A Brief Introduction to Four National Health Databases in the United States

  • Yunwei Gai US Centers for Disease Control and Prevention
  • Nadia Nelipa
  • Frederick Afonso
Keywords: health database, China, MEPS, BRFSS, NHANES


Health and medical care pervade every aspect of our lives. As the world population ages, an entirely new demographic stress will be put on healthcare systems. Some estimates project healthcare costs in the United States to account for 20% of GDP in the next few years. In comparison, China’s total expenditure on health as a percentage of GDP has risen steadily and it is currently below 6%. However, with the rise of life expectancy, an aging population and higher living standards, health expenditure in China will continue to rise.  Another challenge China faces is healthcare system reform to ensure equity and to reduce health disparity. To solve these challenges, accurate collection of health statistics at the national level is needed.

In this article, we introduce and compare four national health databases in United States, which are pillars for evaluating national health profile and for formulating national health policies. The four databases are National Health Interview Survey (NHIS), Medical Expenditure Panel Survey (MEPS), National Health and Nutrition Examination Survey (NHANES) and Behavioral Risk Factor Surveillance System (BRFSS). As an example, we illustrate how to derive the prevalence of cholesterol screening from the four databases. Despite differences, the overall distributions follow similar patterns across four datasets. These databases can be linked with other data sources to answer more complicated questions in health and healthcare.

We hope that this article can draw the attention of Chinese health researchers and policymakers on the importance of health surveillance and can lead to more discussions and interest on how China can benefit from the U.S. experience in conducting health surveillance at the national level.


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