The National Health Interview Survey (NHIS) is the principal source of information on the health of the civilian noninstitutionalized population of the United States and is one of the major data collection programs of the National Center for Health Statistics (NCHS) which is part of the Centers for Disease Control and Prevention (CDC). The National Health Survey Act of 1956 provided for a continuing survey and special studies to secure accurate and current statistical information on the amount, distribution, and effects of illness and disability in the United States and the services rendered for or because of such conditions. The survey referred to in the Act, now called the National Health Interview Survey, was initiated in July 1957. Since 1960, the survey has been conducted by NCHS, which was formed when the National Health Survey and the National Vital Statistics Division were combined. NHIS data are used widely throughout the Department of Health and Human Services (DHHS) to monitor trends in illness and disability and to track progress toward achieving national health objectives. The data are also used by the public health research community for epidemiologic and policy analysis of such timely issues as characterizing those with various health problems, determining barriers to accessing and using appropriate health care, and evaluating Federal health programs. The NHIS also has a central role in the ongoing integration of household surveys in DHHS. The designs of two major DHHS national household surveys have been or are linked to the NHIS. The National Survey of Family Growth used the NHIS sampling frame in its first five cycles and the Medical Expenditure Panel Survey currently uses half of the NHIS sampling frame. Other linkage includes linking NHIS data to death certificates in the National Death Index (NDI). While the NHIS has been conducted continuously since 1957, the content of the survey has been updated about every 10-15 years. In 1996, a substantially revised NHIS questionnaire began field testing. This revised questionnaire, described in detail below, was implemented in 1997 and has improved the ability of the NHIS to provide important health information.

The Health Statistics and Health Research Database is Estonian largest set of health-related statistics and survey results administrated by National Institute for Health Development. Use of the database is free of charge.

The database consists of eight main areas divided into sub-areas. The data tables included in the sub-areas are assigned unique codes. The data tables presented in the database can be both viewed in the Internet environment, and downloaded using different file formats (.px, .xlsx, .csv, .json). You can download the detailed database user manual here (.pdf).

The database is constantly updated with new data. Dates of updating the existing data tables and adding new data are provided in the release calendar. The date of the last update to each table is provided after the title of the table in the list of data tables.

A contact person for each sub-area is provided under the "Definitions and Methodology" link of each sub-area, so you can ask additional information about the data published in the database. Contact this person for any further questions and data requests.

Read more about publication of health statistics by National Institute for Health Development in Health Statistics Dissemination Principles.

Interactive Summary Health Statistics for Adults provide annual estimates of selected health topics for adults aged 18 years and over based on final data from the National Health Interview Survey.

Interactive Summary Health Statistics for Children provide annual estimates of selected health topics for children under age 18 years based on final data from the National Health Interview Survey.

This dataset contains a summary of National Health and Nutrition Examination Survey (NHANES), which is a program of the National Center for Health Statistics from the Centers for Disease Control and Prevention. This survey assesses the health and nutrition of the American population through interview and physical examinations combined.

In 2020, the National Center for Health Statistics (NCHS) partnered with the Census Bureau on an experimental data system called the Household Pulse Survey. This survey was designed to complement the ability of the federal statistical system to rapidly respond and provide relevant information about how emergent issues are impacting American households. Beginning in Phase 4.0 (on January 9, 2024), questions on social support, loneliness, and social isolation were added to the survey. These questions have been included on other nationally representative surveys. Briefly, the question on social support was included on the National Health Interview Survey (NHIS) from July 2020-December 2021 and was added to the 2024 NHIS. The question on loneliness was added to the 2024 NHIS. The questions on social isolation are adapted from the Berkman-Syme Social Network Index and were included on an earlier cycle of the National Health and Nutrition Examination Survey. For more information, please visit: https://www.cdc.gov/nchs/covid19/pulse/lack-socialconnection.htm

Note: This dataset is historical only and there are not corresponding datasets for more recent time periods. For that more-recent information, please visit the Chicago Health Atlas at https://chicagohealthatlas.org.

