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Suggested citation

Lloyd PC, Helms VE, Simon AE, et al. Linkage of 1999–2012 National Health

Interview Survey and National Health and Nutrition Examination Survey data

to U.S. Department of Housing and Urban Development administrative records.

National Center for Health Statistics. Vital Health Stat 1(60). 2017.

Library of Congress Cataloging-in-Publication Data

Names: National Center for Health Statistics (U.S.), issuing body.

Title: Linkage of 1999-2012 National Health Interview Survey and National

Health and Nutrition Examination Survey data to U.S. Department of Housing and Urban Development administrative records.

Other titles: Vital and health statistics. Ser. 1, Programs and collection

procedures ; no. 60. | DHHS publication ; no. 2018-1336. 0276-4733

Description: Hyattsville, Maryland : U.S. Department of Health and Human

Services, Centers for Disease Control and Prevention, National Center for Health Statistics, October 2017. | Series: Vital and health statistics.

Series 1, Program and collection procedures ; Number 60 | Series: DHHS pub

; number 2018-1336 | "October 2017." | Includes bibliographical references.

Identifiers: LCCN 2017045165| ISBN 9780840606853 (pbk.) | ISBN 0840606850

(pbk.)

Subjects:   |MESH: National Health Interview Survey (U.S.) | National Health and Nutrition Examination Survey (U.S.) | United States. Department of

Housing and Urban Development. |

Health Surveys--methods | Records as

Topic | United States Government Agencies | United States

Classification: LCC RA407.3 | NLM W2 A N148va no. 60 2017 | DDC 614.4/

273--dc23 LC record available at https://lccn.loc.gov/2017045165

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Printed on acid-free paper.

Vital and Health Statistics

Series 1, Number 60

Linkage of 1999–2012 National

Health Interview Survey and

National Health and Nutrition

Examination Survey Data to

U.S. Department of Housing

and Urban Development

Administrative Records

Programs and Collection Procedures

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics

Hyattsville, Maryland

October 2017

DHHS Publication No. (PHS) 2018–1336

National Center for Health Statistics

Charles J. Rothwell, M.S., M.B.A.,  Director

Jennifer H. Madans, Ph.D.,  Associate Director for Science

Office of Analysis and Epidemiology

Irma E. Arispe, Ph.D.,  Director

Makram Talih, Ph.D.,  Associate Director for Science

Contents

Acknowledgments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .v

Abstract . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1

Data Sources .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .2

NHIS  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .2

NHANES .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .2

HUD Administrative Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2

Data Linkage Approval, Eligibility, and Process . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3

Linkage Approval and Eligibility.   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .3

Linkage Process  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4

Linked NCHS–HUD Data .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .5

General Description of Linked Data Files . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5

Access to Linked NCHS–HUD Data Files .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .7

Analytic Considerations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7

Sample Weights.   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .8

Analyses Using Linked NCHS–HUD Data  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8

Descriptive Analyses of Linked NHIS–HUD and NHANES–HUD Participants .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .8

Conclusion   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9

Published Research Papers Using NCHS Surveys Linked to HUD Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

Appendix I. U.S. Department of Housing and Urban Development’s Largest Housing Assistance Programs . . . . . . . . . . . . 21

Appendix II. Summary of Linked National Center for Health Statistics–U.S. Department of Housing

and Urban Development Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22

Appendix III. Data Variable Considerations.   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   . 23

Appendix IV. Evaluation of NCHS–HUD Data Linkage: Comparison With HUD Program Recipients . . . . . . . . . . . . . . . 25

iii

Detailed Tables

1.

Sample size and percentage of survey participants linked to HUD data, by survey year and age at interview:

National Health Interview Survey, 1999–2012 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

2.

Sample size and percentage of survey participants linked to HUD data, by survey year and age at interview:

National Health and Nutrition Examination Survey, 1999–2012 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

3.

Linked NCHS–HUD file sample size and percentage of linked survey participants with concurrent HUD

enrollment within 1, 2, and 3 years of survey interview, by survey and age at interview.   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   . 15

4.

Unweighted sample size and weighted percent distribution of ever-linked 2008–2012 NHIS–HUD participants

aged 0–17 years, by selected sociodemographic and health characteristics.   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   . 17

5.

Unweighted sample size and weighted percent distribution of ever-linked 2008–2012 NHIS–HUD participants

aged 18 and over, by selected sociodemographic and health characteristics . . . . . . . . . . . . . . . . . . . . . . . . . 18

6.

Unweighted sample size and weighted percent distribution of ever-linked 2009–2012 NHANES–HUD participants

aged 0–17 years, by selected sociodemographic and health characteristics.   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   . 19

7.

Unweighted sample size and weighted percent distribution of ever-linked 2009–2012 NHANES–HUD participants

aged 18 and over, by selected sociodemographic and health characteristics . . . . . . . . . . . . . . . . . . . . . . . . . 20

Text Figures

1.

Process used to link National Center for Health Statistics survey data to U.S. Department of Housing and

Urban Development administrative data sources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  4

2.

Temporal alignment of National Center for Health Statistics surveys linked to U.S. Department of Housing and

Urban Development administrative data files . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6

Appendix Tables

I.

Linked NCHS–HUD data files: Name, population, and description  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22

II.

Number and percent distribution of concurrently linked 2012 NHIS–HUD participants and 2012

HUD-assisted tenants, by HUD program and selected HUD-collected demographic characteristics.   .   .   .   .   .   .   .   .   .   .   .   . 26

III.   Number and percent distribution of concurrently linked 2009–2012 NHANES–HUD participants and

2009–2012 HUD-assisted tenants, by HUD program and selected HUD-collected demographic characteristics . . . . . . 29

Appendix Figures

I.

All 2012 HUD-assisted tenants and concurrently linked 2012  NHIS–HUD participants,

by HUD housing category .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   . 27

II.

All 2012 HUD-assisted tenants and concurrently linked 2012  NHIS–HUD participants,

by sex and age group.   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   . 27

III.   All 2012 HUD-assisted tenants and concurrently linked 2012  NHIS–HUD participants,

by percentage of households with disabled or elderly persons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28

IV.   All 2012 HUD-assisted tenants and concurrently linked 2012  NHIS–HUD participants,

by household characteristics .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   . 28

V.

All 2009–2012 HUD-assisted tenants and concurrently linked 2009–2012  NHANES–HUD

participants, by HUD housing category . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30

VI.   All 2009–2012 HUD-assisted tenants and concurrently linked 2009–2012  NHANES–HUD

participants, by sex and age group.   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   .   . 30

VII.   All 2009–2012 HUD-assisted tenants and concurrently linked 2009–2012  NHANES–HUD

participants, by percentage of households with disabled or elderly persons  . . . . . . . . . . . . . . . . . . . . . . . . . 31

VIII.   All 2009–2012 HUD-assisted tenants and concurrently linked 2009–2012  NHANES–HUD

participants, by household characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31

iv

Acknowledgments

The authors gratefully acknowledge

the following persons for their

contributions to the success of the

National Center for Health Statistics

(NCHS)–U.S. Department of Housing

and Urban Development (HUD) data

linkage project: Peter Meyer, Sonali

Sinha, and Pei-Lu Chiu of NCHS for

previous research in linking National

Health Interview Survey and HUD data;

Clinton Thompson, Deborah Ingram, and

Eric Miller of NCHS for careful review

and feedback on the report; Dean Judson

of NCHS for methodological guidance in

developing the linkage-eligible adjusted

sample weights; Fred Selck of NCHS

for leading the data linkage project

during its early stages; Jesse Bassich of

NCHS for programming assistance; Lynn

Rodgers and Pramod Pamnani of HUD

for programming expertise in creating

the HUD administrative data file; Lydia

Taghavi of HUD for programming

support; Brent Mast and Carol Leming of

HUD for providing input on the contents

of the linked file; Donna Miller and Eve

Powell-Griner of NCHS for providing

input on confidentiality and privacy of

linked survey participants; and Amy

Branum and Makram Talih of NCHS

for their careful review of this report.

The authors gratefully acknowledge the

editorial staff for their critical review

and preparation of this report, which was

edited and produced by the NCHS Office

of Information Services, Information

Design and Publishing Staff: Jane Sudol

edited the report, and typesetting and

graphics were done by Odell D. Eldridge

(contractor).

v

Abstract

Background

The National Center for Health

Linkage of 1999–2012 National

Statistics (NCHS) provides statistical

information to guide actions and

Health Interview Survey and

policy to improve the health of

the American people. NCHS has

developed a data linkage program

National Health and Nutrition

that links its cross-sectional health

survey data to information from vital

Examination Survey Data to

and administrative data sources.

Through a collaborative interagency

agreement between NCHS and

U.S. Department of Housing

the U.S. Department of Housing

and Urban Development (HUD),

participants in two national health

and Urban Development

surveys administered by NCHS were

linked to administrative data from HUD.

Administrative Records

Methods

by Patricia C. Lloyd, National Center for Health Statistics; Veronica E.

This report describes and

Helms, U.S. Department of Housing and Urban Development; Alan E.

evaluates the data linkage of

Simon, Cordell Golden, James Brittain, Eileen Call, and Lisa B. Mirel,

1999–2012 National Health Interview

National Center for Health Statistics; Barry L. Steffen, Jon Sperling,

Survey (NHIS) and National Health

and Nutrition Examination Survey

and Elizabeth C. Rudd, U.S. Department of Housing and Urban

(NHANES) to administrative records

Development; Jennifer D. Parker, National Center for Health Statistics; from HUD through 2014. A brief

and Carol S. Star, U.S. Department of Housing and Urban Development

overview of the data sources,

methods used for linkage, details of

the resulting linked data files, and

analytic considerations are provided.

Introduction

interagency agreement between NCHS

and the U.S. Department of Housing and

Conclusions

Urban Development (HUD), participant

The National Center for Health

The NCHS–HUD linkage

records from these two NCHS surveys

Statistics (NCHS) is the nation’s principal

demonstrates the feasibility of linking

were linked to administrative data from

agency providing health statistics to

population health survey data to

HUD’s largest federal housing assistance

identify and address health issues. To

administrative records from federal

programs, which include Housing Choice

maximize the scientific value of NCHS

programs and enhances two NCHS

Vouchers (HCVs), multifamily (MF), and

population-based surveys, the agency

population health surveys, NHANES

public housing (PH) programs. The HUD

and NHIS, by al owing examination of

has developed a data linkage program

administrative files contain housing,

the relationship between housing and

that links health survey data to vital

income, and household characteristics

health.

and administrative data sources. Linked

as well as program participation data for

data files enable researchers to use

HCV, MF, and PH program recipients in

Keywords: record linkage • linked

longitudinal data from administrative

all 50 states and the District of Columbia.

data • HUD • housing • NHIS •

databases or mortality data in

NHANES

This report summarizes the data

combination with cross-sectional data

sources and linkage methods used to

to examine and provide more insight on

create the linked NCHS–HUD data

factors that influence disability, health

files. It provides linkage rates for the

care utilization, morbidity, and mortality

1999–2012 NHIS–HUD and NHANES–

among different U.S. subpopulations.

HUD linked files and the percentage

Two NCHS national health

distribution of selected characteristics

surveys—the National Health Interview

among linked survey participants.

Survey (NHIS) and the National

Appendix I contains a summary of

Health and Nutrition Examination

the HUD programs included in linked

Survey (NHANES)—monitor the

data sets. Appendix II summarizes the

health and well-being of the civilian

contents of the linked NCHS–HUD data

noninstitutionalized population of the

files. Appendix III provides details about

United States. Through a collaborative

the files and a description of some key

Page 1

Page 2   Series 1, No. 60

variables for researchers to consider

utilization, health insurance, and income

examinations and health measurements

when using the linked NCHS–HUD data.  and assets.

are performed in a specially designed

Appendix IV describes an evaluation

From each family, one sample adult

and equipped mobile examination center

comparing characteristics among linked

(not necessarily the head of household)

(MEC), which travels to locations

2012 NHIS–HUD and 2009–2012

and one sample child (if any children

throughout the country. The study team

NHANES–HUD participants to those of

under age 18 years are present) are

consists of a physician, medical and

HCV, MF, and PH program recipients,

randomly selected, and detailed survey

health technicians, and dietary and health

using HUD administrative data from the

data are collected on specific health

interviewers.

same time period.

topics using the Sample Adult Core and

The NHANES interview includes

the Sample Child Core questionnaires.

demographic, socioeconomic, dietary,

Data Sources

Data for the Sample Child questionnaire

and health-related questions. The

is obtained from a knowledgeable adult

examination component consists of

in the household, usually a parent.

medical, dental, and physiological

NHIS

Data are collected through a

measurements, as well as laboratory tests.

personal household interview conducted

Survey findings are used to determine

NHIS is a cross-sectional household

by interviewers employed and trained

the prevalence of major diseases and risk

interview survey designed to monitor the  by the U.S. Census Bureau according factors for diseases. NHANES findings

health of the civilian noninstitutionalized  to procedures specified by NCHS. A are also the basis for national standards

U.S. population through the collection

computer-assisted personal interviewing

for such measurements as height and

and analysis of data on a broad range of

(CAPI) mode using a laptop computer

weight and for national growth charts.

health topics (1). NCHS has conducted

has been used since 1997. For more

Data are also collected on chronic and

NHIS continuously since 1957, and the

information on NHIS, visit: https://www.

previously undiagnosed conditions.

content of the survey is periodically

cdc.gov/nchs/nhis.htm.

More information on NHANES is

updated. The sampling plan follows a

available from: https://www.cdc.gov/

multistage area probability design that

NHANES

nchs/nhanes.htm.

permits the representative sampling of

households and noninstitutional group

NHANES utilizes interviews,

HUD Administrative Data

quarters (e.g., college dormitories). The

laboratory tests, and physical

sampling plan is redesigned after every

examinations to assess the health

HUD’s largest housing assistance

decennial census. The NHIS 1995–2005

and nutritional status of civilian

programs, which include Housing Choice

survey design oversampled black as well

noninstitutionalized adults and

Vouchers (HCVs), multifamily (MF)

as Hispanic persons; the 2006–2012

children in the United States (3). The

programs, and public housing (PH)

design oversampled black, Hispanic, and

survey currently includes a nationally

programs, are included in the linked

Asian persons (2).

representative sample of about 5,000

NCHS–HUD data. MF programs provide

Demographic and basic health

persons in about 15 counties across

affordable housing through contracts

information are collected on everyone

the country each year. Oversampled

with private owners of apartment

in the household. For the years of data

subgroups for 1999–2006 included

buildings. HCV and PH programs

used for linkage, the Core questions

non-Hispanic black as well as Mexican-

are managed by local public housing

have remained largely unchanged.

American persons; low-income persons

agencies (PHAs), which oversee data

This allows for trend analyses and

of non-Hispanic white and other race and  collection and manage housing assistance for data from more than 1 year to be

ethnicity (beginning in 2000); adolescents  program implementation. Buildings of pooled to increase sample size for

aged 12–19; and non-Hispanic white

PH programs are owned by PHAs. The

analytic purposes. For 1999–2012

and other persons aged 70 and over.

HCV program gives tenants a voucher

NHIS, the Core section contains four

Oversampled subgroups for 2007–2010

that covers part of their rent in a private-

major components: Household, Family,

included all Hispanic as well as non-

market unit. Administrative data for

Sample Adult, and Sample Child. The

Hispanic black persons; low-income

HUD-assisted households are submitted

Household component collects limited

persons of non-Hispanic white and other

by housing providers. Additional

demographic information on all of the

race and ethnicity; and non-Hispanic

information about these programs is

individuals in a particular household. The  white and other persons aged 80 and

provided in Appendix I and the Analytic

Family component verifies and collects

over (4,5). Beginning with the NHANES  Guidelines (7).

additional demographic information on

2011–2012 cycle, non-Hispanic Asian

each member from each family in the

persons were also oversampled in

household and collects data on topics

addition to the ongoing oversample of

including health status and limitations,

subgroups from 2007–2010 (6).

injuries, health care access and

Health interviews are conducted

in participants’ homes. Physical

Series 1, No. 60   Page 3

Public and Indian Housing

administrative records included in the

MF programs, or PH programs. More

Information Center

Transaction File were restricted to MF

information about HUD eligibility

program transactions occurring June 30,

criteria is available from the HUD

Local PHAs collect and

1996–December 31, 2014, and HCV

website: https://www.huduser.gov/portal/

electronically submit information

and PH program transactions occurring

home.html.

to the Public and Indian Housing

December 1, 1999–December 31, 2014.

