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pdf2017 MCBS Community Questionnaire
Variable Name
MR Screen Name
Question Type
IAQ - Income and Assets
Question Text/Description
Code List
Routing
INCOME AND ASSETS QUESTIONNAIRE SPECIFICATIONS
CRITERIA
INTTYPE=C001, C002, C004, C005, C006, C008, C009, C010
SPALIVE=ALL
SEASON=SUMMER
SPPROXY=SP or PROXY
Other: N/A
PLACEMENT
Administer after PVQ.
Now I have some questions about income and other financial resources for [you/(SP)] [and (your/his/her)
(wife/husband/partner)].
LFINTRO1
LFINTRO1
no entry
As with all information collected by the MCBS, the data are confidential and covered by the Privacy Act of 1974.
(01) CONTINUE
Your answers will be combined with those of other respondents, and [your/his/her] Medicare benefits will not be
(-7) Empty
affected in any way by your answers to these questions.
LFINTRO2
GIVE BROCHURE TO RESPONDENT. ALLOW A FEW MINUTES FOR RESPONDENT TO REVIEW
BROCHURE IF NECESSARY.
BOX LFINTRO1
LFINTRO2
LFINTRO2
routing
If SPAISTATUS = 3 (Deceased in Community) or 4 (Deceased in Institutition), go to IAQ50 TOTAL_COMBINED1.
Otherwise, go to LIFINTRO2 - LFINTRO2.
As the brochure explains, your responses to these questions can help us determine the impact of income on
[your/his/her] use and access to health care. I will be asking a series of questions about [your/(SP’s)/you and
your (wife’s/husband’s/partner's)/(SP) and (his/her) (wife’s/husband’s/partner's)] income and other financial
resources. First, I will ask whether [you/(SP)/you and your (wife/husband/partner)/(SP) and (his/her)
(wife/husband/partner)] had particular types of income or other resources. All these questions can be answered
with a "yes" or a "no." Then, I will ask you to estimate [your/(SP's)/their] total income. [Please answer all
questions for [you and your (wife/husband/partner)/(SP) and (his/her) (wife/husband/partner)].
(01) CONTINUE
(-7) Empty
LF1
Did [you/(SP)] do any work for pay in the last week? By the last week, I mean the week beginning on Sunday
[MONTH, DAY OF SUNDAY PRIOR TO TODAY/MONTH, DAY OF SUNDAY PRIOR TO THE SATURDAY
BEFORE TODAY’S DATE] and ending [today/on Saturday (MONTH, DAY OF SATURDAY PRIOR TO TODAY’S
DATE)]?
(1) YES
(2) NO
(-8) DON’T KNOW
(-9) REFUSED
(1) LF4
(2) LF1B
(-8) BOX LF13
(-9) BOX LF13
code one
Is this because [you were/(SP) was] retired or [you/(SP)] never worked?
(01) RETIRED
(02) NEVER WORKED
(03) NO, NEITHER OF THESE IS TRUE
(-8) DON'T KNOW
(-8) REFUSED
(1) BOX LF13
(2) BOX LF13
(3) LF2
(-8) BOX LF13
(-9) BOX LF13
code one
(1) YES
[Do you/Does (SP)] have a job from which [you were/(he/she) was] absent last week because of illness, vacation, (2) NO
or some other reason?
(-8) DON’T KNOW
(-9) REFUSED
(1) LF4
(2) LF3
(-8) BOX LF13
(-9) BOX LF13
code one
(1) YES
Now think about last month, that is [MONTH BEFORE INTERVIEW MONTH]. Did [you/(SP)] do any work for pay (2) NO
at any time in the last month?
(-8) DON’T KNOW
(-9) REFUSED
(1) LF8
(2) BOX LF13
(-8) BOX LF13
(-9) BOX LF13
no entry
Please feel free to refer to any records or other persons who may be of assistance to you.
WORKWEEK
RETNEVWK
IAABSENT
WORKMONTH
MULTIJOB
LF1
LF1B
LF2
LF3
LF4
code one
yes/no
Last week, did [you/(SP)] have more than one job, including part-time, evening, or weekend work?
How many hours per week [do you/does (SP)] usually work at [your/his/her] [job/main job]? [By main job, I mean
the job at which (you work/{he/she} works) the most hours.]
HOURSPERWEE
LF5
K
quantity unit
ENTER NUMBER OF HOURS USUALLY WORK
(1) YES
(2) NO
(-8) DON’T KNOW
(-9) REFUSED
LF5
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED
(1) BOX LF1
(-8) LF8
(-9) LF8
IF NUMBER OF HOURS VARY EACH WEEK, ENTER 997
Page 1 of 22
2017 MCBS Community Questionnaire
Variable Name
HOURSLASTWE
EK1
HOURSLASTWE
EK2
IAQ - Income and Assets
MR Screen Name
Question Type
Question Text/Description
BOX LF1
routing
If LF2=1 (YES, ABSENT LAST WEEK), go to LF7.
Otherwise, go to LF6.
LF6
quantity unit
How many hours did [you/(SP)] work last week?
ENTER NUMBER OF HOURS
LF7
quantity unit
You said [you were/(SP) was] absent from work last week. How many hours did [you/he/she] work the last week
[you were/(he/she) was] at work?
ENTER NUMBER OF HOURS
PAYSCHEDULE
LF8
OSPAYSCHEDUL
LF8A
E
Code List
Routing
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED
(1) LF8
(-8) LF8
(-9) LF8
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED
LF8
(1) LF9
(2) LF9
(3) LF9
(4) LF9
(5) LF9
(9) LF8A
(-8) LF9
(-9) LF9
code one
[Are you/Is (SP)/In (your/{SP}’s)] main job, [are you/is (he/she)] paid every week, every two weeks, two times a
month, or on some other schedule?
(1) EVERY WEEK
(2) EVERY TWO WEEKS
(3) TWO TIMES A MONTH
(4) ONCE A MONTH
(5) DAILY
(9) OTHER SCHEDULE (SPECIFY)
(-8) DON’T KNOW
(-9) REFUSED
verbatim
SPECIFY OTHER PAYMENT SCHEDULE
(1) [continuous response]
LF9
(1) ENTER PAYCHECK AMOUNT
(2) ENTER PAY PER HOUR
(3) ENTER PAY PER DAY
(-8) DON’T KNOW
(-9) REFUSED
(1) LF9A
(2) LF9B
(3) LF9C
(-8) BOX LF13
(-9) BOX LF13
(1) [continuous response]
LF10
(1) [continuous response]
LF10
(1) [continuous response]
LF10
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED
BOX LF13
(1) YES
(2) NO
(-8) DON’T KNOW
(-9) REFUSED
(1) LF14
(2) HO1
(-8) HO1
(-9) HO1
How much was [your/(SP)’s] last paycheck before taxes and any other deductions [for (your/his/her) main job]?
IF NEEDED: We don’t need an exact dollar amount. An approximate amount is fine.
LASTPAYCHECK LF9
code one
IF NEEDED: If it is easier, you can just tell me how much [you earn/(SP) earns] per hour or per day.
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to understand
how people manage financially as they age and what effect this might have on their health.
ENTER PAYCHECK AMOUNT
PAYCHECKAMT
LF9A
quantity unit
$
PAYCHECKHOU
RLY
ENTER PAY PER HOUR
LF9B
quantity unit
$
ENTER PAY PER DAY
PAYCHECKDAILY LF9C
quantity unit
$
Now thinking about the month of [CURRENT MONTH -1 MONTH], how much did [you/(SP)] earn altogether from
any work [you/he/she] did in [CURRENT MONTH -1 MONTH], before taxes and before any other deductions?
IF NEEDED: We don’t need an exact dollar amount. An approximate amount is fine.
MONTHPAY
LF10
quantity unit
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to understand
how people manage financially as they age and what effect this might have on their health.
ENTER DOLLAR AMOUNT
$
BOX LF13
SPOUSEWORK
LF13
routing
If the SP has a spouse or partner who is living in the household (ROSTREL=2 or 56, HHFLAG=1), go to LF13.
Otherwise, go to HO1.
code one
Did [you/(your/{SP}’s) (husband/wife/partner)] do any work for pay in the month of [CURRENT MONTH-1
MONTH]?
Page 2 of 22
2017 MCBS Community Questionnaire
Variable Name
MR Screen Name
Question Type
IAQ - Income and Assets
Question Text/Description
Code List
Routing
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED
HO1
In [CURRENT MONTH -1 MONTH], how much altogether did [you/your/(SP)’s] [husband/wife/partner] earn before
taxes and before any other deductions?
IF NEEDED: We don’t need an exact dollar amount. An approximate amount is fine.
SPOUSEEARN
LF14
quantity unit
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to understand
how people manage financially as they age and what effect this might have on their health.
ENTER DOLLAR AMOUNT
$
IAOWNHOME
MORTGAGE
HO1
HO2
code one
code one
Next, I'd like to ask you some questions about the [home/apartment or condo] [at SP’s (ADDRESS 1, ADDRESS
(1) OWN
2) from PERSON ROSTER].
(2) RENT (OR PAY MONTHLY AMOUNT)
(3) SOME OTHER ARRANGEMENT
[Do you/Does (SP)] [or (SP FIRSTNAME LASTNAME)/(SPOUSE FIRSTNAME LASTNAME)/(PARTNER
(-8) DON’T KNOW
FIRSTNAME LASTNAME)] own the [home/apartment or condo] at [SP’s (ADDRESS 1, ADDRESS 2) from
(-9) REFUSED
PERSON ROSTER], rent it, or is there some other arrangement?
Is [your/(SP)’s] [or (SP FIRSTNAME LASTNAME)/(SPOUSE FIRSTNAME LASTNAME)/(PARTNER
FIRSTNAME LASTNAME)'s] mortgage paid off or are monthly mortgage payments still being made?
IF NEEDED: Include any payments on a home equity loan or second mortgage.
MORTGAGE_AM
HO3
T1
How much altogether is that each month?
quantity unit
ENTER DOLLAR AMOUNT
SHOW CARD IA1
MORTGATE_AMT
HO3A
2
code one
Please look at this card and tell me which is closest.
IF NEEDED: Include any payments on a home equity loan or second mortgage.
MORTGAGELGN
HO3B
TH
code one
[Do you/Does (SP)] [or (SP FIRSTNAME LASTNAME)/(SPOUSE FIRSTNAME LASTNAME)/(PARTNER
FIRSTNAME LASTNAME)] expect to pay off the mortgage within 5 years, 10 years, or longer?
IF NEEDED: Include any payments on a home equity loan or second mortgage.
(1) HO2
(2) HO6
(3) HO5
(-8) HO5
(-9) HO5
(1) PAID OFF
(2) STILL MAKE PAYMENTS
(3) REVERSE MORTGAGE
(-8) DON’T KNOW
(-9) REFUSED
(1) HO4
(2) HO3
(3) HO4
(-8) HO4
(-9) HO4
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED
(1) HO3B
(-8) HO3A
(-9) HO3B
(1) LESS THAN $250
(2) $250 TO LESS THAN $500
(3) $500 TO LESS THAN $1,000
(4) $1,000 TO LESS THAN $3,000
(5) $3,000 TO LESS THAN $5,000
(6) $5,000 OR MORE
(-8) DON’T KNOW
(-9) REFUSED
HO3B
(1) WITHIN 5 YEARS
(2) WITHIN 10 YEARS
(3) LONGER THAN 10 YEARS
(-8) DON’T KNOW
(-9) REFUSED
HO3C
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED
(1) HO4
(-8) HO3D
(-9) HO4
(1) less than $50,000,
(2) $50,000 to less than $100,000, or
(3) $100,000 or more?
(-8) DON’T KNOW
(-9) REFUSED
HO4
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED
(1) IAQINTRO1
(-8) HO4A
(-9) IAQINTRO1
About how much [do you/does (SP)] [or (SP FIRSTNAME LASTNAME)/(SPOUSE FIRSTNAME
LASTNAME)/(PARTNER FIRSTNAME LASTNAME)] still owe on the mortgage?
