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America's Children: Key National Indicators of Well-Being, 2021

Air Quality System

The Air Quality System (AQS) contains ambient air pollution data collected by the U.S. Environmental Protection Agency (EPA) and by state, local, and tribal air pollution control agencies. Data on criteria pollutants (particulate matter, ozone, carbon monoxide, nitrogen dioxide, sulfur dioxide, and lead) consist of air quality measurements collected by sensitive equipment at thousands of monitoring stations in all 50 states, plus the District of Columbia, the Commonwealth of Puerto Rico, and the U.S. Virgin Islands. Each monitor measures the concentration of a particular pollutant in the air. Monitoring data indicate the average pollutant concentration during a specified time interval, usually 1 hour or 24 hours. The AQS also contains meteorological data, descriptive information about each monitoring station (including its geographic location and operator), and data quality assurance/quality control information. Data are available from AQS dating back to 1957. The system is administered by the EPA's Office of Air Quality Planning and Standards, Outreach and Information Division, in Research Triangle Park, North Carolina. For the Outdoor Air Quality indicator, a county is considered to have a pollutant concentration above the level of the current air quality standard if the measured pollutant level was greater than the level of the standard at any monitor within the county during the year. The indicator is calculated as the sum of children living in counties with pollutant concentrations above the level of a standard divided by the total number of children in the United States. This calculation differs from the method for identifying areas in violation of an air quality standard. See America's Children and the Environment at https://www.epa.gov/ace (Indicator E1) for further discussion.

Agency Contact:
Nick Mangus
U.S. Environmental Protection Agency
Phone: 919-541-5549
Email: mangus.nick@epa.gov

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American Community Survey

The American Community Survey (ACS) is an annual nationwide survey that replaced the long form decennial censuses beginning in 2010. The objective of the ACS is to provide data users with timely housing, social, and economic data that are updated every year and can be compared across states, communities, and population groups.

The ACS was implemented in three parts: (1) Demonstration period, 1996–1998, beginning at four sites; (2) Comparison site period, 1999–2004, comparing 31 sites continuously over this period as well as adding other counties to the survey in preparation for full implementation; and (3) Full implementation nationwide in 2005. Sampling of group quarters was added in 2006. Starting in January 2005, the U.S. Census Bureau implemented the ACS in every county of the United States, with an annual sample of 3 million housing units. Beginning in 2006, the survey data have been available every year for large geographic areas and population groups of 65,000 or more.

For small areas and population groups of 20,000 or less, a period of 5 years is necessary to accumulate a large enough sample to provide estimates with accuracy similar to the decennial census. Each month, a systematic sample of addresses is selected from the most current Master Address file (MAF). The sample represents the entire United States. Data are generally collected by mail or the internet; however, households that do not respond by mail or the internet may be contacted using computer-assisted telephone interviewing (CATI), computer-assisted personal interviewing (CAPI), or both.

Information about the ACS is available online at https://www.census.gov/programs-surveys/acs/.

Agency Contact:
U.S. Census Bureau Customer Service Center
https://ask.census.gov
Phone: 800-923-8282

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American Housing Survey

The American Housing Survey (AHS) is sponsored by the Office of Policy Development and Research of the U.S. Department of Housing and Urban Development and is conducted by the U.S. Census Bureau. The survey provides data necessary for evaluating progress toward "a decent home and a suitable living environment for every American family," a goal affirmed in 1949 and 1968 legislation. The AHS began as an annual survey in 1973 and has been conducted biennially in odd-numbered years since 1985. A longitudinal, nationally representative sample of 60,000 housing units plus newly constructed units was surveyed during the period 1985 to 2013, and a new sample was drawn in 2015. Transient accommodations, military and worker housing, and institutional quarters are excluded. AHS data detail the types, size, conditions, characteristics, costs and values, equipment, utilities, and dynamics of the housing inventory, as well as some information about neighborhood conditions. Data include demographic, financial, and mobility characteristics of the occupants. Since 1997, the AHS has been conducted using computer-assisted personal interviewing.

Information about the AHS is available online at https://www.census.gov/programs-surveys/ahs.html.

Agency Contact:
George R. Carter III
Office of Policy Development and Research
U.S. Department of Housing and Urban Development
Phone: 202-402-5873
Email: George.R.Carter@hud.gov

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Civil Rights Data Collection

The U.S. Department of Education's Office for Civil Rights (OCR) has surveyed the Nation's public elementary and secondary schools since 1968. The survey was first known as the OCR Elementary and Secondary School Survey; in 2004, it was renamed the Civil Rights Data Collection (CRDC). The survey collects data on school discipline, access to and participation in high-level mathematics and science courses, teacher characteristics, school finances, and other school characteristics. These data are reported by race/ethnicity, sex, and disability.

Data in the survey are collected pursuant to 34 C.F.R. [Code of Federal Regulations] Section 100.6(b) of the U.S. Department of Education regulation implementing Title VI of the Civil Rights Act of 1964. The requirements also are incorporated by reference in Department regulations implementing Title IX of the Education Amendments of 1972, Section 504 of the Rehabilitation Act of 1973, and the Age Discrimination Act of 1975. School, district, state, and national data are currently available. Data from individual public schools and districts are used to generate national and state data.

The CRDC has generally been conducted biennially in each of the 50 states plus the District of Columbia. (Puerto Rico was added to the collection for 2017–18.) The 2009–10 CRDC was collected from a sample of approximately 7,000 school districts and over 72,000 schools in those districts. It was made up of two parts: Part 1 contained beginning-of-year "snapshot" data and Part 2 contained cumulative, or end-of-year, data.

The 2011–12, 2013–14, 2015–16, and 2017–18 CRDC were surveys of all public schools and school districts in the Nation. The 2011–12 survey collected data from approximately 16,500 school districts and 97,000 schools, the 2013–14 survey collected data from approximately 16,800 school districts and 95,500 schools, the 2015–16 survey collected data from about 17,400 school districts and 96,400 schools, and the 2017–18 survey collected data from about 17,600 school districts and 97,600 schools.

The CRDC webpage (https://www2.ed.gov/about/offices/list/ocr/data.html) contains, among other information, survey forms, lists of data elements, and lists of questions and answers pertaining to the 2009–10 through 2017–18 CRDC surveys.

Further information on the CRDC may be obtained from
Office for Civil Rights
U.S. Department of Education
400 Maryland Avenue SW
Washington, DC 20202
Email: OCR@ed.gov
https://www2.ed.gov/about/offices/list/ocr/data.html

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Current Population Survey

Core Survey and Supplements. The Current Population Survey (CPS) is a nationwide survey of about 60,000 households conducted monthly for the U.S. Bureau of Labor Statistics by the U.S. Census Bureau. The survey is representative of the civilian noninstitutionalized population of the United States with a sample located in more than 2,000 counties and independent cities and coverage in every state and the District of Columbia.

The CPS core survey is the primary source of information on the employment characteristics of the civilian noninstitutionalized population, including estimates of unemployment released every month by the U.S. Bureau of Labor Statistics.

In addition to the core survey, monthly CPS supplements provide additional demographic and social data. The Annual Social and Economic Supplement (ASEC)— formerly called the March Supplement—and the October school enrollment supplement provide information used to estimate the status and well-being of children. The ASEC and school enrollment supplement have been administered every year since 1947. In this report, data on poverty status, health insurance, and the parents' highest level of school completed or degree attained are derived from the ASEC. The October supplement to the CPS asks questions on school enrollment by grade and other school characteristics about each member of the household age 3 or over. In this report, data on high school completion and college enrollment are derived from the October supplement. The food security supplement, introduced in April 1995 and administered in December since 2001, is described in detail below.

