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pdfNotice – CDC estimates the average public reporting burden for this collection of information as
60 minutes per response, including the time for reviewing instructions, searching existing
data/information sources, gathering and maintaining the data/information needed, and
completing and reviewing the collection of information. An agency may not conduct or sponsor,
and a person is not required to respond to a collection of information unless it displays a
currently valid OMB control number. Send comments regarding this burden estimate or any
other aspect of this collection of information, including suggestions for reducing this burden to
CDC/ATSDR Information Collection Review Office, 1600 Clifton Road, MS D-74, Atlanta, GA
30333; ATTN: PRA (0920-0214).
Assurance of Confidentiality: We take your privacy very seriously. All information that relates
to or describes identifiable characteristics of individuals, a practice, or an establishment will be
used only for statistical purposes. NCHS staff, contractors, and agents will not disclose or release
responses in identifiable form without the consent of the individual or establishment in
accordance with section 308(d) of the Public Health Service Act (42 U.S.C. 242m(d)), and the
Confidential Information Protection and Statistical Efficiency Act of 2018 (CIPSEA Pub. L. No.
115-435, 132 Stat. 5529 § 302). In accordance with CIPSEA, every NCHS employee,
contractor, and agent has taken an oath and is subject to a jail term of up to five years, a fine of
up to $250,000, or both if he or she willfully discloses ANY identifiable information about
you. In addition to the above cited laws, NCHS complies with the Federal Cybersecurity
Enhancement Act of 2015 (6 U.S.C. § 151 and 151 note) which protects Federal information
systems from cybersecurity risks by screening their networks.
Question ID: VFY.0010.00.1
Variable name: CURRES_A
Interview module: VFY(Adult.VFY)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: (GEN.ASTAT=2 or GEN.CBSTAT_A=1)
Universe Description: The Sample Adult section has not been started or completed or has a Sample
Adult callback setup
Question Text:
Response:
Enter the line number of the person to whom you are speaking.
00.
01.
02.
03.
04.
05.
06.
07.
08.
09.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
Not on roster
^ALIASNAME[1]
^ALIASNAME[2]
^ALIASNAME[3]
^ALIASNAME[4]
^ALIASNAME[5]
^ALIASNAME[6]
^ALIASNAME[7]
^ALIASNAME[8]
^ALIASNAME[9]
^ALIASNAME[10]
^ALIASNAME[11]
^ALIASNAME[12]
^ALIASNAME[13]
^ALIASNAME[14]
^ALIASNAME[15]
^ALIASNAME[16]
^ALIASNAME[17]
^ALIASNAME[18]
^ALIASNAME[19]
^ALIASNAME[20]
^ALIASNAME[21]
^ALIASNAME[22]
Page 1 of 430
23.
24.
25.
^ALIASNAME[23]
^ALIASNAME[24]
^ALIASNAME[25]
Skip Instructions: <1-25> [goto AVAIL_A]
Question ID: VFY.0020.00.1
Variable name: AVAIL_A
Interview module: VFY(Adult.VFY)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: (GEN.ASTAT=2 or GEN.CBSTAT_A=1)
Universe Description: The Sample Adult section has not been started or completed or has a Sample
Adult callback setup
Question Text:
Response:
Fills:
The next questions must be answered by ^SANAME. Probe as necessary to
determine the availability of ^SANAME. If Sample Adult refuses to participate enter
CTRL-R. Read if necessary: The next questions are about ^SANAME.
^Awayschool ^IshesheArethey_A ^stayinghere available now? ^ONCAMPSA
1.
2.
3.
RF:
Available
Not Available or not able to answer right now
Physical or mental condition prohibits responding
Refused
^SANAME
Sample Adult's name
^Awayschool
If Roster.HHC.tblNAME.bPerson.ONOFFCAMPUS
IN (1,RF,DK), fill: "Earlier, you said ^SANAME is
living away at school or college."
^IshesheArethey_A
If SEX_A=1 fill: "Is he"
If SEX_A=2 fill: "Is she"
If SEX_A IN ('DK'. 'RF") fill: "Are they"
^stayinghere
If ONOFFCAMPUS IN (1,DK,RF) fill: "staying here
and"
^ONCAMPSA
If
Roster.HHC.tblNAME.bPerson.ONOFFCAMPUS=1
and GEN.HHRESPSA_FLG ne 1, fill:
*If the on-campus Sample Adult is currently at the
sample unit and able to complete the interview:
Proceed with the Sample Adult interview.
Page 2 of 430
*If the on-campus Sample Adult is not currently at
the sample unit and able to complete the interview:
Proceed with arranging a callback.
Skip Instructions: <1> if CURRES_A ne PX_A [goto INTMODE_A]
elseif Roster.HHC.tblNAME.bPerson[PX_A].ONOFFCAMPUS IN (1,RF,DK)
and GEN.HHRESPSA_FLG ne 1 [goto VFYONCAMP_A]
else [goto VFYALL_A]
<2> [goto bCallback.CB_POSSIBLE] then if there is a Sample child and they
have not been interviewed [goto Child.VFY.CURRES_C]
elseif GEN.OUTCOME=203 [goto BCK.THANKS_SUF]
else [goto BCK.THANKS_INSUF]
<3> [goto PROXY_A]
if there is a SC [goto Child.VFY.CURRES_C]
elseif GEN.OUTCOME=203 [goto BCK.THANKS_SUF]
else [goto BCK.THANKS_INSUF]
Question ID: VFY.0030.00.1
Variable name: PROXY_A
Interview module: VFY(Adult.VFY)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: AVAIL_A=3
Universe Description: The Sample Adult's physical or mental condition prohibits responding.
Question Text:
Response:
Proxy interviews can be done for sample adults that have a mental or physical
condition that prevents them from responding for themselves. Is a family member
or caregiver that is knowledgeable about ^SANAME's health available?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Page 3 of 430
Fills:
^SANAME
Sample Adult's name
Skip Instructions: <1> [goto PROXYREL_A]
<2,RF,DK> [goto PROXYCALL_A]
Question ID: VFY.0040.00.1
Variable name: PROXYREL_A
Interview module: VFY(Adult.VFY)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: PROXY_A=1
Universe Description: Knowledgeable proxy is available.
Question Text:
Response:
Fills:
What is this person's relationship to ^SANAME?
1.
2.
3.
4.
DK:
RF:
Relative who lives in household
Relative who doesn't live in household
Nonrelative who lives in household
Nonrelative who does not live in household
Don't Know
Refused
^SANAME
Sample Adult's name
Skip Instructions: <1,3> if PCNT18PLUS=1 [goto ERR1_PROXYREL_A]
else [goto PROXYLNO_A]
<2,4,RF,DK> [goto INTMODE_A]
Page 4 of 430
Check Name: ERR1_PROXYREL_A
Text:
{check ERR1_PROXYREL_A} This is not a valid option as there are no other adults
18+ living in the household. Please correct.
Hard / Soft Edit: Hard
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: PCNT18PLUS=1 and PROXYREL_A IN (1,3)
Universe Description: Sample Adult is the only person in the household 18+ and answer category
"Relative who lives in household" or "Other non-relative who lives in
household" was selected at PROXYREL_A
Question ID: VFY.0050.00.1
Variable name: PROXYLNO_A
Interview module: VFY(Adult.VFY)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: PROXYREL_A IN (1,3)
Universe Description: Sample adult proxy is a relative or non relative who lives in the household
Question Text:
Response:
Select the person in this household who is the proxy for ^SANAME.
01.
02.
03.
04.
05.
^ALIASNAME[1]
^ALIASNAME[2]
^ALIASNAME[3]
^ALIASNAME[4]
^ALIASNAME[5]
Page 5 of 430
06.
07.
08.
09.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
Fills:
^ALIASNAME[6]
^ALIASNAME[7]
^ALIASNAME[8]
^ALIASNAME[9]
^ALIASNAME[10]
^ALIASNAME[11]
^ALIASNAME[12]
^ALIASNAME[13]
^ALIASNAME[14]
^ALIASNAME[15]
^ALIASNAME[16]
^ALIASNAME[17]
^ALIASNAME[18]
^ALIASNAME[19]
^ALIASNAME[20]
^ALIASNAME[21]
^ALIASNAME[22]
^ALIASNAME[23]
^ALIASNAME[24]
^ALIASNAME[25]
^SANAME
Sample Adult's name
Skip Instructions: <1-25> if PROXYLNO_A ne CURRES_A [goto INTMODE_A]
elseif
PROXYLNO_A=CURRES_A
and
Roster.HHC.tblNAME.bPerson[PX_A].ONOFFCAMPUS IN (1,RF,DK) and
HHRESPSA_FLG ne 1 [goto VFYONCAMP_A]
else [goto VFYALL_A]
Question ID: VFY.0060.00.1
Variable name: PROXYCALL_A
Interview module: VFY(Adult.VFY)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: PROXY_A IN (2,RF,DK)
Universe Description: Knowledgeable proxy is not available.
Question Text:
Can a callback with someone knowledgeable about ^SANAME's health be
arranged?
Response:
Page 6 of 430
1.
2.
Fills:
Yes
No
^SANAME
Sample Adult's name
Skip Instructions: <1> [goto bCallback.CB_POSSIBLE], then
if there is a Sample child and they have not been interviewed [goto
Child.VFY.CURRES_C]
else [goto BCK.THANKS_CB]
<2> if there is a Sample child and they have not been interviewed [goto
Child.VFY.CURRES_C]
elseif GEN.OUTCOME=203 [goto BCK.THANKS_SUF]
else [goto BCK.THANKS_INSUF]
Question ID: VFY.0070.00.1
Variable name: INTMODE_A
Interview module: VFY(Adult.VFY)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: (CURRES_A ne PX_A AND AVAIL_A=1) OR (PROXYREL_A IN (2,4,RF,DK))
OR (PROXYLNO_A IN (1-25) AND PROXYLNO_A ne CURRES_A)
Universe Description: Sample Adults 18+ and
Not initially speaking to the Sample Adult but now speaking to the Sample
Adult OR
Now speaking to a proxy respondent who is not on the roster or refused or
don't know if on the roster OR
Now speaking to a proxy respondent who is on the roster and who wasn't who
you were initially speaking to
Question Text:
Response:
How are you contacting ^SARESP?
1.
Personal visit
Page 7 of 430
2.
Fills:
Telephone
^SARESP
FillSample Adult respondent's name
Skip Instructions: <1> if Roster.HHC.tblNAME.bPerson[PX_A].ONOFFCAMPUS IN (1,RF,DK)
and GEN.HHRESPSA_FLG ne 1 [goto VFYONCAMP_A]
else[goto VFYALL_A]
<2> [goto TINTRO_A]
Question ID: VFY.0080.00.1
Variable name: TINTRO_A
Interview module: VFY(Adult.VFY)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: INTMODE_A=2
Universe Description: Sample Adults 18+ and interviewer is conducting a telephone interview with
new respondent
Question Text:
Response:
Fills:
Hello, my name is ( say your name). I'm calling from the U.S. Census Bureau.
We are conducting the National Health Interview Survey on behalf of the
National Center for Health Statistics, part of the Centers for Disease Control
and Prevention (CDC). This is a nationwide survey about the health of both
adults and children. I have some information from ^HHRESP. Now, I would like
to ask you some questions.
Read if necessary: I believe I am calling you on a
cell phone. Before we continue, I have to ask: Are you currently driving a
vehicle?
Even if the respondent is using a hands-free device while driving, you
must enter '1'.
DK:
RF:
Don't Know
Refused
^HHRESP
Display the name of the person selected at
Roster.HHC.HHRESPAVAIL
Page 8 of 430
Skip Instructions: <1,RF,DK> [goto ATTN_A]
<2> [goto LETTER_A]
Question ID: VFY.0090.00.1
Variable name: ATTN_A
Interview module: VFY(Adult.VFY)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: TINTRO_A=1
Universe Description: Sample Adults 18+ and interviewer is conducting a telephone interview with
new respondent who is driving
Question Text:
For your safety, we will call you back at another time.
Enter 1 to continue.
Response:
Skip Instructions: <1> [goto bCallback.CB_POSSIBLE]
Question ID: VFY.0100.00.1
Variable name: LETTER_A
Interview module: VFY(Adult.VFY)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: TINTRO_A=2
Universe Description: Sample Adults 18+ and interviewer is conducting a telephone interview with
new respondent who is not driving
Question Text:
Response:
If sample adult is a new respondent read question below, otherwise enter 1 Read
if necessary: A letter describing the National Health Interview Survey was sent to your
home recently. Do you remember seeing the letter?
DK:
RF:
Don't Know
Refused
Page 9 of 430
Skip Instructions: <1,2,RF,DK> [goto S_INTRO_A]
Question ID: VFY.0110.00.1
Variable name: S_INTRO_A
Interview module: VFY(Adult.VFY)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: TINTRO_A=2
Universe Description: Sample Adults 18+ and interviewer is conducting a telephone interview with
new respondent who is not driving
Question Text:
?[F1] If sample adult is a new respondent read question below, otherwise enter 1
Read if necessary: There are a few things I need to cover before we continue. I'd like
you to know that taking part in this survey is voluntary. You may choose not to
answer any questions you don't wish to answer, or end the interview at any time
without penalty. We are required by Federal law to develop and follow strict
procedures to protect the confidentiality of your information and use your answers
only for statistical research. I can describe these laws if you wish. Except for the
National Center for Health Statistics and Census Bureau employees and specially
designated agents, no one can see your answers until all information that could
identify you and/or your family has been removed. Only after that will your data be
made available to researchers. For most adults, the survey will take less than
^SATIME minutes. I'd like to continue now unless you have any questions. If
respondent asks for more information about the privacy laws, press F1.
Response:
Fills:
^SATIME
If GEN.CSTAT=1 and GEN.SAMEFAM_FLG=1, fill:
35
else, fill: 45
Skip Instructions: <1> if Roster.HHC.tblNAME.bPerson[PX_A].ONOFFCAMPUS IN (1,RF,DK)
and GEN.HHRESPSA_FLG ne 1 [goto VFYONCAMP_A]
else [goto VFYALL_A]
Page 10 of 430
Question ID: VFY.0120.00.1
Variable name: VFYONCAMP_A
Interview module: VFY(Adult.VFY)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: Roster.HHC.tblNAME.bPerson.ONOFFCAMPUS
IN
(1,RF,DK)
(AVAIL_A=1 or PROXY_A=1) and GEN.HHRESPSA_FLG ne 1
and
Universe Description: Sample Adults 18+ living in on-campus housing and the Sample Adult is not
the household respondent
Question Text:
Response:
I want to confirm some information. Do you live in on-campus housing or
off-campus housing? Read if necessary: On-campus housing includes residence
halls and dorms where students live together. It also includes buildings that are
owned, leased, or managed by the school. Fraternities and sororities are on-campus
housing.
1.
2.
DK:
RF:
On campus
Off campus
Don't Know
Refused
Skip Instructions: <1,RF,DK> [goto VFYALL_A]
<2> [goto NOMORE_A]
Question ID: VFY.0130.00.1
Variable name: VFYALL_A
Interview module: VFY(Adult.VFY)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: (AVAIL_A=1 or PROXY_A=1) and VFYONCAMP_A ne 2
Universe Description: Sample adults 18+ and the Sample Adult or a proxy is available to continue
the interview and the Sample Adult is not identified as away at college and
living in off-campus housing
Question Text:
^Verifyintro I have recorded ^yoursexis, you are ^AGE_A, ^NATORG_A, and
^RACE_A. Would you like to make any changes to this ^additionalinfo_A?
^RACEVRBATvalue_A If respondent "refuses" or says "don't know", enter "2" for
"no." Read if necessary: By sex we mean sex at birth.
Response:
Page 11 of 430
1.
2.
Fills:
Yes
No
^Verifyintro
If VFYONCAMP_A=empty "I want to confirm some
information."
else fill nothing
^yoursexis
If GEN.SEX_FINAL=1 fill "your sex is male"
If GEN.SEX_FINAL=2 fill "your sex is female"
If
GEN.SEX_FINAL=DK
and
GEN.HHRESPSA_FLG=1 fill "you do not know your
sex"
If
GEN.SEX_FINAL=RF
and
GEN.HHRESPSA_FLG=1 fill "you do not wish to
provide your sex"
If
GEN.SEX_FINAL
IN
(DK,RF)
and
GEN.HHRESPSA_FLG ne1 fill "your sex was not
provided"
^AGE_A
if GEN.AGE_FINAL ne RF, DK fill with age
elseif
GEN.AGE_FINAL
IN
(RF,DK)
andRoster.HHC.tblAGE.blkPerson[PX_A].AGE65=2
fill "65 or older"
elseif
GEN.AGE_FINAL
in
(RF,DK)
andRoster.HHC.tblAGE.blkPerson[PX_A].AGE65=1
fill "between 18 and 64"
elseif GEN.AGE_FINAL IN (RF, DK) and
Roster.HHC.tblAGE.blkPerson[PX_A].AGE65
IN
(RF,DK,empty) fill "18 and older"
^NATORG_A
If GEN.NATO_FINAL=1 fill: "you are of Hispanic or
Latino origin"
If GEN.NATO_FINAL=2 fill: "you are not of Hispanic
or Latino origin"
If
GEN.NATO_FINAL=DK
and
GEN.HHRESPSA_FLG=1 fill: "you do not know if
you are of Hispanic or Latino origin"
If
GEN.NATO_FINAL=RF
and
GEN.HHRESPSA_FLG=1 fill: "you do not wish to
provide information about your Hispanic or Latino
origin"
If
GEN.NATO_FINAL
IN
(DK,RF)
and
GEN.HHRESPSA_FLG ne 1 fill "information about
your Hispanic or Latino origin was not provided"
^RACE_A
Ifrace
or
races
GEN.RACE_FINAL[PX_A].RACE_FINAL
Page 12 of 430
fill:
IN
"you
are ^RACEFILLAND_A."
If GEN.RACE_FINAL[PX_A].RACE_FINAL=DK and
GEN.HHRESPSA_FLG=1 fill "you do not know your
race."
If GEN.RACE_FINAL[PX_A].RACE_FINAL=RF and
GEN.HHRESPSA_FLG=1 fill: "you do not wish to
provide your race."
If
GEN.RACE_FINAL[PX_A].RACE_FINAL
IN
(DK,RF) and GEN.HHRESPSA_FLG ne 1 fill "your
race was not provided."
^additionalinfo_A
See attachment for fill instructions
^RACEVRBATvalue_A
IF
GEN.HHRESPSA_FLG
ne
1
and
GEN.RACE_FINAL[PX_A].RACE_VRBAT_FINAL ne
(empty,RF,DK), fill "If respondent wants information
on which other race they are listed as,
say^RACE_VRBAT."
Skip Instructions: <1> [goto VFYDEM_A]
<2> if GEN.SEX_FINAL IN (RF,DK) [goto SEXGUESS_A]
elseif GEN.NATO_FINAL=1 [goto HISPTYPE_A]
elseif GEN.RACE_FINAL=6 [goto PITYPE_A]
elseif GEN.RACE_FINAL=7 [goto ASIANTYPE_A]
elseif
(NEWRACE_A=8
or
(NEWRACE_A=empty
and
GEN.HHRESPSA_FLG
ne
1
and
Roster.HHC.tblRACE.bperson.RACE_SP[PX_A] in (ZZ,RF,DK)))
[goto
RACEOTHER_A]
else [goto BMONTH_A]
Page 13 of 430
Question ID: VFY.0140.00.1
Variable name: VFYDEM_A
Interview module: VFY(Adult.VFY)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: VFYALL_A=1
Universe Description: Sample Adults 18+ would like to change demographic information
Question Text:
Response:
Read if necessary: What should I change?
Enter all that apply, separate with
commas. Read if necessary: By sex we mean sex at birth.
1.
2.
3.
4.
DK:
RF:
Sex
Age
Hispanic or Latino Origin
Race
Don't Know
Refused
Skip Instructions: if 1 IN VFYDEM_A [goto NEWSEX_A]
elseif (2,3,4) IN VFYDEM_A and GEN.SEX_FINAL[PX_A] IN (RF,DK) [goto
SEXGUESS_A]
elseif 2 IN VFYDEM_A and GEN.SEX_FINAL[PX_A] NOT IN (RF,DK)[goto
NEWAGE_A]
elseif 3 IN VFYDEM_A and GEN.SEX_FINAL[PX_A] NOT IN (RF,DK) [goto
NEWNATORG_A]
elseif 4 IN VFYDEM_A and GEN.SEX_FINAL[PX_A] NOT IN (RF,DK) [goto
NEWRACE_A]
If GEN.SEX_FINAL[PX_A] IN (RF,DK) [goto SEXGUESS_A]
elseif GEN.NATO_FINAL=1 [goto HISPTYPE_A]
elseif GEN.RACE_FINAL=6 [goto PITYPE_A]
elseif GEN.RACE_FINAL=7 [goto ASIANTYPE_A]
elseif (NEWRACE_A=8 or (NEWRACE_A=empty and
GEN.HHRESPSA_FLG
ne
1
and
Roster.HHC.tblRACE.bperson.RACE_SP[PX_A] in (ZZ,RF,DK)))
[goto
RACEOTHER_A]
else [goto BMONTH_A]
Page 14 of 430
Question ID: VFY.0150.00.1
Variable name: NEWSEX_A
Interview module: VFY(Adult.VFY)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: 1 IN VFYDEM_A
Universe Description: Respondent said his/her sex is not correct
Question Text:
Response:
Are you male or female?
1.
2.
DK:
RF:
Read if necessary: By sex we mean sex at birth.
Male
Female
Don't Know
Refused
Skip Instructions: if
GEN.SEX_FINAL[PX_A]=RF,DK
and
NEWSEX_A=RF,DK
[goto
SEXGUESS_A]
elseif 2 IN VFYDEM_A [goto NEWAGE_A]
elseif 3 IN VFYDEM_A [goto NEWNATORG_A]
elseif 4 IN VFYDEM_A [goto NEWRACE_A]
elseif GEN.NATO_FINAL=1 [goto HISPTYPE_A]
elseif GEN.RACE_FINAL[PX_A].RACE_FINAL=6 [goto PITYPE_A]
elseif GEN.RACE_FINAL[PX_A].RACE_FINAL=7 [goto ASIANTYPE_A]
elseif (NEWRACE_A=8 or (NEWRACE_A=empty and GEN.HHRESPSA_FLG
ne 1 and Roster.HHC.tblRACE.bperson.RACE_SP[PX_A] in (ZZ,RF,DK)))
[goto RACEOTHER_A]
else [goto BMONTH_A]
Page 15 of 430
Question ID: VFY.0160.00.1
Variable name: SEXGUESS_A
Interview module: VFY(Adult.VFY)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: GEN.SEX_FINAL IN (DK,RF) and (VFYDEM_A NOT IN 1 or (VFYDEM_A=1
and NEWSEX_A IN (RF,DK)))
Universe Description: Sample adults for whom there is no sex provided by the household respondent
and did not give a sex when asked to verify information
Question Text:
Response:
Fills:
Enter your best guess of ^SANAME's sex.
1.
2.
Male
Female
^SANAME
Sample Adult's name
Skip Instructions: <1,2>
if 2 IN VFYDEM_A [goto NEWAGE_A]
elseif 3 IN VFYDEM_A [goto NEWNATORG_A]
elseif 4 IN VFYDEM_A [goto NEWRACE_A]
elseif GEN.NATO_FINAL=1 [goto HISPTYPE_A]
elseif GEN.RACE_FINAL=6 [goto PITYPE_A]
elseif GEN.RACE_FINAL=7 [goto ASIANTYPE_A]
elseif (NEWRACE_A=8 or (NEWRACE_A=empty and GEN.HHRESPSA_FLG
ne 1 and Roster.HHC.tblRACE.bperson.RACE_SP[PX_A] in (ZZ,RF,DK)))
[goto RACEOTHER_A]
else [goto BMONTH_A]
Page 16 of 430
Question ID: VFY.0170.00.1
Variable name: NEWAGE_A
Interview module: VFY(Adult.VFY)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: 2 IN VFYDEM_A
Universe Description: Sample Adult 18+ said his/her age is not correct
Question Text:
Response:
How old are you?
DK:
RF:
Enter age.