IF NEEDED: The nearest $10,000 is fine.
MORTGAGEOWE
HO3C
1
quantity unit
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to understand
how people manage financially as they age and what effect this might have on their health.
IF NEEDED: Include any payments on a home equity loan or second mortgage.
ENTER DOLLAR AMOUNT
MORTGAGEOWE
HO3D
2
code one
Is the amount owed…
What is the present value of this [home/apartment or condo]? I mean, about what would it bring if it was sold
today, not counting any loans or outstanding mortgages?
PRESENTVALUE
HO4
1
IF NEEDED: Your best guess or the nearest $10,000 is fine.
quantity unit
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to understand
how people manage financially as they age and what effect this might have on their health.
ENTER DOLLAR AMOUNT
Page 3 of 22
2017 MCBS Community Questionnaire
Variable Name
MR Screen Name
PRESENTVALUE
HO4A
2
Question Type
IAQ - Income and Assets
Question Text/Description
SHOW CARD IA2
code one
Please look at this card and tell me which is closest.
PAYRENT
HO5
yes/no
RENTAMT1
HO6
quantity unit
[Do you/Does (SP)] [or (SP FIRSTNAME LASTNAME)/(SPOUSE FIRSTNAME LASTNAME)/(PARTNER
FIRSTNAME LASTNAME)] pay rent to live here?
How much is that each month?
ENTER DOLLAR AMOUNT
SHOW CARD IA3
RENTAMT2
HO6A
code one
Please look at this card and tell me which is closest.
BOX HO1
SECTION8
HO7
routing
yes/no
Code List
Routing
(1) LESS THAN $50,000
(2) $50,000 TO LESS THAN $75,000
(3) $75,000 TO LESS THAN $100,000
(4) $100,000 TO LESS THAN $200,000
(5) $200,000 TO LESS THAN $300,000
(6) $300,000 TO LESS THAN $500,000
(7) $500,000 TO LESS THAN $750,000
(8) $750,000 OF MORE
(-8) DON’T KNOW
(-9) REFUSED
IAQINTRO1
(1) YES
(2) NO
(-8) DON’T KNOW
(-9) REFUSED
(1) HO6
(2) IAQINTRO1
(-8) IAQINTRO1
(-9) IAQINTRO1
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED
(1) IAQINTRO1
(-8) HO6A
(-9) HO6A
(1) LESS THAN $250
(2) $250 TO LESS THAN $500
(3) $500 TO LESS THAN $1,000
(4) $1,000 TO LESS THAN $3,000
(5) $3,000 TO LESS THAN $5,000
(6) $5,000 OR MORE
(-8) DON’T KNOW
(-9) REFUSED
BOX HO1
(1) YES
(2) NO
(-8) DON’T KNOW
(-9) REFUSED
IAQINTRO1
If HO6>=$750 or HO6A=4 ($1,000 TO LESS THAN $3,000), 5 ($3,000 TO LESS THAN $5,000), OR 6 ($5,000
OR MORE) go to IAQINTRO1.
Otherwise, go to HO7.
Is this home in Section 8 or public housing or housing for low-income seniors?
We are interested in how people are getting along financially these days. The next few questions are about
income and other resources. Your responses can help us understand how people manage financially as they
age.
IAQINTRO1
IAQINTRO1
no entry
Please feel free to refer to any records or other persons that may be of assistance in answering these questions.
Many of these questions ask about “last month.” By last month, I mean in [CURRENT MONTH – 1].
SSRR_LASTMON
IAQ1
TH
BOX IAQ1
code all
Did [you/(SP)] [or (SP FIRSTNAME LASTNAME)/(SPOUSE FIRSTNAME LASTNAME)/(PARTNER FIRSTNAME
(1) YES, SP RECEIVED PAYMENT FROM SOURCE
LASTNAME)] receive Social Security retirement and/or Railroad Retirement payments in the last month, that is in
(2) YES, SPOUSE/PARTNER RECEIVED PAYMENT
[CURRENT MONTH –1]?
FROM
SOURCE
IF NEEDED: These checks are either automatically deposited in the bank or mailed to arrive on the 3rd of every
(3) NO PAYMENT RECEIVED FROM THIS SOURCE
month. If mailed, they are often sent in gold or manila-colored envelopes.
(-8) DON’T KNOW
(-9) REFUSED
[SELECT ALL THAT APPLY]
routing
IF IAQ1 NE (1) SP PAYMENT THEN GO TO IAQ4, ELSE GO TO IAQ2
SSDEPOSIT
IAQ2
code one
[Do you/Does (SP)] get payments by direct deposit, on a prepaid card, or by mail?
(1) MAIL
(2) DIRECT DEPOSIT
(3) PREPAID CARD
(-8) DON’T KNOW
(-9) REFUSED
MMSTARTSS
IAQ3
quantity unit
What month and year did [you/(SP)] start receiving Social Security?
[ENTER MONTH AND YEAR]
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED
(1) BOX IAQ1
(2) BOX IAQ1
(3) IAQ4
(-8) IAQ4
(-9) IAQ4
IAQ3-MMSTARTSS
IAQ3-YYSTARTSS
Page 4 of 22
2017 MCBS Community Questionnaire
IAQ - Income and Assets
Variable Name
MR Screen Name
Question Type
Question Text/Description
Code List
Routing
YYSTARTSS
IAQ3
quantity unit
What month and year did [you/(SP)] start receiving Social Security?
[ENTER MONTH AND YEAR]
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED
IAQ4
code all
(1) YES, SP RECEIVED PAYMENT FROM SOURCE
Did [you/(SP)] [or (SP FIRSTNAME LASTNAME)/(SPOUSE FIRSTNAME LASTNAME)/(PARTNER FIRSTNAME
(2) YES, SPOUSE/PARTNER RECEIVED PAYMENT
LASTNAME)] receive Supplemental Security Income, which is also called SSI, last month?
FROM
SOURCE
IF NEEDED: These are monthly government payments to lower-income people in need.
(3) NO PAYMENT RECEIVED FROM THIS SOURCE
(-8) DON’T KNOW
[SELECT ALL THAT APPLY]
(-9) REFUSED
IAQ5
code all
Did [you/(SP)] [or (SP FIRSTNAME LASTNAME)/(SPOUSE FIRSTNAME LASTNAME)/(PARTNER FIRSTNAME (1) YES, SP RECEIVED PAYMENT FROM SOURCE
LASTNAME)] receive any payments from the Veteran’s Administration, last month related to military service or
(2) YES, SPOUSE/PARTNER RECEIVED PAYMENT
veteran survivor’s benefits?
FROM
SOURCE
[IF NEEDED: The Veteran's Administration is also known as the U.S. Department of Veterans Affairs.]
(3) NO PAYMENT RECEIVED FROM THIS SOURCE
(-8) DON’T KNOW
[SELECT ALL THAT APPLY]
(-9) REFUSED
IAQ6
SSI_LASTMONTH IAQ4
VA_LASTMONTH IAQ5
People sometimes have other retirement income. This may be from pensions or retirement plans related to their
jobs.
PENSION_LASTM
IAQ6
ONTH
code all
[Do you/Does (SP)] [or (SP FIRSTNAME LASTNAME/SPOUSE FIRSTNAME LASTNAME/PARTNER
FIRSTNAME LASTNAME)] have any pension plans that were a job-related or union benefit?
IF NEEDED: These plans often require that a person work for a certain number of years before they qualify or
“are vested” in the pension plan.
(1) YES, SP HAS PENSION
(2) YES, SPOUSE/PARTNER HAS PENSION
(3) NO PENSIONS
(-8) DON’T KNOW
(-9) REFUSED
IAQ7
[SELECT ALL THAT APPLY]
SHOW CARD IA4
(1) YES, SP HAS 401K, 403B, IRA, OR OTHER
RETIREMENT PLANS
(2) YES, SPOUSE/PARTNER HAS 401K, 403B, IRA,
OR
IF NEEDED: 401Ks and 403Bs are plans where you contribute an amount each month from your paycheck, and
OTHER RETIREMENT PLANS
your employer may match some of your contribution.
(3) NO PLANS
(-8) DON’T KNOW
IF NEEDED: IRAs, also known as Individual Retirement Accounts, are a type of plan you set up on your own.
(-9) REFUSED
Please look at the types of retirement plans on this card. [Do you/Does (SP)] [or (SP FIRSTNAME
LASTNAME/SPOUSE FIRSTNAME LASTNAME/PARTNER FIRSTNAME LASTNAME)] have any of these?
401K_LASTMONT IAQ7
H
code all
IAQ8
[SELECT ALL THAT APPLY]
MUTUALFUNDS
BONDS
IAQ8
IAQ9
code all
(1) YES, SP HAS ASSET
[(Not including the retirement accounts we have already talked about, {do you/does [SP]})/(Do you/Does {SP})]
(2) YES, SPOUSE/PARTNER HAS ASSET
[or (SP FIRSTNAME LASTNAME)/(SPOUSE FIRSTNAME LASTNAME)/(PARTNER FIRSTNAME LASTNAME)] (3) YES, SP AND SPOUSE/PARTNER HAVE ASSET
own any mutual funds or stocks?
JOINTLY
(4) NO ASSET OF THIS TYPE
[SELECT ALL THAT APPLY]
(-8) DON’T KNOW
(-9) REFUSED
IAQ9
code all
(1) YES, SP HAS ASSET
Not including what we’ve already talked about, [do you/does (SP)] [or (SP FIRSTNAME
(2) YES, SPOUSE/PARTNER HAS ASSET
LASTNAME)/(SPOUSE FIRSTNAME LASTNAME)/(PARTNER FIRSTNAME LASTNAME)] own any bonds, such (3) YES, SP AND SPOUSE/PARTNER HAVE ASSET
as Government Savings Bonds, corporate, municipal, or other types of bonds?
JOINTLY
(4) NO ASSET OF THIS TYPE
[SELECT ALL THAT APPLY]
(-8) DON’T KNOW
(-9) REFUSED
IAQ10
The next questions ask about different kinds of bank or savings accounts people sometimes have or property
they own.
CHECKING
IAQ10
code all
Not counting what we’ve already talked about, [do you/does (SP)] [or (SP FIRSTNAME
LASTNAME)/(SPOUSE FIRSTNAME LASTNAME)/(PARTNER FIRSTNAME LASTNAME)] have...
A checking account?
(1) YES, SP HAS ASSET
(2) YES, SPOUSE/PARTNER HAS ASSET
(3) YES, SP AND SPOUSE/PARTNER HAVE ASSET
JOINTLY
(4) NO ASSET OF THIS TYPE
(-8) DON’T KNOW
(-9) REFUSED
IAQ11
Page 5 of 22
2017 MCBS Community Questionnaire
Variable Name
SAVINGS
MR Screen Name
IAQ11
Question Type
code all
IAQ - Income and Assets
Question Text/Description
[IF NEEDED: Not counting what we’ve already talked about, [do you/does (SP)] [or (SP FIRSTNAME
LASTNAME)/(SPOUSE FIRSTNAME LASTNAME)/(PARTNER FIRSTNAME LASTNAME)] have...]
A savings account or money market account?
CERTDEPOSIT
IAQ12
code all
[IF NEEDED: Not counting what we’ve already talked about, [do you/does (SP)] [or (SP FIRSTNAME
LASTNAME)/(SPOUSE FIRSTNAME LASTNAME)/(PARTNER FIRSTNAME LASTNAME)] have...]
Certificates of deposit?
OTHER_LAND
IAQ13
code all
[Do you/Does (SP)] [or (SP FIRSTNAME LASTNAME)/(SPOUSE FIRSTNAME LASTNAME)/(PARTNER
FIRSTNAME LASTNAME)] own a business, a farm, or any other real estate [besides (your/{SP}’s) home],
including land or rental properties?
[SELECT ALL THAT APPLY]
IAQINTRO2
IAQINTRO2
BOX IAQ2
no entry
We now have a few questions about income which are important for understanding how
people manage financially as they age.
routing
If IAQ1 = 1 (SP RECEIVED SS/RR) and 2 (SPOUSE RECEIVED SS/RR), go to IAQ14.
