Reported Child Health Status, Hispanic Ethnicity, and Language of Interview: United States, 2011-2012.

OBJECTIVES: This report has three objectives: a) to describe the reported health status of four subgroups of school-age children: Hispanic children with a Spanish interview (Hispanic­Spanish interview), Hispanic children with an English interview (Hispanic­English interview), non-Hispanic black children, and non-Hispanic white children; b) to describe selected characteristics of children in the four subgroups; and c) to consider whether the characteristics of children account for subgroup variations in reported health status. DATA SOURCE AND METHODS: Data from the 2011­2012 National Survey of Children's Health were used to describe the health status of children aged 5­17 years using three categories: a) poor or fair, b) good, and c) very good or excellent health. The reported health status of children in the four subgroups was examined using multinomial logistic regression, controlling for the effects of demographic and socioeconomic characteristics and a measure of acculturation. RESULTS: Compared with children in the other subgroups, Hispanic­Spanish interview children were more likely to have reports of poor or fair health (10.6% compared with 1.8%­4.4%) and good health (39.7% compared with 7.7%­ 14.4%). Controlling for demographic and socioeconomic characteristics and a measure of acculturation eliminated the subgroup differences in poor or fair health, but not good health. Even after adjustment for confounders, Hispanic­Spanish interview children more often were reported to have good health rather than very good or excellent health compared with children in the other subgroups. CONCLUSIONS: Worse reported health status of Hispanic­Spanish interview children, compared with children in other subgroups, could not be explained completely by the confounders in the analysis. Additional research is needed to determine whether the worse reported health status of Hispanic children with Spanish interviews reflects the actual health conditions of these children or difficulties in translating the health status question.

Concordance between survey report of Medicaid enrollment and linked Medicaid administrative records in two national studies.

The National Health and Nutrition Examination Survey (NHANES) and the National Health Interview Survey (NHIS) are population-based surveys that have each been linked to administrative data from the Centers for Medicare and Medicaid Services (CMS): the Medicaid Analytic eXtract (MAX) files. These linked data were used to examine, among children under age 18 years, respondent-level concordance between Medicaid or the Children's Health Insurance Program (CHIP) enrollment as reported in each survey (NHANES and NHIS) and as indicated by administrative data from the MAX files. Concordance was defined as having Medicaid/CHIP reported as a health insurance source in the survey questionnaire and having a CMS Medicaid/CHIP administrative record in the same month and year as the interview. Records were also considered concordant if there was no report of Medicaid/CHIP coverage based on the interview response and no match to the CMS administrative records for Medicaid enrollment. Between NHANES and MAX, 88% of observations were concordant with respect to Medicaid or CHIP enrollment, yielding a Kappa of 0.71. Between NHIS and MAX, 89% of observations were concordant with respect to Medicaid or CHIP enrollment, yielding a Kappa of 0.73. These concordance rates provide support for the use of both administrative and NHANES and NHIS as a valuable tool for public health researchers and survey methodologists.

Identifying emotional and behavioral problems in children aged 4-17 years: United States, 2001-2007.

OBJECTIVES: This report examines two measures that identify children with emotional and behavioral problems: high scores based on questions in the brief version of the Strengths and Difficulties Questionnaire (SDQ) and a single question about serious (definite or severe) overall emotional and behavioral difficulties. Children were classified into four groups, those with: only high scores on the brief SDQ, only serious overall difficulties, both high scores on the brief SDQ and serious overall difficulties, and neither high scores on brief SDQ nor serious overall difficulties. Children's characteristics, conditions, and service use in these four groups were compared. METHODS: Data from the 2001-2007 National Health Interview Survey identified the emotional and behavioral problems, characteristics, conditions, and service use of children aged 4-17 years. RESULTS: Approximately 7% of children had either high scores on the brief SDQ or serious overall difficulties, with 2% having only high scores on the brief SDQ, 3% having only serious overall difficulties, and 2% having both high scores on the brief SDQ and serious overall difficulties. Characteristics of the three groups of children identified with emotional and behavioral problems differed from each other and from children without problems. Children in each of the groups with emotional and behavioral problems, compared with children without problems, were more likely to have developmental conditions and to have used services. Additionally, children with serious overall difficulties (either with or without high scores on the brief SDQ) were more likely to have developmental conditions, receive special education, and use mental health services than children with only high scores on the brief SDQ.