This dataset contains a selection of 27 indicators of public health significance by Chicago community area, with the most updated information available. The indicators are rates, percents, or other measures related to natality, mortality, infectious disease, lead poisoning, and economic status. See the full description at https://data.cityofchicago.org/api/assets/2107948F-357D-4ED7-ACC2-2E9266BBFFA2.

The National Health and Nutrition Examination Survey (NHANES) is a program of studies designed to assess the health and nutritional status of adults and children in the United States. An ongoing annual survey combines interviews and physical examinations. The NHANES interview includes demographic, socioeconomic, dietary, and health-related questions. The examination component consists of medical, dental, and physiological measurements, as well as laboratory tests administered by highly trained medical personnel.

Ancillary studies include the NHANES National Youth Fitness Survey (NNYFS) and NHANES Epidemiologic Followup Study (NHEFS). NNYFS was conducted in 2012 to evaluate the physical activity and fitness of children aged 3 to 15 years old through interviews and fitness tests. NHEFS is a longitudinal survey of adults aged 25 to 74 years old in the NHANES I (1971-1975) cohort who completed a medical examination. Data was collected in follow-up rounds in 1982-1984, 1986, 1987, and 1992 through subject and proxy interviews and vital record search. Available data files include vital and tracing status, demographic information, interview data on health status, health care facility inpatient data, and mortality data.

This database is part of the National Medical Information System (NMIS). The National Health Care Practitioner Database (NHCPD) supports Veterans Health Administration Privacy Act requirements by segregating personal information about health care practitioners such as name and social security number from patient information recorded in the National Patient Care Database for Ambulatory Care Reporting and Primary Care Management Module.

2019–present. The National Health Interview Survey (NHIS) is a nationally representative household health survey of the U.S. civilian noninstitutionalized population. The NHIS data are used to monitor trends in illness and disability, track progress toward achieving national health objectives, for epidemiologic and policy analysis of various health problems, determining barriers to accessing and using appropriate health care, and evaluating Federal health programs. NHIS is conducted continuously throughout the year by the National Center for Health Statistics (NCHS). Public-use data files on adults and children with corresponding imputed income data files, and survey paradata are released annually. The NHIS data website (https://www.cdc.gov/nchs/nhis/documentation/index.html) features the most up-to-date public-use data files and documentation for downloading including questionnaire, codebooks, CSV and ASCII data files, programs and sample code, and in-depth survey description. Most of the NHIS data are included in the public use files. NHIS is protected by Federal confidentiality laws that state the data collected by NCHS may be used only for statistical reporting and analysis. Some NHIS variables have been suppressed or edited in the public use files to protect confidentiality. Analysts interested in using data that has been suppressed or edited may apply for access through the NCHS Research Data Center at https://www.cdc.gov/rdc/. In 2019, NHIS launched a redesigned content and structure that differs from its previous questionnaire designs. NHIS has been conducted continuously since 1957.

Changelog:

Update September 20, 2021: Data and overview updated to reflect data used in the September 15 story Over Half of States Have Rolled Back Public Health Powers in Pandemic. It includes 303 state or local public health leaders who resigned, retired or were fired between April 1, 2020 and Sept. 12, 2021. Previous versions of this dataset reflected data used in the Dec. 2020 and April 2021 stories.

Overview

Across the U.S., state and local public health officials have found themselves at the center of a political storm as they combat the worst pandemic in a century. Amid a fractured federal response, the usually invisible army of workers charged with preventing the spread of infectious disease has become a public punching bag.

In the midst of the coronavirus pandemic, at least 303 state or local public health leaders in 41 states have resigned, retired or been fired since April 1, 2020, according to an ongoing investigation by The Associated Press and KHN.

According to experts, that is the largest exodus of public health leaders in American history.

