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In sun 1 hour, effect on skin

Codes and Frequencies

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For sample adults, SUN1HR reports what would happen to their skin if, after several months of not being in the sun very much, the respondent went out in the sun for an hour without sunscreen or protective clothing. In 2010, this question was also asked of sample children between the ages of 14 and 17.

Questionnaire Text 

The question for SUN1HR has been preceded by differing introductory statements. In 2000, interviewers stated, "Now we are going to ask you about cancer prevention. The next few questions are about the time you spend in the sun." In 2005 and forward, interviewers stated, "Now, we are going to ask you about your skin's reaction to the sun."

In 1992, 2000, 2005, but not 2010 and forward, respondents were shown a flashcard listing the response categories. In 2010 and forward, respondents were read the response categories but not shown a flashcard. Although the question remained essentially the same, there were very small changes in the wording of the question. There is also a slight change in the response category wording between 1992 and later years. See the survey text tab.

In 1992, the survey form instructs the interviewer to read the categories if it is a telephone interview and to mark only one category. If respondents state that they don't go out in the sun, the Field Representative's Manual from 1992 directs interviewers to, "Ask what would happen IF he/she were out in the sun." In 2000, 2005, 2010, and 2020 the Field Representative's Manual directed interviewers to read if necessary, "Even if you do not go out in the sun, what would happen if you did?" The 2005, 2010, and 2020 Manuals add, "Use the most recent experience. If none, then think about the past." The 2015 Manual explains that "the respondent should have an idea of what typically happens to his/her skin in the sun based on past experiences."

In 2000, 2010 and forward, the survey form directed interviewers not to read the response category, "do not go out in the sun." This direction was not given in the survey form for 2005 despite continuing presence of the response category. However, there is instruction given to interviewers in the 2005 and 2015 Manual , "...You might want to use summer or warmer weather as a reference. Then if respondent still can't answer, you might want to suggest using childhood experience as a reference. Do NOT read the answer, "do not go out in the sun." This response category was not a choice in 1992.

The 2000 Manual also provides, "By 'sunburn' we mean your skin turns pink or red or hurts for 12 hours or more," and "If asked how much skin needs to be burned, include: 'a burn on even a small part of your body.'" The 2005 and forward Manuals consolidates this to, "By 'sunburn' we mean even a small part of your skin turns red or hurts for 12 hours or more."


According to the Field Representative's Manuals for 2000, 2005, 2010, and 2015, "protective clothing" is "any clothing that protects the skin by blocking the sun," and the 1992 Manual offered a similar definition ("any clothing that blocks the sun from the skin"). The 2000 and 2005 Manuals also included the following description of "sunscreen":

Sunscreens protect from too much sunlight which can cause sunburns. Sunscreens help to prevent other problems related to sun exposure, such as aging skin and precancerous growths. Sunscreens currently come in a variety of forms (such as gels, lotions, and sprays, and sticks).

The 2010 Manual included a nearly identical definition. The 2015 Manual added sunblock to the definition along with sunscreen.

Location of Question and Data Use 

In 1992, SUN1HR was part of a series of questions on Cancer Screening Knowledge and Practice. In 2000 and later, SUN1HR was part of a series of questions on Sun Protection Behaviors included in the Cancer Screening sections of the Sample Adult Cancer Control Modules. According to the Field Representative's Manuals for 2000 and later, the purpose of these questions was to "determine the sun protection practices in the population." The Manuals for 2000 and later continued:

Exposure to the sun's ultraviolet (UV) rays appears to be the most important factor in the development of skin cancer. Thus, skin cancer is largely preventable when sun protection behaviors are consistently used.

The 2000 Field Representative's Manual included the following statement regarding how the data from the Sun Protection Behaviors questions may be used:

This information allows for monitoring changes in sun protection behaviors in comparison with earlier NHIS surveys. It also allows for comparisons among subgroups of the population and to examine factors that may influence sun avoidance practices. Together, this information will be useful in developing public health and health services programs to increase effective avoidance of exposure to the sun.

The 2005, 2010, and 2015Manuals provided a similarly worded description of how the data may be used.


While the substantive meaning of the question for SUN1HR was largely consistent across time, the question wording, number of response categories, the supplemental comments made by interviewers differed across years, and the 2019 redesign. Given these issues, responses from 2000 and forward are generally comparable. However, because the 1992 survey form did not include the response category, "do not go out in the sun," researchers are cautioned against comparing 1992 to later years.

There are also some differences in the meaning in the meaning of "refused," "not ascertained," and "don't know" as used in 2000 and 2005 and later. Both the 2000 and 2005 Survey Descriptions cautioned that while "all sample adults were to be asked the questions in the Cancer Control Module, some persons did not complete the supplement." However, whereas in 2000, persons who answered less than 50 percent of the questions in the supplement had a value of "not ascertained" automatically inserted in the appropriate fields of the Cancer Control Module file, in 2005, 2010, and 2015, persons who answered none of the questions in the supplement had a value of "not ascertained" automatically inserted in the appropriate fields of the Cancer Control Module file.

Finally, the NHIS questionnaire was substantially redesigned in 2019 to introduce a different data collection structure and new content. For more information on changes in terminology, universes, and data collection methods beginning in 2019, please see the user note.


  • 1992: Half of sample persons age 18+ in quarters 1 and 2, and in 2 weeks of quarter 3 (excluded from CACT supplement).
  • 2000; 2005; 2015: Sample adults age 18+.
  • 2010: Sample children age 14-17 and sample adults age 18+.
  • 2020: Sample adults age 18+.


  • 1992, 2000, 2005, 2010, 2015, 2020