Health

Health

 

Child

The child survey regularly collected a range of detailed information on each child's current health conditions and health history. Table 1 gives an overview of the types of reports of physical development and mental health asked over the survey rounds for children.

Table 1. Health Data in the NLSY79 Child Surveys

Child Health 1986

1988-1992

1994 1996-2002 2004-20162
Rating of child's health       M M
Does health limit school or play M M M M M
Physical, emotional, or mental condition requiring: treatment, medicine, or special equipment M M M M M
Type/duration of limiting health conditions M M M M M
Accidents/injuries needing medical attention in last 12 months M M M M M
Accidents/injuries needing hospitalization since last interview/since birth   M M M M
Number of illnesses requiring medical attention or treatment M M M M M
Date of last routine health checkup M M M M M
Date of last dental checkup/work M M M M M
Source of health insurance, if any M M M M M
Behavioral, emotional, or mental problems; did insurance cover doctor visit M M M M M
Or prescription drugs taken to help control activity/behavior M M M M M
Menarche; age at 1st menses for female child (and mother) M M M M M
Right/left handedness       M M
Child's eye and hair color M        
Height and body weight of child M-I M-I M-I M-I M-I
Healthcare during pregnancy leading to child's birth1 M M M M M
Postnatal infant healthcare and feeding1 M M M M M
Temperament Scales (<4 years) M M M M M
Motor and Social Development Scale (<4 years) M M M M M
Behavior Problems Index (4+ years) M M M M M
Asthma         M/C
Cigarette use; age first smoked; frequency   C C C C
Alcohol use; age first drank; frequency   C C C C
Marijuana use; age first used; frequency   C C C C
Substance use (like glue, gas, sprays, fluids) that are "sniffed/huffed"; age first used; frequency     C C C
Other drug use (LSD, cocaine, uppers, downers); age first used; frequency   C C C C
 
NOTE: Users are reminded that, while Child and Young Adult health items are presented separately in this table, all child health items were collected for young adults when they were age 14 or younger in the years their mothers were interviewed.
"C" denotes child report, "M" denotes mother report, and "M-I" denotes either mother report or interviewer measurement (with a flag indicating the source of report for each survey year).
1 Pre- and postnatal items have been asked in the mother's main Youth interview since 1982 so that most information has been collected for most births. This information includes child's birth weight and length, mother's weight gain, type of delivery, etc.
2A limited number of child health questions were asked in 2018.

Overall rating of child's health

From 1996-2018, mothers were asked to rate the child's health on a 4-point scale from "poor" to "excellent."

The items that indicate the mother's rating of each child's general health, for children under age 15, are listed below:

Question Name Description Survey Year
MS961711 SCHOOL & FAMILY BACKGROUND: MOTHER RATING OF CHILD HEALTH 
1996
MS985019A
SCHOOL & FAMILY BACKGROUND: MOTHER RATING OF CHILD HEALTH
1998
BKGN-46A
CHILD BACKGROUND: MOTHER RATING OF CHILD HEALTH 
2000-2004
MS-BKGN-46A CHILD BACKGROUND: MOTHER RATING OF CHILD HEALTH
2006-2018

Health conditions

NLSY79 mothers were also asked to report on their children's health history and medical treatment received in the twelve months prior to the survey. The National Health Interview Survey (NHIS) was the principal source for various NLSY79 child health questions. For example, the limiting conditions questions were taken from the Child Core of the NHIS and from the NHIS Parent questionnaire section on family involvement in education (i.e., PJ3. Does CHILD have any physical, emotional, or mental condition that limits or interferes with his or her ability to do regular schoolwork? To take part in sports, games, or other activities with children his or her age?). Through 2000, a mark-all item for a list of limiting conditions was accompanied by a single follow-up question: asking how long has the child had the limiting condition(s). Starting in 2002, updates in the design of the NLSY79 Child questionnaire allowed users to identify potentially unrelated limiting conditions when multiple conditions are reported, along with the duration and onset of these various separate conditions.