The process for determining linkage

Information Center (PIC) for households

These program transaction periods are

eligibility and collecting personally

receiving HCVs or PH assistance. Each

referred to as the linked NCHS–HUD

identifiable information (PII) varied

occasion that data are entered into the

administrative period.

by NCHS survey and year (cycle). For

system is referred to as a transaction.

NHANES, PII was consistently collected

The administrative purpose of the

during the time frame used for linkage,

periodic transactions is to ensure that

Data Linkage

but the process for obtaining consent

tenant rent contributions, which are

Approval, Eligibility,  for record linkage varied across the

based on income, are determined

survey cycles. For 1999–2008 NHANES

accurately. Information collected on the

and Process

participants, refusal to provide an SSN

administrative forms include: dates of

was considered an implicit refusal

enrollment and participation, program

for record linkage. For 2009–2012

recertification, family characteristics,

Linkage Approval and

NHANES, participants were explicitly

detailed income and asset information

Eligibility

asked for consent to be included in record

for all household members, and an

linkage activities during the informed

estimate of the family's anticipated income

All NCHS data linkage activities are  consent process prior to interview.

for the next 12 months, including sources

reviewed and approved by the NCHS

Participants who provided an affirmative

of that income. More information about

Research Ethics Review Board (ERB).

response to the linkage question were

recertification for HCV and PH programs is  The NCHS Research ERB, which

considered linkage-eligible, conditional

available from the Analytic Guidelines (7).

functions similar to an Institutional

on having sufficient PII.

Review Board (IRB), is an appointed

For NHIS, changes over time in the

Tenant Rental Assistance

ethics review committee that ensures

process for collecting PII and the addition

Certification System

research involving human participants

of a question to obtain explicit consent

and the welfare of study participants

for linkage meant that the criteria for

Owner/agents and contract

conform to federal regulations. The

linkage eligibility varied by survey year.

administrators of MF units collect and

NCHS–HUD linkage was reviewed and

For 1999–2006, the full nine-digit SSN

electronically submit information to HUD  approved by the NCHS Research ERB.

(SSN9) was requested. For 1999–2001,

through the Tenant Rental Assistance

Survey data and HUD administrative  SSN9 was requested for all NHIS

Certification System (TRACS). As with

records were linked only for NCHS–

participants. For 2002–2003, SSN9 was

PIC, TRACS collects dates of enrollment

HUD linkage-eligible survey participants.  requested for only the family respondent.

and participation, program recertification,

NCHS determined eligibility for this

For 2004–2006, SSN9 was requested

detailed income and asset information for

linkage based on whether the survey

for the NHIS family respondent, sample

all household members, and an estimate

participant provided certain data elements  adult, and sample child. For these years, of the family's anticipated income for the

necessary for linkage, including Social

if participants refused to provide SSNs,

next 12 months, including sources of that

Security number (SSN), sex, month of

they were implicitly considered to have

income. Also like PIC, each occasion that

birth, year of birth, first name, and last

refused record linkage. During that time

data are entered into the system is referred  name; did not refuse data linkage; and period, the refusal rate for providing

to as a transaction. More information

did not refuse to respond to questions

SSN increased, which reduced the

about TRACS and recertification for MF

about receiving rental assistance (NHIS

number of NHIS participants eligible

programs is available from the Analytic

only). The question about receiving rental  for record linkage (8). In an attempt to Guidelines (7).

assistance was asked only of families

counter the decline in linkage eligibility

reporting that they lived in a rental

rates, research was conducted at NCHS

HUD transaction dates included  property. Very few families living in a to assess the accuracy of National

in NCHS–HUD administrative

rental property refused to answer the

Death Index matches using partial SSN

period

question about receiving rental assistance  and other PII. The research assessed (less than 1% in each of the 1999–2012

algorithms using the last four and last

For the linkage described in

NHIS survey years). NCHS–HUD

six digits of SSNs. The results provided

this report, HUD programming staff

linkage eligibility is distinct from HUD

sufficient evidence to support changes in

created an extract of HUD transactions

program eligibility; the latter defines

how NHIS collected SSNs for linkage

for recipients of HCV, MF, and PH

whether a person meets eligibility criteria  (9). Beginning in 2007, NHIS attempted programs based on PIC and TRACS,

to receive HUD housing assistance

to decrease linkage refusal rates by

referred to as the Transaction File. HUD

through HCVs and related programs,

adding a short introduction before asking

Page 4   Series 1, No. 60

for SSN during the interview, requesting

Linkage Process

Medicare Health Insurance Claim (HIC)

only the last four SSN digits (SSN4)

number, if provided. SSN9 was extracted

instead of all nine and asking participants

Figure 1 presents the overall process  from the Medicare HIC number only for their explicit permission to link to

for linking NCHS survey data to HUD

if the survey participant was identified

administrative records if SSN4 had not

administrative data. HUD provided a

as the primary claimant for Medicare

been provided (8). Also at this time, the

data file, referred to as the HUD finder

benefits.

NCHS Research ERB determined that

file, containing PII (e.g., SSN, first and

The linkage was predominantly

for NHIS 2007 forward, only primary

last name, sex, date of birth, a unique

deterministic or rules-based, meaning that

respondents (sample adult and sample

HUD-created identification [ID], and

a set of criteria had to be met for a pair

children) would be eligible for linkage to  a sequence number to identify specific of records to be linked. Two approaches

administrative records.

transactions) of individual HCV, MF,

were used to link NCHS survey data to

NCHS survey participants under

or PH program recipients. NCHS staff

HUD administrative records. The first

age 18 at the time of the survey are

verified that the SSNs on the HUD files

approach was used for NCHS survey

considered linkage-eligible if the above-

were valid before linking to a file of

years when the SSN9 was collected from

mentioned linkage eligibility criteria

1999–2012 NHIS and NHANES linkage-

survey participants (1999–2006 NHIS

are met and consent is provided by

eligible survey participants. For example,  and all NHANES cycles). This approach their parent or guardian at the time of

if an SSN contained fewer than nine

linked survey participants to HUD

the survey. Once the child participant

digits; nonnumeric values; the first three

administrative records by matching on

becomes an adult, however, they do not

digits “000,” “666,” or in the 900 series;

valid SSN9, year of birth, month of birth,

have the opportunity to provide or deny

the second group of two digits as “00”; or  and sex.

consent for linking their survey data

the third group of four digits as “0000,”

The second approach accommodated

to administrative data based on their

it was not considered valid. For survey

the NHIS survey years when SSN4

experience as an adult. In accordance

participants who did not provide a valid

was collected. This approach matched

with NCHS Research ERB guidelines,

SSN yet did not refuse to provide their

on SSN4, year of birth, month of birth,

the linked NCHS–HUD data of child

SSN, SSN9 was extracted from their

sex, first name, last name, and day of

participants are available only for

records that occurred prior to the survey

participant’s 18th birthday. For example,

a 15-year-old linkage-eligible survey

participant of NHIS 2005 can be linked to

NCHS survey data

HUD administrative records. Linked data

containing HUD administrative data for

2007 and earlier years could be accessed

by a researcher and included in analyses

because the child survey participant

would have been under age 18 during this

time. However, NCHS is not authorized

Eligible for linkage

Ineligible for linkage

to provide researchers access to HUD

administrative records for that child

survey participant from 2008 through

HUD finder file:

2012 because the child survey participant

– HUD unique identification

would have been aged 18 or older.

number

Table 1 presents the total number of

– Social Security number

Data linkage

Nonmatched records

– Last name

1999–2012 NHIS participants for each

– First name

survey year and age group (0–17 years,

– Date of birth

18–39, 40–64, and 65 and over), the

– Sex

number who were eligible for linkage,

the percentage eligible out of the total

sample, the number who were linked,

Matched records

and the percentage who were linked out

of those eligible for linkage. Data are

presented for all NHIS participants, both

sample adults and sample children. Table

NOTE: NCHS is National Center for Health Statistics; HUD is U.S. Department of Housing and Urban Development.

SOURCES: NCHS, National Health Interview Survey and National Health and Nutrition Examination Survey, 1999–2012,

2 shows similar results for 1999–2012

data linked to HUD administrative records, 1996–2014.

NHANES participants. Data are presented

for all NHANES participants and for

Figure 1. Process used to link National Center for Health Statistics survey data to those who were examined in the MEC.

U.S. Department of Housing and Urban Development administrative data sources

Series 1, No. 60   Page 5

birth, thus incorporating first and last

records were used for each linkage-

concurrency files, seven separate episode

names and day of birth into the matching  eligible NCHS survey participant based files, and a weights file, are available only

criteria. Agreement on first name and

on variations of names. HUD records

through the NCHS Research Data Center

last name was based on exact spelling

could be matched to any or all of the

(RDC). Appendix Table I describes

matches or, because spelling variants

submission records created for a survey

each of the files that compose the linked

of names are common, was based on

participant. For example, the name

NCHS–HUD data. Data documentation,

the way a name sounds rather than how

“Beth” may be a nickname for a formal

including the Analytic Guidelines (7) and

it is spelled. The sound-alike systems

name like “Elizabeth.” In this situation,

Data Dictionary (11), feasibility files,

included both a variation of the New

a record for “Beth” and a record for

and sample read-in software programs to

York State Identification Intelligence

“Elizabeth” were created and submitted

import the feasibility files, can be found

System (NYSIIS) and the Soundex

for linkage.

on the NCHS website: https://www.cdc.

algorithm (10). NYSIIS converts a name

Once the linkage was performed

gov/nchs/data-linkage/hud.htm. Details to a phonetic coding. For example,

and the best-matched record was

about each of the linked files are provided

records with last names Smith and

selected, NCHS created an NCHS finder

in the following section.

Smyth received equivalent NYSIIS

file containing the HUD-created ID

codes, and both would be selected as a

and binary indicator flags for survey

NHIS–HUD and NHANES–

potential match for an NCHS submission  participants who were linked to the HUD  HUD public-use feasibility files with Smith (or Smyth) as a last name.

administrative files for HCV, MF, or

Similarly, Soundex is a phonetic

PH program recipients through 2014.

NCHS created the 1999–2012

algorithm for indexing names by sound,

This file was delivered to HUD, and

NHIS–HUD public-use feasibility file

as pronounced in English. The goal is for  HUD programming staff prepared and and the 1999–2012 NHANES–HUD

homophones to be encoded to the same

delivered to NCHS a single transactions-

feasibility file, which can be downloaded

representation so that they can agree

level file containing data summarized

directly from the NCHS website and

despite minor differences in spelling.

for the person’s household as well as

merged with public-use NHIS and

Specifically, the second approach linked

data summarized for the individual HUD  NHANES data, respectively.

survey participants to administrative

housing assistance recipients who were

The feasibility files contain data on

records based on matching the last four

linked to NCHS survey participants.

survey participants’ linkage eligibility

digits of SSN, year of birth, month of

NCHS programming staff ensured

status for the NCHS–HUD linkage,

birth, sex, and meeting at least one of the  that all linked survey participants final match status, and whether the

following conditions:

identified in the linkage process were

survey participant ever participated in

returned in the transaction file. NCHS

HCV, MF, or PH programs. A survey

● Soundex of first names and last

staff edited the HUD Transaction File to

participant is classified as “ever receiving

names agree and are not missing

resolve discrepancies with linked records  HUD housing assistance” if the survey

● NYSIIS of first names and last

so that the final transaction file met ERB

participant was linkage-eligible and

names agree and are not missing

guidelines. The final linked transaction

had at least one transaction in the HUD

● Soundex of nonmissing first names

file served as the basis for creating the

administrative database during the

agree and day of birth agree

linked files.

linked NCHS–HUD administrative time

● Soundex of nonmissing last names

period. Also provided are three variables

agree and day of birth agree

representing ever participation in HCV,

● NYSIIS of nonmissing first names

Linked NCHS–HUD  MF, or PH programs during the linked

agree and day of birth agree

Data

NCHS–HUD administrative time period.

● NYSIIS of nonmissing last names

Program participation is not mutually

agree and day of birth agree

exclusive across the administrative

● Soundex first name agrees with

General Description of

period. For example, a person may

Soundex last name and Soundex

receive assistance as an MF program

last name agrees with Soundex first

Linked Data Files

recipient and then receive an HCV during

name

the linked NCHS–HUD administrative

● NYSIIS first name agrees with

The linked NCHS survey data and

period.

NYSIIS last name and NYSIIS last

HUD administrative data were used

The feasibility files can be used to

name agrees with NYSIIS first name

to produce 12 separate data files. Two

public-use feasibility files, one for

determine the maximum available sample

NCHS participants whose data fields  the 1999–2012 NHIS and one for the

size to assess the feasibility of conducting

matched the equivalent administrative

1999–2012 NHANES, are available on

analyses using the linked NCHS–HUD

fields using either of the two approaches

the NCHS data linkage website:

data by allowing researchers who are

were identified as linked records.

https://www.cdc.gov/nchs/data-linkage/

developing NCHS RDC proposals

To increase the likelihood of finding

index.htm. Ten restricted-use files, to determine if sufficient numbers of

a match, multiple or alternate submission  consisting of the transaction and individuals and sufficient degrees of

freedom exist in the category of interest

Page 6   Series 1, No. 60

among those that have been successfully

NCHS–HUD restricted-use

of enrollment in a HUD program and is

linked to HUD administrative data.

transaction file

characterized by a start date and an end

These publicly available files also make

date. A graphical depiction of an episode

it possible to identify demographic

The transaction file contains a record  is presented in Figure 2.

and health status variables available in

for each HUD administrative transaction

Seven episode files contain start

the corresponding survey public-use

of the linked 1999–2012 NHIS–HUD and  and end dates for participation episodes.

data through subdividing the survey

NHANES–HUD participants, and may

One file is for all HUD programs overall,

sample, calculating estimates of numbers  contain more than one record per person.  and six additional files are for HUD

of people in categories of interest,

The transaction file contains detailed

subprograms based on the transaction

and determining cell sizes by related

member and household attributes that

data and assumptions about reasonable

categories.

are contained in HUD administrative

intervals between transactions (Appendix

Note that the feasibility files do not

systems. Transactions for child

Table I). Most HUD housing assistance

contain data pertaining to the timing

participants that occurred after the child’s  recipients are required to recertify each of HUD assistance or details about the

18th birthday were removed during

year, and consequently, a transaction

housing unit; instead, they contain record  postprocessing, per ERB guidance.

is expected each year. However, some

status variables and record counts to

HUD programs have longer intervals

assist researchers who are considering

NCHS–HUD restricted-use

between recertifications. The episode

whether to initiate an RDC proposal.

episode files

files are useful primarily for longitudinal

Researchers should be aware that all

analysis related to the duration and

NCHS surveys linked to the HUD

To facilitate analyses using the

timing of housing assistance episodes,

administrative data have complex survey

linked files, episode files were created

and conditions or outcomes that may

designs. Therefore, considerations of

with a single record per person containing  have pre-existed or occurred after such sample size and statistical power should

the start and end dates for each period

episodes.

take into account the survey design to

of continuous enrollment, or episode.

produce statistically reliable analyses (2,6).

An episode is a single continuous period

SP1

SP2

SP3

1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014

NOTES: The figure shows three possible scenarios related to the temporal alignment of the linked survey and housing assistance data for three hypothetical survey participants (SPs). In each timeline, the arrow represents the year of the National Center for Health Statistics (NCHS) survey, and the rectangular box represents the time period (episode) during which the SP

received housing assistance from the U.S. Department of Housing and Urban Development (HUD). SP1 received HUD assistance after his or her interview, SP2 received HUD

assistance before his or her interview, and SP3 received HUD assistance concurrent with his or her interview.

SOURCES: NCHS, National Health Interview Survey and National Health and Nutrition Examination Survey, 1999–2012, data linked to HUD administrative records, 1996–2014.

