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pdf2018 MCBS Community Questionnaire
Variable Name
MR Screen Name
DIQ-DEMOGRAPHICS AND INCOME
Question Type
Question Text/Description
Code List
Routing
DEMOGRAPHICS AND INCOME QUESTIONNAIRE SPECIFICATIONS
CRITERIA
INTTYPE=C003
SPALIVE=ALL
SEASON=FALL
SPPROXY=SP or PROXY
Other: N/A
PLACEMENT
Administer after SCQ.
NOTES: USQ removed from Fall round in R79. Therefore, DIQ is now asked after SCQ.
DIINT
HISPORIG
DIINTROA
DI1A
no entry
The next few questions are about Hispanic origin and race.
DI1A - HISPORIG
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
(01) DI1B - HISPORDT
(02) DI2A - RACECODE
(-8) DI2A - RACECODE
(-9) DI2A - RACECODE
yes/no
[Are you/Is (SP)] of Hispanic, (Latino/Latina), or Spanish origin?
(01) DI2A - RACECODE
(02) DI2A - RACECODE
(03) DI2A - RACECODE
(91) DI1B - HISPDTOS
(-8) DI2A - RACECODE
(-9) DI2A - RACECODE
HISPORDT
DI1B
code all
(01) 1 MEXICAN/MEXICAN AMERICAN/CHICANO(A)
(02) PUERTO RICAN
SHOW CARD DI1
(03) CUBAN
Looking at this card, [are you/is (SP)] Mexican, Mexican American, or (Chicano/Chicana), Puerto Rican, Cuban,
(91) OTHER HISPANIC, LATINO(A), OR SPANISH
or of another Hispanic, (Latino/Latina) or Spanish origin?
ORIGIN
CHECK ALL THAT APPLY.
(-8) Don't Know
(-9) Refused
HISPDTOS
DI1B
verbatim text
OTHER ORIGIN (SPECIFY)
(01) continuous answer
DI2A - RACECODE
(01) AMERICAN INDIAN OR ALASKA NATIVE
(02) ASIAN
(03) BLACK OR AFRICAN AMERICAN
(04) NATIVE HAWAIIAN OR OTHER PACIFIC
ISLANDER
(05) WHITE
(-8) Don't Know
(-9) Refused
(01) BOX DI2B
(02) BOX DI2B
(03) BOX DI2B
(04) BOX DI2B
(05) BOX DI2B
(-8) BOX DI2B
(-9) BOX DI2B
(01) ASIAN INDIAN
(02) CHINESE
(03) FILIPINO
(04) JAPANESE
(05) KOREAN
(06) VIETNAMESE
(91) OTHER ASIAN GROUP
(-8) Don't Know
(-9) Refused
(01) BOX DI2C
(02) BOX DI2C
(03) BOX DI2C
(04) BOX DI2C
(05) BOX DI2C
(06) BOX DI2C
(91) DI2B - RACEASOS
(-8) BOX DI2C
(-9) BOX DI2C
(01) continuous answer
BOX DI2C
You can choose more than one group.
CHECK ALL THAT APPLY.
(01) NATIVE HAWAIIAN
(02) GUAMANIAN OR CHAMORRO
(03) SAMOAN
(91) OTHER PACIFIC ISLANDER GROUP
(-8) Don't Know
(-9) Refused
(01) ENGWELL - D12F
(02) ENGWELL - D12F
(03) ENGWELL - D12F
(91) DI2C - RACEPIOS
(-8) ENGWELL - D12F
(-9) ENGWELL - D12F
OTHER PACIFIC ISLANDER GROUP (SPECIFY)
(01) continuous answer
ENGWELL - D12F
RACECODE
RACEASDT
DI2A
code all
SHOW CARD DI2
Looking at this card, what [is/was] [your/(SP)'s] race?
[ASK IF NECESSARY: Are there any options from this card that you would like me to record?]
BOX DI2B
routing
IF DI2A-RACECODE INCLUDES 2/Asian, GO TO DI2B - RACEASDT.
ELSE GO TO BOX DI2C.
DI2B
code all
SHOW CARD DI3
Looking at this card, [are you/is (SP)] Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese or some
other Asian group?
You can choose more than one group.
CHECK ALL THAT APPLY.
RACEASOS
RACEPIDT
RACEPIOS
DI2B
verbatim text
OTHER ASIAN GROUP (SPECIFY)
BOX DI2C
routing
IF DI2A-RACECODE INCLUDES 4/NatHawOrOthPaclsl, GO TO DI2C - RACEPIDT.
ELSE GO TO ENGWELL - D12F
DI2C
DI2C
code all
verbatim text
SHOW CARD DI4
Looking at this card, [are you/is (SP)] Native Hawaiian, Guamanian or Chamorro, Samoan, or some other
Pacific Islander group?
Page 1 of 3
2018 MCBS Community Questionnaire
Variable Name
ENGWELL
ENGREAD
OTHRLANG
MR Screen Name
DI2F
DI2FB
DI2D
DIQ-DEMOGRAPHICS AND INCOME
Question Type
code one
code one
yes/no
Question Text/Description
Code List
Routing
How well [do you/does (SP)] speak English? Would you say…
(01) Very well
(02) Well
(03) Not Well, or
(04) Not at all?