Accidents and injuries

Questions about child accidents and injuries were asked beginning with the 1988 survey. Mothers reported: 1) whether the child had an accident in the past 12 months that required medical attention, and 2) whether the child ever had an accident (not necessarily in the past 12 months) requiring hospitalization. If the mother answered yes to either of these questions, she was asked the specific month and year of the three most recent accidents. The way that these questions were framed means that information is available for varying time periods for different children. Some researchers interested in linking these events with maternal work history have organized the data into quarters to deal with the seasonal patterns in accident rates (Currie and Hotz, 2001). The NHIS series on accidents and injuries was the source of these NLSY79 child questions.

Asthma

With support from the Centers for Disease Control and Prevention, a series of asthma-related health questions was added to the NLSY79 main Youth, Child, and young adult in 2004. Mothers were asked if they had ever been diagnosed with asthma, their age when diagnosed, whether they still had the disease, when they last had experienced symptoms, if there had been any episodes in the past 12 months, whether unscheduled medical care had been received in the past 12 months due to asthma, what medicine they used for quick relief from asthma attacks, and whether they used a daily medication to prevent attacks. Respondents were asked how much the asthma limited their activities and whether their sleep was disrupted because of the illness. They were also asked whether they had smoked in the past 30 days, how often, how many cigarettes per day, whether anyone else had smoked in the house in the past 2 weeks, and whether they had been diagnosed with any other chronic lung diseases.

Mothers were asked similar asthma-related questions about their children. Respondents reported whether any of their children had been diagnosed with asthma; at what age each child had been diagnosed; whether the child's father had ever been diagnosed with asthma; whether the child had experienced any episodes in the last 12 months; whether unscheduled medical care had been received for the child in the last 12 months due to asthma; how many school days had been missed due to asthma; whether any sleep had been missed or activities limited due to asthma; and whether asthma medications were taken.

The NLSY79 child-based asthma items labeled ASTHMAyyyy in the child datafile are based on inputs from the NLSY Main Youth interview, in which mothers report asthma symptoms for each biological child under age 15.

Children 10 and older were asked if they had had any asthma symptoms in the past month, how much asthma limited school work, participation in physical education class, and physical activities. Question names for asthma items from the Child Supplement begin with the stem CS-ASTHMA. These items can be found in the CHILD HEALTH and year-specific CHILD SUPPLEMENT areas of interest.

Birth histories

On a regular basis, the NLSY79 has collected pre- and postnatal care information from the sample women as they became mothers. Fertility questions in the main Youth interview ask about all pregnancies/live births, a cumulative inventory of all children reported, and contraceptive methods used. NLSY79 mothers report on their health and behavior during each pregnancy. Pre- and postnatal practices are detailed below under "Prenatal and infant care."

Handedness

Beginning in 1996, NLSY79 mothers were asked a series of questions about whether each child was right-handed or left-handed. Mothers were asked which hand the child used for writing, throwing a ball, and brushing his or her teeth.


Question 1996 1998 2000-2004 2006-2016
Which hand child uses for writing CS96H-11C CS98H-11C HLTH-12A MS-HLTH-12A
Which hand child uses for throwing a ball CS96H-11D CS98H-11D HLTH-12B MS-HLTH-12B
Which hand child uses for brushing teeth CS96H-11E CS98H-11E HLTH-12C MS-HLTH-12C

The Motor and Social Development Scale, explained in detail in the Child Assessments section of the topical guide, also contains items related to when the child held an object in one hand. A more detailed series of handedness questions posed to children once they become eligible for the young adult interview can be found in the YA HEALTH area of interest.

NOTE: NLSY79 mothers were asked the following question in 1993: Were you born naturally left-handed or right-handed? Reports of “ambidextrous” or “neither” were recorded.

Health care access/Medical visits

Details concerning use of the medical system included the presence, number, and type of accidents, injuries, or illnesses requiring medical attention in the past 12 months; hospitalization history in the past 24 months; timing of last routine health and dental checkups; and coverage by and type of health insurance. The health services questions are drawn from the Child Core of the National Health Interview Survey (NHIS).