Figure 2. Temporal alignment of National Center for Health Statistics surveys linked to U.S. Department of Housing and Urban Development administrative data files

Series 1, No. 60   Page 7

NCHS–HUD restricted-use

Table 3 presents the number and

SUDAAN software package (Procedure

concurrency file

percentage of NHIS and NHANES linked  WTADJUST or WTADJX) (16) was

participants who received HUD housing

used to adjust the statistical weights for

The NCHS–HUD concurrency file

assistance concurrently, within 1, 2, and

nonresponse with auxiliary information,

is a restricted-use file that contains a

3 years of their survey interview. Data

specifically age, race and ethnicity, and

single record for each linked participant

are presented by survey year and age at

sex. NCHS provides adjusted sample

and summarizes information based on

the time of interview (0–17 years, 18–39,  weights in a weights file based on this timing of housing assistance relative to

40–64, and 65 and over).

approach to account for differences

the date of the NCHS survey interview

in characteristics among linkage-

or examination. This file includes all

NCHS–HUD restricted-use

eligible and linkage-ineligible survey

linked survey participants, whether

participants. Because inferences may

they were classified as concurrent

sample weights file

depend on the approach used to adjust

or nonconcurrent. A linked survey

The weights file contains a record

sample weights—within SUDAAN’s

participant is classified as concurrent

for each 1999–2012 NHIS and NHANES  WTADJUST or using a different

if he or she was administered their

participant who was linkage-eligible, and  calibration approach—researchers NCHS survey interview or examination

contains five sample weights (sample

are advised to seek assistance from a

between the start and end dates of a HUD  adult weight, sample child weight, and mathematical statistician for guidance on

assistance episode. A graphical depiction

person weight for NHIS, and interview

their particular project. Note that other

of a survey participant who concurrently

weight and MEC weight for NHANES)

approaches to calculating weights or

received HUD assistance at the time of

that correspond to the survey and are

handling possible linkage-eligibility bias

the survey (SP3) is provided in Figure 2.

adjusted for linkage eligibility. All

with other statistical software packages

A nonconcurrent participant would have

linkage-ineligible survey participants

can be used. More information about the

partaken in the NCHS survey at some

are given a weight of zero. The linkage

eligibility-adjusted survey weights can be

point outside of their HUD assistance

eligibility-adjusted sample weights were

found in the Analytic Guidelines (7).

episode (SP1 and SP2 in Figure 2).

derived using a model-based calibration

The concurrency file enables

approach.

researchers to determine whether linked

Access to Linked NCHS–

The sample weights provided in the

survey participants concurrently received  NCHS population health survey data HUD Data Files

HUD housing assistance at the time of

files adjust for oversampling of specific

the NHIS or NHANES interview or

subgroups and differential nonresponse.

Due to confidentiality requirements,

NHANES examination. Several factors

The sample weights are poststratified

NCHS restricts the availability of linked

influence the temporal alignment of

to annual population totals for specific

NCHS–HUD data files to researchers

the survey and administrative data,

population domains to provide nationally  who have approved research proposals including age of the survey participant,

representative estimates (2,12–14).

through NCHS RDC, with the exception

HUD program eligibility, discontinuous

Previous research suggests that survey

of the NCHS–HUD feasibility files

program coverage, and residential

participants who provide sufficient PII

(available from: https://www.cdc.gov/

mobility of the survey participants.

for linkage are not a random sample

nchs/data-linkage/hud-feasibility.htm).

More information about the concurrency

of survey participants. For some

More information regarding RDC and

variables is provided in Appendix III.

characteristics, linkage-eligible survey

instructions for submitting an RDC

For researchers interested in

participants may differ systematically

proposal are available from:

examining the timing of HUD assistance

from survey participants who are not

https://www.cdc.gov/rdc/.

for nonconcurrent linked participants, the  linkage-eligible; failing to account for number of days between the interview

linkage eligibility when examining

Analytic

date and the end date of their most recent  these differences may lead to biased HUD episode was calculated, as well as

results (15). Analyses using the linked

Considerations

the number of days between the interview  NCHS–HUD data should include only date and the start date of their next

linkage-eligible survey participants rather

This section highlights general

HUD episode. Although these variables

than the full survey sample, and NCHS

considerations and guidelines for analysis

cannot be accessed directly by the

recommends using sample weights that

when using the linked data files; more

researcher, researchers can request their

are adjusted for linkage eligibility.

detailed information can be found in

own categories in their RDC proposal,

To adjust for the potential bias that

the Analytic Guidelines (7). These

based on the number of days between

may result from differences between the

general considerations do not replace

the NCHS interview or examination and

linkage-eligible and linkage-ineligible

the guidance for analyzing data from

a HUD transaction. More information

populations, the linked NCHS–HUD

NHIS and NHANES. NCHS encourages

about these timing variables is provided

data contain linkage-eligibility adjusted

researchers who discover new analytic

in Appendix III.

weights. A model-based calibration

issues during the course of their analysis

approach developed within the

Page 8   Series 1, No. 60

of the linked data to report them to

Careful consideration is needed when  comparison between the population of

the NCHS Data Linkage Program via

examining characteristics among NCHS–

linked survey participants and the overall

datalinkage@cdc.gov.

HUD linked participants and defining an

population of HUD housing assistance

As part of a researcher’s proposal

analytic sample of linked participants.

recipients is presented in Appendix IV.

to RDC, restricted variables from NCHS

Although some characteristics (e.g., sex

Descriptive statistics for 2008–2012

surveys and variables from the HUD files  or race and ethnicity) are not likely to NHIS and 2009–2012 NHANES

need to be specifically requested within

change over time or be associated with

participants and linked survey

the same proposal. For more information

receipt of HUD housing assistance,

participants from those same surveys are

about restricted-use NCHS survey

other characteristics (e.g., type of health

presented in Tables 4–7. Children (aged

data, visit: https://www.cdc.gov/rdc/

insurance coverage or poverty status)

0–17 years) and adults (aged 18 and

b1datatype/dt122.htm. In the proposal, may differ because these characteristics

over) are presented separately. Summary

the researcher provides a file containing

are associated with receipt of HUD

statistics for the linked NHIS–HUD data

variables from the public-use NCHS

housing assistance. As a result, survey

are presented in Tables 4 and 5; linked

survey data to RDC for merging with the

participants who were linked at any time

NHANES–HUD summary statistics are

requested restricted variables from NCHS  during the administrative period and

shown in Tables 6 and 7. The sample

surveys and the linked NCHS–HUD file

those who were receiving HUD housing

weights used in preparing the summary

variables. An RDC staff member verifies

assistance at the time of their survey

statistics are those in the weights file

the full list of variables (restricted and

interview or examination may differ for

and are adjusted for linkage eligibility

public-use) and consults with the data

several characteristics.

as described previously. Researchers

divisions at NCHS that are responsible

When combining years of survey

should be aware that applying different

for producing the files, as well as with

data, NCHS recommends that researchers  analytic approaches (i.e., variable the NCHS confidentiality office to ensure  assess the assumption of no trend in parameterization and alternative

that no potential disclosure risk of survey  the estimates of the research variables approaches to weight adjustment) may

participants exists. A description of

of interest over the time periods being

result in findings different from those

selected variables that may be useful in

combined, including trends in the receipt

presented below.

analyses of the linked NCHS–HUD data

of housing assistance, and changes in the

The following criteria were used

files is included in Appendix III.

quality of the HUD administrative data

to assess similarities and differences

that may affect their study results.

in the selected sociodemographic and

Sample Weights

health characteristics between linked

Descriptive Analyses  participants and the survey population:

All proposals to use the linked data

should request the correct sample weight

of Linked NHIS–HUD  1.  If the percentage for each

to be used. The weights file contains a

category (e.g., male or female) of

single record for all survey participants of  and NHANES–HUD

a characteristic (e.g., sex) is equal

1999–2012 NHIS and NHANES, as well

Participants

for both linked participants and the

as adjusted sample weights from NHIS

survey population, it is described as

(person weight, sample adult weight,

being the same.

and sample child weight) and NHANES

The linked NCHS–HUD data

2.  If the relative difference between

(interview weight and MEC weight). See  allow for many different analyses,

the linked sample and the survey

the Data Dictionary for more information  but note that the population of linked population, defined as:

about these variables (11).

survey participants may differ from

| Xpopulation – Xlinked | / Xpopulation

both their respective survey populations

Analyses Using Linked

as well as the overall population of

is between 0.0 and 0.1 for all

NCHS–HUD Data

HUD housing assistance recipients.

categories of the characteristic, the

Survey participants who were linked

linked sample is described as being

NCHS recommends that researchers

to the HUD administrative data may

“consistent or similar” to the survey

using the linked NCHS–HUD data

not be representative of the larger

population with respect to that

combine survey years to increase sample

survey populations and differ by certain

characteristic.

size, if needed. Consult the analytic

characteristics, such as poverty status,

3.  If the relative difference between

guidelines for NHANES (6,17) and NHIS  that would make them more likely to

the linked sample and the survey

(18,19) for instructions on combining

receive HUD housing assistance. This

population for at least one category

years. Even though the survey periods for  section provides a brief descriptive of the characteristic is 0.1 or greater,

the linked 1999–2012 NHIS–HUD and

analysis of the linked NHIS–HUD and

the linked sample is described

NHANES–HUD data files overlap, data

NHANES–HUD participants and their

as being “different (higher/more

from the two surveys should be analyzed

similarities to and differences from

or lower/less)” than the survey

separately.

their respective survey populations. A

population with respect to that

characteristic.

Series 1, No. 60   Page 9

Because the two populations (linked  child survey participants that were male of HUD housing assistance recipients

participants and the survey population)

(49.1%) and female (50.9%) were similar  because of the sample design of the were not statistically independent and

to the percentages among the NHANES

surveys, which include only the civilian

measures of correlation between the two

population aged 0–17 years (males

noninstitutionalized U.S. population. In

populations were not readily available,

50.7%, females 49.3%). However, the

Appendix IV,  characteristics of the linked

comparisons were not statistically tested.

distributions of age, race and ethnicity,

sample and the entire HUD-assisted

Descriptive statistics for 2008–2012

poverty status, health status, and health

population are presented to illustrate

NHIS child participants and linked child

insurance coverage differed between the

similarities and differences between

survey participants are presented in

two populations. More of the linked child  linked survey participants and the entire

Table 4. The percentages of the linked

survey participants were aged 12–17

population receiving HUD assistance.

child survey participants that were

years (40.6% compared to 34.5%) and

male (49.6%) and female (50.4%) were

non-Hispanic black (45.8% compared

Conclusion

similar to the percentages among the

to 14.2%), and had family incomes

NHIS population aged 0–17 years (males  that were below the poverty threshold 51.1%, females 48.9%). However, the

(61.0% compared to 23.5%). Compared

The linked NCHS–HUD data are

distributions of age, race and ethnicity,

to NHANES child participants, linked

the first NCHS linked data product

poverty status, health status, and health

child survey participants had a higher

combining health and housing assistance

insurance coverage differed between

percentage with fair or poor health

data and stem from an interagency

the two populations. Compared to the

(7.1% compared to 4.3%) and a lower

collaboration between NCHS and HUD.

population of NHIS child participants,

percentage with no health insurance

These data provide information about

more of the linked child survey

coverage (5.5% compared to 8.0%).

health characteristics of persons who

participants were aged 6–11 years (38.5%

Descriptive statistics for 2009–

received HUD housing assistance during

compared to 32.9%) and non-Hispanic

2012 NHANES adult participants and

the 1999–2014 HUD administrative

black (47.7% compared to 15.3%), and

linked adult survey participants aged

period, including those receiving HUD

had family incomes that were below the

18 and over are presented in Table 7.

housing assistance at the time of their

poverty threshold (59.2% compared to

The distributions of sex, age, race and

survey interview and/or examination.

21.5%). The percentage of children with

ethnicity, poverty status, health status,

While the distribution of various

fair or poor health was higher among the

and health insurance coverage differed

characteristics (such as sex, or race and

linked child survey participants (5.0%)

between the two populations. Compared

ethnicity) remained consistent between

than among NHIS child participants

to NHANES adult participants, more

individuals who had been linked and the

(1.9%), and more linked child survey

linked adult survey participants were

overall sample, several characteristics

participants had public insurance (67.7%)  female (66.7% compared to 51.7%), aged  appear to differ (such as poverty status).

compared to NHIS child participants

18–39 (52.8% compared to 38.7%), and

These differences in characteristics, as

(26.6%).

non-Hispanic black (35.6% compared

well as changes in the data or receipt of

Descriptive statistics for 2008–2012

to 11.6%), and had family incomes that

assistance over time, may impact findings

NHIS adult participants and linked adult

were below the poverty guideline (47.1%  from analyses of the linked NCHS–HUD

survey participants are presented in Table 5.  compared to 15.8%), had fair or poor data.

The distributions of sex, age, race and

health (33.5% compared to 17.2%), and

The linkage of health data from

ethnicity, poverty status, health status,

were uninsured (26.1% compared to

NHIS and NHANES to housing

and health insurance coverage among

20.3%).

assistance data from the HUD

linked adult survey participants differed

These results may assist researchers

administrative records enhances the

between the two populations. Compared

in understanding how linked survey

utility of these population health surveys

to NHIS adult participants, more linked

participants differ from the overall

as well as the HUD administrative data.

adult survey participants were female

survey sample and demonstrate that

The NCHS–HUD linkage provides

(69.5% compared to 51.7%), aged

inferences about research findings

a unique opportunity to examine the

18–39 (54.9% compared to 39.1%), and

based on the linked sample may not be

relationship between receipt of assisted

non-Hispanic black (37.1% compared

generalizable to the national population.

housing and various health-related

to 11.9%), and had family incomes that

Additionally, the linked data are not

outcomes, such as access to health care

were below the poverty threshold (48.0%  intended to reflect the entire population and utilization of health services, general

compared to 12.8%), fair or poor health

of HUD housing assistance recipients.

health status, health characteristics, and

(29.1% compared to 12.7%), and public

The linked participants represent

health behaviors.

insurance (47.7% compared to 15.3%).

the survey participants that received

Descriptive statistics for 2009–2012

federal housing assistance at some

NHANES child participants and linked

time point in the linked NCHS–HUD

child survey participants are presented

administrative period. This may not

in Table 6. The percentages of linked

be the same as the entire population

Page 10   Series 1, No. 60

Published Research

National Center for Health Statistics.  16.  RTI International. SUDAAN

Papers Using NCHS

Vital Health Stat 2(161). 2013.

language manual, vol 1–2

6.  National Center for Health Statistics.

(Release 11). 2012.

Surveys Linked to

National Health and Nutrition

17.  Johnson CL, Paulose-Ram R,

Examination Survey: Analytic

Ogden CL, et al. National Health

HUD Data

guidelines, 2011–2012. Hyattsville,

and Nutrition Examination Survey:

MD. 2013.

Analytic guidelines, 1999–2010.

7.  Lloyd PC, Helms VE. NCHS–HUD

National Center for Health Statistics.

● Ahrens KA, Haley BA, Rossen

linked data: Analytic considerations

Vital Health Stat 2(161). 2013.

LM, Lloyd PC, Aoki Y. Housing

and guidelines. Hyattsville, MD:

18.  National Center for Health Statistics.

assistance and blood lead levels:

National Center for Health Statistics.

Variance estimation guidance, NHIS

Children in the United States,

2016. Available from: https:/ www.

2006–2015. Hyattsville, MD. 2016.

2005–2012. Am J Public Health

cdc.gov/nchs/data/datalinkage/nchs_

19.  National Center for Health Statistics.

106(11):2049–56. 2016.

hud_analytic_considerations.pdf.

Variance estimation and other

● Fenelon A, Mayne P, Simon AE,

8.  Miller DM, Gindi RM, Parker JD.

analytic issues in the 1997–2005

Rossen LM, Helms V, Lloyd P, et al.

Trends in record linkage refusal

NHIS. Hyattsville, MD. 2009.

Housing assistance programs and

rates: Characteristics of National

adult health in the United States. Am

Health Interview Survey participants

J Public Health 107(4):571–8. 2017.

who refuse record linkage. Presented

● Helms VE, King BA, Ashley PJ.

at: Joint Statistical Meeting. Miami

Cigarette smoking and adverse health

Beach, FL: American Statistical

outcomes among adults receiving

Association. 2011.

federal housing assistance. Prev Med  9.  Sayer B, Cox C. How many digits

99:171–7. 2017.

in a handshake? The role of SSN

● Simon AE, Fenelon A, Helms E,

in NDI record linkage. Presented

Lloyd PC, Rossen LM. HUD housing

at: Joint Statistical Meeting. San

assistance associated with lower

Francisco, CA: American Statistical

uninsurance rates and unmet medical

Association. 2003.

need. Health Aff 36(6):1016–23. 2017. 10.  Black PE. Dictionary of algorithms and data structures. 2009. Available

References

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dictionary. 2016.

National Health Interview Survey.

12.  Botman SL, Moriarity CL. Design

NCHS Fact Sheet. 2016.

and estimation for the National

2.  Parsons VL, Moriarity C, Jonas K,

Health Interview Survey, 1995–

et al. Design and estimation for the

2004. National Center for Health

National Health Interview Survey,

Statistics. Vital Health Stat 2(130).

2006–2015. National Center for

2000.

Health Statistics. Vital Health Stat

13.  Curtin LR, Mohadjer LK,

2(165). 2014.

Dohrmann SM, et al. The National

3.  National Center for Health Statistics.

Health and Nutrition Examination

National Health and Nutrition

Survey: Sample design, 1999–2006.

