Mike Stobbe, Associated Press
NEW YORK (AP) — The federal government is planning to reduce the scope of the National Health Interview Survey, raising concerns among researchers that this could lead to an underestimation of the number of Americans with disabilities.
Proposed changes may eliminate at least half of the survey questions as part of an effort to streamline the 69-year-old survey, which has faced declining response rates. Advocates and researchers suggest that this reduction could result in misclassifying up to a quarter of wheelchair users and more than a third of individuals who are blind or deaf as not disabled. This misclassification could hinder the government's ability to address the health needs of many disabled Americans and assess the impact of changes to Medicaid and other health insurance programs.
Officials are currently finalizing the cuts, with predictions that the reductions may not be as extensive as previously indicated. Proposed questions for removal include those related to memory, fatigue, arthritis, and mobility issues, as well as inquiries about the use of assistive devices like hearing aids and wheelchairs.
Scott Landes, a sociology professor at Syracuse University, expressed concern, stating, "We just won't know any of that anymore."
The survey, which currently includes 490 health questions for adults, is expected to be reduced to approximately 200 to 225 questions in the 2028 iteration, according to Stephen Blumberg from the Centers for Disease Control and Prevention (CDC), who oversees the survey.
Conducted annually by U.S. Census Bureau workers on behalf of the CDC, the survey has a budget of $40 million and gathers responses from around 30,000 households each year. The data collected has informed public understanding of various health issues, including chronic fatigue syndrome prevalence, X-ray usage, seizure incidence in children, and health insurance coverage rates.
Participation in such surveys has declined, with the National Health Interview Survey being particularly time-consuming, often taking an hour or more to complete. The planned redesign aims to reduce the time commitment to about half an hour.
Factors contributing to the redesign include budget constraints and challenges in recruiting sufficient personnel for in-person interviews, exacerbated by a federal hiring freeze last year. Additionally, the Census Bureau is adjusting its data collection methods in preparation for the 2030 census, which has implications for the health survey.
The survey's methodology is also set to change, with participants receiving invitations to complete the survey online or via paper questionnaires, rather than starting with in-person or telephone interviews. However, Census Bureau staff will still conduct a smaller follow-up round of in-person surveys.
A notice regarding the survey redesign was published in the Federal Register in August, initiating a public comment period that will end on October 20.