Health insurance

From the first Child survey in 1986, mothers were asked in the Child Supplement whether each child was covered by health insurance, not including public assistance, provided either by an employer or by an individual plan. They were also asked whether Medicaid covers each child's health care. Starting in 1994, mothers of young adult children in the household were asked this same set of questions in the fertility section of the main Youth questionnaire. These items are assigned to the BIRTH RECORD areas of interest in the NLSY79 main Youth file and can be linked to specific children by use of the child ID. There are also limited questions about the respondent's health plan related to children in the HEALTH area of interest of the main Youth file. The child health insurance questions are based on the Family Section of the 1981 National Health Interview Survey (NHIS).

Health assessments

The child assessment data collection included a number of questions and scales designed to capture child health information and to measure the child's temperament, motor and social development, and behavior problems. This information was obtained from the mother. The How My Child Usually Acts/Temperament Scale forms a measure of temperament or behavioral style over the past two-week period (in most survey years for children under age seven). The Motor and Social Development Scale measures motor-social-cognitive development for children under age four. The Behavior Problems Index elicits mother ratings of children four years of age or older in areas of problem behavior such as hyperactivity, anxiety, dependency, aggressiveness, and peer conflict.  These child health assessments were originally all in the paper self-administered booklet called the Mother Supplement. In 2000 the questions related to Temperament, Motor & Social Development were moved to CAPI format and administered in the Child Supplement. Data items related to the individual assessment responses are therefore found in the MOTHER SUPPLEMENT areas of interest for 1986-1998 and in both the CHILD SUPPLEMENT and MOTHER SUPPLEMENT areas of interest in 2000. In 2002 and 2004, all the child health items (except height and weight) were in the MOTHER SUPPLEMENT area of interest. From 2006 to 2018, height and weight were also included in the MOTHER SUPPLEMENT area of interest.

Height and body weight

In each survey round, the child's height and body weight at the time of interview were measured either by the interviewer or recorded as reported by the mother or child. Height and weight questions appear in each year-specific CHILD SUPPLEMENT area of interest.

Starting in 2006, there are potentially three reports for each child, one in the Mother Supplement section of the mother's main Youth interview and in the Child Supplement, made during the actual child interview, and for children aged 10 years and older, a self-report of height and weight in the CHILD SELF-ADMINISTERED SUPPLEMENT. Dates and method of report may differ substantially between the mother's main interview and the child supplement.

Height

In the Child Supplement, the method of height report (tape measurement; mother report; child report) was recorded, starting with the second (1988) survey round. Starting in 2000, the method of report question is named HLTH-HGT-REPT. To find the method of report questions in prior rounds, search Word in Title contains “HOW WAS HEIGHT REPORTED” in Investigator.

Variables coding child's height can be located using a 'Word in Title contains "Height"' search in Investigator. Since 2002, a separate question indicates whether the child's height was recorded in feet and inches or in inches only. The method of recording questions are named HLTH-HGT-MTHDCK. Overall height in inches (HLTH-HGTCALC) is computed from the entered values. Note that in 2002 only, this calculated height value is reported with two implied decimal places.

From 2006-2018, information on the height each child was also captured in the Mother Supplement. Question names for the height questions from the Mother Supplement start with MS-HLTH-HGT, and are assigned to both the CHILD HEALTH and year-specific MOTHER SUPPLEMENT areas of interest.

From 2006-20124, children ages 10-14 self-reported their height in feet and inches. The question names for these items begin with CSAS-P5-HGT.

Weight

In the Child Supplement, the method of report (scale measurement, mother report; child report) was recorded, starting with the second (1988) survey round.

Starting in 2000, the method of report question is named HLTH-WGT-REPT. To find the method of report questions in prior rounds, search Word in Title contains “HOW WAS WEIGHT REPORTED” in Investigator.