Examination Survey. NCHS Fact

National Center for Health Statistics.

Sheet. 2016.

Vital Health Stat 2(155). 2012.

4.  Zipf G, Chiappa M, Porter KS, et

14.  Curtin LR, Mohadjer LK,

al. National Health and Nutrition

Dohrmann SM, et al. National

Examination Survey: Plan and

Health and Nutrition Examination

operations, 1999–2010. National

Survey: Sample design, 2007–2010.

Center for Health Statistics. Vital

National Center for Health Statistics.

Health Stat 1(56). 2013.

Vital Health Stat 2(160). 2013.

5.  Johnson CL, Paulose-Ram R,

15.  Judson DH, Parker JD, Larsen

Ogden CL, et al. National Health

MD. Adjusting sample weights for

and Nutrition Examination Survey:

linkage-eligibility using SUDAAN.

Analytic guidelines, 1999–2010.

Hyattsville, MD: National Center for

Health Statistics. 2013.

Table 1. Sample size and percentage of survey participants linked to HUD data, by survey year and age at interview: National Health Interview Survey, 1999–2012

All NHIS participants

Sample Adult

Sample Child

Eligible for linkage

Linked to HUD

Eligible for linkage

Linked to HUD

Eligible for linkage

Linked to HUD

Survey year and

age (years) at

Total

Percent of

Percent of

Total

Percent of

Percent of

Total

Percent of

Percent of

NHIS interview

sample

n

total

n

eligible

sample

n

total

n

eligible

sample

n

total

n

eligible

1999–2012

Total  . . . . . . . . . . . . . . . . . . .   1,291,224   316,102

24.48

27,555

8.72

413,027

205,905

49.85

18,610

9.04

166,212

41,599

25.03

4,939

11.87

1999

Total  . . . . . . . . . . . . . . . . . . .

97,059

36,822

37.94

2,673

7.26

30,801

17,115

55.57

1,411

8.24

12,910

3,698

28.64

344

9.30

0–17  . . . . . . . . . . . . . . . . .

27,271

7,050

25.85

698

9.90

...

...

...

...

...

12,910

3,698

28.64

344

9.30

18–39  . . . . . . . . . . . . . . . .

30,183

11,709

38.79

905

7.73

12,544

6,716

53.54

603

8.98

...

...

...

...

...

40–64  . . . . . . . . . . . . . . . .

28,605

12,387

43.30

671

5.42

12,255

6,750

55.08

465

6.89

...

...

...

...

...

65 and over . . . . . . . . . . . .

11,000

5,676

51.60

399

7.03

6,002

3,649

60.80

343

9.40

...

...

...

...

...

2000

Total  . . . . . . . . . . . . . . . . . . .

100,618

35,318

35.10

2,815

7.97

32,374

16,605

51.29

1,433

8.63

13,376

3,504

26.2

393

11.22

0–17  . . . . . . . . . . . . . . . . .

28,495

6,755

23.71

829

12.27

...

...

...

...

...

13,376

3,504

26.2

393

11.22

18–39  . . . . . . . . . . . . . . . .

31,153

11,263

36.15

892

7.92

13,283

6,512

49.03

609

9.35

...

...

...

...

...

40–64  . . . . . . . . . . . . . . . .

29,764

11,903

39.99

680

5.71

12,911

6,609

51.19

479

7.25

...

...

...

...

...

65 and over . . . . . . . . . . . .

11,206

5,397

48.16

414

7.67

6,180

3,484

56.38

345

9.90

...

...

...

...

...

2001

Total  . . . . . . . . . . . . . . . . . . .

100,760

35,397

35.13

2,701

7.63

33,326

16,997

51.00

1,384

8.14

13,579

3,551

26.15

406

11.43

0–17  . . . . . . . . . . . . . . . . .

28,572

6,763

23.67

807

11.93

...

...

...

...

...

13,579

3,551

26.15

406

11.43

18–39  . . . . . . . . . . . . . . . .

30,941

11,131

35.97

912

8.19

13,555

6,590

48.62

612

9.29

...

...

...

...

...

40–64  . . . . . . . . . . . . . . . .

30,230

12,191

40.33

612

5.02

13,619

6,939

50.95

461

6.64

...

...

...

...

...

65 and over . . . . . . . . . . . .

11,017

5,312

48.22

370

6.97

6,152

3,468

56.37

311

8.97

...

...

...

...

...

2002

Total  . . . . . . . . . . . . . . . . . . .

93,386

16,681

17.86

1,385

8.30

31,044

11,353

36.57

1,119

9.86

12,524

...

...

...

...

0–17  . . . . . . . . . . . . . . . . .

26,191

...

...

...

...

...

...

...

...

...

12,524

...

...

...

...

18–39  . . . . . . . . . . . . . . . .

28,298

6,148

21.73

600

9.76

12,467

4,219

33.84

455

10.78

...

...

...

...

...

40–64  . . . . . . . . . . . . . . . .

28,312

7,134

25.20

472

6.62

12,717

4,629

36.40

373

8.06

...

...

...

...

...

65 and over . . . . . . . . . . . .

10,585

3,399

32.11

313

9.21

5,860

2,505

42.75

291

11.62

...

...

...

...

...

2003

Total  . . . . . . . . . . . . . . . . . . .

92,148

14,805

16.07

1,305

8.81

30,852

10,223

33.14

1,062

10.39

12,249

...

...

...

...

0–17  . . . . . . . . . . . . . . . . .

25,537

...

...

...

...

...

...

...

...

...

12,249

...

...

...

...

18–39  . . . . . . . . . . . . . . . .

27,809

5,383

19.36

568

10.55

12,154

3,782

31.12

446

11.79

...

...

...

...

...

40–64  . . . . . . . . . . . . . . . .

28,529

6,416

22.49

474

7.39

12,939

4,204

32.49

384

9.13

...

...

...

...

...

65 and over . . . . . . . . . . . .

10,273

3,006

29.26

263

8.75

5,759

2,237

38.84

232

10.37

...

...

...

...

...

2004

Ser

Total  . . . . . . . . . . . . . . . . . . .

94,460

21,744

23.02

1,790

8.23

31,326

13,428

42.87

1,170

8.71

12,424

3,170

25.52

384

12.11

0–17  . . . . . . . . . . . . . . . . .

26,161

3,175

12.14

384

12.09

...

...

...

...

...

12,424

3,170

25.52

384

12.11

ies 1, No

18–39  . . . . . . . . . . . . . . . .

28,015

6,896

24.62

648

9.40

12,052

5,080

42.15

517

10.18

...

...

...

...

...

40–64  . . . . . . . . . . . . . . . .

29,526

7,984

27.04

463

5.80

13,255

5,503

41.52

384

6.98

...

...

...

...

...

65 and over . . . . . . . . . . . .

10,758

3,689

34.29

295

8.00

6,019

2,845

47.27

269

9.46

...

...

...

...

...

. 60



Page 1

1

See footnotes at end of table.

Page 1

Table 1. Sample size and percentage of survey participants linked to HUD data, by survey year and age at interview: National Health Interview Survey, 1999–2012—Con.

2

All NHIS participants

Sample Adult

Sample Child



Eligible for linkage

Linked to HUD

Eligible for linkage

Linked to HUD

Eligible for linkage

Linked to HUD

Ser

Survey year and

ies 1, No

age (years) at

Total

Percent of

Percent of

Total

Percent of

Percent of

Total

Percent of

Percent of

NHIS interview

sample

n

total

n

eligible

sample

n

total

n

eligible

sample

n

total

n

eligible

2005

. 60

Total  . . . . . . . . . . . . . . . . . . .

98,649

18,765

19.02

1,608

8.57

31,428

11,727

37.31

1,036

8.83

12,523

2,658

21.22

331

12.45

0–17  . . . . . . . . . . . . . . . . .

26,814

2,660

9.92

332

12.48

...

...

...

...

...

12,523

2,658

21.22

331

12.45

18–39  . . . . . . . . . . . . . . . .

28,982

5,778

19.94

619

10.71

11,810

4,260

36.07

488

11.46

...

...

...

...

...

40–64  . . . . . . . . . . . . . . . .

31,623

7,137

22.57

442

6.19

13,540

4,959

36.62

351

7.08

...

...

...

...

...

65 and over   . . . . . . . . . . .

11,230

3,190

28.41

215

6.74

6,078

2,508

41.26

197

7.85

...

...

...

...

...

2006

Total  . . . . . . . . . . . . . . . . . . .

75,716

13,319

17.59

1,370

10.29

24,275

8,418

34.68

919

10.92

9,837

1,806

18.36

249

13.79

0–17  . . . . . . . . . . . . . . . . .

20,903

1,806

8.64

249

13.79

...

...

...

...

...

9,837

1,806

18.36

249

13.79

18–39  . . . . . . . . . . . . . . . .

22,578

4,322

19.14

535

12.38

9,418

3,235

34.35

440

13.60

...

...

...

...

...

40–64  . . . . . . . . . . . . . . . .

23,845

4,922

20.64

387

7.86

10,210

3,401

33.31

300

8.82

...

...

...

...

...

65 and over   . . . . . . . . . . .

8,390

2,269

27.04

199

8.77

4,647

1,782

38.35

179

10.04

...

...

...

...

...

2007

Total  . . . . . . . . . . . . . . . . . . .

75,764

14,247

18.8

1,338

9.39

23,393

11,643

49.77

1,012

8.69

9,417

2,604

27.65

326

12.52

0–17  . . . . . . . . . . . . . . . . .

20,719

2,604

12.57

326

12.52

...

...

...

...

...

9,417

2,604

27.65

326

12.52

18–39  . . . . . . . . . . . . . . . .

22,598

4,358

19.28

484

11.11

8,864

4,358

49.17

484

11.11

...

...

...

...

...

40–64  . . . . . . . . . . . . . . . .

24,008

5,029

20.95

349

6.94

9,946

5,029

50.56

349

6.94

...

...

...

...

...

65 and over   . . . . . . . . . . .

8,439

2,256

26.73

179

7.93

4,583

2,256

49.23

179

7.93

...

...

...

...

...

2008

Total  . . . . . . . . . . . . . . . . . . .

74,236

15,268

20.57

1,462

9.58

21,781

12,438

57.10

1,109

8.92

8,815

2,830

32.1

353

12.47

0–17  . . . . . . . . . . . . . . . . .

19,914

2,830

14.21

353

12.47

...

...

...

...

...

8,815

2,830

32.1

353

12.47

18–39  . . . . . . . . . . . . . . . .

22,116

4,574

20.68

538

11.76

8,067

4,574

56.70

538

11.76

...

...

...

...

...

40–64  . . . . . . . . . . . . . . . .

23,728

5,380

22.67

374

6.95

9,270

5,380

58.04

374

6.95

...

...

...

...

...

65 and over   . . . . . . . . . . .

8,478

2,484

29.3

197

7.93

4,444

2,484

55.90

197

7.93

...

...

...

...

...

2009

Total  . . . . . . . . . . . . . . . . . . .

88,446

21,580

24.4

2,208

10.23

27,731

17,413

62.79

1,653

9.49

11,156

4,167

37.35

555

13.32

0–17  . . . . . . . . . . . . . . . . .

23,830

4,167

17.49

555

13.32

...

...

...

...

...

11,156

4,167

37.35

555

13.32

18–39  . . . . . . . . . . . . . . . .

25,952

6,306

24.3

794

12.59

10,277

6,306

61.36

794

12.59

...

...

...

...

...

40–64  . . . . . . . . . . . . . . . .

28,546

7,608

26.65

592

7.78

11,961

7,608

63.61

592

7.78

...

...

...

...

...

65 and over   . . . . . . . . . . .

10,118

3,499

34.58

267

7.63

5,493

3,499

63.70

267

7.63

...

...

...

...

...

2010

Total  . . . . . . . . . . . . . . . . . . .

89,976

20,139

22.38

1,917

9.52

27,157

16,073

59.19

1,447

9.00

11,277

4,066

36.06

470

11.56

0–17  . . . . . . . . . . . . . . . . .

24,057

4,066

16.9

470

11.56

...

...

...

...

...

11,277

4,066

36.06

470

11.56

18–39  . . . . . . . . . . . . . . . .

26,788

5,970

22.29

684

11.46

10,200

5,970

58.53

684

11.46

...

...

...

...

...

40–64  . . . . . . . . . . . . . . . .

28,691

6,912

24.09

515

7.45

11,507

6,912

60.07

515

7.45

...

...

...

...

...

65 and over . . . . . . . . . . . .

10,440

3,191

30.57

248

7.77

5,450

3,191

58.55

248

7.77

...

...

...

...

...

See footnotes at end of table.

Table 1. Sample size and percentage of survey participants linked to HUD data, by survey year and age at interview: National Health Interview Survey, 1999–2012—Con.

All NHIS participants

Sample Adult

Sample Child

Eligible for linkage

Linked to HUD

Eligible for linkage

Linked to HUD

Eligible for linkage

Linked to HUD

Survey year and

age (years) at

Total

Percent of

Percent of

Total

Percent of

Percent of

Total

Percent of

Percent of

NHIS interview

sample

n

total

n

eligible

sample

n

total

n

eligible

sample

n

total

n

eligible

2011

Total  . . . . . . . . . . . . . . . . . . .

101,875

25,786

25.31

2,378

9.22

33,014

21,055

63.78

1,820

8.64

12,850

4,731

36.82

558

11.79

0–17  . . . . . . . . . . . . . . . . .

26,802

4,731

17.65

558

11.79

...

...

...

...

...

12,850

4,731

36.82

558

11.79

18–39  . . . . . . . . . . . . . . . .

29,970

7,704

25.71

901

11.70

12,191

7,704

63.19

901

11.70

...

...

...

...

...

40–64  . . . . . . . . . . . . . . . .

32,586

8,870

27.22

608

6.85

13,921

8,870

63.72

608

6.85

...

...

...

...

...

65 and over   . . . . . . . . . . .

12,517

4,481

35.80

311

6.94

6,902

4,481

64.92

311

6.94

...

...

...

...

...

2012

Total  . . . . . . . . . . . . . . . . . . .

108,131

26,231

24.26

2,605

9.93

34,525

21,417

62.03

2,035

9.50

13,275

4,814

36.26

570

11.84

0–17  . . . . . . . . . . . . . . . . .

28,016

4,814

17.18

570

11.84

...

...

...

...

...

13,275

4,814

36.26

570

11.84

18–39  . . . . . . . . . . . . . . . .

31,184

7,555

24.23

972

12.87

12,434

7,555

60.76

972

12.87

...

...

...

...

...

40–64  . . . . . . . . . . . . . . . .

35,361

9,218

26.07

700

7.59

14,709

9,218

62.67

700

7.59

...

...

...

...

...

65 and over . . . . . . . . . . . .

13,570

4,644

34.22

363

7.82

7,382

4,644

62.91

363

7.82

...

...

...

...

...

... Category not applicable.

NOTE: HUD is U.S. Department of Housing and Urban Development, and NHIS is National Health Interview Survey.

SOURCES: NCHS, 1999–2012 NHIS data linked to 1999–2014 HUD administrative records.

Ser

ies 1, No

. 60



Page 1

3

Page 14   Series 1, No. 60

Table 2. Sample size and percentage of survey participants linked to HUD data, by survey year and age at interview: National Health and Nutrition Examination Survey, 1999–2012

All NHANES participants

MEC participants

Eligible for linkage

Linked to HUD

Eligible for linkage

Linked to HUD

Survey year and

age (years) at

Total

Percent of

Percent of

Total

Percent of

Percent of

NHANES interview

sample

n

total

n

eligible

sample

n

total

n

eligible

1999–2012

Total  . . . . . . . . . . . . . . . . . . . . . . .  71,916

50,559

70.30

6,532

12.92

75,127

48,769

64.92

6,354

13.03

1999–2000

Total  . . . . . . . . . . . . . . . . . . . . . . .

9,965

7,235

72.60

882

12.19

10,648

6,843

64.27

850

12.42

0–17  . . . . . . . . . . . . . . . . . . . . .

4,517

2,933

64.93

452

15.41

4,728

2,839

60.05

443

15.60

18–39  . . . . . . . . . . . . . . . . . . . .

2,263

1,714

75.74

188

10.97

2,425

1,607

66.27

183

11.39

40–64  . . . . . . . . . . . . . . . . . . . .

1,793

1,475

82.26

127

8.61

1,907

1,400

73.41

122

8.71

65 and over . . . . . . . . . . . . . . . .

