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pdf2021 MCBS Community Questionnaire
Variable Name
MR Screen Name
IAQ-INCOME AND ASSETS
Question Type
Question Text/Description
Code List
Routing
(01) CONTINUE
(-7) Empty
BOX LFINTRO1
INCOME AND ASSETS QUESTIONNAIRE SPECIFICATIONS
CRITERIA
INTTYPE=C001, C002, C004, C005, C006, C010
SPALIVE=ALL
SEASON=SUMMER
SPPROXY=SP or PROXY
Other: N/A
PLACEMENT
Administer after CPQ.
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.
Your answers will be combined with those of other respondents, and [your/his/her] Medicare benefits will not be
affected in any way by your answers to these questions.
GIVE BROCHURE TO RESPONDENT. ALLOW A FEW MINUTES FOR RESPONDENT TO REVIEW BROCHURE
IF NECESSARY.
BOX LFINTRO1
LFINTRO2
LFINTRO2
routing
no entry
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)]
(01) CONTINUE
had particular types of income or other resources. All these questions can be answered with a "yes" or a "no."
(-7) Empty
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)].
LF1
Please feel free to refer to any records or other persons who may be of assistance to you.
WORKWEEK
LF1
code one
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
RETNEVWK
LF1B
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
(-9) REFUSED
(1) BOX LF13
(2) BOX LF13
(3) LF2
(-8) BOX LF13
(-9) BOX LF13
IAABSENT
LF2
code one
[Do you/Does (SP)] have a job from which [you were/(he/she) was] absent last week because of illness, vacation,
or some other reason?
(1) YES
(2) NO
(-8) DON’T KNOW
(-9) REFUSED
(1) LF4
(2) LF3
(-8) BOX LF13
(-9) BOX LF13
WORKMONTH
LF3
code one
(1) YES
Now think about last month, that is [MONTH BEFORE INTERVIEW MONTH]. Did [you/(SP)] do any work for pay at (2) NO
any time in the last month?
(-8) DON’T KNOW
(-9) REFUSED
(1) LF8
(2) BOX LF13
(-8) BOX LF13
(-9) BOX LF13
MULTIJOB
LF4
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.]
HOURSPERWEEK
LF5
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 19
2021 MCBS Community Questionnaire
Variable Name
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.
HOURSLASTWEEK1
LF6
quantity unit
HOURSLASTWEEK2
LF7
quantity unit
How many hours did [you/(SP)] work last week?
ENTER NUMBER OF HOURS
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
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
(91) LF8A
(-8) LF9
(-9) LF9
PAYSCHEDULE
LF8
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
(91) OTHER SPECIFY
(-8) DON’T KNOW
(-9) REFUSED
OSPAYSCHEDULE
LF8A
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
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.
PAYCHECKAMT
LF9A
quantity unit
PAYCHECKHOURLY
LF9B
quantity unit
PAYCHECKDAILY
LF9C
quantity unit
ENTER PAYCHECK AMOUNT
$
ENTER PAY PER HOUR
$
ENTER PAY PER DAY
$
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
(1) [continuous response]
(-8) DON’T KNOW
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to understand how
(-9) REFUSED
people manage financially as they age and what effect this might have on their health.
BOX LF13
ENTER DOLLAR AMOUNT
$
SPOUSEWORK
BOX 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.
LF13
code one
Did [you/(your/{SP}’s) (husband/wife/partner)] do any work for pay in the month of [CURRENT MONTH-1 MONTH]?
(1) YES
(2) NO
(-8) DON’T KNOW
(-9) REFUSED
(1) LF14
(2) HO1
(-8) HO1
(-9) 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
(1) [continuous response]
(-8) DON’T KNOW
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to understand how
(-9) REFUSED
people manage financially as they age and what effect this might have on their health.
HO1
ENTER DOLLAR AMOUNT
$
Page 2 of 19
2021 MCBS Community Questionnaire
IAQ-INCOME AND ASSETS
Variable Name
MR Screen Name
Question Type
IAOWNHOME
HO1
code one
MORTGAGE
HO2
code one
Question Text/Description
Next, I'd like to ask you some questions about the [home/apartment or condo] that is [your/(SP)’s] main residence.
[Do you/Does (SP)] [or (SP FIRSTNAME LASTNAME)/(SPOUSE FIRSTNAME LASTNAME)/(PARTNER
FIRSTNAME LASTNAME)] own the [home/apartment or condo] 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_AMT1
HO3
quantity unit
How much altogether is that each month?
ENTER DOLLAR AMOUNT
SHOW CARD IA1
MORTGATE_AMT2
HO3A
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.
MORTGAGELGNTH
HO3B
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.
Code List
Routing
(1) OWN
(2) RENT (OR PAY MONTHLY AMOUNT)
(3) SOME OTHER ARRANGEMENT
(-8) DON’T KNOW
(-9) REFUSED
(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
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.