Else if IA1 = 1 (SP RECEIVED SS/RR), go to IAQ15A.
Else if IA1 = 2 (SPOUSE RECEIVED SS/RR), go to IAQ16A.
Otherwise, go to BOX IAQ3.
First, what was the amount of [your/(SP)’s] and [(SP FIRSTNAME LASTNAME)/(SPOUSE FIRSTNAME
LASTNAME)/(PARTNER FIRSTNAME LASTNAME)]’s most recent monthly Social Security or Railroad
Retirement payment (for the month of [CURRENT MONTH – 1])?
SSRR_COMBINE
IAQ14
D1
code one
IF NEEDED: We don’t need an exact dollar amount.
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to understand
how people manage financially as they age and what effect this might have on their health.
SSRR_COMBINE
IAQ14A
D2
SSRR_COMBINE
IAQ14B
D3
quantity unit
ENTER COMBINED SP AND SPOUSE/PARTNER SOCIAL SECURITY/RAILROAD RETIREMENT AMOUNT
SHOW CARD IA5
code one
Please look at this card and tell me which is closest.
Code List
Routing
(1) YES, SP HAS ASSET
(2) YES, SPOUSE/PARTNER HAS ASSET
(3) YES, SP AND SPOUSE/PARTNER HAVE ASSET
JOINTLY
(4) NO ASSET OF THIS TYPE
(-8) DON’T KNOW
(-9) REFUSED
IAQ12
(1) YES, SP HAS ASSET
(2) YES, SPOUSE/PARTNER HAS ASSET
(3) YES, SP AND SPOUSE/PARTNER HAVE ASSET
JOINTLY
(4) NO ASSET OF THIS TYPE
(-8) DON’T KNOW
(-9) REFUSED
IAQ13
(1) YES, SP HAS ASSET
(2) YES, SPOUSE/PARTNER HAS ASSET
(3) YES, SP AND SPOUSE/PARTNER HAVE ASSET
JOINTLY
(4) NO ASSET OF THIS TYPE
(-8) DON’T KNOW
(-9) REFUSED
IAQINTRO2
BOX IAQ2
(1) ENTER COMBINED AMOUNT
(2) ENTER SP AND SPOUSE/PARTNER AMOUNTS
SEPARATELY
(-8) DON’T KNOW
(-9) REFUSED
(1) IAQ14A
(2) IAQ15A
(-8) IAQ14B
(-9) IAQ14B
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED
(1) BOX IAQ3
(-8) IAQ14B
(-9) IAQ14B
(1) LESS THAN $1,300
(2) $1,300 TO LESS THAN $1,700
(3) $1,700 TO LESS THAN $2,200
(3) $2,200 TO LESS THAN $2,600
(5) $2,600 OR MORE
(-8) DON’T KNOW
(-9) REFUSED
BOX IAQ3
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED
(1) BOX IAQ2A
(-8) IAQ15B
(-9) IAQ15B
(1) LESS THAN $700
(2) $700 TO LESS THAN $1,000
(3) $1,000 TO LESS THAN $1,300
(4) $1,300 TO LESS THAN $1,600
(5) $1,600 OR MORE
(-8) DON’T KNOW
(-9) REFUSED
BOX IAQ2A
What was the amount of [your/(SP)’s] most recent monthly Social Security or Railroad Retirement payment (for
the month of [CURRENT MONTH – 1])?
IF NEEDED: We don’t need an exact dollar amount.
SSRR_SP_AMT1 IAQ15A
quantity unit
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to understand
how people manage financially as they age and what effect this might have on their health.
ENTER SP SOCIAL SECURITY/RAILROAD RETIREMENT AMOUNT
SHOW CARD IA6
SSRR_SP_AMT2 IAQ15B
code one
Please look at this card and tell me which is closest.
Page 6 of 22
2017 MCBS Community Questionnaire
Variable Name
IAQ - Income and Assets
MR Screen Name
Question Type
Question Text/Description
BOX IAQ2A
routing
If IAQ14 = 2 (ENTER SP AND SPOUSE/PARTNER AMOUNTS SEPARATELY), go to IAQ16A.
Otherwise, go to BOX IAQ3.
Code List
Routing
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED
(1) BOX IAQ3
(-8) IAQ16B
(-9) IAQ16B
(1) LESS THAN $700
(2) $700 TO LESS THAN $1,000
(3) $1,000 TO LESS THAN $1,300
(4) $1,300 TO LESS THAN $1,600
(5) $1,600 OR MORE
(-8) DON’T KNOW
(-9) REFUSED
BOX IAQ3
(1) ENTER COMBINED AMOUNT
(2) ENTER SP AND SPOUSE/PARTNER AMOUNTS
SEPARATELY
(-8) DON’T KNOW
(-9) REFUSED
(1) IAQ17A
(2) IAQ18A
(-8) IAQ17B
(-9) IAQ17B
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED
(1) BOX IAQ4
(-8) IAQ17B
(-9) IAQ17B
(1) LESS THAN $300
(2) $300 TO LESS THAN $700
(3) $700 TO LESS THAN $1,000
(4) $1,000 OR MORE
(-8) DON’T KNOW
(-9) REFUSED
BOX IAQ4
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED
(1) BOX IAQ3A
(-8) IAQ18B
(-9) IAQ18B
(1) LESS THAN $100
(2) $100 TO LESS THAN $200
(3) $200 TO LESS THAN $400
(4) $400 TO LESS THAN $700
(5) $700 OR MORE
(-8) DON’T KNOW
(-9) REFUSED
BOX IAQ3A
What was the amount of [your/(SPOUSE FIRSTNAME LASTNAME)'s/(PARTNER FIRSTNAME LASTNAME)’s]
most recent monthly Social Security or Railroad Retirement payment (for the month of [CURRENT MONTH –
1])?
SSRR_SPOUSE_
IAQ16A
AMT1
quantity unit
IF NEEDED: We don’t need an exact dollar amount.
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to understand
how people manage financially as they age and what effect this might have on their health.
ENTER SPOUSE/PARTNER SOCIAL SECURITY/RAILROAD RETIREMENT AMOUNT
SSRR_SPOUSE_
IAQ16B
AMT2
BOX IAQ3
SHOW CARD IA6
code one
Please look at this card and tell me which is closest.
routing
If IAQ4 = 1 (SP RECEIVED SSI) and 2 (SPOUSE RECEIVED SSI), go to IAQ17.
Else if IAQ4 = 1 (SP RECEIVED SSI), go to IAQ18A.
Else if IAQ4 = 2 (SPOUSE RECEIVED SSI), go to IAQ19A.
Otherwise, go to BOX IAQ4.
What was the amount of [your/(SP)’s] and [(SP FIRSTNAME LASTNAME)/(SPOUSE FIRSTNAME
LASTNAME)/(PARTNER FIRSTNAME LASTNAME)]’s most recent monthly SSI payment (for the month of
[CURRENT MONTH – 1])?
SSRR_COMBINE
IAQ17
D1
code one
IF NEEDED: We don’t need an exact dollar amount.
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to understand
how people manage financially as they age and what effect this might have on their health.
SSRR_COMBINE
IAQ17A
D2
SSRR_COMBINE
IAQ17B
D3
quantity unit
ENTER COMBINED SP AND SPOUSE/PARTNER SSI AMOUNT
SHOW CARD IA7
code one
Please look at this card and tell me which is closest.
What was the amount of [your/(SP)’s] most recent monthly SSI payment (for the month of [CURRENT MONTH –
1])?
IF NEEDED: We don’t need an exact dollar amount.
SSI_SP_AMT1
IAQ18A
quantity unit
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to understand
how people manage financially as they age and what effect this might have on their health.
ENTER SP SSI AMOUNT
SHOW CARD IA8
SSI_SP_AMT2
IAQ18B
code one
Please look at this card and tell me which is closest.
BOX IAQ3A
routing
If IAQ17 = 2 (ENTER SP AND SPOUSE/PARTNER AMOUNTS SEPARATELY), go to IAQ19A.
Otherwise, go to BOX IAQ4.
Page 7 of 22
2017 MCBS Community Questionnaire
Variable Name
MR Screen Name
Question Type
IAQ - Income and Assets
Question Text/Description
Code List
Routing
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED
(1) BOX IAQ4
(-8) IAQ19B
(-9) IAQ19B
(1) LESS THAN $100
(2) $100 TO LESS THAN $200
(3) $200 TO LESS THAN $400
(4) $400 TO LESS THAN $700
(5) $700 OR MORE
(-8) DON’T KNOW
(-9) REFUSED
BOX IAQ4
(1) ENTER COMBINED AMOUNT
(2) ENTER SP AND SPOUSE/PARTNER AMOUNTS
SEPARATELY
(-8) DON’T KNOW
(-9) REFUSED
(1) IAQ20A
(2) IAQ21A
(-8) IAQ20B
(-9) IAQ20B
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED
(1) BOX IAQ5
(-8) IAQ20B
(-9) IAQ20B
(1) LESS THAN $1,000
(2) $1,000 TO LESS THAN $1,400
(3) $1,400 TO LESS THAN $1,800
(4) $1,800 TO LESS THAN $2,200
(5) $2,200 OR MORE
(-8) DON’T KNOW
(-9) REFUSED
BOX IAQ5
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED
(1) BOX IAQ4A
(-8) IAQ21B
(-9) IAQ21B
(1) LESS THAN $500
(2) $500 TO LESS THAN $700
(3) $700 TO LESS THAN $900
(4) $900 TO LESS THAN $1,100
(5) $1,100 OR MORE
(-8) DON’T KNOW
(-9) REFUSED
BOX IAQ4A
What was the amount of [your/(SPOUSE FIRSTNAME LASTNAME)'s/(PARTNER FIRSTNAME LASTNAME)'s]
most recent monthly SSI payment (for the month of [CURRENT MONTH – 1])?
SSI_SPOUSE_AM
IAQ19A
T3
IF NEEDED: We don’t need an exact dollar amount.
quantity unit
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to understand
how people manage financially as they age and what effect this might have on their health.
ENTER SPOUSE/PARTNER SSI AMOUNT
SSI_SPOUSE_AM
IAQ19B
T4
BOX IAQ4
SHOW CARD IA8
code one
Please look at this card and tell me which is closest.
routing
If IAQ5 = 1 (SP RECEIVED VA) and 2 (SPOUSE RECEIVED VA), go to IAQ20.
Else if IAQ5 = 1 (SP RECEIVED VA), go to IA21A.
Else if IAQ5 = 2 (SPOUSE RECEIVED VA), go to IAQ22A.
Otherwise, go to BOX IAQ5.
What was the amount of [your/(SP)’s] and [(SP FIRSTNAME LASTNAME)/(SPOUSE FIRSTNAME
LASTNAME)/(PARTNER FIRSTNAME LASTNAME)]’s most recent monthly Veteran’s Administration payment
(for the month of [CURRENT MONTH – 1])?
VA_AMT_COMBI
IAQ20
NED1
code one
IF NEEDED: We don’t need an exact dollar amount.
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to understand
how people manage financially as they age and what effect this might have on their health.
VA_AMT_COMBI
IAQ20A
NED2
VA_AMT_COMBI
IAQ20B
NED3
quantity unit
ENTER COMBINED SP AND SPOUSE/PARTNER VA AMOUNT
SHOW CARD IA9
code one
Please look at this card and tell me which is closest.
What was the amount of [your/(SP)’s] most recent monthly Veteran’s Administration payment (for the month of
[CURRENT MONTH – 1])?
IF NEEDED: We don’t need an exact dollar amount.
VA_SP_AMT1
IAQ21A
quantity unit
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to understand
how people manage financially as they age and what effect this might have on their health.
ENTER SP VA AMOUNT
SHOW CARD IA10
VA_SP_AMT2
IAQ21B
code one
Please look at this card and tell me which is closest.