Don't Know
Refused
Skip Instructions: <0-120, RF, DK> if 3 IN VFYDEM_A [goto NEWNATORG_A]
elseif 4 IN VFYDEM_A [goto NEWRACE_A]
elseif GEN.NATO_FINAL=1 [goto HISPTYPE_A]
elseif GEN.RACE_FINAL[PX_A].RACE_FINAL=6 [goto PITYPE_A]
elseif GEN.RACE_FINAL[PX_A].RACE_FINAL=7 [goto ASIANTYPE_A]
elseif (NEWRACE_A=8 or (NEWRACE_A=empty and GEN.HHRESPSA_FLG
ne 1 and Roster.HHC.tblRACE.bperson.RACE_SP[PX_A] in (ZZ,RF,DK)))
[goto RACEOTHER_A]
else [goto BMONTH_A]
Question ID: VFY.0190.00.1
Variable name: NEWNATORG_A
Interview module: VFY(Adult.VFY)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: 3 IN VFYDEM_A
Universe Description: Sample Adult 18+ said his/her Hispanic Origin is not correct
Question Text:
Do you consider yourself to be Hispanic or Latino?
Response:
Page 17 of 430
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> if 4 IN VFYDEM_A [goto NEWRACE_A]
elseif GEN.NATO_FINAL=1 [goto HISPTYPE_A]
elseif GEN.RACE_FINAL[PX_A].RACE_FINAL=6 [goto PITYPE_A]
elseif GEN.RACE_FINAL[PX_A].RACE_FINAL=7 [goto ASIANTYPE_A]
elseif
(NEWRACE_A=8
or
(NEWRACE_A=empty
and
GEN.HHRESPSA_FLG
ne
1
and
Roster.HHC.tblRACE.bperson.RACE_SP[PX_A] in (ZZ,RF,DK)))
[goto
RACEOTHER_A]
else [goto BMONTH_A]
Question ID: VFY.0200.00.1
Variable name: NEWRACE_A
Interview module: VFY(Adult.VFY)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: 4 IN VFYDEM_A
Universe Description: Sample Adult 18+ said his/her race is not correct
Question Text:
Response:
What race or races do you consider yourself to be? Please select 1 or more of
these categories: White, Black, African American, American Indian, Alaska
Native, Native Hawaiian, Pacific Islander, Asian, or some other race? Enter all
that apply, separate with commas.
1.
2.
3.
4.
5.
White
Black/African American
American Indian
Alaska Native
Native Hawaiian
Page 18 of 430
6.
7.
8.
DK:
RF:
Pacific Islander
Asian
Some other race
Don't Know
Refused
Skip Instructions: <1-8,RF,DK> if GEN.NATO_FINAL=1 [goto HISPTYPE_A]
elseif GEN.RACE_FINAL[PX_A].RACE_FINAL=6 [goto PITYPE_A]
elseif GEN.RACE_FINAL[PX_A].RACE_FINAL=7 [goto
ASIANTYPE_A]
elseif (NEWRACE_A=8 or (NEWRACE_A=empty and
GEN.HHRESPSA_FLG
ne
1
and
Roster.HHC.tblRACE.bperson.RACE_SP[PX_A] in (ZZ,RF,DK)))
[goto
RACEOTHER_A]
else [goto BMONTH_A]
Question ID: VFY.0210.00.1
Variable name: HISPTYPE_A
Interview module: VFY(Adult.VFY)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: GEN.NATO_FINAL[PX_A]=1
NOMORE_A ne 1
and
(AVAIL_A=1
or
PROXY_A=1)
and
Universe Description: Respondent is of Hispanic Origin
Question Text:
Response:
What is your Hispanic or Latino ancestry or origin, such as Mexican, Mexican
American, ^CHICANOA, Central or South American, Puerto Rican, Cuban,
Dominican (Republic), or Other Hispanic, ^LATINOA, or Spanish -- and if you
have more than one, tell me all of them. Enter all that apply, separate with
commas.
1.
2.
Mexican, Mexican American, or Chicano(a)
Central American
Page 19 of 430
3.
4.
5.
6.
7.
DK:
RF:
Fills:
South American
Puerto Rican (Boricua)
Cuban
Dominican (Republic)
Other Hispanic, Latino(a), or Spanish (specify)
Don't Know
Refused
^CHICANOA
If SEX_FINAL = 1 fill: "Chicano"
if SEX_FINAL = 2,DK,RF fill "Chicano or Chicana"
^LATINOA
If SEX_FINAL= 1 fill: "Latino"
if SEX_FINAL = 2,DK,RF fill "Latino or Latina"
Skip Instructions: <7> [goto HISPOTHER_A]
<1-6,RF,DK>
if GEN.RACE_FINAL[PX_A]=6 [goto PITYPE_A]
elseif GEN.RACE_FINAL[PX_A]=7 [goto ASIANTYPE_A]
elseif (NEWRACE_A=8 or (NEWRACE_A=empty and GEN.HHRESPSA_FLG
ne 1 and Roster.HHC.tblRACE.bPerson.RACE_SP[PX_A] in (ZZ,RF,DK)))
[goto RACEOTHER_A]
else [goto BMONTH_A]
Question ID: VFY.0220.00.1
Variable name: HISPOTHER_A
Interview module: VFY(Adult.VFY)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: HISPTYPE_A=7
Universe Description: Respondent is of Other Hispanic Origin
Question Text:
Response:
?[F1] What is your Hispanic or Latino ancestry or origin? If you have more than
one, tell me all of them. Start typing and then select from list. If Hispanic or Latino
ancestry is not on the list, type "ZZ" and enter verbatim.
If any of the following are
mentioned, backup to previous screen and correct the entry. Mexican Mexican
American Chicano/Chicana Central American (REFER TO HELP SCREEN) South
American (REFER TO HELP SCREEN) Puerto Rican (Boricua) Cuban/Cuban
American Dominican (Republic) If respondent provides more than one other
Hispanic or Latino ancestry or origin, select 'ZZ' from the lookup table. At the next
question, enter ALL the other Hispanic or Latino ancestries or origins in the verbatim
field.
DK:
Don't Know
Page 20 of 430
RF:
Refused
Skip Instructions: [goto HISPVRBAT_A]
if GEN.RACE_FINAL[PX_A]=6 [goto
PITYPE_A]
elseif GEN.RACE_FINAL[PX_A]=7 [goto ASIANTYPE_A]
elseif (NEWRACE_A=8 or (NEWRACE_A=empty and GEN.HHRESPSA_FLG
ne 1 and Roster.HHC.tblRACE.bPerson.RACE_SP[PX_A] in (ZZ,RF,DK)))
[goto RACEOTHER_A]
else [goto BMONTH_A]
Question ID: VFY.0230.00.1
Variable name: HISPVRBAT_A
Interview module: VFY(Adult.VFY)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: HISPOTHER_A=ZZ
Universe Description: Sample Adult 18+ who report some other Hispanic Ancestry and this is not
choosen from the picklist
Question Text:
Response:
Read if necessary: What is your Hispanic or Latino ancestry or origin? If you have
more than one, tell me all of them.
DK:
RF:
Don't Know
Refused
Skip Instructions: if GEN.RACE_FINAL[PX_A].RACE_FINAL=6 [goto
PITYPE_A]
elseif GEN.RACE_FINAL[PX_A].RACE_FINAL=7 [goto ASIANTYPE_A]
elseif (NEWRACE_A=8 or (NEWRACE_A=empty and GEN.HHRESPSA_FLG
ne 1 and Roster.HHC.tblRACE.bPerson.RACE_SP[PX_A].RACE_FINAL in
(ZZ,RF,DK))) [goto RACEOTHER_A]
else [goto BMONTH_A]
Page 21 of 430
Question ID: VFY.0240.00.1
Variable name: PITYPE_A
Interview module: VFY(Adult.VFY)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: GEN.RACE_FINAL[PX_A].RACE_FINAL=6 and (AVAIL_A=1 or PROXY_A=1)
and NOMORE_A ne 1
Universe Description: Respondent identifies race as Pacific Islander
Question Text:
Response:
I have recorded that you are Pacific Islander. What specific ethnic group or
groups are you-- such as Guamanian or Chamorro, Samoan, or other Pacific
Islander? If you are more than one, tell me all of them. Enter all that apply,
separate with commas.
1.
2.
3.
DK:
RF:
Guamanian or Chamorro
Samoan
Other Pacific Islander
Don't Know
Refused
Skip Instructions: <3> [goto PIOTHER_A]
<1,2,RF,DK>
if
GEN.RACE_FINAL[PX_A].RACE_FINAL=7
[goto
ASIANTYPE_A]
elseif (NEWRACE_A=8 or (NEWRACE_A=empty and GEN.HHRESPSA_FLG
ne 1 and Roster.HHC.tblRACE.bPerson.RACE_SP[PX_A] IN (ZZ,RF,DK)))
[goto RACEOTHER_A]
else [goto BMONTH_A]
Page 22 of 430
Question ID: VFY.0250.00.1
Variable name: PIOTHER_A
Interview module: VFY(Adult.VFY)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: PITYPE_A=3
Universe Description: Sample Adult 18+ who identifies as Other Pacific Islander
Question Text:
Response:
Read if necessary: I have recorded that you are Pacific Islander. What specific ethnic
group or groups are you? If you are more than one, tell me all of them. Start typing
and then select from list. If Pacific Islander ethnic group is not on the list, type "ZZ"
and enter verbatim. If respondent provides more than one ethnic group, select 'ZZ'
from the lookup table. At the next question, enter ALL the ethnic groups in the
verbatim field.
DK:
RF:
Don't Know
Refused
Skip Instructions: [goto PIVRBAT_A]
if GEN.RACE_FINAL[PX_A].RACE_FINAL=7 [goto ASIANTYPE_A]
elseif (NEWRACE_A=8 or (NEWRACE_A=empty and HHRESPSA_FLG ne 1
and Roster.HHC.tblRACE.bPerson.RACE_SP[PX_A] IN (ZZ,RF,DK))) [goto
RACEOTHER_A]
else [goto BMONTH_A]
Question ID: VFY.0260.00.1
Variable name: PIVRBAT_A
Interview module: VFY(Adult.VFY)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: PIOTHER_A=ZZ
Universe Description: Sample Adult 18+ who report some other group of Pacific Islander not on the
picklist
Question Text:
Response:
Read if necessary: I have recorded that you are Pacific Islander. What specific ethnic
group or groups are you? If you are more than one, tell me all of them.
DK:
RF:
Don't Know
Refused
Page 23 of 430
Skip Instructions:
if GEN.RACE_FINAL[PX_A].RACE_FINAL=7 [goto ASIANTYPE_A]
elseif (NEWRACE_A=8 or (NEWRACE_A=empty and GEN.HHRESPSA_FLG
ne 1 and Roster.HHC.tblRACE.bPerson.RACE_SP[PX_A] IN (ZZ,RF,DK)))
[goto RACEOTHER_A]
else [goto BMONTH_A]
Question ID: VFY.0270.00.1
Variable name: ASIANTYPE_A
Interview module: VFY(Adult.VFY)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: GEN.RACE_FINAL[PX_A].RACE_FINAL=7 and (AVAIL_A=1 or PROXY_A=1)
and NOMORE_A ne 1
Universe Description: Sample Adult identifies race as Asian
Question Text:
Response:
I have recorded that you are Asian. What specific ethnic group or groups are
you-- such as Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese,
or Other Asian? If you are more than one, tell me all of them. Enter all that
apply, separate with commas.
1.
2.
3.
4.
5.
6.
7.
DK:
RF:
Asian Indian
Chinese
Filipino
Japanese
Korean
Vietnamese
Other Asian
Don't Know
Refused
Skip Instructions: <7> [goto ASIANOTHER_A]
<1-6,RF,DK>
elseif (NEWRACE_A=8 or (NEWRACE_A=empty and GEN.HHRESPSA_FLG
ne
1
and
Roster.HHC.tblRACE.bPerson.RACE_SP[PX_A]
in
(ZZ,RF,DK)))[goto RACEOTHER_A]
else [goto BMONTH_A]
Page 24 of 430
Question ID: VFY.0280.00.1
Variable name: ASIANOTHER_A
Interview module: VFY(Adult.VFY)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: ASIANTYPE_A=7
Universe Description: Respondent identifies as other Asian
Question Text:
Response:
What is your specific Asian ethnic group or groups? If you have more than one,
tell me all of them. Start typing and then select from list. If Asian ethnic group is not
on the list, type "ZZ" and enter verbatim.
If any of the following are mentioned,
backup to previous screen and correct the entry. (Asian) Indian Chinese Filipino
Japanese Korean Vietnamese If respondent provides more than one ethnic group,
select 'ZZ' from the lookup table. At the next question, enter ALL the ethnic groups in
the verbatim field.
DK:
RF:
Don't Know
Refused
Skip Instructions: (NEWRACE_A=8 or (NEWRACE_A=empty and
GEN.HHRESPSA_FLG
ne
1
and
Roster.HHC.tblRACE.bPerson.RACE_SP[PX_A] in (ZZ,RF,DK))) [goto
RACEOTHER_A]
else [goto BMONTH_A]
Question ID: VFY.0290.00.1
Variable name: ASIANVRBAT_A
Interview module: VFY(Adult.VFY)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: ASIANOTHER_A=ZZ
Universe Description: Sample Adult 18+ who report some other ethnic group of Asian that is not on
the picklist
Question Text:
Response:
Read if necessary: What is your specific Asian ethnic group or groups? If you have
more than one, tell me all of them.
DK:
RF:
Don't Know
Refused
Page 25 of 430
Skip Instructions:
if (NEWRACE_A=8 or (NEWRACE_A=empty and GEN.HHRESPSA_FLG ne
1 and Roster.HHC.tblRACE.bPerson.RACE_SP[PX_A] in (ZZ,RF,DK))) [goto
RACEOTHER_A]
else [goto BMONTH_A]
Question ID: VFY.0300.00.1
Variable name: RACEOTHER_A
Interview module: VFY(Adult.VFY)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: (AVAIL_A=1 or PROXY_A=1) and (NEWRACE_A=8 or (NEWRACE_A=empty
and GEN.HHRESPSA_FLG ne 1 and ROSTER.HHC.RACE_SP[PX_A] IN
(ZZ,RF,DK)))
Universe Description: Sample Adults 18+ and race was changed to "some other race" in verification
section or where the Sample Adult respondent is not the Household
respondent and did not report a new race and were identified by the household
respondent as being "some other race" not on the roster other race picklist
Question Text:
Response:
What other race or races do you consider yourself to be? Start typing and then
select from list. If race is not on the list, type "ZZ" and enter verbatim.
If
respondent provides more than one other race, select 'ZZ' from the lookup table. At
the next question, enter ALL the other races in the verbatim field.
DK:
RF:
Don't Know
Refused
Skip Instructions: [goto RACEVRBAT]
[goto BMONTH_A]
Page 26 of 430
Question ID: VFY.0310.00.1
Variable name: RACEVRBAT_A
Interview module: VFY(Adult.VFY)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: RACEOTHER_A=ZZ
Universe Description: Sample adults 18+ who are some other race and this is not selected from
Sample adult picklist
Question Text:
Response:
Read if necessary: What other race or races do you consider yourself to be?
DK:
RF:
Don't Know
Refused
Skip Instructions: [goto BMONTH_A]
Question ID: VFY.0340.01.1
Variable name: BMONTH_A
Interview module: VFY(Adult.VFY)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: (AVAIL_A=1 or PROXY_A=1) and DOB_COUNT_A lt 2
Universe Description: Sample adults 18+ and someone is available to continue the interview and
date of birth was verified as incorrect fewer than 2 times
Question Text:
Response:
1 of 3 What is your date of birth? Please give month, day, and year for the
date of birth.
Enter month of birth.
1.
2.
3.
January
February
March
Page 27 of 430
4.
5.
6.
7.
8.
9.
10.
11.
12.
DK:
RF:
April
May
June
July
August
September
October
November
December
Don't Know
Refused
Skip Instructions: <1-12,RF,DK> [goto BDAY_A]
Question ID: VFY.0340.02.1
Variable name: BDAY_A
Interview module: VFY(Adult.VFY)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: (AVAIL_A=1 or PROXY_A=1) and DOB_COUNT_A lt 2
Universe Description: Sample adults 18+ and someone is available to continue the interview and
date of birth was verified as incorrect fewer than 2 times
Question Text:
Response:
2 of 3
DK:
RF:
Enter day of birth.
Don't Know
Refused
Skip Instructions: <1-31,RF,DK> Only allow valid days for month entered. if days not valid [goto
ERR_BDAY_A]
else [goto BYEAR_A]
Page 28 of 430
Check Name: ERR_BDAY_A
Text:
{check ERR_BDAY_A}
^BDAY_A is not a valid day for ^BMONTH_A.
Hard / Soft Edit: Hard
Fills:
^BDAY_A
Fill value from Adult.VFY.BDAY_A
^BMONTH_A
Fill value from Adult.VFY.BMONTH_A
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: Invalid dates for the month entered
Question ID: VFY.0340.03.1
Variable name: BYEAR_A
Interview module: VFY(Adult.VFY)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: (AVAIL_A=1 or PROXY_A=1) and DOB_COUNT_A lt 2
Universe Description: Sample adults 18+ and someone is available to continue the interview and
date of birth was verified as incorrect fewer than 2 times
Question Text:
Response:
3 of 3
DK:
RF:
Enter year of birth.
If year of birth is before 1900, enter 1900.
Don't Know
Refused
Skip Instructions: <1900-current year,RF,DK>
if (BYEAR_A gt current year) or (BYEAR_A=current year and BMONTH_A gt
current month) or (BYEAR_A=current year and BMONTH_A=current month
and BDAY_A gt current day) [goto ERR_BYEAR_A]
elseif BDAY_A=29 and BMONTH_A=2 and (BYEAR=2000 or BYEAR_A/4
remainder ne 0) [goto ERR_BDAYLEAP_A]
elseif GEN.AGE_FINAL IN (RF,DK) [goto AGEGUESS_A]
elseif ((BYEAR_A not IN (RF,DK) and AGETEMP_A not IN (RF,DK) and
AGETEMP_A ne AGE_CALC_A) AND (AGETEMP_A not IN (RF,DK) and
AGETEMP_A ne AGE_CALCMINUS1_A)) and DOB_COUNT_A ne 1 [goto
Page 29 of 430
VFYDOB_A]
elseif (AGETEMP_A eq (AGE_CALC_A or AGE_CALCMINUS1_A)) or
DOB_COUNT_A=1
if GEN.AGE_FINAL[PX_A] lt 18 [goto NOMORE_A]
else [goto next section]
Check Name: ERR_BDAYLEAP_A
Text:
{check ERR_BDAYLEAP_A}
^BDAY_A is not a valid day for ^BMONTH_A.
Hard / Soft Edit: Hard
Fills:
^BDAY_A
Fill value from Adult.VFY.BDAY_A
^BMONTH_A
Fill value from Adult.VFY.BMONTH_A
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: Invalid dates for the month entered
Check Name: ERR_BYEAR_A
Text:
{check ERR_BYEAR_A}
Future date invalid
Hard / Soft Edit: Hard
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: (BYEAR_A>current
year)
or
(BYEAR_A=current
BMONTH_A>current
month)
or
(BYEAR_A=current
BMONTH_A=current month and BDAY_A>current day)
Universe Description: Birthday is in the future
Page 30 of 430
year
year
and
and
Question ID: VFY.0370.00.1
Variable name: AGEGUESS_A
Interview module: VFY(Adult.VFY)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: GEN.AGE_FINAL IN (DK,RF)
Universe Description: Sample Adult's age is don't know or refused
Question Text:
An age has not been collected and we are unable to determine an age based upon
the date of birth. What is your best guess at ^ALIASNAME's age?
Response:
Fills:
^ALIASNAME
Fill value from Roster.HHC.ALIAS[PX]
Skip Instructions: <18-120> [goto next section]
Question ID: VFY.0380.00.1
Variable name: VFYDOB_A
Interview module: VFY(Adult.VFY)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: ((BYEAR_A not IN (DK,RF) and AGETEMP_A not IN (DK,RF) and
AGETEMP_A ne AGE_CALC_C) AND (AGETEMP_A not IN (DK,RF) and
AGETEMP_A
ne
AGE_CALCMINUS1_A
and
(AGETEMP_A
ne
AGE_CALCSASTART_A
AND
SASTARTAGE_FLG
ne
1)))
and
DOB_COUNT_A ne 1 and
Universe Description: Sample Adults whose age provided in either HHC or NEWAGE_A does not
match either age calculated from date of birth information
Question Text:
There is a difference between the age the computer calculated from your date
of birth of ^AGEDOB_A_fill and the age I had previously recorded of
^TEMPAGE_A. I recorded your ^dateofbirth
Response:
Page 31 of 430
1.
2.
DK:
RF:
Fills:
Yes
No
Don't Know
Refused
^dateofbirth
If BDAY_A, BMONTH,A and BYEAR_A are all valid,
fill: "date of birth as ^BMONTH_A ^BDAY_A,
^BYEAR_A, is that correct?"
If only BMONTH_A and BYEAR_A are valid, fill:
"date of birth as ^BMONTH_A ^BYEAR_A, is that
correct?"
If only BDAY_A and BYEAR_A are valid, fill: "year of
birth as ^BYEAR_A, is that correct?"
If only BYEAR_A is valid, fill: "year of birth as
^BYEAR_A, is that correct?"
^AGEDOB_A_fill
Fill one age calculated from AGE_CALC_A as
"(age)"
Fill two ages calculated from AGE_CALC_A and
AGE_CALCMINUS1_A as "(age) or (age)"
^TEMPAGE_A
Fill value of AGETEMP_A
Skip Instructions: <1,RF,DK> if GEN.AGE_FINAL[PX_A] lt 18 [goto NOMORE_A]
else [goto next section]
<2> if DOB_COUNT_A le 1 [goto BMONTH_A]
else if GEN.AGE_FINAL[PX_A] lt 18 [goto NOMORE_A]
else [goto next section]
Page 32 of 430
Question ID: VFY.0390.00.1
Variable name: NOMORE_A
Interview module: VFY(Adult.VFY)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: GEN.AGE_FINAL[PX_A] lt 18 or VFYONCAMP_A=2
Universe Description: Sample adult whose age is now less than 18 or lives off campus
Question Text:
Response:
Fills:
^SANAME is no longer the sample adult for this family. End this interview and begin
the Sample Child Interview. If there is no Sample Child or the Sample Child interview
has been completed, EXIT Not everyone in our survey is asked all questions. I
have all the information that I need about you at this time.
Enter '1' to
Continue.
1.
Enter 1 to Continue
^SANAME
Sample Adult's name
Skip Instructions: <1> if there is a Sample Child that has not been interviewed [goto
Child.VFY.CURRES_C]
else if GEN.OUTCOME IN 215 [goto BCK.THANKS_INSUF]
else [goto BCK.THANKS_SUF]
Question ID: HIS.0010.00.1
Variable name: PHSTAT_A
Interview module: HIS(Adult.HIS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Would you say your health in general is excellent, very good, good, fair, or
poor?
Response:
Page 33 of 430
1.
2.
3.
4.
5.
DK:
RF:
Excellent
Very Good
Good
Fair
Poor
Don't Know
Refused
Skip Instructions: <1-5,RF,DK> [goto next section]
Question ID: LSF.0010.00.3
Variable name: LSATIS4_A
Interview module: LSF(Adult.LSF)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
In general, how satisfied are you with your life? Are you very satisfied,
satisfied, dissatisfied, or very dissatisfied?
1.
2.
3.
4.
DK:
RF:
Very satisfied
Satisfied
Dissatisfied
Very dissatisfied
Don't Know
Refused
Skip Instructions: <1-4,RF,DK> [goto next section]
Page 34 of 430
Question ID: HYP.0010.00.1
Variable name: HYPINTRO_A
Interview module: HYP(Adult.HYP)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
Now I am going to ask you about certain medical conditions.
continue.
1.
Enter '1' to
Enter 1 to Continue
Skip Instructions: <1> [goto HYPEV_A]
Question ID: HYP.0020.00.1
Variable name: HYPEV_A
Interview module: HYP(Adult.HYP)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
Have you EVER been told by a doctor or other health professional that you had
...Hypertension, also called high blood pressure? Enter '1' if respondent is
taking medication to control his/her high blood pressure.
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> [goto HYPDIF_A]
<2,RF,DK> [goto next section]
Page 35 of 430
Question ID: HYP.0030.00.1
Variable name: HYPDIF_A
Interview module: HYP(Adult.HYP)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: HYPEV_A=1
Universe Description: Sample Adults 18+ who were ever told they had hypertension
Question Text:
Response:
Were you told on two or more DIFFERENT visits that you had hypertension or
high blood pressure? Enter '1' if respondent is taking medication to control
his/her high blood pressure.
