• Component Description
• Eligible Sample
• Interview Setting and Mode of Administration
• Quality Assurance & Quality Control
• Data Processing and Editing
• Analytic Notes
• Codebook
  • SEQN - Respondent sequence number
  • ACD010A - Speak English at home-Non-Hispanics
  • ACD010B - Speak Spanish at home-Non-Hispanics
  • ACD010C - Other language at home-Non-Hispanics
  • ACD040 - Language(s) spoken at home-Hispanics

National Health and Nutrition Examination Survey

August 2021-August 2023 Data Documentation, Codebook, and Frequencies

Acculturation (ACQ_L)

Data File: ACQ_L.xpt

First Published: September 2024

Last Revised: NA

Component Description

The Acculturation section (variable name prefix ACQ) provides personal interview data on language use in the home. Questions asked and response categories used were customized, based on self-identified race and Hispanic origin, as shown in the table below.

Participants' Self-Identification	Question Asked	Response Categories	Variable Name for Data Release
Non-Hispanic White, Non-Hispanic Black, Non-Hispanic Asian or Other race - including multi-racial	What language(s) do you usually speak at home?	Check all that apply: - English (ACD010A) - Spanish (ACD010B) - Other languages (ACD010C)	ACD010A-C
Mexican American or Other Hispanic	What language(s) do you usually speak at home? Do you speak only Spanish, more Spanish than English, both equally, more English than Spanish, or only English?	- Only Spanish - More Spanish than English - Both equally - More English than Spanish - Only English	ACD040

Eligible Sample

All participants aged 3 years and older were eligible.

Interview Setting and Mode of Administration

These questions were asked by trained interviewers using the Computer-Assisted Personal Interview (CAPI) system in the participant’s home or by telephone.

Participants 16 and older and emancipated minors were interviewed directly. A proxy provided information for participants who were under 16 and for those who could not answer the questions themselves.

The NHANES ACQ is available on the NHANES website: NHANES August 2021-August 2023 Questionnaire Instruments (cdc.gov). 

Quality Assurance & Quality Control

The CAPI system is programmed with automated data consistency checks to reduce data entry errors. CAPI also uses online help screens to assist interviewers in defining key terms used in the questionnaire. During the August 2021-August 2023 data collection cycle, ACQ data were systematically reviewed for logical, processing, and data input errors on a periodic basis; and interviewer-specific feedback and retraining was performed as appropriate.

Data Processing and Editing

Edits were made to ensure the completeness, consistency, and analytic usefulness of the data.

Analytic Notes

ACD010A, ACD010B, ACD010C (Language spoken at home for non-Hispanic White, non-Hispanic Black, non-Hispanic Asian, and Other races including multiracial)
These variables encoded the information on language(s) spoken at home for non-Hispanic white, non-Hispanic black, and non-Hispanic Asian participants, and participants of other races including multiracial. Responses to the question were collected as “check all that apply,” which means that the participants could report more than one language and all of their responses were recorded. 

In NHANES 2011-2020, to accommodate oversampling of non-Hispanic Asian population in the survey, an additional item was included to ascertain the language(s) spoken at home for non-Hispanic Asians (ACD110), and the information were released separately for this group in the public use files. In the current cycle, due to the discontinuing of Asian oversampling, this question was dropped. Similar to NHANES 1999-2010, Non-Hispanic Asians in the August 2021 – August 2023 sample were asked the same question as other non-Hispanic participants, and have the information reported in ACD010A to ACD010C, as well.

Analysts who wish to include “language spoken at home” data in analyses that use multiple 2-year NHANES cycles, may recode variables ACD011A, ACD011B, ACD011C, and ACD110 to create variables compatible with those released with the NHANES August 2021 – August 2023 data (i.e., ACD010A, ACD010B, and ACD010C) using the following SAS programming code:
     If SDDSRVYR in (7, 8, 9, 66) then do;
       ACD010B = ACD011B;
       If ACD110 in (2, 3, 4, 5) then ACD010A = 1;
       Else ACD010A = ACD011A;
       If ACD110 in (1, 2, 3, 4) then ACD010C = 9;
       Else ACD010C = ACD011C;
    End;
where SDDSRVYR represents the survey cycle year.

ACD040 (Language spoken at home for Hispanics)
In the current ACQ instrument, the item number for this question is ACQ042. However, to keep the data release variable name consistent with those in previous cycles, the responses to ACQ042 were renamed ACD040.

Although these data were collected as part of the household questionnaire, if they are merged with the MEC exam data, exam sample weights should be used for the analyses.

Please refer to the NHANES Analytic Guidelines and the on-line NHANES Tutorial for further details on the use of sample weights and other analytic issues.

Codebook and Frequencies