1,392

1,113

79.96

115

10.33

1,588

997

62.78

102

10.23

2001–2002

Total  . . . . . . . . . . . . . . . . . . . . . . .  11,039

8,715

78.95

1,199

13.76

11,601

8,346

71.94

1,160

13.90

0–17  . . . . . . . . . . . . . . . . . . . . .

5,046

3,709

73.50

711

19.17

5,207

3,626

69.64

700

19.31

18–39  . . . . . . . . . . . . . . . . . . . .

2,507

2,002

79.86

266

13.29

2,606

1,929

74.02

261

13.53

40–64  . . . . . . . . . . . . . . . . . . . .

2,023

1,753

86.65

108

6.16

2,104

1,691

80.37

104

6.15

65 and over . . . . . . . . . . . . . . . .

1,463

1,251

85.51

114

9.11

1,684

1,100

65.32

95

8.64

2003–2004

Total  . . . . . . . . . . . . . . . . . . . . . . .  10,122

8,084

79.87

1,075

13.30

10,601

7,764

73.24

1,045

13.46

0–17  . . . . . . . . . . . . . . . . . . . . .

4,502

3,265

72.52

600

18.38

4,664

3,176

68.10

587

18.48

18–39  . . . . . . . . . . . . . . . . . . . .

2,321

1,930

83.15

258

13.37

2,425

1,856

76.54

255

13.74

40–64  . . . . . . . . . . . . . . . . . . . .

1,805

1,573

87.15

126

8.01

1,896

1,501

79.17

123

8.19

65 and over . . . . . . . . . . . . . . . .

1,494

1,316

88.09

91

6.91

1,616

1,231

76.18

80

6.50

2005–2006

Total  . . . . . . . . . . . . . . . . . . . . . . .  10,348

7,298

70.53

911

12.48

10,746

7,073

65.82

888

12.55

0–17  . . . . . . . . . . . . . . . . . . . . .

4,785

3,079

64.35

522

16.95

4,954

3,001

60.58

510

16.99

18–39  . . . . . . . . . . . . . . . . . . . .

2,507

1,816

72.44

211

11.62

2,614

1,748

66.87

205

11.73

40–64  . . . . . . . . . . . . . . . . . . . .

1,867

1,448

77.56

111

7.67

1,925

1,413

73.40

109

7.71

65 and over . . . . . . . . . . . . . . . .

1,189

955

80.32

67

7.02

1,253

911

72.71

64

7.03

2007–2008

Total  . . . . . . . . . . . . . . . . . . . . . . .  10,149

6,724

66.25

873

12.98

10,536

6,543

62.10

858

13.11

0–17  . . . . . . . . . . . . . . . . . . . . .

3,921

2,186

55.75

427

19.53

4,075

2,127

52.20

417

19.61

18–39  . . . . . . . . . . . . . . . . . . . .

2,203

1,537

69.77

217

14.12

2,274

1,501

66.01

215

14.32

40–64  . . . . . . . . . . . . . . . . . . . .

2,469

1,823

73.84

157

8.61

2,543

1,784

70.15

156

8.74

65 and over . . . . . . . . . . . . . . . .

1,556

1,178

75.71

72

6.11

1,644

1,131

68.80

70

6.19

2009–2010

Total  . . . . . . . . . . . . . . . . . . . . . . .  10,537

6,607

62.70

754

11.41

10,821

6,482

59.90

738

11.39

0–17  . . . . . . . . . . . . . . . . . . . . .

4,010

2,084

51.97

299

14.35

4,127

2,041

49.45

293

14.36

18–39  . . . . . . . . . . . . . . . . . . . .

2,392

1,587

66.35

219

13.80

2,450

1,560

63.67

217

13.91

40–64  . . . . . . . . . . . . . . . . . . . .

2,612

1,808

69.22

153

8.46

2,658

1,783

67.08

149

8.36

65 and over . . . . . . . . . . . . . . . .

1,523

1,128

74.06

83

7.36

1,586

1,098

69.23

79

7.19

2011–2012

Total  . . . . . . . . . . . . . . . . . . . . . . .

9,756

5,896

60.43

838

14.21

10,174

5,718

56.20

815

14.25

0–17  . . . . . . . . . . . . . . . . . . . . .

3,892

1,904

48.92

339

17.80

4,061

1,849

45.53

332

17.96

18–39  . . . . . . . . . . . . . . . . . . . .

2,261

1,468

64.93

229

15.60

2,348

1,420

60.48

222

15.63

40–64  . . . . . . . . . . . . . . . . . . . .

2,353

1,601

68.04

158

9.87

2,431

1,568

64.50

156

9.95

65 and over . . . . . . . . . . . . . . . .

1,250

923

73.84

112

12.13

1,334

881

66.04

105

11.92

NOTE: HUD is U.S. Department of Housing and Urban Development, NHANES is National Health and Nutrition Examination Survey, and MEC is mobile examination center.

SOURCES: NCHS, 1999–2012 NHANES data linked to 1996–2014 HUD administrative records.

Series 1, No. 60   Page 15

Table 3. Linked NCHS–HUD file sample size and percentage of linked survey participants with concurrent HUD enrollment within 1, 2, and 3 years of survey interview, by survey and age at interview

Linked

Concurrently

Within 1 year

Within 2 years

Within 3 years

respondents

linked

of interview

of interview

of interview

Survey year and

age (years) at

Percent of

Percent of

Percent of

Percent of

NCHS interview

n

n

all linked

n

all linked

n

all linked

n

all linked

NHIS

1999–2012 total  . . . . . . . . . . . . . . . .

27,555

11,060

40.1

16,076

58.3

18,666

67.7

20,394

74.0

1999 total  . . . . . . . . . . . . . . . . . . . . .

2,673

234

08.8

1,106

41.4

1,638

61.3

1,805

67.5

0–17  . . . . . . . . . . . . . . . . . . . . . . .

698

48

06.9

316

45.3

488

69.9

520

74.5

18–39  . . . . . . . . . . . . . . . . . . . . . .

905

56

06.2

327

36.1

507

56.0

584

64.5

40–64  . . . . . . . . . . . . . . . . . . . . . .

671

56

08.4

241

35.9

355

52.9

390

58.1

65 and over . . . . . . . . . . . . . . . . . .

399

74

18.6

222

55.6

288

72.2

311

77.9

2000 total  . . . . . . . . . . . . . . . . . . . . .

2,815

735

26.1

1,557

55.3

1,783

63.3

1,998

71.0

0–17  . . . . . . . . . . . . . . . . . . . . . . .

829

226

27.3

496

59.8

571

68.9

637

76.8

18–39  . . . . . . . . . . . . . . . . . . . . . .

892

192

21.5

455

51.0

540

60.5

621

69.6

40–64  . . . . . . . . . . . . . . . . . . . . . .

680

160

23.5

331

48.7

369

54.3

416

61.2

65 and over . . . . . . . . . . . . . . . . . .

414

157

37.9

275

66.4

303

73.2

324

78.3

2001 total  . . . . . . . . . . . . . . . . . . . . .

2,701

806

29.8

1,517

56.2

1,777

65.8

1,933

71.6

0–17  . . . . . . . . . . . . . . . . . . . . . . .

807

234

29.0

464

57.5

565

70.0

612

75.8

18–39  . . . . . . . . . . . . . . . . . . . . . .

912

229

25.1

478

52.4

565

62.0

622

68.2

40–64  . . . . . . . . . . . . . . . . . . . . . .

612

195

31.9

320

52.3

366

59.8

399

65.2

65 and over . . . . . . . . . . . . . . . . . .

370

148

40.0

255

68.9

281

76.0

300

81.1

2002 total  . . . . . . . . . . . . . . . . . . . . .

1,385

483

34.9

802

57.9

959

69.2

1,046

75.5

0–17  . . . . . . . . . . . . . . . . . . . . . . .

...

...

...

...

...

...

...

...

...

18–39  . . . . . . . . . . . . . . . . . . . . . .

600

176

29.3

320

53.3

410

68.3

457

76.2

40–64  . . . . . . . . . . . . . . . . . . . . . .

472

167

35.4

277

58.7

317

67.2

343

72.7

65 and over . . . . . . . . . . . . . . . . . .

313

140

44.7

205

65.5

232

74.1

246

78.6

2003 total  . . . . . . . . . . . . . . . . . . . . .

1,305

537

41.2

800

61.3

929

71.2

1,023

78.4

0–17  . . . . . . . . . . . . . . . . . . . . . . .

...

...

...

...

...

...

...

...

...

18–39  . . . . . . . . . . . . . . . . . . . . . .

568

188

33.1

299

52.6

367

64.6

431

75.9

40–64  . . . . . . . . . . . . . . . . . . . . . .

474

218

46.0

304

64.1

344

72.6

367

77.4

65 and over . . . . . . . . . . . . . . . . . .

263

131

49.8

197

74.9

218

82.9

225

85.6

2004 total  . . . . . . . . . . . . . . . . . . . . .

1,790

771

43.1

1,091

61.0

1,279

71.5

1,407

78.6

0–17  . . . . . . . . . . . . . . . . . . . . . . .

384

162

42.2

242

63.0

289

75.3

325

84.6

18–39  . . . . . . . . . . . . . . . . . . . . . .

648

230

35.5

359

55.4

430

66.4

489

75.5

40–64  . . . . . . . . . . . . . . . . . . . . . .

463

207

44.7

273

59.0

319

68.9

345

74.5

65 and over . . . . . . . . . . . . . . . . . .

295

172

58.3

217

73.6

241

81.7

248

84.1

2005 total  . . . . . . . . . . . . . . . . . . . . .

1,608

688

42.8

951

59.1

1,107

68.8

1,227

76.3

0–17  . . . . . . . . . . . . . . . . . . . . . . .

332

142

42.8

209

63.0

246

74.1

272

81.9

18–39  . . . . . . . . . . . . . . . . . . . . . .

619

229

37.0

331

53.5

394

63.7

446

72.1

40–64  . . . . . . . . . . . . . . . . . . . . . .

442

182

41.2

250

56.6

291

65.8

318

72.0

65 and over . . . . . . . . . . . . . . . . . .

215

135

62.8

161

74.9

176

81.9

191

88.8

2006 total  . . . . . . . . . . . . . . . . . . . . .

1,370

601

43.9

799

58.3

930

67.9

1,066

77.8

0–17  . . . . . . . . . . . . . . . . . . . . . . .

249

99

39.8

140

56.2

174

69.9

207

83.1

18–39  . . . . . . . . . . . . . . . . . . . . . .

535

197

36.8

283

52.9

327

61.1

383

71.6

40–64  . . . . . . . . . . . . . . . . . . . . . .

387

185

47.8

230

59.4

267

69.0

305

78.8

65 and over . . . . . . . . . . . . . . . . . .

199

120

60.3

146

73.4

162

81.4

171

85.9

2007 total  . . . . . . . . . . . . . . . . . . . . .

1,338

667

49.9

822

61.4

953

71.2

1,048

78.3

0–17  . . . . . . . . . . . . . . . . . . . . . . .

326

164

50.3

211

64.7

248

76.1

269

82.5

18–39  . . . . . . . . . . . . . . . . . . . . . .

484

215

44.4

270

55.8

323

66.7

357

73.8

40–64  . . . . . . . . . . . . . . . . . . . . . .

349

168

48.1

206

59.0

234

67.1

261

74.8

65 and over . . . . . . . . . . . . . . . . . .

179

120

67.0

135

75.4

148

82.7

161

89.9

2008 total  . . . . . . . . . . . . . . . . . . . . .

1,462

729

49.9

905

61.9

998

68.3

1,094

74.8

0–17  . . . . . . . . . . . . . . . . . . . . . . .

353

170

48.2

221

62.6

246

69.7

269

76.2

18–39  . . . . . . . . . . . . . . . . . . . . . .

538

212

39.4

279

51.9

320

59.5

370

68.8

40–64  . . . . . . . . . . . . . . . . . . . . . .

374

208

55.6

244

65.2

266

71.1

286

76.5

65 and over . . . . . . . . . . . . . . . . . .

197

139

70.6

161

81.7

166

84.3

169

85.8

2009 total  . . . . . . . . . . . . . . . . . . . . .

2,208

1,161

52.6

1,389

62.9

1,566

70.9

1,690

76.5

0–17  . . . . . . . . . . . . . . . . . . . . . . .

555

283

51.0

358

64.5

413

74.4

448

80.7

18–39  . . . . . . . . . . . . . . . . . . . . . .

794

347

43.7

419

52.8

489

61.6

543

68.4

40–64  . . . . . . . . . . . . . . . . . . . . . .

592

337

56.9

391

66.1

431

72.8

457

77.2

65 and over . . . . . . . . . . . . . . . . . .

267

194

72.7

221

82.8

233

87.3

242

90.6

See footnotes at end of table.

Page 16   Series 1, No. 60

Table 3. Linked NCHS–HUD file sample size and percentage of linked survey participants with concurrent HUD enrollment within 1, 2, and 3 years of survey interview, by survey and age at interview—Con.

Linked

Concurrently

Within 1 year

Within 2 years

Within 3 years

respondents

linked

of interview

of interview

of interview

Survey year and

age (years) at

Percent of

Percent of

Percent of all

Percent of all

NCHS interview

n

n

all linked

n

all linked

n

linked

n

linked

NHIS—Con.

2010 total  . . . . . . . . . . . . . . . . . . . . .

1,917

974

50.8

1,198

62.5

1,337

69.7

1,447

75.5

0–17  . . . . . . . . . . . . . . . . . . . . . . .

470

215

45.7

283

60.2

329

70.0

365

77.7

18–39  . . . . . . . . . . . . . . . . . . . . . .

684

274

40.1

366

53.5

421

61.6

458

67.0

40–64  . . . . . . . . . . . . . . . . . . . . . .

515

294

57.1

343

66.6

370

71.8

395

76.7

65 and over . . . . . . . . . . . . . . . . . .

248

191

77.0

206

83.1

217

87.5

229

92.3

2011 total. . . . . . . . . . . . . . . . . . . . . .

2,378

1,231

51.8

1,481

62.3

1,623

68.3

1,731

72.8

0–17  . . . . . . . . . . . . . . . . . . . . . . .

558

266

47.7

351

62.9

394

70.6

423

75.8

18–39  . . . . . . . . . . . . . . . . . . . . . .

901

384

42.6

469

52.1

521

57.8

562

62.4

40–64  . . . . . . . . . . . . . . . . . . . . . .

608

349

57.4

404

66.5

437

71.9

466

76.6

65 and over . . . . . . . . . . . . . . . . . .

311

232

74.6

257

82.6

271

87.1

280

90.0

2012 total  . . . . . . . . . . . . . . . . . . . . .

2,605

1,443

55.4

1,658

63.7

1,787

68.6

1,879

72.1

0–17  . . . . . . . . . . . . . . . . . . . . . . .

570

319

56.0

387

67.9

415

72.8

433

76.0

18–39  . . . . . . . . . . . . . . . . . . . . . .

972

419

43.1

501

51.5

558

57.4

595

61.2

40–64  . . . . . . . . . . . . . . . . . . . . . .

700

415

59.3

455

65.0

486

69.4

519

74.1

65 and over . . . . . . . . . . . . . . . . . .

363

290

79.9

315

86.8

328

90.4

332

91.5

NHANES

1999–2012 total  . . . . . . . . . . . . . . . .

6,532

2,573

39.4

3,963

60.7

4,616

70.7

5,104

78.1

1999–2000 total  . . . . . . . . . . . . . . . .

882

202

22.9

498

56.5

608

68.9

654

74.2

0–17  . . . . . . . . . . . . . . . . . . . . . . .

452

101

22.4

266

58.9

326

72.1

349

77.2

18–39  . . . . . . . . . . . . . . . . . . . . . .

188

34

18.1

86

45.7

117

62.2

126

67.0

40–64  . . . . . . . . . . . . . . . . . . . . . .

127

19

15.0

62

48.8

74

58.3

82

64.6

65 and over . . . . . . . . . . . . . . . . . .

115

48

41.7

84

73.0

91

79.1

97

84.4

2001–2002 total  . . . . . . . . . . . . . . . .

1,199

343

28.6

702

58.6

848

70.7

935

78.0

0–17  . . . . . . . . . . . . . . . . . . . . . . .

711

219

30.8

452

63.6

534

75.1

587

82.6

18–39  . . . . . . . . . . . . . . . . . . . . . .

266

60

22.6

127

47.7

169

63.5

192

72.2

40–64  . . . . . . . . . . . . . . . . . . . . . .

108

27

25.0

54

50.0

66

61.1

72

66.7

65 and over . . . . . . . . . . . . . . . . . .

114

37

32.5

69

60.5

79

69.3

84

73.7

2003–2004 total  . . . . . . . . . . . . . . . .

