Material Handouts

Attachment 11d
Material Handouts

A. Confidentiality Brochure..................................................................................................... 11d-2
B. Sample Selection Flyer........................................................................................................ 11d-4
C. Welcome to NHANES Brochure ........................................................................................ 11d-5
D. Overview Brochure ............................................................................................................ 11d-7
E. Environmental Exposures Flyer ........................................................................................ 11d-11

11d-1

11d-A
More than 60 years of protecting
your privacy
The National Center for Health Statistics
(NCHS) protects your privacy and has
effective methods for keeping your
information safe.
• The first National Health and Nutrition
Examination Survey (NHANES) was
conducted in 1960.
• We remove all of your personal
information from our data files,
including your name, address, and
telephone number, to make sure no
one knows you took part in NHANES.
• We will never release any data if they
represent a place where few people
live to make sure no one can be
identified.
• All computers are password protected.
Data are kept on secure servers to
prevent unauthorized access.
• NHANES publishes summary reports
so no one who takes part in our survey
can be identified.

We combine the responses
from thousands of
participants across the
United States to report on
the “big picture” of our
nation’s health.

Learn More
For more information on NHANES visit:
www.cdc.gov/nhanes
You may also call toll-free
(English or Spanish)
at: 800-344-1386
Data from the National Center for Health
Statistics (NCHS) are released in reports
found on the
NCHS website at
https://www.cdc.gov/nchs
For specific questions about how NCHS
protects the information you provide,
contact the NCHS Confidentiality Officer at:
1-888-642-4159
[email protected]
The Privacy Act Systems Notice used for
NHANES provides information on routine
uses, policies and practices for storing,
retrieving, accessing, retaining, and
disposing of records is available here:
https://www.cdc.gov/
SORNnotice/09-20-0164.htm

The Nation’s Mobile Health Survey

11d-2

How the
National Health
and Nutrition
Examination
Survey Keeps
Your Information
Confidential

Protecting Your Privacy
Federal law protects your
information.
We take your privacy very seriously.
• Federal law does not allow us to share
information that identifies you or your
family without your permission.
• We will keep all your survey data safe
and secure. When we share data with our
partners to help prepare and process the
data, we do so in a way that protects your
privacy as required by law.
• Although NCHS will not disclose any of
your information, if we see signs of abuse
we are required to report it to social
services or the police.

19 ConfBroch-V1

Assurance of Confidentiality – We take
your privacy very seriously. All information
that relates to or describes identifiable
characteristics of individuals, a practice,
or an establishment will be used only
for statistical purposes. NCHS staff,
contractors, and agents will not disclose
or release responses in identifiable form
without the consent of the individual or
establishment in accordance with section
308(d) of the Public Health Service Act
(42 U.S.C. 242m(d)) and the Confidential
Information Protection and Statistical
Efficiency Act or CIPSEA (44 U.S.C. 35613583). In accordance with CIPSEA, every
NCHS employee, contractor, and agent has
taken an oath and is subject to a jail term
of up to five years, a fine of up to $250,000,
or both if he or she willfully discloses
ANY identifiable information about you. In
addition to the above cited laws, NCHS
complies with the Federal Cybersecurity
Enhancement Act of 2015 (6 U.S.C. §§
151 and 151 note) which protects federal
information systems from cybersecurity
risks by screening their networks.

11d-3

The NHANES pledge protects your
privacy.
Anyone working on NHANES must sign
a pledge to protect your privacy. Sharing
your information without your permission is
against the law.
We will not tell others that you are taking
part in NHANES.
• Taking part in NHANES will not affect your
benefits like Medicare, Medicaid, Social
Security, food stamps, or disability.
• We encourage you not to tell others about
your participation in NHANES. This helps
prevent someone from trying to find your
information in NHANES public data files.

NCHS is required by law to
protect your data using strict
privacy standards.

11d-B
National Health and Nutrition Examination Survey

How are NHANES participants selected?
A computer program first randomly selects areas, then
neighborhoods, then households, and lastly, people.
Stage 1: Areas
The United States is divided into distinct groups based on how
similar the areas are to each other. Each year, one or two areas
are selected to be visited from each group.
Stage 2: Subareas or Neighborhoods
Within each area, neighborhoods with a large number of households
are selected.
Stage 3: Houses, Condos, Apartments,
and Other Households
All of the households within those subareas
or neighborhoods are identified; then we will
select a few households from these subareas
for the study.
Stage 4: People
Selected households are asked to complete a short
survey about all the people who live at that address.
The computer program then determines if anyone in
the home is eligible to participate in NHANES.

