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pdfHealth Functioning and Status (HFQ)
Variable Name
MR Screen Name
BOX HFBEG
Question type
routing
GENHELTH
HFA1
code one
COMPHLTH
HFA2
code one
FUTRHLTH
HFA2B
code one
DISHEAR
DIS1
yes/no
DISSEE
DIS2
yes/no
DISDECISION
DIS3
yes/no
DISWALK
DIS4
yes/no
DISBATH
DIS5
yes/no
DISERRANDS
DIS6
yes/no
Question text/description
GO TO HFA1 - GENHELTH
Code list
(01) excellent,
(02) very good,
(03) good,
In general, compared to other people [your/(SP's)] age, would you say that [your/his/her] health is . . .
(04) fair, or
(05) poor?
(-8) DON'T KNOW
(-9) REFUSED
(01) much better now than one year ago,
SHOW CARD HF1
(02) somewhat better now than one year ago,
(03) about the same,
Compared to one year ago, how would you rate [your/(SP's)] health in general now?
(04) somewhat worse now than one year ago, or
(05) much worse now than one year ago?
Would you say [your/(SP's)] health is . . .
(-8) DON'T KNOW
(-9) REFUSED
(01) it will get much better
(02) it will get somewhat better
SHOW CARD HF2
(03) it will not change
(04) it will get somewhat worse
In the next 6 months, what do you think will happen to [your/(SP's)] overall health?
(05) it will get much worse
(-8) DON'T KNOW
(-9) REFUSED
(01) YES
Now, I would like to ask you about [your/(SP's)] health.
(02) NO
(-8) DON'T KNOW
[Are you/Is (SP)] deaf or [do you/does (SP)] have serious difficulty hearing?
(-9) REFUSED
(01) YES
(02) NO
[Are you/Is (SP)] blind or [do you/does (SP)] have serious difficulty seeing, even when wearing glasses?
(-8) DON'T KNOW
(-9) REFUSED
(01) YES
Because of a physical, mental, or emotional condition, [do you/does (SP)] have serious difficulty
(02) NO
concentrating, remembering, or making decisions?
(-8) DON'T KNOW
(-9) REFUSED
(01) YES
(02) NO
[Do you/Does (SP)] have serious difficulty walking or climbing stairs?
(-8) DON'T KNOW
(-9) REFUSED
(01) YES
(02) NO
[Do you/Does (SP)] have difficulty dressing or bathing?
(-8) DON'T KNOW
(-9) REFUSED
(01) YES
Because of a physical, mental, or emotional condition, [do you/does (SP)] have difficulty doing errands alone (02) NO
such as visiting a doctor's office or shopping?
(-8) DON'T KNOW
(-9) REFUSED
Health Functioning and Status (HFQ)
Variable Name
MR Screen Name
HELMTACT
HFA3
Question type
code one
Question text/description
How much of the time during the past month has [your/(SP's)] health limited [your/(SP's)] social activities,
like visiting with friends or close relatives?
Would you say . . .
ECHELP
HFB1
yes/no
[Do you/Does (SP)] wear eyeglasses or contact lenses?
ECTROUB
HFB2
code one
Which statement best describes [your/(SP's)] vision [while wearing glasses or contact lenses]... no trouble
seeing, a little trouble, a lot of trouble, or no usable vision?
[Have you/Has (SP)] been told that [you are/he is/she is] legally blind?
ECLEGBLI
HFB2A
yes/no
EDOCEXAM
HFB6
yes/no
[EXPLAIN IF NECESSARY: Informally, a person is legally blind when, even with corrective lenses, they cannot
see well enough to drive.]
[Have you/Has (SP)] had an eye examination by an eye doctor since (LAST HF MONTH YEAR)?
INCLUDE OPHTHALMOLOGISTS AND OPTOMETRISTS.
EDOCLAST
HFB7
code one
How long has it been since [your/(SP's)] last eye examination by an eye doctor?
Code list
(01) none of the time,
(02) some of the time,
(03) most of the time, or
(04) all of the time?
(-8) DON'T KNOW
(-9) REFUSED
(01) YES
(02) NO
(03) SP IS BLIND
(-8) DON'T KNOW
(-9) REFUSED
(01) NO TROUBLE SEEING
(02) A LITTLE TROUBLE SEEING
(03) A LOT OF TROUBLE SEEING
(04) NO USABLE VISION
(-8) DON'T KNOW
(-9) REFUSED
(01) YES
(02) NO
(-8) DON'T KNOW
(-9) REFUSED
(01) YES
(02) NO
(-8) DON'T KNOW
(-9) REFUSED
(01) NEVER HAD EYE EXAM BY EYE DOCTOR
(02) 1 YEAR TO LESS THAN 2 YEARS
(03) 2 YEARS TO LESS THAN 5 YEARS
(04) 5 YEARS OR MORE
(-8) DON'T KNOW
(-9) REFUSED
I have a couple of questions about [your/(SP’s)] last eye examination.
EDOCTYPE
HFB7A
code one
EDOCTYOS
HFB7A
verbatim text
EDOCDLAT
HFB7B
yes/no
ECATARAC
HFB7C
yes/no
(01) OPTOMETRIST
Was the eye examination given by an optometrist, ophthalmologist or some other type of doctor or eye care
(02) OPHTHALMOLOGIST
professional?
(91) OTHER DOCTOR SPECIALTY
(-8) DON'T KNOW
[EXPLAIN IF NECESSARY: An optometrist is a doctor of optometry (O.D.) who diagnoses and treats visual
(-9) REFUSED
health problems. An ophthalmologist is a doctor of medicine (M.D.) who specializes in surgery and diseases of
the eye.]
OTHER (SPECIFY)
Again, thinking about [your/(SP’s)] last eye examination, were dilating drops used in [your/(SP)’s] eyes?
(01) YES
(02) NO
[EXPLAIN IF NECESSARY: Dilating drops are used to enlarge the pupil for eye examinations. The drops often (-8) DON'T KNOW
make your eyes more sensitive to bright light and may cause temporary blurry vision.]
(-9) REFUSED
I am going to read a list of eye conditions. Please tell me if [you have/(SP) has] ever been told by a doctor or
other health professional that [you/he/she] had any of these conditions.
(01) YES
(02) NO
[Have you/Has (SP)] ever been told by a doctor or other health professional that [you/he/she] had…
(-8) DON'T KNOW
(-9) REFUSED
Cataracts?
Health Functioning and Status (HFQ)
Variable Name
MR Screen Name
Question type
Question text/description
EGLAUCOM
HFB7C
yes/no
Glaucoma?
ERETINOP
HFB7C
yes/no
Diabetic retinopathy?
EMACULAR
HFB7C
yes/no
Macular degeneration or age-related macular degeneration, also called AMD?
BOX HFB1A
routing
IF ECATARAC=02/NO, GO TO BOX HFB1. ELSE GO TO HFB10 - ECCATOP.
ECCATOP
HFB10
yes/no
[Have you/Has (SP)] ever had an operation for cataracts?
BOX HFB1
routing
IF HFB7C - ERETINOP = 1/Yes OR HFB7C - EMACULAR = 1/Yes, GO TO HFB11 - ELASRSUR.
ELSE GO TO HFC1 - HCHELP.
Laser surgery to the back of the eye, or retina, is a commonly used treatment for diabetic retinopathy and
macular degeneration.
ELASRSUR
HFB11
yes/no
[Have you/Has (SP)] ever had laser surgery to the back of either eye for one of these conditions?
Code list
(01) YES
(02) NO
(-8) DON'T KNOW
(-9) REFUSED
(01) YES
(02) NO
(-8) DON'T KNOW
(-9) REFUSED
(01) YES
(02) NO
(-8) DON'T KNOW
(-9) REFUSED
(01) YES
(02) NO
(-8) DON'T KNOW
(-9) REFUSED
(01) YES
(02) NO
(-8) DON'T KNOW
(-9) REFUSED
[EXPLAIN IF NECESSARY: This does not include "Lasik" surgery to the front of the eye used to correct vision.]
HCHELP
HFC1
yes/no
HCTROUB
HFC2
code one
HCKNOWMC
HFC3
code one
HCCOMDOC
HFC4
code one
(01) YES
(02) NO
[Do you/Does (SP)] use a hearing aid?
(03) SP IS DEAF
(-8) DON'T KNOW
(-9) REFUSED
(01) NO TROUBLE HEARING
(02) A LITTLE TROUBLE HEARING
Which statement best describes [your/(SP's)] hearing [with a hearing aid]: no trouble hearing, a little trouble, (03) A LOT OF TROUBLE HEARING
a lot of trouble, or deaf?
(04) DEAF
(-8) DON'T KNOW
(-9) REFUSED
(01) NO TROUBLE
How much trouble [do you/does (SP)] have finding out things [you need/he needs/she needs] to know about (02) A LITTLE TROUBLE
Medicare because [of (your/his/her) difficulty hearing/(you are/he is/she is) deaf]? Would you say [you
(03) A LOT OF TROUBLE
have/she has/he has] no trouble, a little trouble, or a lot of trouble?
(-8) DON'T KNOW
(-9) REFUSED
(01) NO TROUBLE
How much trouble [do you/does (SP)] have communicating with [your/his/her] doctor or other health
(02) A LITTLE TROUBLE
professional because [of (your/his/her) difficulty hearing/(you are/he is/she is) deaf]? Would you say [you
(03) A LOT OF TROUBLE
have/she has/he has] no trouble, a little trouble, or a lot of trouble?
(-8) DON'T KNOW
(-9) REFUSED
Health Functioning and Status (HFQ)
Variable Name
MR Screen Name
Question type
FOODTRBL
HFD1A
code one
HEIGHTFT
HFE1
numeric
HEIGHTIN
HFE1
numeric
WEIGHT
HFE1
numeric
DIFINTRO
HFHINTRO
no entry
DIFSTOOP
HFH1
code 1
Question text/description
Code list
(01) NO TROUBLE
(02) A LITTLE TROUBLE
How much trouble [do you/does (SP)] have eating solid foods because of problems with [your/his/her] mouth
(03) A LOT OF TROUBLE
or teeth? Would you say [you have/she has/he has] no trouble, a little trouble, or a lot of trouble?
(-8) DON'T KNOW
(-9) REFUSED
(01) continuous answer
How tall [are you/is (SP)]?
(-8) DON'T KNOW
(-9) REFUSED
(01) continuous answer
How tall [are you/is (SP)]?
(-8) DON'T KNOW
(-9) REFUSED
How much [do you/does (SP)] weigh?
(01) continuous answer
(-8) DON'T KNOW
[WEIGHT SHOULD BE RECORDED IN POUNDS]
(-9) REFUSED
Now, I'm going to ask about how difficult it is, on average, for [you/(SP)] to do certain kinds of activities.
(01) CONTINUE
Please tell me for each activity whether [you have/(SP) has] no difficulty at all, a little difficulty, some
(-7) Empty
difficulty, a lot of difficulty, or [is/are] not able to do it.
(01) NO DIFFICULTY AT ALL
SHOW CARD HF3
(02) A LITTLE DIFFICULTY
(03) SOME DIFFICULTY
How much difficulty, if any, [do you/does (SP)] have stooping, crouching, or kneeling? Would you say [you
(04) A LOT OF DIFFICULTY
have/(SP) has] no difficulty at all, a little difficulty, some difficulty, a lot of difficulty, or [is/are] not able to do (05) NOT ABLE TO DO IT
it?
(-8) Don't Know
(-9) Refused
SHOW CARD HF3
DIFLIFT
HFH2
code 1
DIFREACH
HFH3
code 1
DIFWRITE
HFH4
code 1
(01) NO DIFFICULTY AT ALL
(02) A LITTLE DIFFICULTY
How much difficulty, if any, [do you/does (SP)] have lifting or carrying objects as heavy as 10 pounds, like a
(03) SOME DIFFICULTY
heavy bag of groceries?
(04) A LOT OF DIFFICULTY
(05) NOT ABLE TO DO IT
[PROBE IF NECESSARY: Would you say [you have/(SP) has] no difficulty at all, a little difficulty, some difficulty, (-8) Don't Know
a lot of difficulty, or [is/are] not able to do it?]
(-9) Refused
(01) NO DIFFICULTY AT ALL
SHOW CARD HF3
(02) A LITTLE DIFFICULTY
(03) SOME DIFFICULTY
What about reaching or extending arms above shoulder level?
(04) A LOT OF DIFFICULTY
(05) NOT ABLE TO DO IT
[PROBE IF NECESSARY: Would you say [you have/(SP) has] no difficulty at all, a little difficulty, some difficulty,
(-8) Don't Know
a lot of difficulty, or [is/are] not able to do it?]
(-9) Refused
(01) NO DIFFICULTY AT ALL
SHOW CARD HF3
(02) A LITTLE DIFFICULTY
(03) SOME DIFFICULTY
How much difficulty, if any, [do you/does (SP)] have either writing or handling and grasping small objects?
(04) A LOT OF DIFFICULTY
(05) NOT ABLE TO DO IT
[PROBE IF NECESSARY: Would you say [you have/(SP) has] no difficulty at all, a little difficulty, some difficulty,
(-8) Don't Know
a lot of difficulty, or [is/are] not able to do it?]
(-9) Refused
Health Functioning and Status (HFQ)
Variable Name
MR Screen Name
Question type
DIFWALK
HFH5
code 1
PHYSACTINTRO
HFH10INT
no entry
VIGUNIT
HFH10
quantity unit
VIGNUM
HFH10
quantity unit
MODUNIT
HFH11
quantity unit
MODNUM
HFH11
numeric
MUSUNIT
HFH12
quantity unit
MUSNUM
HFH12
numeric
Question text/description
Code list
(01) NO DIFFICULTY AT ALL
SHOW CARD HF3
(02) A LITTLE DIFFICULTY
(03) SOME DIFFICULTY
What about walking a quarter of a mile - that is, about 2 or 3 blocks?
(04) A LOT OF DIFFICULTY
(05) NOT ABLE TO DO IT
[PROBE IF NECESSARY: Would you say [you have/(SP) has] no difficulty at all, a little difficulty, some difficulty,
(-8) Don't Know
a lot of difficulty, or [is/are] not able to do it?]