1,075

475

44.2

683

63.5

789

73.4

883

82.1

0–17  . . . . . . . . . . . . . . . . . . . . . . .

600

275

45.8

408

68.0

467

77.8

523

87.2

18–39  . . . . . . . . . . . . . . . . . . . . . .

258

103

39.9

143

55.4

174

67.4

196

76.0

40–64  . . . . . . . . . . . . . . . . . . . . . .

126

48

38.1

72

57.1

78

61.9

90

71.4

65 and over . . . . . . . . . . . . . . . . . .

91

49

53.9

60

65.9

70

76.9

74

81.3

2005–2006 total  . . . . . . . . . . . . . . . .

911

369

40.5

558

61.3

667

73.2

730

80.1

0–17  . . . . . . . . . . . . . . . . . . . . . . .

522

217

41.6

335

64.2

407

78.0

445

85.3

18–39  . . . . . . . . . . . . . . . . . . . . . .

211

69

32.7

114

54.0

139

65.9

152

72.0

40–64  . . . . . . . . . . . . . . . . . . . . . .

111

50

45.1

64

57.7

70

63.1

78

70.3

65 and over . . . . . . . . . . . . . . . . . .

67

33

49.3

45

67.2

51

76.1

55

82.1

2007–2008 total  . . . . . . . . . . . . . . . .

873

402

46.1

518

59.3

590

67.6

664

76.1

0–17  . . . . . . . . . . . . . . . . . . . . . . .

427

207

48.5

273

63.9

306

71.7

341

79.9

18–39  . . . . . . . . . . . . . . . . . . . . . .

217

85

39.2

112

51.6

132

60.8

151

69.6

40–64  . . . . . . . . . . . . . . . . . . . . . .

157

78

49.7

91

58.0

106

67.5

120

76.4

65 and over . . . . . . . . . . . . . . . . . .

72

32

44.4

42

58.3

46

63.9

52

72.2

2009–2010 total  . . . . . . . . . . . . . . . .

754

346

45.9

459

60.9

512

67.9

574

76.1

0–17  . . . . . . . . . . . . . . . . . . . . . . .

299

148

49.5

201

67.2

228

76.3

257

86.0

18–39  . . . . . . . . . . . . . . . . . . . . . .

219

59

26.9

93

42.5

112

51.1

129

58.9

40–64  . . . . . . . . . . . . . . . . . . . . . .

153

79

51.6

97

63.4

103

67.3

116

75.8

65 and over . . . . . . . . . . . . . . . . . .

83

60

72.3

68

81.9

69

83.1

72

86.8

2011–2012 total. . . . . . . . . . . . . . . . .

838

436

52.0

545

65.0

602

71.8

664

79.2

0–17  . . . . . . . . . . . . . . . . . . . . . . .

339

182

53.7

234

69.0

260

76.7

290

85.6

18–39  . . . . . . . . . . . . . . . . . . . . . .

229

82

35.8

118

51.5

131

57.2

152

66.4

40–64  . . . . . . . . . . . . . . . . . . . . . .

158

85

53.8

94

59.5

108

68.4

117

74.1

65 and over . . . . . . . . . . . . . . . . . .

112

87

77.7

99

88.4

103

92.0

105

93.8

… Category not applicable.

NOTE: NCHS is National Center for Health Statistics; HUD is U.S. Department of Housing and Urban Development; NHIS is National Health Interview Survey; and NHANES is National Health and Nutrition Examination Survey.

SOURCES: NCHS, 1999–2012 NHIS and NHANES data linked to 1996–2014 HUD administrative records.

Series 1, No. 60   Page 17

Table 4. Unweighted sample size and weighted percent distribution of ever-linked 2008–2012 NHIS–HUD participants aged 0–17 years, by selected sociodemographic and health characteristics

All NHIS and HUD participants

Linked participants

Percent

Percent

Characteristic

n

(weighted)

n

(weighted)

Sex

Male  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

62,663

51.1

1,245

49.6

Female  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

59,956

48.9

1,261

50.4

Age group (years)

0–5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

40,651

34.0

712

28.8

6–11  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

40,969

32.9

883

38.5

12–17  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

40,999

33.1

911

32.7

Race and Hispanic origin

Hispanic  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

40,019

22.8

543

18.1

Non-Hispanic:

White. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

52,740

56.1

638

31.1

Black . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

21,022

15.3

1,248

47.7

Other. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

8,838

5.8

77

*3.1

Poverty level1

Below 100% of federal threshold  . . . . . . . . . . . . . . . . . . . . . . . . .

31,376

21.5

1,442

59.2

100%–200% or more of federal threshold  . . . . . . . . . . . . . . . . . .

30,639

23.1

700

27.5

200% or more of federal threshold . . . . . . . . . . . . . . . . . . . . . . . .

60,604

55.5

364

13.3

Health status2

Excellent/Very good  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

98,889

82.7

1,801

73.0

Good. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

20,975

15.3

578

22.0

Fair/Poor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2,673

1.9

127

*5.0

Health insurance

No coverage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

10,541

7.7

137

*5.3

Private insurance  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

59,576

54.8

341

14.4

Public Insurance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

38,021

26.6

1,694

67.7

Other coverage. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

13,691

10.3

330

12.4

* Percentage estimate may be statistically unreliable because the absolute width of its Korn-Graubard confidence interval is between 5 and 30 percentage points, yet its relative width is larger than 130%.

1Based on published U.S. Census Bureau poverty thresholds.

2Self-reported.

NOTES: Missing responses are not presented. NHIS is National Health Interview Survey, and HUD is U.S. Department of Housing and Urban Development.

SOURCES: NCHS, 2008–2012 NHIS data linked to 1996–2014 HUD data.

Page 18   Ser

ies 1, No. 60

Table 5. Unweighted sample size and weighted percent distribution of ever-linked 2008–2012 NHIS–HUD participants aged 18 and over, by selected sociodemographic and health characteristics

All NHIS and HUD

participants

Linked participants

Percent

Percent

Characteristic

n

(weighted)

n

(weighted)

Sex

Male  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

159,645

48.3

2,087

30.5

Female  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

178,897

51.7

5,977

69.5

Age group (years)

18–39  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

134,928

39.1

3,889

54.9

40–64 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

148,491

43.9

2,789

32.3

65 and over. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55,123

17.0

1,386

12.8

Race and Hispanic origin

Hispanic  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

71,800

14.1

1,396

17.5

Non-Hispanic:

White. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

190,468

68.4

2,949

41.1

Black . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

49,091

11.9

3,377

37.1

Other. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

27,183

5.7

342

4.3

Poverty level1

Below 100% of federal threshold  . . . . . . . . . . . . . . .

50,690

12.8

4,386

48.0

100%–200% of federal threshold  . . . . . . . . . . . . . . .

69,661

18.8

2,356

30.5

200% of federal threshold or more . . . . . . . . . . . . . .

218,191

68.4

1,322

21.5

Health status2

Excellent/Very good  . . . . . . . . . . . . . . . . . . . . . . . . .

197,900

60.3

2,909

40.0

Good. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

94,218

26.8

2,562

30.8

Fair/Poor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

45,882

12.7

2,588

29.1

Health insurance

No coverage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

67,656

17.5

1,653

23.5

Private insurance  . . . . . . . . . . . . . . . . . . . . . . . . . . .

200,361

63.2

1,681

23.0

Public insurance . . . . . . . . . . . . . . . . . . . . . . . . . . . .

55,963

15.3

4,255

47.7

Other coverage. . . . . . . . . . . . . . . . . . . . . . . . . . . . .

11,364

3.1

452

5.3

1Based on published U.S. Census Bureau poverty thresholds.

2Self-reported.

NOTES: Missing responses are not presented. NHIS is National Health Interview Survey, and HUD is U.S. Department of Housing and Urban Development.

SOURCES: NCHS, 2008–2012 NHIS data linked to 1996–2014 HUD data.

Series 1, No. 60   Page 19

Table 6. Unweighted sample size and weighted percent distribution of ever-linked 2009–2012 NHANES–HUD participants aged 0–17 years, by selected sociodemographic and health characteristics

All NHANES and HUD

participants

Linked participants

Percent

Percent

Characteristic

n

weighted

n

weighted

Sex

Male  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

4,009

50.7

336

49.1

Female  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

3,893

49.3

302

50.9

Age group (years)

0–5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

3,318

32.9

201

25.1

6–11  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2,585

32.5

233

34.3

12–17  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1,999

34.5

204

40.6

Race and Hispanic origin

Hispanic  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2,354

18.9

112

16.9

Non-Hispanic:

White. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2,389

56.0

97

26.6

Black . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1,894

14.2

359

45.8

Other. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1,265

10.9

70

10.6

Family income to poverty guideline ratio1

Less than 1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2,646

23.5

415

61.0

1 to 2. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1,942

22.3

156

24.9

More than 2  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2,668

47.6

50

11.1

Health status2

Excellent/Very good  . . . . . . . . . . . . . . . . . . . . . . . . .

5,538

74.7

423

66.0

Good. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1,925

21.0

163

26.9

Fair/Poor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

438

4.3

52

7.1

Health insurance

Has coverage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

7,207

91.8

606

94.5

No coverage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

678

8.0

32

5.5

1Calculated using U.S. Department of Health and Human Services poverty guidelines.

2Self-reported.

NOTES: Missing responses are not presented. NHANES is National Health and Nutrition Examination Survey, and HUD is U.S.

Department of Housing and Urban Development.

SOURCES: NCHS, 2009–2012 NHANES data linked to 1996–2014 HUD data.

Page 20   Series 1, No. 60

Table 7. Unweighted sample size and weighted percent distribution of ever-linked 2009–2012

NHANES–HUD participants aged 18 and over, by selected sociodemographic and health characteristics

All NHANES and HUD

participants

Linked participants

Percent

Percent

Characteristic

n

(weighted)

n

(weighted)

Sex

Male  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6,072

48.3

339

33.3

Female  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6,319

51.7

615

66.7

Age group (years)

18–39  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

4,653

38.7

448

52.8

40–64 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

4,965

44.2

311

34.6

65 and over. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2,773

17.1

195

12.6

Race and Hispanic origin

Hispanic  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2,830

13.1

173

21.3

Non-Hispanic:

White. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

5,296

67.1

257

35.3

Black . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2,733

11.6

446

35.6

Other. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1,532

8.3

78

7.8

Family income to poverty guideline ratio

Less than 1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2,823

15.8

506

47.1

1 to 2. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2,984

18.9

284

32.0

More than 2  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

5,394

57.9

108

15.3

Health status1

Excellent/Very good  . . . . . . . . . . . . . . . . . . . . . . . . .

4,855

47.6

267

30.1

Good. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

4,580

35.1

334

36.4

Fair/Poor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2,952

17.2

353

33.5

Health insurance

Has coverage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

9,326

79.6

721

73.8

No coverage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

3,047

20.3

231

26.1

1Self-reported.

NOTES: Missing responses are not presented. NHANES is National Health and Nutrition Examination Survey, and HUD is U.S.

Department of Housing and Urban Development.

SOURCES: NCHS, 2009–2012 NHANES data linked to 1996–2014 HUD data.

Series 1, No. 60   Page 21

Appendix I. U.S. Department of Housing and Urban Development’s

Largest Housing Assistance Programs

This appendix describes basic

Multifamily Programs

for eligible low-income residents. HUD

characteristics of the U.S. Department

also provides technical assistance to help

of Housing and Urban Development’s

The multifamily (MF) program

PHAs plan, develop, and manage PH

(HUD) largest housing assistance

category in the linked NCHS–HUD

developments.

programs that are included in the linked

data encompasses a number of separate,

For PH residents, income must be

National Center for Health Statistics

distinct HUD programs, including:

verified at re-examination periods every

(NCHS) survey and HUD files. More

Section 221(d)(3) Below Market

12–18 months. At re-examination, if

detailed information on these programs can  Interest Rate, Section 236 Multifamily the person’s or family’s income exceeds

be found in the Analytic Guidelines (7).

Housing, Rental Assistance, Project-

80% of area median income, then PHA

Based Section 8 (or PBS8) Voucher

may reassess their eligibility for public

Housing Choice Vouchers

Assistance in Multifamily Housing,

housing. In PH programs, specific

and Related Programs

Section 202 Supportive Housing for the

calculations are used to determine a

Elderly Program, Section 202/162—

tenant’s monthly rent amount.

The Housing Choice Voucher (HCV)  Project Assistance Contract, Section

As with tenants in an HCV program,

program is the federal government’s

811 Supportive Housing for Persons

tenants participating in PH programs may

largest housing assistance program,

with Disabilities, and Rent Supplement.

be served by either MTW or non-MTW

allowing low-income families, the

Because each of these programs lacked

PHAs, which have different mandates

elderly, and persons with disabilities

sufficient sample size on an individual

for data completeness and frequency

to choose and lease safe and affordable

basis in the linked file, they were

of recertification. More information on

housing. In the HCV program, housing

combined into a single MF program

the MTW demonstration project can be

assistance is tenant-based, meaning that

category in the linked data files.

found in the Analytic Guidelines (7).

participants find their own housing in the

In all MF programs, subsidies are

private market. Participants are free to

paid directly to private property owners

choose any housing that meets program

who provide a certain percentage of

requirements and are not limited to units

their housing units at affordable rates

located in subsidized housing projects.

for low-income persons who qualify.

For example, participants can choose

Ownership may be for-profit or nonprofit.

single-family homes, townhouses, or

HUD subsidies (i.e., rental subsidies,

apartments. When a public housing

below-market interest financing, insured

agency (PHA) issues a voucher to a

mortgages, and other forms of assistance)

family, the family is responsible for

typically are linked with ongoing rental

finding suitable housing, and the rental

assistance for annual operating costs.

unit owner must agree to participate in

MF program assistance is tied to the

the program. Selected units must meet

property, unlike tenant-based rental

minimal standards of health and safety

assistance programs (e.g., HCVs), and

as determined by the PHA. In the linked

tenants cannot take their rental housing

data, the HCV program also includes

assistance subsidy elsewhere. Assistance

Homeownership Voucher, Project-

always stays with the owner of the

Based Voucher, Section 8 Moderate

development during the duration of their

Rehabilitation, and Section 8 Rental

assistance contract.

Certificate programs.

The Moving to Work (MTW)

Public Housing

demonstration program was introduced to

give PHAs flexibility with public housing

The PH program was established to

(PH) and HCV programs. Participants in

provide safe rental housing for eligible

HCV programs may be served by either

low-income families, the elderly, and

MTW or non-MTW PHAs, which have

persons with disabilities. PH dwellings

different mandates for data completeness

range from scattered-site single-family

and frequency of recertification. More

detached houses to high-rise apartment

information on the MTW demonstration

buildings. HUD provides capital

project can be found in the Analytic

subsidies and operating subsidies to

Guidelines (7).

local PHAs that manage public housing

Page 22   Series 1, No. 60

Appendix II. Summary of Linked National Center for Health Statistics–

U.S. Department of Housing and Urban Development Data

Table I. Linked NCHS–HUD data files: Name, population, and description

Data files

Universe

Description

Feasibility:

1999–2012 NHIS–HUD

All 1999–2012 NHIS and NHANES participants

NCHS created two feasibility files for each linked survey

file to aid researchers performing sample size and

1999–2012 NHANES–HUD

power calculations for potential analyses. The feasibility

files contain linkage eligibility information and program

participation indicators for each 1999–2012 NHIS and

NHANES participant. See Analytic Guidelines for details on

using these files to determine sample size.

Transaction

All 1999–2012 NHIS and NHANES participants

This file contains each transaction of the linked 1999–2012

linked to HUD administrative data

NHIS–HUD and NHANES–HUD participants. As noted in

Analytic Guidelines, transactions for children were removed

if the transaction occurred after the child’s 18th birthday.

Episode:

Episode_dates

All 1999–2012 NHIS and NHANES participants

Seven episode files contain start and end dates for

linked to HUD administrative data

participation in HUD programs, based on transaction data

and assumptions about reasonable intervals between

Episode dates–MTW HCV

Linked participants with at least one Moving to

transactions. Because most HUD recipients must recertify

Work Housing Choice Voucher transaction

each year, a transaction is expected each year. However,

certain HUD program categories (e.g., Moving to Work)

have longer intervals between recertifications. See Analytic

Episode dates–MTW PH

Linked participants with at least one Moving to

Guidelines for details on construction of the episode files.