MORTGAGEOWE1
HO3C
quantity unit
(1) [continuous response]
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to understand how (-8) DON’T KNOW
people manage financially as they age and what effect this might have on their health.
(-9) REFUSED
(1) HO4
(-8) HO3D
(-9) HO4
IF NEEDED: Include any payments on a home equity loan or second mortgage.
ENTER DOLLAR AMOUNT
MORTGAGEOWE2
HO3D
code one
Is the amount owed…
(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
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?
PRESENTVALUE1
HO4
quantity unit
IF NEEDED: Your best guess or the nearest $10,000 is fine.
(1) [continuous response]
(-8) DON’T KNOW
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to understand how (-9) REFUSED
people manage financially as they age and what effect this might have on their health.
(1) IAQINTRO1
(-8) HO4A
(-9) IAQINTRO1
ENTER DOLLAR AMOUNT
PRESENTVALUE2
HO4A
code one
SHOW CARD IA2
Please look at this card and tell me which is closest.
(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
Page 3 of 19
2021 MCBS Community Questionnaire
IAQ-INCOME AND ASSETS
Variable Name
MR Screen Name
Question Type
Question Text/Description
Code List
Routing
PAYRENT
HO5
yes/no
[Do you/Does (SP)] [or (SP FIRSTNAME LASTNAME)/(SPOUSE FIRSTNAME LASTNAME)/(PARTNER
FIRSTNAME LASTNAME)] pay rent to live here?
(1) YES
(2) NO
(-8) DON’T KNOW
(-9) REFUSED
(1) HO6
(2) BOX HO1
(-8) BOX HO1
(-9) BOX HO1
RENTAMT1
HO6
quantity unit
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED
(1) BOX HO1
(-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
(1) YES, SP RECEIVED PAYMENT FROM SOURCE
(2) YES, SPOUSE/PARTNER RECEIVED PAYMENT
FROM
SOURCE
(3) NO PAYMENT RECEIVED FROM THIS SOURCE
(-8) DON’T KNOW
(-9) REFUSED
(1) BOX IAQ1
(2) BOX IAQ1
(3) IAQ4
(-8) IAQ4
(-9) IAQ4
(1) MAIL
(2) DIRECT DEPOSIT
(3) PREPAID CARD
(-8) DON’T KNOW
(-9) REFUSED
BOX IAQ1A
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED
IAQ3-YSTRTSOC
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED
IAQ4-SSI_LASTMONTH
(1) YES, SP RECEIVED PAYMENT FROM SOURCE
(2) YES, SPOUSE/PARTNER RECEIVED PAYMENT
FROM
SOURCE
(3) NO PAYMENT RECEIVED FROM THIS SOURCE
(-8) DON’T KNOW
(-9) REFUSED
IAQ5
RENTAMT2
SECTION8
How much is that each month?
ENTER DOLLAR AMOUNT
SHOW CARD IA3
HO6A
code one
BOX HO1
routing
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.
HO7
yes/no
Is this home in Section 8 or public housing or housing for low-income seniors?
Please look at this card and tell me which is closest.
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].
Did [you/(SP)] [or (SP FIRSTNAME LASTNAME)/(SPOUSE FIRSTNAME LASTNAME)/(PARTNER FIRSTNAME
LASTNAME)] receive Social Security retirement and/or Railroad Retirement payments in the last month, that is in
[CURRENT MONTH –1]?
SSRR_LASTMONTH
IAQ1
code all
BOX IAQ1
routing
IF IAQ1 NE (1) SP PAYMENT THEN GO TO IAQ4, ELSE GO TO IAQ2
IAQ2
code one
[Do you/Does (SP)] get payments by direct deposit, on a prepaid card, or by mail?
BOX IAQ1A
routing
MSTRTSOC
IAQ3
quantity unit
YSTRTSOC
IAQ3
quantity unit
IF NEEDED: These checks are either automatically deposited in the bank or mailed to arrive on the 3rd of every
month. If mailed, they are often sent in gold or manila-colored envelopes.
[SELECT ALL THAT APPLY]
SSDEPOSIT
IF SP HAS EVER REPORTED THE MONTH AND YEAR THEY STARTED RECEIVING SOCIAL SECURITY (P_
MSTRTSOC ^=., DK, or R AND P_ YSTRTSOC ^=., DK, or R), GO TO IAQ4- SSI_LASTMONTH
ELSE GO TO IAQ3- MSTRTSOC
What month and year did [you/(SP)] start receiving Social Security?
[ENTER MONTH AND YEAR]
What month and year did [you/(SP)] start receiving Social Security?
[ENTER MONTH AND YEAR]
Did [you/(SP)] [or (SP FIRSTNAME LASTNAME)/(SPOUSE FIRSTNAME LASTNAME)/(PARTNER FIRSTNAME
LASTNAME)] receive Supplemental Security Income, which is also called SSI, last month?
SSI_LASTMONTH
IAQ4
code all
IF NEEDED: These are monthly government payments to lower-income people in need.
