The California Health Interview Survey:
A Tool for Monitoring Migrant Health
David Grant, PhD
UCLA Center for Health Policy Research
Director, California Health Interview Survey
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This morning’s presentation
 Overview of the California Health Interview Survey (CHIS)
 CHIS introduction
 CHIS methodology & sample
 CHIS topics and content
 CHIS specific content for immigrant health research
 Access to CHIS data
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CHIS introduction
 The California Health Interview Survey (CHIS) is California’s
source of state and local population-based health data
 CHIS is designed from the ground up to provide easily accessible
data that can be used:
1. To support decision making at the local level and statewide in public health
and health care
 For policy analysis, development and advocacy
 For State and county surveillance of public health indicators
 For service and program planning, development, and evaluation
2. To understand and measure health needs and disparities in California —
characterized by ethnic, geographic, age, and social class diversity
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CHIS introduction
 Conducted every other year since 2001
 Became a continuous survey in 2011
 Funded by federal and state health agencies, California and
national foundations, and others
 CHIS data is widely used by
 State agencies
 County health departments
 Academic researchers and students
 Advocacy groups and CBOs
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Methods: how is CHIS done?
 Large, geographically stratified random digit dial (RDD)
telephone survey designed to provide statistically reliable
estimates:
1. At the local level for counties (adults) and statewide
2. For major racial/ethnic groups and many ethnic subgroups
 Geographic stratification
 56 total geographically defined strata
 2 counties with sub-county strata
 Los Angeles: 8 Service Planning Areas (SPAs)
 San Diego: 6 Health Regions
 39 individual county strata
 3 grouped county strata containing the 17 smallest counties
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Methods: how is CHIS done?
 Two separate RDD samples:
1. Landline telephone numbers at stratum level (56 strata)
2. Cellular telephone numbers (since CHIS 2007) at “region” level
(7 regions)
 Ethnic oversamples
 Koreans and Vietnamese oversampled in each CHIS cycle through:
 Geographic targeting
 Surname list sample
 Interviews conducted in 6 languages: English, Spanish,
Chinese (Cantonese and Mandarin), Korean, and Vietnamese
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Methods: how is CHIS done?
 One adult selected at random in each household, plus
children and teens if available
 Three separate interviews
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Adult (age 18+) ~ 30 to 35 minutes
Adolescents (age 12-17) ~ 20 minutes
Children (age 0-11, by adult proxy) ~ 15 minutes
 Proxy responses for frail or ill elders (age 65+)
 CHIS became a “continuous” survey in 2011
 Previous cycles—intensive data collection effort for 7 to 9 months
every other year
 Continuous model: steady, less intensive effort to collect same amount
of data (about 48,000 households) over 24 months
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CHIS sample
 CHIS sample by cycle and age group
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Age Group
2001
2003
2005
2007
2009
Adult (18+)
56,270
42,044
43,020
51,048
47,614
Child (0-11)
12,802
8,526
11,358
9,913
8,945
Teen (12-17)
5,733
4,010
4,029
3,638
3,379
CHIS Topics & Content
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What information does CHIS collect?
 Health behaviors, including:
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Alcohol consumption and binge drinking
Tobacco use (past and current)
Illegal drug use (teens)
Physical activity, dietary intake
Cancer screening, flu shot, HIV/STD testing, use of seat belts and
bike helmets
 Health conditions:
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General health
Chronic conditions such as asthma, diabetes, heart disease, high
blood pressure, stroke, COPD, etc.
Cancer diagnoses and family history
Disability
What information does CHIS collect?
 Access to and use of health care services
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Usual source of care
Visits to doctor, ER use
Hospitalizations
 Health insurance coverage:
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Current coverage
Coverage type (employer-based, private purchase, MediCal,
Healthy Families, MediCare)
HMO enrollment and plan details
Coverage past 12 months
 Uninsured
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Reasons for lack of coverage
Medi-Cal and Healthy Families eligibility (age < 65)
Eligibility for coverage under ACA (expanded Medicaid/Exchange)
What information does CHIS collect?
 Mental health
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Mental health status, past 30-days and past 12-months
Perceived need for use of mental health services
Utilization of and barriers to use of mental health services
 Other topics & information
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Food security and hunger
Public program participation
Geocoding of households and schools
Social relationships and neighborhood conditions (2003)
Inter-personal violence (2007 & 2009)
… and numerous other topics
What information does CHIS collect?
 Rich demographic data, including:
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Age, sex, race/ethnicity, ethnic origin/ancestry, marital status,
sexual orientation
Country of birth, years in US, mother/father’s country of birth
Language of interview, language/s spoken at home, English
proficiency
Employment status, income, poverty level, educational
attainment, Veteran’s status
 Other useful content for immigrant health research
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Communication with doctor, language concordance, need for
translator
Health literacy (information from doctor’s office, Rx)
Citizenship status (citizen, green card, pending, other)
Ability to link adult, teen, and child records
Access to CHIS Data & Findings
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Easy access to CHIS data & findings
 Dissemination of data & findings through multiple
formats is a hallmark of CHIS
 Publications on the web
 AskCHIS online query tool
 Data files
 Public use
 Confidential
Much more information on access to CHIS data at the
Wednesday afternoon CHIS workshop
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Thank you
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