The CPS sample is selected from a complete address list of geographically delineated primary sampling units, which are based on census addresses and updated using recent construction and other data. It is administered through field representatives, either in person or by telephone using computer-assisted personal interviewing (CAPI). Some CPS data also are collected through a centralized telephone operation, computer-assisted telephone interviewing (CATI). For more information regarding the CPS, its sampling structure, and estimation methodology, see Design and Methodology: Current Population Survey (Technical Paper 77, October 2019) available online at https://www.census.gov/programs-surveys/cps/technical-documentation/complete.html.

The 2014 CPS ASEC (which refers to health insurance coverage estimates of the 2013 calendar year) is the first to use the improved measures of health insurance coverage. Following more than a decade of research, evaluation, and consultation with outside experts, the U.S. Census Bureau implemented an approach shown to improve the accuracy of health insurance coverage measurement. For a list of references, please see the U.S. Census Bureau director's statement on the improved set of health insurance coverage questions at https://www.census.gov/newsroom/archives/2014-pr/cb14-67.html. Due to these changes, data for the 2014 CPS ASEC are not comparable with data from earlier years.

The 2014 CPS ASEC included redesigned questions for income and health insurance coverage. All of the approximately 98,000 addresses were selected to receive the improved set of health insurance coverage items. The improved income questions were implemented using a split panel design. Approximately 68,000 addresses were selected to receive a set of income questions similar to those used in the 2013 CPS ASEC. The remaining 30,000 addresses were selected to receive the redesigned income questions. The source of data for tables in this volume is the CPS ASEC sample of 98,000 addresses.

There was an implementation of an updated processing system for the 2018 CPS ASEC. For more information, see technical documentation at https://www2.census.gov/programs-surveys/demo/datasets/income-poverty/time-series/data-extracts/2018/cps-asec-bridge-file/2018-asec-bridge-file-documentation.pdf and information on the updated processing system at https://www.census.gov/data/datasets/time-series/demo/income-poverty/cps-asec-design.html. Due to these changes, data for the 2018 CPS ASEC are not comparable with data from earlier years.

Food Security Supplement. The food security supplement contains a systematic set of questions validated as measures of the severity of food insecurity on a 12-month and a 30-day basis. Statistics presented in this report are based on 12-month data from the CPS food security supplements. The food security questions are based on material reported in prior research on hunger and food security and reflect the consensus of nearly 100 experts at the 1994 Food Security and Measurement Conference, convened jointly by the National Center for Health Statistics and the Food and Nutrition Service of the U.S. Department of Agriculture. The supplement was developed, tested, and refined further by the conferees, members of a Federal interagency working group, and survey methods specialists for the U.S. Census Bureau's Center for Survey Methods Research. All households interviewed in the CPS in December are eligible for the supplement. Special supplement sample weights were computed to adjust for the demographic characteristics of supplement noninterviews.

Information about food security is available online at the Economic Research Service at https://www.ers.usda.gov/topics/food-nutrition-assistance/food-security-in-the-us/. Information about the CPS is available online at https://www.census.gov/cps.

Agency Contacts:
For more information on:
Education (early childhood and high school completion):
Chris Chapman
National Center for Education Statistics
Phone: 202-245-7103
Email: Chris.Chapman@ed.gov

Education (higher education):
Cris de Brey
National Center for Education Statistics
Phone: 202-245-8419
Email: Cristobal.DeBrey@ed.gov

English language learners:
U.S. Census Bureau Customer Service Center
http://ask.census.gov
Phone: 800-923-8282

Family structure:
U.S. Census Bureau Customer Service Center
http://ask.census.gov
Phone: 800-923-8282

Food security:
Alisha Coleman-Jensen
Economic Research Service
U.S. Department of Agriculture
Phone: 202-694-5456
Email: alisha.coleman-jensen@usda.gov
Laura J. Hales
Economic Research Service
U.S. Department of Agriculture
Phone: 816-412-7441
Email: laura.hales@usda.gov

Poverty, family income, and health insurance:
U.S. Census Bureau Customer Service Center
http://ask.census.gov
Phone: 800-923-8282

Secure parental employment and youth neither enrolled in school nor working:
Vernon Brundage, Jr.
U.S. Bureau of Labor Statistics
Phone: 202-691-5456
Email: Brundage.vernon@bls.gov

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Decennial Census Data

The U.S. Census Bureau conducted decennial censuses in the United States in 2000, 2010, and 2020, as well as in previous decades back to 1790. Statistical data from the censuses of 2000 and 2010 are available through data.census.gov.

Date:
April 1, 2000 (Census Day) is the reference date for Census 2000.
April 1, 2010 (Census Day) is the reference date for the 2010 Census.
April 1, 2020 (Census Day) is the reference date for the 2020 Census

Census 2000 and earlier decennial censuses gathered information on demographic, social, economic, and housing characteristics of the population. Census 2000 datasets include more subjects than those for later censuses because Census 2000 used both a short form (with a limited number of characteristics for every person and every housing unit) and a long form (with additional questions asked of a sample of persons and housing units). The short form provided information on age, sex, race, Hispanic or Latino origin, household relationship, tenure (whether a housing unit is owner- or renter-occupied), and occupancy status. The long form covered additional population characteristics, such as income, educational attainment, labor force status, place of birth, etc., and additional housing characteristics.

In the 2010 and 2020 Census of the United States, a limited number of questions were asked of every person and every housing unit. Population and housing characteristics not covered in the decennial Census can be found in data from the American Community Survey, also available on data.census.gov.

In any large-scale statistical operation such as the decennial Census, human- and computer-related errors occur. These errors are commonly referred to as nonsampling errors. Such errors include not enumerating every household or every person in the population, not obtaining all required information from the respondents, obtaining incorrect or inconsistent information, and recording information incorrectly.

Although it is impossible to completely eliminate nonsampling error from an operation as large and complex as the decennial census, the Census Bureau attempts to control the sources of such error during the collection and processing operations. Please see https:/www.census.gov/programs-surveys/decennial-census/decade/2020/planning-management/process/data-quality.html or https:/www.census.gov/newsroom/press-releases/2021/quality-indicators-on-2020-census.html for quality indicators on the 2020 Census.

For information on the computation and use of standard errors, contact
U.S. Census Bureau Customer Service Center
http://ask.census.gov
Phone: 800-923-8282

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Monitoring the Future

The Monitoring the Future (MTF) study is a continuing series of surveys intended to assess the changing lifestyles, values, and preferences of American youth. Each year since 1975, high school seniors from a representative sample of public and private high schools have participated in this study. The 2022 survey was the 31st survey to include comparable samples of 8th and 10th graders in addition to seniors. The study is conducted by the University of Michigan's Institute for Social Research (ISR) under a grant from the National Institute on Drug Abuse. The survey design consists of a multistage random sample, where the stages include selection of geographic areas, one or more schools in each area, and a sample of students within each school. Data are collected in the spring of each year using questionnaires administered in the classroom by representatives from ISR. The 2022 survey included a total of 31,438 students from 308 schools nationwide.

In 2020, data collection was halted earlier than usual due to the COVID-19 pandemic and subsequent stay-at-home orders. This resulted in smaller samples being obtained that year, but analyses show that these samples were nationally representative.

Adjustments in 10th-grade change scores in 2009. All figures and tables in this report omit the 10th-graders data point from the 2008 survey because the data for that year were believed to be inaccurate due to sampling error, a highly unusual occurrence. This was the first time there was a need to adjust the data from a survey in the 43 years of the study; fortunately, only a single grade was affected.

Several facts led to this decision. First, it was observed that in 2008, 10th grade was the only grade that showed a decline in marijuana use, as well as in the indexes of use that include marijuana. In 2009, it was the only grade to show an increase in some of those same measures. Although trends do sometimes differ from one grade to another, the fact that this happened in just a single year led to the conclusion that the 10th-grade sample from 2008 likely showed erroneously low levels of use of certain drugs—particularly marijuana and alcohol—most likely because of sampling error. Other findings also supported this interpretation.

