Blog & News
Now Available on State Health Compare: Five Updated Measures and One Brand New Measure
July 27, 2022:Estimates for five measures of health care access, affordability, and use have now been updated on SHADAC’s State Health Compare web tool. One new measure, Had Dental Visit has also been added to the tool. The new and updated measures are all produced using data from the National Health Interview Survey (NHIS), conducted by the National Center for Health Statistics (NCHS). SHADAC produces these state-level measures using restricted-access data through the Minnesota Research Data Center (MnRDC). SHADAC’s State Health Compare is the only source of state-specific data for these measures which are essential for monitoring individuals’ access to and use of medical care, along with their ability to afford care.
These measures now contain data updated through 2020, using two-year pooled periods (i.e., 2017-2018, 2019-2020). The measures can be broken down by Total, Age, and Coverage Type (Public, Private, Uninsured). Additional breakdowns—such as Race and Ethnicity—will be highlighted within future SHADAC blogs as they become available.
Updated and new measures include:
NEW: Had Dental Visit
This measure describes the percent of individuals who had a dental examination or cleaning during the past twelve months.
Had Usual Source of Medical Care
This measure captures rates of individuals who had a usual place of medical care other than an emergency department during the past twelve months.
![](https://www.shadac.org/sites/default/files/general-doctor-visi.png)
This measure provides rates of individuals who had any visit to a general doctor or provider within the last year.
![](https://www.shadac.org/sites/default/files/ED-visit.png)
This measure looks at rates of individuals who had any type of visit to an emergency department in the past twelve months.
![](https://www.shadac.org/sites/default/files/medical-bill.png)
This measure examines rates of individuals who had trouble paying off medical bills during past twelve months for the civilian non-institutionalized population.
![](https://www.shadac.org/sites/default/files/change-drug.png)
This measure highlights rates of individuals who were prescribed medication in the past twelve months who made changes to medical drugs because of cost during the past twelve months for the civilian non-institutionalized population. This includes delaying filling a prescription, taking less medicine, or skipping medication doses to save money.
Click here to explore these measures on State Health Compare!
Data Sources
The estimates were produced using restricted NHIS data in the MnRDC. Measures have been updated with data through 2020 using two-year pooled periods, including (a) 2017-2018 and (b) 2019-2020.
Blog & News
2021 NHIS Full-Year Health Insurance Estimates Early Release: Coverage Rates Remain Stable Overall, Changes Visible across Demographic Groups (Infographic)
May 10, 2022:The National Center for Health Statistics (NCHS) released health insurance coverage estimates for 2021 from the National Health Interview Survey (NHIS) as part of the NHIS Early Release Program. The estimates captured in this report are some of the first available coverage estimates for 2021 from a federal survey.
National-level estimates are available by breakdowns including age, sex, poverty status, race and ethnicity, and by state Medicaid expansion status. The NHIS full-year estimates for 2021 do not include either full or partial state-level data, as has been the case since the survey was redesigned in 2019. However, NCHS periodically releases state-level estimates of coverage, which SHADAC has previously covered on our blog and will continue to monitor and report on any future releases.
Changes between the 2020 and 2021 coverage estimates were minimal when examining rates of private coverage and those without health insurance coverage. However, the 2021 report indicates a slight uptick in public coverage which is consistent with trends in survey and administrative data since the start of the coronavirus (COVID-19) pandemic in the United States. The rates across all coverage types experienced several more notable shifts when examined by sex as well as race and ethnicity.
Changes in the NHIS
The COVID-19 pandemic significantly impacted 2020 NHIS field procedures (including interview format), response rates, and resulting data analytic files, though NCHS found minimal nonresponse bias in the 2020 NHIS. A recent SHADAC issue brief reported on these and other changes to federal surveys that were similarly impacted by the pandemic.
It is also worth noting that 2021 NHIS coverage estimates are based on information collected from 29,696 sample adults and 8,293 sample children. In 2019, the NHIS underwent a substantial redesign of its content and structure and one of the largest changes, the elimination of the family questionnaire, has resulted in a substantial reduction of the available sample size for the survey (though the NCHS also estimates a positive effect on higher response rates). It is likely that a survey with a larger sample size would find more significant year-over-year changes in coverage rates.
Notes on Race and Ethnicity Estimates from NHIS
The NHIS Early Release report from which the figures for the race/ethnicity category are drawn does not further disaggregate statistics by more detailed race and ethnicity categories. Individuals not identifying as Hispanic; non-Hispanic White, Black, or Asian; or identifying with multiple, non-Hispanic race categories are classified as “multiple races or any other race.”
Additionally, there are many factors that historically widen disparities in coverage across race and ethnicity; race-based discrimination in employment and systemic racism are two possible contributors.
Other NHIS analyses from 2022
- 2022 NHIS Early Release: Estimates for First Half of the Year Show Continued Fall of Uninsured Rates (Blog) December 2022
- 2022 NHIS Early Release: Quarter 1 estimates show potential post-pandemic rebounds (Blog) August 2022
- NHIS: National Rates of Health Insurance Coverage for Third Quarter of 2021 Statistically Unchanged from 2020 (Blog) January 2022
Source
Cohen, R.A., Cha, A.E., Terlizzi, E.P., & Martinez, M.E. (2022, May 5). Health insurance coverage: Early release of estimates from the National Health Interview Survey, 2021. National Center for Health Statistics (NCHS). https://www.cdc.gov/nchs/data/nhis/earlyrelease/insur202205.pdf
Publication
Comparing Federal Government Surveys That Count the Uninsured: 2021
With the release of new insurance coverage estimates from surveys conducted by the U.S. Census Bureau, the Agency for Healthcare Research and Quality (AHRQ), and the Centers for Disease Control and Prevention (CDC), SHADAC has updated our annual “Comparing Federal Government Surveys that Count the Uninsured” brief.
The brief provides an annual update to comparisons of uninsurance estimates from four federal surveys:
- The American Community Survey (ACS)
- The Current Population Survey (CPS)
- The Medical Expenditure Panel Survey - Household Component (MEPS-HC)
- The National Health Interview Survey (NHIS)
In this brief, SHADAC presents current and historical national estimates of uninsurance along with the most recent available state-level estimates from these surveys (where possible). We also discuss the main reasons for variation in the estimates across the different surveys as well as possible reasons for incomparability of estimates across and within the surveys.
Due to the substantial impacts of the COVID-19 pandemic on federal survey data collection and production, this year the brief also includes a brief overview of the unique challenges faced by each agency conducting the four surveys due to pandemic-related disruptions, how the agencies addressed and compensated for these challenges, and what these impacts mean in terms of utilizing survey data on health insurance coverage for 2020.
Download a PDF of the Comparing Federal Government Surveys Brief.
Last year’s brief with data from the 2020 collection year, and certain 2019 collection-year data, can be accessed here.