BOX IAQ4A
routing
If IAQ20 = 2 (ENTER SP AND SPOUSE/PARTNER AMOUNTS SEPARATELY), go to IAQ22A.
Otherwise, go to BOX IAQ5.
Page 8 of 22
2017 MCBS Community Questionnaire
Variable Name
MR Screen Name
Question Type
IAQ - Income and Assets
Question Text/Description
Code List
Routing
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED
(1) BOX IAQ5
(-8) IAQ22B
(-9) IAQ22B
(1) LESS THAN $500
(2) $500 TO LESS THAN $700
(3) $700 TO LESS THAN $900
(4) $900 TO LESS THAN $1,100
(5) $1,100 OR MORE
(-8) DON’T KNOW
(-9) REFUSED
BOX IAQ5
(1) ENTER COMBINED AMOUNT
(2) ENTER SP AND SPOUSE/PARTNER AMOUNTS
SEPARATELY
(-8) DON’T KNOW
(-9) REFUSED
(1) IAQ23A
(2) IAQ24A
(-8) IAQ23B
(-9) IAQ23B
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED
(1) BOX IAQ6
(-8) IAQ23B
(-9) IAQ23B
(1) LESS THAN $600
(2) $600 TO LESS THAN $1,300
(3) $1,300 TO LESS THAN $2,100
(4) $2,100 TO LESS THAN $5,900
(5) $5,900 OR MORE
(-8) DON’T KNOW
(-9) REFUSED
BOX IAQ6
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED
(1) BOX IAQ5A
(-8) IAQ24B
(-9) IAQ24B
(1) LESS THAN $400
(2) $400 TO LESS THAN $900
(3) $900 TO LESS THAN $1,600
(4) $1,600 TO LESS THAN $3,800
(5) $3,800 OR MORE
(-8) DON’T KNOW
(-9) REFUSED
BOX IAQ5A
What was the amount of [your/(SPOUSE FIRSTNAME LASTNAME)/(PARTNER FIRSTNAME LASTNAME)’s]
most recent monthly Veteran’s Administration payment (for the month of [CURRENT MONTH – 1])?
VA_SPOUSE_AM
IAQ22A
T1
IF NEEDED: We don’t need an exact dollar amount.
quantity unit
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to understand
how people manage financially as they age and what effect this might have on their health.
ENTER SPOUSE/PARTNER VA AMOUNT
VA_SPOUSE_AM
IAQ22B
T2
BOX IAQ5
PENSION_COMBI
IAQ23
NED1
SHOW CARD IA10
code one
Please look at this card and tell me which is closest.
routing
If IAQ6 = 1 (SP RECEIVED PENSION PLAN) and 2 (SPOUSE RECEIVED PENSION PLAN), go to IAQ23.
Else if IAQ6 = 1 (SP RECEIVED PENSION PLAN), go to IAQ24A.
Else if IAQ6 = 2 (SPOUSE RECEIVED PENSION PLAN), go to IAQ25A.
Otherwise, go to BOX IAQ6.
You told me earlier that [you/(SP)] and [({SP FIRSTNAME LASTNAME}/{SPOUSE FIRSTNAME
LASTNAME}/{PARTNER FIRSTNAME LASTNAME}] have job-related pension plans. In all, how much was
received from these pension plans in the last month, before any federal or state taxes were taken out (for the
month of [CURRENT MONTH – 1])?
code one
IF NEEDED: We don’t need an exact dollar amount.
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to understand
how people manage financially as they age and what effect this might have on their health.
PENSION_COMBI
IAQ23A
NED2
PENSION_COMBI
IAQ23B
NED3
quantity unit
ENTER COMBINED SP AND SPOUSE/PARTNER PENSION PLAN AMOUNT
SHOW CARD IA11
code one
Please look at this card and tell me which is closest.
[You told me earlier that (you have/{SP} has) a job-related pension plan.] In all, how much was received from
[(your/{SP}'s) job-related/this] pension plan in the last month, before any federal or state taxes were taken out (for
the month of [CURRENT MONTH – 1])?
PENSION_SP_A
MT1
IAQ24A
quantity unit
IF NEEDED: We don’t need an exact dollar amount.
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to understand
how people manage financially as they age and what effect this might have on their health.
ENTER SP PENSION PLAN AMOUNT
PENSION_SP_A
MT2
SHOW CARD IA12
IAQ24B
code one
Please look at this card and tell me which is closest.
BOX IAQ5A
routing
If IAQ23 = 2 (ENTER SP AND SPOUSE/PARTNER AMOUNTS SEPARATELY), go to IAQ25A.
Otherwise, go to BOX IAQ6.
Page 9 of 22
2017 MCBS Community Questionnaire
Variable Name
MR Screen Name
Question Type
IAQ - Income and Assets
Question Text/Description
Code List
Routing
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED
(1) BOX IAQ6
(-8) IAQ25B
(-9) IAQ25B
(1) LESS THAN $400
(2) $400 TO LESS THAN $900
(3) $900 TO LESS THAN $1,600
(4) $1,600 TO LESS THAN $3,800
(5) $3,800 OR MORE
(-8) DON’T KNOW
(-9) REFUSED
BOX IAQ6
(1) ENTER COMBINED AMOUNT
(2) ENTER SP AND SPOUSE/PARTNER AMOUNTS
SEPARATELY
(-8) DON’T KNOW
(-9) REFUSED
(1) IAQ26A
(2) IAQ27A
(-8) IAQ26B
(-9) IAQ26B
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED
(1) BOX IAQ7
(-8) IAQ26B
(-9) IAQ26B
(1) LESS THAN $34,000
(2) $34,000 TO LESS THAN $82,000
(3) $82,000 TO LESS THAN $175,000
(4) $175,000 TO LESS THAN $413,000
(5) $413,000 OR MORE
(-8) DON’T KNOW
(-9) REFUSED
BOX IAQ7
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED
(1) BOX IAQ6A
(-8) IAQ27B
(-9) IAQ27B
(1) LESS THAN $20,000
(2) $20,000 TO LESS THAN $47,000
(3) $47,000 TO LESS THAN $92,000
(4) $92,000 TO LESS THAN $218,000
(5) $218,000 OR MORE
(-8) DON’T KNOW
(-9) REFUSED
BOX IAQ6A
[You told me earlier that (you have/{(SPOUSE FIRSTNAME LASTNAME)/(PARTNER FIRSTNAME LASTNAME)
has}) a job-related pension plan.] In all, how much was received from [(your/{SPOUSE FIRSTNAME
LASTNAME}'s/{PARTNER FIRSTNAME LASTNAME}'s job-related)/this] pension plan in the last month, before
any federal or state taxes were taken out (for the month of [CURRENT MONTH – 1])?
PENSION_SPOU
IAQ25A
SE_AMT1
quantity unit
IF NEEDED: We don’t need an exact dollar amount.
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to understand
how people manage financially as they age and what effect this might have on their health.
ENTER SPOUSE/PARTNER PENSION PLAN AMOUNT
PENSION_SPOU
IAQ25B
SE_AMT2
BOX IAQ6
SHOW CARD IA12
code one
Please look at this card and tell me which is closest.
routing
If IAQ7 = 1 (SP HAS RETIREMENT ACCT) and 2 (SPOUSE HAS RETIREMENT ACCT), go to IAQ26.
Else if IAQ7 = 1 (SP HAS RETIREMENT ACCT), go to IAQ27A.
Else if IAQ7 = 2 (SPOUSE HAS RETIREMENT ACCT), go to IAQ28A.
Otherwise, go to BOX IAQ9.
This next question is a bit different. You mentioned that [you/(SP)] and [(SP FIRSTNAME
LASTNAME)/(SPOUSE FIRSTNAME LASTNAME)/(PARTNER FIRSTNAME LASTNAME)] have retirement
accounts. In total, about how much is currently in all of these retirement accounts?
401K_COMBINED
IAQ26
1
code one
IF NEEDED: Retirement accounts include 401K, 403B, IRA, and other retirement accounts.
IF NEEDED: We don’t need an exact dollar amount.
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to understand
how people manage financially as they age and what effect this might have on their health.
401K_COMBINED
IAQ26A
2
401K_COMBINED
IAQ26B
3
quantity unit
ENTER COMBINED SP AND SPOUSE/PARTNER RETIREMENT ACCOUNT AMOUNT
SHOW CARD IA13
code one
Please look at this card and tell me which is closest.
This next question is a bit different. You mentioned that [you have/(SP) has] retirement accounts. In total, about
how much is currently in all of these retirement accounts?
IF NEEDED: Retirement accounts include 401K, 403B, IRA and other retirement accounts.
401K_SP_AMT1
IAQ27A
quantity unit
IF NEEDED: We don’t need an exact dollar amount.
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to understand
how people manage financially as they age and what effect this might have on their health.
ENTER SP RETIREMENT ACCOUNT AMOUNT
SHOW CARD IA14
401K_SP_AMT2
IAQ27B
code one
Please look at this card and tell me which is closest.
Page 10 of 22
2017 MCBS Community Questionnaire
Variable Name
IAQ - Income and Assets
MR Screen Name
Question Type
Question Text/Description
BOX IAQ6A
routing
If IAQ26 = 2 (ENTER SP AND SPOUSE/PARTNER AMOUNTS SEPARATELY), go to IAQ28A.
Otherwise, go to BOX IAQ7.
Code List
Routing
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED
(1) BOX IAQ7
(-8) IAQ28B
(-9) IAQ28B
(1) LESS THAN $20,000
(2) $20,000 TO LESS THAN $47,000
(3) $47,000 TO LESS THAN $92,000
(4) $92,000 TO LESS THAN $218,000
(5) $218,000 OR MORE
(-8) DON’T KNOW
(-9) REFUSED
BOX IAQ7
(1) ENTER COMBINED AMOUNT
(2) ENTER SP AND SPOUSE/PARTNER AMOUNTS
SEPARATELY
(-8) DON’T KNOW
(-9) REFUSED
(1) IAQ29A
(2) IAQ30A
(-8) IAQ29B
(-9) IAQ29B
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED
(1) BOX IAQ8
(-8) IAQ29B
(-9) IAQ29B
(1) LESS THAN $200
(2) $200 TO LESS THAN $500
(3) $500 TO LESS THAN $1,000
(4) $1,000 TO LESS THAN $2,500
(5) $2,500 OR MORE
(-8) DON’T KNOW
(-9) REFUSED
BOX IAQ8
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED
(1) BOX IAQ7A
(-8) IAQ30B
(-9) IAQ30B
(1) LESS THAN $100
(2) $100 TO LESS THAN $300
(3) $300 TO LESS THAN $700
(4) $700 TO LESS THAN $1,700
(5) $1,700 OR MORE
(-8) DON’T KNOW
(-9) REFUSED
BOX IAQ7A
This next question is a bit different. You mentioned that [you have/({SPOUSE FIRSTNAME
LASTNAME}/{PARTNER FIRSTNAME LASTNAME} has)] retirement accounts. In total, about how much is
currently in all of these retirement accounts?
IF NEEDED: Retirement accounts include 401K, 403B, IRA and other retirement accounts.
401K_SPOUSE_A
IAQ28A
MT1
quantity unit
IF NEEDED: We don’t need an exact dollar amount.
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to understand
how people manage financially as they age and what effect this might have on their health.
ENTER SPOUSE/PARTNER RETIREMENT ACCOUNT AMOUNT
401K_SPOUSE_A
IAQ28B
MT2
BOX IAQ7
SHOW CARD IA14
code one
Please look at this card and tell me which is closest.
routing
If IAQ7 = 1 (SP HAS RETIREMENT ACCT) and 2 (SPOUSE HAS RETIREMENT ACCT), go to IAQ29.
Else if IAQ7 = 1 (SP HAS RETIREMENT ACCT), go to IAQ30A.
Else if IAQ7 = 2 (SPOUSE HAS RETIREMENT ACCT), go to IAQ31A.
Otherwise, go to BOX IAQ8.
