National Center for Health Statistics DCC CENTERS FOR DISEASE CONTROL AND PREVENTION Women’s Health Data in the National Survey of Family Growth (NSFG) Anjani Chandra, Ph.D.

NSFG - purposes Help to explain birth certificate data Collect periodic data on the “intermediate variables” related to fertility & reproductive health in the U.S. Enable demographic & public health research in these areas

Social factors Intercourse variables: Intermediate variables Timing of first intercourse Percent of women who ever had intercourse Time spent in marriage (separation, divorce) Frequency of intercourse Fertility (live births) Race/ethnicity Religion Labor force participation Education Income Access to health care Family background Community environment (economic, social, etc.) Pregnancy outcome (gestation) variables: Miscarriage and stillbirth Induced abortion Conception variables: Contraceptive use Sterilization Infertility

Uses of NSFG data “Snapshot” of U.S. fertility, family formation, and reproductive health Track national health objectives e.g., Healthy People 2010 Family Planning, MCH, and HIV/STD Objectives Evaluate health & social policies Research

NSFG - sample design Nationally representative sample of women Civilian non-institutionalized population of women Probability sample; multistage, stratified, cluster design; 8-10,000 women per Cycle 6 Cycles so far (1973, 1976, 1982, 1988, 1995, 2002) 1988 & 1995 samples based on NHIS

Summary of Women’s Health Data in 2002 NSFG

Complete Pregnancy History For pregnancies: Date, outcome, gest. length, wantedness of each For all recent (non-abortion) pregnancies: Smoking during pregnancy 1 st prenatal care visit For live births: Birth weight and sex (regardless of date of birth) Payment for delivery and maternity leave (recent births) Breastfeeding (children 18 and under)

Sexual Experience First intercourse; characteristics of first partner Numbers of sexual partners Lifetime; last 12 months Partner history (last 12 months)

Contraceptive History Method use for any reason Methods ever used First method used and method used at 1 st sex Partner-specific method use (3 most recent in last 12 mos) Month-by-month method calendar for last 3 years Method use preceding pregnancies

Sterilization and Infertility Sterilization operations: type, date, reasons, reversals 12-month infertility Impaired fecundity Nonsurgical sterility Subfecundity 36-month infertility

Health Services Family planning services Infertility & miscarriage services Other medical services Focus on use of Title X Clinics Focus on last 12 months

Reproductive Health Pelvic Inflammatory Disease Other reproductive health-related conditions & behaviors Diabetes (preg-related or other) Hypertension (preg-related or other) HIV testing

Audio CASI Pregnancy re-reporting Cigarette, alcohol, and other drug use Forced sexual intercourse (18-44 only) Other types of sex and numbers of sexual partners Same-sex partners Sexual orientation & attraction Sexually transmitted infections Other sensitive items related to sexual behavior & STD/HIV risk

Public Use Data Files  Cycles are currently available  Files available for Cycle 6 will include o Female file o Pregnancy file o Male file  Web-based documentation for Cycle 6 will include o User’s Guide o Codebook o Questionnaires

Restricted Use Data Files:  Omitted Items File (mainly Audio CASI data)  Contextual Data Files (community characteristics for 2000 & 2002 addresses; 4 levels of aggregation)

For further information on NSFG (including Cycle 6 PUF release): Contextual data access for Cycle 5 NSFG-NHIS linked analysis (Cycles 4 & 5) Restricted-use files for Cycle 6 Summary reports on 1995 NSFG (similar reports planned for Cycle 6) Series 23, #19 (Findings) Series 1, #36 (Methodology, field operations) Series 2, #124 (Sample design, variance estimation, imputation)