Veteran status
Ask of all persons age 18 or older.
Ask once at first interview. If blank or no, ask or verify at subsequent interviews.
Questions:
From the
American Community Survey (slightly modified to be asked directly of
R) –
Have
you ever served on active duty in the U.S. Armed Forces, Reserves,
or National Guard?
[Mark one box.]
Never served in the military
Only on active duty for training in the Reserves or National Guard
Now on active duty [Verify if person already said yes to Q20 on control card]
On active duty in the past, but not now
When did you serve on active duty in the U.S. Armed Forces? [Mark a box for each period in which the person served, even if just for part of the period.]
September 2001 or later
August 1990 to August 2001 (including Persian Gulf War)
May 1975 to July 1990
Vietnam era (August 1964 to April 1975)
February 1955 to July 1967
Korean War (July 1950 to January 1955)
January 1947 to June 1950
World War II (December 1941 to December 1946)
November 1941 or earlier
Citizenship
Ask of all persons age 12 or older.
Ask once. If blank or no, ask or verify at subsequent interviews.
Question:
From the American Community Survey (slightly modified to be asked
directly of R) –
Are you a citizen of the United
States? That is, were you a born in the United States, born in a U.S.
territory, born of U.S. citizen parent(s), or become a citizen of the
U.S. through naturalization?
Yes, born in the United States
Yes, born in Puerto Rico, Guam, the U.S. Virgin Islands, or Northern Marianas
Yes, born abroad of U.S. citizen parent or parents
Yes, U.S. citizen by naturalization
No, not a U.S. citizen
Disability
Ask of all persons age 12 or older.
Ask at 1st, 3rd, 5th, and 7th interview, or if never asked before.
Questions:
From the NCVS-2
–
Are
you deaf or do you have serious difficulty hearing?
Yes
No
Are you blind or do you have serious difficulty seeing even when wearing glasses?
Yes
No
Because of a physical, mental, or emotional condition, do you have serious difficulty…
a. Concentrating, remembering or making decisions?
Yes
No
b. Walking or climbing stairs?
Yes
No
c. Dressing or bathing?
Yes
No
Because of a physical, mental, or emotional condition, do you have difficulty doing errands alone such as visiting a doctor's office or shopping?
[NOTE: This question would be asked only of persons age 15 or older.]
Yes
No
NOTE: Disability items from the NCVS-2 will be dropped (168-173e).
Sexual orientation
Ask of all persons age 16 or older.
Ask at 1st, 3rd, 5th, and 7th interview, or if never asked before.
Questions:
From the National Health Interview Survey –
(NOTE: question numbers from cognitive testing are included for
reference to skip patterns, but the actual question numbers will
change)
Q24a. Which of the following best represents how you think
of yourself?
[If NCVS control card sex question = Male]
Gay [skip to Q27]
Straight, that is, not gay [skip to Q27]
Bisexual [skip to Q27]
Something else [skip to Q25]
I don’t know the answer [skip to Q26]
Refused [skip to Q27]
Q24b. Which of the following best represents how you think of yourself?
[If NCVS control card sex question = Female]
Lesbian or gay [skip to Q27]
Straight, that is, not lesbian or gay [skip to Q27]
Bisexual [skip to Q27]
Something else [ask Q25]
I don’t know the answer [skip to Q26]
Refused [skip to Q27]
Q25. What do you mean by something else?
You are not straight, but identify with another label such as queer, trisexual, omnisexual or pansexual [skip to Q27]
You are transgender, transsexual or gender variant [skip to Q27]
You
have not figured out or are in the process of figuring out your
sexuality
[skip to Q27]
You do not think of yourself as having sexuality [skip to Q27]
You do not use labels to identify yourself [skip to Q27]
You mean something else [skip to Q27]
Refused [skip to Q27]
Don't know [skip to Q27]
Q26. What do you mean by don't know?
You don’t understand the words
You understand the words, but you have not figured out or are in the process of figuring out your sexuality
You mean something else
Refused
Don’t know
Gender identity
Ask of all persons age 16 or older.
Ask at 1st, 3rd, 5th, and 7th interview, or if never asked before.
Questions:
From the 2015 California Health Interview Survey
–
(NOTE: question numbers from cognitive testing are
included for reference to skip patterns, but the actual question
numbers will change)
Q27. On your original birth certificate, was your sex
assigned as male or female?
Male
Female
Refused
Don’t know
Q28a. Do you currently describe yourself as a man, woman, or transgender person?
Man [if Q27 ne Male, then skip to Q28c; else, skip to next section]
Woman [if Q27 ne Female, then skip to Q28c; else skip to next section]
Transgender person [skip to next section]
None of these [skip to Q28b]
Q28b. What is your current gender identity?
Specify ________________________ [skip to next section]
Refused [skip to next section]
Don’t know [skip to next section]
ASK IF Q27 and Q28a DO NOT MATCH
Q28c. Just to confirm, you were assigned {INSERT RESPONSE FROM Q27} at birth and now describe yourself as a {Q28a}. Is that correct?
Yes
No
Refused
Don’t
know
Household income
Ask of household respondent.
Ask at 1st, 3rd, 5th, and 7th interview. If blank, ask at 2nd, 4th, and 6th interview.
Current item:
Which category on this card represents the TOTAL combined income of all members of this HOUSEHOLD during the past 12 months? This includes money from jobs, net income from business, farm or rent, pensions, dividends, interest, Social Security payments, and any other money income received by members of this HOUSEHOLD who are 14 years of age or older.
Less than $5,000
$5,000 to $7,499
$7,500 to $9,999
$10,000 to $12,499
$12,500 to $14,999
$15,000 to $17,499
$17,500 to $19,999
$20,000 to $24,999
$25,000 to $29,999
$30,000 to $34,999
$35,000 to $39,999
$40,000 to $49,999
$50,000 to $74,999
$75,000 and over
Refused
Missing
Revised item:
Which category on this card represents the TOTAL combined income of all members of this HOUSEHOLD during the past 12 months? This includes money from jobs, net income from business, farm or rent, pensions, dividends, interest, Social Security payments, and any other money income received by members of this HOUSEHOLD who are 14 years of age or older.
Less than $5,000
$5,000 to $7,499
$7,500 to $9,999
$10,000 to $12,499
$12,500 to $14,999
$15,000 to $17,499
$17,500 to $19,999
$20,000 to $24,999
$25,000 to $29,999
$30,000 to $34,999
$35,000 to $39,999
$40,000 to $49,999
$50,000 to $74,999
$75,000 to $99,999
$100,000 to $149,999
$150,000 to $199,999
$200,000 or more
Refused
Missing
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Truman, Jennifer |
File Modified | 0000-00-00 |
File Created | 2021-01-21 |