Variables coding child’s weight can be located using the following search in Investigator:

                Word in Title (enter search term) contains "weight"  AND
                Word in Title (enter search term) contains "health"

Since 2002, a separate question indicates whether the child's weight was recorded in pounds and ounces or in ounces only. The method of recording questions are named HLTH-WGT-MTHDCK. Overall weight in pounds (HLTH-WGTCALC) is computed from the entered values. Note that in 2002 only, this calculated weight value is reported with two implied decimal places.

From 2006-2018, information on the weight of each child was also captured in the Mother Supplement. Question names for the weight questions from the Mother Supplement start with MS-HLTH-WGT and are assigned to both the CHILD HEALTH and year-specific MOTHER SUPPLEMENT areas of interest.

From 2006-2014, children ages 10-14 self-reported their weight in pounds. The question name for these items is CSAS-P5-WGT.

Important Information

While an effort is made to review "out of range" values in the child data that are clearly mis-entered, height and weight values generally appear in the database as reported by the mother.

Starting in 2002, a machine check compares the computed height and weight to identify out-of-range values. These questions are named HLTH-HGTCOMP and HLTH-WGTCOMP in the Child Supplement and MS-HLTH-HGTCOMP and MS-HLTH-WGTCOMP in the Mother Supplement. Interviewers are asked to either confirm the value as entered or to correct the entered value.

Immunization

In the fertility section of the 1986-1990 NLSY79 main Youth questionnaire, mothers were asked to report on the types of shots administered to each child.  Users should note that only the subset of immunization questions (DPT/oral polio and measles) most comparable across these survey years is included in the Child file. The questions used to construct the immunization variables were not asked after 1990 and therefore children born since that time have been assigned a missing value on these variables. The NLSY79 child series on shots is from the Immunizations section of the National Health Interview Survey (NHIS).

Menarche

Starting with the first child survey year, mothers were asked about whether each daughter had started menstruation and, if so, the date and age of the first menses. From 1986 to 2000, these questions are assigned to the year-specific CHILD SUPPLEMENT area of interest. From 2002 to 2018 these questions are assigned to the year-specific MOTHER SUPPLEMENT area of interest.

Mental health

At each survey point through 2018, the mother was asked whether in the past 12 months her child has been referred for professional assistance with a behavioral, emotional, or mental problem or made any visits to a psychiatrist, psychologist, or counselor. She was also asked about use of medication to control the child's activity level or behavior. Comparable questions continue to be asked of the young adults, allowing researchers the opportunity to continue examining health issues into adulthood.

Child behavior problems. From 1986-2016, mothers reportws on behavior problems for each child age four and over. Summary scores for the Behavior Problems Index, developed by Peterson and Zill, are based on items were derived from the Achenbach Behavior Problems Checklist (Achenbach and Edelbrock 1981) and other child behavior scales (Graham and Rutter 1968; Kellam et al., 1975; Rutter, Tizard and Whitmore 1970). The Behavior Problems total score is based on responses from the mothers to 28 questions in the Mother Supplement (items 1-26, 31, and 32 in the Behavior Problems Index scale). These mother-report questions ask about specific behaviors that children age four and over may have exhibited in the previous three months, including anxiety, depression, antisocial behavior, headstrong behavior, hyperactivity, dependency, and peer conflict. Details on the items and their scales, as well as a full list of summary scores, can be found in the discussion of the Behavior Problems Index section.

Child depression: child-report. Starting with the 1992 NLSY79 Child survey and continuing through 2014, the following depression or child "moods" items were self-administered by children age 10-14:

