About the Data Used in This Brief
The National Survey of Children’s Health (NSCH) was conducted in 2003, 2007, 2011/12, and 2016 in all 50 states and the District of Columbia. The 2016 National Survey of Children’s Health was funded and directed by the Health Resources and Services Administration’s (HRSA) Maternal and Child Health Bureau (MCHB). The 2016 NSCH was significantly redesigned and differs from the prior survey cycles; therefore, comparisons cannot be drawn across all years of the survey. The survey uses an address-based sample that utilizes internet-based web and mailed paper data collection instruments fielded by the U.S. Census Bureau. One child in each household with children was randomly selected to be the focus of the study. A parent or guardian knowledgeable about the child answered questions about the child and themselves. The survey is representative of children under 18 years of age, both nationwide and within each state. A total of 50,212 surveys were completed.
The prevalence of ACEs described in this brief are derived from the following questions asked of parents:
- To the best of your knowledge, has this child EVER experienced any of the following?
- Parent or guardian divorced or separated (Yes/No)
- Parent or guardian died (Yes/No)
- Parent or guardian served time in jail (Yes/No)
- Saw or heard parents or adults slap, hit, kick, punch one another in the home (Yes/No)
- Was a victim of violence or witnessed violence in his or her neighborhood (Yes/No)
- Lived with anyone who was mentally ill, suicidal, or severely depressed (Yes/No)
- Lived with anyone who had a problem with alcohol or drugs (Yes/No)
- SINCE THIS CHILD WAS BORN, how often has it been very hard to get by on your family’s income—hard to cover the basics like food or housing? (Very Often, Somewhat Often, Rarely, Never)
Cases were not included in the analysis if any questions were left unanswered. Six percent of the sample did not answer any of the questions.
The relative confidence interval for each estimate presented in the tables is calculated by dividing the absolute 95 percent confidence interval by the estimate and multiplying by 100. If the relative confidence interval for a given estimate (for example, the percent of black non-Hispanic children with more than one ACE) is more than 120 percent, we suggest that the estimate be interpreted with caution, as it may not be reliable.
Differences between state and national estimates were tested for statistical significance by comparing the 95 percent confidence intervals. If the confidence intervals did not overlap, the differences are marked as significant in the tables.
Differences between the racial/ethnic groups were tested using an ordered logit regression, with white non-Hispanic as the reference group.
Included in the “Other, Non-Hispanic” category are children reported as Hawaiian/Pacific Islander, American Indian/Alaska Native, two or more races, or another race not already listed. For children in these racial categories, there were not sufficient numbers in the 2016 NSCH sample to allow reliable estimates of ACEs for all states or Census divisions.