[SELECT ALL THAT APPLY]
Page 4 of 19
2021 MCBS Community Questionnaire
Variable Name
VA_LASTMONTH
MR Screen Name
IAQ5
IAQ-INCOME AND ASSETS
Question Type
code all
Question Text/Description
Code List
Routing
Did [you/(SP)] [or (SP FIRSTNAME LASTNAME)/(SPOUSE FIRSTNAME LASTNAME)/(PARTNER FIRSTNAME
LASTNAME)] receive any payments from the Veteran’s Administration, last month related to military service or
veteran survivor’s benefits?
(1) YES, SP RECEIVED PAYMENT FROM SOURCE
(2) YES, SPOUSE/PARTNER RECEIVED PAYMENT
FROM
SOURCE
(3) NO PAYMENT RECEIVED FROM THIS SOURCE
(-8) DON’T KNOW
(-9) REFUSED
IAQ6
[IF NEEDED: The Veteran's Administration is also known as the U.S. Department of Veterans Affairs.]
[SELECT ALL THAT APPLY]
People sometimes receive retirement income from other sources, such as pensions.
[Do you/Does (SP)] [or (SP FIRSTNAME LASTNAME/SPOUSE FIRSTNAME LASTNAME/PARTNER FIRSTNAME
LASTNAME)] receive income from any pension plans that were a job-related or union benefit?
PENSION_LASTMONTH
IAQ6
code all
(1) YES, SP RECEIVED PAYMENT FROM PENSION
IF NEEDED: These plans often require that a person work for a certain number of years before they qualify or “are
(2) YES, SPOUSE/PARTNER RECEIVED PAYMENT
vested” in the pension plan.
FROM PENSION
(3) NO PAYMENT RECEIVED FROM PENSIONS
IF NEEDED: Are you currently receiving income from the pension plan?
(-8) DON’T KNOW
(-9) REFUSED
SELECT “YES” ONLY IF THE RESPONDENT IS CURRENTLY RECEIVING INCOME FROM THE PENSION
PLAN.
IAQ7
[SELECT ALL THAT APPLY]
SHOW CARD IA4
401K_LASTMONTH
IAQ7
code all
These next questions are a bit different and ask about assets [you/(SP)] [or (SP FIRSTNAME
LASTNAME/SPOUSE FIRSTNAME LASTNAME/PARTNER FIRSTNAME LASTNAME)] might own or contribute to,
such as retirement plans, mutual funds, and bonds.
(1) YES, SP HAS 401K, 403B, IRA, OR OTHER
RETIREMENT PLANS
Please look at the types of retirement plans on this card. [Do you/Does (SP)] [or (SP FIRSTNAME
(2) YES, SPOUSE/PARTNER HAS 401K, 403B, IRA, OR
LASTNAME/SPOUSE FIRSTNAME LASTNAME/PARTNER FIRSTNAME LASTNAME)] have any of these?
OTHER RETIREMENT PLANS
IAQ8
(3) NO PLANS
IF NEEDED: 401Ks and 403Bs are plans where you contribute an amount each month from your paycheck, and
(-8) DON’T KNOW
your employer may match some of your contribution.
(-9) REFUSED
IF NEEDED: IRAs, also known as Individual Retirement Accounts, are a type of plan you set up on your own.
[SELECT ALL THAT APPLY]
MUTUALFUNDS
IAQ8
code all
[(Not including the retirement accounts we have already talked about, {do you/does [SP]})/(Do you/Does {SP})] [or
(SP FIRSTNAME LASTNAME)/(SPOUSE FIRSTNAME LASTNAME)/(PARTNER FIRSTNAME LASTNAME)] own
any mutual funds or stocks?
[SELECT ALL THAT APPLY]
BONDS
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 as (3) YES, SP AND SPOUSE/PARTNER HAVE ASSET
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
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?
SAVINGS
IAQ11
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...]
A savings account or money market account?
CERTDEPOSIT
IAQ12
code all
(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
[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?
IAQ9
IAQ10
(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
(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
Page 5 of 19
2021 MCBS Community Questionnaire
Variable Name
MR Screen Name
IAQ-INCOME AND ASSETS
Question Type
Question Text/Description
Code List
IAQINTRO2
BOX IAQ2
OTHER_LAND
IAQ13
code all
(1) YES, SP HAS ASSET
[Do you/Does (SP)] [or (SP FIRSTNAME LASTNAME)/(SPOUSE FIRSTNAME LASTNAME)/(PARTNER
(2) YES, SPOUSE/PARTNER HAS ASSET
FIRSTNAME LASTNAME)] own a business, a farm, or any other real estate [besides (your/{SP}’s) home], including (3) YES, SP AND SPOUSE/PARTNER HAVE ASSET
land or rental properties?
JOINTLY
(4) NO ASSET OF THIS TYPE
[SELECT ALL THAT APPLY]
(-8) DON’T KNOW
(-9) REFUSED
IAQINTRO2
IAQINTRO2
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.