(-9) Refused
We are interested in two types of physical activity - vigorous and moderate. Vigorous activities cause large
(01) CONTINUE
increases in breathing or heart rate. Moderate activities cause small increases in breathing or heart rate. First
(-7) Empty
I will ask about the vigorous activities that [you do/(SP) does].
(01) NUMBER OF MINUTES PER DAY
In a typical week, how much time [do you/does (SP)] spend doing vigorous activities, such as team sports,
(02) NUMBER OF HOURS PER DAY
running, aerobics, heavy house or yard work, or anything else that causes large increases in breathing or
(03) NUMBER OF HOURS PER WEEK
heart rate?
(04) NUMBER OF HOURS PER MONTH
(96) NONE
IF TIME REPORTED IN BOTH MINUTES AND HOURS, ROUND TO NEAREST HOUR.
(-8) Don't Know
(-9) Refused
In a typical week, how much time [do you/does (SP)] spend doing vigorous activities, such as team sports,
running, aerobics, heavy house or yard work, or anything else that causes large increases in breathing or
(01) [Continuous answer.]
heart rate?
(-8) Don't Know
(-9) Refused
IF TIME REPORTED IN BOTH MINUTES AND HOURS, ROUND TO NEAREST HOUR.
(01) NUMBER OF MINUTES PER DAY
(02) NUMBER OF HOURS PER DAY
In a typical week, how much time [do you/does (SP)] spend doing moderate activities, such as brisk walking,
(03) NUMBER OF HOURS PER WEEK
bicycling, gardening, golf, swimming, or vacuuming?
(04) NUMBER OF HOURS PER MONTH
(96) NONE
IF TIME REPORTED IN BOTH MINUTES AND HOURS, ROUND TO NEAREST HOUR.
(-8) Don't Know
(-9) Refused
In a typical week, how much time [do you/does (SP)] spend doing moderate activities, such as brisk walking,
(01) continous answer
bicycling, gardening, golf, swimming, or vacuuming?
Now I’m going to ask you about activities [you/(SP)] may do to increase [your/(SP)'s] muscle strength or
(01) NUMBER OF MINUTES PER DAY
flexibility.
(02) NUMBER OF HOURS PER DAY
(03) NUMBER OF HOURS PER WEEK
In a typical week, how much time [you/(SP)] spend doing exercises to increase [your/(SP)'s] muscle strength (04) NUMBER OF HOURS PER MONTH
or flexibility, such as lifting weights, push-ups, sit-ups, stretching, or yoga?
(96) NONE
(-8) Don't Know
IF TIME REPORTED IN BOTH MINUTES AND HOURS, ROUND TO NEAREST HOUR.
(-9) Refused
In a typical week, how much time [you/(SP)] spend doing exercises to increase [your/(SP)'s] muscle strength
or flexibility, such as lifting weights, push-ups, sit-ups, stretching, or yoga?
IF TIME REPORTED IN BOTH MINUTES AND HOURS, ROUND TO NEAREST HOUR.
(01) Continunous answer
Health Functioning and Status (HFQ)
Variable Name
MR Screen Name
Question type
Question text/description
Next, I'm going to read a list of medical conditions. [Since (LAST HF MONTH YEAR) has/Has] a doctor or other
health professional [ever] told [you/(SP)] that [you/he/she] had any of these conditions?
MEDCONDINTRO HFJINTRO
no entry
[INTERVIEWER: IF THE SP IS CURRENTLY TAKING MEDICATION TO CONTROL A CONDITION, THE RESPONSE
RECORDED SHOULD BE "YES" TO INDICATE THAT THE SP HAS THE CONDITION.]
BOX HFJ1
OCARTERY
HFJ1
routing
yes/no
[Since (LAST HF MONTH YEAR) has/Has] a doctor or other health professional [ever] told [you/(SP)] that
[you/he/she] had...
[[Since (LAST HF MONTH YEAR) has/Has] a doctor or other health professional [ever] told [you/(SP)] that
[you/he/she] [still has/still have/had/has/have...]
HFJ2
BOX HFJ2
yes/no
routing
(01) CONTINUE
(-7) Empty
IF SP HAS EVER REPORTED HAVING HARDENING OF THE ARTERIES IN A PREVIOUS ROUND
(sample_person.P_OCHPB=1), GO TO HFJ2 - OCHBP.
ELSE GO TO HFJ1 - OCARTERY.
hardening of the arteries or arteriosclerosis?
OCHBP
Code list
hypertension, sometimes called high blood pressure?
[INTERVIEWER: IF THE RESPONDENT IS CURRENTLY TAKING MEDICATION TO CONTROL A CONDITION, THE
RESPONSE RECORDED SHOULD BE "YES" TO INDICATE THAT THE R HAS THE CONDITION.]
IF SP IS IN THE SUPPLEMENTAL SAMPLE [sample_person.INTTYPE=3], GO TO HFJ3 - YRHBP.
ELSE GO TO HFJ4 - OCMYOCAR.
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
Health Functioning and Status (HFQ)
Variable Name
MR Screen Name
YRHBP
OCMYOCAR
HFJ3
HFJ4
BOX HFJ3
Question type
yes/no
yes/no
routing
YRMYOCAR
HFJ5
yes/no
OCCHD
HFJ6
yes/no
BOX HFJ4
routing
YRCHD
HFJ7
yes/no
OCCFAIL
HFJ8
yes/no
BOX HFJ5
routing
HFJ9
yes/no
YRCFAIL
Question text/description
Since (LAST HF MONTH YEAR), did a doctor or other health professional tell [you/(SP)] that [you/he/she] still
had hypertension or high blood pressure?
[INTERVIEWER: IF THE RESPONDENT IS CURRENTLY TAKING MEDICATION TO CONTROL A CONDITION, THE
RESPONSE RECORDED SHOULD BE "YES" TO INDICATE THAT THE R HAS THE CONDITION.]
[[Since (LAST HF MONTH YEAR) has/Has] a doctor or other health professional [ever] told [you/(SP)] that
[you/he/she] had...]
a myocardial infarction or heart attack?
IF SP IS IN THE SUPPLEMENTAL SAMPLE [sample_person.INTTYPE=3], GO TO HFJ5 - YRMYOCAR.
ELSE GO TO HFJ6 - OCCHD.
HFJ14
yes/no
[NOTE TO FI: This includes problems with the valves of the heart, such as aortic stenosis, and problems with
the rhythm of the heartbeat, such as atrial fibrillation.]
YRHRTCND
BOX HFJ8
routing
HFJ15
yes/no
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
(01) YES
Since (LAST HF MONTH YEAR), did a doctor or other health professional tell [you/(SP)] that [you/he/she] had (02) NO
a myocardial infarction or heart attack?
(-8) Don't Know
(-9) Refused
[[Since (LAST HF MONTH YEAR) has/Has] a doctor or other health professional [ever] told [you/(SP)] that
(01) YES
[you/he/she] had...]
(02) NO
(-8) Don't Know
[a new episode of] angina pectoris or coronary heart disease?
(-9) Refused
IF SP IS IN THE SUPPLMENTAL SAMPLE [sample_person.INTTYPE=3], GO TO HFJ7 - YRCHD.
ELSE GO TO HFJ8 - OCCFAIL.
(01) YES
Since (LAST HF MONTH YEAR), did a doctor or other health professional tell [you/(SP)] that [you/he/she] had (02) NO
an episode of angina pectoris or coronary heart disease?
(-8) Don't Know
(-9) Refused
[[Since (LAST HF MONTH YEAR) has/Has] a doctor or other health professional [ever] told [you/(SP)] that
(01) YES
[you/he/she] had...]
(02) NO
(-8) Don't Know
[a new episode of] congestive heart failure?
(-9) Refused
IF SP IS IN THE SUPPLMENTAL SAMPLE [sample_person.INTTYPE=3], GO TO HFJ9 - YRCFAIL.
ELSE GO TO HFJ14 - OCOTHHRT.
(01) YES
Since (LAST HF MONTH YEAR), did a doctor or other health professional tell [you/(SP)] that [you/he/she] had (02) NO
an episode of congestive heart failure?
(-8) Don't Know
(-9) Refused
[[Since (LAST HF MONTH YEAR) has/Has] a doctor or other health professional [ever] told [you/(SP)] that
[you/he/she] had...]
[a new episode of] any other heart condition?
OCHRTCND
Code list
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
[DO NOT RECORD THE NAME OF THE CONDITION AT THIS QUESTION.]
IF SP IS IN THE SUPPLMENTAL SAMPLE [sample_person.INTTYPE=3], GO TO HFJ15 - YRHRTCND.
ELSE GO TO HFJ16 - OCSTROKE.
Since (LAST HF MONTH YEAR), did a doctor or other health professional tell [you/(SP)] that [you/he/she] had
(01) YES
an episode of any other heart condition?
(02) NO
(-8) Don't Know
[NOTE TO FI: This includes problems with the valves of the heart, such as aortic stenosis, and problems with
(-9) Refused
the rhythm of the heartbeat, such as atrial fibrillation.]
Health Functioning and Status (HFQ)
Variable Name
MR Screen Name
OCSTROKE
HFJ16
Question type
yes/no
Question text/description
[[Since (LAST HF MONTH YEAR) has/Has] a doctor or other health professional [ever] told [you/(SP)] that
[you/he/she] had...]
a stroke, a brain hemorrhage, or a cerebrovascular accident?
[NOTE: This includes transient ischemic attack (TIA) which is sometimes referred to as a ministroke.]
BOX HFJ9
routing
YRSTROKE
HFJ17
yes/no
OCCHOLES
HFJ17A
yes/no
YRCHOLES
HFJ17B
yes/no
BOX HFJ29
routing
BLOSWGHT
HFJ45
yes/no
CLOSWGHT
HFJ46
yes/no
OCCSKIN
HFJ18
yes/no
BOX HFJ10
routing
HFJ19
yes/no
YRCSKIN
Code list
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
IF SP IS IN THE SUPPLMENTAL SAMPLE [sample_person.INTTYPE=3], GO TO HFJ17 - YRSTROKE.
ELSE GO TO HFJ17A - OCCHOLES.
Since (LAST HF MONTH YEAR), did a doctor or other health professional tell [you/(SP)] that [you/he/she] had (01) YES
a stroke, a brain hemorrhage, or a cerebrovascular accident?
(02) NO
(-8) Don't Know
[NOTE: This includes transient ischemic attack (TIA) which is sometimes referred to as a ministroke.]
(-9) Refused
Has a doctor or other health professional ever told [you/(SP)] that [you/he/she] had high cholesterol?
(01) YES
(02) NO
[INTERVIEWER: IF THE RESPONDENT IS CURRENTLY TAKING MEDICATION TO CONTROL A CONDITION, THE
(-8) Don't Know
RESPONSE RECORDED SHOULD BE "YES" TO INDICATE THAT THE R HAS THE CONDITION.]
(-9) Refused
Since (LAST HF MONTH YEAR), did a doctor or other health professional tell [you/(SP)] that [you/he/she] had
(01) YES
high cholesterol?
(02) NO
(-8) Don't Know
[INTERVIEWER: IF THE RESPONDENT IS CURRENTLY TAKING MEDICATION TO CONTROL A CONDITION, THE
(-9) Refused
RESPONSE RECORDED SHOULD BE "YES" TO INDICATE THAT THE R HAS THE CONDITION.]
IF ROUND= FALL 2018 ROUND 82, GO TO HFJ45-BLOSWGHT.
ELSE IF SP IS IN THE BASELINE INTERIVEW (sample_person.INTTYPE=3) GO TO HFJ45-BLOSWGHT. IF
P_EVRLOSWGHT=0 THEN GO TO HFJ46-CLOSWGHT. ELSE GO TO HFJ18 - OCCSKIN.
(01) YES
To lower risk for certain diseases, [have you/ has (SP)] ever been told by a doctor or health professional to
(02) NO
control weight or lose weight?
(-8) Don't Know
(-9) Refused
(01) YES
To lower risk for certain diseases, since (SAMPLE_PERSON.DATE_FALLRND) [have you/ has (SP)] been told by (02) NO
a doctor or health professional to control weight or lose weight?
(-8) Don't Know
(-9) Refused
[I've recorded that [you/(SP)] previously reported having had skin cancer.]
(01) YES
[[Since (LAST HF MONTH YEAR) has/Has] a doctor or other health professional [ever] told [you/(SP)] that
(02) NO
[you/he/she] had...]
(-8) Don't Know
(-9) Refused
[a new occurrence of] skin cancer?
IF SP IS IN THE SUPPLMENTAL SAMPLE [sample_person.INTTYPE=3], GO TO HFJ19 - YRCSKIN.
ELSE GO TO HFJ20 - OCCANCER.
(01) YES
Since (LAST HF MONTH YEAR), did a doctor or other health professional tell [you/(SP)] that [you/he/she] had (02) NO
an occurrence of skin cancer?
(-8) Don't Know
(-9) Refused
Health Functioning and Status (HFQ)
Variable Name
MR Screen Name
OCCANCER
HFJ20
BOX HFJ11
Question type
yes/no
routing
YRCANCER
HFJ21
yes/no
OCCCODE
HFJ22
code all
OCCOS
HFJ22
verbatim text
BOX HFJ13
routing
HFJ24
yes/no
OCARTHRH
Question text/description
[I've recorded that [you/(SP)] previously reported having had a tumor, growth, malignancy, or cancer of the
[READ RESPONSES BELOW].]
[Since (LAST HF MONTH YEAR), has/Has] a doctor or other health professional [ever] told [you/(SP)] that
[you/he/she] had any [other] kind of cancer, malignancy, or tumor other than skin cancer?
Code list
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
INCLUDE BENIGN OR NON-MALIGNANT TUMORS OR GROWTHS.
IF SP IS IN THE SUPPLMENTAL SAMPLE [sample_person.INTTYPE=3], GO TO HFJ21 - YRCANCER.
ELSE GO TO HFJ22 - OCCCODE.
(01) YES
Since (LAST HF MONTH YEAR), did a doctor or other health professional tell [you/(SP)] that [you/he/she] had (02) NO
any kind of cancer, malignancy, or tumor other than skin cancer?