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5

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4
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2

The United States population is made up of
different types of people. To produce reliable health
estimates, each type of person must be represented
in the sample. You were randomly selected to take
part in NHANES.
You have the chance to represent thousands
of other people like you!

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2

www.cdc.gov/nhanes
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2

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For more information about NHANES

Telephone: 800-344-1386
Email: [email protected]
Internet: www.cdc.gov/nchs/

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Why were you selected?

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11d-C

NHANES data
tell us ...
Over the past 60 years, NHANES data
from people like you have helped
to make the lives of everyone in the
United States safer and healthier.

Welcome!
Be proud! NHANES participants
contribute to what we know
about the health and nutrition
of people in the United States.
To thank you, we give you
a generous token of our
appreciation, free health tests,
and your results.

For more information visit:
www.cdc.gov/nhanes
You may also call toll-free
(English or Spanish)
at 800-344-1386
Your Field Interviewer:

Be one of the hundreds of
thousands of people who have
been part of NHANES during the
last 60 years! Now you and a
few of your neighbors have the
chance to help us to improve
our country’s health.

Welcome to NHANES!
Thank you for helping to improve
the health of everyone in the
United States!

You have been chosen to take part
in the National Health and Nutrition
Examination Survey, or NHANES.

What chemicals
in our food and
environment
are harming
people’s health

What a healthy
growth rate is
for babies and
children

How many people
in the United States
have high blood
pressure, high
cholesterol, and
diabetes

This study is conducted by the National
Center for Health Statistics, which is part
of the Centers for Disease Control and
Prevention and the U.S. Department of
Health and Human Services.
The Nation’s Mobile Health Survey

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Initial
Interview

Find out who in your home can
participate.
• It only takes 5 minutes!
• One of our professional
interviewers will visit your home
to ask a few questions about the
people living in your home.

In-Home
Interview

Free
Health Exam

Two Dietary
Phone Interviews

and {$HH INCENTIVE}
Token of Thanks

and a {$MEC Incentive Range}
Token of Thanks

with additional {$MIN DI INCENTIVE}
Token of Thanks

Complete a health survey.

Visit our Mobile Exam Center for a
free health exam.

Our professional interviewer will visit
your home to ask about:
• your health, and

• We will measure your height,
weight, and blood pressure, and
conduct additional physical tests.

You will

• any health problems receive a token
of our thanks
you have, such as
for
your time.
diabetes or asthma.

• We will also do blood tests and ask
for a urine sample.
• You will get the results
of your health exam.
• You can choose to
share the results with
your doctor to help you
make decisions about
your health.

Why did you choose me?
Every year, NHANES visits only a few
communities across the United States. We
cannot go to every house in the U.S., so a
computer program randomly chooses which
ones to talk with.
Your household is one of a few selected
in your community, and no one else can
take your place. You have been chosen to
represent up to 60,000 people, making your
participation very important!

Are there arrangements for the free
health exam?
• We will pay for your transportation costs.
• We will pay for childcare or eldercare while
you are at the Mobile Exam Center.

Does my information stay private?
Yes! Your information stays private – the law
requires that we keep your information safe.

We will call to ask about:

• the foods you consume,
• who plans your meals,
• the beverages you drink, and
• vitamins and medicines
you may take.

You will receive
another token
of our thanks
for your time.

• The National Center for Health Statistics is
America’s leading health statistics agency.
We have over 60 years of experience
protecting people’s privacy.

• Taking part in the survey does not
affect government benefits you or
your household may receive, such as
Medicare, Medicaid, Social Security,
Social Security Disability, or food stamps.

• We do not share your name, address, or
phone number with anyone outside the study.

Why should I do all the steps?

• We combine the information of everyone in
the study. This gives us a good picture of the
health of people in the U.S. while protecting
your privacy.

Each step of the study is important. When
you do all the steps, we have complete
information from you and everyone in the
study. This makes our data more reliable.
11d-6

Complete two telephone surveys.

You will receive
another token
of our thanks
for your time.

Complete!

10 WelcBroch-V1

11d-D

NHANES has monitored the Nation’s nutrition
and health for more than 60 years!

This survey combines information
from personal interviews with
standardized health exams performed
in our Mobile Exam Centers.

NHANES’s record of important
accomplishments is made possible
by the hundreds of thousands of
Americans who have participated!