Many left due to political blowback or pandemic pressure, as they became the target of groups that have coalesced around a common goal — fighting and even threatening officials over mask orders and well-established public health activities like quarantines and contact tracing. Some left to take higher profile positions, or due to health concerns. Others were fired for poor performance. Dozens retired. An untold number of lower level staffers have also left.

The result is a further erosion of the nation’s already fragile public health infrastructure, which KHN and the AP documented beginning in 2020 in the Underfunded and Under Threat project.

Findings

The AP and KHN found that:

• One in five Americans live in a community that has lost its local public health department leader during the pandemic
• Top public health officials in 28 states have left state-level departments ## Using this data To filter for data specific to your state, use this query

To get total numbers of exits by state, broken down by state and local departments, use this query

Methodology

KHN and AP counted how many state and local public health leaders have left their jobs between April 1, 2020 and Sept. 12, 2021.

The government tasks public health workers with improving the health of the general population, through their work to encourage healthy living and prevent infectious disease. To that end, public health officials do everything from inspecting water and food safety to testing the nation’s babies for metabolic diseases and contact tracing cases of syphilis.

Many parts of the country have a health officer and a health director/administrator by statute. The analysis counted both of those positions if they existed. For state-level departments, the count tracks people in the top and second-highest-ranking job.

The analysis includes exits of top department officials regardless of reason, because no matter the reason, each left a vacancy at the top of a health agency during the pandemic. Reasons for departures include political pressure, health concerns and poor performance. Others left to take higher profile positions or to retire. Some departments had multiple top officials exit over the course of the pandemic; each is included in the analysis.

Reporters compiled the exit list by reaching out to public health associations and experts in every state and interviewing hundreds of public health employees. They also received information from the National Association of City and County Health Officials, and combed news reports and records.

Public health departments can be found at multiple levels of government. Each state has a department that handles these tasks, but most states also have local departments that either operate under local or state control. The population served by each local health department is calculated using the U.S. Census Bureau 2019 Population Estimates based on each department’s jurisdiction.

KHN and the AP have worked since the spring on a series of stories documenting the funding, staffing and problems around public health. A previous data distribution detailed a decade's worth of cuts to state and local spending and staffing on public health. That data can be found here.

Attribution

Findings and the data should be cited as: "According to a KHN and Associated Press report."

Is Data Missing?

If you know of a public health official in your state or area who has left that position between April 1, 2020 and Sept. 12, 2021 and isn't currently in our dataset, please contact authors Anna Maria Barry-Jester annab@kff.org, Hannah Recht hrecht@kff.org, Michelle Smith mrsmith@ap.org and Lauren Weber laurenw@kff.org.

Footnotes for Health, US - Asthma in children younger than age 18, by selected characteristics: United States.

Data on asthma in children younger than age 18 in the United States, by selected characteristics. Data are from Health, United States. Source: National Center for Health Statistics, National Health Interview Survey.