(-8) Don't Know
(-9) Refused
(01) LUNG
(02) COLON (BOWEL)
(03) BREAST
(04) UTERUS
(05) PROSTATE
(06) BLADDER
(07) OVARY
(08) STOMACH
(09) CERVIX
(10) BRAIN
(11) KIDNEY
SHOW CARD HF4
(12) THROAT
(16) BLOOD
[Since the first time a doctor or other health professional told [you/(SP)] that [you/he/she] had a cancer,
(17) BONE
malignancy, or tumor, on/On] what part or parts of [your/(SP's)] body was the cancer or tumor other than
(18) ESOPHAGUS
skin cancer found?
(19) GALL BLADDER
(20) LARYNX (WINDPIPE)
[PROBE: Any other part?]
(21) LEUKOCYTES (LEUKEMIA)
CHECK ALL THAT APPLY
(22) LIVER
(23) LYMPH NODES (LYMPHOMA)
(24) MOUTH/TONGUE/LIP
(25) PANCREAS
(26) RECTUM
(27) SOFT TISSUE/FAT
(28) TESTIS
(29) THYROID
(91) OTHER
(-8) Don't Know
(-9) Refused
Specify the part of parts of your body where the cancer or tumor was found.
(01) [Continuous answer.]
IF SP HAS EVER REPORTED HAVING RHEUMATOID ARTHRITIS IN A PREVIOUS ROUND
(sample_person.P_OCARTHRH=1), GO TO BOX HFJ13B.
ELSE GO TO HFJ24 - OCARTHRH.
[[Since (LAST HF MONTH YEAR) has/Has] a doctor or other health professional [ever] told [you/(SP)] that
(01) YES
[you/he/she] had...]
(02) NO
(-8) Don't Know
rheumatoid arthritis?
(-9) Refused
Health Functioning and Status (HFQ)
Variable Name
MR Screen Name
BOX HFJ13B
OCOSARTH
OCARTH
YRARTHRD
OCMENTAL
OCALZMER
OCDEMENT
HFJ24B
Question type
routing
yes/no
BOX HFJ14
routing
HFJ25
yes/no
BOX HFJ15
routing
HFJ26
yes/no
BOX HFJ16
routing
HFJ28
yes/no
BOX HFJ16A
routing
HFJ29A
yes/no
BOX HFJ16B
routing
HFJ29B
yes/no
BOX HFJ30
BASKDEPRS
HFJ47
yes/no
Question text/description
IF SP HAS EVER REPORTED HAVING OSTEOARTHRITIS IN A PREVIOUS ROUND
(sample_person.P_OCOSARTH=1), GO TO BOX HFJ14.
ELSE GO TO HFJ24B-OCOSARTH.
[[Since (LAST HF MONTH YEAR) has/Has] a doctor or other health professional [ever] told [you/(SP)] that
[you/he/she] had...]
Code list
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
osteoarthritis?
IF SP HAS EVER REPORTED HAVING ARTHRITIS OTHER THAN RHEUMATOID ARTHRITIS IN A PREVIOUS ROUND
[sample_person.P_OCARTH=1], GO TO BOX HFJ16.
ELSE GO TO HFJ25 - OCARTH.
[[Since (LAST HF MONTH YEAR) has/Has] a doctor or other health professional [ever] told [you/(SP)] that
(you/he/she) had...]
(01) YES
(02) NO
arthritis, other than rheumatoid or osteoarthritis?
(-8) Don't Know
(-9) Refused
IF SP IS IN THE SUPPLMENTAL SAMPLE, GO TO HFJ26 - YRARTHRD.
ELSE GO TO BOX HFJ16A.
(01) YES
Since (LAST HF MONTH YEAR), did a doctor or other health professional tell [you/(SP)] that [you/he/she] had (02) NO
arthritis, other than rheumatoid or osteoarthritis, in any part of [your/his/her] body?
(-8) Don't Know
(-9) Refused
IF SP IS IN THE SUPPLMENTAL SAMPLE (sample_person.INTTYPE=3), GO TO HFJ28 - OCMENTAL.
ELSE GO TO BOX HFJ16A.
[Has a doctor or other health professional ever told [you/(SP)] that [you/he/she] had...]
(01) YES
an intellectual disability?
(02) NO
(-8) Don't Know
[EXPLAIN IF NECESSARY:] This is also known as intellectual development disorder or a general learning
(-9) Refused
disability. It was formerly known as mental retardation.
IF SP HAS EVER REPORTED HAVING ALZHEIMER’S DISEASE IN A PREVIOUS ROUND
(sample_person.P_OCALMER=1), GO TO BOX HFJ30.
ELSE GO TO HFJ29A - OCALZMER.
[[Since (LAST HF MONTH YEAR) has/Has] a doctor or other health professional [ever] told [you/(SP)] that
(01) YES
[you/he/she] had...]
(02) NO
(-8) Don't Know
Alzheimer's disease?
(-9) Refused
IF SP HAS EVER REPORTED HAVING DEMENTIA IN A PREVIOUS ROUND (sample_person.P_OCDEMENT=1), GO
TO BOX HFJ30.
ELSE GO TO HFJ29B - OCDEMENT.
[[Since (LAST HF MONTH YEAR) has/Has] a doctor or other health professional [ever] told [you/(SP)] that
(01) YES
[you/he/she] had...]
(02) NO
(-8) Don't Know
any type of dementia other than Alzheimer's disease?
(-9) Refused
IF ROUND= FALL 2018 ROUND 82, GO TO HFJ47-BASKDEPRS.
ELSE IF SP IS IN THE BASELINE INTERIVEW (sample_person.INTTYPE=3) GO TO HFJ47-BASKDEPRS. IF
P_EVRASKDEPRESS=0 THEN GO TO HFJ48-CASKDEPRS. ELSE GO TO HFJ30AA - OCDEPRSS.
(01) YES
Has a doctor or other health professional ever asked [you/(SP)] if there was a period of time when
(02) NO
[you/he/she] felt sad, empty, or depressed?
(-8) Don't Know
(-9) Refused
Health Functioning and Status (HFQ)
Variable Name
MR Screen Name
Question type
Question text/description
CASKDEPRS
yes/no
Since (SAMPLE_PERSON.DATE_FALLRND), has a doctor or other health professional asked [you/(SP)] if there
was a period of time when [you/he/she] felt sad, empty, or depressed?
OCDEPRSS
HFJ48
HFJ30AA
BOX HFJ17A
yes/no
routing
YRDEPRSS
HFJ30BB
yes/no
OCPSYCHO
HFJ30A
yes/no
BOX HFJ17B
routing
HFJ31A
yes/no
BOX HFJ19
routing
OCOSTEOP
HFJ32
yes/no
OCBRKHIP
HFJ33
yes/no
BOX HFJ20
routing
YRPSYCHO
YRBRKHIP
OCPARKIN
HFJ34
yes/no
BOX HFJ21
routing
HFJ35
yes/no
[[Since (LAST HF MONTH YEAR) has/Has] a doctor or other health professional [ever] told [you/(SP)] that
[you/he/she] had...]
depression?
IF SP IS IN THE SUPPLEMENTAL SAMPLE (sample_person.INTTYPE=3), GO TO HFJ30BB - YRDEPRSS.
ELSE GO TO HFJ30A - OCPSYCHO.
Code list
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
(01) YES
Since (LAST HF MONTH YEAR), did a doctor or other health professional tell [you/(SP)] that [you/he/she] had (02) NO
depression?
(-8) Don't Know
(-9) Refused
[[Since (LAST HF MONTH YEAR) has/Has] a doctor or other health professional [ever] told [you/(SP)] that
[you/he/she] had...]
(01) YES
(02) NO
a mental or psychiatric disorder other than depression?
(-8) Don't Know
(-9) Refused
[INCLUDE ALCOHOLISM AS A MENTAL OR PSYCHIATRIC DISORDER.]
IF SP IS IN THE SUPPLEMENTAL SAMPLE (sample_person.INTTYPE=3), GO TO HFJ31A - YRPSYCHO.
ELSE GO TO BOX HFJ19.
Since (LAST HF MONTH YEAR), did a doctor or other health professional tell [you/(SP)] that [you/he/she] had (01) YES
a mental or psychiatric disorder other than depression?
(02) NO
(-8) Don't Know
[INCLUDE ALCOHOLISM AS A MENTAL OR PSYCHIATRIC DISORDER.]
(-9) Refused
IF SP HAS EVER REPORTED HAVING OSTEOPOROSIS IN A PREVIOUS ROUND (sample_person.P_OCOSTEOP=1),
GO TO HFJ33 - OCBRKHIP.
ELSE GO TO HFJ32 - OCOSTEOP.
[[Since (LAST HF MONTH YEAR) has/Has] a doctor or other health professional [ever] told [you/(SP)] that
(01) YES
[you/he/she] had...]
(02) NO
(-8) Don't Know
osteoporosis, sometimes called fragile or soft bones?
(-9) Refused
[[Since (LAST HF MONTH YEAR) has/Has] a doctor or other health professional [ever] told [you/(SP)] that
(01) YES
[you/he/she] had...]]
(02) NO
(-8) Don't Know
a broken hip?
(-9) Refused
IF SP IS IN THE SUPPLMENTAL SAMPLE (sample_person.INTTYPE=3), GO TO HFJ34 - YRBRKHIP.
ELSE GO TO BOX HFJ21.
(01) YES
Since (LAST HF MONTH YEAR), did a doctor or other health professional tell [you/(SP)] that [you/he/she] had (02) NO
a broken hip?
(-8) Don't Know
(-9) Refused
IF SP HAS EVER REPORTED HAVING PARKINSON’S DISEASE IN A PREVIOUS ROUND
(sample_person.P_OCPARKIN=1), GO TO BOX HFJ22.
ELSE GO TO HFJ35 - OCPARKIN.
[[Since (LAST HF MONTH YEAR) has/Has] a doctor or other health professional [ever] told [you/(SP)] that
(01) YES
[you/he/she] had...]
(02) NO
(-8) Don't Know
Parkinson's disease?
(-9) Refused
Health Functioning and Status (HFQ)
Variable Name
MR Screen Name
BOX HFJ22
OCEMPHYS
OCPPARAL
HFJ36
HFJ37
BOX HFJ23
YRPPARAL
OCAMPUTE
HAVEPROS
Question type
routing
yes/no
yes/no
routing
HFJ38
yes/no
BOX HFJ24
routing
HFJ39
yes/no
BOX HFJ25
routing
HFJ40
yes/no
Question text/description
IF SP HAS EVER REPORTED HAVING EMPHYSEMA, ASTHMA OR COPD IN A PREVIOUS ROUND
(sample_person.P_OCEMPHYS=1), GO TO HFJ37 - OCPPARAL.
ELSE GO TO HFJ36 - OCEMPHYS.
[[Since (LAST HF MONTH YEAR) has/Has] a doctor or other health professional [ever] told [you/(SP)] that
[you/he/she] had...]
emphysema, asthma, or COPD?
COPD=CHRONIC OBSTRUCTIVE PULMONARY DISEASE
IF SP IS OBVIOUSLY PARTIALLY OR COMPLETELY PARALYZED, SELECT "YES" AND DO NOT ASK. OTHERWISE,
ASK:
[[Since (LAST HF MONTH YEAR) has/Has] a doctor or other health professional [ever] told [you/(SP)] that
[you/he/she] had...]
YRPROST
HFJ41
routing
yes/no
HFJ41A
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
(01) YES
Since (LAST HF MONTH YEAR), did a doctor or other health professional tell [you/(SP)] that [you/he/she] had (02) NO
complete or partial paralysis?
(-8) Don't Know
(-9) Refused
IF SP HAS EVER REPORTED AN ABSENCE OR LOSS OF ARM OR LEG IN A PREVIOUS ROUND
(sample_person.P_OCAMPUTE=1), GO TO BOX HFJ25.
ELSE GO TO HFJ39 - OCAMPUTE.
(01) YES
IF SP IS OBVIOUSLY MISSING ONE OR MORE LIMBS, SELECT "YES" AND DO NOT ASK. OTHERWISE, ASK:
(02) NO
(-8) Don't Know
What about absence or loss of an arm or a leg?
(-9) Refused
IF SP IS FEMALE (ROSTSEX=2 or (roster.ROSTSEX=2 where ROSTNUM=1)), GO TO HFJ41A - OCBETES.
ELSE GO TO HFJ40 - HAVEPROS.
[[Before (you/[SP]) had prostate surgery, did a doctor or other health professional ever tell/Since (LAST HF
MONTH YEAR), has/Has] a doctor or other health professional [ever] told [you/(SP)] that [you/he] had...]
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
IF SP IS IN THE SUPPLMENTAL SAMPLE (sample_person.INTTYPE=3, GO TO HFJ41 - YRPROST.
ELSE GO TO HFJ41A - OCBETES.
Since (LAST HF MONTH YEAR), did a doctor or other health professional tell [you/(SP)] that [you/he] had an
enlarged prostate or benign prostatic hypertrophy (BPH)?
Has a doctor or other health professional ever told [you/(SP)] that [you/he/she] had any type of diabetes,
including:
OCBETES
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
complete or partial paralysis?
IF SP IS IN THE SUPPLMENTAL SAMPLE (sample_person.INTTYPE=3, GO TO HFJ38 - YRPPARAL.
ELSE GO TO BOX HFJ24.
an enlarged prostate or benign prostatic hypertrophy (BPH)?
BOX HFJ26
Code list
yes/no
sugar diabetes, high blood sugar, (borderline diabetes, pre-diabetes, or pregnancy-related
diabetes/borderline diabetes, or pre-diabetes)?
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
Health Functioning and Status (HFQ)
Variable Name
MR Screen Name
Question type
Question text/description
SHOW CARD HF5
Code list
Looking at this card, please tell me which type of diabetes the doctor or other health professional said that
[you have/(SP) has].
OCDTYPE
HFJ41B
code 1
OCDTYPOS
HFJ41B
verbatim text
OCDVISIT
HFJ41C
BOX HFJ27
(01) TYPE 1
(02) TYPE 2
(03) BORDERLINE
[IF THE RESPONDENT REPORTS MORE THAN ONE TYPE OF DIABETES, PROBE FOR THE MOST RECENT TYPE OF (04) PRE-DIABETES
DIABETES THE DOCTOR TOLD THE RESPONDENT HE/SHE HAS.]