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> [goto HYP12M_A]
<2,RF,DK> [goto HYPMED_A]
Question ID: HYP.0040.00.1
Variable name: HYP12M_A
Interview module: HYP(Adult.HYP)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: HYPDIF_A=1
Universe Description: Sample Adults 18+ who were ever told they had hypertension (2+ visits)
Question Text:
During the past 12 months, have you had hypertension or high blood pressure?
Enter '1' if respondent is taking medication to control his/her high blood pressure.
Response:
Page 36 of 430
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto HYPMED_A]
Question ID: HYP.0050.00.1
Variable name: HYPMED_A
Interview module: HYP(Adult.HYP)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: HYPEV_A=1
Universe Description: Sample Adults 18+ who were ever told they have hypertension
Question Text:
Response:
Are you NOW taking any medication prescribed by a doctor for your high blood
pressure?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto next section]
Question ID: CHL.0010.00.1
Variable name: CHLEV_A
Interview module: CHL(Adult.CHL)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Have you EVER been told by a doctor or other health professional that you had
high cholesterol? Enter ‘1' if respondent is taking medication to control his/her
high cholesterol.
Response:
Page 37 of 430
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> [goto CHL12M_A]
<2,RF,DK> [goto next section]
Question ID: CHL.0020.00.1
Variable name: CHL12M_A
Interview module: CHL(Adult.CHL)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: CHLEV_A=1
Universe Description: Sample Adults 18+ who were ever told they had high cholesterol
Question Text:
Response:
During the past 12 months, have you had high cholesterol? Enter '1' if
respondent is taking medication to control his/her high cholesterol.
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto CHLMED_A]
Question ID: CHL.0030.00.1
Variable name: CHLMED_A
Interview module: CHL(Adult.CHL)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: CHLEV_A=1
Universe Description: Sample Adults 18+ who were ever told they had high cholesterol
Question Text:
Are you NOW taking any medication prescribed by a doctor to help lower your
cholesterol?
Response:
Page 38 of 430
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto next section]
Question ID: CVC.0010.00.1
Variable name: CHDEV_A
Interview module: CVC(Adult.CVC)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
Have you EVER been told by a doctor or other health professional that you had
...Coronary heart disease?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto ANGEV_A]
Question ID: CVC.0020.00.1
Variable name: ANGEV_A
Interview module: CVC(Adult.CVC)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Read if necessary: Have you EVER been told by a doctor or other health
professional that you had ...Angina, also called angina pectoris?
Response:
Page 39 of 430
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto MIEV_A]
Question ID: CVC.0030.00.1
Variable name: MIEV_A
Interview module: CVC(Adult.CVC)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
Read if necessary: Have you EVER been told by a doctor or other health
professional that you had ...A heart attack, also called myocardial infarction?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto STREV_A]
Question ID: CVC.0040.00.1
Variable name: STREV_A
Interview module: CVC(Adult.CVC)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Read if necessary: Have you EVER been told by a doctor or other health
professional that you had ...A stroke?
Response:
Page 40 of 430
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto next section]
Question ID: ASP.0010.00.2
Variable name: ASPMEDEV_A
Interview module: ASP(Adult.ASP)
Inherited Universe: (GEN.AGE_FINAL=40-120) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(GEN.AGE_FINAL=40-120))
Universe Description: Sample Adults 40+
Question Text:
Response:
Has a doctor or other health professional EVER told you to take a low-dose
aspirin each day to prevent or control heart disease? If the respondent
volunteers they have been told to take an aspirin every other day or "regularly" for
these reasons, enter 1 for "yes."
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> [goto ASPMEDNOWN_A]
<2,RF,DK> [goto ASPONOWN_A]
Page 41 of 430
Question ID: ASP.0020.00.2
Variable name: ASPMEDNOWN_A
Interview module: ASP(Adult.ASP)
Inherited Universe: (GEN.AGE_FINAL=40-120) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(GEN.AGE_FINAL=40-120))
Universe: ASPMEDEV_A=1
Universe Description: Sample Adults 40+ who have ever been advised to take a low-dose aspirin
every day to prevent or control heart disease
Question Text:
Response:
Are you NOW following this advice? If the respondent provides an answer such
as "sometimes," "occasionally," or "from time to time," enter '1' for "yes."
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,RF,DK> [goto next section]
<2> [goto ASPMEDSTP_A]
Question ID: ASP.0030.00.2
Variable name: ASPMEDSTP_A
Interview module: ASP(Adult.ASP)
Inherited Universe: (GEN.AGE_FINAL=40-120) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(GEN.AGE_FINAL=40-120))
Universe: ASPMEDNOWN_A=2
Universe Description: Sample Adults 40+ who have ever been advised to take aspirin every day, but
are not currently following that advice
Question Text:
Did a doctor or other health professional advise you to stop taking a low-dose
aspirin every day?
Response:
Page 42 of 430
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto next section]
Question ID: ASP.0040.00.2
Variable name: ASPONOWN_A
Interview module: ASP(Adult.ASP)
Inherited Universe: (GEN.AGE_FINAL=40-120) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(GEN.AGE_FINAL=40-120))
Universe: ASPMEDEV_A IN (2,RF,DK)
Universe Description: Sample Adults 40+ who have not been advised to take aspirin every day or
refused/don't know if they have been advised to take aspirin every day
Question Text:
Response:
On your own, are you now taking a low-dose aspirin each day to prevent or
control heart disease?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto next section]
Page 43 of 430
Question ID: AST.0010.00.1
Variable name: ASEV_A
Interview module: AST(Adult.AST)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
Have you EVER been told by a doctor or other health professional that you had
asthma?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> [goto ASTILL_A]
<2,RF,DK> [goto next section]
Question ID: AST.0020.00.1
Variable name: ASTILL_A
Interview module: AST(Adult.AST)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: ASEV_A=1
Universe Description: Sample Adults 18+ who were ever told they have asthma
Question Text:
Response:
Do you still have asthma?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Page 44 of 430
Skip Instructions: <1,2,RF,DK> [goto ASAT12M_A]
Question ID: AST.0030.00.1
Variable name: ASAT12M_A
Interview module: AST(Adult.AST)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: ASEV_A=1
Universe Description: Sample Adults 18+ who were ever told they had asthma
Question Text:
Response:
During the past 12 months, have you had an episode of asthma or an asthma
attack?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto ASER12M_A]
Question ID: AST.0040.00.1
Variable name: ASER12M_A
Interview module: AST(Adult.AST)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: ASEV_A=1
Universe Description: Sample Adults 18+ who were ever told they had asthma
Question Text:
During the past 12 months, have you had to visit an emergency room or urgent
care center because of asthma?
Response:
Page 45 of 430
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto next section]
Question ID: CAN.0010.00.1
Variable name: CANEV_A
Interview module: CAN(Adult.CAN)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
Have you EVER been told by a doctor or other health professional that you had
...Cancer or a malignancy of any kind?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> [goto CANKIND1_A]
<2,RF,DK> [goto next section]
Question ID: CAN.0020.00.1
Variable name: CANKIND1_A
Interview module: CAN(Adult.CAN)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: CANEV_A=1
Universe Description: Sample Adults 18+ who were ever told they had cancer
Question Text:
What kind of cancer was it?
Enter code for the first kind of cancer.
Response:
Page 46 of 430
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
DK:
RF:
Bladder
Blood
Bone
Brain
Breast
Cervix/Cervical
Colon
Esophagus/Esophageal
Gallbladder
Kidney
Larynx-trachea
Leukemia
Liver
Lung
Lymphoma
Melanoma
Mouth/tongue/lip
Ovary/Ovarian
Pancreas/Pancreatic
Prostate
Rectum/Rectal
Skin (melanoma)
Skin (non-melanoma)
Skin (don't know kind)
Stomach
Testis/Testicular
Throat - pharynx
Thyroid
Uterus/Uterine
Other
Don't Know
Refused
Skip Instructions: If GEN.SEX_FINAL[PX_A]=1 and CANKIND1_A IN (6,18,29)
ERR1_CANKIND_A]
elseif GEN.SEX_FINAL[PX_A]=2 and CANKIND1_A IN (20,26)
ERR2_CANKIND_A]
<1-30,RF,DK> [goto CANAGE1_A]
Page 47 of 430
[goto
[goto
Check Name: ERR1_CANKIND_A
Text:
{signal ERR1_CANKIND_A}
Verify. Code 6 or 18 or 29 is unavailable for males.
Hard / Soft Edit: Soft
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: GEN.SEX_FINAL=1 and (CANKIND1_A IN (6,18,29) or CANKIND2_A IN
(6,18,29) or CANKIND3_A IN (6,18,29))
Check Name: ERR2_CANKIND_A
Text:
{signal ERR2_CANKIND_A}
Verify.Code 20 or 26 is unavailable for females.
Hard / Soft Edit: Soft
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: GEN.SEX_FINAL=2 and (CANKIND1_A IN (20,26) or CANKIND2_A IN
(20,26) or CANKIND3_A IN (20,26))
Question ID: CAN.0030.00.1
Variable name: CANAGE1_A
Interview module: CAN(Adult.CAN)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: CANEV_A=1
Universe Description: Sample Adults 18+ who were ever told they had cancer
Question Text:
Response:
How old were you when a doctor or other health professional first told you that
you had ^CANKIND1? Enter 1 if reported age is 1 or younger.
DK:
RF:
Don't Know
Refused
Page 48 of 430
Fills:
^CANKIND1
If CANKIND1_A = RF,DK fill "this cancer";
else fill "bladder cancer" if CANKIND1_A = 1;
else fill "blood cancer" if CANKIND1_A = 2;
else fill "bone cancer" if CANKIND1_A = 3;
else fill "brain cancer" if CANKIND1_A = 4;
else fill "breast cancer" if CANKIND1_A = 5;
else fill "cervical cancer" if CANKIND1_A = 6;
else fill "colon cancer" if CANKIND1_A = 7;
else fill "esophageal cancer" if CANKIND1_A = 8;
else fill "gallbladder cancer" if CANKIND1_A = 9;
else fill "kidney cancer" if CANKIND1_A = 10;
else fill "larynx-trachea cancer" if CANKIND1_A = 11;
else fill "leukemia" if CANKIND1_A = 12;
else fill "liver cancer" if CANKIND1_A = 13;
else fill "lung cancer" if CANKIND1_A = 14;
else fill "lymphoma" if CANKIND1_A = 15;
else fill "melanoma" if CANKIND1_A = 16;
else fill "mouth/tongue/lip cancer" if CANKIND1_A =
17;
else fill "ovarian cancer" if CANKIND1_A = 18;
else fill "pancreatic cancer" if CANKIND1_A = 19;
else fill "prostate cancer" if CANKIND1_A = 20;
else fill "rectal cancer" if CANKIND1_A = 21;
else fill "skin (melanoma) cancer" if CANKIND1_A =
22;
else fill "skin (non-melanoma) cancer" if
CANKIND1_A = 23;
else fill "skin (don't know kind) cancer" if
CANKIND1_A = 24;
else fill "stomach cancer" if CANKIND1_A = 25;
else fill "testicular cancer" if CANKIND1_A = 26;
else fill "throat/pharynx cancer" if CANKIND1_A =
27;
else fill "thyroid cancer" if CANKIND1_A = 28;
else fill "uterine cancer" if CANKIND1_A = 29;
else fill "other cancer" if CANKIND1_A = 30
Page 49 of 430
Skip Instructions: <1-120,DK> [goto CANKIND2_A]
if CANKIND1_A=RF [goto next section] else [goto CANKIND2_A]
If
number
in
CANAGE1_A
gt
GEN.AGE_FINAL[PX_A]
ERR_CANAGE1_A]
[goto
Check Name: ERR_CANAGE1_A
Text:
{check ERR_CANAGE1_A}
Please correct.
^CANAGE1_A years old is older than age ^SA_AGE.
Hard / Soft Edit: Hard
Fills:
^CANAGE1_A
Fill value from Adult.CAN.CANAGE1_A
^SA_AGE
Fill GEN.AGE_FINAL[PX_A] value for sample adult
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: If GEN.AGE_FINAL=valid and value in CANAGE1_A gt GEN.AGE_FINAL
Question ID: CAN.0040.00.1
Variable name: CANKIND2_A
Interview module: CAN(Adult.CAN)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: CANEV_A=1 and (CANKIND1_A IN (1-30,DK) or CANAGE1_A IN (1-120,DK))
Universe Description: Sample Adults 18+ who were ever told they had cancer and mentioned or
didn't know a first type of cancer OR gave a valid age or did not know age for
first cancer
Question Text:
Have you EVER had any other kinds of cancer?
If yes, ask respondent for
second kind of cancer, enter code. If no, enter '96' for no more.
Response:
Page 50 of 430
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
96.
DK:
RF:
Bladder
Blood
Bone
Brain
Breast
Cervix/Cervical
Colon
Esophagus/Esophageal
Gallbladder
Kidney
Larynx-trachea
Leukemia
Liver
Lung
Lymphoma
Melanoma
Mouth/tongue/lip
Ovary/Ovarian
Pancreas/Pancreatic
Prostate
Rectum/Rectal
Skin (melanoma)
Skin (non-melanoma)
Skin (don't know kind)
Stomach
Testis/Testicular
Throat - pharynx
Thyroid
Uterus/Uterine
Other
No more
Don't Know
Refused
Skip Instructions: If GEN.SEX_FINAL[PX_A]=1 and CANKIND2_A IN (6,18,29)
ERR1_CANKIND_A]
elseif GEN.SEX_FINAL[PX_A]=2 and CANKIND2_A IN (20,26)
ERR2_CANKIND_A]
<1-30,RF,DK> [goto CANAGE2_A]
<96> [goto next section]
Page 51 of 430
[goto
[goto
Question ID: CAN.0050.00.1
Variable name: CANAGE2_A
Interview module: CAN(Adult.CAN)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: CANKIND2_A IN (1-30,DK,RF)
Universe Description: Sample Adults 18+ who selected a second kind of cancer or don't know the
second kind of cancer or refused the second kind of cancer
Question Text:
Response:
Fills:
How old were you when a doctor or other health professional first told you that
you had ^CANKIND2? Enter 1 if reported age is 1 or younger.
DK:
RF:
Don't Know
Refused
^CANKIND2
If CANKIND2_A = R,D fill "this cancer";
else fill "bladder cancer" if CANKIND2_A = 1;
else fill "blood cancer" if CANKIND2_A = 2;
else fill "bone cancer" if CANKIND2_A = 3;
else fill "brain cancer" if CANKIND2_A = 4;
else fill "breast cancer" if CANKIND2_A = 5;
else fill "cervical cancer" if CANKIND2_A = 6;
else fill "colon cancer" if CANKIND2_A = 7;
else fill "esophageal cancer" if CANKIND2_A = 8;
else fill "gallbladder cancer" if CANKIND2_A = 9;
else fill "kidney cancer" if CANKIND2_A = 10;
else fill "larynx-trachea cancer" if CANKIND2_A = 11;
else fill "leukemia" if CANKIND2_A = 12;
else fill "liver cancer" if CANKIND2_A = 13;
else fill "lung cancer" if CANKIND2_A = 14;
else fill "lymphoma" if CANKIND2_A = 15;
else fill "melanoma" if CANKIND2_A = 16;
else fill "mouth/tongue/lip cancer" if CANKIND2_A =
17;
else fill "ovarian cancer" if CANKIND2_A = 18;
else fill "pancreatic cancer" if CANKIND2_A = 19;
else fill "prostate cancer" if CANKIND2_A = 20;
else fill "rectal cancer" if CANKIND2_A = 21;
else fill "skin (melanoma) cancer" if CANKIND2_A =
22;
else fill "skin (non-melanoma) cancer" if
CANKIND2_A = 23;
else fill "skin (don't know kind) cancer" if
CANKIND2_A = 24;
else fill "stomach cancer" if CANKIND2_A = 25;
Page 52 of 430
else fill "testicular cancer" if CANKIND2_A = 26;
else fill "throat/pharynx cancer" if CANKIND2_A =
27;
else fill "thyroid cancer" if CANKIND2_A = 28;
else fill "uterine cancer" if CANKIND2_A = 29;
else fill "other cancer" if CANKIND2_A = 30
Skip Instructions: <1-120,DK> [goto CANKIND3_A]
if CANKIND2_A=RF [goto next section] else [goto CANKIND3_A]
If CANAGE2_A gt GEN.AGE_FINAL[PX_A] [goto ERR_CANAGE2_A]
Check Name: ERR_CANAGE2_A
Text:
{check ERR_CANAGE2_A} ^CANAGE2_A years old is older than age ^SA_AGE.
Please correct.
Hard / Soft Edit: Hard
Fills:
^CANAGE2_A
Fill value from Adult.CAN.CANAGE2_A
^SA_AGE
Fill GEN.AGE_FINAL[PX_A] value for sample adult
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: If GEN.AGE_FINAL=valid and value in CANAGE2_A gt GEN.AGE_FINAL
Page 53 of 430
Question ID: CAN.0060.00.1
Variable name: CANKIND3_A
Interview module: CAN(Adult.CAN)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: CANKIND2_A IN (1-30,DK) or CANAGE2_A IN (1-120,DK)
Universe Description: Sample Adults 18+ who selected a second kind of cancer or don't know the
second kind of cancer or gave a valid age for second cancer or did not know
age for second cancer
Question Text:
Response:
Have you EVER had any other kinds of cancer? If yes, ask respondent for third
kind of cancer, enter code. If no, enter '96' for no more.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
Bladder
Blood
Bone
Brain
Breast
Cervix/Cervical
Colon
Esophagus/Esophageal
Gallbladder
Kidney
Larynx-trachea
Leukemia
Liver
Lung
Lymphoma
Melanoma
Mouth/tongue/lip
Ovary/Ovarian
Pancreas/Pancreatic
Prostate
Rectum/Rectal
Page 54 of 430
22.
23.
24.
25.
26.
27.
28.
29.
30.
96.
DK:
RF:
Skin (melanoma)
Skin (non-melanoma)
Skin (don't know kind)
Stomach
Testis/Testicular
Throat - pharynx
Thyroid
Uterus/Uterine
Other
No more
Don't Know
Refused
Skip Instructions: If
GEN.SEX_FINAL=1
and
CANKIND3_A
IN
(6,18,29)
ERR1_CANKIND_A]
elseif
GEN.SEX_FINAL=2
and
CANKIND3_A
IN
(20,26)
ERR2_CANKIND_A]
<1-30,RF,DK>[goto CANAGE3_A]
<96> [goto next section]
Question ID: CAN.0070.00.1
Variable name: CANAGE3_A
[goto
[goto
Interview module: CAN(Adult.CAN)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: CANKIND3_A IN (1-30,DK,RF)
Universe Description: Sample Adults 18+ who selected a third kind of cancer or don't know or
refused the third kind of cancer
Question Text:
Response:
How old were you when a doctor or other health professional first told you that
you had ^CANKIND3? Enter 1 if reported age is 1 or younger.
DK:
RF:
Don't Know
Refused
Page 55 of 430
Fills:
^CANKIND3
If CANKIND3_A = R,D fill "this cancer";
else fill "bladder cancer" if CANKIND3_A = 1;
else fill "blood cancer" if CANKIND3_A = 2;
else fill "bone cancer" if CANKIND3_A = 3;
else fill "brain cancer" if CANKIND3_A = 4;
else fill "breast cancer" if CANKIND3_A = 5;
else fill "cervical cancer" if CANKIND3_A = 6;
else fill "colon cancer" if CANKIND3_A = 7;
else fill "esophageal cancer" if CANKIND3_A = 8;
else fill "gallbladder cancer" if CANKIND3_A = 9;
else fill "kidney cancer" if CANKIND3_A = 10;
else fill "larynx-trachea cancer" if CANKIND3_A = 11;
else fill "leukemia" if CANKIND3_A = 12;
else fill "liver cancer" if CANKIND3_A = 13;
else fill "lung cancer" if CANKIND3_A = 14;
else fill "lymphoma" if CANKIND3_A = 15;
else fill "melanoma" if CANKIND3_A = 16;
else fill "mouth/tongue/lip cancer" if CANKIND3_A =
17;
else fill "ovarian cancer" if CANKIND3_A = 18;
else fill "pancreatic cancer" if CANKIND3_A = 19;
else fill "prostate cancer" if CANKIND3_A = 20;
else fill "rectal cancer" if CANKIND3_A = 21;
else fill "skin (melanoma) cancer" if CANKIND3_A =
22;
else fill "skin (non-melanoma) cancer" if
CANKIND3_A = 23;
else fill "skin (don't know kind) cancer" if
CANKIND3_A = 24;
else fill "stomach cancer" if CANKIND3_A = 25;
else fill "testicular cancer" if CANKIND3_A = 26;
else fill "throat/pharynx cancer" if CANKIND3_A =
27;
else fill "thyroid cancer" if CANKIND3_A = 28;
else fill "uterine cancer" if CANKIND3_A = 29;
else fill "other cancer" if CANKIND3_A = 30
Page 56 of 430
Skip Instructions: <1-120,DK> [goto CANMORE_A]
if CANKIND3_A=RF [goto next section] else [goto CANMORE_A]
if CANAGE3_A gt GEN.AGE_FINAL[PX_A] [goto ERR_CANAGE3_A]
Check Name: ERR_CANAGE3_A
Text:
{check ERR_CANAGE3_A}
Please correct.
^CANAGE3_A years old is older than age ^SA_AGE.
Hard / Soft Edit: Hard
Fills:
^CANAGE3_A
Fill value from Adult.CAN.CANAGE3_A
^SA_AGE
Fill GEN.AGE_FINAL[PX_A] value for sample adult
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: If GEN.AGE_FINAL=valid and value in CANAGE3_A gt GEN.AGE_FINAL
Question ID: CAN.0080.00.1
Variable name: CANMORE_A
Interview module: CAN(Adult.CAN)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: CANKIND3_A IN (1-30,DK) or CANAGE3_A IN (1-120,DK)
Universe Description: Sample Adults 18+ who selected a third kind of cancer or don't know the third
kind of cancer or selected a valid age for third type of cancer or did not know
age for third type of cancer
Question Text:
Did you have any other kinds of cancer?
Response:
Page 57 of 430
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto next section]
Question ID: DIB.0010.00.1
Variable name: PREDIB_A
Interview module: DIB(Adult.DIB)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
Has a doctor or other health professional EVER told you that you had
prediabetes or borderline diabetes?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> If GEN.SEX_FINAL[PX_A]=2 [goto GESDIB_A]
elseif GEN.SEX_FINAL[PX_A]=1,RF,DK [goto DIBEV_A]
Question ID: DIB.0020.00.1
Variable name: GESDIB_A
Interview module: DIB(Adult.DIB)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: SEX_FINAL[PX_A]=2
Universe Description: Female Sample Adults 18+
Question Text:
Has a doctor or other health professional EVER told you that you had
gestational diabetes, a type of diabetes that occurs ONLY during pregnancy?
Read if necessary: Gestational diabetes is diabetes that you did not have prior to
being pregnant and goes away after you are pregnant. Pregnant women are usually
screened for gestational diabetes during the 24th to 28th week of pregnancy.
Response:
Page 58 of 430
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto DIBEV_A]
Question ID: DIB.0030.00.1
Variable name: DIBEV_A
Interview module: DIB(Adult.DIB)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
Fills:
^NOTPREGDM a doctor or other health professional EVER told you that you
had diabetes?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
^NOTPREGDM
If GESDIB_A ne 1 AND PREDIB_A ne 1: "Has"
If GESDIB_A=1 AND PREDIB_A ne 1: "Not including
gestational diabetes, has"
If PREDIB_A=1 AND GESDIB_A ne 1: "Not including
prediabetes, has"
If GESDIB_A=1 AND PREDIB_A=1: "Not including
prediabetes orgestational diabetes, has"
Skip Instructions: <1> [goto DIBAGE_A]
<2,RF,DK> if PREDIB_A=1 [goto DIBPILL_A]
else if PREDIB_A=2,RF,DK [goto next section]
Page 59 of 430
Question ID: DIB.0040.00.1
Variable name: DIBAGE_A
Interview module: DIB(Adult.DIB)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: DIBEV_A=1
Universe Description: Sample Adults 18+ who were told they had diabetes
Question Text:
Response:
Fills:
How old were you when a doctor or other health professional FIRST told you
that you had diabetes^NOTPREGDM2? Enter '1' if reported age is 1 or younger.