BOX IAQ2
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_COMBINED1
IAQ14
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_COMBINED2
SSRR_COMBINED3
IAQ14A
IAQ14B
quantity unit
code one
ENTER COMBINED SP AND SPOUSE/PARTNER SOCIAL SECURITY/RAILROAD RETIREMENT AMOUNT
SHOW CARD IA5
Please look at this card and tell me which is closest.
Routing
(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
What was the amount of [your/(SP)’s] most recent monthly Social Security or Railroad Retirement payment (for the
month of [CURRENT MONTH – 1])?
SSRR_SP_AMT1
IAQ15A
quantity unit
IF NEEDED: We don’t need an exact dollar amount.
(1) [continuous response]
(-8) DON’T KNOW
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to understand how (-9) REFUSED
people manage financially as they age and what effect this might have on their health.
(1) BOX IAQ2A
(-8) IAQ15B
(-9) IAQ15B
ENTER SP SOCIAL SECURITY/RAILROAD RETIREMENT AMOUNT
SSRR_SP_AMT2
IAQ15B
code one
BOX IAQ2A
routing
SHOW CARD IA6
Please look at this card and tell me which is closest.
(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
If IAQ14 = 2 (ENTER SP AND SPOUSE/PARTNER AMOUNTS SEPARATELY), go to IAQ16A.
Otherwise, go to BOX IAQ3.
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_AMT1
IAQ16A
quantity unit
IF NEEDED: We don’t need an exact dollar amount.
(1) [continuous response]
(-8) DON’T KNOW
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to understand how (-9) REFUSED
people manage financially as they age and what effect this might have on their health.
(1) BOX IAQ3
(-8) IAQ16B
(-9) IAQ16B
ENTER SPOUSE/PARTNER SOCIAL SECURITY/RAILROAD RETIREMENT AMOUNT
SSRR_SPOUSE_AMT2
IAQ16B
code one
BOX IAQ3
routing
SHOW CARD IA6
Please look at this card and tell me which is closest.
(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
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.
Page 6 of 19
2021 MCBS Community Questionnaire
Variable Name
MR Screen Name
IAQ-INCOME AND ASSETS
Question Type
Question Text/Description
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])?
IAQ17_SSI_COMBINED
IAQ17
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.
IAQ17A_SSI_COMBINED
IAQ17B_SSI_COMBINED
IAQ17A
IAQ17B
quantity unit
code one
ENTER COMBINED SP AND SPOUSE/PARTNER SSI AMOUNT
SHOW CARD IA7
Please look at this card and tell me which is closest.
Code List
Routing
(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
What was the amount of [your/(SP)’s] most recent monthly SSI payment (for the month of [CURRENT MONTH –
1])?
SSI_SP_AMT1
IAQ18A
quantity unit
IF NEEDED: We don’t need an exact dollar amount.
(1) [continuous response]
(-8) DON’T KNOW
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to understand how (-9) REFUSED
people manage financially as they age and what effect this might have on their health.
(1) BOX IAQ3A
(-8) IAQ18B
(-9) IAQ18B
ENTER SP SSI AMOUNT
SSI_SP_AMT2
IAQ18B
code one
BOX IAQ3A
routing
SHOW CARD IA8
Please look at this card and tell me which is closest.
(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
If IAQ17 = 2 (ENTER SP AND SPOUSE/PARTNER AMOUNTS SEPARATELY), go to IAQ19A.
Otherwise, go to BOX IAQ4.
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_AMT3
IAQ19A
quantity unit
IF NEEDED: We don’t need an exact dollar amount.
(1) [continuous response]
(-8) DON’T KNOW
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to understand how (-9) REFUSED
people manage financially as they age and what effect this might have on their health.
(1) BOX IAQ4
(-8) IAQ19B
(-9) IAQ19B
ENTER SPOUSE/PARTNER SSI AMOUNT
SSI_SPOUSE_AMT4
IAQ19B
code one
BOX IAQ4
routing
SHOW CARD IA8
Please look at this card and tell me which is closest.
IAQ20
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_COMBINED2
IAQ20A
quantity unit
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
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_COMBINED1
(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
ENTER COMBINED SP AND SPOUSE/PARTNER VA AMOUNT
Page 7 of 19
2021 MCBS Community Questionnaire
Variable Name
VA_AMT_COMBINED3
MR Screen Name
IAQ20B
IAQ-INCOME AND ASSETS
Question Type
code one
Question Text/Description
SHOW CARD IA9
Please look at this card and tell me which is closest.
Code List
Routing
(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
What was the amount of [your/(SP)’s] most recent monthly Veteran’s Administration payment (for the month of
[CURRENT MONTH – 1])?
VA_SP_AMT1
IAQ21A
quantity unit
IF NEEDED: We don’t need an exact dollar amount.
(1) [continuous response]
(-8) DON’T KNOW
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to understand how (-9) REFUSED
people manage financially as they age and what effect this might have on their health.