An examination of the subgroup trend tables shows that in 2009, there were unusually large increases of marijuana use in two regions of the country, the West and the South, raising the possibility that relatively few schools accounted for the increase in that year. Further, there was no evidence in the trend lines from the other two grades that such an increase was actually occurring in those two regions for either marijuana or alcohol use, as would be expected if the 10th-grade data accurately represented the population. Finally, an examination of data from 10th graders in the matched half sample of schools that participated in both the 2008 and 2009 surveys reveals considerably smaller 1-year increases in the use of these two drugs than does the full sample analysis. The changes in the matched half samples are routinely examined to help validate the results from the full samples. Normally, the two indicators of change replicate closely.

Therefore, it was judged unlikely that the apparent decline in 2008 and sharp increase in 2009 for 10th graders are accurate characterizations of the total populations. Thus, the 10th-grade data points from 2008 are omitted in the figures and tables. However, the 1-year change score was calculated using the matched half sample of schools participating in both 2008 and 2009, and it was noted that the change was not significant. Their results should be relatively unaffected by schools entering and leaving the sample each year. Importantly, these adjusted change scores bring the 10th-grade change data much more into line with what is observed to be occurring in the other two grades.

For more information, please see

Johnston, L. D., Miech, R. A., Patrick, M. E., O'Malley, P. M., Schulenberg, J. E., & Bachman, J. G. (2023). Monitoring the Future national survey results on drug use 1975–2022: Overview, key findings on adolescent drug use. Ann Arbor: Institute for Social Research, University of Michigan.

Johnston, L. D., O'Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2010). Monitoring the future: National survey results on drug use, 1975–2009: Volume I, Secondary school students (NIH Publication No. 10-7584). National Institute on Drug Abuse.

Information about MTF is available online at https://www.nida.nih.gov/DrugPages/MTF.html and https://monitoringthefuture.org

Agency Contact:
Jessica Cotto
National Institute on Drug Abuse
Phone: 301-480-2816
Email: jessicacotto@nih.gov

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National Assessment of Educational Progress

The National Assessment of Educational Progress (NAEP) is a series of cross-sectional studies initially implemented in 1969 to assess the educational achievement of U.S. students and monitor changes in those achievements.

In the main national NAEP, a nationally representative sample of students is assessed at Grades 4, 8, and 12 in various academic subjects. The assessment is based on frameworks developed by the National Assessment Governing Board (NAGB). It includes both multiple-choice items and constructed-response items (those requiring written answers). Results are reported in two ways: by average score and by achievement level. Average scores are reported for the Nation, participating states and jurisdictions, and subgroups of the population. Percentages of students performing at or above three achievement levels (NAEP Basic, NAEPProficient, and NAEP Advanced) also are reported for these groups.

From 1990 until 2001, main NAEP was conducted for states and other jurisdictions that chose to participate. In 2002, under the provisions of the No Child Left Behind Act of 2001, all states began to participate in main NAEP, and an aggregate of all state samples replaced the separate national sample. (School district-level assessments—under the Trial Urban District Assessment program—also began in 2002.)

Results are available for the mathematics assessments administered in 2000, 2003, 2005, 2007, 2009, 2011, 2013, 2015, 2017, 2019, and 2022. In 2005, NAGB called for the development of a new mathematics framework. The revisions made to the mathematics framework for the 2005 assessment were intended to reflect recent curricular emphases and better assess the specific objectives for students at each grade level. The revised mathematics framework focuses on two dimensions: mathematical content and cognitive demand. By considering these two dimensions for each item in the assessment, the framework ensures that NAEP assesses an appropriate balance of content, as well as a variety of ways of knowing and doing mathematics. Since the 2005 changes to the mathematics framework were minimal for Grades 4 and 8, comparisons over time can be made between assessments conducted before and after the framework's implementation for these grades. The changes that the 2005 framework made to the Grade 12 assessment, however, were too drastic to allow Grade 12 results from before and after implementation to be directly compared. These changes included adding more questions on algebra, data analysis, and probability to reflect changes in high school mathematics standards and coursework; merging the measurement and geometry content areas; and changing the reporting scale from 0–500 to 0–300. For more information regarding the 2005 mathematics framework revisions, see https://nces.ed.gov/nationsreportcard/mathematics/frameworkcomparison.asp.

Results are available for the reading assessments administered in 2000, 2002, 2003, 2005, 2007, 2009, 2011, 2013, 2015, 2017, 2019, and 2022. In 2009, a new framework was developed for the 4th-, 8th-, and 12th-grade NAEP reading assessments. Both a content alignment study and a reading trend or bridge study were conducted to determine if the new reading assessment was comparable with the prior assessment. Overall, the results of the special analyses suggested that the assessments were similar in terms of their item and scale characteristics and the results they produced for important demographic groups of students. Thus, it was determined that the results of the 2009 reading assessment could still be compared with those from earlier assessment years, thereby maintaining the trend lines first established in 1992. For more information regarding the 2009 reading framework revisions, see https://nces.ed.gov/nationsreportcard/reading/whatmeasure.asp.

NAEP Long-Term Trend Assessments. In addition to conducting the main assessments, NAEP also conducts long-term trend assessments. Long-term trend assessments provide an opportunity to observe the educational progress in reading and mathematics of 9-, 13-, and 17-year-olds since the early 1970s. The long-term trend reading assessment measures students' reading comprehension skills using an array of passages that vary by text types and length. The assessment was designed to measure students' ability to locate specific information in the text provided; make inferences across a passage to provide an explanation; and identify the main idea in the text. The NAEP long-term trend assessment in mathematics measures knowledge of mathematical facts; ability to carry out computations using paper and pencil; knowledge of basic formulas, such as those applied in geometric settings; and the ability to apply mathematics to skills of daily life, such as those involving time and money.

Information about NAEP is available online at https://nces.ed.gov/nationsreportcard.

Agency Contact:
Emmanuel Sikali
Reporting and Dissemination Branch
Assessments Division
National Center for Education Statistics
550 12th Street SW
Washington, DC 20202
Phone: 202-245-7814
Email: emmanuel.sikali@ed.gov

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National Child Abuse and Neglect Data System

National Child Abuse and Neglect Data System

The National Child Abuse and Neglect Data System (NCANDS) annually collects case-level data on reports alleging child abuse and neglect, as well as the results of these reports, from state child protective services agencies. The mandate for NCANDS is based on the Child Abuse Prevention and Treatment Act (CAPTA), as amended in 1988, which directed the Secretary of the Department of Health and Human Services (HHS) to establish a national data collection and analysis program that would make available state child abuse and neglect reporting information. HHS responded by establishing NCANDS as a voluntary, national reporting system. In 1992, HHS produced its first NCANDS report based on data from 1990. The annual data report Child maltreatment evolved from that initial report.

During the early years of the system, states provided aggregated data on key indicators of reporting of alleged child maltreatment. Starting with the 1993 data year, states voluntarily began to submit case-level data. For a number of years, states provided both datasets, but starting with data year 2000, the case-level dataset became the primary source of data for the annual report. In 1996, CAPTA was amended to require that all states receiving funds from the Basic State Grant program work with the Secretary of HHS to provide specific data, to the extent practicable, on children who had been maltreated. The NCANDS data elements were revised to meet these requirements beginning with the submission of 1998 data.

Every year, NCANDS data are submitted voluntarily by the 50 states, the District of Columbia, and the Commonwealth of Puerto Rico. The NCANDS reporting year is based on the federal fiscal year calendar that spans October 1 to September 30. States submit case-level data, called a Child File, by constructing an electronic file of child-specific records for each report of alleged child abuse and neglect that received a Child Protective Services (CPS) response in the form of an investigation or alternative response. Case-level data include information about the characteristics of the reports of abuse and neglect, the children involved, the types of maltreatment, the CPS findings, the risk factors of the child and the caregivers, the services provided, and the perpetrators.