Work public housing transaction

Episode dates–Other MF

Linked participants with at least one Other

multifamily transaction

Episode dates–PBS8

Linked participants with at least one multifamily

project-based Section 8 transaction

Episode dates–PH

Linked participants with at least one public

housing transaction

Episode dates–HCV

Linked participants with at least one Housing

Choice Voucher transaction

Concurrency

All 1999–2012 NHIS and NHANES participants

This file contains variables related to the timing of HUD

linked to HUD administrative data

housing participation relative to NCHS survey participation,

such as indicator variables for receipt of HUD housing

assistance at the time of survey; type of HUD housing

assistance received; and amount of time between last

and next transaction. See Analytic Guidelines for details

on using concurrency variables to identify participants

receiving HUD housing assistance at interview.

Weights

All 1999–2012 NHIS and NHANES participants

Although NHIS and NHANES are designed to be nationally

representative of the U.S. civilian noninstitionalized

population, not all NCHS survey participants are eligible for

linkage. Specific weights have been calculated for analyses

of these surveys when using linked data. One weights file

contains a single record for all participants of 1999–2012

NHIS and NHANES, as well as various survey weights

adjusted for linkage eligibility.

NOTES: NHIS is National Health Interview Survey, and NHANES is National Health and Nutrition Examination Survey. HUD is U.S. Department of Housing and Urban Development, and NCHS is National Center for Health Statistics. Analytic Guidelines is available from: https://www.cdc.gov/nchs/data/datalinkage/nchs_hud_analytic_considerations.pdf.

SOURCES: NCHS, 1999–2012 NHIS and NHANES data linked to 1996–2014 HUD data.

Series 1, No. 60   Page 23

Appendix III. Data Variable Considerations

The following variables may be

Concurrency at examination

● EXM_PH: Lived in non-MTW PH

useful for researchers using the linked

(NHANES only)

HUD-assisted housing at time of

National Center for Health Statistics

examination

(NCHS) and U.S. Department of Housing

● CON_STATUS_EXM: Lived in any

●  EXM_MTW_PH: Lived in MTW

and Urban Development (HUD) data

type of HUD-assisted housing at

PH HUD-assisted housing at time of

because they provide information about

time of examination

examination

whether the survey participant was linked

● CON_STATEX_HCV: Lived in

● EXM_PBS8: Lived in PBS8 MF

to the HUD administrative data and

HCV HUD-assisted housing at time

HUD-assisted housing at time of

the timing of receipt of HUD housing

of examination

examination

assistance relative to the survey interview

● CON_STATEX_MF: Lived in MF

● EXM_OTHER_MF: Lived in non-

and examination date:

HUD-assisted housing at time of

PBS8 MF HUD-assisted housing at

examination

time of examination

● HUD_MATCH_STATUS—This

● CON_STATEX_PH: Lived in PH

variable can be used to identify

HUD-assisted housing at time of

The following 16 variables are

participants who were eligible for

examination

related to the timing of HUD assistance

linkage and who were linked to the

relative to the survey interview or

HUD administrative data.

examination for each HUD program

● Concurrency variables—These

Concurrency by

category (HCV, MF, and PH). Although

binary indicator variables indicate

Subprogram (non-MTW

these variables cannot be directly

whether the survey participant

HCV, MTW HCV,

accessed by researchers, researchers can

received HUD housing assistance at

develop their own categorical variables

the time of interview or examination.  non-MTW PH, MTW PH,

based on the following:

The 20 variables are characterized

PBS8 MF, non-PBS8 MF)

by HUD program category (Housing

HUD Transactions

Choice Voucher [HCV], multifamily

Concurrency at survey interview

[MF], and public housing [PH]) and

Occurring After Survey

● INT_HCV: Lived in non-MTW HCV

subprogram (non-Moving to Work

HUD-assisted housing at time of

[MTW] HCV, MTW HCV, non-

Number of days between

interview

MTW PH, MTW PH, Project-Based

interview and next HUD

● INT_MTW_HCV: Lived in MTW–

Section [PBS] 8, and non-PBS8

HCV HUD-assisted housing at time

transaction

MF) at time of concurrency, and

of interview

●  TIME_A_INT: Number of days

by concurrency at time of survey

● INT_PH: Lived in non-MTW PH

between interview and subsequent

interview or examination (NHANES

HUD-assisted housing at time of

HUD transaction

only):

interview

●  TIME_A_HCV_INT: Number

● INT_MTW_PH: Lived in MTW–PH

of days between interview and

Concurrency by Program

HUD-assisted housing at time of

subsequent HCV transaction

(HCV, MF, PH)

interview

●  TIME_A_MF_INT: Number of days

● INT_PBS8: Lived in PBS8 MF

between interview and subsequent

Concurrency at survey interview

HUD-assisted housing at time of

MF transaction

interview

●  TIME_A_PH_INT: Number of days

● CON_STATUS_INT: Lived in any

● INT_OTHER_MF: Lived in non-

between interview and subsequent

type of HUD-assisted housing at

PBS8 MF HUD-assisted housing at

PH transaction

time of interview

time of interview

● CON_STATIN_HCV: Lived in HCV

HUD-assisted housing at time of

Number of days between

interview

Concurrency at examination

examination and next HUD

● CON_STATIN_MF: Lived in MF

(NHANES only)

transaction (NHANES only)

HUD-assisted housing at time of

● EXM_HCV: Lived in non-MTW

●  TIME_A_EXM: Number of days

interview

HCV HUD-assisted housing at time

between examination and subsequent

● CON_STATIN_PH: Lived in PH

of examination

HUD transaction

HUD-assisted housing at time of

● EXM_MTW_HCV: Lived in MTW–

●  TIME_A_HCV_EXM: Number

interview

HCV HUD-assisted housing at time

of days between examination and

of examination

subsequent HCV transaction

Page 24   Series 1, No. 60

● TIME_A_MF_EXM: Number of

days between examination and

subsequent MF transaction

● TIME_A_PH_EXM: Number of

days between examination and

subsequent PH transaction

HUD Transactions

Occurring Before Survey

Number of days between

interview and previous HUD

transaction

● TIME_B_INT: Number of days

between interview and previous

HUD transaction

● TIME_B_HCV_INT: Number of

days between interview and previous

HCV transaction

● TIME_B_MF_INT: Number of days

between interview and previous MF

transaction

● TIME_B_PH_INT: Number of days

between interview and previous PH

transaction

Number of days between

examination and previous HUD

transaction (NHANES only)

● TIME_B_EXM: Number of days

between examination and previous

HUD transaction

● TIME_B_HCV_EXM: Number

of days between examination and

previous HCV transaction

● TIME_B_MF_EXM: Number of

days between examination and

previous MF transaction

● TIME_B_PH_EXM: Number of

days between examination and

previous PH transaction

Series 1, No. 60   Page 25

Appendix IV. Evaluation of NCHS–HUD Data Linkage: Comparison

With HUD Program Recipients

This analysis assesses whether

categories used in HUD reports or

Because the two populations are not

similarities or differences occur between

publications)

statistically independent and measures of

the linked National Center for Health

● Indicator for households with at least  correlation between the two populations Statistics (NCHS) survey participants

one disabled person, based on HUD’s  were not readily available, comparisons and all recipients of U.S. Department

operational definition of disability:

were not statistically tested.

of Housing and Urban Development

https:/ portal.hud.gov/hudportal/

(HUD)-assisted housing. The percent

HUD?src=/program_offices/

Evaluation of Linked 2012

distribution of selected characteristics

fair_housing_equal_opp/disabilities/

from all HUD housing assistance

inhousing

NHIS–HUD Data: Methods

recipients are presented side by side

● Indicator for households with at least

Recipients of HUD housing

with that from a sample of linked

one elderly person (HUD defines

assistance during the 2012 calendar

NCHS–HUD participants who received

elderly as age 62 and over; therefore,  year were identified based on HUD

assistance during the same time period.

for this comparison, age 62 was

administrative records with effective

This evaluation uses only 1 year of

used as the threshold to define a

dates of Nov. 1, 2011, through Feb.

data (2012) from the National Health

household with an elderly person)

28, 2013. Only the most recent HUD

Interview Survey (NHIS) and two cycles

● Number of bedrooms in unit (0–1, 2,  transaction was retained so that each (2009–2012) of the National Health

3, and 4 or more)

individual was counted only once.

and Nutrition Examination Survey

● Total household members (1, 2, 3, 4,

In this analysis, these HUD housing

(NHANES).

and 5 or more)

assistance recipients are referred to as the

The NCHS–HUD linked samples

population of “all 2012 HUD-assisted

from the 2012 NHIS and the 2009–2012

The following criteria are used to

tenants.” Concurrent 2012 NHIS–HUD

NHANES are included in this analysis;

assess similarities and differences in the

participants are, in theory, a subset of this

however, only variables derived from

selected sociodemographic and household  population. Similarities and differences the HUD administrative data and not the

characteristics between the linked survey

between the concurrent 2012 NHIS–

NCHS survey data are described in the

participants and all recipients of HUD-

HUD participants and all 2012 HUD-

presentations, mainly because the HUD

assisted housing:

assisted tenants demonstrate ways in

administrative data are the only data

1.  If the percentage for each category

which the linked data may or may not be

source available for both the NCHS–

(e.g., male and female) of a

comparable to the population of HUD

HUD linked sample and the population

characteristic (e.g., sex) is equal in

housing assistance recipients.

of HUD housing assistance recipients not

both populations, it is described as

The NHIS sample adult and sample

included in the linked sample. Although

being the same.

child weights were used in the analyses

some of these variables (e.g., sex, age,

2.  If the relative difference between the  to account for unequal probabilities and total number of household members)

two populations, defined as

of selection and survey nonresponse,

are also collected in the NCHS survey,

and were further adjusted for linkage

the mechanism for data collection differs

| XHUDpopulation – Xlinked | / XHUDpopulation

eligibility via poststratification by

between administrative and survey data.

age, race and ethnicity, and sex, using

Analyses of these variables from the

is between 0.0 and 0.1 for all

SUDAAN’s procedure WTADJUST

survey data may yield different results.

categories of the characteristic,

(16). Reweighting of the linked survey

This analysis is not intended to evaluate

concurrent linked survey

data ensures that population totals

the HUD administrative data, but rather

participants are described as

are maintained and helps account for

to present characteristics of both the

“consistent or similar” to all

potential linkage consent bias. The

NCHS–HUD linked sample and the

recipients of HUD-assisted housing

confidence intervals incorporate the

population of HUD housing assistance

with respect to that characteristic.

complex sample design of NHIS.

recipients. The following variables are

3.  If the relative difference between

included in the analysis:

the two populations for at least

one category of the characteristic

Evaluation of Linked 2012

● HUD program category—Housing

is 0.1 or greater, concurrent linked

NHIS–HUD Data: Results

Choice Voucher (HCV), multifamily

survey participants are described

(MF), and public housing (PH)

as “different (higher/more or lower/

A total of 1,434 NHIS 2012

● Sex (male and female)

less)” than all recipients of HUD-

participants were concurrently linked

● Age (0–17, 18–29, 30–44, 45–61, and

assisted housing with respect to that

to HUD administrative data. During the

62 and over; age groups are based on

characteristic.

2012 time frame, the HUD administrative

Page 26   Series 1, No. 60

records contained data on 9,790,425

36.2% male, which was similar to the

between the two populations. The

HUD recipients. Results are presented in

distribution by sex among all 2012 HUD- distribution of total household members

Appendix Table II and Appendix Figures

assisted tenants. The age distributions

was similar between the two populations

I–IV.

were similar between the two populations  in all categories except for the 5 or more For both populations, the HCV

for most age groups. However, the

category; the population

program had the highest participation

percentage of adults aged 30–44 was

of all 2012 HUD-assisted tenants had

(53.7% among all 2012 HUD-assisted

lower among all 2012 HUD-assisted

more individuals living in households

tenants and 49.7% among concurrent

tenants (13.7%) than among concurrent

with 5 or more members (20.8%) than

2012 NHIS–HUD participants). The

2012 NHIS–HUD participants (15.9%).

the population of concurrent 2012

percentage of persons in MF units among

A higher percentage of all 2012

NHIS–HUD participants (17.4%).

all 2012 HUD-assisted tenants was lower  HUD-assisted tenants lived in households (23.1%) than among concurrent 2012

with a disabled person (26.2%) compared  Evaluation of Linked

NHIS–HUD participants (29.5%), and

to concurrent 2012 NHIS–HUD

the percentage of all 2012 HUD-assisted

participants (21.0%). Consistent with

2009–2012 NHANES–HUD

tenants in PH units was higher (23.3%)

the population of all 2012 HUD-assisted

Data: Methods

than among concurrent 2012 NHIS–HUD  tenants (18.6%), 18.3% of concurrent

participants (20.8%).

2012 NHIS–HUD participants lived in

Two NHANES cycles were

Concurrent 2012 NHIS–HUD

a household with an elderly person. The

pooled due to the small sample size of

participants were 63.8% female and

distribution of unit size was consistent

concurrently linked NHANES–HUD

Table II. Number and percent distribution of concurrently linked 2012 NHIS–HUD participants and 2012 HUD-assisted tenants, by HUD

program and selected HUD-collected demographic characteristics

2012 HUD-assisted

2012 concurrently linked NHIS–HUD participants

tenants

( n = 1,434)

95% CI

Percent

HUD program and demographic characteristics

n

Percent

n

(weighted)

Low

High

HUD housing category

Housing Choice Voucher  . . . . . . . . . . . . . . . . . . . . . . .

5,252,249

53.7

635

49.7

44.4

55.1

Multifamily housing . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2,256,365

23.1

441

29.5

23.8

35.9

Public housing  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2,281,811

23.3

358

20.8

16.3

26.1

Sex

Male  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

3,665,200

37.4

460

36.2

32.5

40.0

Female  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6,124,452

62.6

973

63.8

60.0

67.5

Age group (years)

0–17  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

3,931,683

40.2

318

37.2

33.9

40.6

18–29  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1,443,686

14.8

217

16.0

13.5

18.7

30–44 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1,341,524

13.7

270

15.9

13.8

18.4

45–61 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1,474,394

15.1

269

15.0

12.3

18.1

62 and over. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1,599,095

16.3

360

15.9

13.2

19.0

Households

With disabled persons  . . . . . . . . . . . . . . . . . . . . . . . . .

2,567,030

26.2

333

21.0

17.7

27.7

With elderly persons . . . . . . . . . . . . . . . . . . . . . . . . . . .

1,824,617

18.6

383

18.3

15.3

21.8

Unit size (number of bedrooms)

0–1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2,104,962

21.5

486

20.3

17.2

23.8

2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2,936,021

30.0

488

32.8

28.7

37.2

3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

3,543,478

36.2

359

34.7

30.4

39.3

4 or more  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1,205,964

12.3

101

*12.2

9.1

16.3

Total household members

1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2,221,424

22.7

551

23.1

19.8

26.7

2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1,834,022

18.7

307

20.0

17.3

23.0

3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1,978,692

20.2

264

21.5

18.0

25.5

4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1,721,379

17.6

165

17.9

14.6

21.9

5 or more  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2,034,144

20.8

136

17.4

13.7

21.8

* Figure may be statistically unreliable because the absolute width of its Korn-Graubard confidence interval (CI) is between 5 and 30 percentage points, yet its relative width is larger than 130%.

NOTES: CIs for percentages are calculated using SUDAAN with the Korn-Graubard adjustment to the Clopper-Pearson method. NHIS is National Health Interview Survey, and HUD is U.S. Department of Housing and Urban Development.

SOURCES: NCHS, linked NHIS–HUD data sample, 2012; HUD administrative data, 2012.

Series 1, No. 60   Page 27

participants for a single cycle. Recipients

of HUD housing assistance with effective

80

95% CI

All 2012

2012 NHIS–HUD linked

dates from Nov. 1, 2008, through

HUD-assisted

and concurrent

Feb. 28, 2013, were identified from the

tenants

participants

60

HUD administrative records and included

in the analysis to conservatively capture

50

all HUD housing assistance recipients

from the 2009–2012 calendar years.

t 40

If more than one record existed per

individual, only the most recent record

Percen

was retained, so that each person was

30

53.7

counted once at most. In this analysis,

49.7

these HUD housing assistance recipients

20

are referred to as the population of “all

29.5

23.1

23.3

2009–2012 HUD-assisted tenants.”

10

20.8

Concurrent 2009–2012 NHANES–HUD

participants are, in theory, a subset of this

0

Housing Choice

Multifamily housing

Public housing

population. Similarities and differences

Vouchers

between the concurrent 2009–2012

HUD housing category

NHANES–HUD participants and all

NOTES: CI is confidence interval. HUD is U.S. Department of Housing and Urban Development; NHIS is National Health 2009–2012 HUD-assisted tenants

Interview Survey. All variables shown are based on HUD administrative data.