(1) BOX IAQ4A
(-8) IAQ21B
(-9) IAQ21B
ENTER SP VA AMOUNT
VA_SP_AMT2
IAQ21B
code one
BOX IAQ4A
routing
SHOW CARD IA10
Please look at this card and tell me which is closest.
(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
If IAQ20 = 2 (ENTER SP AND SPOUSE/PARTNER AMOUNTS SEPARATELY), go to IAQ22A.
Otherwise, go to BOX IAQ5.
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_AMT1
IAQ22A
quantity unit
IF NEEDED: We don’t need an exact dollar amount.
(1) [continuous response]
(-8) DON’T KNOW
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to understand how (-9) REFUSED
people manage financially as they age and what effect this might have on their health.
(1) BOX IAQ5
(-8) IAQ22B
(-9) IAQ22B
ENTER SPOUSE/PARTNER VA AMOUNT
VA_SPOUSE_AMT2
SHOW CARD IA10
IAQ22B
code one
BOX IAQ5
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.
Please look at this card and tell me which is closest.
(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
PENSION_COMBINED1
IAQ23
code one
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
(1) ENTER COMBINED AMOUNT
[CURRENT MONTH – 1])?
(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.
PENSION_COMBINED2
IAQ23A
quantity unit
ENTER COMBINED SP AND SPOUSE/PARTNER PENSION PLAN AMOUNT
PENSION_COMBINED3
IAQ23B
code one
SHOW CARD IA11
Please look at this card and tell me which is closest.
BOX IAQ5
(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
[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_AMT1
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
Page 8 of 19
2021 MCBS Community Questionnaire
Variable Name
PENSION_SP_AMT2
MR Screen Name
IAQ-INCOME AND ASSETS
Question Type
IAQ24B
code one
BOX IAQ5A
routing
Question Text/Description
SHOW CARD IA12
Please look at this card and tell me which is closest.
quantity unit
Routing
(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
(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
If IAQ23 = 2 (ENTER SP AND SPOUSE/PARTNER AMOUNTS SEPARATELY), go to IAQ25A.
Otherwise, go to BOX IAQ6.
[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_SPOUSE_AMT1 IAQ25A
Code List
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_SPOUSE_AMT2 IAQ25B
BOX IAQ6
code one
routing
SHOW CARD IA12
Please look at this card and tell me which is closest.
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_COMBINED1
IAQ26
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_COMBINED2
401K_COMBINED3
IAQ26A
IAQ26B
quantity unit
code one
ENTER COMBINED SP AND SPOUSE/PARTNER RETIREMENT ACCOUNT AMOUNT
SHOW CARD IA13
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
401K_SP_AMT2
IAQ27B
code one
BOX IAQ6A
routing
SHOW CARD IA14
Please look at this card and tell me which is closest.
If IAQ26 = 2 (ENTER SP AND SPOUSE/PARTNER AMOUNTS SEPARATELY), go to IAQ28A.
Otherwise, go to BOX IAQ7.
Page 9 of 19
2021 MCBS Community Questionnaire
Variable Name
MR Screen Name
IAQ-INCOME AND ASSETS
Question Type
Question Text/Description
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
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_AMT1
IAQ28A
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_AMT2
SHOW CARD IA14
IAQ28B
code one
BOX IAQ7
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.
Please look at this card and tell me which is closest.
RECIEVE_COMBINED1
IAQ29
code one
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
(1) ENTER COMBINED AMOUNT
the month of [CURRENT MONTH – 1])?
(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.
RECIEVE_COMBINED2
IAQ29A
quantity unit
ENTER COMBINED SP AND SPOUSE/PARTNER RETIREMENT ACCOUNT RECEIVED/WITHDRAWN AMOUNT
RECIEVE_COMBINED3
IAQ29B
code one
SHOW CARD IA15
Please look at this card and tell me which is closest.
(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
Last month, how much altogether did [you/(SP)] receive or withdraw from [your/his/her] retirement accounts (for the
month of [CURRENT MONTH – 1])?
RECEIVE_SP1
IAQ30A
quantity unit
IF NEEDED: We don’t need an exact dollar amount.
(1) [continuous response]
(-8) DON’T KNOW
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to understand how (-9) REFUSED
people manage financially as they age and what effect this might have on their health.
(1) BOX IAQ7A
(-8) IAQ30B
(-9) IAQ30B
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.
BOX IAQ7A
routing
If IAQ29 = 2 (ENTER SP AND SPOUSE/PARTNER AMOUNTS SEPARATELY), go to IAQ31A.
Otherwise, go to BOX IAQ8.
(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
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED
(1) BOX IAQ8
(-8) IAQ31B
(-9) IAQ31B
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_SPOUSE1
IAQ31A
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
Page 10 of 19
2021 MCBS Community Questionnaire
Variable Name
RECEIVE_SPOUSE2
MR Screen Name
IAQ-INCOME AND ASSETS
Question Type
Question Text/Description
SHOW CARD IA16
IAQ31B
code one
BOX IAQ8
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.