The Child File is supplemented by agency-level aggregate statistics in a separate data submission called the Agency File. The Agency File contains data that are not reportable at the child-specific level and often are gathered from agencies external to CPS. Information collected in the Agency File include receipt of prevention and postresponse services and caseload and workforce data. States are asked to submit both the Child File and the Agency File each year.

CAPTA (42 U.S.C. §5106a), as amended by the CAPTA Reauthorization Act of 2010 (P.L.111–320), retained the existing definition of child abuse and neglect as, at a minimum:

Any recent act or failure to act on the part of a parent or caretaker that results in death, serious physical or emotional harm, sexual abuse or exploitation; or an act or failure to act, which presents an imminent risk of serious harm.

Each state defines the types of child abuse and neglect in state statute and policy. CPS agencies determine the appropriate response for the alleged maltreatment based on those statutes and policies. The most common response is an investigation. The result of an investigation response is a determination (also known as a disposition) about the alleged child maltreatment.

In NCANDS, a victim is defined as a child for whom the state determined at least one maltreatment was substantiated or indicated and for whom a disposition of substantiated or indicated was assigned. It is important to note that a child may be a victim in one report and a nonvictim in another report. Substantiation is a case determination that concludes that the allegation of maltreatment or risk of maltreatment is supported by state law or policy. "Indicated" is a case determination that concludes that although maltreatment cannot be substantiated by state law or policy, there is reason to suspect that the child may have been maltreated or was at risk of maltreatment.

State statutes also establish the level of evidence needed to determine a disposition of substantiated or indicated. The local CPS agencies respond to the safety needs of the children who are the subjects of child maltreatment reports based on these state definitions and requirements for levels of evidence.

NCANDS data are a critical source of information for many publications, reports, child welfare personnel, researchers, and others. NCANDS data are used as a performance measure in several Federal programs.

NCANDS data also are used for the annual Child Maltreatment report series. Each report summarizes the major national and state-by-state findings for the given fiscal year and is a key resource for thousands of people and organizations across the world. The Children's Bureau has published an annual Child Maltreatment report since 1992. Reports are available on the Children's Bureau website at https://www.acf.hhs.gov/cb/data-research/child-maltreatment.

Rates are based on the number of states submitting data to NCANDS each year; states include the District of Columbia and the Commonwealth of Puerto Rico. Information about NCANDS is available online at https://www.acf.hhs.gov/cb/data-research/ncands.

Agency Contact:
Cara Kelly, PhD
Administration on Children, Youth, and Families
Administration for Children and Families
Email: cara.kelly@acf.hhs.gov

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National Crime Victimization Survey

The National Crime Victimization Survey (NCVS) is the Nation's primary source of information on criminal victimization. The NCVS is sponsored by the Bureau of Justice Statistics and data are collected by the U.S. Census Bureau. The NCVS collects information on nonfatal victimizations, reported and not reported to the police, against persons age 12 or over from a nationally representative sample of U.S. households. In 2021, there were 150,138 household interviews. Overall, 67% of eligible households completed an interview. Within participating households, 238,043 persons completed an interview in 2021, representing an 82% response rate among eligible persons from responding households. Sample households are chosen using a multistage stratified sample design. All household members age 12 and over in selected households are interviewed to obtain information on the frequency, characteristics, and consequences of criminal victimization in the United States. The survey measures the likelihood of victimization by rape, sexual assault, robbery, assault, theft, household burglary, and motor vehicle theft for the population as a whole, as well as for segments of the population such as adolescents and members of various racial and gender groups. Victims also are asked (either in person or by telephone) whether they reported the incident to the police. In instances of personal violent crimes, victims are asked about the characteristics of the perpetrator.

The NCVS is the largest national forum for allowing victims the opportunity to describe the impact of crime and to provide their characteristics and those of violent offenders. It has been ongoing since 1973 and was redesigned in 1992.

Due to changes in survey methodology in 2006, national-level estimates were not comparable with estimates based on NCVS data from previous years. See Criminal Victimization, 2006, https://bjs.ojp.gov/library/publications/criminal-victimization-2006, for more information on the redesigned methodology. In 2016, the NCVS sample was redesigned, and 2016 estimates among youth are not comparable with estimates from other years.

The 2020 NCVS weights include an additional adjustment to address the impact of modified Census Bureau field operations due to COVID-19. For more information on the weighting adjustments applied in 2020, see the Source and Accuracy Statement for the 2020 National Crime Victimization Survey in the NCVS 2020 Codebook (https://www.icpsr.umich.edu/web/NACJD/studies/38090/summary) and Criminal Victimization, 2020 (NCJ 301775, BJS, October 2021).

Information about the NCVS is available online at https://bjs.ojp.gov/programs/ncvs.

Agency Contact:
Alexandra Thompson
Bureau of Justice Statistics
Phone: 202-598-2032
Email: Alexandra.thompson@usdoj.gov

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National Health and Nutrition Examination Survey

The National Health and Nutrition Examination Survey (NHANES) is a major program of the National Center for Health Statistics (NCHS). NHANES is designed to assess the health and nutritional status of adults and children in the United States. The survey is unique in that it combines interviews and health 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. Findings from this survey are used to determine the prevalence of major diseases and risk factors for diseases among the civilian noninstitutionalized population of the United States and serve as the basis for national standards for such measurements as body mass index and blood pressure.

The NHANES program began in the early 1960s and has been conducted as a series of surveys focusing on different population groups or health topics. In 1999, the survey became a continuous program that, in addition to a core focus on major chronic health conditions and nutrition, has flexible content to meet emerging public health concerns. Each year, the survey examines a nationally representative sample of about 5,000 persons located in 15 counties across the country. Health interviews are conducted in respondents' homes. Health measurements are performed in specially designed and equipped mobile centers, which travel to the selected 15 counties during each survey year. The study team consists of medical and health technicians, and dietary and health interviewers.

Data collection is conducted with notebook computers. Survey information is available to NCHS staff within 24 hours of collection, which enhances quality assessment and increases the speed with which data are released to the public.

Since 1999, the sample design has consisted of multiyear, stratified, clustered four-stage samples, with public-use data released in 2-year cycles. In March 2020, the 2019–2020 data collection was interrupted due to the COVID-19 pandemic. As a result, data collection for the 2019–2020 cycle was not completed; the collected data for that period were not nationally representative. To create a nationally representative sample, the partial 2019–March 2020 data were combined with the full dataset from the previous cycle (2017–2018). The resulting files are referred to as the 2017–March 2020 pre-pandemic files. In 2017–March 2020, of the 9,003 children and adolescents ages 1–19 sampled, interviewers collected information for 5,754 children and adolescents, and completed 5,228 examinations. For children and adolescents, the unweighted response rates for interviews and examinations were 56.7% and 51.5%, respectively.

Starting with data updates for the America's Children, 2017, report, the reliability of survey percentage estimates is assessed using the Clopper-Pearson confidence interval, which was adapted for complex surveys by Korn-Graubard, to determine if the estimate is unreliable and should be suppressed. This method has been applied to all NHANES estimates. The reliability of prior estimates for other indicators are evaluated based on relative standard error.

For more information about the survey methodology, see:

National Center for Health Statistics. (2021, May 27). Brief Overview and Analytic Guidelines. https://wwwn.cdc.gov/nchs/nhanes/continuousnhanes/overviewbrief.aspx?Cycle=2017-2020.