Last month, how much altogether did [you/(SP)] and [(SP FIRSTNAME LASTNAME)/(SPOUSE FIRSTNAME
LASTNAME)/(PARTNER FIRSTNAME LASTNAME)] receive or withdraw from all of these retirement accounts
(for the month of [CURRENT MONTH – 1])?
RECIEVE_COMBI
IAQ29
NED1
code one
IF NEEDED: We don’t need an exact dollar amount.
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to understand
how people manage financially as they age and what effect this might have on their health.
RECIEVE_COMBI
IAQ29A
NED2
RECIEVE_COMBI
IAQ29B
NED3
quantity unit
ENTER COMBINED SP AND SPOUSE/PARTNER RETIREMENT ACCOUNT RECEIVED/WITHDRAWN
AMOUNT
SHOW CARD IA15
code one
Please look at this card and tell me which is closest.
Last month, how much altogether did [you/(SP)] receive or withdraw from [your/his/her] retirement accounts (for
the month of [CURRENT MONTH – 1])?
IF NEEDED: We don’t need an exact dollar amount.
RECEIVE_SP1
IAQ30A
quantity unit
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to understand
how people manage financially as they age and what effect this might have on their health.
ENTER SP RETIREMENT ACCOUNT RECEIVED/WITHDRAWN AMOUNT
RECEIVE_SP2
IAQ30B
code one
SHOW CARD IA16
Please look at this card and tell me which is closest.
Page 11 of 22
2017 MCBS Community Questionnaire
Variable Name
IAQ - Income and Assets
MR Screen Name
Question Type
Question Text/Description
BOX IAQ7A
routing
If IAQ29 = 2 (ENTER SP AND SPOUSE/PARTNER AMOUNTS SEPARATELY), go to IAQ31A.
Otherwise, go to BOX IAQ8.
Code List
Routing
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED
(1) BOX IAQ8
(-8) IAQ31B
(-9) IAQ31B
(1) LESS THAN $100
(2) $100 TO LESS THAN $300
(3) $300 TO LESS THAN $700
(4) $700 TO LESS THAN $1,700
(5) $1,700 OR MORE
(-8) DON’T KNOW
(-9) REFUSED
BOX IAQ8
(1) ENTER COMBINED AMOUNT
(2) ENTER SP AND SPOUSE/PARTNER AMOUNTS
SEPARATELY
(-8) DON’T KNOW
(-9) REFUSED
(1) IAQ32A
(2) IAQ33A
(-8) IAQ32B
(-9) IAQ32B
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED
(1) BOX IAQ9
(-8) IAQ32B
(-9) IAQ32B
(1) LESS THAN $2,400
(2) $2,400 TO LESS THAN $6,000
(3) $6,000 TO LESS THAN $12,000
(4) $12,000 TO LESS THAN $30,000
(5) $30,000 OR MORE
(-8) DON’T KNOW
(-9) REFUSED
BOX IAQ9
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED
(1) BOX IAQ8A
(-8) IAQ33B
(-9) IAQ33B
(1) LESS THAN $1,200
(2) $1,200 TO LESS THAN $3,600
(3) $3,600 TO LESS THAN $8,400
(4) $8,400 TO LESS THAN $20,400
(5) $20,400 OR MORE
(-8) DON’T KNOW
(-9) REFUSED
BOX IAQ8A
Last month, how much altogether did [you/(SPOUSE FIRSTNAME LASTNAME)/(PARTNER FIRSTNAME
LASTNAME)] receive or withdraw from [your/his/her] retirement accounts (for the month of [CURRENT MONTH –
1])?
RECEIVE_SPOU
IAQ31A
SE1
quantity unit
IF NEEDED: We don’t need an exact dollar amount.
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to understand
how people manage financially as they age and what effect this might have on their health.
ENTER SPOUSE/PARTNER RETIREMENT ACCOUNT RECEIVED/WITHDRAWN AMOUNT
RECEIVE_SPOU
IAQ31B
SE2
BOX IAQ8
SHOW CARD IA16
code one
Please look at this card and tell me which is closest.
routing
If IAQ7 = 1 (SP HAS RETIREMENT ACCT) and 2 (SPOUSE HAS RETIREMENT ACCT), go to IAQ32.
Else if IAQ7 = 1 (SP HAS RETIREMENT ACCT), go to IAQ33A.
Else if IAQ7 = 2 (SPOUSE HAS RETIREMENT ACCT), go to IAQ34A.
Otherwise, go to BOX IAQ9.
Now thinking about all of last year, that is calendar year [CURRENT YEAR – 1], how much altogether did
[you/(SP)] and [(SP FIRSTNAME LASTNAME)/(SPOUSE FIRSTNAME LASTNAME)/(PARTNER FIRSTNAME
LASTNAME)] receive or withdraw from all of these retirement accounts?
YRRECIEVE_CO
IAQ32
MBINED1
code one
IF NEEDED: We don’t need an exact dollar amount.
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to understand
how people manage financially as they age and what effect this might have on
their health.
YRRECIEVE_CO
IAQ32A
MBINED2
YRRECIEVE_CO
IAQ32B
MBINED3
quantity unit
ENTER COMBINED SP AND SPOUSE/PARTNER RETIREMENT ACCOUNT RECEIVED/WITHDRAWN
AMOUNT
SHOW CARD IA17
code one
Please look at this card and tell me which is closest.
Now thinking about all of last year, that is calendar year [CURRENT YEAR – 1], how much altogether did
[you/(SP)] receive or withdraw from all of [your/his/her] retirement plans?
IF NEEDED: We don’t need an exact dollar amount.
YRRECEIVE_SP1 IAQ33A
quantity unit
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to understand
how people manage financially as they age and what effect this might have on their health.
ENTER SP RETIREMENT ACCOUNT RECEIVED/WITHDRAWN AMOUNT
SHOW CARD IA18
YRRECEIVE_SP2 IAQ33B
code one
Please look at this card and tell me which is closest.
BOX IAQ8A
routing
If IAQ32 = 2 (ENTER SP AND SPOUSE/PARTNER AMOUNTS SEPARATELY), go to IAQ34A.
Otherwise, go to BOX IAQ9.
Page 12 of 22
2017 MCBS Community Questionnaire
Variable Name
MR Screen Name
Question Type
IAQ - Income and Assets
Question Text/Description
Code List
Routing
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED
(1) BOX IAQ9
(-8) IAQ34B
(-9) IAQ34B
(1) LESS THAN $1,200
(2) $1,200 TO LESS THAN $3,600
(3) $3,600 TO LESS THAN $8,400
(4) $8,400 TO LESS THAN $20,400
(5) $20,400 OR MORE
(-8) DON’T KNOW
(-9) REFUSED
BOX IAQ9
Now thinking about all of last year, that is calendar year [CURRENT YEAR – 1], how much altogether did
[you/(SPOUSE FIRSTNAME LASTNAME)/(PARTNER FIRSTNAME LASTNAME)] receive or withdraw from all of
[your/his/her] retirement plans?
YRRECEIVE_SP
OUSE1
IAQ34A
quantity unit
IF NEEDED: We don’t need an exact dollar amount.
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to understand
how people manage financially as they age and what effect this might have on their health.
ENTER SPOUSE/PARTNER RETIREMENT ACCOUNT RECEIVED/WITHDRAWN AMOUNT
YRRECEIVE_SP
OUSE2
SHOW CARD IA18
IAQ34B
code one
Please look at this card and tell me which is closest.
routing
If [IAQ8 = 1 (SP MUTUAL FUNDS) and IAQ8 = 2 (SPOUSE MUTUAL FUNDS)] or IAQ8 = 3 (JOINT MUTUAL
FUNDS) or [IAQ9 = 1 (SP BONDS) and IAQ9 = 2 (SPOUSE BONDS)] or IAQ9 = 3 (JOINT BONDS), go to IAQ35.
Else if IAQ8 = 1 (SP MUTUAL FUNDS) or IAQ9 = 1 (SP BONDS), go to IAQ36A.
Else if IAQ8 = 2 (SPOUSE MUTUAL FUNDS) or IAQ9 = 2 (SPOUSE BONDS), go to IAQ37A.
Otherwise, go to BOX IAQ10.
OTHER_COMBIN
IAQ35
ED1
code one
You told me earlier that [you/(SP)] and [(SP FIRSTNAME LASTNAME)/(SPOUSE/PARTNER FIRSTNAME
LASTNAME)] own [mutual funds or stocks] [government, corporate, or other bonds] that are not part of retirement
(1) ENTER COMBINED AMOUNT
accounts. About how much are these worth?
(2) ENTER SP AND SPOUSE/PARTNER AMOUNTS
SEPARATELY
IF NEEDED: We don’t need an exact dollar amount.
(-8) DON’T KNOW
(-9) REFUSED
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to understand
how people manage financially as they age and what effect this might have on their health.
OTHER_COMBIN
IAQ35A
ED2
quantity unit
ENTER COMBINED SP AND SPOUSE’S/PARTNER'S MUTUAL FUNDS/STOCKS/BONDS AMOUNT
BOX IAQ9
OTHER_COMBIN
IAQ35B
ED3
BOX IAQ9A
OTHER_COMBIN
IAQ35C
ED4
SHOW CARD IA19
code one
Please look at this card and tell me which is closest.
routing
(1) IAQ35A
(2) IAQ36A
(-8) IAQ35B
(-9) IAQ35B
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED
(1) BOX IAQ10
(-8) BOX IAQ9A
(-9) BOX IAQ9A
(1) LESS THAN $9,000
(2) $9,000 TO LESS THAN $18,000
(3) $18,000 TO LESS THAN $93,000
(4) $93,000 TO LESS THAN $350,000
(5) $350,000 OR MORE
(-8) DON’T KNOW
(-9) REFUSED
BOX IAQ10
(1) LESS THAN $600
(2) $600 TO LESS THAN $5,000
(3) $5,000 TO LESS THAN $16,000
(4) $16,000 TO LESS THAN $62,000
(5) $62,000 OR MORE
(-8) DON’T KNOW
(-9) REFUSED
BOX IAQ10
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED
(1) BOX IAQ9C
(-8) BOX IAQ9B
(-9) BOX IAQ9B
If [IAQ8 = 1 (SP MUTUAL FUNDS) and IAQ8 = 2 (SPOUSE MUTUAL FUNDS)] or IAQ8= 3 (JOINT MUTUAL
FUNDS), go to IAQ35B.
Otherwise, go to IAQ35C.
SHOW CARD IA20
code one
Please look at this card and tell me which is closest.
You told me earlier that [you own/(SP) owns] [mutual funds or stocks] [government, corporate, or other bonds]
that are not part of retirement accounts. About how much are these worth?
IF NEEDED: We don’t need an exact dollar amount.
OTHER_SP1
IAQ36A
quantity unit
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to understand
how people manage financially as they age and what effect this might have on their health.
ENTER SP MUTUAL FUNDS/STOCKS/BONDS AMOUNT
Page 13 of 22
2017 MCBS Community Questionnaire
Variable Name
IAQ - Income and Assets
MR Screen Name
Question Type
Question Text/Description
BOX IAQ9B
routing
If IAQ8 = 1 (SP MUTUAL FUNDS), go to IAQ36B.
Otherwise, go to IAQ36C.
SHOW CARD IA21
OTHER_SP2
IAQ36B
code one
Please look at this card and tell me which is closest.
SHOW CARD IA22
OTHER_SP3
IAQ36C
code one
Please look at this card and tell me which is closest.