Please look at this card and tell me which is closest.
Code List
Routing
(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
YRRECIEVE_COMBINED1
IAQ32
code one
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?
(1) ENTER COMBINED AMOUNT
(2) ENTER SP AND SPOUSE/PARTNER AMOUNTS
IF NEEDED: We don’t need an exact dollar amount.
SEPARATELY
(-8) DON’T KNOW
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to understand how (-9) REFUSED
people manage financially as they age and what effect this might have on
their health.
YRRECIEVE_COMBINED2
IAQ32A
quantity unit
ENTER COMBINED SP AND SPOUSE/PARTNER RETIREMENT ACCOUNT RECEIVED/WITHDRAWN AMOUNT
YRRECIEVE_COMBINED3
IAQ32B
code one
SHOW CARD IA17
Please look at this card and tell me which is closest.
(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
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?
YRRECEIVE_SP1
IAQ33A
quantity unit
IF NEEDED: We don’t need an exact dollar amount.
(1) [continuous response]
(-8) DON’T KNOW
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to understand how (-9) REFUSED
people manage financially as they age and what effect this might have on their health.
(1) BOX IAQ8A
(-8) IAQ33B
(-9) IAQ33B
ENTER SP RETIREMENT ACCOUNT RECEIVED/WITHDRAWN AMOUNT
YRRECEIVE_SP2
IAQ33B
code one
BOX IAQ8A
routing
SHOW CARD IA18
Please look at this card and tell me which is closest.
(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
(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
If IAQ32 = 2 (ENTER SP AND SPOUSE/PARTNER AMOUNTS SEPARATELY), 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/(SPOUSE FIRSTNAME LASTNAME)/(PARTNER FIRSTNAME LASTNAME)] receive or withdraw from all of
[your/his/her] retirement plans?
YRRECEIVE_SPOUSE1
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_SPOUSE2
IAQ34B
code one
BOX IAQ9
routing
SHOW CARD IA18
Please look at this card and tell me which is closest.
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.
Page 11 of 19
2021 MCBS Community Questionnaire
Variable Name
MR Screen Name
IAQ-INCOME AND ASSETS
Question Type
Question Text/Description
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
accounts. About how much are these worth?
OTHER_COMBINED1
IAQ35
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.
OTHER_COMBINED2
OTHER_COMBINED3
OTHER_COMBINED4
IAQ35A
quantity unit
IAQ35B
code one
BOX IAQ9A
routing
IAQ35C
code one
ENTER COMBINED SP AND SPOUSE’S/PARTNER'S MUTUAL FUNDS/STOCKS/BONDS AMOUNT
SHOW CARD IA19
Please look at this card and tell me which is closest.
Code List
Routing
(1) ENTER COMBINED AMOUNT
(2) ENTER SP AND SPOUSE/PARTNER AMOUNTS
SEPARATELY
(-8) DON’T KNOW
(-9) REFUSED
(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
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
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?
OTHER_SP1
IAQ36A
quantity unit
BOX IAQ9B
routing
IF NEEDED: We don’t need an exact dollar amount.
(1) [continuous response]
(-8) DON’T KNOW
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to understand how (-9) REFUSED
people manage financially as they age and what effect this might have on their health.
(1) BOX IAQ9C
(-8) BOX IAQ9B
(-9) BOX IAQ9B
ENTER SP MUTUAL FUNDS/STOCKS/BONDS AMOUNT
OTHER_SP2
OTHER_SP3
IAQ36B
code one
IAQ36C
code one
BOX IAQ9C
routing
If IAQ8 = 1 (SP MUTUAL FUNDS), go to IAQ36B.
Otherwise, go to IAQ36C.
SHOW CARD IA21
Please look at this card and tell me which is closest.
SHOW CARD IA22
Please look at this card and tell me which is closest.
(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
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_SPOUSE1
IAQ37A
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
routing
If IAQ8 = 2 (SPOUSE MUTUAL FUNDS), go to IAQ37B.
Otherwise, go to IA37C
Page 12 of 19
2021 MCBS Community Questionnaire
Variable Name
OTHER_SPOUSE2
OTHER_SPOUSE3
MR Screen Name
IAQ37B
IAQ37C
BOX IAQ10
IAQ-INCOME AND ASSETS
Question Type
code one
code one
routing
Question Text/Description
SHOW CARD IA21
Please look at this card and tell me which is closest.
SHOW CARD IA22
Please look at this card and tell me which is closest.
IAQ38
code one
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 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
(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
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.
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_COMBINED1
Code List
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_COMBINED2
IAQ38A
quantity unit
ENTER COMBINED SP AND SPOUSE'S/PARTNER'S ACCOUNTS TOTAL AMOUNT
BOX IAQ10A
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_SEPARATE1
IAQ38B
code one
Please look at this card and tell me which is closest.
