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pdf2023 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 CMQ
BOX DI1
routing
IF ROUND = FALL 2023 ROUND 97 AND INTTYPE ^= C003, GO TO SOGIINT,
ELSE GO TO DIINTROA-DIINT.
DIINT
DIINTROA
no entry
The next few questions are about Hispanic origin and race.
HISPORIG
DI1A
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
DI1A - HISPORIG
(01) YES
(02) NO
(-8) Don't Know
(-9) Refused
(01) DI1B - HISPORDT
(02) DI2A - RACECODE
(-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, or of
(91) OTHER HISPANIC, LATINO(A), OR SPANISH
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
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
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
Page 1 of 4
2023 MCBS Community Questionnaire
Variable Name
RACEPIDT
MR Screen Name
DI2C
DIQ-DEMOGRAPHICS AND INCOME
Question Type
code all
Question Text/Description
Code List
Routing
SHOW CARD DI4
Looking at this card, [are you/is (SP)] Native Hawaiian, Guamanian or Chamorro, Samoan, or some other Pacific
Islander group?
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
ENGWELL - D12F
RACEPIOS
DI2C
verbatim text
OTHER PACIFIC ISLANDER GROUP (SPECIFY)
(01) continuous answer
ENGWELL
DI2F
code one
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
OTHRLANG - D12D
DI2FB - ENGREAD
ENGREAD
DI2FB
code one
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
DI2D
yes/no
[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) D13INTRO - DINT3 SOGIINT
(-8) D13INTRO - DINT3 SOGIINT
(-9) D13INTRO - DINT3 SOGIINT
(01) D13INTRO - DINT3 SOGIINT
(02) D13INTRO - DINT3 SOGIINT
(03) DI3INTRO - DIINT3 SOGIINT
(04) DI3INTRO - DIINT3 SOGIINT
(05) DI3INTRO - DIINT3 SOGIINT
(06) DI3INTRO - DIINT3 SOGIINT
(07) DI3INTRO - DIINT3 SOGIINT
(08) DI3INTRO - DIINT3 SOGIINT
(09) DI3INTRO - DIINT3 SOGIINT
(10) DI3INTRO - DIINT3 SOGIINT
(11) DI3INTRO - DIINT3 SOGIINT
(12) DI3INTRO - DIINT3 SOGIINT
(13) DI3INTRO - DIINT3 SOGIINT
(14) DI3INTRO - DIINT3 SOGIINT
(15) DI3INTRO - DIINT3 SOGIINT
(91) DI2E - WHTLNGOS
(-8) D13INTRO - D13 SOGIINT
(-9) D13INTRO - D13 SOGIINT
D13INTRO - DINT3 SOGIINT
WHATLANG
DI2E
code one
What [is/was] this language?
(01) SPANISH
(02) FRENCH
(03) GERMAN
(04) ITALIAN
(05) TAGALOG
(06) CHINESE (MANDARIN, CANTONESE, or OTHER)
(07) POLISH
(08) KOREAN
(09) RUSSIAN
(10) GREEK
(11) FILIPINO
(12) ARABIC
(13) JAPANESE
(14) VIETNAMESE
(15) PORTUGUESE
(16) HINDI
(91) OTHER
(-8) Don't Know
(-9) Refused
WHTLNGOS
DI2E
verbatim text
SOME OTHER LANGUAGE (SPECIFY)
(01) continuous answer
SOGIINT
SEXORINT
SOGIINT
SEXORINT
no entry
code one
[Next we have some questions about your demographic characteristics, including sexual orientation, gender identity,
education, income, and religious preference. Like all your answers, these will be used to understand the health of
different groups in the population and will be kept confidential.]
/
[Next we have some questions about your demographic characteristics, including sexual
orientation, gender identity, and religious preference. Like all your answers, these will be used to understand the
health of different groups in the population and will be kept confidential.]
[(Do you think of yourself)/(Does (SP) think of themselves)] as (gay/lesbian); straight, that is, not (gay/lesbian);
bisexual; something else; or you don't know the answer?
SEXORINT
(01) (GAY/LESBIAN)
(02) STRAIGHT, THAT IS, NOT (GAY/LESBIAN)
(03) BISEXUAL
(04) SOMETHING ELSE
(05) I DON'T KNOW THE ANSWER
(-8 ) Don't Know
(-9) Refused
(01) SEXASGN
(02) SEXASGN
(03) SEXASGN
(04) SEXORIOS
(05) SEXASGN
(-8) SEXASGN
(-9) SEXASGN
Page 2 of 4
2023 MCBS Community Questionnaire
DIQ-DEMOGRAPHICS AND INCOME
Variable Name
MR Screen Name
Question Type
Question Text/Description
Code List
Routing
SEXORIOS
SEXORIOS
verbatim text
What do you mean by something else?