(05) GESTATIONAL (PREGNANCY-RELATED)
(91) SOME OTHER TYPE
[EXPLAIN IF NECESSARY: “Type 1” was formerly called “insulin dependent” or “juvenile-onset” diabetes. This (-8) Don't Know
type of diabetes usually develops during childhood or adolescence; but, it also can develop in adults.
(-9) Refused
“Type 2” was formerly called “non-insulin dependent” or “adult-onset” diabetes. Until recently, this type of
diabetes was found only in adults; but, now it is also occurring in children.]
SOME OTHER TYPE (SPECIFY)
[IF THE RESPONDENT REPORTS MORE THAN ONE TYPE OF DIABETES, PROBE FOR THE MOST RECENT TYPE OF
DIABETES THE DOCTOR TOLD THE RESPONDENT HE/SHE HAS.]
yes/no
[Were you/Was (SP)] told on two or more different visits that [you/he/she] had diabetes?
routing
IF SP IS IN THE SUPPLEMENTAL SAMPLE AND SP'S AGE AT TIME OF CURRENT MEDICARE ELIGIBILITY WAS
UNDER 65 (sample_person.INTTYPE=3 and sample_person.AGECUREL<65 and greater than 0) THEN
IF SP REPORTED “YES” TO AT LEAST ONE HFJ CONDITION, GO TO HFJ42 - EMCOND.
ELSE IF SP REPORTED “NO” TO ALL HFJ CONDITIONS , GO TO HFJ43 - EMCAUSEVB.
ELSE IF SP IS NOT IN THE SUPPLEMENTAL SAMPLE OR SP'S AGE AT TIME OF CURRENT MEDICARE ELIGIBILITY
WAS NOT UNDER 65 THEN GO TO HFPINTRO - HLTHCAREINTRO.
(01) [Continuous answer.]
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
You told me that [you have/(SP) has] had [READ CONDITIONS LISTED BELOW]. [Was this/Were any of these]
the original cause of [your/(SP's)] becoming eligible for Medicare?
EMCOND
EMCAUSEVB
HFJ42
yes/no
HFJ43
verbatim text
BOX HFJ28
routing
[LIST ALL CONDITIONS WHERE "YES" ANSWER RECORDED AT HFJ1 THROUGH HFJ41C]
[NOTE THAT CONDITIONS MAY NOT BE DISPLAYED WITH THE EXACT CONDITION NAME THAT WAS USED
EARLIER IN THE INTERVIEW (E.G., HYPERTENSION CAN ALSO BE CALLED HIGH BLOOD PRESSURE AT
DIFFERENT QUESTIONS).]
What was the original cause of [your/(SP's)] becoming eligible for Medicare?
RECORD VERBATIM.
IF SP RESPONDED “YES” TO ONLY ONE HFJ CONDITION, GO TO HFPINTRO - HLTHCAREINTRO.
ELSE GO TO HFJ44 - EMCODE.
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
(01) [Continuous answer.]
Health Functioning and Status (HFQ)
Variable Name
MR Screen Name
Question type
Question text/description
EMCODE
HFJ44
code all
EMOS
HFJ44
verbatim text
OTHER (SPECIFY)
Code list
(01) ARTERIES HARDENING
(02) HYPERTENSION
(03) HEART ATTACK
(04) HEART DISEASE
(05) CONGESTIVE HEART FAILURE
(06) HEART VALVE PROBLEM
(07) HEART RHYTHM PROBLEM
(08) OTHER HEART PROBLEM
(09) STROKE OR HEMORRHAGE
(10) SKIN CANCER
(11) CANCER/TUMOR
(12) RHEUMATOID ARTHRITIS
(26) OSTEOARTHRITIS
(13) OTHER ARTHRITIS
(14) INTELLECTUAL DISABILITY
(15) ALZHEIMER'S
(16) DEMENTIA
(17) DEPRESSION
(18) MENTAL DISORDER
(19) OSTEOPOROSIS
(20) BROKEN HIP
(21) PARKINSON'S
(22) EMPHYSEMA/ASTHMA/COPD
(23) PARALYSIS
(24) LOSS OF LIMB
(25) DIABETES
(91) OTHER
(-8) Don't Know
(-9) Refused
(01) [Continuous answer.]
HLTHCAREINTRO
HFPINTRO
no entry
Now I want to ask you about some things that [you/(SP)] may be doing to maintain [your/his/her] health,
either by getting tested for health problems or by taking care of conditions that [you have/she has/he has].
(01) CONTINUE
(-7) Empty
Which of these conditions was the cause of [your/(SP's)] becoming eligible for Medicare?
BOX HFP1A
DIAAGE
HFP1
BOX HFP2
routing
numeric
routing
DIAPRGNT
HFP2
yes/no
DIAINSUL
HFP4
list
[PROBE: Any other condition?]
CHECK UP TO 8 CONDITIONS.
IF (HFJ41A – OCBETES = 1/Yes) AND (HFJ41B - OCDTYPE = 1/TypeOne, 2/TypeTwo, 3/Borderline,
4/PreDiabetes, 91/Other, DK, or RF), GO TO HFP1 - DIAAGE.
ELSE GO TO HFP21 - DIAEVERT.
I recorded that [you were/(SP) was] told by a doctor or other health professional that [you have/she has/he
has] [Type 1 diabetes/Type 2 diabetes/borderline diabetes/pre-diabetes/diabetes].
How old [were you/was (SP)] when [you were/he was/she was] first told that [you/he/she] had diabetes?
IF THE SP IS FEMALE (ROSTSEX=2) AND (HFP1 – DIAAGE is >= 12 and is <= 45) OR (HFP1 – DIAAGE = DK OR
RF), GO TO HFP2 - DIAPRGNT.
ELSE GO TO HFP4 - DIAINSUL.
(01) [Continuous answer.]
(-7) Empty
(-8) Don't Know
(-9) Refused
(01) YES
(02) NO
Did [you/(SP)] have diabetes only during a pregnancy?
(-8) Don't Know
(-9) Refused
Please tell me whether [you use/(SP) uses] any of the following ways to manage [your/his/her] diabetes. [Do (01) YES
you/Does (SP)]…
(02) NO
(-8) Don't Know
take insulin?
(-9) Refused
Health Functioning and Status (HFQ)
Variable Name
MR Screen Name
Question type
DIAMEDS
HFP4
list
DIATEST
HFP4
list
DIASORES
HFP4
list
DIAPRESS
HFP4
list
DIAASPRN
HFP4
list
BOX HFP3
routing
INSUTAKE
HFP5
quantity unit
INSUDAY
INSUWEEK
HFP5
HFP5
quantity unit
quantity unit
BOX HFP4
routing
MEDSTAKE
HFP6
quantity unit
MEDDAY
MEDWEEK
MEDMONTH
HFP6
HFP6
HFP6
quantity unit
quantity unit
quantity unit
BOX HFP5
routing
Question text/description
Code list
Please tell me whether [you use/(SP) uses] any of the following ways to manage [your/his/her] diabetes. [Do (01) YES
you/Does (SP)]…
(02) NO
(-8) Don't Know
take prescription diabetes pills or oral diabetes medicine?
(-9) Refused
Please tell me whether [you use/(SP) uses] any of the following ways to manage [your/his/her] diabetes. [Do (01) YES
you/Does (SP)]…
(02) NO
(-8) Don't Know
test [your/his/her] blood for sugar or glucose?
(-9) Refused
Please tell me whether [you use/(SP) uses] any of the following ways to manage [your/his/her] diabetes. [Do (01) YES
you/Does (SP)]…
(02) NO
(-8) Don't Know
check for sores or irritations on [your/his/her] feet?
(-9) Refused
Please tell me whether [you use/(SP) uses] any of the following ways to manage [your/his/her] diabetes. [Do (01) YES
you/Does (SP)]…
(02) NO
(-8) Don't Know
measure [your/his/her] blood pressure at home?
(-9) Refused
Please tell me whether [you use/(SP) uses] any of the following ways to manage [your/his/her] diabetes. [Do (01) YES
you/Does (SP)]…
(02) NO
(-8) Don't Know
take aspirin regularly for [your/his/her] diabetes?
(-9) Refused
IF HFP4 - DIAINSUL = 1/Yes, GO TO HFP5 - INSUTAKE.
ELSE IF HFP4 - DIAMEDS = 1/Yes, GO TO HFP6 - MEDSTAKE.
ELSE IF HFP4 - DIATEST = 1/Yes, GO TO HFP7 - TESTTAKE.
ELSE IF HFP4 - DIASORES = 1/Yes, GO TO HFP8 - SORECHEK.
ELSE GO TO HFP10 - DIATENYR.
(01) NUMBER OF TIMES PER DAY
(02) NUMBER OF TIMES PER WEEK
How often [do you/does (SP)] take insulin?
(03) USE INSULIN PUMP
(-8) Don't Know
(-9) Refused
How often [do you/does (SP)] take insulin?
(01) [Continuous answer.]
How often [do you/does (SP)] take insulin?
(01) [Continuous answer.]
IF HFP4 – DIAMEDS = 1/Yes, GO TO HFP6 - MEDSTAKE.
ELSE IF HFP4 - DIATEST = 1/Yes, GO TO HFP7 - TESTTAKE.
ELSE IF HFP4 - DIASORES = 1/Yes, GO TO HFP8 - SORECHEK.
ELSE GO TO HFP10 - DIATENYR.
(01) NUMBER OF TIMES PER DAY
(02) NUMBER OF TIMES PER WEEK
How often [do you/does (SP)] take prescription diabetes pills or oral diabetes medicine?
(03) NUMBER OF TIMES PER MONTH
(-8) Don't Know
(-9) Refused
How often [do you/does (SP)] take prescription diabetes pills or oral diabetes medicine?
(01) [Continuous answer.]
How often [do you/does (SP)] take prescription diabetes pills or oral diabetes medicine?
(01) [Continuous answer.]
How often [do you/does (SP)] take prescription diabetes pills or oral diabetes medicine?
(01) [Continuous answer.]
IF HFP4 – DIATEST = 1/Yes, GO TO HFP7 - TESTTAKE.
ELSE IF HFP4 – DIASORES = 1/Yes, GO TO HFP8 - SORECHEK.
ELSE GO TO HFP10 - DIATENYR.
Health Functioning and Status (HFQ)
Variable Name
MR Screen Name
Question type
Question text/description
How often [do you/does (SP)] test [your/his/her] blood for sugar or glucose?
TESTTAKE
HFP7
quantity unit
[PROBE: Include times when it is tested by a family member or friend, but do not include times when it is
tested by a health professional.]
Code list
(01) NUMBER OF TIMES PER DAY
(02) NUMBER OF TIMES PER WEEK
(03) NUMBER OF TIMES PER MONTH
(04) NUMBER OF TIMES PER YEAR
(-8) Don't Know
(-9) Refused
How often [do you/does (SP)] test [your/his/her] blood for sugar or glucose?
TESTDAY
HFP7
quantity unit
TESTWEEK
HFP7
quantity unit
TESTMNTH
HFP7
quantity unit
TESTYEAR
HFP7
quantity unit
BOX HFP6
routing
[PROBE: Include times when it is tested by a family member or friend, but do not include times when it is
tested by a health professional.]
How often [do you/does (SP)] test [your/his/her] blood for sugar or glucose?
[PROBE: Include times when it is tested by a family member or friend, but do not include times when it is
tested by a health professional.]
How often [do you/does (SP)] test [your/his/her] blood for sugar or glucose?
[PROBE: Include times when it is tested by a family member or friend, but do not include times when it is
tested by a health professional.]
How often [do you/does (SP)] test [your/his/her] blood for sugar or glucose?
[PROBE: Include times when it is tested by a family member or friend, but do not include times when it is
tested by a health professional.]
IF HFP4 – DIASORES = 1/Yes, GO TO HFP8 - SORECHEK.
ELSE GO TO HFP10 - DIATENYR.
How often [do you/does (SP)] check [your/his/her] feet for sores or irritations?
SORECHEK
HFP8
quantity unit
[PROBE: Include times when they are checked by a family member or friend, but do not include times when
they are checked by a health professional.]
(01) [Continuous answer.]
(01) [Continuous answer.]
(01) [Continuous answer.]
(01) [Continuous answer.]
(01) NUMBER OF TIMES PER DAY
(02) NUMBER OF TIMES PER WEEK
(03) NUMBER OF TIMES PER MONTH
(04) NUMBER OF TIMES PER YEAR
(-8) Don't Know
(-9) Refused
How often [do you/does (SP)] check [your/his/her] feet for sores or irritations?
SOREDAY
HFP8
quantity unit
SOREWEEK
HFP8
quantity unit
SOREMNTH
HFP8
quantity unit
SOREYEAR
HFP8
quantity unit
DIATENYR
HFP10
yes/no
[PROBE: Include times when they are checked by a family member or friend, but do not include times when
they are checked by a health professional.]
How often [do you/does (SP)] check [your/his/her] feet for sores or irritations?
[PROBE: Include times when they are checked by a family member or friend, but do not include times when
they are checked by a health professional.]
How often [do you/does (SP)] check [your/his/her] feet for sores or irritations?
[PROBE: Include times when they are checked by a family member or friend, but do not include times when
they are checked by a health professional.]
How often [do you/does (SP)] check [your/his/her] feet for sores or irritations?
[PROBE: Include times when they are checked by a family member or friend, but do not include times when
they are checked by a health professional.]
(01) [Continuous answer.]
(01) [Continuous answer.]
(01) [Continuous answer.]
(01) [Continuous answer.]
(01) YES
(02) NO
In the past year has a doctor or other health professional examined [your/his/her] feet for sores or irritations?
(-8) Don't Know
(-9) Refused
Health Functioning and Status (HFQ)
Variable Name
MR Screen Name
Question type
Question text/description
DIADRSAW
numeric
About how many times in the past year [have you/has (SP)] seen a doctor or other health professional for
[your/his/her] diabetes?
numeric
A test of hemoglobin "A one C" measures the average level of blood sugar over the past three months. It is
usually done in a doctor's office. About how many times in the past year has a doctor or other health
professional checked [you/(SP)] for hemoglobin "A one C"?