Chen, T. C., Clark, J., Riddles, M. K., Mohadjer, L. K., & Fakhouri, T. H. I. (2020). National Health and Nutrition Examination Survey, 2015−2018: Sample design and estimation procedures. Vital and Health Statistics, 2(184). National Center for Health Statistics. https://www.cdc.gov/nchs/data/series/sr_02/sr02-184-508.pdf

Information about NHANES is available online at https://www.cdc.gov/nhanes.

Agency Contact:
Lara Akinbami
National Center for Health Statistics
Phone: 301-458-4306
Email: LAkinbami@cdc.gov

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National Health Interview Survey

The National Health Interview Survey (NHIS) is conducted by the National Center for Health Statistics (NCHS). NHIS monitors the health of the U.S. population by collecting and analyzing data on a broad range of topics. NHIS is a continuing nationwide sample survey of the civilian noninstitutionalized population in the U.S., excluding patients in long-term care facilities, persons on active duty with the Armed Forces, prisoners, and U.S. nationals living in foreign countries. Data are collected through personal household interviews by trained interviewers. Before 1997, a paper-and-pencil questionnaire format was used. From 1997 onward, computer-assisted personal interviewing (CAPI) was used. Interviewers obtain information on personal and demographic characteristics, including race and ethnicity, through self-reports or reports by a member of the household. Interviewers also collect data on illnesses, injuries, impairments, chronic conditions, disability, utilization of health services, and other health topics. Each year, the survey is reviewed, and special topics are added or deleted. For most health topics, the survey collects data for an entire year.

The NHIS sample is designed to estimate the national prevalence of health conditions, health service utilization, and health behaviors of the civilian noninstitutionalized population of the United States, and included an oversample of Black, Hispanic, and Asian persons (from 2006 to 2015). The NHIS core questionnaire items are revised about every 10 to 15 years. The sample for the NHIS is redesigned and redrawn about every 10 years to better measure the changing U.S. population and to meet new survey objectives. In 2019, the NHIS questionnaire was redesigned to better meet the needs of data users, the Centers for Disease Control and Prevention, and the Department of Health and Human Services. Starting with the 2019 survey, the NHIS annual data release only includes the Sample Adult, Sample Child, Imputed Income, and Paradata files. Household, family, and person data files are no longer released. Due to changes in weighting and design methodology, direct comparisons between estimates before 2019 and 2019 onward should be made with caution, as the impact of these changes has not been fully evaluated at this time. In 2019, 9,193 children under age 18 were sampled from 33,138 households with a response rate of 59%. (Starting with the 2019 survey, an interviewed household is defined as one where the household roster and a substantial portion of either the Sample Adult Interview or the Sample Child interview is completed. Previous survey cycles defined an interviewed household as one where at least one family in the household completed a substantial portion of the family interview.) In 2020, the COVID-19 pandemic created challenges conducting in-person interviews, resulting in a shift from in-person to all-telephone interviewing in late March 2020. This change caused the response rate to decline. In July 2020, interviews were attempted by telephone first, with follow-ups to complete interviews by personal visit. Due to concerns about possible loss of coverage and lower response rates, the original August–December 2020 sample was reduced to instead provide resources for reinterviewing adults who completed the 2019 NHIS. This resulted in a smaller-than-normal sample of 5,790 children under age 18 from 21,930 households with a response rate of 48% in 2020. Due to ongoing data collection difficulties resulting from the COVID-19 pandemic, interviews were attempted by telephone first from January to April 2021 and in-person visits were only used to follow-up on nonresponse, deliver recruitment materials, and conduct interviews when telephone numbers were unknown. Starting in May 2021, regular in-person survey interviews resumed, and interviewers were given the flexibility to follow up by telephone and contact respondents by telephone first based on local COVID-19 conditions. In 2021, 8,261 children under age 18 were sampled from 30,673 households with a response rate of 50%.

Starting with data updates for the America's Children, 2017, report, the reliability of survey percentage estimates is assessed using the Clopper-Pearson confidence interval, which was adapted for complex surveys by Korn-Graubard, to determine if the estimate is unreliable and should be suppressed. This method has been applied to all NHIS estimates. The reliability of prior estimates for other indicators are evaluated based on relative standard error.

For more information about the survey methodology, see

National Center for Health Statistics. (2022). Survey Description, National Health Interview Survey, 2021. https://ftp.cdc.gov/pub/Health_Statistics/NCHS/Dataset_Documentation/NHIS/2021/srvydesc-508.pdf.

National Center for Health Statistics. (2021, September 30). What's different about the 2020 NHIS Data? https://www.cdc.gov/nchs/nhis/2020nhisdata.htm.

National Center for Health Statistics. (2020). Survey Description, National Health Interview Survey, 2019. ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/Dataset_Documentation/NHIS/2019/srvydesc-508.pdf.

National Center for Health Statistics. (2020, October 6). 2019 Questionnaire Redesign. National Health Interview Survey. https://www.cdc.gov/nchs/nhis/2019_quest_redesign.htm.

Information about NHIS is available online at https://www.cdc.gov/nchs/nhis.htm.

For health data for children, see:

NCHS. Summary health statistics for U.S. children: National Health Interview Survey. https://www.cdc.gov/nchs/nhis/shs.htm.

Agency Contacts:

For more information on:
Health insurance and access to care:
Robin A. Cohen
National Center for Health Statistics
Phone: (301) 458-4152
E-mail: RCohen@cdc.gov

Disability:
Julie Weeks
National Center for Health Statistics
Phone: 301-458-4562
Email: jweeks@cdc.gov

Asthma:
Lara Akinbami
National Center for Health Statistics
Phone: (301) 458-4306
E-mail: LAkinbami@cdc.gov

Emotional and behavioral difficulties:
Shelli Avenevoli
National Institute of Mental Health
Phone: (301) 443-8316
E-mail: avenevos@mail.nih.gov

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National Hospital Ambulatory Medical Care Survey

The National Hospital Ambulatory Medical Care Survey (NHAMCS) Emergency Department (ED) Component is conducted by the National Center for Health Statistics. NHAMCS-ED collects data on ambulatory care visits to hospital emergency departments. Data are abstracted or electronically extracted from medical records by U.S. Census Bureau field representatives. Patient characteristics collected include age, sex, race, ethnicity, and expected source of payment. Visit characteristics collected include reasons for visit, diagnoses, tests and procedures, medications, providers seen, and disposition. Data are also collected on selected hospital characteristics, such as trauma level and electronic health record capabilities. Annual data collection began in 1992.

The survey is a nationally representative sample of in-person visits to EDs in non-Federal, short-stay, and general hospitals. NHAMCS uses a four-stage probability sample design, involving samples of geographic primary sampling units (PSUs); hospitals within PSUs; EDs; and patient visits to EDs.

The hospital sample consists of about 500 hospitals. In 2019, 19,481 ED patient record forms were completed, and the ED hospital response rate was 84.2%. In 2020, 14,860 ED patient record forms were completed, and the ED hospital response rate was 76.2%. For information on how data collection procedures were adapted during the COVID-19 pandemic, see https://pubmed.ncbi.nlm.nih.gov/34878878/.

For background information, see

McCaig, L. F., & McLemore, T. (1994). Plan and operation of the National Hospital Ambulatory Medical Care Survey. Vital and Health Statistics 1(34). National Center for Health Statistics. https://www.cdc.gov/nchs/data/series/sr_01/sr01_034acc.pdf.

Information about NHAMCS is available on the National Health Care Survey website at https://www.cdc.gov/nchs/nhcs/index.htm or the Ambulatory Health Care website at https://www.cdc.gov/nchs/ahcd/index.htm.

Agency Contact:
Julie Weeks
National Center for Health Statistics
Phone: 301-458-4562
Email: jweeks@cdc.gov

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National Household Education Survey

The National Household Education Surveys Program (NHES) is a data collection system designed to address a wide range of education-related issues. Surveys have been conducted in 1991, 1993, 1995, 1996, 1999, 2001, 2003, 2005, 2007, 2012, 2016, and 2019. NHES targets specific populations for detailed data collection. It is intended to provide more detailed data on the topics and populations of interest than are collected through supplements to other household surveys.