DK:
RF:
Don't Know
Refused
^NOTPREGDM2
If GESDIB_A ne 1 AND PREDIB_A ne 1: NO FILL
If GESDIB_A=1 AND PREDIB_A ne 1: ",not
including gestational diabetes"
If PREDIB_A=1 AND GESDIB_A ne 1: ",not
including prediabetes"
If GESDIB_A=1 AND PREDIB_A=1: ",not including
prediabetes orgestational diabetes"
Skip Instructions: <1-120,RF,DK> if DIBAGE_A gt GEN.AGE_FINAL [goto ERR_DIBAGE_A]
else [goto DIBPILL_A]
Check Name: ERR_ DIBAGE_A
Text:
{check ERR_DIBAGE_A}
Please correct.
^DIBAGE_A years old is older than your age ^SA_AGE.
Hard / Soft Edit: Hard
Fills:
^DIBAGE_A
Fill value from Adult.DIB.DIBAGE_A
^SA_AGE
Fill GEN.AGE_FINAL[PX_A] value for sample adult
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: If AGE_FINAL=valid and value in DIBAGE_A gt AGE_FINAL
Page 60 of 430
Universe Description: Age diagnosed with diabetes is greater than SA age
Question ID: DIB.0050.00.1
Variable name: DIBPILL_A
Interview module: DIB(Adult.DIB)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: PREDIB_A=1 or DIBEV_A=1
Universe Description: Sample Adults 18+ who were told they had prediabetes and/or diabetes
Question Text:
Response:
Are you NOW taking diabetic pills to lower your blood sugar? These are
sometimes called oral agents or oral hypoglycemic agents.
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1-2,RF,DK> [goto DIBINS_A]
Question ID: DIB.0060.00.1
Variable name: DIBINS_A
Interview module: DIB(Adult.DIB)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: PREDIB_A=1 or DIBEV_A=1
Universe Description: Sample Adults 18+ who were told they had prediabetes and/or diabetes
Question Text:
Insulin can be taken by shot or pump. Are you NOW taking insulin?
Response:
Page 61 of 430
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> if DIBEV_A=1 [goto DIBINSTIME_A]
else [goto next section]
<2,RF,DK> if DIBEV_A=1 [goto DIBTYPE_A]
else [goto next section]
Question ID: DIB.0070.00.3
Variable name: DIBINSTIME_A
Interview module: DIB(Adult.DIB)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: DIBEV_A=1 and DIBINS_A=1
Universe Description: Sample Adults 18+ who have diabetes and currently take insulin
Question Text:
Response:
Thinking back to when you were first diagnosed with diabetes, how long was it
before you started taking insulin?
1.
2.
3.
4.
DK:
RF:
Less than 1 month
1 month to less than 6 months
6 months to less than 1 year
1 year or more
Don't Know
Refused
Skip Instructions: <1-4,RF,DK> [goto DIBINSSTOP_A]
Page 62 of 430
Question ID: DIB.0080.00.3
Variable name: DIBINSSTOP_A
Interview module: DIB(Adult.DIB)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: DIBEV_A=1 and DIBINS_A=1
Universe Description: Sample Adults 18+ who have diabetes and are taking insulin
Question Text:
Response:
Since you started taking insulin, have you ever stopped taking it for more than
6 months?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> if DIBINSTIME_A IN (1,2,3) [goto DIBINSSTYR_A]
else [goto DIBTYPE_A]
<2,RF,DK> [goto DIBTYPE_A]
Question ID: DIB.0090.00.3
Variable name: DIBINSSTYR_A
Interview module: DIB(Adult.DIB)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: DIBINSTIME_A in (1,2,3) and DIBINSSTOP_A=1
Universe Description: Sample Adults 18+ who have diabetes, who started taking insulin less than 1
year from when they were diagnosed with diabetes, and who stopped taking
insulin for more than 6 months
Question Text:
Was this only during the first year after you were diagnosed with diabetes?
Response:
Page 63 of 430
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto DIBTYPE_A]
Question ID: DIB.0130.00.1
Variable name: DIBTYPE_A
Interview module: DIB(Adult.DIB)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: DIBEV_A=1
Universe Description: Sample Adults 18+ who were told they had diabetes
Question Text:
Response:
According to your doctor or other health professional, what type of diabetes do
you have? Is it type 1, type 2, or some other type? If you don't remember or
weren't told, that's OK.
1.
2.
3.
DK:
RF:
Type 1
Type 2
Other type of diabetes
Don't Know
Refused
Skip Instructions: <1-3,RF,DK> [goto next section]
Question ID: CON.0010.00.1
Variable name: COPDEV_A
Interview module: CON(Adult.CON)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Have you EVER been told by a doctor or other health professional that you had
...Chronic Obstructive Pulmonary Disease, C.O.P.D., emphysema, or chronic
bronchitis?
Response:
Page 64 of 430
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto ARTHEV_A]
Question ID: CON.0020.00.1
Variable name: ARTHEV_A
Interview module: CON(Adult.CON)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
Read if necessary: Have you EVER been told by a doctor or other health
professional that you had ...Some form of arthritis, rheumatoid arthritis, gout,
lupus, or fibromyalgia (fy-bro-my-AL-jee-uh)?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto DEMENEV_A]
Question ID: CON.0030.00.1
Variable name: DEMENEV_A
Interview module: CON(Adult.CON)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Read if necessary: Have you EVER been told by a doctor or other health
professional that you had ...Dementia, including Alzheimer's disease?
Response:
Page 65 of 430
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto ANXEV_A]
Question ID: CON.0040.00.1
Variable name: ANXEV_A
Interview module: CON(Adult.CON)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
Read if necessary: Have you EVER been told by a doctor or other health
professional that you had ...Any type of anxiety disorder? Read if necessary:
Some common types of anxiety disorders include generalized anxiety disorder, social
anxiety disorder, panic disorder, post-traumatic stress disorder,
obsessive-compulsive disorder, and phobias.
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto DEPEV_A]
Question ID: CON.0050.00.1
Variable name: DEPEV_A
Interview module: CON(Adult.CON)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Read if necessary: Have you EVER been told by a doctor or other health
professional that you had ...Any type of depression? Read if necessary: Some
common types of depression include major depression (or major depressive
disorder), bipolar depression, dysthymia, post-partum depression, and seasonal
affective disorder.
Response:
Page 66 of 430
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto next section]
Question ID: SCE.0010.00.3
Variable name: HEPEV_A
Interview module: SCE(Adult.SCE)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
Have you EVER been told by a doctor or other health professional that you had
...Hepatitis?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto CROHNSEV_A]
Question ID: SCE.0020.00.3
Variable name: CROHNSEV_A
Interview module: SCE(Adult.SCE)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Read if necessary: Have you EVER been told by a doctor or other health
professional that you had ...Crohn's disease?
Response:
Page 67 of 430
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto ULCCOLEV_A]
Question ID: SCE.0030.00.3
Variable name: ULCCOLEV_A
Interview module: SCE(Adult.SCE)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
Read if necessary: Have you EVER been told by a doctor or other health
professional that you had ...Ulcerative Colitis?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto PSOREV_A]
Question ID: SCE.0040.00.3
Variable name: PSOREV_A
Interview module: SCE(Adult.SCE)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Read if necessary: Have you EVER been told by a doctor or other health
professional that you had ...Psoriasis (sore-EYE-ah-sis)?
Response:
Page 68 of 430
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto next section]
Question ID: CFS.0010.00.3
Variable name: CFSEV_A
Interview module: CFS(Adult.CFS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
Read if necessary: Have you EVER been told by a doctor or other health
professional that you had ...Chronic Fatigue Syndrome (CFS) or Myalgic
Encephalomyelitis (My-AL-jick In-seff-ah-low-my-uh-LIE-tiss) (ME)?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> [goto CFSNOW_A]
<2,RF,DK> [goto next section]
Question ID: CFS.0020.00.3
Variable name: CFSNOW_A
Interview module: CFS(Adult.CFS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: CFSEV_A=1
Universe Description: Sample Adults 18+ who have been told by a doctor or other health
professional that they had Chronic Fatigue Syndrome or Myalgic
Encephalomyelitis
Question Text:
Do you still have Chronic Fatigue Syndrome (CFS) or ME?
ME is also known as Myalgic Encephalomyelitis (My-AL-jick
In-seff-ah-low-my-uh-LIE-tiss).
Response:
Page 69 of 430
Read if necessary:
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto next section]
Question ID: ISN.0010.00.3
Variable name: MEDRXTRT_A
Interview module: ISN(Adult.ISN)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
In the past 12 months, have you taken prescription medication or had any
medical treatments that a doctor or other health professional told you would
weaken your immune system? Read if necessary: Examples include steroid or
corticosteroid (Core-tih-coe-STAIR-oid) pills, such as prednisone (PRED-nuh-sown),
or other oral or injected medications for treating many types of autoimmune
conditions or certain cancers.
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto HLTHCOND_A]
Question ID: ISN.0020.00.3
Variable name: HLTHCOND_A
Interview module: ISN(Adult.ISN)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Do you currently have a health condition that a doctor or other health
professional told you weakens the immune system^MEDTRT? Read if
necessary: Examples include certain kinds of leukemia, lymphoma, or HIV infection.
Response:
Page 70 of 430
1.
2.
DK:
RF:
Fills:
Yes
No
Don't Know
Refused
^MEDTRT
If MEDRXTRT_A=1, fill: ", even without related
medications or treatments"
Skip Instructions: <1,2,RF,DK> [goto next section]
Question ID: EPI.0010.00.3
Variable name: EPIEV_A
Interview module: EPI(Adult.EPI)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
Have you ever been told by a doctor or other health professional that you have
a seizure disorder or epilepsy?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> [goto EPIMED_A]
<2,RF,DK> [goto next section]
Page 71 of 430
Question ID: EPI.0020.00.3
Variable name: EPIMED_A
Interview module: EPI(Adult.EPI)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: EPIEV_A=1
Universe Description: Sample Adults 18+ who ever had epilepsy
Question Text:
Response:
Are you currently taking any medicine to control your seizure disorder or
epilepsy?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto EPINUMSEIZ_A]
Question ID: EPI.0030.00.3
Variable name: EPINUMSEIZ_A
Interview module: EPI(Adult.EPI)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: EPIEV_A=1
Universe Description: Sample Adults 18+ who ever had epilepsy
Question Text:
Today is ^CURRENTDATE. Think back to the last year about the same time.
About how many seizures of any type have you had during the past 12 months?
Read if necessary: Some people may call it a "convulsion," "fit," "falling out spell,"
"episode," "attack," "drop attack," "staring spell," or "out-of-touch." If the respondent
mentions and counts "auras" as seizures accept the response.
If the respondent
indicates that he/she has had nothing more than an aura and is unsure about
counting the aura(s), do NOT count auras as seizures.
Response:
Page 72 of 430
0.
1.
2.
3.
4.
DK:
RF:
Fills:
0
1
2 or 3
Between 4 and 10
More than 10
Don't Know
Refused
^CURRENTDATE
Fill with current month, day, and year at the time of
the interview.
Skip Instructions: <0-4,RF,DK> [goto EPIDR_A]
Question ID: EPI.0040.00.3
Variable name: EPIDR_A
Interview module: EPI(Adult.EPI)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: EPIEV_A=1
Universe Description: Sample Adults 18+ who ever had epilepsy
Question Text:
Response:
During the past 12 months, have you seen a neurologist or epilepsy specialist
for your seizure disorder or epilepsy?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto next section]
Page 73 of 430
Question ID: SVC.0010.00.3
Variable name: VIMDREV_A
Interview module: SVC(Adult.SVC)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
Have you EVER been told by a doctor or other heath professional that you had
...Diabetic retinopathy?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> [goto VIMLSDR_A]
<2,RF,DK> [goto VIMGLEV_A]
Question ID: SVC.0020.00.3
Variable name: VIMLSDR_A
Interview module: SVC(Adult.SVC)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: VIMDREV_A=1
Universe Description: Sample Adults 18+ who have ever been told they had diabetic retinopathy
Question Text:
Response:
Have you lost any vision due to diabetic retinopathy?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Page 74 of 430
Skip Instructions: <1,2,RF,DK> [goto VIMGLEV_A]
Question ID: SVC.0030.00.3
Variable name: VIMGLEV_A
Interview module: SVC(Adult.SVC)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
Have you EVER been told by a doctor or other heath professional that you had
...Glaucoma?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> [goto VIMLSGL_A]
<2,RF,DK> if GEN.AGE_FINAL ge 45 [goto VIMMDEV_A]
else [goto next section]
Question ID: SVC.0040.00.3
Variable name: VIMLSGL_A
Interview module: SVC(Adult.SVC)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: VIMGLEV_A=1
Universe Description: Sample Adults 18+ who have ever been told they had glaucoma
Question Text:
Have you lost any vision due to glaucoma?
Response:
Page 75 of 430
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> if GEN.AGE_FINAL ge 45 [goto VIMMDEV_A]
else [goto next section]
Question ID: SVC.0050.00.3
Variable name: VIMMDEV_A
Interview module: SVC(Adult.SVC)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: GEN.AGE_FINAL[PX_A] ge 45
Universe Description: Sample Adults 45+
Question Text:
Response:
Have you EVER been told by a doctor or other heath professional that you had
...Macular Degeneration?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> [goto VIMLSMD_A]
<2,RF,DK> [goto VIMCSURG_A]
Question ID: SVC.0060.00.3
Variable name: VIMLSMD_A
Interview module: SVC(Adult.SVC)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: GEN.AGE_FINAL[PX_A] ge 45 and VIMMDEV_A=1
Universe Description: Sample Adults 45+ who have ever been told they had macular degeneration
Question Text:
Have you lost any vision due to macular degeneration?
Response:
Page 76 of 430
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto VIMCSURG_A]
Question ID: SVC.0070.00.3
Variable name: VIMCSURG_A
Interview module: SVC(Adult.SVC)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: GEN.AGE_FINAL[PX_A] ge 45
Universe Description: Sample Adults 45+
Question Text:
Response:
Have you EVER had cataract surgery?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> [goto next section]
<2,RF,DK> [goto VIMCAEV_A]
Question ID: SVC.0080.00.3
Variable name: VIMCAEV_A
Interview module: SVC(Adult.SVC)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: GEN.AGE_FINAL[PX_A] ge 45 and VIMCSURG_A IN (2,RF,DK)
Universe Description: Sample Adults 45+ who have not had cataract surgery or refused or don't
know
Question Text:
Have you EVER been told by a doctor or other heath professional that you had
...Cataracts?
Response:
Page 77 of 430
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> [goto VIMLSCA_A]
<2,RF,DK> [goto next section]
Question ID: SVC.0090.00.3
Variable name: VIMLSCA_A
Interview module: SVC(Adult.SVC)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: GEN.AGE_FINAL[PX_A] ge 45 and VIMCAEV_A=1
Universe Description: Sample Adults 45+ who have ever been told they had cataracts
Question Text:
Response:
Have you lost any vision due to cataracts?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto next section]
Question ID: BMI.0010.00.1
Variable name: PREGNOW_A
Interview module: BMI(Adult.BMI)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: GEN.SEX_FINAL[PX_A]=2 and ((GEN.AGE_FINAL[PX_A] ge 18
GEN.AGE_FINAL[PX_A] le 49) or GEN.AGE_FINAL[PX_A] IN (DK,RF))
Universe Description: Female Sample Adults 18-49 or age is don't know or refused
Question Text:
Are you currently pregnant?
Response:
Page 78 of 430
and
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto HEIGHTFT_A]
Question ID: BMI.0020.01.1
Variable name: HEIGHTFT_A
Interview module: BMI(Adult.BMI)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adult 18+
Question Text:
Response:
Fills:
How tall are you without shoes? Enter M to record metric measurements. If
^SANAME's height is less than 2 feet, enter 2. If ^SANAME's height is greater than 7
feet, enter 7.
DK:
RF:
Don't Know
Refused
^SANAME
Sample Adult's name
Skip Instructions: If HEIGHTFT_A NE <2-7,RF,DK,M> [goto ERR1_HEIGHTFT_A]
If HEIGHTFT_A = <2,3> [goto ERR2_HEIGHTFT_A]
<2-7> [goto HEIGHTIN_A]
[goto WEIGHTLB_A]
[goto HEIGHTM_A]
Page 79 of 430
Check Name: ERR1_HEIGHTFT_A
Text:
{check ERR1_HEIGHTFT_A}
field. Please correct.
Only 2-7, Don't Know/Refused or M allowed in this
Hard / Soft Edit: Hard
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: HEIGHTFT_A NE (2-7,RF,DK,M)
Universe Description: Height is not 2ft-7ft, Refused, Don't know, or Metric
Check Name: ERR2_HEIGHTFT_A
Text:
{signal ERR2_HEIGHTFT_A}
Please verify.
Respondent's height in feet is ^HEIGHTFT?
Hard / Soft Edit: Soft
Fills:
^HEIGHTFT
Fill value from Adult.BMI.HEIGHTFT_A
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: HEIGHTFT_A IN (2,3)
Page 80 of 430
Question ID: BMI.0020.02.1
Variable name: HEIGHTIN_A
Interview module: BMI(Adult.BMI)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: HEIGHTFT_A=2-7
Universe Description: Sample Adult 18+ and height is 2-7ft
Question Text:
Response:
Fills:
Enter inches.
DK:
RF:
Enter '0' if exactly ^HEIGHTFT feet tall.
Don't Know
Refused
^HEIGHTFT
Fill value from Adult.BMI.HEIGHTFT_A
Skip Instructions: <0-11,RF,DK> [goto WEIGHTLB_A]
Check Name: ERR2_HEIGHTIN_A
Text:
{signal ERR2_HEIGHTIN_A}
Probe only if necessary.
Please verify that the height was entered correctly.
Hard / Soft Edit: Soft
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: ((GEN.SEX_FINAL[PX_A]=1 and (AHTINCH_A lt 61 or AHTINCH_A gt 75)) or
(GEN.SEX_FINAL[PX_A]=2 and (AHTINCH_A lt 56 or AHTINCH_A gt 69)) or
(GEN.SEX_FINAL[PX_A] IN (DK,RF) and (AHTINCH_A lt 56 or AHTINCH_A
gt 75)))
Page 81 of 430
Question ID: BMI.0020.04.1
Variable name: HEIGHTM_A
Interview module: BMI(Adult.BMI)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: HEIGHTFT_A=M
Universe Description: Sample Adults 18+ who choose to give their height in metric measurements
Question Text:
Response:
How tall are you without shoes? Enter height in metric. If the height is given in
centimeters, press '0' at meters and enter the measure in centimeters (241
centimeters maximum).
DK:
RF:
Don't Know
Refused
Skip Instructions: <0-2> [goto HEIGHTCM_A]
[goto WEIGHTLB_A]
Question ID: BMI.0020.05.1
Variable name: HEIGHTCM_A
Interview module: BMI(Adult.BMI)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: HEIGHTM_A=0-2
Universe Description: Sample Adults 18+ who entered 0 to 2 meters for height
Question Text:
Response:
Enter centimeters. Enter height in metric.
241 centimeters, enter 241.
DK:
RF:
Don't Know
Refused
Page 82 of 430
If ^SANAME's height is greater than
Fills:
^SANAME
Sample Adult's name
Skip Instructions: <0-241,RF,DK> [goto WEIGHTLB_A]
Check Name: ERR1_HEIGHTCM_A
Text:
{check ERR1_HEIGHTCM_A}
correct.
Total height exceeds maximum allowed.
Please
Hard / Soft Edit: Hard
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: ((HEIGHTM_A=2 and HEIGHTCM_A gt 41) or (HEIGHTM_A=1 and
HEIGHTCM_A gt 141) or (HEIGHTCM_A gt 241))
Check Name: ERR2_HEIGHTCM_A
Text:
{signal ERR2_HEIGHTCM_A}
Probe only if necessary.
Please verify that the height was entered correctly.
Hard / Soft Edit: Soft
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: ((GEN.SEX_FINAL[PX_A]=1 and (AHTCM_A lt 156 or AHTCM_A gt 192)) or
(GEN.SEX_FINAL[PX_A]=2 and (AHTCM_A lt 143 or AHTCM_A gt 176)) or
(GEN.SEX_FINAL[PX_A] IN (DK,RF) and (AHTCM_A lt 143 or AHTCM_A gt
192)))
Page 83 of 430
Question ID: BMI.0030.01.1
Variable name: WEIGHTLB_A
Interview module: BMI(Adult.BMI)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
Fills:
^PREGWEIGH Enter M to record metric measurements. If ^SANAME's weight is
less than 50 pounds, enter 50. If ^SANAME's weight is greater than 500 pounds,
enter 500.
DK:
RF:
Don't Know
Refused
^PREGWEIGH
If GEN.SEX_FINAL=2ANDPREGNOW_A=1: "How
much did you weighbefore your pregnancy?"
else: "How much do you weigh?"
^SANAME
Sample Adult's name
Skip Instructions: If WEIGHTLB_A lt 50 or WEIGHTLB_A gt 500 [goto ERR1_WEIGHTLB_A]
elseif ((GEN.SEX_FINAL[PX_A]=1 and (WEIGHTLB_A lt 113 or
WEIGHTLB_A gt 316)) or (GEN.SEX_FINAL[PX_A]=2 and (WEIGHTLB_A lt
96 or WEIGHTLB_A gt 293)) or (GEN.SEX_FINAL[PX_A] IN (RF,DK) and
(WEIGHTLB_A lt 96 or WEIGHTLB_A gt 316))) [goto ERR2_WEIGHTLB_A]
<50-500,RF,DK> [goto next section]
[goto WEIGHTKG_A]
Page 84 of 430
Check Name: ERR1_WEIGHTLB_A
Text:
{check ERR1_WEIGHTLB_A} Weight is out of range. Only "50-500" or "M" or
"Don't know/Refused" allowed in this field.
Hard / Soft Edit: Hard
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: (WEIGHTLB_A lt 50 or WEIGHTLB_A gt 500) or WEIGHTLB_A not IN (M,
DK, RF)
Universe Description: Weight is less than 50lbs or weight is greater than 500lbs or entered
something other than "M", don't know, or refused.
Check Name: ERR2_WEIGHTLB_A
Text:
{signal ERR2_WEIGHTLB_A}
Probe only if necessary.
Please verify that the weight was entered correctly.
Hard / Soft Edit: Soft
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: ((GEN.SEX_FINAL[PX_A]=1 and (WEIGHTLB_A lt 113 or WEIGHTLB_A gt
316)) or
(GEN.SEX_FINAL[PX_A]=2 and (WEIGHTLB_A lt 96 or WEIGHTLB_A gt
293)) or (GEN.SEX_FINAL[PX_A] IN (DK,RF) and (WEIGHTLB_A lt 96 or
WEIGHTLB_A gt 316)))
Page 85 of 430
Question ID: BMI.0030.02.1
Variable name: WEIGHTKG_A
Interview module: BMI(Adult.BMI)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: WEIGHTLB_A=M
Universe Description: Sample Adults 18+ who chose to give their weight in metric measurements
Question Text:
Response:
Fills:
^PREGWEIGH Enter weight in kilograms. If ^SANAME's weight is less than 23
kilograms, enter 23. If ^SANAME's weight is greater than 226 kilograms, enter 226.
DK:
RF:
Don't Know
Refused
^PREGWEIGH
If GEN.SEX_FINAL=2ANDPREGNOW_A=1: "How
much did you weighbefore your pregnancy?"
else: "How much do you weigh?"
^SANAME
Sample Adult's name
Skip Instructions: If WEIGHTKG_A lt 23 or WEIGHTKG_A gt 226 [goto ERR1_WEIGHTKG_A]
elseif ((GEN.SEX_FINAL[PX]=1 and (WEIGHTKG_A lt 51 or WEIGHTKG_A gt
143)) or (GEN.SEX_FINAL[PX]=2 and (WEIGHTKG_A lt 43 or WEIGHTKG_A
gt 133)) or (GEN.SEX_FINAL[PX] IN (RF,DK) and (WEIGHTKG_A lt 43 or
WEIGHTKG_A gt 143)))[goto ERR2_WEIGHTKG_A]
<23-226,RF,DK> [goto next section]
Page 86 of 430
Check Name: ERR1_WEIGHTKG_A
Text:
{check ERR1_WEIGHTKG_A}
Weight is out of range (23-226).
Please correct.