DIAHEMOC
HFP11
HFP13
SHOW CARD HF6
DIACTRLD
HFP14
code 1
DIAHYPO
HFP14A1
yes/no
Would you say that [your/(SP)'s] blood sugar is well controlled all of the time, most of the time, some of the
time, a little of the time, or none of the time? By "well controlled" we mean a recent hemoglobin "A one C"
result of 7.5 or less or an average fasting blood test of 140 or less.
In the past year, [have you/has (SP)] experienced hypoglycemia, sometimes called low blood sugar or an
insulin reaction?
Please think about the most serious episode of hypoglycemia that [you have/(SP) has] experienced in the past
year.
DIAHYPTR
HFP14A2
code 1
[Were you/Was (SP)] able to treat [yourself/himself/herself] by taking some form of sugar, did [you/he/she]
require treatment from others, or did [you/he/she] require treatment by a hospital?
[EXPLAIN IF NECESSARY: Treatment by a hospital includes being treated in the emergency room or outpatient
department of a hospital, or being admitted as an inpatient.]
DIAFTEVR
HFP14A3
yes/no
[Have you/Has (SP)] ever had any problems with [your/his/her] feet as a result of [your/his/her] diabetes?
DIAFEET
HFP14A
yes/no
[Do you/Does (SP)] currently have any problems with [your/his/her] feet as a result of [your/his/her]
diabetes?
People with diabetes can develop many different foot problems. Please tell me if [you have/(SP) has] ever
been told by a doctor or other health professional that [you/he/she] had any of the following problems with
[your/his/her] feet as a result of [your/his/her] diabetes.
DIANEURO
HFP14B
list
[Have you/Has (SP)] ever been told by a doctor or other health professional that [you/he/she] had…
Neuropathy or nerve damage, which may cause pain or numbness in the feet?
[People with diabetes can develop many different foot problems. Please tell me if [you have/(SP) has] ever
been told by a doctor or other health professional that [you/he/she] had any of the following problems with
[your/his/her] feet as a result of [your/his/her] diabetes.]
DIACIRCF
HFP14B
list
[Have you/Has (SP)] ever been told by a doctor or other health professional that [you/he/she] had…
Poor circulation or blood flow in the feet?
Code list
(01) [Continuous answer.]
(-8) Don't Know
(-9) Refused
(01) [Continuous answer.]
(-8) Don't Know
(-9) Refused
(01) ALL OF THE TIME
(02) MOST OF THE TIME
(03) SOME OF THE TIME
(04) A LITTLE OF THE TIME
(05) NONE OF THE TIME
(-8) Don't Know
(-9) Refused
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
(01) SELF TREATMENT
(02) TREATMENT FROM OTHERS
(03) HOSPITAL TREATMENT
(-8) Don't Know
(-9) Refused
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
Health Functioning and Status (HFQ)
Variable Name
MR Screen Name
DIAULCER
HFP14B
Question type
Question text/description
[People with diabetes can develop many different foot problems. Please tell me if [you have/(SP) has] ever
been told by a doctor or other health professional that [you/he/she] had any of the following problems with
[your/his/her] feet as a result of [your/his/her] diabetes.]
list
[Have you/Has (SP)] ever been told by a doctor or other health professional that [you/he/she] had…
Foot ulcers?
[People with diabetes can develop many different foot problems. Please tell me if [you have/(SP) has] ever
been told by a doctor or other health professional that [you/he/she] had any of the following problems with
[your/his/her] feet as a result of [your/his/her] diabetes.]
DIASKINC
HFP14B
list
[Have you/Has (SP)] ever been told by a doctor or other health professional that [you/he/she] had…
Code list
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
Calluses, infections, or other skin changes affecting the feet?
DIAEYPRB
HFP15
yes/no
DIAKDPEV
HFP16A1
yes/no
DIAKDPRB
HFP16
yes/no
DIAKIDNY
HFP16A
yes/no
DIAMNGE
HFP17
yes/no
DIATRAIN
HFP18
code 1
BOX HFP7
routing
HFP19
code 1
DIAKNOW
(01) YES
(02) NO
[Do you/Does (SP)] have any problems with [your/his/her] eyes as a result of [your/his/her] diabetes?
(-8) Don't Know
(-9) Refused
(01) YES
[Have you/Has (SP)] ever had any problems with [your/his/her] kidneys as a result of [your/his/her] diabetes?
(02) NO
(-8) Don't Know
[EXPLAIN IF NECESSARY: This is tested by looking for protein in the urine.]
(-9) Refused
(01) YES
[Do you/Does (SP)] currently have any problems with [your/his/her] kidneys as a result of [your/his/her]
(02) NO
diabetes?
(-8) Don't Know
(-9) Refused
(01) YES
[Have you/Has (SP)] ever been told by a doctor or other health professional that [you have/she has/he has] (02) NO
chronic kidney disease?
(-8) Don't Know
(-9) Refused
(01) YES
[Have you/Has (SP)] ever participated in a diabetes self-management course or class, or received special
(02) NO
training on how [you/he/she] can manage [your/his/her] diabetes?
(-8) Don't Know
(-9) Refused
(01) LESS THAN 1 YEAR AGO
When was the most recent time that [you/(SP)] participated in a diabetes self-management course or class or (02) 1 YEAR TO LESS THAN 2 YEARS AGO
received special training on how [you/he/she] can manage [your/his/her] diabetes?
(03) 2 YEARS TO LESS THAN 3 YEARS AGO
(04) 3 YEARS TO LESS THAN 5 YEARS AGO
[IF THE RESPONDENT HAS GONE TO MORE THAN ONE COURSE OR TRAINING, PROBE FOR THE MOST RECENT (05) 5 OR MORE YEARS AGO
TIME.]
(-8) Don't Know
(-9) Refused
IF THE SP IS THE RESPONDENT (SPPROXY=1), GO TO HFP19 - DIAKNOW.
ELSE GO TO BOX HFR1.
(01) just about everything you need to know,
(02) most of what you need to know,
(03) some of what you need to know,
SHOW CARD HF7
(04) a little of what you need to know, or
(05) almost none of what you need to know about
How much do you think you know about managing your diabetes? Do you know . . .
managing your diabetes?
(-8) Don't Know
(-9) Refused
Health Functioning and Status (HFQ)
Variable Name
MR Screen Name
Question type
Question text/description
DIASUPPS
yes/no
Before today, did you know that Medicare now helps pay the cost of diabetic testing supplies and selfmanagement education for people with diabetes?
DIAEVERT
HFP20
HFP21
yes/no
[I have recorded that [you have/(SP) has] never been told by a doctor or other health professional that [you
have/she has/he has] diabetes.]
[Have you/Has (SP)] ever had a blood test to see if [you have/she has/he has] diabetes?
DIARECNT
HFP22
code 1
When was the most recent time [you were/(SP) was] tested for diabetes?
BOX HFP8
routing
IF THE SP IS THE RESPONDENT (SPPROXY=1), GO TO HFP23 - DIAAWARE.
ELSE GO TO HFP24 - DIARISK.
DIAAWARE
HFP23
yes/no
Before today, were you aware that there is a blood test to determine if a person has diabetes?
DIARISK
HFP24
yes/no
Has a doctor or other health professional ever told [you/(SP)] that [you are/he is/she is] at high risk for
diabetes?
DIASIGNS
HFP25
yes/no
In the past year, [have you/has (SP)] received any information about the signs, symptoms, or risk factors for
diabetes?
routing
IF (SP HAS EVER HEARD ABOUT COLORECTAL OR COLON CANCER IS UNKNOWN P_COLHEAR=.) AND (SP HAS
NOT REPORTED HAVING COLON, RECTAL OR BOWEL CANCER IN THE CURRENT ROUND OR IN A PREVIOUS
ROUND (OCCCODE not in 02 and P_OCCCOLON^=1), GO TO HFR1 - COLHEAR.
ELSE GO TO BOX HFS1.
BOX HFR1
Now I'd like to talk about a different illness, colorectal or colon cancer, a disease of the lower intestines.
COLHEAR
HFR1
yes/no
Before today, had you ever heard of colorectal or colon cancer?
COLHTEST
HFR3
yes/no
COLHKIT
HFR4
yes/no
COLFDOC
HFR4A
yes/no
Code list
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
(01) LESS THAN 1 YEAR AGO
(02) 1 YEAR TO LESS THAN 2 YEARS AGO
(03) 2 YEARS TO LESS THAN 3 YEARS AGO
(04) 3 YEARS TO LESS THAN 5 YEARS AGO
(05) 5 OR MORE YEARS AGO
(-8) Don't Know
(-9) Refused
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
The fecal occult blood test is a simple test for early signs of colon cancer. It detects invisible traces of blood
found in the stool. The doctor or other health professional can give the patient a kit to collect stool samples at (01) YES
the patient’s home. The test is then sent to a laboratory for the results to be determined.
(02) NO
(-8) Don't Know
Has a doctor or other health professional ever given [you/(SP)] a home testing kit to test for blood in the
(-9) Refused
stool?
(01) YES
(02) NO
Have you ever heard of this home testing kit?
(-8) Don't Know
(-9) Refused
(01) YES
Has a doctor or other health professional ever performed a fecal occult blood test to test for blood in the
(02) NO
stool while [you/(SP)] [were/was] at the doctor’s office?
(-8) Don't Know
(-9) Refused
Health Functioning and Status (HFQ)
Variable Name
MR Screen Name
Question type
Question text/description
COLCARD
HFR5
yes/no
Did [you/(SP)] complete the samples and return them for [your/his/her] most recent test?
COLRECNT
HFR7
code 1
When did [you/(SP)] have [your/his/her] most recent blood stool test (using a home testing kit)?
COLSCOPY
HFR8
yes/no
Another test for early signs of colon cancer is performed in the doctor's office. The doctor uses a flexible
lighted tube to examine the colon and rectum directly. This is called a sigmoidoscopy or colonoscopy.
[Have you/Has (SP)] ever had this exam?
WHENSCOP
HFR9
code 1
When did [you/(SP)] have [your/his/her] most recent sigmoidoscopy or colonoscopy?
HEARSCOP
HFR10
yes/no
Before today, had you ever heard of a sigmoidoscopy or colonoscopy?
BOX HFR2
routing
IF HFR3 - COLHTEST = 1/Yes or HFR4 - COLHKIT = 1/Yes, GO TO HFR13 - COLSCRNS.
ELSE GO TO BOX HFS1.
COLDRREC
HFR11
yes/no
Has a doctor or other health professional ever recommended that [you/(SP)] have this test?
COLSCRNS
HFR13
yes/no
Before today, did you know that Medicare now pays the cost of screening tests for colorectal cancer?
BOX HFS1
routing
OSTINTRO
HFSINTRO
no entry
OSTEVERT
HFS1
yes/no
[Have you/Has (SP)] ever talked with [your/his/her] doctor or other health professional about osteoporosis?
OSTHRISK
HFS2
yes/no
Has a doctor or other health professional ever told [you/(SP)] that [you are/he is/she is] at high risk for
osteoporosis?
IF SP HAS EVER REPORTED HAVING OSTEPOPORIS IN THE CURRENT ROUND OR IN A PREVIOUS ROUND
(OCOSTEOP=1 or sample_person.P_OCOSTEOP-=1 GO TO HFS3 - OSTTEST.
ELSE GO TO HFSINTRO - OSTINTRO.
Now I'd like to talk about a disease called osteoporosis, which can be treated if found early. In osteoporosis,
the bones lose their calcium and become fragile and more easily broken.
Code list
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
(01) LESS THAN 1 YEAR AGO
(02) 1 YEAR TO LESS THAN 2 YEARS AGO
(03) 2 YEARS TO LESS THAN 3 YEARS AGO
(04) 3 YEARS TO LESS THAN 5 YEARS AGO
(05) 5 OR MORE YEARS AGO
(-8) Don't Know
(-9) Refused
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
(01) LESS THAN 1 YEAR AGO
(02) 1 YEAR TO LESS THAN 2 YEARS AGO
(03) 2 YEARS TO LESS THAN 3 YEARS AGO
(04) 3 YEARS TO LESS THAN 5 YEARS AGO
(05) 5 OR MORE YEARS AGO
(-8) Don't Know
(-9) Refused
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
(01) CONTINUE
(-7) Empty
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
Health Functioning and Status (HFQ)
Variable Name
MR Screen Name
Question type
Question text/description
OSTFRACT
yes/no
Have [you/(SP)] ever experienced a fracture that [your/his/her] doctor or other health professional told
[you/him/her] was related to osteoporosis?
OSTTEST
HFS2A
HFS3
yes/no
There is a test to detect osteoporosis at an early stage, called Bone Mass Measurement or Bone Density
Measurement, or DEXA scan.
[Have you/Has (SP)] ever had a Bone Mass or Bone Density Measurement test?
OSTHEAR
HFS4
yes/no
Before today, had you ever heard of this test?
OSTRECNT
HFS5
code 1
When was the most recent time that [you/(SP)] had a Bone Mass or Bone Density Measurement test?
OSTMASS
HFS6
yes/no
Before today, did you know that Medicare would pay for Bone Mass or Bone Density Measurement tests for
Medicare beneficiaries who are at risk for osteoporosis?
Next, we are going to ask some questions about [your/(SP's)] health care needs during the past year.
HCTROUBL
HFAC29
yes/no
Since (LAST HF MONTH YEAR), [have you/has (SP)] had any trouble getting health care that [you/he/she]
wanted or needed?
Code list
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
(01) LESS THAN 1 YEAR AGO
(02) 1 YEAR TO LESS THAN 2 YEARS AGO
(03) 2 YEARS TO LESS THAN 3 YEARS AGO
(04) 3 YEARS TO LESS THAN 5 YEARS AGO
(05) 5 OR MORE YEARS AGO
(-8) Don't Know
(-9) Refused
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
Health Functioning and Status (HFQ)
Variable Name
MR Screen Name
Question type
Question text/description
Why was that?
HCTCODE
HFAC30A
code all
HCTOTHOS
HFAC30A
verbatim text
BOX HFF6
routing
CGETAPPT
HFAC30B
yes/no
[PROBE: Any other reason?]
CHECK ALL THAT APPLY.