SHOW CARD IA24
ACCTS_SEPARATE2
IAQ38C
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
ACCTS_SP2
IAQ39B
routing
code one
If IAQ12 = 1 (SP CDs), go to IAQ39b.
Otherwise, go to IAQ39c.
SHOW CARD IA25
Please look at this card and tell me which is closest.
Page 13 of 19
2021 MCBS Community Questionnaire
Variable Name
ACCTS_SP3
MR Screen Name
IAQ-INCOME AND ASSETS
Question Type
IAQ39C
code one
BOX IAQ10C
routing
Question Text/Description
SHOW CARD IA26
Please look at this card and tell me which is closest.
Code List
Routing
(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
(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
(1) ENTER COMBINED AMOUNT
(2) ENTER SP AND SPOUSE/PARTNER AMOUNTS
SEPARATELY
(-8) DON’T KNOW
(-9) REFUSED
(1) IAQ41A
(2) IAQ42A
(-8) IAQ41B
(-9) IAQ41B
(1) [continuous response]
(-8) DON’T KNOW
(-9) REFUSED
(1) BOX IAQ12
(-8) IAQ41B
(-9) IAQ41B
(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
If IAQ10 = 2 (SPOUSE CHECKING) or IAQ11 = 2 (SPOUSE SAVINGS) or IAQ12 = 2 (SPOUSE CDS), go to
IAQ40A.
Otherwise, go to 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_SPOUSE1
IAQ40A
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_SPOUSE2
ACCTS_SPOUSE3
IAQ40B
IAQ40C
BOX IAQ11
INTEREST_COMBINED1
IAQ41
routing
code one
code one
routing
code one
If IAQ12 = 2 (SPOUSE CDS), go to IAQ40b.
Otherwise, go to IAQ40c.
SHOW CARD IA25
Please look at this card and tell me which is closest.
SHOW CARD IA26
Please look at this card and tell me which is closest.
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.
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 bonds]
[bank accounts or CDs]?
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.
INTEREST_COMBINED2
INTEREST_COMBINED3
IAQ41A
IAQ41B
quantity unit
code one
ENTER SP AND SPOUSE’S/PARTNER’S INTEREST AND DIVIDEND INCOME AMOUNT
SHOW CARD IA27
Please look at this card and tell me which is closest.
Page 14 of 19
2021 MCBS Community Questionnaire
Variable Name
MR Screen Name
IAQ-INCOME AND ASSETS
Question Type
Question Text/Description
Code List
Routing
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]?
INTEREST_SP1
IAQ42A
quantity unit
IF NEEDED: We don’t need an exact dollar amount.
(1) [continuous response]
(-8) DON’T KNOW
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to understand how (-9) REFUSED
people manage financially as they age and what effect this might have on their health.
(1) BOX IAQ11A
(-8) IAQ42B
(-9) IAQ42B
ENTER SP INTEREST AND DIVIDEND INCOME AMOUNT
INTEREST_SP2
IAQ42B
code one
BOX IAQ11A
routing
SHOW CARD IA28
Please look at this card and tell me which is closest.
(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
(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
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_SPOUSE1
IAQ43A
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_SPOUSE2
IAQ43B
code one
BOX IAQ12
routing
SHOW CARD IA28
Please look at this card and tell me which is closest.
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_COMBINED1
IAQ44
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.
LAND_COMBINED2
LAND_COMBINED3
IAQ44A
IAQ44B
quantity unit
code one
ENTER SP AND SPOUSE/PARTNER BUSINESS/FARM/REAL ESTATE COMBINED AMOUNT
SHOW CARD IA29
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?
LAND_SP1
IAQ45A
quantity unit
IF NEEDED: We don’t need an exact dollar amount.
(1) [continuous response]
(-8) DON’T KNOW
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to understand how (-9) REFUSED
people manage financially as they age and what effect this might have on their health.
(1) BOX IAQ12A
(-8) IAQ45B
(-9) IAQ45B
ENTER SP BUSINESS/FARM/REAL ESTATE AMOUNT
Page 15 of 19
2021 MCBS Community Questionnaire
Variable Name
LAND_SP2
MR Screen Name
IAQ-INCOME AND ASSETS
Question Type
IAQ45B
code one
BOX IAQ12A
routing
Question Text/Description
SHOW CARD IA30
Please look at this card and tell me which is closest.
Code List
Routing
(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
(1) ENTER COMBINED AMOUNT
(2) ENTER SP AND SPOUSE/PARTNER AMOUNTS
SEPARATELY
(-8) DON’T KNOW
(-9) REFUSED
(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
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
LAND_SPOUSE2
IAQ46B
code one
BOX IAQ13
routing
SHOW CARD IA30
Please look at this card and tell me which is closest.
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.
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 LASTNAME)]
receive from these businesses or property before any federal or state taxes were taken out?
INCOME_COMBINED1
IAQ47
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.