Hard / Soft Edit: Hard
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: (WEIGHTKG_A lt 23 or WEIGHTKG_A gt 226)
Universe Description: Weight is less than 23kg or weight is greater than 226kg
Check Name: ERR2_WEIGHTKG_A
Text:
{signal ERR2_WEIGHTKG_A}
Probe only if necessary.
Please verify that the weight was entered correctly.
Hard / Soft Edit: Soft
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: ((GEN.SEX_FINAL[PX]=1 and (WEIGHTKG_A lt 51 or WEIGHTKG_A gt 143))
or (GEN.SEX_FINAL[PX]=2 and (WEIGHTKG_A lt 43 or WEIGHTKG_A gt
133)) or (GEN.SEX_FINAL[PX] IN (RF,DK) and (WEIGHTKG_A lt 43 or
WEIGHTKG_A gt 143)))
Page 87 of 430
Question ID: VIS.0010.00.1
Variable name: VISINTRO_A
Interview module: VIS(Adult.VIS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
The next questions ask about difficulties you may have doing certain activities
because of a health problem. Enter '1' to continue.
1.
Enter 1 to Continue
Skip Instructions: <1> [goto WEARGLSS_A]
Question ID: VIS.0020.00.1
Variable name: WEARGLSS_A
Interview module: VIS(Adult.VIS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
Do you wear glasses or contact lenses? Read if necessary: Persons who wear
glasses to read or to do other occasional tasks should answer yes to this question.
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto VISIONDF_A]
Page 88 of 430
Question ID: VIS.0030.00.1
Variable name: VISIONDF_A
Interview module: VIS(Adult.VIS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
Fills:
Do you have difficulty ^AGLASSCNTS? Would you say no difficulty, some
difficulty, a lot of difficulty, or you cannot do this at all?
1.
2.
3.
4.
DK:
RF:
No difficulty
Some difficulty
A lot of difficulty
Cannot do at all
Don't Know
Refused
^AGLASSCNTS
If WEARGLSS_A=1 fill "seeing, even when wearing
glasses or contact lenses";
else fill "seeing"
Skip Instructions: <1-4,RF,DK> [goto next section]
Question ID: HEA.0010.00.1
Variable name: HEARAID_A
Interview module: HEA(Adult.HEA)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Do you use a hearing aid?
Response:
Page 89 of 430
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> [HEARAIDFR_A]
<2,RF,DK> [HEARINGDF_A]
Question ID: HEA.0020.00.1
Variable name: HEARAIDFR_A
Interview module: HEA(Adult.HEA)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: HEARAID_A=1
Universe Description: Sample Adults 18+ who use a hearing aid
Question Text:
Response:
How often do you use your hearing aid(s)? Would you say all of the time, some
of the time, rarely, or never?
1.
2.
3.
4.
DK:
RF:
All of the time
Some of the time
Rarely
Never
Don't Know
Refused
Skip Instructions: <1-4,RF,DK> [HEARINGDF_A]
Page 90 of 430
Question ID: HEA.0030.00.1
Variable name: HEARINGDF_A
Interview module: HEA(Adult.HEA)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
Fills:
Do you have difficulty hearing^HEARAID? Would you say no difficulty, some
difficulty, a lot of difficulty, or you cannot do this at all?
1.
2.
3.
4.
DK:
RF:
No difficulty
Some difficulty
A lot of difficulty
Cannot do at all
Don't Know
Refused
^HEARAID
IfHEARAID_A=1, fill: ", even when using your
hearing aid(s)"
else NO FILL
Skip Instructions: <1-4,RF,DK> [goto next section]
Question ID: MOB.0010.00.1
Variable name: DIFF_A
Interview module: MOB(Adult.MOB)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Do you have difficulty walking or climbing steps? Would you say no difficulty,
some difficulty, a lot of difficulty, or you cannot do this at all?
Response:
Page 91 of 430
1.
2.
3.
4.
DK:
RF:
No difficulty
Some difficulty
A lot of difficulty
Cannot do at all
Don't Know
Refused
Skip Instructions: <1-4,RF,DK> [goto EQUIP_A]
Question ID: MOB.0020.00.1
Variable name: EQUIP_A
Interview module: MOB(Adult.MOB)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
Do you use any equipment or receive help for getting around?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> [goto CANEWLKR_A]
<2,RF,DK> [goto WLK100_A]
Question ID: MOB.0030.00.1
Variable name: WLK100_A
Interview module: MOB(Adult.MOB)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: EQUIP_A IN (2,RF,DK)
Universe Description: Sample Adults 18+ who do not use equipment or receive help for getting
around or refused or don't know
Question Text:
Do you have difficulty walking 100 yards on level ground, that would be about
the length of one football field or one city block? Would you say no difficulty,
some difficulty, a lot of difficulty, or you cannot do this at all?
Response:
Page 92 of 430
1.
2.
3.
4.
DK:
RF:
No difficulty
Some difficulty
A lot of difficulty
Cannot do at all
Don't Know
Refused
Skip Instructions: <1-3,RF,DK> [goto WLK13M_A]
<4> [goto STEPS_A]
Question ID: MOB.0040.00.1
Variable name: WLK13M_A
Interview module: MOB(Adult.MOB)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: WLK100_A IN (1,2,3,RF,DK)
Universe Description: Sample Adults 18+ who have no difficulty, some difficulty, or a lot of difficulty
walking 100 yards or refused or don't know
Question Text:
Response:
Do you have difficulty walking a third of a mile on level ground, that would be
the length of five football fields or five city blocks?
Read if necessary: Would
you say no difficulty, some difficulty, a lot of difficulty, or you cannot do this at all?
1.
2.
3.
4.
DK:
RF:
No difficulty
Some difficulty
A lot of difficulty
Cannot do at all
Don't Know
Refused
Skip Instructions: <1-4,RF,DK> [goto STEPS_A]
Page 93 of 430
Question ID: MOB.0050.00.1
Variable name: STEPS_A
Interview module: MOB(Adult.MOB)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: EQUIP_A IN (2,RF,DK)
Universe Description: Sample Adults 18+ who do not use equipment or receive help for getting
around or refused or don't know
Question Text:
Response:
Do you have difficulty walking up or down 12 steps? Read if necessary:
Would you say no difficulty, some difficulty, a lot of difficulty, you cannot do this at all?
1.
2.
3.
4.
DK:
RF:
No difficulty
Some difficulty
A lot of difficulty
Cannot do at all
Don't Know
Refused
Skip Instructions: <1-4,RF,DK> [goto next section]
Question ID: MOB.0060.00.1
Variable name: CANEWLKR_A
Interview module: MOB(Adult.MOB)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: EQUIP_A=1
Universe Description: Sample Adults 18+ who use equipment or receive help for getting around
Question Text:
Do you use any of the following... ...Cane or walker?
Response:
Page 94 of 430
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto WCHAIR_A]
Question ID: MOB.0070.00.1
Variable name: WCHAIR_A
Interview module: MOB(Adult.MOB)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: EQUIP_A=1
Universe Description: Sample Adults 18+ who use equipment or receive help for getting around
Question Text:
Response:
Read if necessary: Do you use any of the following? ...Wheelchair or scooter?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto PERASST_A]
Question ID: MOB.0080.00.1
Variable name: PERASST_A
Interview module: MOB(Adult.MOB)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: EQUIP_A=1
Universe Description: Sample Adults 18+ who use equipment or receive help for getting around
Question Text:
Read if necessary: Do you use any of the following? ...Someone's assistance?
Response:
Page 95 of 430
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto NOEQWLK100_A]
Question ID: MOB.0090.00.1
Variable name: NOEQWLK100_A
Interview module: MOB(Adult.MOB)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: EQUIP_A=1
Universe Description: Sample Adults 18+ who use equipment or receive help for getting around
Question Text:
Response:
WITHOUT THE USE OF YOUR AID, do you have difficulty walking 100 yards on
level ground, that would be about the length of one football field or one city
block? Would you say no difficulty, some difficulty, a lot of difficulty, or you
cannot do this at all?
1.
2.
3.
4.
DK:
RF:
No difficulty
Some difficulty
A lot of difficulty
Cannot do at all
Don't Know
Refused
Skip Instructions: <1-3,RF,DK> [goto NOEQWLK13M_A]
<4> [goto NOEQSTEPS_A]
Page 96 of 430
Question ID: MOB.0100.00.1
Variable name: NOEQWLK13M_A
Interview module: MOB(Adult.MOB)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: NOEQWLK100_A IN (1,2,3,RF,DK)
Universe Description: Sample Adults 18+ who have no difficulty, some difficulty, or a lot of difficulty
walking 100 yards without the use of their aid or refused or don't know
Question Text:
Response:
WITHOUT THE USE OF YOUR AID, do you have difficulty walking a third of a
mile on level ground, that would be the length of five football fields or five city
blocks? Read if necessary: Would you say no difficulty, some difficulty, a lot of
difficulty, or you cannot do this at all?
1.
2.
3.
4.
DK:
RF:
No difficulty
Some difficulty
A lot of difficulty
Cannot do at all
Don't Know
Refused
Skip Instructions: <1-4,RF,DK> [goto NOEQSTEPS_A]
Question ID: MOB.0110.00.1
Variable name: NOEQSTEPS_A
Interview module: MOB(Adult.MOB)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: EQUIP_A=1
Universe Description: Sample Adults 18+ who use equipment
Question Text:
WITHOUT THE USE OF YOUR AID, do you have difficulty walking up or down 12
steps? Read if necessary: Would you say no difficulty, some difficulty, a lot of
difficulty, or you cannot do this at all?
Response:
Page 97 of 430
1.
2.
3.
4.
DK:
RF:
No difficulty
Some difficulty
A lot of difficulty
Cannot do at all
Don't Know
Refused
Skip Instructions: <1-4,RF,DK> if WCHAIR_A ne 1 [goto EQWLK100_A]
else [goto next section]
Question ID: MOB.0120.00.1
Variable name: EQWLK100_A
Interview module: MOB(Adult.MOB)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: EQUIP_A=1 and WCHAIR_A IN (2,RF,DK)
Universe Description: Sample Adults 18+ who use equipment or receive help for getting around but
do not use a wheelchair or scooter or refused or don't know
Question Text:
Response:
WHEN USING YOUR AID, do you have difficulty walking 100 yards on level
ground, that would be about the length of one football field or one city block?
Read if necessary: Would you say no difficulty, some difficulty, a lot of difficulty, or
you cannot do this at all?
1.
2.
3.
4.
DK:
RF:
No difficulty
Some difficulty
A lot of difficulty
Cannot do at all
Don't Know
Refused
Skip Instructions: <1-3,RF,DK> [goto EQWLK13M_A]
<4> [goto EQSTEPS_A]
Page 98 of 430
Question ID: MOB.0130.00.1
Variable name: EQWLK13M_A
Interview module: MOB(Adult.MOB)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: EQWLK100_A IN (1,2,3,RF,DK)
Universe Description: Sample Adults 18+ who have no difficulty, some difficulty, or a lot of difficulty
walking 100 yards, when using their aid or refused or don't know
Question Text:
Response:
WHEN USING YOUR AID, do you have difficulty walking a third of a mile on
level ground, that would be the length of five football fields or five city blocks?
Read if necessary: Would you say no difficulty, some difficulty, a lot of difficulty, or
you cannot do this at all?
1.
2.
3.
4.
DK:
RF:
No difficulty
Some difficulty
A lot of difficulty
Cannot do at all
Don't Know
Refused
Skip Instructions: <1-4,RF,DK> [goto EQSTEPS_A]
Question ID: MOB.0140.00.1
Variable name: EQSTEPS_A
Interview module: MOB(Adult.MOB)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: EQUIP_A=1 and WCHAIR_A ne 1
Universe Description: Sample Adults 18+ who use equipment or receive help for getting around but
do not use a wheelchair or scooter
Question Text:
WHEN USING YOUR AID, do you have difficulty walking up or down 12 steps?
Read if necessary: Would you say no difficulty, some difficulty, a lot of difficulty, or
you cannot do this at all?
Response:
Page 99 of 430
1.
2.
3.
4.
DK:
RF:
No difficulty
Some difficulty
A lot of difficulty
Cannot do at all
Don't Know
Refused
Skip Instructions: <1-4,RF,DK> [goto next section]
Question ID: COM.0010.00.1
Variable name: COMDIFF_A
Interview module: COM(Adult.COM)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
Using your usual language, do you have difficulty communicating, for example,
understanding or being understood?
Read if necessary: Would you say no
difficulty, some difficulty, a lot of difficulty, or you cannot do this at all?
1.
2.
3.
4.
DK:
RF:
No difficulty
Some difficulty
A lot of difficulty
Cannot do at all
Don't Know
Refused
Skip Instructions: <1-4,RF,DK> [goto next section]
Page 100 of 430
Question ID: COG.0010.00.1
Variable name: COGMEMDFF_A
Interview module: COG(Adult.COG)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
Do you have difficulty remembering or concentrating? Read if necessary:
Would you say no difficulty, some difficulty, a lot of difficulty, or you cannot do this at
all?
1.
2.
3.
4.
DK:
RF:
No difficulty
Some difficulty
A lot of difficulty
Cannot do at all
Don't Know
Refused
Skip Instructions: <1,RF,DK> [goto next section]
<2-4> [goto COGTYPEDFF_A]
Question ID: COG.0020.00.1
Variable name: COGTYPEDFF_A
Interview module: COG(Adult.COG)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: COGMEMDFF_A IN (2,3,4)
Universe Description: Sample Adults 18+ who have some difficulty, a lot of difficulty, or are unable to
remember or concentrate
Question Text:
Is that a difficulty with remembering, concentrating, or both?
Response:
Page 101 of 430
1.
2.
3.
DK:
RF:
Difficulty remembering only
Difficulty concentrating only
Difficulty with both remembering and concentrating
Don't Know
Refused
Skip Instructions: <1,3> [goto COGFRQDFF_A]
<2,RF,DK> [goto next section]
Question ID: COG.0030.00.1
Variable name: COGFRQDFF_A
Interview module: COG(Adult.COG)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: COGTYPEDFF_A IN (1,3)
Universe Description: Sample Adults 18+ who have difficulty remembering or remembering and
concentrating
Question Text:
Response:
How often do you have difficulty remembering? Would you say sometimes,
often, or all of the time?
1.
2.
3.
DK:
RF:
Sometimes
Often
All of the time
Don't Know
Refused
Skip Instructions: <1-3,RF,DK> [goto COGAMTDFF_A]
Page 102 of 430
Question ID: COG.0040.00.1
Variable name: COGAMTDFF_A
Interview module: COG(Adult.COG)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: COGTYPEDFF_A IN (1,3)
Universe Description: Sample Adults 18+ who have difficulty remembering or remembering and
concentrating
Question Text:
Response:
Do you have difficulty remembering a few things, a lot of things, or almost
everything?
1.
2.
3.
DK:
RF:
A few things
A lot of things
Almost everything
Don't Know
Refused
Skip Instructions: <1-3,RF,DK> [goto next section]
Question ID: UPP.0010.00.1
Variable name: UPPSLFCR_A
Interview module: UPP(Adult.UPP)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
Do you have difficulty with self care, such as washing all over or dressing?
Would you say no difficulty, some difficulty, a lot of difficulty, or you cannot do
this at all?
1.
No difficulty
Page 103 of 430
2.
3.
4.
DK:
RF:
Some difficulty
A lot of difficulty
Cannot do at all
Don't Know
Refused
Skip Instructions: <1-4,RF,DK> [goto UPPRAISE_A]
Question ID: UPP.0020.00.1
Variable name: UPPRAISE_A
Interview module: UPP(Adult.UPP)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
Do you have difficulty raising a 2 liter bottle of water or soda from waist to eye
level?
Read if necessary: Would you say no difficulty, some difficulty, a lot of
difficulty, or you cannot do this at all?
1.
2.
3.
4.
DK:
RF:
No difficulty
Some difficulty
A lot of difficulty
Cannot do at all
Don't Know
Refused
Skip Instructions: <1-4,RF,DK> [goto UPPOBJCT_A]
Question ID: UPP.0030.00.1
Variable name: UPPOBJCT_A
Interview module: UPP(Adult.UPP)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Do you have difficulty using your hands and fingers, such as picking up small
objects, for example, a button or pencil, or opening or closing containers or
bottles? Read if necessary: Would you say no difficulty, some difficulty, a lot of
difficulty, or you cannot do this at all?
Response:
Page 104 of 430
1.
2.
3.
4.
DK:
RF:
No difficulty
Some difficulty
A lot of difficulty
Cannot do at all
Don't Know
Refused
Skip Instructions: <1-4,RF,DK> [goto next section]
Question ID: SOC.0010.00.1
Variable name: SOCERRNDS_A
Interview module: SOC(Adult.SOC)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
Because of a physical, mental, or emotional condition, do you have difficulty
doing errands alone such as visiting a doctor's office or shopping? Read if
necessary: Would you say no difficulty, some difficulty, a lot of difficulty, or you
cannot do this at all?
1.
2.
3.
4.
DK:
RF:
No difficulty
Some difficulty
A lot of difficulty
Cannot do at all
Don't Know
Refused
Skip Instructions: <1-4,RF,DK> [goto SOCSCLPAR_A]
Page 105 of 430
Question ID: SOC.0020.00.1
Variable name: SOCSCLPAR_A
Interview module: SOC(Adult.SOC)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
Because of a physical, mental, or emotional condition, do you have difficulty
participating in social activities such as visiting friends, attending clubs and
meetings, or going to parties? Read if necessary: Would you say no difficulty,
some difficulty, a lot of difficulty, or you cannot do this at all?
1.
2.
3.
4.
DK:
RF:
No difficulty
Some difficulty
A lot of difficulty
Cannot do at all
Don't Know
Refused
Skip Instructions: <1-4,RF,DK> [goto SOCWRKLIM_A]
Question ID: SOC.0030.00.1
Variable name: SOCWRKLIM_A
Interview module: SOC(Adult.SOC)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
Are you limited in the kind OR amount of work you can do because of a
physical, mental or emotional problem? Read if necessary: Work includes paid
work, volunteer work, school work, and homework.
1.
Yes
Page 106 of 430
2.
DK:
RF:
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto next section]
Question ID: ADO.0010.00.3
Variable name: DEVDONSET_A
Interview module: ADO(Adult.ADO)
Inherited Universe: (GEN.AGE_FINAL[PX_A] ge 22 and (MOB.DIFF_A IN (3,4) or
MOB.WLK100_A
IN
(3,4)
or
MOB.WLK13M_A
IN
(3,4)
or
MOB.NOEQWLK100_A IN (3,4) or MOB.NOEQWLK13M_A IN (3,4) or
MOB.STEPS_A IN (3,4) or MOB.NOEQSTEPS_A IN (3,4) or
COM.COMDIFF_A IN (3,4) or COG.COGMEMDFF_A IN (3,4) or
UPP.UPPSLFCR_A IN (3,4) or SOC.SOCERRNDS_A IN (3,4))) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(GEN.AGE_FINAL[PX_A] ge 22 and (MOB.DIFF_A IN (3,4) or
MOB.WLK100_A
IN
(3,4)
or
MOB.WLK13M_A
IN
(3,4)
or
MOB.NOEQWLK100_A IN (3,4) or MOB.NOEQWLK13M_A IN (3,4) or
MOB.STEPS_A IN (3,4) or MOB.NOEQSTEPS_A IN (3,4) or
COM.COMDIFF_A IN (3,4) or COG.COGMEMDFF_A IN (3,4) or
UPP.UPPSLFCR_A IN (3,4) or SOC.SOCERRNDS_A IN (3,4))))
Universe Description: Sample Adults age 22+ who said they had a lot of difficulty or could not do the
following activities at all:
Walking or climbing stairs, communicating,
remembering or concentrating, self-care, or doing errands alone
Question Text:
Response:
You said that you have difficulty with ^DIFF. Did ^THISDIFF begin before age
22?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Page 107 of 430
Fills:
^DIFF
if (MOB.WLK100_A IN (3,4) or MOB.WLK13M_A IN
(3,4) or MOB.NOEQWLK100_A IN (3,4) or
MOB.NOEQWLK13M_A IN (3,4)), then fill "walking"
if (MOB.STEPS_AIN (3,4) or MOB.NOEQSTEPS_A
IN (3,4)), then fill "climbing steps"
if none of MOB.WLK100_A, MOB.WLK13M_A,
MOB.NOEQWLK100_A,
MOB.NOEQWLK13M_A,
MOB.STEPS_A, or MOB.NOEQSTEPS_A = 3 or 4,
but MOB.DIFF_A = 3 or 4, then fill "walking or
climbing steps"
If
COM.COMDIFF_A
"communicating"
IN
(3,4),
then
fill
If COG.COGMEMDFF_A IN (3,4),
If COG.COGTYPEDFF_A IN (1,3), then fill
"remembering"
If COG.COGTYPEDFF_A IN (2,3), then fill
"concentrating"
If COG.COGTYPEDFF_A IN (DK,RF), then fill
"remembering or concentrating"
If UPP.UPPSLFCR_A = 3 or 4, then fill "self-care"
If SOC.SOCERRNDS_A = 3 or 4, then fill "doing
errands alone"
If more than two of the above are true, then separate
the fills with commas and place an "and" before the
last item.
If two of the above are true, separate them with
"and"
^THISDIFF
if ADO.countDIFF=1, fill "this difficulty"
elseif ADO.countDIFF gt 1, fill "any of these
difficulties"
Page 108 of 430
Skip Instructions: <1,2,RF,DK> [goto next section]
Question ID: INS.0010.00.1
Variable name: HICOV_A
Interview module: INS(Adult.INS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
?[F1] The next questions are about health insurance. Include health insurance
obtained through employment or purchased directly as well as government
programs like Medicare, Medicaid, and the Children's Health Insurance
Program that provide medical care or help pay medical bills. Are you covered
by any kind of health insurance or some other kind of health care plan?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,RF,DK> [goto HIKIND_A]
<2>
if
(GEN.AGE_FINAL[PX_A]
ge
65
Roster.HHC.tblAGE.blkPerson[PX_A].AGE65=2) [goto MCAREPRB_A]
else [goto MCAIDPRB_A]
Question ID: INS.0020.00.1
Variable name: HIKIND_A
or
Interview module: INS(Adult.INS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: HICOV_A IN (1,RF,DK)
Universe Description: Sample Adults 18+ covered by any kind of health insurance or health care
coverage or refused/don't know if they have insurance or health care
coverage.
Question Text:
?[F1] What kinds of health insurance or health care coverage do you have? Is
it...Private health insurance, Medicare, Medicare supplement, Medicaid,
Children's Health Insurance Program or CHIP, military related health care
including TRICARE, CHAMPUS, VA health care and CHAMP-VA, Indian Health
Service, a state-sponsored health plan, or an other government program?
Enter all that apply, separate with commas.
Page 109 of 430
Response:
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
DK:
RF:
Private health insurance
Medicare (including Medicare Advantage)
Medicare supplement (Medigap)
Medicaid
Children's Health Insurance Program (CHIP)
Military related health care: TRICARE (CHAMPUS) / VA health care /
CHAMP-VA
Indian Health Service
State-sponsored health plan
Other government program
No coverage of any type
Don't Know
Refused
Skip Instructions: if more than 1 answer selected and (10 IN HIKIND_A) [goto ERR1_HIKIND_A]
elseif (GEN.AGE_FINAL[PX_A] ge 65 or (GEN.AGE_FINAL[PX_A] IN (RF,DK)
and Roster.HHC.tblAGE.blkPerson[PX_A]=2) and 2 NOT IN HIKIND_A [goto
MCAREPRB_A]
elseif (GEN.AGE_FINAL[PX_A] lt 65 or (GEN.AGE_FINAL[PX_A] IN (RF,DK)
and Roster.HHC.tblAGE.blkPerson[PX_A].AGE65 IN (1,RF,DK,empty)) and
HIKIND_A IN (10,RF,DK) [goto MCAIDPRB_A]
else [goto SINCOVDE_A]
Check Name: ERR1_HIKIND_A
Text:
{check ERR1_HIKIND_A}
type. Please correct.
