health: Symptoms related to COVID-19, relevant existing conditions and health insurance coverage.
• Economic and Financial Health: Employment, food security, and government cash assistance.
• Social and Mental Health: Communication with friends and family, anxiety and volunteerism. (Questions based on those used on the U.S. Census Bureau’s Current Population Survey.) ## Using this Data - IMPORTANT This is survey data and must be properly weighted during analysis: DO NOT REPORT THIS DATA AS RAW OR AGGREGATE NUMBERS!!

Instead, use our queries linked below or statistical software such as R or SPSS to weight the data.

Queries

If you'd like to create a table to see how people nationally or in your state or city feel about a topic in the survey, use the survey questionnaire and codebook to match a question (the variable label) to a variable name. For instance, "How often have you felt lonely in the past 7 days?" is variable "soc5c".

Nationally: Go to this query and enter soc5c as the variable. Hit the blue Run Query button in the upper right hand corner.

Local or State: To find figures for that response in a specific state, go to this query and type in a state name and soc5c as the variable, and then hit the blue Run Query button in the upper right hand corner.

The resulting sentence you could write out of these queries is: "People in some states are less likely to report loneliness than others. For example, 66% of Louisianans report feeling lonely on none of the last seven days, compared with 52% of Californians. Nationally, 60% of people said they hadn't felt lonely."

Margin of Error

The margin of error for the national and regional surveys is found in the attached methods statement. You will need the margin of error to determine if the comparisons are statistically significant. If the difference is:

• At least twice the margin of error, you can report there is a clear difference.
• At least as large as the margin of error, you can report there is a slight or apparent difference.
• Less than or equal to the margin of error, you can report that the respondents are divided or there is no difference. ## A Note on Timing Survey results will generally be posted under embargo on Tuesday evenings. The data is available for release at 1 p.m. ET Thursdays.

About the Data

The survey data will be provided under embargo in both comma-delimited and statistical formats.

Each set of survey data will be numbered and have the date the embargo lifts in front of it in the format of: 01_April_30_covid_impact_survey. The survey has been organized by the Data Foundation, a non-profit non-partisan think tank, and is sponsored by the Federal Reserve Bank of Minneapolis and the Packard Foundation. It is conducted by NORC at the University of Chicago, a non-partisan research organization. (NORC is not an abbreviation, it part of the organization's formal name.)

Data for the national estimates are collected using the AmeriSpeak Panel, NORC’s probability-based panel designed to be representative of the U.S. household population. Interviews are conducted with adults age 18 and over representing the 50 states and the District of Columbia. Panel members are randomly drawn from AmeriSpeak with a target of achieving 2,000 interviews in each survey. Invited panel members may complete the survey online or by telephone with an NORC telephone interviewer.

Once all the study data have been made final, an iterative raking process is used to adjust for any survey nonresponse as well as any noncoverage or under and oversampling resulting from the study specific sample design. Raking variables include age, gender, census division, race/ethnicity, education, and county groupings based on county level counts of the number of COVID-19 deaths. Demographic weighting variables were obtained from the 2020 Current Population Survey. The count of COVID-19 deaths by county was obtained from USA Facts. The weighted data reflect the U.S. population of adults age 18 and over.

Data for the regional estimates are collected using a multi-mode address-based (ABS) approach that allows residents of each area to complete the interview via web or with an NORC telephone interviewer. All sampled households are mailed a postcard inviting them to complete the survey either online using a unique PIN or via telephone by calling a toll-free number. Interviews are conducted with adults age 18 and over with a target of achieving 400 interviews in each region in each survey.Additional details on the survey methodology and the survey questionnaire are attached below or can be found at https://www.covid-impact.org.

Attribution

Results should be credited to the COVID Impact Survey, conducted by NORC at the University of Chicago for the Data Foundation.

AP Data Distributions

​To learn more about AP's data journalism capabilities for publishers, corporations and financial institutions, go here or email kromano@ap.org.