OTHER (SPECIFY)
IF RESPONSE TO HFAC30A - HCTCODE INCLUDES 8/DrDoesNotAcceptMedicare OR 10/DifficultyGettingAppt,
GO TO HFAC30D - OFFEXPLN.
ELSE GO TO HFAC30B - CGETAPPT.
HFAC30C
(01) SP DOES NOT HAVE MONEY
(02) COST IS TOO HIGH
(03) SERVICES/SUPPLIES NOT COVERED
(04) NEEDED TRANSPORTATION TO
DOCTOR/HOSPITAL
(05) DIFFICULTY GETTING HOME HEALTH CARE
(06) NO TREATMENT AVAILABLE/DOCTOR WON’T
TREAT
(07) WAIT TOO LONG/DOCTOR TOO BUSY
(08) OWN DOCTOR DOESN’T ACCEPT
MEDICARE/COULDN’T FIND DOCTOR WHO ACCEPTS
MEDICARE
(09) NOT ELIGIBLE FOR PUBLIC COVERAGE
(10) DIFFICULTY GETTING APPOINTMENT/ DELAYS
BECAUSE SP ON MEDICARE
(11) DOCTOR REFERRED SP TO SPECIALIST OR OTHER
DOCTOR
(12) HMO REFERRAL PROCESS (DIFFICULTY GETTING)
(13) PROBLEMS WITH HMO DOCTORS NOT GOOD OR
AVAILABLE
(14) HMO WOULD NOT COVER OR PROVIDE SERVICE
(91) OTHER
(-8) Don't Know
(-9) Refused
(01) [Continuous answer.]
(01) YES
Since (LAST HF MONTH YEAR), [have you/has (SP)] been told by a doctor’s office that they cannot schedule an (02) NO
appointment with [you/(SP)]?
(-8) Don't Know
(-9) Refused
What were the reasons the doctor’s office offered as an explanation for not scheduling an appointment with
[you/(SP)]?
CGETCODE
Code list
code all
[PROBE: Any other reason?]
CHECK ALL THAT APPLY
(01) DOCTOR DOES NOT ACCEPT INSURANCE PLAN
(02) ALL OF DOCTORS APPOINTMENTS WERE FULL
(03) DOCTOR IS NOT ACCEPTING ANY NEW PATIENTS
(04) DOCTOR IS NOT ACCEPTING NEW MEDICARE
PATIENTS
(05) DOCTRS HOURS CONFLICTED WITH
REQUIREMENTS OF SP
(06) DOCTOR DOES NOT ACCEPT MEDICAID
(07) DOCTOR DOES NOT ACCEPT MEDICARE AT ALL
(08) DOCTOR DOES NOT ACCEPT MEDICARE
ASSIGNMENT
(09) DOCTOR FELT ANOTHER PROVIDER WOULD BE
BETTER FOR SP
(91) OTHER
(-8) Don't Know
(-9) Refused
Health Functioning and Status (HFQ)
Variable Name
MR Screen Name
CGETOTOS
CGETOTOS
Question type
verbatim text
BOX HFF7
routing
OFFEXPLN
HFAC30D
yes/no
OFFEXVB
HFAC30E
verbatim text
HCDELAY
HFAC31
yes/no
PAYPROB
HFAC32A
yes/no
COLLAGNCY
HFAC32
yes/no
PAYOVRTM
HFAC32B
yes/no
IADLINTRO
HFKINTRO
no entry
PRBTELE
HFKA1
code 1
DONTTELE
HFKA2
yes/no
PRBLHWK
HFKB1
code 1
DONTLHWK
HFKB2
yes/no
Question text/description
Code list
Please specify the other reason.
(01) [Continuous answer.]
IF RESPONSE TO HFAC30C - CGETCODE INCLUDES 4/DocNotAcceptNewMedicare OR 7/DocNotAcceptMCAR,
GO TO HFAC30D - OFFEXPLN.
ELSE GO TO HFAC31 - HCDELAY.
(01) YES
Did the doctor’s office explain why [it is difficult for Medicare patients to get an appointment/Medicare is not (02) NO
accepted] at that practice?
(-8) Don't Know
(-9) Refused
What was that explanation?
(01) [Continuous answer.]
RECORD VERBATIM.
(01) YES
Since (LAST HF MONTH YEAR), [have you/has (SP)] delayed seeking medical care because (you were/he
(02) NO
was/she was) worried about the cost?
(-8) Don't Know
(-9) Refused
(01) YES
Since (LAST HF MONTH YEAR) [have you/has (SP)] had problems paying or were unable to pay any medical
(02) NO
bills?
(-8) Don't Know
(-9) Refused
(01) YES
Because of problems paying medical bills since (LAST HF MONTH YEAR), [have you/has (SP)] been contacted (02) NO
by a collection agency?
(-8) Don't Know
(-9) Refused
(01) YES
(02) NO
[Do you /Does (SP)] currently have any medical bills that are being paid off over time?
(-8) Don't Know
(-9) Refused
Health problems can include physical, mental, emotional, or memory problems. I'd now like to ask you about
(01) CONTINUE
how health problems may affect [your/(SP)'s] ability to perform some other everyday activities. I’d like to
(-7) Empty
know whether [you have/(SP) has] any difficulty doing each activity by [yourself/himself/herself].
(01) YES
Because of a physical, mental, emotional, or memory problem, [do you/does (SP)] have any difficulty...
(02) NO
(03) DOESN'T DO
using the telephone?
(-8) Don't Know
(-9) Refused
(01) YES
[You said that using the telephone is something that [you don't/(SP) doesn't] do.]
(02) NO
(-8) Don't Know
Is this because of a physical, mental, emotional, or memory problem?
(-9) Refused
(01) YES
[Because of a physical, mental, emotional, or memory problem, [do you/does (SP)] have any difficulty…]
(02) NO
(03) DOESN'T DO
doing light housework (like washing dishes, straightening up, or light cleaning)?
(-8) Don't Know
(-9) Refused
[You said that doing light housework (like washing dishes, straightening up, or light cleaning) is something
(01) YES
that [you don't/(SP) doesn't] do.]
(02) NO
(-8) Don't Know
Is this because of a physical, mental, emotional, or memory problem?
(-9) Refused
Health Functioning and Status (HFQ)
Variable Name
MR Screen Name
Question type
Question text/description
[Because of a physical, mental, emotional, or memory problem, [do you/does (SP)] have any difficulty…]
PRBHHWK
HFKC1
code 1
doing heavy housework (like scrubbing floors or washing windows)?
DONTHHWK
HFKC2
yes/no
[You said that doing heavy housework (like scrubbing floors or washing windows) is something that [you
don't/(SP) doesn't] do.]
Is this because of a physical, mental, emotional, or memory problem?
[Because of a physical, mental, emotional, or memory problem, [do you/does (SP)] have any difficulty…]
PRBMEAL
HFKD1
code 1
preparing [your/his/her] own meals?
[You said that preparing [your/his/her] own meals is something that [you don't/(SP) doesn't] do.]
DONTMEAL
HFKD2
yes/no
Is this because of a physical, mental, emotional, or memory problem?
[Because of a physical, mental, emotional, or memory problem, [do you/does (SP)] have any difficulty…]
PRBSHOP
HFKE1
code 1
shopping for personal items (such as toilet items or medicines)?
DONTSHOP
HFKE2
yes/no
[You said that shopping for personal items (such as toilet items or medicines) is something that [you
don't/(SP) doesn't] do.]
Is this because of a physical, mental, emotional, or memory problem?
[Because of a physical, mental, emotional, or memory problem, [do you/does (SP)] have any difficulty…]
PRBBILS
HFKF1
code 1
managing money (like keeping track of expenses or paying bills)?
DONTBILS
HFKF2
BOX HFKA1
HELPTELE
HFKA3
PERSON_HLPRTEL
HFKA4
E
BOX HFKB1
yes/no
routing
yes/no
roster
routing
[You said that managing money (like keeping track of expenses or paying bills) is something that [you
don't/(SP) doesn't] do.]
Is this because of a physical, mental, emotional, or memory problem?
IF HFKA1 - PRBTELE = 1/Yes OR HFKA2 – DONTTELE = 1/Yes, GO TO HFKA3 - HELPTELE.
ELSE GO TO BOX HFKB1.
[[You said that [your/(SP's)] health makes using the telephone difficult./You said that using the telephone is
something that [you don't do/(SP) doesn't do].]]
[Do you/Does (SP)] receive help from another person with...
using the telephone?
You mentioned that [you receive/(SP) receives] help with using the telephone. Who gives that help?
ENTER ALL HELPERS.
IF HFKB1 - PRBLHWK = 1/Yes or HFKB2 - DONTLHWK = 1/Yes, GO TO HFKB3 - HELPLHWK.
ELSE GO TO BOX HFKC1.
Code list
(01) YES
(02) NO
(03) DOESN'T DO
(-8) Don't Know
(-9) Refused
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
(01) YES
(02) NO
(03) DOESN'T DO
(-8) Don't Know
(-9) Refused
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
(01) YES
(02) NO
(03) DOESN'T DO
(-8) Don't Know
(-9) Refused
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
(01) YES
(02) NO
(03) DOESN'T DO
(-8) Don't Know
(-9) Refused
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
(01) [Continuous answer.]
Health Functioning and Status (HFQ)
Variable Name
MR Screen Name
HELPLHWK
HFKB3
Question type
Question text/description
[[You said that [your/(SP's)] health makes doing light housework (like washing dishes, straightening up, or
light cleaning) difficult./You said that doing light housework (like washing dishes, straightening up, or light
cleaning) is something that [you don't do/(SP) doesn't do].]]
yes/no
[Do you/Does (SP)] receive help from another person with...
PERSON_HLPRLH
WK
HELPHHWK
HFKB4
roster
BOX HFKC1
routing
HFKC3
yes/no
PERSON_HLPRHH
HFKC4
WK
BOX HFKD1
HELPMEAL
HFKD3
PERSON_HLPRME
HFKD4
AL
HELPSHOP
roster
routing
yes/no
roster
BOX HFKE1
routing
HFKE3
yes/no
PERSON_HLPRSHO
HFKE4
P
BOX HFKF1
roster
routing
Code list
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
doing light housework (like washing dishes, straightening up, or light cleaning)?
You mentioned that [you receive/(SP) receives] help with doing light housework (like washing dishes,
(01) [Continuous answer.]
straightening up, or light cleaning). Who gives that help?
IF HFKC1 - PRBHHWK = 1/Yes or HFKC2 - DONTHHWK = 1/Yes, GO TO HFKC3 - HELPHHWK.
ELSE GO TO BOX HFKD1
[[You said that [your/(SP's)] health makes doing heavy housework (like scrubbing floors or washing windows)
difficult./You said that heavy housework (like scrubbing floors or washing windows) is something that [you
(01) YES
don't do/(SP) doesn't do].]]
(02) NO
(-8) Don't Know
[Do you/Does (SP)] receive help from another person with...
(-9) Refused
doing heavy housework (like scrubbing floors or washing windows)?
You mentioned that [you receive/(SP) receives] help with doing heavy housework (like scrubbing floors or
washing windows). Who gives that help?
ENTER ALL HELPERS.
IF HFKD1 – PRBMEAL = 1/Yes or HFKD2 – DONTMEAL = 1/Yes, GO TO HFKD3 - HELPMEAL.
ELSE GO TO BOX HFKE1.
[[You said that [your/(SP's)] health makes preparing [your/his/her] own meals difficult./You said that
preparing [your/his/her] own meals is something that [you don't do/(SP) doesn't do].]]
[Do you/Does (SP)] receive help from another person with...
(01) [Continuous answer.]
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
preparing [your/his/her] own meals?
You mentioned that [you receive/(SP) receives] help with preparing [your/his/her] own meals. Who gives
that help?
(01) [Continuous answer.]
ENTER ALL HELPERS.
IF HFKE1 – PRBSHOP = 1/Yes or HFKE2 – DONTSHOP = 1/Yes, GO TO HFKE3 - HELPSHOP.
ELSE GO TO BOX HFKF1.
[[You said that [your/(SP's)] health makes shopping for personal items (such as toilet items or medicines)
difficult./You said that shopping for personal items (such as toilet items or medicines) is something that [you
(01) YES
don't do/(SP) doesn't do].]]
(02) NO
(-8) Don't Know
[Do you/Does (SP)] receive help from another person with...
(-9) Refused
shopping for personal items (such as toilet items or medicines)?
You mentioned that [you receive/(SP) receives] help with shopping for personal items (such as toilet items or
medicines). Who gives that help?
(01) [Continuous answer.]
ENTER ALL HELPERS.
IF HFKF1- PRBBILS = 1/Yes or HFKF2 – DONTBILS = 1/Yes, GO TO HFKF3 - HELPBILS.
ELSE GO TO HFLINTRO - ADLSINTRO.
Health Functioning and Status (HFQ)
Variable Name
MR Screen Name
Question type
HELPBILS
yes/no
HFKF3
PERSON_HLPRBILS HFKF4
roster
ADLSINTRO
HFLINTRO
no entry
HPPDBATH
HFLA1
code 1
DONTBATH
HFLA2
yes/no
HPPDDRES
HFLB1
code 1
DONTDRES
HFLB2
yes/no
HPPDEAT
HFLC1
code 1
DONTEAT
HFLC2
yes/no
HPPDCHAR
HFLD1
code 1
DONTCHAR
HFLD2
yes/no
Question text/description
Code list
[[You said that [your/(SP's)] health makes managing money (like keeping track of expenses or paying bills)
difficult./You said that managing money (like keeping track of expenses or paying bills) is something that [you
(01) YES
don't do/(SP) doesn't do].]]
(02) NO
(-8) Don't Know
[Do you/Does (SP)] receive help from another person with...
(-9) Refused
managing money (like keeping track of expenses or paying bills)?
You mentioned that [you receive/(SP) receives] help with managing money (like keeping track of expenses or
paying bills). Who gives that help?
(01) [Continuous answer.]
ENTER ALL HELPERS.
Remembering that health problems can include physical, mental, emotional, or memory problems, I'd now
like to ask you about how health problems may affect [your/(SP)'s] ability to perform some other everyday
(01) CONTINUE
activities. I’d like to know whether [you have/(SP) has] any difficulty doing each activity by
(-7) Empty
[yourself/himself/herself] and without special equipment.