Cannot mark "no coverage of any kind" and another
Hard / Soft Edit: Hard
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: if more than 1 answer selected at HIKIND_A and (<10> in HIKIND_A)
Page 110 of 430
Question ID: INS.0030.00.1
Variable name: MCAREPRB_A
Interview module: INS(Adult.INS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: (GEN.AGE_FINAL[PX_A] ge 65 or (GEN.AGE_FINAL[PX_A] IN (DK,RF) and
Roster.HHC.tblAGE.blkPerson[PX_A].AGE65=2)) and 2 NOT IN HIKIND_A
Universe Description: Sample Adults 65+ who have not indicated they had Medicare in HIKIND_A
Question Text:
Response:
?[F1] Are you covered by Medicare?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto SINCOVDE_A]
Question ID: INS.0040.00.1
Variable name: MCAIDPRB_A
Interview module: INS(Adult.INS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: (GEN.AGE_FINAL[PX_A] lt 65 or (GEN.AGE_FINAL IN (RF,DK) and
Roster.HHC.tblAGE.bPerson[PX_A].AGE65
IN
(1,RF,DK,empty))
and
HIKIND_A IN (10,RF,DK)
Universe Description: Sample Adults 18-64 who have indicated they are uninsured, refused, or don't
know their type of health insurance
Question Text:
?[F1] There is a program called Medicaid that pays for health care for persons
in need. ^STATEMA Are you covered by Medicaid?
Response:
Page 111 of 430
1.
2.
DK:
RF:
Fills:
Yes
No
Don't Know
Refused
^STATEMA
if STMEDICAID ne empty, fill: "In ^STATENAME it is
alsocalled ^STMEDICAID."
else fill: blank
Skip Instructions: <1,2,RF,DK> [goto SINCOVDE_A]
Question ID: INS.0050.00.1
Variable name: SINCOVDE_A
Interview module: INS(Adult.INS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
Fills:
?[F1] ^INADDITIONARE you covered by a SEPARATE plan that only pays for
dental services?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
^INADDITIONARE
If
(HIKIND_A=1-9
or
MCAIDPRB_A=1),
fill
^HITYPEANOSS, are"
else fill "Are"
Skip Instructions: <1,2,RF,DK> [goto SINCOVVS_A]
Page 112 of 430
MCAREPRB_A=1
"In
addition
or
to
Question ID: INS.0060.00.1
Variable name: SINCOVVS_A
Interview module: INS(Adult.INS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
?[F1] Are you covered by a SEPARATE plan that only pays for vision services?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto SINCOVRX_A]
Question ID: INS.0070.00.1
Variable name: SINCOVRX_A
Interview module: INS(Adult.INS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
?[F1] Are you covered by a SEPARATE plan that only pays for prescriptions?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto HICHANGE_A]
Page 113 of 430
Question ID: INS.0080.00.1
Variable name: HICHANGE_A
Interview module: INS(Adult.INS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
Fills:
?[F1] I have recorded you are ^COVEREDA. Is this correct?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
^COVEREDA
if
HIKIND_A=10,R,D
and
(MCAIDPRB_A=2,R,DorMCAREPRB_A=2,R,D) and
SINCOVDE_A=2,R,Dand SINCOVVS_A=2,R,Dand
SINCOVRX_A=2,R,Dfill: "not covered by health
insurance"
else fill: "covered by ^HITYPEA"
Skip Instructions: <1,RF,DK>
if 02 in HIKIND_A or MCAREPRB_A=1[goto MCPART_A]
else if 04 in HIKIND_A or MCAIDPRB_A=1[goto MACHMN_A]
else if 01 in HIKIND_A [goto SET_INSPRI_FLAG]
else if 03 in HIKIND_A [goto SET_INSPRI_FLAG]
else if 05 in HIKIND_A [goto CHNAME_A]
else if 08 in HIKIND_A [goto OPNAME_A]
else if 09 in HIKIND_A [goto OGNAME_A]
else if 06 in HIKIND_A [goto MILSPC_A]
else if 07 in HIKIND_A [goto HINOTYR_A]
else if 10 in HIKIND_A and (MCAIDPRB_A IN (2,RF,DK) or MCAREPRB_A IN
(2,RF,DK))[goto HILAST_A]
else [goto FINISH_A]
<2> [goto ERR1_HICHANGE_A]
Page 114 of 430
Check Name: ERR1_HICHANGE_A
Text:
{signal ERR1_HICHANGE_A} Suppress this error to go back to HIKIND_A and
update coverage. Close this error to change your answer to HICHANGE_A.
Hard / Soft Edit: Soft
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: HICHANGE_A=2
Universe Description: Answered health insurance coverage is incorrect
Skip Instructions: [goto HIKIND_A]
[goto HICHANGE_A]
Question ID: INS.0090.00.1
Variable name: MCPART_A
Interview module: INS(Adult.INS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: 02 IN HIKIND_A or MCAREPRB_A=1
Universe Description: Sample Adults 18+ with Medicare
Question Text:
Response:
?[F1] What type of Medicare coverage do you have? Is it Part A - hospital
insurance, Part B - medical insurance, or both?
1.
2.
3.
DK:
RF:
Part A- hospital only
Part B- medical only
Both Part A and Part B
Don't Know
Refused
Page 115 of 430
Skip Instructions: <1> [goto MCPARTD_A]
<2-3,RF,DK> [goto MCCHOICE_A]
Question ID: INS.0100.00.1
Variable name: MCCHOICE_A
Interview module: INS(Adult.INS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: (02 IN HIKIND_A or MCAREPRB_A=1) and MCPART_A IN (2,3,RF,DK)
Universe Description: Sample Adults 18+ with Medicare that have part B Medicare or don't know or
refused if they have part B Medicare
Question Text:
Response:
?[F1] Are you enrolled in a Medicare Advantage plan?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto MCHMO_A]
Question ID: INS.0110.00.1
Variable name: MCHMO_A
Interview module: INS(Adult.INS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: (02 IN HIKIND_A or MCAREPRB_A=1) and MCPART_A IN (2,3,RF,DK)
Universe Description: Sample Adults 18+ with Medicare that have part B Medicare or don't know or
refused if they have part B Medicare
Question Text:
?[F1] Are you under a Medicare managed care arrangement, such as an HMO,
that is, a Health Maintenance Organization?
Response:
Page 116 of 430
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> [goto MCANAME_A]
<2,RF,DK> if MCCHOICE_A=1 [goto MCANAME_A]
elseif MCCHOICE_A IN (2,RF,DK) [goto MCPARTD_A]
Question ID: INS.0120.00.1
Variable name: MCANAME_A
Interview module: INS(Adult.INS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: MCCHOICE_A=1 or MCHMO_A=1
Universe Description: Sample Adults 18+ with a Medicare Advantage plan or a Medicare managed
care arrangement
Question Text:
Response:
?[F1] What is the name of your Medicare Advantage or Medicare HMO plan?
DK:
RF:
Don't Know
Refused
Skip Instructions: [goto MCDNCOV_A]
Question ID: INS.0121.00.1
Variable name: MCDNCOV_A
Interview module: INS(Adult.INS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: MCCHOICE_A=1 or MCHMO_A=1
Universe Description: Sample Adults 18+ with a Medicare Advantage plan or a Medicare managed
care arrangement
Question Text:
?[F1] Does ^MEDADVNAME_A pay for any of the costs for dental care?
Response:
Page 117 of 430
1.
2.
DK:
RF:
Fills:
Yes
No
Don't Know
Refused
^MEDADVNAME_A
If
MCANAME_A=RESPONSE,
fill
value
of
MCANAME_A
elseif MCANAME_A IN (DK,RF), fill: "this Medicare
Advantage or Medicare HMO plan"
Skip Instructions: <1,2,RF,DK> [goto MCVSCOV_A]
Question ID: INS.0122.00.1
Variable name: MCVSCOV_A
Interview module: INS(Adult.INS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: MCCHOICE_A=1 or MCHMO_A=1
Universe Description: Sample Adults 18+ with a Medicare Advantage plan or a Medicare managed
care arrangement
Question Text:
Response:
Fills:
?[F1] Does ^MEDADVNAME_A pay for any of the costs for routine vision care,
such as glasses and contact lenses?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
^MEDADVNAME_A
If
MCANAME_A=RESPONSE,
fill
value
of
MCANAME_A
elseif MCANAME_A IN (DK,RF), fill: "this Medicare
Advantage or Medicare HMO plan"
Page 118 of 430
Skip Instructions: <1,2,RF,DK> [goto MCPARTD_A]
Question ID: INS.0130.00.1
Variable name: MCPARTD_A
Interview module: INS(Adult.INS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: 02 IN HIKIND_A or MCAREPRB_A=1
Universe Description: Sample Adults 18+ with Medicare
Question Text:
Response:
?[F1] Are you enrolled in Medicare Part D, also known as the Medicare
Prescription Drug Plan?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK>
if 04 in HIKIND_A or MCAIDPRB_A=1 [goto MACHMN_A]
elseif 01 in HIKIND_A [goto SET_INSPRI_FLAG]
elseif 03 in HIKIND_A [goto SET_INSPRI_FLAG]
elseif 05 in HIKIND_A [goto CHNAME_A]
elseif 08 in HIKIND_A [goto OPNAME_A]
elseif 09 in HIKIND_A [goto OGNAME_A]
elseif 06 in HIKIND_A [goto MILSPC_A]
else [goto HINOTYR_A]
Page 119 of 430
Question ID: INS.0140.00.1
Variable name: MACHMN_A
Interview module: INS(Adult.INS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: 04 IN HIKIND_A or MCAIDPRB_A=1
Universe Description: Sample Adults 18+ with Medicaid coverage
Question Text:
Response:
?[F1] The next questions are about Medicaid coverage. What is the name of
your Medicaid health plan?
DK:
RF:
Don't Know
Refused
Skip Instructions: [goto MAXCHNG_A]
Question ID: INS.0150.00.1
Variable name: MAXCHNG_A
Interview module: INS(Adult.INS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: 04 IN HIKIND_A or MCAIDPRB_A=1
Universe Description: Sample Adults 18+ with Medicaid coverage
Question Text:
Response:
?[F1] Was your Medicaid obtained through Healthcare.gov or the
^MARKETPLACE?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Page 120 of 430
Fills:
^MARKETPLACE
If no state specified below, fill "Health Insurance
Marketplace"
If state specified below fill:
If CA then fill "Health Insurance Marketplace, such
as Covered California"
If CO then fill "Health Insurance Marketplace, such
as Connect for Health Colorado"
If CT then fill "Health Insurance Marketplace, such
as Access Health CT"
If DC then fill "Health Insurance Marketplace, such
as DC Health Link"
If ID then fill "Health Insurance Marketplace, such as
Your Health Idaho"
If MA then fill "Health Insurance Marketplace, such
as Massachusetts Health Connector"
If MD then fill "Health Insurance Marketplace, such
as Maryland Health Connection"
If MN then fill "Health Insurance Marketplace, such
as MNsure"
If NJ then fill "Health Insurance Marketplace, such as
GetCoveredNJ"
If NV then fill "Health Insurance Marketplace, such
as Nevada Health Link"
If NY then fill "Health Insurance Marketplace, such
as NY State of Health"
If PA then fill "Health Insurance Marketplace, such
as Pennie"
If RI then fill "Health Insurance Marketplace, such as
HealthSource RI"
If VT then fill "Health Insurance Marketplace, such as
Vermont Health Connect"
If WA then fill "Health Insurance Marketplace, such
as Washington Health Plan Finder"
Skip Instructions: <1,2,RF,DK> [goto MAPREM_A]
Page 121 of 430
Question ID: INS.0160.00.1
Variable name: MAPREM_A
Interview module: INS(Adult.INS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: 04 IN HIKIND_A or MCAIDPRB_A=1
Universe Description: Sample Adults 18+ with Medicaid coverage
Question Text:
Response:
?[F1] A health insurance premium is the amount you or a family member pay
each month for health care coverage. Do you or a family member pay a
premium for this Medicaid plan?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto MADEDUC_A]
Question ID: INS.0170.00.1
Variable name: MADEDUC_A
Interview module: INS(Adult.INS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: 04 IN HIKIND_A or MCAIDPRB_A=1
Universe Description: Sample Adults 18+ with Medicaid coverage
Question Text:
?[F1] A deductible is the amount you have to pay for health care before your
health insurance or health coverage plan will start paying your medical bills.
Does your Medicaid plan have an annual deductible? Read if necessary: A
deductible is different from a copay (copayment).
Response:
Page 122 of 430
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> [goto MAHDHP_A]
<2,RF,DK>
if 01 in HIKIND_A [goto SET_INSPRI_FLAG]
else if 03 in HIKIND_A [goto SET_INSPRI_FLAG]
else if 05 in HIKIND_A [goto CHNAME_A]
else if 08 in HIKIND_A [goto OPNAME_A]
else if 09 in HIKIND_A [goto OGNAME_A]
else if 06 in HIKIND_A [goto MILSPC_A]
else [goto HINOTYR_A]
Question ID: INS.0180.00.1
Variable name: MAHDHP_A
Interview module: INS(Adult.INS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: MADEDUC_A=1
Universe Description: Sample Adults 18+ with Medicaid coverage who have a deductible
Question Text:
Response:
Fills:
?[F1] Is the annual deductible for medical care for this plan less than
^HDHPDED or ^HDHPDED or more? If there is a separate deductible for
prescription drugs, hospitalization, or out-of-network care, do not include those
deductible amounts here.
1.
2.
DK:
RF:
Less than ^HDHPDED
^HDHPDED or more
Don't Know
Refused
^HDHPDED
Fill: $1,400
Page 123 of 430
Skip Instructions: <1,2,RF,DK>
if 01 in HIKIND_A [goto SET_INSPRI_FLAG]
elseif 03 in HIKIND_A [goto SET_INSPRI_FLAG]
elseif 05 in HIKIND_A [goto CHNAME_A]
elseif 08 in HIKIND_A [goto OPNAME_A]
elseif 09 in HIKIND_A [goto OGNAME_A]
elseif 06 in HIKIND_A [goto MILSPC_A]
else [goto HINOTYR_A]
Question ID: INS.0270.00.1
Variable name: PLANNAME1_A
Interview module: INS(Adult.INS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: INSPRI1_FLG1_A=1 and INSPRI1_FLG2_A=1 and INSPRI1_FLG3_A=1 and
GEN.INSPRI_FLG=1
and
GEN.SAMEFAM_FLG=1
and
Child.INS.PLANNAME1_C=empty
Universe Description: Sample Adults 18+ with private health insurance coverage, where the Sample
Child interview has already been conducted, the Sample Child is in the same
family, and the Sample Child also had private health insurance, and the first
private plan is not self only coverage, a plan name was not don't know or
refused, and the source and who pays for the coverage is not don't know or
refused.
Question Text:
Response:
Fills:
Earlier I recorded that ^SCNAME was covered by ^HIPNAM1_C. Are you
covered by this same plan as ^SCNAME?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
^SCNAME
Fill ALIAS of HHSTAT_C=1
^HIPNAM1_C
Fill value from Child.INS.HIPNAM1_C
Page 124 of 430
Skip Instructions: <1> if Child.INS.bPlan[1].POLHLD_C ne 1 [goto POLHLDA1_A]
elseif Child.INS.bPlan[1].POLHLD_C=1 [goto PRPOLHP1_A]
<2,RF,DK> if INSPRI2_FLG2_A=1 and INSPRI2_FLG3_A=1 and
INSPRI2_FLG4_A=1 and INSPRI2_FLG5_A=1 and INSPRI_FLG=1 and
SAMEFAM_FLG=1
and
CHILD.INS.PLANNAME2_C=empty
[goto
PLANNAME2_A] else [goto HIPNAM1_A]
Question ID: INS.0280.00.1
Variable name: POLHLDA1_A
Interview module: INS(Adult.INS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: PLANNAME1_A=1 and Child.INS.bPlan[1].POLHLD_C IN (2,RF,DK)
Universe Description: Sample Adults 18+ with a shared private health plan with the Sample Child,
where the child is not the policyholder for their first private plan or refused or
don't know.
Question Text:
Response:
Fills:
?[F1] Health insurance plans are usually obtained in one person's name even if
other family members are covered by that plan. That person is called the
policyholder. Are you the policyholder for ^HIPNAM1_C?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
^HIPNAM1_C
Fill value from Child.INS.HIPNAM1_C
Skip Instructions: <1>
if
INSPRI2_FLG2_A=1
and
INSPRI2_FLG3_A=1
INSPRI2_FLG4_A=1 and INSPRI2_FLG5_A=1 [goto PLANNAME2_A]
else [goto MORPLAN_A]
<2,RF,DK> [goto PRPOLHP1_A]
Page 125 of 430
and
Question ID: INS.0290.00.1
Variable name: PRPOLHP1_A
Interview module: INS(Adult.INS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: PLANNAME1_A=1 and (Child.INS.bPlan[1].POLHLD_C=1 or POLHLDA1_A
IN (2,RF,DK))
Universe Description: Sample Adults 18+ with a shared private health plan with the Sample Child,
where the Child is the policy holder or where the Sample Adult is not the
policyholder for the first plan or refused or don't know.
Question Text:
Response:
Fills:
?[F1] How are you related to the policyholder for ^HIPNAM1_C? Are you the
policyholder's child, spouse, former spouse, or are you related in some other
way?
1.
2.
3.
4.
DK:
RF:
Child
Spouse
Former spouse
Some other relationship
Don't Know
Refused
^HIPNAM1_C
Fill value from Child.INS.HIPNAM1_C
Skip Instructions: <1-4,RF,DK> if INSPRI2_FLG2_A=1 and INSPRI2_FLG3_A=1
INSPRI2_FLG4_A=1 and INSPRI2_FLG5_A=1 [goto PLANNAME2_A]
else [goto MORPLAN_A]
Page 126 of 430
and
Question ID: INS.0300.00.1
Variable name: PLANNAME2_A
Interview module: INS(Adult.INS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: INSPRI2_FLG2_A=1 and INSPRI2_FLG3_A=1 and INSPRI2_FLG4_A=1 and
INSPRI2_FLG5_A=1 and GEN.INSPRI_FLG=1 and GEN.SAMEFAM_FLG=1
and Child.INS.PLANNAME2_C=empty
Universe Description: Sample Adults 18+ with private health insurance coverage, where the Sample
Child interview has already been conducted, the Sample Child is in the same
family, and the Sample Child also had private health insurance, and listed two
plans. The second private plan is not self only coverage, a plan name was not
don't know or refused, and the source and who pays for the coverage is not
don't know or refused.
Question Text:
Response:
Fills:
Earlier I recorded that ^SCNAME was covered by a second plan: ^HIPNAM2_C.
Are you covered by this same plan as ^SCNAME?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
^SCNAME
Fill ALIAS of HHSTAT_C=1
^HIPNAM2_C
Fill value from Child.INS.HIPNAM2_C
Skip Instructions: <1> if Child.INS.bPlan[2].POLHLD_C ne 1 [goto POLHLDA2_A],
if Child.INS.bPlan[2].POLHLD_C=1 [goto PRPOLHP2_A]
<2,RF,DK> if PLANNAME1_A IN(2,RF,DK,empty) [goto HIPNAM1_A]
else [goto MORPLAN_A]
Page 127 of 430
Question ID: INS.0310.00.1
Variable name: POLHLDA2_A
Interview module: INS(Adult.INS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: PLANNAME2_A=1 and Child.INS.bPlan[2].POLHLD_C IN (2,RF,DK)
Universe Description: Sample Adults 18+ with a shared private health plan with the Sample Child,
where the child is not the policyholder for their second private plan or refused
or don't know.
Question Text:
Response:
Fills:
?[F1] Read if necessary: Health insurance plans are usually obtained in one
person's name even if other family members are covered by that plan. That person is
called the policyholder. Are you the policyholder for ^HIPNAM2_C?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
^HIPNAM2_C
Fill value from Child.INS.HIPNAM2_C
Skip Instructions: <1> if PLANNAME1_A IN (2,RF,DK,empty) [goto MORPLAN_A]
elseif 05 in HIKIND_A [goto CHNAME_A]
elseif 08 in HIKIND_A [goto OPNAME_A]
elseif 09 in HIKIND_A [goto OGNAME_A]
elseif 06 in HIKIND_A [goto MILSPC_A]
else [goto HINOTYR_A]
<2,RF,DK>[goto PRPOLHP2_A]
Page 128 of 430
Question ID: INS.0320.00.1
Variable name: PRPOLHP2_A
Interview module: INS(Adult.INS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: PLANNAME2_A=1 and (Child.INS.bPlan[2].POLHLD_C=1 or POLHLDA2_A
IN (2,RF,DK))
Universe Description: Sample Adults 18+ with a shared private health plan with the Sample Child,
where the Sample Child is the policy holder for the second plan or the Sample
Adult is not the policyholder for the second plan or refused or don't know.
Question Text:
Response:
Fills:
?[F1] How are you related to the policyholder for ^HIPNAM2_C? Are you the
policyholder's child, spouse, former spouse, or are you related in some other
way?
1.
2.
3.
4.
DK:
RF:
Child
Spouse
Former spouse
Some other relationship
Don't Know
Refused
^HIPNAM2_C
Fill value from Child.INS.HIPNAM2_C
Skip Instructions: <1-4,RF,DK> if PLANNAME1_A IN (2,RF,DK,empty) [goto MORPLAN_A]
elseif 05 in HIKIND_A [goto CHNAME_A]
elseif 08 in HIKIND_A [goto OPNAME_A]
elseif 09 in HIKIND_A [goto OGNAME_A]
elseif 06 in HIKIND_A [goto MILSPC_A]
else [goto HINOTYR_A]
Page 129 of 430
Question ID: INS.0330.00.1
Variable name: HIPNAM1_A
Interview module: INS(Adult.INS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: 03 IN HIKIND_A or (01 IN HIKIND_A and PLANNAME1_A
(2,RF,DK,empty) and PLANNAME2_A IN (2,RF,DK,empty))
IN
Universe Description: Sample Adults 18+ enrolled in a Medigap plan or private health insurance and
the sample adult did not share or refused or did not know if they shared or did
not have a value for both of the two listed private plans for the sample child
Question Text:
Response:
?[F1] It is important that we record the complete and accurate name of each
private health insurance plan. What is the COMPLETE name of your plan? Do
NOT include plans that only provide extra cash while in the hospital or plans
that pay for only one type of service such as long term care, accidents, or
dental care. Read if necessary: Do you have a health plan card or something with
the plan name on it?
DK:
RF:
Don't Know
Refused
Skip Instructions: [goto MORPLAN_A]
Question ID: INS.0340.00.1
Variable name: MORPLAN_A
Interview module: INS(Adult.INS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: HIPNAM1_A
ne
empty
or
((PLANNAME1_A=1
and
PLANNAME2_A=2,RF,DK,empty) or (PLANNAME1_A=2,RF,DK,empty and
PLANNAME2_A=1))
Universe Description: Sample Adults 18+ enrolled in a private health plan where the name of the
plan was given or don't know or refused or the sample adult only shared one
private plan with the Sample Child.
Question Text:
?[F1] Are you covered by any other private health insurance plans?
Response:
Page 130 of 430
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> [goto HIPNAM2_A]
<2,RF,DK>
if (PLANNAME1_A=1 or PLANNAME2_A=1) then
if 05 in HIKIND_A [goto CHNAME_A]
elseif 08 in HIKIND_A [goto OPNAME_A]
elseif 09 in HIKIND_A [goto OGNAME_A]
elseif 06 in HIKIND_A [goto MILSPC_A]
else [goto HINOTYR_A]
else [goto bPlan[1].POLHLD_A]
Question ID: INS.0350.00.1
Variable name: HIPNAM2_A
Interview module: INS(Adult.INS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: MORPLAN_A=1
Universe Description: Sample Adults 18+ with a second private health insurance plan
Question Text:
Response:
?[F1] What is the name of that private health insurance plan?
Read if
necessary: Do you have a health plan card or something with the plan name on it?
DK:
RF:
Don't Know
Refused
Skip Instructions: [goto bPlan[1].POLHLD_A]
Page 131 of 430
Question ID: INS.0370.00.1
Variable name: POLHLD_A
Interview module: INS(Adult.INS.bPlan)
Inherited Universe: (HIPNAM1_A ne empty or HIPNAM2_A ne empty) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(HIPNAM1_A ne empty or HIPNAM2_A ne empty))
Universe Description: Sample Adults 18+ with private health insurance coverage where a plan name
was given or refused or don't know.