  CHILD SELF-ADMIN: DEPRESSION - HOW OFTEN CHILD FEELS SAD AND BLUE
  CHILD SELF-ADMIN: DEPRESSION - HOW OFTEN CHILD FEELS NERVOUS, TENSE, OR ON EDGE
  CHILD SELF-ADMIN: DEPRESSION - HOW OFTEN CHILD FEELS HAPPY
  CHILD SELF-ADMIN: DEPRESSION - HOW OFTEN CHILD FEELS BORED
  CHILD SELF-ADMIN: DEPRESSION - HOW OFTEN CHILD FEELS LONELY
  CHILD SELF-ADMIN: DEPRESSION - HOW OFTEN CHILD FEELS TIRED OR WORN OUT
  CHILD SELF-ADMIN: DEPRESSION - HOW OFTEN CHILD FEELS EXCITED ABOUT SOMETHING
  CHILD SELF-ADMIN: DEPRESSION - HOW OFTEN CHILD FEELS TOO BUSY TO GET EVERYTHING DONE
  CHILD SELF-ADMIN: DEPRESSION - HOW OFTEN CHILD FEELS PRESSURED BY MOTHER OR FATHER

The 9-item scale came from the National Commission on Children (NCC) Survey of Parents and Children. The specific source for these questions can be found in the 1990 NCC Parent and Child Final Questionnaire and Codebook for Children, questions V432-V440. The moods items were in the Child Self-Administered Supplement (CSAS) stand-alone instrument through 2002 and were part of the self-administered section of the Child Supplement from 2004 to 2014. Beginning in 2016, these items have been asked of 12 and 13 year olds as part of the YA survey and can be found in the YA ATTITUDES area of interest.

Child depression: mother-report. The Behavior Problems Index, completed by mothers for children ages 4 and older, contains items that can be used to create an Anxious/Depressed subscale. These items, administered in the Mother Supplement, are listed below:

      Question Name
BPI Item Description Subscale Scale 1986-1998 2000 2000-2004 2006-2016
Has sudden changes in mood or feeling Anxious/Depressed Externalizing * MS2-01 BPI-01 MS-BPI-01
Feels/complains no one loves him/her Anxious/Depressed Internalizing * MS2-02 BPI-02 MS-BPI-02
Is too fearful or anxious Anxious/Depressed

Externalizing/Internalizing

* MS2-05 BPI-05 MS-BPI-05
Feels worthless or inferior Anxious/Depressed Internalizing * MS2-14 BPI-14 MS-BPI-14
Is unhappy, sad or depressed Anxious/Depressed Externalizing/Internalizing * MS2-20 BPI-20 MS-BPI-20
NOTE: Prior to 2000, question names were based on questionnaire location. For a detailed discussion of the BPI items, including tips on locating the items in the early survey rounds, see the Behavior Problems Index section.

Prenatal and infant care

Maternal prenatal care information and health-related characteristics are provided on the NLSY79 Child and Young Adult file. Various pieces of information derived from mother reports in the fertility section of the main NLSY79 youth questionnaire are linked to each individual biological child. The following information is available for most children in the file: prenatal doctor visits, maternal alcohol/cigarette/drug use during pregnancy, other prenatal behaviors (vitamin intake, salt intake, etc.); amniocentesis, ultrasound performed; was child born early or late; cesarean birth; mother's weight gain during pregnancy; child's birth length and birth weight; length of hospital stay; well-baby/sick baby health care in first year; breastfeeding history; other infant feeding practices. The child pre- and postnatal data are assigned to the PRE/POST NATAL area of interest in the data files.

Users who attempt in-depth analyses based on the pregnancy and postnatal information should review the Fertility Section of the main Youth questionnaire to ascertain when certain questions were asked about specific children of specific ages. For example, while birth weight was reported in 1983 for all children born as of that date, certain feeding questions were applicable only to a subset of children. Feeding questions about solid foods, which may have been inappropriate for an infant in 1983, were updated in 1984 or 1985, depending on the developmental stage of the child at each interview date. Also, unlike the series of child illness questions asked of the mother starting in the 1984, the 1983 interview schedule refers to illnesses experienced by the youngest child in the first year only if the child had been hospitalized (see Section 10, Q. 40A and B, pages 10-105 of the 1983 NLSY main youth questionnaire). Users interested in maternal and child health information related to pregnancy and birth in the NLSY79 should consult the report titled Maternal Child Health Data from the NLSY (PDF), by Mott and Quinlan (1991), available on the Research/Technical Reports page.

