National Health Interview Survey

OMB Control No: 0920-0214	ICR Reference No: 200910-0920-008
Status: Historical Active	Previous ICR Reference No: 200811-0920-004
Agency/Subagency: HHS/CDC	Agency Tracking No:
Title: National Health Interview Survey
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 01/04/2010
Retrieve Notice of Action (NOA)	Date Received in OIRA: 10/21/2009
Terms of Clearance: Prior terms continue.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2013	36 Months From Approved	12/31/2009
Responses	220,400	0	119,600
Time Burden (Hours)	34,977	0	28,017
Cost Burden (Dollars)	0	0	0

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Abstract: The annual National Health Interview Survey (NHIS) is a major source of general statistics on the health of the U.S. population and has been in the field every year since 1957. This household-based survey collects demographic and health-related information on a nationally representative sample of households throughout the country. This request is to extend data collection for the core NHIS and to modify selected sections of the NHIS for the next three years to cycle in and cycle out supplementary questions.

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Authorizing Statute(s): PL: Pub.L. 101 - 445 301 Name of Law: The National Nutrition Monitoring and Related Research Act of 1990    PL: Pub.L. 104 - 170 136 Name of Law: The Food Quality Protection Act of 1996    US Code: 42 USC 242 Name of Law: Public Health Service Act

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	74 FR 25553	05/28/2009
30-day Notice:	Federal Register Citation:	Citation Date:
	74 FR 53261	10/16/2009
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 15

IC Title Form No. Form Name Screener Questionnaire--Line 1 1 OMB Statement and Screener Section of the Family Core - line 2 2 Family Core - line 2 Child Cancer--Line 8 8 Child Cancer--Line 8 Adult Occupational Injury--Line 9 9 Chile Cancer--Line 8 Adult Epilepsy--Line 10 10 Adult Epilepsy--Line 10 Adult Quality of Life--Line 11 11 Adult Quality of Life--Line 11 Child Record Check--Line 12 12 Child Record Check--Line 12 Teen Record Check--Line 13 13 Teen Record Check--Line 13 Child Mental Health--Line 14 14 Child Mental Health--Line 14 Reinterview Survey--Line 15 15 Reinterview Survey--Line 15 Adult Core--line 3 3 Adult Core--line3 Child Core--line 4 4 Child Core--line 4 Child and Adult Immunization--Line 5 5 Child and Adult Immunization--Line 5 Family Disability--Line 6 6 Family Disability--Line 6 Adult Cancer--Line 7 7 Adult Cancer--Line 7

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	220,400	119,600	0	100,800	0	0
Annual Time Burden (Hours)	34,977	28,017	0	6,960	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: The current NHIS burden is 28,017 hours. For the 2010 NHIS survey the total burden is estimated to be about 34,977 hours, an increase of 6,960 hours. The total burden is higher because the supplements are longer in 2010 and the sample size reflects a full sample.

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Annual Cost to Federal Government: $31,000,000

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

Agency Contact: Petunia Gissendaner 4046390164

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
		(a) It is necessary for the proper performance of agency functions;
		(b) It avoids unnecessary duplication;
		(c) It reduces burden on small entities;
		(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
		(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
		(f) It indicates the retention periods for recordkeeping requirements;
		(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
			(i) Why the information is being collected;
			(ii) Use of information;
			(iii) Burden estimate;
			(iv) Nature of response (voluntary, required for a benefit, or mandatory);
			(v) Nature and extent of confidentiality; and
			(vi) Need to display currently valid OMB control number;
		(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
		(i) It uses effective and efficient statistical survey methodology (if applicable); and
		(j) It makes appropriate use of information technology.
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
Certification Date: 10/21/2009

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