Question Text:
Response:
Fills:
?[F1] I am going to ask you some questions about ^FIRSTPLANA. Health
insurance plans are usually obtained in one person's name even if other family
members are covered by that plan. That person is called the policyholder. Are
you the policyholder for ^THISPLANA?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
^THISPLANA
if PlanNum=1 then
if HIPNAM1_A IN (RF,DK) fill: "this plan"
else fill: "^HIPNAM1_A"
if PlanNum=2 then
if HIPNAM2_A IN (RF,DK) fill: "this plan"
Else fill: "^HIPNAM2_A"
^FIRSTPLANA
if PlanNum=1 then
if HIPNAM1_A IN (RF,DK) and HIPNAM2_A=
empty fill: "this plan"
elseif HIPNAM1_A IN (RF,DK) fill: "this first plan"
else fill: "this ^HIPNAM1_A plan"
if PlanNum=2 then
if HIPNAM2_A IN (RF,DK) fill: "this second plan"
else fill: "this ^HIPNAM2_A plan"
Page 132 of 430
Skip Instructions: <1,RF,DK> [goto PRPLCOV_A]
<2> [goto PRPOLH_A]
Question ID: INS.0380.00.1
Variable name: PRPLCOV_A
Interview module: INS(Adult.INS.bPlan)
Inherited Universe: (HIPNAM1_A ne empty or HIPNAM2_A ne empty) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(HIPNAM1_A ne empty or HIPNAM2_A ne empty))
Universe: POLHLD_A=1,RF,DK
Universe Description: Sample Adults 18+ with private health insurance coverage where a plan name
was given or refused or don't know and where the Sample Adult is the
policyholder or refused or don't know
Question Text:
Response:
Does this plan cover someone other than yourself?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto PLNWRK_A]
Question ID: INS.0390.00.1
Variable name: PRPOLH_A
Interview module: INS(Adult.INS.bPlan)
Inherited Universe: (HIPNAM1_A ne empty or HIPNAM2_A ne empty) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(HIPNAM1_A ne empty or HIPNAM2_A ne empty))
Universe: POLHLD_A=2
Universe Description: Sample Adults 18+ with private health insurance who are not the policyholder
Question Text:
?[F1] How are you related to the policyholder? Are you the policyholder's child,
spouse, former spouse, or are you related in some other way?
Response:
Page 133 of 430
1.
2.
3.
4.
DK:
RF:
Child
Spouse
Former spouse
Some other relationship
Don't Know
Refused
Skip Instructions: <1-4,RF,DK> [goto PLNWRK_A]
Question ID: INS.0400.00.1
Variable name: PLNWRK_A
Interview module: INS(Adult.INS.bPlan)
Inherited Universe: (HIPNAM1_A ne empty or HIPNAM2_A ne empty) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(HIPNAM1_A ne empty or HIPNAM2_A ne empty))
Universe Description: Sample Adults 18+ with private health insurance coverage where a plan name
was given or refused or don't know
Question Text:
Response:
?[F1] Which one of these categories best describes how this plan was
obtained? Was it obtained through an employer or union, purchased directly,
obtained through Healthcare.gov or the Affordable Care Act, also known as
Obamacare, obtained through a state or local government or community
program or obtained in some other way?
1.
2.
3.
4.
5.
DK:
RF:
Through an employer, union, or professional association
Purchased directly
Through Healthcare.gov or the Affordable Care Act, also known as
Obamacare
Through a state or local government or community program
Other
Don't Know
Refused
Skip Instructions: <1,3> [goto PLNPAY_A]
<2,4,RF,DK> [goto PLNEXCHG_A]
<5> [goto PLNWKSP_A]
Page 134 of 430
Question ID: INS.0410.00.1
Variable name: PLNWKSP_A
Interview module: INS(Adult.INS.bPlan)
Inherited Universe: (HIPNAM1_A ne empty or HIPNAM2_A ne empty) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(HIPNAM1_A ne empty or HIPNAM2_A ne empty))
Universe: PLNWRK_A=5
Universe Description: Sample Adults 18+ with private health insurance coverage where a plan name
was given or refused or don't know and private health insurance coverage was
obtained from an other source
Question Text:
Response:
Read if necessary: How was this plan obtained?
DK:
RF:
Don't Know
Refused
Skip Instructions: [goto PLNEXCHG_A]
Question ID: INS.0420.00.1
Variable name: PLNEXCHG_A
Interview module: INS(Adult.INS.bPlan)
Inherited Universe: (HIPNAM1_A ne empty or HIPNAM2_A ne empty) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(HIPNAM1_A ne empty or HIPNAM2_A ne empty))
Universe: PLNWRK_A IN (2,4,5,RF,DK)
Universe Description: Sample Adults 18+ with private health insurance coverage where a plan name
was given or refused or don't know that is directly purchased, or obtained
through a state, local, government or community program, or obtained another
way, or refused/don't know how obtained
Question Text:
?[F1] Was the plan obtained through Healthcare.gov or the ^MARKETPLACE?
Response:
Page 135 of 430
1.
2.
DK:
RF:
Fills:
Yes
No
Don't Know
Refused
^MARKETPLACE
If no state specified below, fill "Health Insurance
Marketplace"
If state specified below fill:
If CA then fill "Health Insurance Marketplace, such
as Covered California"
If CO then fill "Health Insurance Marketplace, such
as Connect for Health Colorado"
If CT then fill "Health Insurance Marketplace, such
as Access Health CT"
If DC then fill "Health Insurance Marketplace, such
as DC Health Link"
If ID then fill "Health Insurance Marketplace, such as
Your Health Idaho"
If MA then fill "Health Insurance Marketplace, such
as Massachusetts Health Connector"
If MD then fill "Health Insurance Marketplace, such
as Maryland Health Connection"
If MN then fill "Health Insurance Marketplace, such
as MNsure"
If NJ then fill "Health Insurance Marketplace, such as
GetCoveredNJ"
If NV then fill "Health Insurance Marketplace, such
as Nevada Health Link"
If NY then fill "Health Insurance Marketplace, such
as NY State of Health"
If PA then fill "Health Insurance Marketplace, such
as Pennie"
If RI then fill "Health Insurance Marketplace, such as
HealthSource RI"
If VT then fill "Health Insurance Marketplace, such as
Vermont Health Connect"
If WA then fill "Health Insurance Marketplace, such
as Washington Health Plan Finder"
Page 136 of 430
Skip Instructions: <1,2,RF,DK> [goto PLNPAY_A]
Question ID: INS.0430.00.1
Variable name: PLNPAY_A
Interview module: INS(Adult.INS.bPlan)
Inherited Universe: (HIPNAM1_A ne empty or HIPNAM2_A ne empty) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(HIPNAM1_A ne empty or HIPNAM2_A ne empty))
Universe Description: Sample Adults 18+ with private health insurance coverage where a plan name
was given or refused or don't know.
Question Text:
Response:
Who pays for this health insurance plan?
commas.
1.
2.
3.
4.
5.
6.
DK:
RF:
Enter all that apply, separate with
Self or family (living in the household)
Employer or union
Someone outside the household
Medicare
Medicaid
Other government program
Don't Know
Refused
Skip Instructions: if <1> IN PLNPAY_A [goto HICOSTN_A]
else if <2-6> IN PLNPAY_A or PLNPAY_A IN (RF,DK)[goto PRDEDUC_A]
Question ID: INS.0440.00.1
Variable name: HICOSTN_A
Interview module: INS(Adult.INS.bPlan)
Inherited Universe: (HIPNAM1_A ne empty or HIPNAM2_A ne empty) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(HIPNAM1_A ne empty or HIPNAM2_A ne empty))
Universe: 1 IN PLNPAY_A
Universe Description: Sample Adults 18+ with private health insurance coverage where a plan name
was given or refused or don't know who paid for by self or family
Question Text:
Response:
?[F1] How much ^DOYOUFAM currently spend for health insurance premiums
for ^FIRSTPLANA? Please include payroll deductions for premiums.
DK:
Don't Know
Page 137 of 430
RF:
Fills:
Refused
^DOYOUFAM
if PCNT_A=1 fill "do you",
else fill "does your family"
^FIRSTPLANA
if PlanNum=1 then
if HIPNAM1_A IN (RF,DK) and HIPNAM2_A=
empty fill: "this plan"
elseif HIPNAM1_A IN (RF,DK) fill: "this first plan"
else fill: "this ^HIPNAM1_A plan"
if PlanNum=2 then
if HIPNAM2_A IN (RF,DK) fill: "this second plan"
else fill: "this ^HIPNAM2_A plan"
Skip Instructions: <20000-99995> [goto ERR1_HICOSTN_A]
<1-19999> [goto HICOSTT_A]
[goto PRDEDUC_A]
Check Name: ERR1_HICOSTN_A
Text:
{signal ERR1_HICOSTN_A}
corrections if necessary.
[^HICOSTN_A] is unusually high. Please verify. Make
Hard / Soft Edit: Soft
Fills:
^HICOSTN_A
Fill value from Adult.INS.HICOSTN_A
Inherited Universe: (HIPNAM1_A ne empty or HIPNAM2_A ne empty) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(HIPNAM1_A ne empty or HIPNAM2_A ne empty))
Universe: if HICOSTN_A ge 20000
Page 138 of 430
Question ID: INS.0440.02.1
Variable name: HICOSTT_A
Interview module: INS(Adult.INS.bPlan)
Inherited Universe: (HIPNAM1_A ne empty or HIPNAM2_A ne empty) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(HIPNAM1_A ne empty or HIPNAM2_A ne empty))
Universe: HICOSTN_A IN (1-99995)
Universe Description: Sample Adults 18+ with private health insurance coverage where a plan name
was given or refused or don't know who gave a premium amount.
Question Text:
?[F1]
Response:
1.
2.
3.
4.
5.
6.
7.
8.
DK:
RF:
Enter time period for premium payments.
Once a week
Once every 2 weeks
Once a month
Twice a month
Every two months
Quarterly (every 3 months)
Once a year
Twice a year
Don't Know
Refused
Skip Instructions: <1-8,RF,DK> [goto PRDEDUC_A]
Question ID: INS.0450.00.1
Variable name: PRDEDUC_A
Interview module: INS(Adult.INS.bPlan)
Inherited Universe: (HIPNAM1_A ne empty or HIPNAM2_A ne empty) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(HIPNAM1_A ne empty or HIPNAM2_A ne empty))
Universe Description: Sample Adults 18+ with private health insurance plans where a plan name
was given or refused or don't know.
Question Text:
?[F1] A deductible is the amount you have to pay for health care before your
health insurance or health coverage plan will start paying your medical bills.
Does this health plan have an annual deductible? Read if necessary: A
deductible is different from a copay (copayment).
Response:
Page 139 of 430
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> [goto PRHDHP_A]
<2,RF,DK> [goto INTROCOV_A]
Question ID: INS.0460.00.1
Variable name: PRHDHP_A
Interview module: INS(Adult.INS.bPlan)
Inherited Universe: (HIPNAM1_A ne empty or HIPNAM2_A ne empty) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(HIPNAM1_A ne empty or HIPNAM2_A ne empty))
Universe: PRDEDUC_A=1
Universe Description: Sample Adults 18+ with private health insurance coverage where a plan name
was given or refused or don't know with a deductible
Question Text:
Response:
Fills:
?[F1] Is the ^FAM_A annual deductible for medical care for this plan less than
^HDHPAMT_A, or ^HDHPAMT_A or more? If there is a separate deductible for
prescription drugs, hospitalization, or out-of-network care, do not include those
deductible amounts here.
1.
2.
DK:
RF:
Less than ^HDHPAMT_A
^HDHPAMT_A or more
Don't Know
Refused
^FAM_A
if POLHLD_A=2 or PRPLCOV_A=1, fill 'family'.
Else no fill.
^HDHPAMT_A
if
POLHLD_A=2
"^HDHPDED_family"
Else fill "^HDHPDED"
Page 140 of 430
or
PRPLCOV_A=1,
fill
Skip Instructions: <1> [goto INTROCOV_A]
<2,RF,DK> [goto HSAHRA_A]
Question ID: INS.0470.00.1
Variable name: HSAHRA_A
Interview module: INS(Adult.INS.bPlan)
Inherited Universe: (HIPNAM1_A ne empty or HIPNAM2_A ne empty) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(HIPNAM1_A ne empty or HIPNAM2_A ne empty))
Universe: PRHDHP_A=2,RF,DK
Universe Description: Sample Adults 18+ with private health insurance coverage where a plan name
was given or refused or don't know with a high deductible
Question Text:
Response:
There are special accounts or funds that can be used to pay for medical
expenses, sometimes referred to as Health Savings Accounts or HSAs, Health
Reimbursement Accounts or HRAs, Personal Care accounts, Personal Medical
funds, or Choice funds. These are DIFFERENT from Flexible Spending
Accounts or FSAs. Is there one of these accounts or funds with this plan?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto INTROCOV_A]
Page 141 of 430
Question ID: INS.0475.00.1
Variable name: INTROCOV_A
Interview module: INS(Adult.INS.bPlan)
Inherited Universe: (HIPNAM1_A ne empty or HIPNAM2_A ne empty) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(HIPNAM1_A ne empty or HIPNAM2_A ne empty))
Universe Description: Sample Adults 18+ with private health insurance coverage where a plan name
was given or refused or don't know
Question Text:
Response:
Fills:
The next three questions are about services ^FIRSTPLANA may cover.
'1' to continue.
1.
Enter
Enter 1 to Continue
^FIRSTPLANA
if PlanNum=1 then
if HIPNAM1_A IN (RF,DK) and HIPNAM2_A=
empty fill: "this plan"
elseif HIPNAM1_A IN (RF,DK) fill: "this first plan"
else fill: "this ^HIPNAM1_A plan"
if PlanNum=2 then
if HIPNAM2_A IN (RF,DK) fill: "this second plan"
else fill: "this ^HIPNAM2_A plan"
Skip Instructions: <1> [goto PRRXCOV_A]
Question ID: INS.0480.00.1
Variable name: PRRXCOV_A
Interview module: INS(Adult.INS.bPlan)
Inherited Universe: (HIPNAM1_A ne empty or HIPNAM2_A ne empty) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(HIPNAM1_A ne empty or HIPNAM2_A ne empty))
Universe Description: Sample Adults 18+ with private health insurance coverage where the name of
the plan was given or refused or don't know
Question Text:
Does ^FIRSTPLANA pay for any of the costs for medications prescribed by a
doctor? Read if necessary: Even if you have not used this benefit, please answer
if this plan would cover at least some of the costs if you were prescribed medications.
Response:
Page 142 of 430
1.
2.
DK:
RF:
Fills:
Yes
No
Don't Know
Refused
^FIRSTPLANA
if PlanNum=1 then
if HIPNAM1_A IN (RF,DK) and HIPNAM2_A=
empty fill: "this plan"
elseif HIPNAM1_A IN (RF,DK) fill: "this first plan"
else fill: "this ^HIPNAM1_A plan"
if PlanNum=2 then
if HIPNAM2_A IN (RF,DK) fill: "this second plan"
else fill: "this ^HIPNAM2_A plan"
Skip Instructions: <1,2,RF,DK> [goto PRDNCOV_A]
Question ID: INS.0490.00.1
Variable name: PRDNCOV_A
Interview module: INS(Adult.INS.bPlan)
Inherited Universe: (HIPNAM1_A ne empty or HIPNAM2_A ne empty) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(HIPNAM1_A ne empty or HIPNAM2_A ne empty))
Universe Description: Sample Adults 18+ with private health insurance coverage where the plan
name was given or refused or don't know.
Question Text:
Response:
Does ^FIRSTPLANA pay for any of the costs for dental care? Read if
necessary: Even if you have not used this benefit, please answer if this plan would
cover at least some of the costs if you did have dental care.
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Page 143 of 430
Fills:
^FIRSTPLANA
if PlanNum=1 then
if HIPNAM1_A IN (RF,DK) and HIPNAM2_A=
empty fill: "this plan"
elseif HIPNAM1_A IN (RF,DK) fill: "this first plan"
else fill: "this ^HIPNAM1_A plan"
if PlanNum=2 then
if HIPNAM2_A IN (RF,DK) fill: "this second plan"
else fill: "this ^HIPNAM2_A plan"
Skip Instructions: <1,2,RF,DK> [goto PRVSCOV_A]
Question ID: INS.0500.00.1
Variable name: PRVSCOV_A
Interview module: INS(Adult.INS.bPlan)
Inherited Universe: (HIPNAM1_A ne empty or HIPNAM2_A ne empty) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(HIPNAM1_A ne empty or HIPNAM2_A ne empty))
Universe Description: Sample Adults 18+ with private health insurance coverage where a plan name
was given or refused or don't know.
Question Text:
Response:
Fills:
Does ^FIRSTPLANA pay for any of the costs for routine vision care, such as
glasses and contact lenses? Read if necessary: Even if you have not used this
benefit, please answer if this plan would cover at least some of the costs if you did
have vision care.
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
^FIRSTPLANA
if PlanNum=1 then
if HIPNAM1_A IN (RF,DK) and HIPNAM2_A=
empty fill: "this plan"
elseif HIPNAM1_A IN (RF,DK) fill: "this first plan"
else fill: "this ^HIPNAM1_A plan"
if PlanNum=2 then
if HIPNAM2_A IN (RF,DK) fill: "this second plan"
else fill: "this ^HIPNAM2_A plan"
Page 144 of 430
Skip Instructions: <1,2,RF,DK> If there is another plan [goto bPlan for next plan]
elseif 05 in HIKIND_A [goto CHNAME_A]
elseif 08 in HIKIND_A [goto OPNAME_A]
elseif 09 in HIKIND_A [goto OGNAME_A]
elseif 06 in HIKIND_A [goto MILSPC_A]
else [goto HINOTYR_A]
Question ID: INS.0510.00.1
Variable name: CHNAME_A
Interview module: INS(Adult.INS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: 05 IN HIKIND_A
Universe Description: Sample Adults 18+ with a CHIP plan
Question Text:
Response:
?[F1] Earlier I recorded that you are covered by the Children's Health Insurance
Program or CHIP. What is the name of the plan?
DK:
RF:
Don't Know
Refused
Skip Instructions: [goto CHXCHNG_A]
Question ID: INS.0520.00.1
Variable name: CHXCHNG_A
Interview module: INS(Adult.INS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: 05 IN HIKIND_A
Universe Description: Sample Adults 18+ with a CHIP plan
Question Text:
?[F1] Was your CHIP plan obtained through Healthcare.gov or the
^MARKETPLACE?
Response:
Page 145 of 430
1.
2.
DK:
RF:
Fills:
Yes
No
Don't Know
Refused
^MARKETPLACE
If no state specified below, fill "Health Insurance
Marketplace"
If state specified below fill:
If CA then fill "Health Insurance Marketplace, such
as Covered California"
If CO then fill "Health Insurance Marketplace, such
as Connect for Health Colorado"
If CT then fill "Health Insurance Marketplace, such
as Access Health CT"
If DC then fill "Health Insurance Marketplace, such
as DC Health Link"
If ID then fill "Health Insurance Marketplace, such as
Your Health Idaho"
If MA then fill "Health Insurance Marketplace, such
as Massachusetts Health Connector"
If MD then fill "Health Insurance Marketplace, such
as Maryland Health Connection"
If MN then fill "Health Insurance Marketplace, such
as MNsure"
If NJ then fill "Health Insurance Marketplace, such as
GetCoveredNJ"
If NV then fill "Health Insurance Marketplace, such
as Nevada Health Link"
If NY then fill "Health Insurance Marketplace, such
as NY State of Health"
If PA then fill "Health Insurance Marketplace, such
as Pennie"
If RI then fill "Health Insurance Marketplace, such as
HealthSource RI"
If VT then fill "Health Insurance Marketplace, such as
Vermont Health Connect"
If WA then fill "Health Insurance Marketplace, such
as Washington Health Plan Finder"
Page 146 of 430
Skip Instructions: <1,2,RF,DK> [goto CHPREM_A]
Question ID: INS.0530.00.1
Variable name: CHPREM_A
Interview module: INS(Adult.INS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: 05 IN HIKIND_A
Universe Description: Sample Adults 18+ with a CHIP plan
Question Text:
Response:
?[F1] A health insurance premium is the amount you or a family member pays
each month for health care coverage. Do you or a family member pay a
premium for this CHIP plan?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto CHDEDUC_A]
Question ID: INS.0540.00.1
Variable name: CHDEDUC_A
Interview module: INS(Adult.INS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: 05 IN HIKIND_A
Universe Description: Sample Adults 18+ with a CHIP plan
Question Text:
?[F1] A deductible is the amount you have to pay for health care before your
health insurance or health coverage plan will start paying your medical bills.
Does your CHIP plan have an annual deductible? Read if necessary: A
deductible is different from a copay (copayment).
Response:
Page 147 of 430
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> [goto CHHDHP_A]
<2,RF,DK> if 08 in HIKIND_A [goto OPNAME_A]
elseif 09 in HIKIND_A [goto OGNAME_A]
elseif 06 in HIKIND_A [goto MILSPC_A]
else [goto HINOTYR_A]
Question ID: INS.0550.00.1
Variable name: CHHDHP_A
Interview module: INS(Adult.INS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: CHDEDUC_A=1
Universe Description: Sample Adults 18+ who have a CHIP plan deductible
Question Text:
Response:
Fills:
?[F1] Is the annual deductible for medical care for this plan less than
^HDHPDED or ^HDHPDED or more? If there is a separate deductible for
prescription drugs, hospitalization, or out-of-network care, do not include those
deductible amounts here.
1.
2.
DK:
RF:
Less than ^HDHPDED
^HDHPDED or more
Don't Know
Refused
^HDHPDED
Fill: $1,400
Skip Instructions: <1,2,RF,DK> if 08 in HIKIND_A [goto OPNAME_A]
elseif 09 in HIKIND_A [goto OGNAME_A]
elseif 06 in HIKIND_A [goto MILSPC_A]
else [goto HINOTYR_A]
Page 148 of 430
Question ID: INS.0560.00.1
Variable name: OPNAME_A
Interview module: INS(Adult.INS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: 08 IN HIKIND_A
Universe Description: Sample Adults 18+ with a state-sponsored plan
Question Text:
Response:
?[F1] Earlier I recorded that you are covered by a state-sponsored plan. What is
the name of the plan?
DK:
RF:
Don't Know
Refused
Skip Instructions: [goto OPXCHNG_A]
Question ID: INS.0570.00.1
Variable name: OPXCHNG_A
Interview module: INS(Adult.INS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: 08 IN HIKIND_A
Universe Description: Sample Adults 18+ with a state-sponsored plan
Question Text:
Response:
?[F1] Was your state-sponsored plan obtained through Healthcare.gov or the
^MARKETPLACE?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Page 149 of 430
Fills:
^MARKETPLACE
If no state specified below, fill "Health Insurance
Marketplace"
If state specified below fill:
If CA then fill "Health Insurance Marketplace, such
as Covered California"
If CO then fill "Health Insurance Marketplace, such
as Connect for Health Colorado"
If CT then fill "Health Insurance Marketplace, such
as Access Health CT"
If DC then fill "Health Insurance Marketplace, such
as DC Health Link"
If ID then fill "Health Insurance Marketplace, such as
Your Health Idaho"
If MA then fill "Health Insurance Marketplace, such
as Massachusetts Health Connector"
If MD then fill "Health Insurance Marketplace, such
as Maryland Health Connection"
If MN then fill "Health Insurance Marketplace, such
as MNsure"
If NJ then fill "Health Insurance Marketplace, such as
GetCoveredNJ"
If NV then fill "Health Insurance Marketplace, such
as Nevada Health Link"
If NY then fill "Health Insurance Marketplace, such
as NY State of Health"
If PA then fill "Health Insurance Marketplace, such
as Pennie"
If RI then fill "Health Insurance Marketplace, such as
HealthSource RI"
If VT then fill "Health Insurance Marketplace, such as
Vermont Health Connect"
If WA then fill "Health Insurance Marketplace, such
as Washington Health Plan Finder"
Skip Instructions: <1,2,RF,DK> [goto OPPREM_A]
Page 150 of 430
Question ID: INS.0580.00.1
Variable name: OPPREM_A
Interview module: INS(Adult.INS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: 08 IN HIKIND_A
Universe Description: Sample Adults 18+ with a state-sponsored plan
Question Text:
Response:
?[F1] A health insurance premium is the amount you or a family member pays
each month for health care coverage. Do you or a family member pay a
premium for this state-sponsored plan?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto OPDEDUC_A]
Question ID: INS.0590.00.1
Variable name: OPDEDUC_A
Interview module: INS(Adult.INS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: 08 IN HIKIND_A
Universe Description: Sample Adults 18+ with a state-sponsored plan
Question Text:
?[F1] A deductible is the amount you have to pay for health care before your
health insurance or health coverage plan will start paying your medical bills.