(01) YES
Because of a physical, mental, emotional, or memory problem, [do you/does (SP)] have any difficulty...
(02) NO
(03) DOESN'T DO
bathing or showering?
(-8) Don't Know
(-9) Refused
(01) YES
[You said that bathing or showering is something that [you don't/(SP) doesn't] do.]
(02) NO
(-8) Don't Know
Is this because of a physical, mental, emotional, or memory problem?
(-9) Refused
(01) YES
[Because of a physical, mental, emotional, or memory problem, [do you/does (SP)] have any difficulty…]
(02) NO
(03) DOESN'T DO
dressing?
(-8) Don't Know
(-9) Refused
(01) YES
[You said that dressing is something that [you don't/(SP) doesn't] do.]
(02) NO
(-8) Don't Know
Is this because of a physical, mental, emotional, or memory problem?
(-9) Refused
(01) YES
[Because of a physical, mental, emotional, or memory problem, [do you/does (SP)] have any difficulty…]
(02) NO
(03) DOESN'T DO
eating?
(-8) Don't Know
(-9) Refused
(01) YES
[You said that eating is something that [you don't/(SP) doesn't] do.]
(02) NO
(-8) Don't Know
Is this because of a physical, mental, emotional, or memory problem?
(-9) Refused
(01) YES
[Because of a physical, mental, emotional, or memory problem, [do you/does (SP)] have any difficulty…]
(02) NO
(03) DOESN'T DO
getting in or out of bed or chairs?
(-8) Don't Know
(-9) Refused
(01) YES
[You said that getting in or out of bed or chairs is something that [you don't/(SP) doesn't] do.]
(02) NO
(-8) Don't Know
Is this because of a physical, mental, emotional, or memory problem?
(-9) Refused
Health Functioning and Status (HFQ)
Variable Name
MR Screen Name
Question type
Question text/description
[Because of a physical, mental, emotional, or memory problem, [do you/does (SP)] have any difficulty…]
HPPDWALK
HFLE1
code 1
walking?
[You said that walking is something that [you don't/(SP) doesn't] do.]
DONTWALK
HFLE2
code 1
Is this because of a physical, mental, emotional, or memory problem?
[Because of a physical, mental, emotional, or memory problem, [do you/does (SP)] have any difficulty…]
HPPDTOIL
HFLF1
code 1
using the toilet, including getting up and down?
[You said that using the toilet is something that [you don't/(SP) doesn't] do.]
DONTTOIL
HFLF2
yes/no
Is this because of a physical, mental, emotional, or memory problem?
BOX HFLA1
HELPBATH
HFLA3
routing
yes/no
IF HFLA1 – HPPDBATH = 1/Yes OR HFLA2 - DONTBATH = 1/Yes, GO TO HFLA3 - HELPBATH.
ELSE GO TO BOX HFLB1.
[[You said [your/(SP's)] health makes bathing or showering difficult./You said that bathing or showering is
something [you don't/(SP) doesn't] do.]]
[Do you/Does (SP)] receive help from another person with bathing or showering?
Does someone usually stay nearby just in case [you need/(SP) needs] help with bathing or showering?
PCHKBATH
HFLA4
yes/no
[That is, does someone usually stay or come into the room to check on [you/him/her]?]
EQIPBATH
LONGBATH
STILBATH
HELPDRES
HFLA5
yes/no
[Do you/Does (SP)] use special equipment or aids to help [you/him/her] with bathing or showering?
BOX HFLA2
routing
IF HFLA3 – HELPBATH = 1/Yes, GO TO HFLA6 - LONGBATH.
ELSE GO TO BOX HFLB1.
HFLA6
code 1
HFLA7
yes/no
BOX HFLB1
routing
HFLB3
yes/no
Code list
(01) YES
(02) NO
(03) DOESN'T DO
(-8) Don't Know
(-9) Refused
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
(01) YES
(02) NO
(03) DOESN'T DO
(-8) Don't Know
(-9) Refused
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
How long [have you/has (SP)] needed help with bathing or showering? Has it been . . .
(01) less than three months,
(02) three months or more but less than one year, or
(03) one year or more?
(-8) Don't Know
(-9) Refused
Do you expect that [you/(SP)] will still need help with bathing or showering three months from now?
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
IF HFLB1 - HPPDDRES = 1/Yes OR HFLB2 – DONTDRES = 1/Yes, GO TO HFLB3 - HELPDRES.
ELSE GO TO BOX HFLC1.
[[You said [your/(SP's)] health makes dressing difficult./You said that dressing is something [you don't/(SP)
doesn't] do.]]
[Do you/Does (SP)] receive help from another person with dressing?
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
Health Functioning and Status (HFQ)
Variable Name
MR Screen Name
Question type
Question text/description
Does someone usually stay nearby just in case [you need/(SP) needs] help with dressing?
PCHKDRES
HFLB4
yes/no
[That is, does someone usually stay or come into the room to check on [you/him/her]?]
EQIPDRES
LONGDRES
STILDRES
HELPEAT
HFLB5
yes/no
[Do you/Does (SP)] use special equipment or aids to help [you/him/her] with dressing?
BOX HFLB2
routing
IF HFLB3 – HELPDRES = 1/Yes, GO TO HFLB6 - LONGDRES.
ELSE GO TO BOX HFLC1.
HFLB6
code 1
HFLB7
yes/no
BOX HFLC1
routing
HFLC3
yes/no
How long [have you/has (SP)] needed help with dressing? Has it been . . .
(01) less than three months,
(02) three months or more but less than one year, or
(03) one year or more?
(-8) Don't Know
(-9) Refused
Do you expect that [you/(SP)] will still need help with dressing three months from now?
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
IF HFLC1 - HPPDEAT = 1/Yes OR HFLC2 – DONTEAT = 1/Yes, GO TO HFLC3 - HELPEAT.
ELSE GO TO BOX HFLD1.
[[You said [your/(SP's)] health makes eating difficult./You said that eating is something [you don't/(SP)
doesn't] do.]]
[Do you/Does (SP)] receive help from another person with eating?
Does someone usually stay nearby just in case [you need/(SP) needs] help with eating?
PCHKEAT
HFLC4
yes/no
[That is, does someone usually stay or come into the room to check on [you/him/her]?]
EQIPEAT
LONGEAT
STILEAT
HFLC5
yes/no
[Do you/Does (SP)] use special equipment or aids to help [you/him/her] with eating?
BOX HFLC2
routing
IF HFLC3 - HELPEAT = 1/Yes, GO TO HFLC6 - LONGEAT.
ELSE GO TO BOX HFLD1.
HFLC6
code 1
Code list
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
How long [have you/has (SP)] needed help with eating? Has it been . . .
(01) less than three months,
(02) three months or more but less than one year, or
(03) one year or more?
(-8) Don't Know
(-9) Refused
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
HFLC7
yes/no
Do you expect that [you/(SP)] will still need help with eating three months from now?
BOX HFLD1
routing
IF HFLD1 – HPPDCHAR = 1/Yes OR HFLD2 - DONTCHAR = 1/Yes, GO TO HFLD3 - HELPCHAR.
ELSE GO TO BOX HFLE1.
Health Functioning and Status (HFQ)
Variable Name
MR Screen Name
Question type
HELPCHAR
HFLD3
yes/no
PCHKCHAR
HFLD4
yes/no
EQIPCHAR
HFLD5
yes/no
BOX HFLD2
routing
LONGCHAR
STILCHAR
HELPWALK
HFLD6
code 1
HFLD7
yes/no
BOX HFLE1
routing
HFLE3
yes/no
Question text/description
Code list
[[You said [your/(SP's)] health makes getting in or out of bed or chairs difficult./You said that getting in or out (01) YES
of bed or chairs is something [you don't/(SP) doesn't] do.]]
(02) NO
(-8) Don't Know
[Do you/Does (SP)] receive help from another person with getting in or out of bed or chairs?
(-9) Refused
Does someone usually stay nearby just in case [you need/(SP) needs] help with getting in or out of bed or
(01) YES
chairs?
(02) NO
(-8) Don't Know
[That is, does someone usually stay or come into the room to check on (you/him/her)?]
(-9) Refused
(01) YES
[Do you/Does (SP)] use special equipment or aids to help [you/him/her] with getting in or out of bed or
(02) NO
chairs?
(-8) Don't Know
(-9) Refused
IF HFLD3 – HELPCHAR = 1/Yes, GO TO HFLD6 - LONGCHAR.
ELSE GO TO BOX HFLE1.
How long [have you/has (SP)] needed help with getting in or out of bed or chairs? Has it been . . .
(01) less than three months,
(02) three months or more but less than one year, or
(03) one year or more?
(-8) Don't Know
(-9) Refused
Do you expect that [you/(SP)] will still need help with getting in or out of bed or chairs three months from
now?
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
IF HFLE1- HPPDWALK = 1/Yes OR HFLE2 – DONTWALK = 1/Yes, GO TO HFLE3 - HELPWALK.
ELSE GO TO BOX HFLF1.
[[You said [your/(SP's)] health makes walking difficult./You said that walking is something [you don't/(SP)
doesn't] do.]]
[Do you/Does (SP)] receive help from another person with walking?
Does someone usually stay nearby just in case [you need/(SP) needs] help with walking?
PCHKWALK
HFLE4
yes/no
[That is, does someone usually stay or come into the room to check on (you/him/her)?]
EQIPWALK
LONGWALK
STILWALK
HFLE5
yes/no
[Do you/Does (SP)] use special equipment or aids to help [you/him/her] with walking?
BOX HFLE2
routing
IF HFLE3 - HELPWALK = 1/Yes, GO TO HFLE6 - LONGWALK.
ELSE GO TO BOX HFLF1.
HFLE6
HFLE7
code 1
yes/no
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
How long [have you/has (SP)] needed help with walking? Has it been . . .
(01) less than three months,
(02) three months or more but less than one year, or
(03) one year or more?
(-8) Don't Know
(-9) Refused
Do you expect that [you/(SP)] will still need help with walking three months from now?
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
Health Functioning and Status (HFQ)
Variable Name
MR Screen Name
Question type
BOX HFLF1
routing
HELPTOIL
HFLF3
yes/no
PCHKTOIL
HFLF4
yes/no
EQIPTOIL
HFLF5
yes/no
BOX HFLF2
routing
LONGTOIL
STILTOIL
HFLF6
code 1
HFLF7
yes/no
BOX HFLA3
routing
PERSON_HLPRBAT
HFLA9
H
BOX HFLB3
PERSON_HLPRDRE
HFLB9
S
BOX HFLC3
PERSON_HLPREAT HFLC9
BOX HFLD3
PERSON_HLPRCHA
HFLD9
R
BOX HFLE3
Question text/description
Code list
IF HFLF1 – HPPDTOIL = 1/Yes OR HFLF2 – DONTTOIL = 1/Yes, GO TO HFLF3 - HELPTOIL.
ELSE GO TO BOX HFLA3.
[[You said [your/(SP's)] health makes using the toilet difficult./You said that using the toilet is something [you (01) YES
don't/(SP) doesn't] do.]]
(02) NO
(-8) Don't Know
[Do you/Does (SP)] receive help from another person with using the toilet, including getting up and down?
(-9) Refused
Does someone usually stay nearby just in case [you need/(SP) needs] help with using the toilet, including
(01) YES
getting up and down?
(02) NO
(-8) Don't Know
[That is, does someone usually stay or come into the room to check on [you/him/her]?]
(-9) Refused
(01) YES
[Do you/Does (SP)] use special equipment or aids to help [you/him/her] with using the toilet, including
(02) NO
getting up and down?
(-8) Don't Know
(-9) Refused
IF HFLF3 - HELPTOIL = 1/Yes, GO TO HFLF6 - LONGTOIL.
ELSE GO TO BOX HFLA3.
How long [have you/has (SP)] needed help with using the toilet? Has it been . . .
(01) less than three months,
(02) three months or more but less than one year, or
(03) one year or more?
(-8) Don't Know
(-9) Refused
Do you expect that [you/(SP)] will still need help with using the toilet three months from now?
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
IF HFLA3 - HELPBATH = 1/Yes, GO TO HFLA9 - PERSON_HLPRBATH.
ELSE GO TO BOX HFLB3.
You mentioned that [you receive/(SP) receives] help with bathing and showering. Who gives that help?
roster
routing
(01) [Continuous answer.]
ENTER ALL HELPERS.
IF HFLB3 - HELPDRES = 1/Yes, GO TO HFLB9 - PERSON_HLPRDRES.
ELSE GO TO BOX HFLC3.
You mentioned that [you receive/(SP) receives] help with dressing. Who gives that help?
roster
routing
(01) [Continuous answer.]
ENTER ALL HELPERS.
IF HFLC3 – HELPEAT = 1/Yes, GO TO HFLC9 - PERSON_HLPREAT.
ELSE GO TO BOX HFLD3.
You mentioned that [you receive/(SP) receives] help with eating. Who gives that help?
roster
routing
roster
routing
(01) [Continuous answer.]
ENTER ALL HELPERS.
IF HFLD3 – HELPCHAR = 1/Yes, GO TO HFLD9 - PERSON_HLPRCHAR.
ELSE GO TO BOX HFLE3.
You mentioned that [you receive/(SP) receives] help with getting in or out of bed or chairs. Who gives that
help?
ENTER ALL HELPERS.
IF HFLE3 – HELPWALK = 1/Yes, GO TO HFLE9 - PERSON_HLPRWALK.
ELSE GO TO BOX HFLF3.
(01) [Continuous answer.]
Health Functioning and Status (HFQ)
Variable Name
MR Screen Name
PERSON_HLPRWA
HFLE9
LK
BOX HFLF3
PERSON_HLPRTOI
HFLF9
L
BOX HFL4
PERSON_HLPRMO
HFL10
ST
Question type
Question text/description
You mentioned that [you receive/(SP) receives] help with walking. Who gives that help?
roster
routing
(01) [Continuous answer.]
ENTER ALL HELPERS.
IF HFLF3 – HELPTOIL = 1/Yes, GO TO HFLF9 - PERSON_HLPRTOIL.
ELSE GO TO BOX HFL4.
