迈克·斯托贝 纽约 — 联邦政府正计划大幅缩减其最具影响力的健康调查，一些研究人员担心这些变化会导致对残疾美国人数量的低估。
MIKE STOBBE NEW YORK — The federal government is planning to dramatically shrink its most influential health survey, and some researchers worry that the changes will underestimate how many Americans are disabled.
至少一半的调查问题可能被删除。这一节省成本的改革是持续努力的一部分，旨在精简这项已有69年历史的全国健康访谈调查，该调查多年来一直面临回应率下降的问题。
At least half the survey questions could be axed. The cost-saving change is part of an ongoing effort to slim down the 69-year-old National Health Interview Survey, which for years has been suffering from declining response rates.
根据一些倡导者和研究者的说法，多达四分之一的轮椅使用者以及超过三分之一的盲人或聋人可能因调查缩短而被错误归类为非残疾人士。这可能导致政府无法认识到许多残疾美国人的健康需求，或无法评估医疗补助或其他健康保险计划变化造成的损害，他们表示。
As many as a quarter of wheelchair users and more than a third of people who are blind or deaf could be miscategorized as not disabled because of the shorter survey, according to some advocates and researchers. That could leave the government unable to recognize the health needs of many disabled Americans, or the damage caused by changes to Medicaid or other health insurance programs, they say.
这些削减方案仍在协商中，官员预计精简幅度不会像早期提议中建议的那样严重。
The cuts are being ironed out and officials predict the whittling won’t be as severe as what’s been suggested in earlier proposals.
被提议删除的问题涉及记忆力、疲劳、关节炎、行走和爬楼梯困难，以及助听器、拐杖、轮椅和电动代步车的使用情况。
Questions that have been proposed for removal deal with memory, fatigue, arthritis, difficulty walking and climbing stairs, as well as others about the use of hearing aids, canes, wheelchairs and scooters.
“我们就不会再知道这些了，”研究残疾人群的雪城大学社会学教授斯科特·兰德斯说道。
“We just won’t know any of that anymore,” said Scott Landes, a Syracuse University sociology professor who researches people with disabilities.
官员们仍在确定具体削减幅度。目前，该调查针对成年人包含490个健康问题。疾病控制与预防中心（CDC）负责监督该调查的斯蒂芬·布卢姆伯格表示，美国官员预计2028年的问卷将包含大约200到225个问题。
Officials are still determining exactly how much cutting will take place. Currently, the survey has 490 health questions for adults. U.S. officials expect that the 2028 questionnaire will have about 200 to 225 questions, said the Centers for Disease Control and Prevention’s Stephen Blumberg, who oversees the survey.
美国人口普查局的工作人员每年代表CDC进行此项调查。这是一个每年耗资4000万美元的项目，每年约有3万户家庭回答问题。
U.S. Census Bureau workers conduct the survey every year on behalf of the CDC. It’s a $40 million annual project, and around 30,000 households answer the questions each year.
他们的回答影响了公众对许多问题的认知，比如慢性疲劳综合症的普遍程度、接受X光检查的人数、美国儿童中癫痫发作的比例，以及拥有医疗保险的美国人数量。这些调查结果也是我们衡量国家在肥胖和吸烟等问题上是否取得进展（或出现倒退）的重要依据。
Their answers have shaped the public’s understanding of topics including how common chronic fatigue syndrome is, how many people get X-rays, what proportion of U.S. children suffer seizures, and how many Americans have health insurance . The survey’s responses also are the foundation of how we measure the nation’s progress — or backsliding — on problems such as obesity and smoking.
如今，越来越少的人愿意参与这类调查了。尤其是“全国健康访谈调查”（National Health Interview Survey），因为这项调查通常需要花费一小时甚至更长时间，且传统上是由调查员面对面地提问的。
Fewer people are interested in participating in such surveys. And the National Health Interview Survey is particularly daunting, as it can take an hour or more and has traditionally involved an in-person interviewer asking the questions.
Blumberg表示，此次计划中的调查设计改革应该能将调查时间缩短至大约半小时。
The planned redesign should cut it to about a half hour, Blumberg said.
“人们很忙，更加重视自己的隐私；有些人也不信任政府会妥善保护他们的个人信息，并确保这些数据仅用于统计分析，”他说，“因此越来越少的人认为向政府提供个人信息是一种公民义务。”这项调查首次进行是在1957年，此后每15到20年会更新一次内容。最近一次更新是在七年前，这引发了一些人士的质疑——为什么要在这么短的时间内就对调查方式做出重大改变？
“People are busy. They’re more protective of their privacy, and some don’t trust the government to protect their data and use it only for statistical purposes,” he said. “Fewer people see sharing information with the government as their civic duty.”The survey was first conducted in 1957, and has been updated every 15 to 20 years. The latest update was put into the field seven years ago, prompting some advocates to ask why it was being changed so quickly.
Blumberg指出，虽然美国卫生与公共服务部（Department of Health and Human Services）和白宫管理及预算办公室（White House Office of Management and Budget）在特朗普政府期间推动了联邦卫生机构的重大改革（包括裁员、削减研究经费等），但它们并没有下令进行这次调查设计的调整。实际上，推动这次改革的主要因素是预算紧张，以及难以招募足够的人员来进行大量的面对面访谈；去年联邦政府的招聘禁令也加剧了这一困难。
The U.S. Department of Health and Human Services and the White House Office of Management and Budget were behind dramatic staff reductions, research funding overhauls and other federal health agency changes under the current Trump administration. But neither ordered this redesign, Blumberg said. Rather, the factors driving the current redesign include tightening budgets and difficulties fielding enough workers to do so many in-person interviews — which was affected last year by a federal hiring freeze .
他还提到，美国人口普查局（Census Bureau）正在为2030年的人口普查重新配置数据收集系统，这一调整也对本次健康调查产生了影响。
Another factor: The Census Bureau is reconfiguring its data collection platforms for the 2030 census in a way that affected the health survey, he said.
与之相关的是，对健康调查进行方式的拟议改变。人们将不再通过面对面或电话访谈开始调查，而是收到邀请，在线填写调查问卷或填写纸质问卷。这是因为，根据官员的说法，面对面访谈在封闭社区增多、无门卫的锁闭建筑以及门铃摄像头普及的情况下已被证明难以开展。
Related to all that is a proposed change in how the health survey is conducted. Instead of starting with in-person or telephone interviews, people will receive an invitation to fill out the survey online or to fill out a paper questionnaire. That’s because in-person interviews have proven difficult with the proliferation of gated communities, locked buildings without door attendants and doorbell cameras, according to officials.
然而，人口普查局工作人员将在第二轮较小规模的调查中入户走访，布卢姆伯格表示。
However, Census Bureau staff will visit homes for a smaller second round of surveying, Blumberg said.
关于调查重新设计的通知于8月在《联邦纪事》上发布，公众意见征求期将持续至10月20日。
A notice about the survey redesign appeared in the Federal in August, opening a public comment period that runs through Oct. 20.