CDC Growth Chart

NHANES data help create national
references for key health measures
like height, weight, and osteoporosis.
Children’s growth charts are updated
using the latest NHANES data.
Using reliable population health data
from NHANES, organizations can
establish policies and plan research,
education, and health promotion
programs.
NHANES is conducted by the
National Center for Health Statistics
(NCHS), part of the Centers for
Disease Control and Prevention (CDC)
and the U.S. Department of Health
and Human Services.

Birth to 36 months: Boys
Length-for-age and Weight-for-age percentiles
Birth
cm

L
E
N
G
T
H

3

6

9

in
41
40
100
39
38
95
37
36
90
35
34
85
33
32
80
31
30
75
29
28
70
27
26
65
25
24
60
23
22
55
21
20
50
19
18
45
17
16
40
15

16

15

18

cm
100
95

25
10
5

90

95

17

90

16

in
41
40
39
38
37
36
35

L
E
N
G
T
H

38
36
34

75

15
32

50

14

25

13

10

12

5

AGE (MONTHS)

12

15

Mother’s Stature
Father’s Stature
Date
Age
Birth

6

10

18

21

Weight

4
8
3

3

6

9

Published May 30, 2000 (modified 4/20/01).
SOURCE: Developed by the National Center for Health Statistics in collaboration with
the National Center for Chronic Disease Prevention and Health Promotion (2000).
http://www.cdc.gov/growthcharts

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36

33

75

7

2
kg
Birth

30

50

5

6

27

95
90

12

lb

RECORD #

24

21

AGE (MONTHS)

14
W
E
I
G
H
T

12

NAME

24

27

30

Gestational
Age:
Weeks
Length
Head Circ.

33

36

30
28
26

11

24

10

22

9

20

8

18

kg

16
lb

Comment

W
E
I
G
H
T

Why NHANES Matters

NHANES Mobile Exam Centers

NHANES is an essential resource to understand
health in the United States.

NHANES uses state-of-the-art Mobile Exam
Centers that travel around the country. Highly
trained staff collect health and physical
measurements, as well as blood, urine, and other
biological samples from participants.

NHANES data are used to:
• Determine the prevalence and risk factors of
major diseases

Based on age, gender, and current testing
guidelines, NHANES participants may receive
exams for

• Assess the nutritional status of the U.S.
population and its association with health
promotion and disease prevention

•
•
•
•
•
•
•
•
•

• Develop national standards for measurements
such as height, weight, and osteoporosis
• Identify the prevalence of undiagnosed diseases
such as diabetes

Oral health
Vision
Hearing
Bone density
Infection
Environmental exposure
Kidney and liver function
Environmental and food sensitivities and allergies
And more

NHANES Data Spotlight

Trends in Racial Disparities in High Blood Pressure (Hypertension)
NHANES Hypertension
2011–2018

Main findings

Awareness

Racial/Ethnic
Disparity
White Black
Hispanic Asian

Medical
Intensity
Blood
Pressure
Control

• Despite receiving more medications to
treat high blood pressure, Black people
have poorer control of high blood
pressure compared with White people.
• Asian and Hispanic people have poorer
control of high blood pressure. This
was found to be associated with their
decreased awareness of having high
blood pressure and receiving treatment
when compared to white people.
Source: American Heart Association’s
journal “Hypertension,” 2022

NHANES Data Spotlight

Oral Health
Data from NHANES (2017–2018) reveal that oral
health inequities remain. People living in poverty
are 102 times more likely to have difficulty doing
their job because of oral health conditions and 215
times more likely to have oral pain than those at
higher incomes (CareQuest Institute of Oral Health,
2023).
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11d-8

People living
in poverty are

215 times more
likely to have oral pain.

NHANES Participants

NHANES participants receive:

NHANES participants are randomly selected from
across the country. People who are selected receive
a letter to introduce the survey.

• Free health exams at the NHANES Mobile Exam
Centers and results that can be shared with
their health care providers
• Compensation for transportation and childcare
or adult care costs
• A generous token of appreciation for their time

NHANES participants complete:
• In-person interviews at their home on a broad
range of topics related to health and behaviors
• Telephone interviews about diet and nutrition.

Initial
Screener

In-Home
Interview

All information collected from participants is kept
confidential. Privacy is protected by federal laws.

Free Health Exam

Dietary Phone
Interview 1

Dietary Phone
Interview 2
Complete!

{$HH Incentive} Token of Thanks

{$MEC Incentive Range}
Token of Thanks

{$DI Incentive} Token of Thanks

{$DI Incentive} Token of Thanks

NHANES Research Community

NHANES Staff

The following agencies, among others, collaborate
in the design and development of NHANES:

NHANES staff are highly trained health personnel
and professional interviewers.

