The Initial Creation of a Family Well-being Index Using the National Survey of Children's Health

The well-being of families is critical for health, but a family well-being metric has not yet been developed for use in federal surveys, making it impossible to assess national trends in family well-being. The National Survey for Children's Health (NSCH) includes items relating to different dimensions of family well-being. The purpose of this study was to conduct exploratory research to create an index of family well-being using items from the NSCH to examine trends in family well-being among families with children in the United States.

Using the 2016 and 2021 NSCH, we created an index of family well-being. We compared family well-being across families with children in different age groups and examined trends over time between 2016 and 2021. Finally, we examined correlations between family well-being and 6 child health outcomes (chronic headaches, diabetes, depression, anxiety, attention-deficit hyperactivity disorder (ADHD), and behavioral and conduct disorders).

The final family well-being index had 10 items/constructs. Children 0 to 5 years were more likely than older children to have caregivers whose responses met criteria for most family well-being items. Between 2016 and 2021, family health remained relatively steady, but there were significant changes in 6 of the 10 family well-being index items, with some items increasing and some decreasing in 2021 compared with 2016. Family well-being was modestly correlated with all 6 children's health outcomes.

By having a family well-being index in federal surveys, trends in family well-being can be examined over time. Changes in children's health can also be assessed relating to family well-being.