INCOME_COMBINED2
INCOME_COMBINED3
IAQ47A
IAQ47B
quantity unit
code one
ENTER SP AND SPOUSE/PARTNER FROM BUSINESS/FARM/REAL ESTATE COMBINED AMOUNT
SHOW CARD IA31
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 income did [you/(SP)]
receive from these businesses or property before any federal or state taxes were taken out?
INCOME_SP1
IAQ48A
quantity unit
IF NEEDED: We don’t need an exact dollar amount.
(1) [continuous response]
(-8) DON’T KNOW
IF NEEDED: We know questions like these may be difficult to answer, but we need to know this to understand how (-9) REFUSED
people manage financially as they age and what effect this might have on their health.
(1) BOX IAQ13A
(-8) IAQ48B
(-9) IAQ48B
ENTER SP BUSINESS/FARM/REAL ESTATE AMOUNT
Page 16 of 19
2021 MCBS Community Questionnaire
Variable Name
INCOME_SP2
MR Screen Name
IAQ-INCOME AND ASSETS
Question Type
IAQ48B
code one
BOX IAQ13A
routing
Question Text/Description
SHOW CARD IA32
Please look at this card and tell me which is closest.
Code List
Routing
(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
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_SPOUSE1
IAQ49A
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_SPOUSE2
IAQ49B
code one
SHOW CARD IA32
Please look at this card and tell me which is closest.
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_COMBINED1
IAQ50
quantity unit
How much was [your/(SP)’s] [and (SP FIRSTNAME LASTNAME)/(SPOUSE FIRSTNAME LASTNAME)/(PARTNER
(1) [continuous response]
FIRSTNAME LASTNAME)'s] total income before taxes for last year (this is, for the 12 months ending in December
(-8) DON’T KNOW
[CURRENT YEAR - 1])?
(-9) REFUSED
(1) BOX IAQ13B
(-8) BOX IAQ14
(-9) BOX IAQ14
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.
TOTAL_COMBINED2
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.
IAQ51A
code one
SHOW CARD IA33
Please look at this card and tell me which is closest.
(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
Page 17 of 19
2021 MCBS Community Questionnaire
Variable Name
TOTAL_SP1
MR Screen Name
IAQ-INCOME AND ASSETS
Question Type
IAQ51B
code one
BOX IAQ15
routing
Question Text/Description
SHOW CARD IA34
Please look at this card and tell me which is closest.
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)
LUMP_SUM1
IAQ52B
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)]?
DO NOT PROBE.
LUMP_SUM2
IAQ52C
code one
Did it amount to less than $50,000, more than $50,000, or what?
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
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 IAQ15
(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) LAWSUIT
(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
If SPAISTATUS = 3 (Deceased in Community) or 4 (Deceased in Institution), go to BOX ENDIAQ.
Otherwise, go to IAQ52-LUMP.
SHOWCARD IA35
LUMP
Code List
[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.]
PVCAR1
BOX CO2
routing
CO3
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
Page 18 of 19
2021 MCBS Community Questionnaire
Variable Name
MR Screen Name
IAQ-INCOME AND ASSETS
Question Type
PVCAR2
CO3A
code one
FSINTRO1
FSINTRO1
no entry
Question Text/Description
SHOW CARD IA36
Please look at this card and tell me which is closest.
Code List
Routing
(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
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].
FS1
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
FS1
code one
(1) OFTEN TRUE
(2) SOMETIMES TRUE
(3) NEVER TRUE
The first statement is, The food that [I/we/(SP)/(SP) or other adults in (SP)'s household] bought just didn’t last, and
(-8) DON’T KNOW
[I/we/he/she/they] didn’t have money to get more.
(-9) REFUSED
FS2
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.
(1) OFTEN TRUE
(2) SOMETIMES TRUE
(3) NEVER TRUE
(-8) DON’T KNOW
[IF NEEDED: For these statements, please tell me whether the statement was often true, sometimes true, or never
(-9) REFUSED
true for [you/your household/(SP)/(SP)'s household] in the last 12 months—that is, since last [current month].]
FS3
code one
(1) YES
In the last 12 months, since last (name of current month), did [you/you or other adults in your household/(SP)/((SP)
(2) NO
or other adults in (SP)'s household] ever cut the size of [your/his/her/their] meals or skip meals because there
(-8) DON’T KNOW
wasn't enough money for food?
(-9) REFUSED
(1) FS3A
(2) FS4
(-8) FS4
(-9) FS4
FS3A
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
EATLESS
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
HUNGRY
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 RXQ.
FOODLAST_OFTEN
FS2
code one
SKIPMEAL
FS3
SKIPMEAL_OFTEN
Was that often, sometimes, or never true for [you/your household/(SP)/(SP)'s household] in the last 12 months?
Page 19 of 19
| File Type | application/pdf |
| File Title | Medicare Current Beneficiary Survey Section Specifications for IAQ |
| Subject | Medicare beneficiaries, MCBS community questionnaire, 2021, Income and assets, IAQ |
| Author | NORC |
| File Modified | 2021-08-13 |
| File Created | 2021-08-03 |