• Centers for Disease Control and Prevention
(CDC)

• Many staff are bilingual in English and Spanish.
• Staff are trained to collect data in a culturally
sensitive manner.
• All staff must adhere to strict federal laws
protecting participant privacy, keeping all
information collected in the survey private.

• National Institutes of Health
• U.S. Department of Agriculture
• Food and Drug Administration
NHANES findings are made available through a
series of publications and articles in scientific and
technical journals.
De-identified NHANES data are available for data
users and researchers throughout the world.
NHANES Data Spotlight

Dietary Supplements

3 in 5 adults

From 2017 to March 2020, just over one in three
youth and nearly three in five adults used dietary
supplements. Use of multiple dietary supplements
increased with increasing age, income, and
education, and varied by race and Hispanic origin
(National Health Statistics Reports, 2023).

used dietary supplements

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How to Get More Information
https://www.cdc.gov/nchs/nhanes/

800-344-1386

[email protected]
Include subject line: NHANES

https://www.cdc.gov/nchs/nhanes/

References
CareQuest (2023). New oral health data reflect inequities, barrier. Available at https://www.carequest.org/
system/files/CareQuest-Institute-NHANES-Oral-Health-Data-Reflect-Barriers-Inequities-Infographic.pdf
Lu, Y., Liu, L., Dhingra, L. S., Massey, D., Caraballo, C., Mahajan, S., Spatz, E. S., Onuma, O., Herrin, J., &
Krumholz, H. M. (2022). National trends in racial and ethnic disparities in antihypertensive medication use and
blood pressure control among adults with hypertension, 2011–2018. Hypertension, 79, 207-2017. https://doi.
org/10.1161/HYPERTENSIONAHA.121.18381
Mishra, S., Gahche, J. J., Ogden, C. L., Dimeler, M., Potischman, N., & Ahluwalia, N. (2023). National Health and
Nutrition Examination Survey, 2017–March 2020. National Health Statistics Reports, Number 183.
National Center for Health Statistics (NCHS). (2023). Dietary supplement use in the United States: National Health
and Nutrition Examination Survey, 2017–March 2020. Available at https://www.cdc.gov/nchs/data/nhsr/nhsr183.pdf
Assurance of Confidentiality – We take your privacy very seriously. All information that relates to or describes
identifiable characteristics of individuals, a practice, or an establishment will be used only for statistical
purposes. NCHS staff, contractors, and agents will not disclose or release responses in identifiable form without
the consent of the individual or establishment in accordance with section 308(d) of the Public Health Service
Act (42 U.S.C. 242m(d)) and the Confidential Information Protection and Statistical Efficiency Act or CIPSEA (44
U.S.C. 3561-3583). In accordance with CIPSEA, every NCHS employee, contractor, and agent has taken an oath
and is subject to a jail term of up to five years, a fine of up to $250,000, or both if he or she willfully discloses
ANY identifiable information about you. In addition to the above cited laws, NCHS complies with the Federal
Cybersecurity Enhancement Act of 2015 (6 U.S.C. §§ 151 and 151 note) which protects Federal information
systems from cybersecurity risks by screening their networks.

24 OverBroch-V1

11d-10

11d-E

Making Us Safer and Healthier
For over 60 years, information from NHANES exams has helped create essential public health policies.
These policies have made us safer and healthier.
Now is your chance to take part in NHANES. You can help protect and improve your health, the health of
your family, your community, and the United States now and into the future.

Have you been exposed to harmful substances found in the environment?
By taking part in NHANES, you may get tests to see if you have recently been exposed to harmful materials
like lead.

What can I be tested for if I participate in NHANES?
NHANES may test your blood and urine to find out if you have been exposed to
the chemicals below.

Lead
• Found in some water pipes, soil, children’s toys, paint not made in the United States
and homes painted before 1978
• Can make you more likely to have high blood pressure and kidney damage
• Can harm the nervous systems of unborn babies and young children

Mercury
• Found in some fish, shellfish, thermometers, and batteries
• Can cause shaking, memory loss, or problems thinking
• Can cause brain damage, hearing, and seeing problems in unborn babies

Cadmium
• Found in some foods, tobacco smoke, some workplaces, and in the air when coal or oil
are burned
• Can cause kidney disease and make you more likely to have low bone density as an adult

Learn More
For more information on NHANES visit: www.cdc.gov/nhanes
You may also call toll-free (English or Spanish) at: 800-344-1386
For more information on certain environmental exposures, visit: www.atsdr.cdc.gov

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