(01) continuous answer
SEXASGN
SEXASGN
SEXASGN
code one
What sex [(were you)/(was (SP))] assigned at birth on [your/his/her] original birth certificate?
(01) MALE
(02) FEMALE
(-8 ) Don't Know
(-9) Refused
GENIDENT
GENIDENT
GENIDENT
code one
[(Do you)/(Does (SP))] currently describe [yourself/himself/herself] as male, female or transgender?
(01) MALE
(02) FEMALE
(03) TRANSGENDER
(04) NONE OF THESE
(-8 ) Don't Know
(-9) Refused
BOX DI2D
BOX DI2D
routing
IF SP IS IN THE BASELINE INTERIVEW (sample_person.INTTYPE=3) GO TO DI3INTRO-DIINT3.
ELSE GO TO RELGPREF.
DI3INTRO
no entry
The next questions are about education and income.
DIINT3
DI3A - SPDEGRCV
(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
SCHOOL CERTIFICATE OR DIPLOMA (BEYOND THE
HIGH SCHOOL LEVEL)
(06) SOME COLLEGE, BUT NO DEGREE
(07) ASSOCIATE DEGREE
(08) BACHELOR'S DEGREE
(09) MASTER'S, PROFESSIONAL OR DOCTORATE
DEGREE
(-8) Don't Know
(-9) Refused
SPDEGRCV
DI3A
code one
SHOW CARD DI5
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,
HOME SCHOOLING, OR UNDER OTHER UNIQUE CIRCUMSTANCES, REFER THE RESPONDENT TO THE
SHOWCARD AND ASK FOR THE NEAREST EQUIVALENT.]
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 sources.
(01) LESS THAN $25,000/YEAR
(02) $25,000 OR MORE/YEAR
[PROBE IF NECESSARY: In estimating [your/(SP's)] total income, you can respond for all of the past 12 months, or (03) LESS THAN $2080/MONTH
provide a one month estimate.]
(04) $2080/MONTH OR MORE
(-8) Don't Know
[EXPLAIN IF NECESSARY: Income is important in analyzing the information we collect. For example, this
(-9) Refused
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
DI4INTRO - DIINT4
Page 3 of 4
2023 MCBS Community Questionnaire
Variable Name
SPINCLET
MR Screen Name
DI5A
DIQ-DEMOGRAPHICS AND INCOME
Question Type
code one
Question Text/Description
SHOW CARD DI6
Looking at this card, which letter best represents [your and your spouse's/(SP's) and (his/her) spouse's/[your/(SP's)]]
total income before taxes during the past 12 months? Include income from jobs, Social Security, Railroad
Retirement, other retirement income, and the other sources of income we just talked about.
[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.]
What is [you/(SP)'s] religious preference?
RELGPREF
RELGPREF
code one
[IF NEEDED: This is the religion/religious preference with which you most closely identify]
RELGPROS
RELGPROS
verbatim text
What is [you/(SP)'s] religious preference?
BOX DI3
routing
IF ROUND = FALL 2023 ROUND 97 AND INTTYPE in(C001, C002, C004, C005, C006), GO TO DVH.
ELSE IF INTTYPE in(C003), GO TO END SECTION.
Code List
Routing
(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 DI3
RELGPREF
(01) PROTESTANT
(02) CATHOLIC
(03) EASTERN ORTHODOX, SUCH AS GREEK OR
RUSSIAN ORTHODOX
(04) JEWISH
(05) BUDDHIST
(06) HINDU
(07) MUSLIM, ISLAM, SUFI, SUNNI, OR SHIA
(08) SOME OTHER RELIGION
(09) NO RELIGION
(-8) DON'T KNOW
(-9) REFUSED
(01) BOX DI3
(02) BOX DI3
(03) BOX DI3
(04) BOX DI3
(05) BOX DI3
(06) BOX DI3
(07) BOX DI3
(08) RELGPROS
(09) BOX DI3
(-8) BOX DI3
(-9) BOX DI3
(01) continuous answer
BOX DI3
Page 4 of 4
File Type | application/pdf |
Author | Marisa Wishart |
File Modified | 2022-03-25 |
File Created | 2022-03-25 |