You mentioned that [you receive/(SP) receives] help with using the toilet. Who gives that help?
roster
routing
Code list
(01) [Continuous answer.]
ENTER ALL HELPERS.
IF MORE THAN ONE PERSON SELECTED AT HFLA9, HFLB9, HFLC9, HFLD9, HFLE9, AND/OR HFLF9, GO TO HFL10
- PERSON_HLPRMOST.
ELSE GO TO HFM1 - FALLANY.
Which of these persons gives [you/(SP)] the most help with these things?
roster
(01) [Continuous answer.]
SELECT ONLY ONE.
FALLANY
HFM1
yes/no
FALLTIME
HFM2
numeric
FALLHELP
HFM3A
yes/no
FALCODE
HFM3B
code all
FALOTHOS
HFM3B
verbatim text
FALLIMIT
HFM3C
yes/no
FALLBACK
HFM3D
code 1
FALLFEAR
HFM3E
numeric
BOX MH1
routing
(01) YES
(02) NO
Since (LAST HF MONTH YEAR), [have you/has (SP)] fallen down?
(-8) Don't Know
(-9) Refused
Since (LAST HF MONTH YEAR), how many times [have you/has (SP)] fallen down?
[Continuous answer.]
Don't Know
ENTER "95" IF 95 OR MORE FALLS REPORTED.
Refused
(01) YES
Thinking about the [most recent) time that [you/(SP)] fell, did [you/he/she] hurt [yourself/himself/herself]
(02) NO
badly enough to get medical help?
(-8) Don't Know
(-9) Refused
(01) BROKEN BONE/FRACTURE
(02) SPRAIN/STRAIN
(03) BRUISE
What kind of injury did [you/(SP)] have in that [most recent] fall?
(04) CUT/WOUND/LACERATION
(05) CONCUSSION
[PROBE: Anything else?]
(06) DISLOCATION
(91) OTHER
CHECK ALL THAT APPLY.
(96) NO INJURY
(-8) Don't Know
(-9) Refused
OTHER (SPECIFY)
(01) [Continuous answer.]
(01) YES
(02) NO
Did [your/(SP's)] [most recent] fall cause [you/him/her] to limit [your/his/her] regular acivities?
(-8) Don't Know
(-9) Refused
(01) LESS THAN ONE WEEK
(02) ONE WEEK OR MORE
How long did it take [you/(SP)] to get back to regular activities after [your/his/her] [most recent] fall?
(03) NEVER RESUMED REGULAR ACTIVITIES
(-8) Don't Know
(-9) Refused
(01) [Continuous answer.]
How would you rate [your/(SP's)] fear of falling on a scale of 1 to 6, where 1 is "Not at all afraid of falling" and
(-8) Don't Know
6 is "Extremely afraid of falling"?
(-9) Refused
If the respondent is a proxy (SPPROXY=2), go to HFQ1 - LOSTURIN.
Else go to HFN1 - HFGAD1.
Health Functioning and Status (HFQ)
Variable Name
MR Screen Name
Question type
Question text/description
The next few questions ask about the last two weeks.
SHOW CARD HF8
HFGAD1
HFN1
list
Over the last 2 weeks, how often have you been bothered by the following problems?
Feeling nervous, anxious, or on edge
SHOW CARD HF8
HFGAD2
HFN2
list
[Over the last 2 weeks, how often have you been bothered by the following problems?]
Not being able to stop or control worrying.
SHOW CARD HF8
HFPHQ1
HFN3
list
[Over the last 2 weeks, how often have you been bothered by the following problems:]
little interest or pleasure in doing things? Would you say…
SHOW CARD HF8
HFPHQ2
HFN4
list
[Over the last 2 weeks, how often have you been bothered by the following problems:]
feeling down, depressed, or hopeless?
SHOW CARD HF8
HFPHQ3
HFN5
list
[Over the last 2 weeks, how often have you been bothered by the following problems:]
trouble falling or staying asleep, or sleeping too much?
SHOW CARD HF8
HFPHQ4
HFN6
list
[Over the last 2 weeks, how often have you been bothered by the following problems:]
feeling tired or having little energy?
SHOW CARD HF8
HFPHQ5
HFN7
list
[Over the last 2 weeks, how often have you been bothered by the following problems:]
poor appetite or overeating?
SHOW CARD HF8
HFPHQ6
HFN8
list
[Over the last 2 weeks, how often have you been bothered by the following problems:]
feeling bad about yourself – or that you are a failure or have let yourself or your family down?
Code list
(01) NOT AT ALL
(02) SEVERAL DAYS
(03) MORE THAN HALF THE DAYS
(04) NEARLY EVERY DAY
(-8) REFUSED
(-9) DON’T KNOW
(01) NOT AT ALL
(02) SEVERAL DAYS
(03) MORE THAN HALF THE DAYS
(04) NEARLY EVERY DAY
(-8) REFUSED
(-9) DON’T KNOW
(01) NOT AT ALL
(02) SEVERAL DAYS
(03) MORE THAN HALF THE DAYS
(04) NEARLY EVERY DAY
(-8) REFUSED
(-9) DON’T KNOW
(01) NOT AT ALL
(02) SEVERAL DAYS
(03) MORE THAN HALF THE DAYS
(04) NEARLY EVERY DAY
(-8) REFUSED
(-9) DON’T KNOW
(01) NOT AT ALL
(02) SEVERAL DAYS
(03) MORE THAN HALF THE DAYS
(04) NEARLY EVERY DAY
(-8) REFUSED
(-9) DON’T KNOW
(01) NOT AT ALL
(02) SEVERAL DAYS
(03) MORE THAN HALF THE DAYS
(04) NEARLY EVERY DAY
(-8) REFUSED
(-9) DON’T KNOW
(01) NOT AT ALL
(02) SEVERAL DAYS
(03) MORE THAN HALF THE DAYS
(04) NEARLY EVERY DAY
(-8) REFUSED
(-9) DON’T KNOW
(01) NOT AT ALL
(02) SEVERAL DAYS
(03) MORE THAN HALF THE DAYS
(04) NEARLY EVERY DAY
(-8) REFUSED
(-9) DON’T KNOW
Health Functioning and Status (HFQ)
Variable Name
MR Screen Name
Question type
HFPHQ7
HFN9
list
HFPHQ8
HFN10
list
HFPHQ10
HFN11
code one
LOSTURIN
HFQ1
code 1
TALKURIN
HFQ2
yes/no
FEELURIN
HFQ3
yes/no
REASURIN
HFQ4
yes/no
SURGURIN
HFQ5
yes/no
BOX HFT1
routing
Question text/description
Code list
(01) NOT AT ALL
SHOW CARD HF8
(02) SEVERAL DAYS
(03) MORE THAN HALF THE DAYS
[Over the last 2 weeks, how often have you been bothered by the following problems:]
(04) NEARLY EVERY DAY
(-8) REFUSED
trouble concentrating on things, such as reading the newspaper or watching TV?
(-9) DON’T KNOW
SHOW CARD HF8
(01) NOT AT ALL
(02) SEVERAL DAYS
[Over the last 2 weeks, how often have you been bothered by the following problems:]
(03) MORE THAN HALF THE DAYS
(04) NEARLY EVERY DAY
moving or speaking so slowly that other people could have noticed? Or the opposite – being so fidgety or
(-8) REFUSED
restless that you have been moving around a lot more than usual?
(-9) DON’T KNOW
(01) Not at all difficult,
SHOW CARD HF9
(02) Somewhat difficult,
(03) Very difficult,
How difficult have these problems made it for you to do your work, take care of things at home, or get along (04) Extremely difficult?
with people?
(-8) REFUSED
(-9) DON’T KNOW
(01) MORE THAN ONCE A WEEK
(02) ABOUT ONCE A WEEK
(03) 2-3 TIMES A MONTH
SHOW CARD HF10
(04) ABOUT ONCE A MONTH
(05) EVERY 2-3 MONTHS
I'd like to ask about a health problem that is more common than people think. Please look at this card and
(06) ONCE OR TWICE A YEAR
tell me how often, if at all, since (LAST HF MONTH YEAR) [you have/(SP) has] lost urine because [you/he/she] (07) NOT AT ALL
could not control [your/his/her] bladder.
(08) SP IS ON DIALYSIS OR CATHETERIZATION OR
UROSTOMY OR BLADDER BAG
(-8) Don't Know
(-9) Refused
(01) YES
(02) NO
[Have you/Has (SP)] talked about this problem with [your/(SP’s)] doctor or other health professional?
(-8) Don't Know
(-9) Refused
(01) YES
Has [your/(SP’s)] doctor or other health professional asked [you/him/her] about how [you/he/she] feel[s]
(02) NO
about this problem?
(-8) Don't Know
(-9) Refused
(01) YES
Has [your/(SP’s)] doctor or other health professional examined [you/him/her] to figure out why [you/he/she] (02) NO
[lose/loses] urine?
(-8) Don't Know
(-9) Refused
(01) YES
Has [your/(SP’s)] doctor or other health professional talked with [you/him/her] about taking medicine or
(02) NO
having surgery for this problem?
(-8) Don't Know
(-9) Refused
IF HFJ2 - OCHBP = 1/Yes, GO TO HFT1 - HYPETOLD.
ELSE GO TO BOX HFEND.
Health Functioning and Status (HFQ)
Variable Name
MR Screen Name
HYPETOLD
HFT1
Question type
code 1
Question text/description
We have recorded that [you were/(SP) was] told by a doctor or other health professional that [you had/he
had/she had] hypertension, also called high blood pressure.
[Were you/Was (SP)] told on two or more different medical visits that [you/he/she] had high blood pressure
or hypertension?
[EXPLAIN IF NECESSARY: We are interested in knowing whether [your/(SP’s)] blood pressure was high for
more than one reading.]
HYPEAGE
HFT2
numeric
HYPEAGE_LESSON
HFT2
E
numeric
HYPEHOME
HFT6D
yes/no
HYPEMEDS
HFT6G
yes/no
HYPEDRNK
HFT6J
yes/no
BOX HFT2
routing
HFT7
numeric
HYPELONG_LESSO
HFT7
NE
numeric
HYPELONG
HYPEMANY
HYPECOND
HYPECTRL
BOX HFT3
routing
HFT8
numeric
HFT11A
HFT12A
code 1
code 1
Code list
(01) YES
(02) NO
(03) SP NEVER HAD HIGH BLOOD
PRESSURE/PREVIOUS RESPONSE ENTERED IN ERROR
(-8) Don't Know
(-9) Refused
(01) [Continuous answer.]
(-8) Don't Know
(-9) Refused
How old [were you/was (SP)] when (you were/he was/she was) first told that [you/he/she] had high blood
(01) LESS THAN ONE YEAR OLD
pressure?
(-7) Empty
(01) YES
Because of [your/his/her] high blood pressure, [are you/is (SP)] now measuring [your/his/her] blood pressure (02) NO
at home?
(-8) Don't Know
(-9) Refused
(01) YES
Because of [your/his/her] high blood pressure, [are you/is (SP)] now taking prescribed medicine for
(02) NO
[your/his/her] high blood pressure?
(-8) Don't Know
(-9) Refused
(01) YES
[Have you/Has (SP)] cut down on drinking alcoholic beverages because of [your/his/her] high blood
(02) NO
pressure?]
(-8) Don't Know
(-9) Refused
IF HFT6G - HYPEMEDS = 1/Yes, GO TO HFT7 - HYPELONG.
ELSE GO TO HFT12A - HYPECTRL.
(01) [Continuous answer.]
How long [have you/has (SP)] been treated with prescribed medicines for [your/his/her] high blood pressure? (-8) Don't Know
(-9) Refused
(01) LESS THAN ONE YEAR
How long [have you/has (SP)] been treated with prescribed medicines for [your/his/her] high blood pressure?
(-7) Empty
IF SP IS IN THE SUPPLEMENTAL SAMPLE (sample_person.INTTYPE=3), GO TO HFT8 - HYPEMANY.
ELSE GO TO HFT11A - HYPECOND.
How many different prescribed medicines [do you/does (SP)] take for [your/his/her] high blood pressure?
(01) [Continuous answer.]
(-8) Don't Know
[WE ARE ASKING ABOUT HOW MANY DIFFERENT PRESCRIBED MEDICINES FOR HIGH BLOOD PRESSURE ARE
(-9) Refused
TAKEN BY THE RESPONDENT, NOT THE NUMBER OF PILLS THEY MIGHT TAKE IN ONE DAY.]
How old [were you/was (SP)] when [you were/he was/she was] first told that [you/he/she] had high blood
pressure?
How often [do you/does (SP)] have trouble with side effects from [your/his/her] blood pressure
(01) ALWAYS
medicines[s]? Please tell me if [you/he/she] always, sometimes, or never [have/has] trouble with side effects. (02) SOMETIMES
(03) NEVER
[EXPLAIN IF NECESSARY: By "side effects", I mean that the medicine causes any condition such as fatigue,
(-8) Don't Know
headache, or coughing.]
(-9) Refused
Doctors and other health professionals often recommend changing your habits or lifestyle, such as changing
your diet, or getting regular exercise in order to control blood pressure. How confident are you that
[you/(SP)] can follow these recommendation?
Would you say that you are very confident, confident, somewhat confident, or not at all confident?
(01) VERY CONFIDENT
(02) CONFIDENT
(03) SOMEWHAT CONFIDENT
(04) NOT AT ALL CONFIDENT
(-8) Don't Know
(-9) Refused
Health Functioning and Status (HFQ)
Variable Name
MR Screen Name
BOX HFT4
Question type
routing
Question text/description
IF HFT6G - HYPEMEDS = 1/Yes, GO TO HFT13 - HYPEPAY.
ELSE GO TO BOX HFEND.
HYPEPAY
HFT13
yes/no
[Do you/Does (SP)] have difficulty paying for the medicine[s] [your/his/her] doctor or other health
professional prescribes for [your/his/her] high blood pressure?
HYPESKIP
HFT14
yes/no
[Do you/Does (SP)] ever skip taking [your/his/her] medicine, take less medicine than prescribed, or share
medicine because of the cost of the medicine?
Code list
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
| File Type | application/pdf |
| Author | SLA |
| File Modified | 2017-10-24 |
| File Created | 2017-10-24 |