BOX IAQ9C
routing
Code List
Routing
(1) LESS THAN $8,000
(2) $8,000 TO LESS THAN $62,000
(3) $62,000 TO LESS THAN $192,000
(4) $192,000 TO LESS THAN $213,000
(5) $213,000 OR MORE
(-8) DON’T KNOW
(-9) REFUSED
BOX IAQ9C
(1) LESS THAN $300
(2) $300 TO LESS THAN $2,500
(3) $2,500 TO LESS THAN $8,000
(4) $8,000 TO LESS THAN $37,000
(5) $37,000 OR MORE
(-8) DON’T KNOW
(-9) REFUSED
BOX IAQ9C
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED
(1) BOX IAQ10
(-8) BOX IAQ9D
(-9) BOX IAQ9D
(1) LESS THAN $8,000
(2) $8,000 TO LESS THAN $62,000
(3) $62,000 TO LESS THAN $192,000
(4) $192,000 TO LESS THAN $213,000
(5) $213,000 OR MORE
(-8) DON’T KNOW
(-9) REFUSED
BOX IAQ10
(1) LESS THAN $300
(2) $300 TO LESS THAN $2,500
(3) $2,500 TO LESS THAN $8,000
(4) $8,000 TO LESS THAN $37,000
(5) $37,000 OR MORE
(-8) DON’T KNOW
(-9) REFUSED
BOX IAQ10
If IAQ8 = 2 (SPOUSE MUTUAL FUNDS) or IAQ9 = 2 (SPOUSE BONDS), go to IAQ37A.
Otherwise, go to BOX IAQ10.
You told me earlier that [you own/(SPOUSE FIRSTNAME LASTNAME) owns/(PARTNER FIRSTNAME
LASTNAME) owns] [mutual funds or stocks] [government, corporate, or other bonds] that are not part of
retirement accounts. About how much are these worth?
OTHER_SPOUSE
IAQ37A
1
quantity unit
IF NEEDED: We don’t need an exact dollar amount.
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to understand
how people manage financially as they age and what effect this might have on their health.
ENTER SPOUSE’S/PARTNER’S MUTUAL FUNDS/STOCKS/BONDS AMOUNT
BOX IAQ9D
OTHER_SPOUSE
IAQ37B
2
OTHER_SPOUSE
IAQ37C
3
BOX IAQ10
routing
If IAQ8 = 2 (SPOUSE MUTUAL FUNDS), go to IAQ37B.
Otherwise, go to IA37B.
SHOW CARD IA21
code one
Please look at this card and tell me which is closest.
SHOW CARD IA22
code one
Please look at this card and tell me which is closest.
routing
If [IAQ10 = 1 (SP CHECKING) and IAQ10 = 2 (SPOUSE CHECKING)] or [IAQ10 = 3 (JOINT CHECKING) or
[IAQ11 = 1 (SP SAVINGS) and IAQ11 = 2 (SPOUSE SAVINGS)] or IAQ11 = 3 (JOINT SAVINGS), or [IAQ12 = 1
(SP CDS) and IAQ12= 2 (SPOUSE CDS)] or IAQ12 = 3 (JOINT CDS), go to IAQ38.
Else if IAQ10 = 1 (SP CHECKING) or IAQ11 = 1 (SP SAVINGS) or IAQ13 = 1 (SP CDS), go to IAQ39A.
Else if IAQ10 = 2 (SPOUSE CHECKING) or IAQ11 = 2 (SPOUSE SAVINGS) or IAQ13 = 2 (SPOUSE CDS), go
to IAQ40A.
Otherwise, go to BOX IAQ11.
Page 14 of 22
2017 MCBS Community Questionnaire
Variable Name
MR Screen Name
Question Type
IAQ - Income and Assets
Question Text/Description
Code List
Routing
(1) ENTER COMBINED AMOUNT
(2) ENTER SP AND SPOUSE/PARTNER AMOUNTS
SEPARATELY
(-8) DON’T KNOW
(-9) REFUSED
(1) IAQ38A
(2) IAQ39A
(-8) IAQ38B
(-9) IAQ38B
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED
(1) BOX IAQ11
(-8) BOX IAQ10A
(-9) BOX IAQ10A
(1) LESS THAN $11,000
(2) $11,000 TO LESS THAN $25,000
(3) $25,000 TO LESS THAN $50,000
(4) $50,000 TO LESS THAN $108,000
(5) $108,000 OR MORE
(-8) DON’T KNOW
(-9) REFUSED
BOX IAQ11
(1) LESS THAN $2,000
(2) $2,000 TO LESS THAN $7,000
(3) $7,000 TO LESS THAN $17,000
(4) $17,000 TO LESS THAN $57,000
(5) $57,000 OR MORE
(-8) DON’T KNOW
(-9) REFUSED
BOX IAQ11
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED
(1) BOX IAQ10C
(-8) BOX IAQ10B
(-9) BOX IAQ10B
(1) LESS THAN $8,000
(2) $8,000 TO LESS THAN $13,000
(3) $13,000 TO LESS THAN $28,000
(4) $28,000 TO LESS THAN $54,000
(5) $54,000 OR MORE
(-8) DON’T KNOW
(-9) REFUSED
BOX IAQ10C
(1) LESS THAN $500
(2) $500 TO LESS THAN $1,900
(3) $1,900 TO LESS THAN $5,000
(4) $5,000 TO LESS THAN $20,000
(5) $20,000 OR MORE
(-8) DON'T KNOW
(-9) REFUSED
BOX IAQ10C
You told me earlier that [you/(SP)] and [(SP FIRSTNAME LASTNAME)/(SPOUSE FIRSTNAME
LASTNAME)/(PARTNER FIRSTNAME LASTNAME)] have [checking accounts] [savings or money market
accounts] [certificates of deposit or CDs].
ACCTS_COMBIN
IAQ38
ED1
code one
If you added up all of these accounts, about how much were they worth early last month (meaning in the
beginning of [CURRENT MONTH – 1])?
IF NEEDED: We don’t need an exact dollar amount.
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to understand
how people manage financially as they age and what effect this might have on their health.
ACCTS_COMBIN
IAQ38A
ED2
BOX IAQ10A
quantity unit
ENTER COMBINED SP AND SPOUSE'S/PARTNER'S ACCOUNTS TOTAL AMOUNT
routing
If IAQ12 = [1 (SP CDs) and 2 (SPOUSE CDs)] or 3 (JOINT CDs), go to IAQ38B.
Otherwise, go to IAQ38C.
SHOW CARD IA23
ACCTS_SEPARA
IAQ38B
TE1
code one
Please look at this card and tell me which is closest.
SHOW CARD IA24
ACCTS_SEPARA
IAQ38C
TE2
code one
Please look at this card and tell me which is closest.
You told me earlier that [you have/(SP) has] [a checking account] [a savings or money market account]
[certificates of deposit or CDs].
If you added up all of these accounts, about how much were they worth early last month (meaning in the
beginning of [CURRENT MONTH – 1])?
ACCTS_SP1
IAQ39A
quantity unit
IF NEEDED: We don’t need an exact dollar amount.
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to understand
how people manage financially as they age and what effect this might have on their health.
ENTER SP ACCOUNTS TOTAL AMOUNT
BOX IAQ10B
routing
If IAQ12 = 1 (SP CDs), go to IAQ39b.
Otherwise, go to IAQ39c.
SHOW CARD IA25
ACCTS_SP2
IAQ39B
code one
Please look at this card and tell me which is closest.
SHOW CARD IA26
ACCTS_SP3
IAQ39C
code one
Please look at this card and tell me which is closest.
Page 15 of 22
2017 MCBS Community Questionnaire
Variable Name
IAQ - Income and Assets
MR Screen Name
Question Type
Question Text/Description
BOX IAQ10C
routing
If IAQ10 = 2 (SPOUSE CHECKING) or IAQ11 = 2 (SPOUSE SAVINGS) or IAQ12 = 2 (SPOUSE CDS), go to
IAQ40A.
Otherwise, go to BOX IAQ11.
Code List
Routing
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED
(1) BOX IAQ11
(-8) BOX IAQ10D
(-9) BOX IAQ10D
(1) LESS THAN $8,000
(2) $8,000 TO LESS THAN $13,000
(3) $13,000 TO LESS THAN $28,000
(4) $28,000 TO LESS THAN $54,000
(5) $54,000 OR MORE
(-8) DON’T KNOW
(-9) REFUSED
BOX IAQ11
(1) LESS THAN $500
(2) $500 TO LESS THAN $1,900
(3) $1,900 TO LESS THAN $5,000
(4) $5,000 TO LESS THAN $20,000
(5) $20,000 OR MORE
(-8) DON'T KNOW
(-9) REFUSED
BOX IAQ11
You told me earlier that [you have/(SPOUSE FIRSTNAME LASTNAME)/(PARTNER FIRSTNAME LASTNAME)
has] [a checking account] [a savings or money market account] [certificates of deposit or CDs].
If you added up all of these accounts, about how much were they worth early last month (meaning in the
beginning of [CURRENT MONTH – 1])?
ACCTS_SPOUSE
IAQ40A
1
quantity unit
IF NEEDED: We don’t need an exact dollar amount.
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to understand
how people manage financially as they age and what effect this might have on their health.
ENTER SPOUSE/PARTNER ACCOUNTS TOTAL AMOUNT
BOX IAQ10D
ACCTS_SPOUSE
IAQ40B
2
ACCTS_SPOUSE
IAQ40C
3
routing
If IAQ12 = 2 (SPOUSE CDS), go to IAQ40b.
Otherwise, go to IAQ40c.
SHOW CARD IA25
code one
Please look at this card and tell me which is closest.
SHOW CARD IA26
code one
Please look at this card and tell me which is closest.
routing
If [IAQ8 = 1 (SP MUTUAL FUNDS) and IAQ8 = 2 (SPOUSE MUTUAL FUNDS)] or IAQ8 = 3 (JOINT MUTUAL
FUNDS) or
[IAQ9 = 1 (SP BONDS) and IAQ9 = 2 (SPOUSE BONDS)] or IAQ9 = 3 (JOINT BONDS), or
[IAQ10 = 1 (SP CHECKING) and IAQ10 = 2 (SPOUSE CHECKING)] or IAQ10 = 3 (JOINT CHECKING) or
[IAQ11 = 1 (SP SAVINGS) and IAQ11 = 2 (SPOUSE SAVINGS)] or IAQ11 = 3 (JOINT SAVINGS), or
[IAQ12 = 1 (SP CDS) and IAQ12= 2 (SPOUSE CDS)] or IAQ12 = 3 (JOINT CDS), go to IAQ41.
Else if IAQ8 = 1 (SP MUTUAL FUNDS) or IAQ9 = 1 (SP BONDS) or IAQ10 = 1 (SP CHECKING) or IAQ11 = 1
(SP
SAVINGS) or IAQ12 = 1 (SP CDS), go to IAQ42A.
Else if IAQ8 = 2 (SPOUSE MUTUAL FUNDS) or IAQ9 = 2 (SPOUSE BONDS) or IAQ10 = 2 (SPOUSE
CHECKING) or
IAQ11 = 2 (SPOUSE SAVINGS) or IAQ12 = 2 (SPOUSE CDS), go to IAQ43A.
Otherwise, go to BOX IAQ12.
INTEREST_COM
IAQ41
BINED1
code one
Now thinking about all of last year, that is calendar year [CURRENT YEAR – 1], how much interest and dividend
income did [you/(SP)] and [(SP FIRSTNAME LASTNAME)/(SPOUSE FIRSTNAME LASTNAME)/(PARTNER
FIRSTNAME LASTNAME)] have altogether from [mutual funds or stocks] [government, corporate, or other
(1) ENTER COMBINED AMOUNT
bonds] [bank accounts or CDs]?
(2) ENTER SP AND SPOUSE/PARTNER AMOUNTS
SEPARATELY
IF NEEDED: We don’t need an exact dollar amount.
(-8) DON’T KNOW
(-9) REFUSED
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to understand
how people manage financially as they age and what effect this might have on their health.
INTEREST_COM
IAQ41A
BINED2
quantity unit
ENTER SP AND SPOUSE’S/PARTNER’S INTEREST AND DIVIDEND INCOME AMOUNT
BOX IAQ11
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED
(1) IAQ41A
(2) IAQ42A
(-8) IAQ41B
(-9) IAQ41B
(1) BOX IAQ12
(-8) BOX IAQ11A
(-9) BOX IAQ11A
Page 16 of 22
2017 MCBS Community Questionnaire
Variable Name
MR Screen Name
INTEREST_COM
IAQ41B
BINED3
Question Type
IAQ - Income and Assets
Question Text/Description
SHOW CARD IA27
code one
Please look at this card and tell me which is closest.