The 1991 NHES included a survey on early childhood program participation. Investigators screened approximately 60,000 households to identify a sample of about 14,000 children, ages 3–8. They interviewed parents to collect information about these children's educational activities and the role of the family in the children's learning. In 1993, the National Center for Education Statistics (NCES) fielded a school readiness survey in which parents of approximately 11,000 children ages 3–7 or in 2nd grade or below were asked about their children's experiences in early childhood programs, developmental level, school adjustment and related problems, early primary school experiences, general health and nutrition status, home activities, and family characteristics (including family stability and economic risk factors). In 1995, NCES also fielded a survey on early childhood program participation, similar to that of 1991. It entailed screening approximately 44,000 households and interviewing 14,000 parents of children from birth through 3rd grade. In 1996, NCES fielded a survey of parent and family involvement in education, interviewing nearly 21,000 parents of children in Grades 3–12. About 8,000 youth in Grades 6–12 were also interviewed about their community service and civic involvement. The 1999 NHES was designed to collect end-of-the-decade estimates of key indicators collected in previous NHES surveys and to collect data from children and their parents about plans for the child's education after high school. Approximately 60,000 households were screened for a total of about 31,000 interviews with parents of children from birth through Grade 12 (including about 6,900 infants, toddlers, and preschoolers) and adults age 16 or over not enrolled in Grade 12 or below.

Three surveys were fielded as part of the 2001 NHES. The Early Childhood Program Participation Survey was similar in content to the 1995 collection and collected data about the education of 7,000 prekindergarten children ranging in age from birth to age 6. The Before- and After-School Programs and Activities Survey collected data about nonparental care arrangements and educational activities in which children participate before and after school. Data were collected for approximately 10,000 children in kindergarten through Grade 8. The third survey fielded in 2001 was the Adult Education and Lifelong Learning Survey, which gathered data about the formal and informal educational activities of 11,000 adults.

The 2005 NHES included surveys that covered early childhood program participation and after-school programs and activities. Data were collected from parents of about 7,200 children for the Early Childhood Program Participation Survey and from parents of nearly 11,700 children for the After-School Programs and Activities Survey. These surveys were substantially similar to the surveys conducted in 2001, with the exceptions that the Early Childhood Program Participation Survey and the After-School Programs and Activities Survey did not collect information about before-school care for school-age children.

The 2007 NHES fielded the Parent and Family Involvement in Education Survey, which was similar in design and content to the Parent and Family Involvement in Education Survey fielded in 2003. New features added in 2007 were questions about supplemental education services provided by schools and school districts (including use of and satisfaction with such services), as well as questions to efficiently identify the school attended by the sampled students. For the 2007 Parent and Family Involvement Survey, interviews were completed with parents of 10,680 sampled children in kindergarten through Grade 12, including 10,370 students enrolled in public or private schools and 310 homeschooled children.

NHES:2012, NHES:2016, and NHES:2019 included the Parent and Family Involvement in Education Survey and the Early Childhood Program Participation Survey. The Parent and Family Involvement in Education Survey gathered data on students who were enrolled in kindergarten through Grade 12 or who were homeschooled at equivalent grade levels. Survey questions that pertained to students enrolled in kindergarten through Grade 12 requested information on various aspects of parent involvement in education (such as help with homework, family activities, and parent involvement at school), and survey questions pertaining to homeschooled students requested information on the student's homeschooling experiences, the sources of the curriculum, and the reasons for homeschooling. The Early Childhood Program Participation Survey focused on children age 6 or younger who were not yet enrolled in kindergarten. The survey questionnaire covered children's participation in early education and care arrangements provided by relatives or nonrelatives in private homes, center-based day care, or preschool programs (including Head Start). Additional topics included family learning activities, early literacy and numeracy skills, out-of-pocket expenses for nonparental care and education, factors related to parents' selection of providers, and parents' perceptions of care and education quality. Parents also were asked about child characteristics, including the child's health and disability status; characteristics of the child's parents or guardians who live in the household; and household characteristics.

Additional information about the NHES is available online at https://nces.ed.gov/nhes/.

Agency Contact:
Michelle McNamara
Sample Surveys Division
National Center for Education Statistics
550 12th Street SW
Washington, DC 20202
Phone: 202-245-7033
Email: michelle.mcnamara@ed.gov

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National Immunization Survey

The National Immunization Surveys (NIS) are a family of telephone surveys used to monitor vaccination coverage among children ages 19–35 months (NIS-Child), adolescents ages 13–17 years (NIS-Teen), and for influenza vaccination, ages 6 months–17 years (NIS-Flu). Data collection for NIS-Child began in April 1994 to assess vaccination coverage after measles outbreaks in the early 1990s. Similar to the NIS-Child, the NIS-Teen was launched in 2006.

The NIS provide population-based, state, selected local area, and territorial estimates of vaccination coverage among children and adolescents using a standard survey methodology. The surveys collect data through telephone interviews with parents or guardians in all 50 states, the District of Columbia, and some cities or counties and U.S. territories. Cell phone numbers are randomly selected and called to identify one or more age-eligible children or adolescents from the household. The parents and guardians of eligible children for NIS-Child and adolescents for NIS-Teen are asked during the interview for the names of their children's or teen's vaccination providers and permission to contact them. With this permission, a questionnaire is mailed to each child's vaccination provider(s) to collect the information on the types of vaccinations, number of doses, dates of administration, and other administrative data about the health care facility. Estimates of vaccination coverage are determined for vaccinations recommended by the Advisory Committee on Immunization Practices (ACIP). Children and adolescents are classified as being up to date based on the ACIP-recommended numbers of doses for each vaccine. All vaccination coverage estimates are based on provider-reported vaccination history.

Information about the NIS is available online at https://www.cdc.gov/vaccines/imz-managers/nis/index.html.

Agency Contact:
James A. Singleton, PhD
Centers for Disease Control and Prevention
Phone: 404-639-8560
Email: JSingleton@cdc.gov

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National Survey on Drug Use and Health

The National Survey on Drug Use and Health (NSDUH) is sponsored by the Center for Behavioral Health Statistics and Quality of the Substance Abuse and Mental Health Services Administration (SAMHSA).

NSDUH has been conducted since 1971 and serves as the primary source of information on the prevalence and incidence of illicit drug, alcohol, and tobacco use in the civilian noninstitutionalized population ages 12 and over in the United States. Information about substance use and substance use disorders, mental health problems, and receipt of substance abuse and mental health treatment is also included.

The survey covers residents of households (living in houses/townhouses, apartments, condominiums, etc.), persons in noninstitutional group quarters (e.g., shelters, rooming/boarding houses, college dormitories, migratory workers' camps, and halfway houses), and civilians living on military bases. The survey excludes homeless people who do not use shelters, active military personnel, and residents of institutional group quarters. NSDUH data are not only representative of the population nationally but also representative of the population in each state and the District of Columbia. The survey design includes an independent, multistage area probability sample for each state and the District of Columbia to accommodate state estimates of substance use and mental health. The unit analysis is at the person level. Respondents are given a choice of mode of data collection, either through in-person interviews or via a web survey. Computer-assisted interviewing (CAI) methods, including audio computer-assisted self-interviewing (ACASI), are used to provide a private and confidential setting to complete in-person interviews. Over 67,500 interviews are conducted each year using these methods.