Smoking/Exposure to smoking

Questions on smoking were asked in each Child survey round from 1988 to 2014. Children 10 years of age and older were asked about age at first use and extent of cigarette use. Variables related to smoking for NLSY79 children can be found in the CHILD SELF-ADMINISTERED area of interest of the data files. See the Cigarette & Drug Use section of the topical guide for more details about child smoking items.

A more extensive set of questions is asked of NLSY79 children once they became NLSY79 young adults. Additionally, the NLSY79 main Youth (mothers of NLSY79 children) include detailed questions on the quantity and frequency of cigarette use.

NLSY79 mothers have been asked, in several survey years, about their own smoking habits as well as those of other household members. This information, in light of the fact that interviewed children are largely resident in their mothers' households, offer opportunities to link the child data with maternal and household smoking information. Cigarette use data for NLSY79 respondents are available as follows:

  • Data were collected, during the 1984 main Youth survey on
    • age at first use
    • most recent use
    • number of cigarettes smoked in the past 30 days. 
  • The 1992, 1994, 1998, and 2010-2014 NLSY79 main Youth surveys gathered information from those respondents on:
    • whether they had smoked at least 100 cigarettes in their life
    • the age that they started smoking daily
    • the number of months/years since they had last smoked daily 
  • The 1983-1986, 1988, 1990, 1992, and 1994-2014 surveys gathered, for female NLSY79 respondents, information on whether they had smoked in the twelve months before pregnancy and, if so, on the number of cigarettes smoked during pregnancy (2000-present).

For a detailed description of these items, consult the NLSY79 main Youth users guide topical section on Cigarette Use.

An additional source of information about secondhand smoke can be found in the Young Adult surveys. Starting in 2004, the Young Adult survey contains two items that asks about exposure to secondhand smoke, including (1) a question about anyone smoking in the home in the previous two weeks and (2) whether the YA respondent had spent time routinely in a place that smelled of cigarette smoke:

Question Name Title Area of Interest
Q14A-4 HAS ANYONE SMOKED CIGARETTES OR TOBACCO PRODUCTS IN HOME IN PAST 2 WEEKS? YA HEALTH
Q14A-5 HAS R ROUTINELY SPENT TIME IN PLACE WHERE SMELLED CIGARETTE SMOKE IN PAST TWO WEEKS? YA HEALTH

Used in combination with RESTYPE (for linkage to the mother's household), the first item about tobacco in the home can be connected to the child data, for interviewed YAs living in the mother's household (RESTYPEyy=19 or 20), to obtain additional information about smoking in the child's household. The constructed RESTYPE variables are assigned to the YA COMMON KEY VARIABLES area of interest:

  RESTYPEyy TYPE OF RESIDENCE R LIVES IN -- CONSTRUCTED 1994-1998
  RESTYPEyyyy TYPE OF RESIDENCE R LIVES IN -- CONSTRUCTED 2000-present

Substance use

From 1988-2014, the child survey included questions for children ages 10 to 14 about consumption of alcohol, cigarettes, marijuana, and other drugs. See the Alcohol Use and Cigarette & Drug Use sections of the Topical Guide for more details about these questions. Substance use questions can be found in the CHILD-SELF ADMINISTERED and year-specific CHILD SUPPLEMENT areas of interest.

Survey Instruments Health-related questions are found in Mother Supplement. Prenatal and infant care items are found in the Fertility section of the main Youth questionnaire. Asthma questions asked of the child are included in the Child Supplement. Substance use questions are asked in the Child Self-Administered Supplement. BPI, MSD, and Temperament items are asked in the Mother Supplement.
Areas of Interest

ASSESSMENT (BPI, MSD, Temperament scores)
CHILD HEALTH
MOTHER SUPPLEMENT
CHILD SUPPLEMENT
PRE/POST NATAL CARE
CHILD SELF-ADMINISTERED SUPPLEMENT