Code List
Routing
(1) LESS THAN $200
(2) $200 TO LESS THAN $1,000
(3) $1,000 TO LESS THAN $4,000
(4) $4,000 TO LESS THAN $16,000
(5) $16,000 OR MORE
(-8) DON’T KNOW
(-9) REFUSED
BOX IAQ12
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED
(1) BOX IAQ11A
(-8) IAQ42B
(-9) IAQ42B
(1) LESS THAN $400
(2) $400 TO LESS THAN $1,000
(3) $1,000 TO LESS THAN $2,000
(4) $2,000 TO LESS THAN $11,000
(5) $11,000 OR MORE
(-8) DON’T KNOW
(-9) REFUSED
BOX IAQ11A
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED
(1) BOX IAQ12
(-8) IAQ43B
(-9) IAQ43B
(1) LESS THAN $400
(2) $400 TO LESS THAN $1,000
(3) $1,000 TO LESS THAN $2,000
(4) $2,000 TO LESS THAN $11,000
(5) $11,000 OR MORE
(-8) DON’T KNOW
(-9) REFUSED
BOX IAQ12
(1) ENTER COMBINED AMOUNT
(2) ENTER SP AND SPOUSE/PARTNER AMOUNTS
SEPARATELY
(-8) DON’T KNOW
(-9) REFUSED
(1) IAQ44A
(2) IAQ45A
(-8) IAQ44B
(-9) IAQ44B
Now thinking about all of last year, that is calendar year [CURRENT YEAR – 1], how much interest and dividend
income did [you/(SP)] have altogether from [mutual funds or stocks] [bonds] [bank accounts or CDs]?
IF NEEDED: We don’t need an exact dollar amount.
INTEREST_SP1
IAQ42A
quantity unit
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to understand
how people manage financially as they age and what effect this might have on their health.
ENTER SP INTEREST AND DIVIDEND INCOME AMOUNT
SHOW CARD IA28
INTEREST_SP2
IAQ42B
code one
Please look at this card and tell me which is closest.
BOX IAQ11A
routing
If IAQ8 = 2 (SPOUSE MUTUAL FUNDS) or IAQ9 = 2 (SPOUSE BONDS) or IAQ10 = 2 (SPOUSE CHECKING) or
IAQ11 = 2 (SPOUSE SAVINGS) or IAQ12 = 2 (SPOUSE CDS), go to IAQ43A.
Otherwise, go to BOX IAQ12.
Now thinking about all of last year, that is calendar year [CURRENT YEAR – 1], how much interest and dividend
income did [you/(SPOUSE FIRSTNAME LASTNAME)/(PARTNER FIRSTNAME LASTNAME)] have altogether
from [mutual funds or stocks] [bonds] [bank accounts or CDs]?
INTEREST_SPOU
IAQ43A
SE1
quantity unit
IF NEEDED: We don’t need an exact dollar amount.
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to understand
how people manage financially as they age and what effect this might have on their health.
ENTER SPOUSE/PARTNER INTEREST AND DIVIDEND INCOME AMOUNT
INTEREST_SPOU
IAQ43B
SE2
BOX IAQ12
SHOW CARD IA28
code one
Please look at this card and tell me which is closest.
routing
If [IAQ13 = 1 (SP BUSINESS/FARM/REAL ESTATE) and IAQ13 = 2 (SPOUSE BUSINESS/FARM/REAL
ESTATE)] or IAQ13 =3 (JOINT BUSINESS/FARM/REAL ESTATE), go to IAQ44.
Else if IAQ13 = 1 (SP BUSINESS/FARM/REAL ESTATE), go to IAQ45A.
Else if IAQ13 = 2 (SPOUSE BUSINESS/FARM/REAL ESTATE), go to IAQ46A.
Otherwise, go to BOX IAQ13.
You told me earlier that [you/(SP)] and [(SP FIRSTNAME LASTNAMe)/(SPOUSE FIRSTNAME
LASTNAME)/PARTNER FIRSTNAME LASTNAME] have a business, a farm, or real estate [other than (SP)’s
home]. If that were sold today and any debts on it were paid off, about how much would it bring?
LAND_COMBINE
IAQ44
D1
code one
IF NEEDED: We don’t need an exact dollar amount.
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to understand
how people manage financially as they age and what effect this might have on their health.
Page 17 of 22
2017 MCBS Community Questionnaire
Variable Name
MR Screen Name
LAND_COMBINE
IAQ44A
D2
LAND_COMBINE
IAQ44B
D3
IAQ - Income and Assets
Question Type
Question Text/Description
Code List
Routing
quantity unit
ENTER SP AND SPOUSE/PARTNER BUSINESS/FARM/REAL ESTATE COMBINED AMOUNT
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED
(1) BOX IAQ13
(-8) IAQ44B
(-9) IAQ44B
(1) LESS THAN $30,000
(2) $30,000 TO LESS THAN $101,000
(3) $101,000 TO LESS THAN $247,000
(4) $247,000 TO LESS THAN $703,000
(5) $703,000 OR MORE
(-8) DON’T KNOW
(-9) REFUSED
BOX IAQ13
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED
(1) BOX IAQ12A
(-8) IAQ45B
(-9) IAQ45B
(1) LESS THAN $18,000
(2) $18,000 TO LESS THAN $68,000
(3) $68,000 TO LESS THAN $122,000
(4) $122,000 TO LESS THAN $293,000
(5) $293,000 OR MORE
(-8) DON’T KNOW
(-9) REFUSED
BOX IAQ12A
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED
(1) BOX IAQ13
(-8) IAQ46B
(-9) IAQ46B
(1) LESS THAN $18,000
(2) $18,000 TO LESS THAN $68,000
(3) $68,000 TO LESS THAN $122,000
(4) $122,000 TO LESS THAN $293,000
(5) $293,000 OR MORE
(-8) DON’T KNOW
(-9) REFUSED
BOX IAQ13
SHOW CARD IA29
code one
Please look at this card and tell me which is closest.
You told me earlier that [you have/(SP) has] a business, a farm, or real estate [other than (SP)’s home]. If that
were sold today and any debts on it were paid off, about how much would it bring?
IF NEEDED: We don’t need an exact dollar amount.
LAND_SP1
IAQ45A
quantity unit
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to understand
how people manage financially as they age and what effect this might have on their health.
ENTER SP BUSINESS/FARM/REAL ESTATE AMOUNT
SHOW CARD IA30
LAND_SP2
IAQ45B
code one
Please look at this card and tell me which is closest.
BOX IAQ12A
routing
If IAQ13 = 2 (SPOUSE BUSINESS/FARM/REAL ESTATE), go to IAQ46A.
Otherwise, go to BOX IAQ13.
You told me earlier that [you have/(SPOUSE FIRSTNAME LASTNAME)/(PARTNER FIRSTNAME LASTNAME)
has] a business, a farm, or real estate [other than (SP)’s home]. If that were sold today and any debts on it were
paid off, about how much would it bring?
LAND_SPOUSE1
quantity unit
IF NEEDED: We don’t need an exact dollar amount.
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to understand
how people manage financially as they age and what effect this might have on their health.
ENTER SPOUSE/PARTNER BUSINESS/FARM/REAL ESTATE AMOUNT
SHOW CARD IA30
LAND_SPOUSE2 IAQ46B
code one
Please look at this card and tell me which is closest.
BOX IAQ13
routing
If [IAQ13 = 1 (SP BUSINESS/FARM/REAL ESTATE) and IAQ13 = 2 (SPOUSE BUSINESS/FARM/REAL
ESTATE)] or IAQ13 = 3 (JOINT BUSINESS/FARM/REAL ESTATE), go to IAQ47.
Else if IAQ13 = 1 (SP BUSINESS/FARM/REAL ESTATE), go to IAQ48A.
Else if IAQ13 = 2 (SPOUSE BUSINESS/FARM/REAL ESTATE), go to IAQ49A.
Otherwise, go to IAQ50.
Page 18 of 22
2017 MCBS Community Questionnaire
Variable Name
MR Screen Name
IAQ - Income and Assets
Question Type
Question Text/Description
INCOME_COMBI
IAQ47
NED1
code one
Now thinking about all of last year, that is calendar year [CURRENT YEAR – 1], how much income did [you/(SP)]
and [(SP FIRSTNAME LASTNAME)/(SPOUSE FIRSTNAME LASTNAME)/(PARTNER FIRSTNAME
(1) ENTER COMBINED AMOUNT
LASTNAME)] receive from these businesses or property before any federal or state taxes were taken out?
(2) ENTER SP AND SPOUSE/PARTNER AMOUNTS
SEPARATELY
IF NEEDED: We don’t need an exact dollar amount.
(-8) DON’T KNOW
(-9) REFUSED
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to understand
how people manage financially as they age and what effect this might have on their health.
INCOME_COMBI
IAQ47A
NED2
quantity unit
ENTER SP AND SPOUSE/PARTNER FROM BUSINESS/FARM/REAL ESTATE COMBINED AMOUNT
INCOME_COMBI
IAQ47B
NED3
SHOW CARD IA31
code one
Please look at this card and tell me which is closest.
Code List
Routing
(1) IAQ47A
(2) IAQ48A
(-8) IAQ47B
(-9) IAQ47B
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED
(1) IAQ50
(-8) IAQ47B
(-9) IAQ47B
(1) LESS THAN $3,600
(2) $3,600 TO LESS THAN $12,000
(3) $12,000 TO LESS THAN $25,000
(4) $25,000 TO LESS THAN $64,000
(5) $64,000 OR MORE
(-8) DON’T KNOW
(-9) REFUSED
IAQ50
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED
(1) BOX IAQ13A
(-8) IAQ48B
(-9) IAQ48B
(1) LESS THAN $3,600
(2) $3,600 TO LESS THAN $7,200
(3)$7,200 TO LESS THAN $14,000
(4) $14,000 TO LESS THAN $38,000
(5) $38,000 OR MORE
(-8) DON’T KNOW
(-9) REFUSED
BOX IAQ13A
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED
(1) IAQ50
(-8) IAQ49B
(-9) IAQ49B
(1) LESS THAN $3,600
(2) $3,600 TO LESS THAN $7,200
(3)$7,200 TO LESS THAN $14,000
(4) $14,000 TO LESS THAN $38,000
(5) $38,000 OR MORE
(-8) DON’T KNOW
(-9) REFUSED
IAQ50
Now thinking about all of last year, that is calendar year [CURRENT YEAR – 1], how much income did [you/(SP)]
receive from these businesses or property before any federal or state taxes were taken out?
IF NEEDED: We don’t need an exact dollar amount.
INCOME_SP1
IAQ48A
quantity unit
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to understand
how people manage financially as they age and what effect this might have on their health.
ENTER SP BUSINESS/FARM/REAL ESTATE AMOUNT
SHOW CARD IA32
INCOME_SP2
IAQ48B
code one
Please look at this card and tell me which is closest.
BOX IAQ13A
routing
If IAQ3 = 2 (SPOUSE BUSINESS/FARM/REAL ESTATE), go to IAQ49A.
Otherwise, go to IAQ50.
Now thinking about all of last year, that is calendar year [CURRENT YEAR – 1], how much income did
[you/(SPOUSE FIRSTNAME LASTNAME)/(PARTNER FIRSTNAME LASTNAME)] receive from these
businesses or property before any federal or state taxes were taken out?
INCOME_SPOUS
IAQ49A
E1
quantity unit
IF NEEDED: We don’t need an exact dollar amount.
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to understand
how people manage financially as they age and what effect this might have on their health.
ENTER SPOUSE/PARTNER BUSINESS/FARM/REAL ESTATE AMOUNT
INCOME_SPOUS
IAQ49B
E2
SHOW CARD IA32
code one
Please look at this card and tell me which is closest.