SOURCES: NCHS, linked NHIS–HUD data sample, 2012; HUD administrative data, 2012.

demonstrate ways in which the linked

data may or may not be comparable to the

population of HUD housing assistance

Figure I. All 2012 HUD-assisted tenants and concurrently linked 2012 NHIS–HUD

recipients.

participants, by HUD housing category

The sample weights, accounting

for unequal probabilities of selection

and sex using SUDAAN’s WTADJUST

and helps account for potential linkage

and survey nonresponse, were further

(16). Reweighting of the linked survey data  consent bias. The confidence intervals adjusted for linkage eligibility via

ensures that population totals are maintained  reflect the complex design of NHANES.

poststratification by age, race and ethnicity,

80

95% CI

All 2012

2012 NHIS-HUD

HUD-assisted

linked and concurrent

tenants

participants

70

60

50

40

Percent

30

62.6

63.8

20

37.4

36.2

40.2

37.2

10

14.8

16.0

13.7

15.9

15.1 15.0

16.3

15.9

0

Male

Female

0–17

18–29

30–44

45–61

62 and over

Sex

Age group (years)

NOTES: CI is confidence interval. HUD is U.S. Department of Housing and Urban Development; NHIS is National Health Interview Survey. All variables shown are based on HUD

administrative data.

SOURCES: NCHS, linked NHIS–HUD data sample, 2012; HUD administrative data, 2012.

Figure II. All 2012 HUD-assisted tenants and concurrently linked 2012 NHIS–HUD participants, by sex and age group

Page 28   Series 1, No. 60

Evaluation of Linked

2009–2012 NHANES–HUD

40

95% CI

All 2012

2012 NHIS–HUD linked

HUD-assisted

and concurrent

Data: Results

tenants

participants

A total of 782 NHANES 2009–2012

30

participants were concurrently linked

to HUD administrative data. During

the 2009–2012 time frame, the HUD

administrative records contained data

20

on 14,148,465 HUD recipients. Results

Percent

are presented in Appendix Table III and

26.2

Appendix Figures V–VIII.

21.0

18.6

18.3

In both populations, the HCV

10

program was the most common housing

assistance program. Compared to all

2009–2012 HUD-assisted tenants,

0

concurrent 2009–2012 NHANES–HUD

Households with disabled persons

Households with elderly persons

participants received more assistance

through HCV programs (60.4%

NOTES: CI is confidence interval. HUD is U.S. Department of Housing and Urban Development; NHIS is National Health Interview Survey. All variables shown are based on HUD administrative data.

compared to 54.3%, respectively) and

SOURCES: NCHS, linked NHIS–HUD data sample, 2012; HUD administrative data, 2012.

fewer received assistance through MF

(17.6% compared to 20.9%) and PH

Figure III. All 2012 HUD-assisted tenants and concurrently linked 2012 NHIS–HUD

programs (22.0% compared to 24.7%).

participants, by percentage of households with disabled or elderly persons The percentages of concurrent

2009–2012 NHANES–HUD participants

that were female (65.2%) and male

of the five age categories, no differences

45–61 compared with all 2009–2012

(34.8%) were consistent with those of

were observed between the two populations.  HUD-assisted tenants (18.4% compared to all 2009–2012 HUD-assisted tenants

However, more concurrent 2009–2012

13.7%), and fewer were aged 18–29 (13.6%

(females 61.6%, males 38.4%). For three  NHANES–HUD participants were aged

compared to 17.2%).

60

95% CI

All 2012

2012 NHIS–HUD

HUD-assisted

linked and concurrent

tenants

participants

50

40

30

Percent

20

36.2

30.0 32.8

34.7

10

21.5 20.3

22.7 23.1

18.7 20.0

20.2 21.5

17.6 17.9

20.8 17.4

12.3 12.2

0

0–1

2

3

4 or more

1

2

3

4

5 or more

Number of bedrooms

Total household members

NOTES: CI is confidence interval. HUD is U.S. Department of Housing and Urban Development; NHIS is National Health Interview Survey. All variables shown are based on HUD

administrative data.

SOURCES: NCHS, linked NHIS–HUD data sample, 2012; HUD administrative data, 2012.

Figure IV. All 2012 HUD-assisted tenants and concurrently linked 2012 NHIS–HUD participants, by household characteristics

Series 1, No. 60   Page 29

Table III. Number and percent distribution of concurrently linked 2009–2012 NHANES–HUD participants and 2009–2012 HUD-assisted tenants, by HUD program and selected HUD-collected demographic characteristics 2009–2012 concurrently linked

2009–2012 HUD-assisted

NHANES–HUD participants

tenants

( n = 782)

95% CI

HUD program and

Percent

demographic characteristics

n

Percent

n

(weighted)

Low

High

HUD housing category

Housing Choice Voucher  . . . . . . . . . . . . . . . . . . . . . . .

7,685,573

54.3

436

60.4

48.5

71.2

Multifamily housing . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2,962,641

20.9

167

*17.6

11.9

25.2

Public housing  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

3,500,251

24.7

179

22.0

12.9

34.9

Sex

Male  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

5,436,525

38.4

317

34.8

30.7

39.2

Female  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

8,710,946

61.6

465

65.2

60.9

69.4

Age group (years)

0–17  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

5,683,455

40.2

332

37.3

31.5

43.4

18–29  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2,431,653

17.2

79

13.6

10.5

17.4

30–44 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1,897,090

13.4

79

13.8

11.7

16.2

45–61 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1,935,830

13.7

111

18.4

15.3

21.9

62 and over. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2,200,128

15.6

181

17.0

12.8

22.2

Households

With disabled persons  . . . . . . . . . . . . . . . . . . . . . . . . .

3,588,153

25.4

151

23.2

17.1

30.6

With elderly persons . . . . . . . . . . . . . . . . . . . . . . . . . . .

2,508,121

17.7

195

18.9

14.4

24.5

Unit size (number of bedrooms)

0–1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2,974,052

21.0

182

20.4

14.8

27.6

2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

4,142,288

29.3

189

23.8

18.6

29.9

3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

5,246,890

37.1

320

45.3

40.2

50.5

4 or more  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1,785,235

12.6

91

*10.5

6.9

15.6

Total household members

1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

3,166,498

22.4

201

23.8

18.2

29.3

2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2,443,175

17.3

122

14.6

11.8

18.0

3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2,897,762

20.5

158

21.7

17.2

27.1

4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2,577,165

18.2

132

19.3

14.9

24.5

5 or more  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

3,045,711

21.6

162

21.1

14.8

29.2

* Figure may be statistically unreliable because it is based on fewer than 8 degrees of freedom.

NOTES: Confidence intervals (CIs) for percentages are calculated using SUDAAN with the Korn-Graubard adjustment to the Clopper-Pearson method.  NHANES is National Health and Nutrition Examination Survey, and HUD is U.S. Department of Housing and Urban Development.

SOURCES: NCHS, linked NHANES–HUD data sample, 2009–2012;  HUD administrative data, 2009–2012.

Page 30   Series 1, No. 60

Similar percentages of all 2009–2012

80

95% CI

All 2009–2012

2009–2012 NHANES–HUD

HUD-assisted tenants (25.4%) and

HUD-assisted

linked and concurrent

concurrent 2009–2012 NHANES–HUD

70

tenants

participants

participants (23.2%) lived in a household

containing a disabled person. Consistent

60

with the population of all 2009–2012

HUD-assisted tenants (17.7%), 18.9% of

50

concurrent 2009–2012 NHANES–HUD

t

participants lived in a household containing

40

an elderly person. The distribution of unit

Percen

60.4

size differed between the two populations

30

54.3

for all categories except the 0–1 number

20

of bedrooms category. The distribution

of total household members was similar

24.7

10

20.9

22.0

between the two populations except for the

17.6

category with a household size of two: The

0

population of all 2009–2012 HUD-assisted

Housing Choice

Multifamily housing

Public housing

Vouchers

tenants had more individuals living in

HUD housing category

households with a size of two (17.3%) than

NOTES: CI is confidence interval. HUD is U.S. Department of Housing and Urban Development; NHANES is National the population of concurrent 2009–2012

Health and Nutrition Examination Survey. All variables shown are based on HUD administrative data.

NHANES–HUD participants (14.6%).

SOURCES: NCHS, linked NHANES–HUD data sample, 2009–2012; HUD administrative data, 2009–2012.

Figure V. All 2009–2012 HUD-assisted tenants and concurrently linked 2009–2012

NHANES–HUD participants, by HUD housing category

80

95% CI

All 2009–2012

2009–2012 NHANES–HUD

HUD-assisted

linked and concurrent

tenants

participants

70

60

50

40

Percent

65.2

30

61.6

20

38.4

40.2

34.8

37.3

10

17.2

18.4

13.6

13.4

13.7

15.6

17.0

13.8

0

Male

Female

0–17

18–29

30–44

45–61

62 and over

Sex

Age group (years)

NOTES: CI is confidence interval. HUD is U.S. Department of Housing and Urban Development; NHANES is National Health and Nutrition Examination Survey.

All variables shown are based on HUD administrative data.

SOURCES: NCHS, linked NHANES–HUD data sample, 2009–2012; HUD administrative data, 2009–2012.

Figure VI. All 2009–2012 HUD-assisted tenants and concurrently linked 2009–2012 NHANES–HUD participants, by sex and age group

Series 1, No. 60   Page 31

Conclusion

noninstitutionalized U.S. population

overall population of HUD assistance

living in HUD-assisted housing at some

recipients. Among concurrent linked

The linked NCHS–HUD data

point in the administrative period and

NHIS–HUD and NHANES–HUD

represent a sample of the civilian

may or may not be comparable to the

participants, the percentages of males

and females and the percentage of those

living in a household with an elderly

40

95% CI

All 2009–2012

2009–2012 NHANES–HUD

person were similar to the corresponding

HUD-assisted

linked and concurrent

percentages among all HUD tenants.

tenants

participants

Differences between the two populations

were observed by program category

30

of HUD housing assistance received,

age, household disability status, size

of unit, and total number of household

members. Differences in characteristics

20

that were not measured here (e.g.,

Percent

income and health insurance coverage,

25.4

among others) between concurrent linked

23.2

10

survey participants and the population

17.7

18.9

of HUD housing assistance recipients

should also be taken into consideration.

These differences may impact the

0

generalizability of study results from

Households with disabled persons

Households with elderly persons

analyses of the linked NCHS–HUD data

NOTES: CI is confidence interval. HUD is U.S. Department of Housing and Urban Development; NHANES is National to the overall population of HUD housing

Health and Nutrition Examination Survey. All variables shown are based on HUD administrative data.

assistance recipients.

SOURCES: NCHS, linked NHANES–HUD data sample, 2012; HUD administrative data, 2012.

Figure VII. All 2009–2012 HUD-assisted tenants and concurrently linked 2009–2012

NHANES–HUD  participants, by percentage of households with disabled or elderly persons 60

95% CI

All 2009–2012

2009–2012 NHANES–HUD

HUD-assisted

linked and concurrent

tenants

participants

50

40

30

Percent

45.3

20

37.1

29.3

10

21.0

22.4 23.8

20.4

23.8

21.7

17.3

20.5

18.2 19.3

21.6 21.1

12.6

14.6

10.5

0

0–1

2

3

4 or more

1

2

3

4

5 or more

Number of bedrooms

Total household members

NOTES: CI is confidence interval. HUD is U.S. Department of Housing and Urban Development; NHANES is National Health and Nutrition Examination Survey. All variables shown are based on HUD administrative data.

SOURCES: NCHS, linked NHANES–HUD data sample, 2009–2012; HUD administrative data, 2009–2012.

Figure VIII. All 2009–2012 HUD-assisted tenants and concurrently linked 2009–2012 NHANES–HUD participants, by household characteristics

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Document Outline

- Contents

- Detailed Tables

- Text Figures

- Appendix Tables

- Appendix Figures

- Acknowledgments

- Abstract

- Background

- Methods

- Conclusions

- Introduction

- Data Sources

- NHIS

- NHANES

- HUD Administrative Data

- Public and Indian Housing Information Center

- Tenant Rental Assistance Certification System

- HUD transaction dates included in NCHS–HUD administrative period

- Data Linkage Approval, Eligibility, and Process

- Linkage Approval and Eligibility

- Linkage Process

- Linked NCHS–HUD Data

- General Description of Linked Data Files

- NHIS–HUD and NHANES–HUD public-use feasibility files

- NCHS–HUD restricted-use transaction file

- NCHS–HUD restricted-use episode files

- NCHS–HUD restricted-use concurrency file

- NCHS–HUD restricted-use sample weights file

- Access to Linked NCHS–HUD Data Files

- Analytic Considerations

- Sample Weights

- Analyses Using Linked NCHS–HUD Data

- Descriptive Analyses of Linked NHIS–HUD and NHANES–HUD Participants

- Conclusion

- Published Research Papers Using NCHS Surveys Linked to HUD Data

- References

- Appendix I. U.S. Department of Housing and Urban Development’s Largest Housing Assistance Programs

- Housing Choice Vouchers and Related Programs

- Multifamily Programs

- Public Housing

- Appendix II. Summary of Linked National Center for Health Statistics–U.S. Department of Housing and Urban Development Data

- Appendix III. Data Variable Considerations

- Concurrency by Program (HCV, MF, PH)

- Concurrency at survey interview

- Concurrency at examination (NHANES only)

- Concurrency by Subprogram (non-MTW HCV, MTW HCV, non-MTW PH, MTW PH, PBS8 MF, non-PBS8 MF)

- Concurrency at survey interview

- Concurrency at examination (NHANES only)

- HUD Transactions Occurring After Survey

- Number of days between interview and next HUD transaction

- Number of days between examination and next HUD transaction (NHANES only)

- HUD Transactions Occurring Before Survey

- Number of days between interview and previous HUD transaction

- Number of days between examination and previous HUD transaction (NHANES only)

- Appendix IV. Evaluation of NCHS–HUD Data Linkage: Comparison With HUD Program Recipients

- Evaluation of Linked 2012 NHIS–HUD Data: Methods

- Evaluation of Linked 2012 NHIS–HUD Data: Results

- Evaluation of Linked 2009–2012 NHANES–HUD Data: Methods

- Evaluation of Linked 2009–2012 NHANES–HUD Data: Results

Table of Contents

Contents

Detailed Tables

Text Figures

Appendix Tables

Appendix Figures

Acknowledgments

Abstract

Background

Methods

Conclusions

Introduction

Data Sources

NHIS

NHANES

HUD Administrative Data

Public and Indian Housing Information Center

Tenant Rental Assistance Certification System

HUD transaction dates included in NCHS–HUD administrative period

Data Linkage Approval, Eligibility, and Process

Linkage Approval and Eligibility

Linkage Process

Linked NCHS–HUD Data

General Description of Linked Data Files

NHIS–HUD and NHANES–HUD public-use feasibility files

NCHS–HUD restricted-use transaction file

NCHS–HUD restricted-use episode files

NCHS–HUD restricted-use concurrency file

NCHS–HUD restricted-use sample weights file

Access to Linked NCHS–HUD Data Files

Analytic Considerations

Sample Weights

Analyses Using Linked NCHS–HUD Data

Descriptive Analyses of Linked NHIS–HUD and NHANES–HUD Participants

Conclusion

Published Research Papers Using NCHS Surveys Linked to HUD Data

References

Appendix I. U.S. Department of Housing and Urban Development’s Largest Housing Assistance Programs

Housing Choice Vouchers and Related Programs

Multifamily Programs

Public Housing

Appendix II. Summary of Linked National Center for Health Statistics–U.S. Department of Housing and Urban Development Data

Appendix III. Data Variable Considerations

Concurrency by Program (HCV, MF, PH)

Concurrency at survey interview

Concurrency at examination (NHANES only)

Concurrency by Subprogram (non-MTW HCV, MTW HCV, non-MTW PH, MTW PH, PBS8 MF, non-PBS8 MF)

Concurrency at survey interview

Concurrency at examination (NHANES only)

HUD Transactions Occurring After Survey

Number of days between interview and next HUD transaction

Number of days between examination and next HUD transaction (NHANES only)

HUD Transactions Occurring Before Survey

Number of days between interview and previous HUD transaction

Number of days between examination and previous HUD transaction (NHANES only)

Appendix IV. Evaluation of NCHS–HUD Data Linkage: Comparison With HUD Program Recipients

Evaluation of Linked 2012 NHIS–HUD Data: Methods

Evaluation of Linked 2012 NHIS–HUD Data: Results

Evaluation of Linked 2009–2012 NHANES–HUD Data: Methods

Evaluation of Linked 2009–2012 NHANES–HUD Data: Results