The purpose of the National Health Interview Survey (NHIS) is to obtain information about the amount and distribution of illness, its effects in terms of disability and chronic impairments, and the kinds of health services people receive. Implementation of a redesigned NHIS, consisting of a basic module, a periodic module, and a topical module, began in 1997 (see NATIONAL HEALTH INTERVIEW SURVEY, 1997 [ICPSR 2954]). The 2008 NHIS contains the Household, Family, Person, Sample Adult, and Sample Child files from the basic module. Each record in Part 1, Household Level, contains data on type of living quarters, number of families in the household responding and not responding, and the month and year of the interview for each sampling unit. Part 2, Family Level, is made up of reconstructed variables from the person-level data of the basic module and includes information on sex, age, race, marital status, Hispanic origin, education, veteran status, family income, family size, major activities, health status, activity limits, and employment status, along with industry and occupation. As part of the basic module, Part 3, Person Level, provides information on all family members with respect to health status, limitation of daily activities, cognitive impairment, and health conditions. Also included are data on years at current residence, region variables, height, weight, bed days, doctor visits, hospital stays, and health care access and utilization. A randomly-selected adult in each family was interviewed for Part 4, Sample Adult, regarding respiratory conditions, renal conditions, AIDS, joint symptoms, health status, limitation of daily activities, and behaviors such as smoking, alcohol consumption, and physical activity. Additionally, questions regarding oral health, asthma, balance, cancer screening, heart disease, HPV, immunization, and vision were fielded. Part 5, Sample Child, provides information from an adult in the household on medical conditions of one child in the household, such as respiratory problems, seizures, allergies, and use of special equipment like hearing aids, braces, or wheelchairs. Also included are variables regarding child behavior, Attention Deficit Hyperactivity Disorder (ADHD), oral health, asthma, indoor tanning, HPV, immunization, mental health, and vision. Part 6, Injury/Poison Episode, is an episode-based file that contains information about the external cause and nature of the injury or poisoning episode and what the person was doing at the time of the injury or poisoning episode, in addition to the date and place of occurrence. Part 7, Injury/Poison Episode Verbatim, contains edited narrative text descriptions of the injury or poisoning, provided by the respondent. Part 8, Paradata, does not contain health related information, but rather data which are related to the interview process, including measures of time, contact-ability, and cooperation.

Health, United States is the report on the health status of the country. Every year, the report presents an overview of national health trends organized around four subject areas: health status and determinants, utilization of health resources, health care resources, and health care expenditures and payers.

Interactive Summary Health Statistics for Adults, by Detailed Race and Ethnicity provide estimates as three-year averages of selected health topics for adults aged 18 years and over based on final data from the National Health Interview Survey.

The purpose of the National Health Interview Survey (NHIS) is to obtain information about the amount and distribution of illness, its effects in terms of disability and chronic impairments, and the kinds of health services people receive. The 1976 Health Insurance Supplement provides variables from the core Person File (see HEALTH INTERVIEW SURVEY, 1976 [ICPSR 8340]) including sex, age, race, marital status, veteran status, education, income, industry and occupation codes, and limits on activity. The variables unique to this supplement cover information about individuals' health coverage, such as whether they have Medicare or Medicaid, private hospital insurance, employer or union-based coverage, whether it is private coverage obtained through another group, kinds of coverage, and if they received care under an insurance plan in the past year. Information about private plan combinations and reasons for no insurance is also available.

Health expenditure in the U.S. has been a hotly debated topic among political parties, especially on the verge of presidential elections. Health expenditures in the U.S. have been increasing over time and are projected to keep increasing. As of 2023, the U.S. spent a total of *** trillion U.S. dollars on healthcare. U.S. health expenditure in comparison The U.S has some of the highest expenditures for health care in the world. With a total health spending of roughly ** percent of the country’s GDP, the U.S. has far surpassed the country with the second highest health expenditure as a share of GDP, Germany. The United States, despite having a mixed method of healthcare financing and insurances, also has one of the highest shares of domestic governmental health expenditures. U.S. health care payers There are several different governmental and non-governmental agencies that are responsible for health care funding and payments in the United States. Currently, private insurance and Medicare are the two largest payers of U.S. health care. Direct health care costs are not the only things that these payers are responsible for. They may also be partly responsible for prescription drug costs. Again, private insurance and Medicare are the two largest payers of prescription drug costs in the U.S. Among all the payers of health care costs in the U.S., Medicare has experienced the highest level of health spending increases in recent years.

The California Department of Public Health collects, analyzes, and reports data on human disease and conditions, healthcare, facilities and services, and about race, gender, and socioeconomic status.

Interactive Summary Health Statistics for Adults provide annual estimates of selected health topics for adults aged 18 years and over based on final data from the National Health Interview Survey. Search, visualize, and download these and other estimates from over 120 health topics with the NCHS Data Query System (DQS), available from: https://www.cdc.gov/nchs/dataquery/index.htm.

Deaths covering Smoking only to 2019.