Information about NSDUH is available online at https://www.samhsa.gov/data/data-we-collect/nsduh-national-survey-drug-use-and-health. To access SAMHSA's public-use files, including an online data analysis tool, please visit https://datafiles.samhsa.gov/. NSDUH-restricted files, including state and other geographic identifiers, can be accessed through the Research Data Center (RDC) system of the National Center for Health Statistics. For RDC-related questions, please email rdca@cdc.gov.

Agency Contact:
Center for Behavioral Health Statistics and Quality
Substance Abuse and Mental Health Services Administration
Email: CBHSQRequest@samhsa.hhs.gov

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National Vital Statistics System—Linked Birth/Infant Death Data Set

The National Center for Health Statistics' (NCHS) National Vital Statistics System collects and publishes data on births and deaths in the United States. The period data set of the Linked Birth/Infant Death Data Set is used to produce the statistics presented in this report. In the period-linked data set, the numerator consists of all infant deaths occurring in a given year linked to their corresponding birth certificates from that calendar year or the previous year. The Linked file includes all the variables on the national natality file, as well as medical information reported for the same infant on the death record and the age of the infant at death. The infant's race and Hispanic origin are classified based on the race and Hispanic origin of the mother reported on the birth certificate. This is preferred over race and Hispanic origin on the death certificate because information on the birth certificate is usually provided by the parents, while information on the death certificate may be completed by a third party (like the coroner or physician). Linked files are available starting with the birth cohort of 1983. Linked files were not produced for the 1992–1994 data years.

Race Reporting. The 2003 revision of the U.S. Standard Certificate of Live Birth uses revised race and ethnicity sections conforming to the 1997 Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity. The 2003 revision permits reporting of more than one race (multiple races). In 2003, states began adopting this new certificate on a rolling basis. Starting with the 2017 linked data set, single-race data are available for all 50 states and the District of Columbia. For data before 2017, bridged-race categories were presented to provide uniformity and comparability of data over time. Therefore, data for race groups for 2017 onwards are not comparable with earlier data. The bridged population estimates can be found online at https://www.cdc.gov/nchs/nvss/bridged_race.htm.

For more information, see:

Ely, D. M., & Driscoll, A. K. (2022). Infant mortality in the United States, 2020: Data from the period linked birth/infant death file. National Vital Statistics Reports, 71(5). National Center for Health Statistics. DOI: https://dx.doi.org/10.15620/cdc:120700.

Information about the Linked Birth/Infant Death file is available online at https://www.cdc.gov/nchs/nvss/linked-birth.htm.

Agency contact:
Joyce Martin
National Center for Health Statistics
Phone: 301-458-4362
Email: jamartin@cdc.gov

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National Vital Statistics System—Mortality

The National Center for Health Statistics' (NCHS) National Vital Statistics System (NVSS) collects and publishes data on deaths in the United States. NCHS obtains information on deaths from the registration offices of all states, New York City, and the District of Columbia. Funeral directors and family members provide demographic information on death certificates. Medical certification of cause of death is provided by a physician, medical examiner, or coroner.

Cause of death. For 1980–1998, cause of death is classified according to the International Classification of Diseases (ICD), 9th Revision. For 1999 onward, cause of death is classified according to the ICD, 10th Revision. The following ICD codes are used in the America's Children report:

Cause of Death ICD-9 ICD-10
Birth defects 740–759 Q00–Q99
Cancer 140–208 C00–C97
COVID-19 . . . U07.1
Heart disease 390–398, 402, 404–429 I00–I09, I11, I13, I20–I51
Homicide E960–E969 *U01–*U02, X85–Y09, 87.1
Influenza and pneumonia 480–487 J09–J18
Injuries (intentional and unintentional) E800–E869, E880–E929, E950–E999 *U01–*U03, V01–Y36, Y85–Y87, Y89
     Drowning E830.0–E830.9, E832.0–E832.9, E910.0–E910.9, E954, E964, E984 W65–74, X71, X92, Y21
     Fall E880.0–E886.9, E888, E957.0–E957.9, E968.1, E987.0–E987.9 W00–W19, X80, Y01, Y30
     Fire and burns E890–E899, E924.0–E924.9, E958.1, E958.2, E958.7, E961, E968.0, E968.3, E988.1, E988.2, 988.7 *U01.3, X00–X19, X76–77, X97–X98, Y26–Y27, Y36.3
Firearms E922, E955.0–E955.4, E965.0–E965.4, E970, E985.0–E985.4 *U01.4, W32–W34, X72–X74, X93–X95, Y22–Y24, Y35.0
     Firearm homicide E965.0–E965.4 *U01.4, X93–X95
     Firearm suicide E955.0–E955.4 X72–X74
Motor vehicle traffic E810–E825 V02–V04, V09.0, V09.2, V12–V14, V19.0–V19.2, V19.4–V19.6, V20–V79, V80.3–V80.5, V81.0–V81.1, V82.0–V82.1, V83–V86, V87.0–V87.8, V88.0–V88.8, V89.0, V89.2
Pedestrian (nontraffic) E800.2, E801.2, E802.2, E803.2, E804.2, E805.2, E806.2, E807.2, E820.7, E821.7, E822.7, E823.7, E824.7, E825.7,E826.0, E827.0, E828.0, E829.0 V01.0, V02.0, V03.0, V04.0, V05, V06, V09.0, V09.1, V09.3, V09.9
Suffocation E911–E913.9, E953.0–E953.9, E963, E983.0–E983.9 W75–W84, X70, X91, Y20
Suicide E950–E959 *U03, X60–X84, Y87.0
Unintentional injuries E800–E869, E880–E929 V01–X59, Y85–Y86

... Category not applicable.

Population denominators. Population denominators are based on Census data. The 2003 revision of the U.S. Standard Certificate of Death uses revised race and ethnicity sections conforming to the 1997 Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity. The 2003 revision permits reporting of more than one race (multiple races). In 2003, states began adopting this new certificate on a rolling basis. Starting with 2018 data, all 50 states and the District of Columbia have adopted the 2003 certificate. Prior to 2018 data, to provide uniformity and comparability of data for trend comparison, bridged race categories were presented. Therefore, data for race groups for 2018 and subsequent years are not comparable with earlier data. The bridged population estimates can be found online at https://www.cdc.gov/nchs/nvss/bridged_race.htm. Prior to America's Children, 2003, rates were based on populations estimated from the 1990 Census.

For more information about these methodologies, see:

Ingram, D. D., Weed, J. A., Parker, J. D., Hamilton, B. E., Schenker, N., Arias, E., & Madans, J. (2003). U.S. Census 2000 population with bridged race categories. Vital Health Statistics, 2(135). National Center for Health Statistics. https://www.cdc.gov/nchs/nvss/bridged_race.htm.

Anderson, R. N., & Arias, E. (2003). The effect of revised populations on mortality statistics for the United States, 2000. National Vital Statistics Reports, 51(9). National Center for Health Statistics. https://www.cdc.gov/nchs/data/nvsr/nvsr51/nvsr51_09.pdf.

National Center for Health Statistics. (2015, November 6). Comparability of cause-of-death between ICD revisions. https://www.cdc.gov/nchs/nvss/mortality/comparability_icd.htm.

For more information on national mortality data, see:

Murphy, S. L., Kochanek, K. D., Xu, J., & Arias, E. (2022). Mortality in the United States, 2021 (NCHS Data Brief, No. 456). National Center for Health Statistics. DOI: https://dx.doi.org/10.15620/cdc:122516.

Xu, J., Murphy, S. L., Kochanek, K. D., & Arias, E. (2021). Deaths: Final data for 2019. National Vital Statistics Reports, 70(8). National Center for Health Statistics. DOI: https://dx.doi.org/10.15620/cdc:106058.

National Center for Health Statistics. (2004). Technical appendix. Vital statistics of the United States, 1999, vol. II, mortality, part A. https://www.cdc.gov/nchs/data/statab/techap99.pdf.