Page 19 of 22
2017 MCBS Community Questionnaire
Variable Name
MR Screen Name
Question Type
IAQ - Income and Assets
Question Text/Description
Code List
Routing
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED
(1) BOX IAQ13B
(-8) BOX IAQ14
(-9) BOX IAQ14
(01) A. Less than $5,000
(02) B. $5,000 - less than $10,000
(03) C. $10,000 - less than $15,000
(04) D. $15,000 - less than $20,000
(05) E. $20,000 - less than $25,000
(06) F. $25,000 - less than $30,000
(07) G. $30,000 - less than $40,000
(08) H. $40,000 - less than $50,000
(09) I. $50,000 - less than $66,000
(10) J. $66,000 - less than $109,000
(11) K. $109,000 or more
(-8) DON’T KNOW
(-9) REFUSED
BOX IAQ15
(01) A. Less than $5,000
(02) B. $5,000 - less than $10,000
(03) C. $10,000 - less than $15,000
(04) D. $15,000 - less than $20,000
(05) E. $20,000 - less than $25,000
(06) F. $25,000 - less than $30,000
(07) G. $30,000 - less than $40,000
(08) H. $40,000 - less than $50,000
(09) I. $50,000 - less than $66,000
(10) J. $66,000 - less than $109,000
(11) K. $109,000 or more
(-8) DON’T KNOW
(-9) REFUSED
BOX IAQ15
Now I want to ask about [your/(SP)’s] [and (SP FIRSTNAME LASTNAME)/(SPOUSE FIRSTNAME
LASTNAME)/(PARTNER FIRSTNAME LASTNAME)’s] total income for last year, that is, for the calendar year
ending in December [CURRENT YEAR - 1], before any federal or state taxes were taken out.
Now think about that total income from:
[Social Security or Railroad Retirement] [Supplemental Security Income] [the Veteran’s Administration] [a
pension plan] [any retirement accounts] [mutual funds or stocks] [bonds] [bank accounts] [CDs] [business, farm
or real estate] [jobs] and from any other sources.
TOTAL_COMBINE
IAQ50
D1
quantity unit
How much was [your/(SP)’s] [and (SP FIRSTNAME LASTNAME)/(SPOUSE FIRSTNAME
LASTNAME)/(PARTNER FIRSTNAME LASTNAME)'s] total income before taxes for last year (this is, for the 12
months ending in December [CURRENT YEAR - 1])?
IF NEEDED: We don’t need an exact dollar amount – the nearest $1,000 is fine.
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to understand
how people manage financially as they age and what effect this might have on their health.
ENTER TOTAL INCOME FOR LAST YEAR.
DO NOT INCLUDE LUMP SUM PAYMENTS RECEIVED FROM AN INHERITANCE, A TRUST FUND, AN
INSURANCE SETTLEMENT, A PENSION SETTLEMENT, OR A GIFT.
BOX IAQ13B
routing
If SPAISTATUS = 3 (Deceased in Community) or 4 (Deceased in Institution), go to BOX ENDIAQ.
Otherwise, go to IAQ52-LUMP.
BOX IAQ14
routing
If SP has a spouse or partner who is living in the household (ROSTREL=2 or 65, HHFLAG=1), go to IAQ51A.
Otherwise, go to IAQ51B.
TOTAL_COMBINE
IAQ51A
D2
SHOW CARD IA33
code one
Please look at this card and tell me which is closest.
SHOW CARD IA34
TOTAL_SP1
IAQ51B
code one
Please look at this card and tell me which is closest.
BOX IAQ15
routing
If SPAISTATUS = 3 (Deceased in Community) or 4 (Deceased in Institution), go to BOX ENDIAQ.
Otherwise, go to IAQ52-LUMP.
Page 20 of 22
2017 MCBS Community Questionnaire
Variable Name
MR Screen Name
Question Type
IAQ - Income and Assets
Question Text/Description
Code List
Routing
(1) YES, SP OR SPOUSE/PARTNER RECEIVED
PAYMENT FROM SOURCE
(2) NO PAYMENT RECEIVED FROM THIS SOURCE
(-8) DON’T KNOW
(-9) REFUSED
(1) IAQ52A - LUMPFORM
(2) CO1 - OWNCAR
(-8) CO1 - OWNCAR
(-9) CO1 - OWNCAR
(1) INSURANCE SETTLEMENT
(2) PENSION SETTLEMENT
(3) INHERITANCE (OR TRUST)
(4) GIFT
(5) LASWSUIT
(91) OTHER (SPECIFY)
(-8) DON'T KNOW
(-9) REFUSED
(1) IAQ52B - LUMP_SUM1
(2) IAQ52B - LUMP_SUM1
(3) IAQ52B - LUMP_SUM1
(4) IAQ52B - LUMP_SUM1
(5) IAQ52B - LUMP_SUM1
(91) IAQ52A - LUMP_OTH
(-8) IAQ52B - LUMP_SUM1
(-9) IAQ52B - LUMP_SUM1
(1) [continuous response]
(-8) DON'T KNOW
(-9) REFUSED
IAQ52B - LUMP_SUM1
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED
(1) CO1 - OWNCAR
(-8) IAQ52C - LUMP_SUM2
(-9) IAQ52C - LUMP_SUM2
(1) LESS THAN $50K
(2) ABOUT $50K
(3) MORE THAN $50K
(-8) DON'T KNOW
(-9) REFUSED
CO1 - OWNCAR
(1) YES
(2) NO
(-8) DON’T KNOW
(-9) REFUSED
(1) CO2
(2) FSINTRO1
(-8) FSINTRO1
(-9) FSINTRO1
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED
(1) BOX CO2
(-8) FSINTRO1
(-9) FSINTRO1
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED
(1) FSINTRO1
(-8) CO3A
(-9) CO3A
(1) LESS THAN $2,500
(2) $2,500 TO LESS THAN $5,000
(3) $5,000 TO LESS THAN $7,500
(4) $7,500 TO LESS THAN $10,000
(5) $10,000 TO LESS THAN $20,000
(6) $20,000 OR MORE
(-8) DON’T KNOW
(-9) REFUSED
FSINTRO1
SHOWCARD IA35
LUMP
IAQ52
code one
People sometimes receive large amounts of money or property in the form of an inheritance, a trust fund, an
insurance settlement, and so on. Now thinking about last year, that is, the calendar year ending in December
[CURRENT YEAR - 1], [have you/has (SP)] [or (SP FIRSTNAME LASTNAME)/(SPOUSE FIRSTNAME
LASTNAME)/(PARTNER FIRSTNAME LASTNAME)] received money or property in the form of an inheritance, a
trust fund, an insurance settlement, a pension settlement, a gift, or a lawsuit?
SHOWCARD IA35
LUMPFORM
IAQ52A
code one
What was the largest lump sum [you/(SP)] [or (SP FIRSTNAME LASTNAME)/(SPOUSE FIRSTNAME
LASTNAME)/(PARTNER FIRSTNAME LASTNAME)] received - was it from an inheritance, a trust, an insurance
settlement, a pension settlement, a gift, a lawsuit, or what?
LUMP_OTH
IAQ52A
verbatim text
OTHER (SPECIFY)
quantity unit
About how much did [you/(SP)] [or (SP FIRSTNAME LASTNAME)/(SPOUSE FIRSTNAME
LASTNAME)/(PARTNER FIRSTNAME LASTNAME)] receive from the [insurance settlement/pension
settlement/inheritance or trust/gift/lawsuit/(OTHER)]?
LUMP_SUM1
IAQ52B
DO NOT PROBE.
Did it amount to less than $50,000, more than $50,000, or what?
LUMP_SUM2
IAQ52C
code one
DO NOT PROBE.
Now, I would like to change topics and talk about automobiles [you own/(SP) owns] [or (your/his/her)
(husband/wife/partner) owns].
OWNCAR
CO1
yes/no
[Do you/Does (SP)] [or (your/his/her) (husband/wife/partner)] own any cars, trucks, or vans?
IF NEEDED: Do not include recreational vehicles, such as motorcycles, trailers, motor homes, boats, or
airplanes.
How many vehicles [do you/does (SP)] [or (your/his/her) (husband/wife/partner)] own?
NUMCAR
CO2
quantity unit
ENTER NUMBER OF VEHICLES
[IF NEEDED: Do not include leased cars.]
BOX CO2
PVCAR1
CO3
routing
quantity unit
If CO2 < 2, go to FSINTRO1.
Otherwise, go to CO3 - PVCAR1.
Altogether, what is their present value, that is, about how much would they bring if [you/(SP)] sold them on
today’s market?
ENTER DOLLAR AMOUNT
SHOW CARD IA36
PVCAR2
CO3A
code one
Please look at this card and tell me which is closest.
Page 21 of 22
2017 MCBS Community Questionnaire
IAQ - Income and Assets
Variable Name
MR Screen Name
Question Type
Question Text/Description
FSINTRO1
FSINTRO1
no entry
These next questions are about the food eaten in [your/(SP)'s] household in the last 12 months, since [current
month] of last year and whether [you were/he was/she was/they were] able to afford the food [you need/he
needs/she needs/they need].
I’m going to read you some statements that people have made about their food situation. For these statements,
please tell me whether the statement was often true, sometimes true, or never true for [you/your
household/(SP)/(SP)'s household] in the last 12 months—that is, since last [current month].
FOODLAST
Code List
Routing
FS1
(1) OFTEN TRUE
(2) SOMETIMES TRUE
(3) NEVER TRUE
(-8) DON’T KNOW
(-9) REFUSED
FS2
(1) OFTEN TRUE
(2) SOMETIMES TRUE
(3) NEVER TRUE
(-8) DON’T KNOW
(-9) REFUSED
FS3
In the last 12 months, since last (name of current month), did [you/you or other adults in your
household/(SP)/((SP) or other adults in (SP)'s household] ever cut the size of [your/his/her/their] meals or skip
meals because there wasn't enough money for food?
(1) YES
(2) NO
(-8) DON’T KNOW
(-9) REFUSED
(1) FS3A
(2) FS4
(-8) FS4
(-9) FS4
code one
How often did this happen—almost every month, some months but not every month, or in only 1 or 2 months?
(1) ALMOST EVERY MONTH
(2) SOME MONTHS BUT NOT EVERY MONTH
(3) IN ONLY 1 OR 2 MONTHS
(-8) DON’T KNOW
(-9) REFUSED
FS4
code one
In the last 12 months, did [you/(SP)] ever eat less than [you/he/she] felt [you/he/she] should because there
wasn't enough money for food?
(1) YES
(2) NO
(-8) DON’T KNOW
(-9) REFUSED
FS5
FS5
code one
In the last 12 months, [were you/was (SP)] ever hungry but didn't eat because there wasn't enough money for
food?
(1) YES
(2) NO
(-8) DON’T KNOW
(-9) REFUSED
BOX ENDIAQ
BOX ENDIAQ
routing
GO TO PAQ.
FS1
code one
The first statement is, The food that [I/we/(SP)/(SP) or other adults in (SP)'s household] bought just didn’t last,
and [I/we/he/she/they] didn’t have money to get more.
Was that often, sometimes, or never true for [you/your household/(SP)/(SP)'s household] in the last 12 months?
The next statement is: [I/we/(SP)/(SP) or other adults in (SP)'s household] couldn’t afford to eat balanced meals.
FOODLAST_OFT
FS2
EN
SKIPMEAL
FS3
SKIPMEAL_OFTE
FS3A
N
EATLESS
HUNGRY
FS4
Was that often, sometimes, or never true for [you/your household/(SP)/(SP)'s household] in the last 12 months?
code one
[IF NEEDED: For these statements, please tell me whether the statement was often true, sometimes true, or
never true for [you/your household/(SP)/(SP)'s household] in the last 12 months—that is, since last [current
month].]
code one
Page 22 of 22
| File Type | application/pdf |
| File Title | Medicare Current Beneficiary Survey Section Specifications for IAQ |
| Subject | Medicare beneficiaries, MCBS community questionnaire, 2017, Income and assets, IAQ |
| Author | NORC |
| File Modified | 2017-08-17 |
| File Created | 2017-08-10 |