(-8) Don't Know
(-9) Refused
How well [do you/does (SP)] read English? Would you say…
(01) Very well
(02) Well
(03) Not Well, or
(04) Not at all?
(-8) Don't Know
(-9) Refused
OTHRLANG - D12D
[Do you/Does (SP)] speak a language other than English at home?
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
(01) DI2E - WHATLANG
(02) DI3INTRO - DIINT3
(-8) DI3INTRO - DIINT3
(-9) DI3INTRO - DINT3
(01) DI3INTRO - DIINT3
(02) DI3INTRO - DIINT3
(03) DI3INTRO - DIINT3
(91) DI2E - WHTLNGOS
(-8) D13INTRO - D13
(-9) D13INTRO - D13
D13INTRO - DINT3
DI2FB - ENGREAD
WHATLANG
DI2E
code one
What [is/was] this language?
(01) SPANISH
(02) FRENCH
(03) GERMAN
(91) OTHER
(-8) Don't Know
(-9) Refused
WHTLNGOS
DI2E
verbatim text
SOME OTHER LANGUAGE (SPECIFY)
(01) continuous answer
DIINT3
DI3INTRO
no entry
The next questions are about education and income.
DI3A - SPDEGRCV
DI4INTRO - DIINT4
SPDEGRCV
DI3A
code one
(01) NO SCHOOLING COMPLETED
(02) NURSERY SCHOOL TO 8TH GRADE
(03) 9TH-12TH GRADE, NO DIPLOMA
(04) HIGH SCHOOL GRADUATE (HIGH SCHOOL
DIPLOMA OR THE EQUIVALENT)
(05) VOCATIONAL/TECHNICAL/BUSINESS/TRADE
SHOW CARD DI5
SCHOOL CERTIFICATE OR DIPLOMA (BEYOND
What is the highest degree or level of school [you have/(SP) has] completed?
[IF THE SAMPLE PERSON ATTENDED SCHOOL IN A FOREIGN COUNTRY, IN AN UNGRADED SCHOOL, THE HIGH SCHOOL LEVEL)
(06) SOME COLLEGE, BUT NO DEGREE
HOME SCHOOLING, OR UNDER OTHER UNIQUE CIRCUMSTANCES, REFER THE RESPONDENT TO
(07) ASSOCIATE DEGREE
THE SHOWCARD AND ASK FOR THE NEAREST EQUIVALENT.]
(08) BACHELOR'S DEGREE
(09) MASTER'S, PROFESSIONAL OR DOCTORATE
DEGREE
(-8) Don't Know
(-9) Refused
DIINT4
DI4INTRO
no entry
In studies like this, people are sometimes grouped together according to income.
DI4 - SPINC25K
code one
Was [your and your spouse's/(SP's) and (his/her) spouse's/[your/(SP's)]] total income during the past 12 months
less than $25,000 or $25,000 or more, before taxes? Include income from jobs, Social Security, Railroad
Retirement, other retirement income, Supplemental Security Income (SSI), pensions, interest, and any other
(01) LESS THAN $25,000/YEAR
sources.
(02) $25,000 OR MORE/YEAR
(03) LESS THAN $2080/MONTH
[PROBE IF NECESSARY: In estimating [your/(SP's)] total income, you can respond for all of the past 12
(04) $2080/MONTH OR MORE
months, or provide a one month estimate.]
(-8) Don't Know
(-9) Refused
[EXPLAIN IF NECESSARY: Income is important in analyzing the information we collect. For example, this
information helps us learn whether persons in one income group use certain types of medical care services or
have certain medical conditions more or less often than those in another group.]
(01) DI5A - SPINCLET
(02) DI5A - SPINCLET
(03) DI5A - SPINCLET
(04) DI5A - SPINCLET
(-8) BOX DI3
(-9) BOX DI3
SPINC25K
DI4
Page 2 of 3
2018 MCBS Community Questionnaire
Variable Name
SPINCLET
MR Screen Name
DIQ-DEMOGRAPHICS AND INCOME
Question Type
Question Text/Description
Code List
DI5A
code one
(01) A. Less than $5,000
(02) B. $5,000 - less than $10,000
(03) C. $10,000 - less than $15,000
SHOW CARD DI6
(04) D. $15,000 - less than $20,000
Looking at this card, which letter best represents [your and your spouse's/(SP's) and (his/her)
(05) E. $20,000 - less than $25,000
spouse's/[your/(SP's)]] total income before taxes during the past 12 months? Include income from jobs, Social
(06) F. $25,000 - less than $30,000
Security, Railroad Retirement, other retirement income, and the other sources of income we just talked about.
(07) G. $30,000 - less than $40,000
(08) H. $40,000 - less than $50,000
[EXPLAIN IF NECESSARY: Income is important in analyzing the information we collect. For example, this
(09) I. $50,000 - less than $66,000
information helps us learn whether persons in one income group use certain types of medical care services or
(10) J. $66,000 - less than $109,000
have certain medical conditions more or less often than those in another group.]
(11) K. $109,000 or more
(-8) Don't Know
(-9) Refused
BOX DI3
routing
GO TO END SECTION.
Routing
BOX DI3
Page 3 of 3
| File Type | application/pdf |
| File Modified | 0000-00-00 |
| File Created | 0000-00-00 |