Information about NVSS deaths data is available online at https://www.cdc.gov/nchs/nvss/deaths.htm.

Agency Contacts:
For more information on:
Child mortality:
Donna Hoyert
National Center for Health Statistics
Phone: 301-458-4279
Email: dhoyert@cdc.gov
Adolescent mortality:
Julie Weeks
National Center for Health Statistics
Phone: 301-458-4562
Email: jweeks@cdc.gov

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National Vital Statistics System—Natality

The National Center for Health Statistics' (NCHS) National Vital Statistics System (NVSS) collects and publishes data on births in the United States. NCHS obtains information from the registration offices of all states, New York City, and the District of Columbia. The birth certificate must be filed with the local registrar of the district in which the birth occurs. Each birth must be reported promptly; the reporting requirements vary from state to state, ranging from 24 hours to as much as 10 days after the birth. Demographic information on birth certificates, such as race and ethnicity, is provided by the mother at the time of birth. Hospital records provide the base for information on birthweight.

Population Denominators. Population denominators are based on Census data. The 2003 revision of the U.S. Standard Certificate of Live Birth uses revised race and ethnicity sections conforming to the 1997 Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity. The 2003 revision permits reporting of more than one race (multiple races). In 2003, states began adopting this new certificate on a rolling basis. Starting with 2016 data, all 50 states and the District of Columbia have adopted the 2003 certificate. Prior to 2016 data, to provide uniformity and comparability of data for trend comparison, bridged-race categories were presented. Therefore, data for race groups for 2016 and subsequent years are not comparable with earlier data. The bridged population estimates can be found online at https://www.cdc.gov/nchs/nvss/bridged_race.htm. Prior to America's Children, 2003, rates were based on populations estimated from the 1990 Census.

Detailed information on the methodologies used to develop the revised populations, including the populations for birth rates for teenagers and birth rates for unmarried teenagers, is presented in several publications.

For more information about these methodologies, see:

Matthews, T. J., & Hamilton, B. E. (2019). Total fertility rates by state and race and Hispanic origin: United States, 2017. National Vital Statistics Reports, 68(1). National Center for Health Statistics. https://www.cdc.gov/nchs/data/nvsr/nvsr68/nvsr68_01-508.pdf

Ventura, S. J., Hamilton, B. E., & Sutton, P. D. (2003). Revised birth and fertility rates for the United States, 2000 and 2001. National Vital Statistics Reports, 51(4). National Center for Health Statistics. https://www.cdc.gov/nchs/data/nvsr/nvsr51/nvsr51_04.pdf

Hamilton, B. E., Sutton, P. D., & Ventura, S. J. (2003). Revised birth and fertility rates for the 1990s and new rates for Hispanic Populations, 2000 and 2001: United States. National Vital Statistics Reports, 51(12). National Center for Health Statistics. https://www.cdc.gov/nchs/data/nvsr/nvsr51/nvsr51_12.pdf

Ingram, D. D., Weed, J. A., Parker, J. D., Hamilton, B. E., Schenker, N., Arias, E., & Madans, J. (2003). U.S. Census 2000 population with bridged race categories. Vital and Health Statistics, 2(135). National Center for Health Statistics. https://www.cdc.gov/nchs/nvss/bridged_race.htm

For more information on national natality data, see

Osterman, M. J. K., Hamilton, B. E., Martin, J. A., Driscoll, A. K., & Valenzuela, C.P. (2023). Births: Final data for 2021. National Vital Statistics Reports, 72(1). National Center for Health Statistics. DOI: https://dx.doi.org/10.15620/cdc:122047.

National Center for Health Statistics. (2008). Detailed technical notes. United States, 2005, natality. https://wonder.cdc.gov/wonder/sci_data/natal/detail/type_txt/natal05/TechAppendix05.pdf

Information about NVSS births data is available online at https://www.cdc.gov/nchs/nvss/births.htm.

Agency Contact:
Joyce Martin
National Center for Health Statistics
Phone: 301-458-4362
Email: JMartin@cdc.gov

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Safe Drinking Water Information System

The Safe Drinking Water Information System (SDWIS) is the national regulatory compliance database for the drinking water program of the U.S. Environmental Protection Agency (EPA). SDWIS includes information on the Nation's 160,000 public water systems and data submitted by states and EPA regions in conformance with reporting requirements established by statute, regulation, and guidance.

The EPA sets national standards for drinking water. These requirements take three forms: maximum contaminant levels (MCLs, the maximum allowable level of a specific contaminant in drinking water), treatment techniques (specific methods that facilities must follow to remove certain contaminants), and monitoring and reporting requirements (schedules that utilities must follow to report testing results). States report any violations of these three types of standards to the EPA.

Water systems must monitor for contaminant levels on fixed schedules and report to the EPA when a maximum contaminant level has been exceeded. States also must report when systems fail to meet specified treatment techniques. More information about the maximum contaminant levels can be found online at https://www.epa.gov/ground-water-and-drinking-water/table-regulated-drinking-water-contaminants.

The EPA sets minimum monitoring schedules that drinking water systems must follow. These minimum monitoring schedules (states may require systems to monitor more frequently) vary by the type and size of the drinking water system, the source water (surface water or ground water), and contaminant. For example, at a minimum, all drinking water systems regularly monitor nitrate, community water systems that serve surface water monitor daily for turbidity, and ground water systems may monitor inorganic contaminants every 9 years.

SDWIS includes data on the total population served by each public water system and the state in which the public water system is located. However, SDWIS does not include the number of children served. The fractions of the population served by noncompliant public water systems in each state were estimated using the total population served by violating community water systems divided by the total population served by all community water systems. The numbers of children served by violating public water systems in each state were estimated by multiplying the fraction of the population served by violating public water systems by the number of children (ages 0–17) in the state.

Information about SDWIS is available online at https://www.epa.gov/enviro/sdwis-overview.

Agency Contact:
Renee Morris
Office of Ground Water and Drinking Water
U.S. Environmental Protection Agency
Phone: 202-564-8037
Email: morris.renee@epa.gov

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Youth Risk Behavior Surveillance System

The Youth Risk Behavior Surveillance System (YRBSS) was developed in 1990 to monitor health risk behaviors and experiences that contribute to the leading causes of death, disability, and social problems among youth and adults in the United States.

The YRBSS includes national, state, and local school-based surveys of representative samples of 9th- through 12th-grade students. These surveys are conducted every 2 years, usually during the spring semester. The national Youth Risk Behavior Survey (YRBS), conducted by the Centers for Disease Control and Prevention, provides data representative of high school students in public and private schools in the United States. The state and local surveys, conducted by departments of health and education, typically provide data representative of public high school students in each state or local school district. Survey procedures for the national, state, and local surveys are designed to protect students' privacy by allowing for anonymous and voluntary participation. Before survey administration, local parental permission procedures are followed. Students complete the self-administered questionnaire during one class period and record their responses directly on an electronic device, computer-scannable booklet, or answer sheet.

For the 2021 national YRBS, the sampling frame consisted of all public and private schools with students in at least one of Grades 9–12 in the 50 states and the District of Columbia. A three-stage cluster sample design produced a nationally representative sample of students in Grades 9–12 who attend public and private schools. All students in selected classes were eligible to participate. Schools, classes, and students that refused to participate were not replaced. In 2021, 17,508 questionnaires were completed in 152 schools. The school response rate was 73%, and the student response rate was 79%. The overall response rate (school response rate multiplied by the student response rate) was 57%.

Information about the YRBSS, including the 2021 national YRBS, is available online at https://www.cdc.gov/yrbs.

Agency Contact:
Mike Underwood, PhD
Chief, School-Based Surveillance Branch
Division of Adolescent and School Health
Centers for Disease Control and Prevention
Phone: 404-718-1471
Email: jmunderwood@cdc.gov

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