Does your state-sponsored plan have an annual deductible? Read if
necessary: A deductible is different from a copay (copayment).
Response:
Page 151 of 430
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1>[goto OPHDHP_A]
<2,RF,DK> if 09 in HIKIND_A [goto OGNAME_A]
elseif 06 in HIKIND_A [goto MILSPC_A]
else [goto HINOTYR_A]
Question ID: INS.0600.00.1
Variable name: OPHDHP_A
Interview module: INS(Adult.INS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: OPDEDUC_A=1
Universe Description: Sample Adults 18+ with a state-sponsored plan with a deductible
Question Text:
Response:
Fills:
?[F1] Is the annual deductible for medical care for this plan less than
^HDHPDED or ^HDHPDED or more? If there is a separate deductible for
prescription drugs, hospitalization, or out-of-network care, do not include those
deductible amounts here.
1.
2.
DK:
RF:
Less than ^HDHPDED
^HDHPDED or more
Don't Know
Refused
^HDHPDED
Fill: $1,400
Skip Instructions: <1,2,RF,DK> if 09 in HIKIND_A [goto OGNAME_A]
elseif 06 in HIKIND_A [goto MILSPC_A]
else [goto HINOTYR_A]
Page 152 of 430
Question ID: INS.0610.00.1
Variable name: OGNAME_A
Interview module: INS(Adult.INS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: 09 IN HIKIND_A
Universe Description: Sample Adults 18+ who have an other government plan
Question Text:
Response:
?[F1] Earlier I recorded that you are covered by an other government program.
What is the name of the plan?
DK:
RF:
Don't Know
Refused
Skip Instructions: [goto OGXCHNG_A]
Question ID: INS.0620.00.1
Variable name: OGXCHNG_A
Interview module: INS(Adult.INS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: 09 IN HIKIND_A
Universe Description: Sample Adults 18+ who have an other government plan
Question Text:
Response:
?[F1] Was your other government plan obtained through Healthcare.gov or the
^MARKETPLACE?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Page 153 of 430
Fills:
^MARKETPLACE
If no state specified below, fill "Health Insurance
Marketplace"
If state specified below fill:
If CA then fill "Health Insurance Marketplace, such
as Covered California"
If CO then fill "Health Insurance Marketplace, such
as Connect for Health Colorado"
If CT then fill "Health Insurance Marketplace, such
as Access Health CT"
If DC then fill "Health Insurance Marketplace, such
as DC Health Link"
If ID then fill "Health Insurance Marketplace, such as
Your Health Idaho"
If MA then fill "Health Insurance Marketplace, such
as Massachusetts Health Connector"
If MD then fill "Health Insurance Marketplace, such
as Maryland Health Connection"
If MN then fill "Health Insurance Marketplace, such
as MNsure"
If NJ then fill "Health Insurance Marketplace, such as
GetCoveredNJ"
If NV then fill "Health Insurance Marketplace, such
as Nevada Health Link"
If NY then fill "Health Insurance Marketplace, such
as NY State of Health"
If PA then fill "Health Insurance Marketplace, such
as Pennie"
If RI then fill "Health Insurance Marketplace, such as
HealthSource RI"
If VT then fill "Health Insurance Marketplace, such as
Vermont Health Connect"
If WA then fill "Health Insurance Marketplace, such
as Washington Health Plan Finder"
Skip Instructions: <1,2,RF,DK> [goto OGPREM_A]
Page 154 of 430
Question ID: INS.0630.00.1
Variable name: OGPREM_A
Interview module: INS(Adult.INS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: 09 IN HIKIND_A
Universe Description: Sample Adults 18+ who have an other government plan
Question Text:
Response:
?[F1] A health insurance premium is the amount you or a family member pays
each month for health care coverage. Do you or a family member pay a
premium for your other government plan?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto OGDEDUC_A]
Question ID: INS.0640.00.1
Variable name: OGDEDUC_A
Interview module: INS(Adult.INS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: 09 IN HIKIND_A
Universe Description: Sample Adults 18+ with an other government plan
Question Text:
?[F1] A deductible is the amount you have to pay for health care before your
health insurance or health coverage plan will start paying your medical bills.
Does your other government plan have an annual deductible? Read if
necessary: A deductible is different from a copay (copayment).
Response:
Page 155 of 430
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> [goto OGHDHP_A]
<2,RF,DK> if 06 in HIKIND_A [goto MILSPC_A]
else [goto HINOTYR_A]
Question ID: INS.0650.00.1
Variable name: OGHDHP_A
Interview module: INS(Adult.INS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: OGDEDUC_A=1
Universe Description: Sample Adults 18+ with an other government plan with a deductible
Question Text:
Response:
Fills:
?[F1] Is the annual deductible for medical care for this plan less than
^HDHPDED or ^HDHPDED or more? If there is a separate deductible for
prescription drugs, hospitalization, or out-of-network care, do not include those
deductible amounts here.
1.
2.
DK:
RF:
Less than ^HDHPDED
^HDHPDED or more
Don't Know
Refused
^HDHPDED
Fill: $1,400
Skip Instructions: <1,2,RF,DK> if 06 in HIKIND_A [goto MILSPC_A]
else [goto HINOTYR_A]
Page 156 of 430
Question ID: INS.0660.00.1
Variable name: MILSPC_A
Interview module: INS(Adult.INS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: 06 IN HIKIND_A
Universe Description: Sample Adults 18+ with military related health care
Question Text:
Response:
?[F1] Earlier I recorded that you are covered by military related health care.
What types of military related health care are you covered by?
Enter all that
apply, separate with commas.
1.
2.
3.
DK:
RF:
VA health care
TRICARE (CHAMPUS)
CHAMP-VA (do not include CHAMPUS)
Don't Know
Refused
Skip Instructions: <1-3,RF,DK> [goto HINOTYR_A]
Question ID: INS.0670.00.1
Variable name: HILAST_A
Interview module: INS(Adult.INS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: 10 IN HIKIND_A and (MCAIDPRB_A IN (2,RF,DK) or MCAREPRB_A IN
(2,RF,DK))
Universe Description: Sample Adults 18+ without known health insurance and answered no, refused
or don't know to the Medicaid probe or the Medicare probe.
Question Text:
How long has it been since you last had health care coverage that paid for
doctor's visits or hospital stays?
Response:
Page 157 of 430
0.
1.
2.
3.
4.
5.
6.
DK:
RF:
Never
Within the past year (anytime less than 12 months ago)
Within the last 2 years (1 year but less than 2 years ago)
Within the last 3 years (2 years but less than 3 years ago)
Within the last 5 years (3 years but less than 5 years ago)
Within the last 10 years (5 years but less than 10 years ago)
10 years ago or more
Don't Know
Refused
Skip Instructions: <1> [goto HILASTMY_A]
<2,3> [goto HISTOPJOB_A]
<4,5,6,0,RF,DK> [goto RSNHICOST_A]
Question ID: INS.0680.00.1
Variable name: HILASTMY_A
Interview module: INS(Adult.INS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: HILAST_A=1
Universe Description: Sample Adults 18+ without known health insurance who last had insurance at
some time within the last 12 months
Question Text:
Response:
In the past 12 months, how many months were you without coverage?
than 1 month, enter '1'.
DK:
RF:
Don't Know
Refused
Skip Instructions: <1-12,RF,DK> [goto HISTOPJOB_A]
Page 158 of 430
If less
Question ID: INS.0690.00.1
Variable name: HISTOPJOB_A
Interview module: INS(Adult.INS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: HILAST_A IN (1,2,3)
Universe Description: Sample Adults 18+ who have been uninsured for less than 3 years
Question Text:
Response:
?[F1] Think about the last time that you did have health care coverage that paid
for doctor's visits or hospital stays. I am going to read a list of reasons why
someone might no longer be enrolled in coverage. Please tell me, yes or no, if
this is a reason why you are no longer enrolled in your last health care plan.
You or the policyholder retired, lost a job, or changed employers?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto HISTOPMISS_A]
Question ID: INS.0700.00.1
Variable name: HISTOPMISS_A
Interview module: INS(Adult.INS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: HILAST_A IN (1,2,3)
Universe Description: Sample Adults 18+ who have been uninsured for less than 3 years
Question Text:
Read if necessary: Are you no longer enrolled in your last health care plan
because... You missed a deadline for signing up or paying for the coverage?
Response:
Page 159 of 430
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto HISTOPAGE_A]
Question ID: INS.0710.00.1
Variable name: HISTOPAGE_A
Interview module: INS(Adult.INS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: HILAST_A IN (1,2,3)
Universe Description: Sample Adults 18+ who have been uninsured for less than 3 years
Question Text:
Response:
Read if necessary: Are you no longer enrolled in your last health care plan
because... You became ineligible because of your age or because you left
school?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto HISTOPCOST_A]
Question ID: INS.0720.00.1
Variable name: HISTOPCOST_A
Interview module: INS(Adult.INS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: HILAST_A IN (1,2,3)
Universe Description: Sample Adults 18+ who have been uninsured for less than 3 years
Question Text:
Read if necessary: Are you no longer enrolled in your last health care plan
because... The cost for your coverage increased?
Response:
Page 160 of 430
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto HISTOPELIG_A]
Question ID: INS.0730.00.1
Variable name: HISTOPELIG_A
Interview module: INS(Adult.INS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: HILAST_A IN (1,2,3)
Universe Description: Sample Adults 18+ who have been uninsured for less than 3 years
Question Text:
Response:
?[F1] Read if necessary: Are you no longer enrolled in your last health care plan
because... You had Medicaid or other public coverage, but were no longer
eligible?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto RSNHICOST_A]
Question ID: INS.0740.00.1
Variable name: RSNHICOST_A
Interview module: INS(Adult.INS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: 10 IN HIKIND_A and (MCAIDPRB_A IN (2,RF,DK) or MCAREPRB_A IN
(2,RF,DK))
Universe Description: Sample Adults 18+ without known health insurance and answered no, refused
or don't know to the Medicare probe or the Medicaid probe.
Question Text:
^INSREASONS Are you currently uninsured because coverage is not
affordable?
Response:
Page 161 of 430
1.
2.
DK:
RF:
Fills:
Yes
No
Don't Know
Refused
^INSREASONS
If HILAST_A IN (0,4,5,6,RF,DK) fill: "There are many
reasons why people do not have health insurance
coverage."
If HILAST_A IN (1,2,3) fill: "We just discussed
reasons you lost coverage. Now I am going to ask
you some questions about why you haven't obtained
coverage."
Skip Instructions: <1,2,RF,DK> [goto RSNHIWANT_A]
Question ID: INS.0750.00.1
Variable name: RSNHIWANT_A
Interview module: INS(Adult.INS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: 10 IN HIKIND_A and (MCAIDPRB_A IN (2,RF,DK) or MCAREPRB_A IN
(2,RF,DK))
Universe Description: Sample Adults 18+ without known health insurance and answered no, refused
or don't know to the Medicare probe or the Medicaid probe.
Question Text:
Response:
There are other reasons that people do not have health insurance coverage.
^PLUSCOSTA you currently uninsured because... ...you do not need or want
coverage?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Page 162 of 430
Fills:
^PLUSCOSTA
if RSNHICOST_A = 1 then fill "In addition to cost,
are"
Else fill "Are"
Skip Instructions: <1,2,RF,DK> [goto RSNHIELIG_A]
Question ID: INS.0760.00.1
Variable name: RSNHIELIG_A
Interview module: INS(Adult.INS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: 10 IN HIKIND_A and (MCAIDPRB_A IN (2,RF,DK) or MCAREPRB_A IN
(2,RF,DK))
Universe Description: Sample Adults 18+ without known health insurance and answered no, refused
or don't know to the Medicaid probe or the Medicare probe
Question Text:
Response:
Fills:
Read if necessary: There are other reasons that people do not have health
insurance coverage. ^PLUSCOSTA you currently uninsured because... ...you are
not eligible for coverage?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
^PLUSCOSTA
if RSNHICOST_A = 1 then fill "In addition to cost,
are"
Else fill "Are"
Skip Instructions: <1,2,RF,DK> [goto RSNHICONF_A]
Page 163 of 430
Question ID: INS.0770.00.1
Variable name: RSNHICONF_A
Interview module: INS(Adult.INS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: 10 IN HIKIND_A and (MCAIDPRB_A IN (2,RF,DK) or MCAREPRB_A IN
(2,RF,DK))
Universe Description: Sample Adults 18+ without known health insurance and answered no, refused
or don't know to the Medicaid probe or the Medicare probe
Question Text:
Response:
Fills:
Read if necessary: There are other reasons that people do not have health
insurance coverage. ^PLUSCOSTA you currently uninsured because... ...the
process of signing up for coverage is too difficult or confusing?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
^PLUSCOSTA
if RSNHICOST_A = 1 then fill "In addition to cost,
are"
Else fill "Are"
Skip Instructions: <1,2,RF,DK> [goto RSNHIMEET_A]
Question ID: INS.0780.00.1
Variable name: RSNHIMEET_A
Interview module: INS(Adult.INS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: 10 IN HIKIND_A and (MCAIDPRB_A IN (2,RF,DK) or MCAREPRB_A IN
(2,RF,DK))
Universe Description: Sample Adults 18+ without known health insurance and answered no, refused
or don't know to the Medicaid probe or the Medicare probe
Question Text:
Read if necessary: There are other reasons that people do not have health
insurance coverage. ^PLUSCOSTA you currently uninsured because... ...you
cannot find a plan that meets your needs?
Response:
Page 164 of 430
1.
2.
DK:
RF:
Fills:
Yes
No
Don't Know
Refused
^PLUSCOSTA
if RSNHICOST_A = 1 then fill "In addition to cost,
are"
Else fill "Are"
Skip Instructions: <1,2,RF,DK> [goto RSNHIWAIT_A]
Question ID: INS.0790.00.1
Variable name: RSNHIWAIT_A
Interview module: INS(Adult.INS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: 10 IN HIKIND_A and (MCAIDPRB_A IN (2,RF,DK) or MCAREPRB_A IN
(2,RF,DK))
Universe Description: Sample Adults 18+ without known health insurance and answered no, refused
or don't know to the Medicare probe or the Medicaid probe
Question Text:
Response:
Fills:
Read if necessary: There are other reasons that people do not have health
insurance coverage. ^PLUSCOSTA you currently uninsured because... ...you
applied for coverage but it has not started yet?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
^PLUSCOSTA
if RSNHICOST_A = 1 then fill "In addition to cost,
are"
Else fill "Are"
Page 165 of 430
Skip Instructions: <1,2,RF,DK> [goto RSNHIOTH_A]
Question ID: INS.0800.00.1
Variable name: RSNHIOTH_A
Interview module: INS(Adult.INS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: 10 IN HIKIND_A and (MCAIDPRB_A IN (2,RF,DK) or MCAREPRB_A IN
(2,RF,DK))
Universe Description: Sample Adults 18+ without known health insurance and answered no, refused
or don't know to the Medicare probe or the Medicaid probe
Question Text:
Response:
Is there another reason that you currently do not have health insurance
coverage?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> [goto RSNHIOTHSP_A]
<2,RF,DK> [goto next section]
Question ID: INS.0810.00.1
Variable name: RSNHIOTHSP_A
Interview module: INS(Adult.INS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: RSNHIOTH_A=1
Universe Description: Sample Adults 18+ who have another reason for not having coverage
Question Text:
Response:
What is your other reason for not having coverage?
DK:
RF:
Don't Know
Refused
Page 166 of 430
Skip Instructions: [goto next section]
Question ID: INS.0820.00.1
Variable name: HINOTYR_A
Interview module: INS(Adult.INS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: 01<=HIKIND_A<=09 or (MCAIDPRB_A=1 or MCAREPRB_A=1)
Universe Description: Sample Adults 18+ with known health insurance coverage or responded yes to
the medicare probe or medicaid probe
Question Text:
Response:
In the past 12 months, was there any time when you did NOT have ANY health
insurance or coverage?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> [goto HINOTMYR_A]
<2,RF,DK> [goto FINISH_A]
Question ID: INS.0830.00.1
Variable name: HINOTMYR_A
Interview module: INS(Adult.INS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: 01<=HIKIND_A<=09
HINOTYR_A=1
or
(MCAIDPRB_A=1
or
MCAREPRB_A=1)
and
Universe Description: Sample Adults 18+ with known health insurance coverage and did not have
health insurance for some period of time in the past 12 months
Question Text:
Response:
In the past 12 months, about how many months were you without coverage?
If less than 1 month, enter '1'.
DK:
RF:
Don't Know
Refused
Page 167 of 430
Skip Instructions: <1-12,RF,DK> [goto FINISH_A]
Question ID: INS.0840.00.1
Variable name: FINISH_A
Interview module: INS(Adult.INS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
The Sample Adult health insurance section is now complete.
continue.
1.
Enter '1' to
Enter 1 to Continue
Skip Instructions: <1> [goto next section]
Question ID: PAY.0010.00.1
Variable name: PAYINTRO_A
Interview module: PAY(Adult.PAY)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: (GEN.SAMEFAM_FLG=1
and
GEN.PAY_FLG_C=empty)
(GEN.SAMEFAM_FLG=1
and
GEN.PAY_FLG_C=2
GEN.SARESPSC_FLG ne 1) or (GEN.SAMEFAM_FLG ne 1)
or
and
Universe Description: Sample Adults 18+ living in same family as the Sample Child when the
Sample Child PAY section has not been completed
or Sample Adults living in same family as Sample Child when the Sample
Child respondent is not the Sample Adult and the Sample Child respondent
answered don't or refused to PAYBLL12M_C and PAYNOBLLNW_C
or Sample adults living in different families than the Sample Child
Question Text:
?[F1] Now I am going to ask you about your medical bills. Include bills for
doctors, dentists, hospitals, therapists, medication, equipment, and nursing
home or home care. ^Dormfill
Enter '1' to continue.
Response:
Page 168 of 430
1.
Fills:
Enter 1 to Continue
^Dormfill
If
Roster.HHC.tblNAME.bPerson[PX_A].ONOFFCAMP
US=1, fill "When I ask about your family, please think
about your family living at ^HNO ^HNOSUF
^STRNAME."
else leave blank
Skip Instructions: <1> [goto PAYBLL12M_A]
Question ID: PAY.0020.00.1
Variable name: PAYBLL12M_A
Interview module: PAY(Adult.PAY)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: (SAMEFAM_FLG=1 and PAY_FLG_C=blank) or (SAMEFAM_FLG=1 and
PAY_FLG_C=2 and SARESPSC_FLG ne 1) or (SAMEFAM_FLG ne 1)
Universe Description: Sample Adults 18+ living in same family as the Sample Child when the
Sample Child PAY section has not been completed
or Sample Adults living in same family as Sample Child when the Sample
Child respondent is not the Sample Adult and the Sample Child respondent
answered don't or refused to PAYBILL12M_C and PAYNOBLLNW_C
or Sample adults living in different families than the Sample Child
Question Text:
Response:
?[F1] In the past 12 months, did ^youanyone have problems paying or were
unable to pay any medical bills?
Read if necessary: Include bills for doctors,
dentists, hospitals, therapists, medication, equipment, nursing home or home care.
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Page 169 of 430
Fills:
^youanyone
If GEN.PCNT_A=1 fill "you";
else fill "anyone in the family"
Skip Instructions: <1,RF,DK> [goto PAYNOBLLNW_A]
<2> [goto PAYWORRY_A]
Question ID: PAY.0030.00.1
Variable name: PAYNOBLLNW_A
Interview module: PAY(Adult.PAY)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: ((SAMEFAM_FLG=1 and PAY_FLG_C=blank) or (SAMEFAM_FLG=1 and
PAY_FLG_C=2 and SARESPSC_FLG ne 1) or (SAMEFAM_FLG ne 1)) and
PAYBLL12M_A IN (1,RF,DK)
Universe Description: Sample Adults 18+ where anyone in the family has difficulty playing medical
bills or don't know or refused and Sample Adult is living in same family as the
Sample Child when the Sample Child PAY section has not been completed
or Sample Adults living in same family as Sample Child when the Sample
Child respondent is not the Sample Adult and the Sample Child respondent
answered don't or refused to PAYBILL12M_C and PAYNOBLLNW_C
or Sample adults living in different families than the Sample Child AND who
said they/anyone in their family has problems paying their medical bills or don't
know or refuse to answer if they/anyone in their family has problems paying
bills
Question Text:
Response:
^DoyouDoesanyoneinfam currently have any medical bills that you are unable
to pay at all?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Page 170 of 430
Fills:
^DoyouDoesanyoneinfamIf GEN.PCNT_A=1 fill "Do you";
else fill "Does anyone in your family"
Skip Instructions: <1,2,RF,DK> [goto PAYWORRY_A]
Question ID: PAY.0040.00.1
Variable name: PAYWORRY_A
Interview module: PAY(Adult.PAY)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
If you get sick or have an accident, how worried are you that you will be able to
pay your medical bills? Are you very worried, somewhat worried, or not at all
worried?
1.
2.
3.
DK:
RF:
Very worried
Somewhat worried
Not at all worried
Don't Know
Refused
Skip Instructions: <1-3,RF,DK> [goto next section]
Page 171 of 430
Question ID: CVL.0010.00.3
Variable name: CVDINTRO_A
Interview module: CVL(2023 Future Content.Adult.CVL)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
The next set of questions are about coronavirus or COVID-19.
continue.
1.
Enter '1' to
Enter 1 to Continue
Skip Instructions: <1> [goto EVERCOVD_A]
Question ID: CVL.0020.00.3
Variable name: EVERCOVD_A
Interview module: CVL(2023 Future Content.Adult.CVL)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
Have you ever had COVID-19? Read if necessary: Include being told by a doctor
that you had or likely had COVID-19. Also include antibodies or blood tests as well
as other forms of testing for COVID-19, such as a nasal swabbing or throat swabbing.
Also include if you had close contact with someone who had COVID-19 and you had
symptoms.
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> [goto LONGCOVD1_A]
<2,RF,DK> [goto next section]
Page 1 of 3
Question ID: CVL.0030.00.3
Variable name: LONGCOVD1_A
Interview module: CVL(2023 Future Content.Adult.CVL)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: EVERCOVD_A=1
Universe Description: Sample Adults 18+ who have ever had COVID-19
Question Text:
Response:
Did you have any symptoms lasting 3 months or longer that you did not have
prior to having coronavirus or COVID-19? Read if necessary: Long term
symptoms may include tiredness or fatigue, difficulty thinking, concentrating,
forgetfulness or memory problems, sometimes referred to as "brain fog," difficulty
breathing or shortness of breath, joint or muscle pain, fast-beating or pounding heart
(also known as heart palpitations), chest pain, dizziness on standing, menstrual
changes, changes to taste/smell, and inability to exercise.
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto SYMPNOW1_A]
Question ID: CVL.0040.00.3
Variable name: SYMPNOW1_A
Interview module: CVL(2023 Future Content.Adult.CVL)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: LONGCOVD1_A=1
Universe Description: Sample Adults 18+ who have ever had COVID-19 and had symptoms lasting 3
months or longer
Question Text:
Do you have symptoms NOW?
Response:
Page 2 of 3
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> if LONGCOVD1_A=1 [goto LCVDACT_A]
else [goto next section]
Question ID: CVL.0050.00.3
Variable name: LCVDACT_A
Interview module: CVL(2023 Future Content.Adult.CVL)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: LONGCOVD1_A=1 and SYMPNOW1_A=1
Universe Description: Sample Adults 18+ with COVID-19 symptoms lasting 3 months or longer that
they did not have prior to having coronavirus or COVID-19 and they have
symptoms now
Question Text:
Response:
How much do these long-term symptoms reduce your ability to carry out
day-to-day activities compared with the time before you had COVID-19? Would
you say... Read categories below.
1.
2.
3.
4.
DK:
RF:
Not at all
A little
A lot
Somewhere in between a little or a lot
Don't Know
Refused
Skip Instructions: <1-4,RF,DK> [goto next section]
Page 3 of 3
Question ID: DNC.0010.00.2
Variable name: DNCINTRO_A
Interview module: DNC(Adult.DNC)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
These next questions ask about your dental care.
1.
Enter 1 to Continue
Skip Instructions: <1> [goto DENPREV_A]
Page 175 of 430
Enter '1' to continue.
Question ID: DNC.0020.00.2
Variable name: DENPREV_A
Interview module: DNC(Adult.DNC)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
About how long has it been since you last had a dental examination or
cleaning? Read if necessary: Include cleanings from all types of dental care
providers such as dentists, orthodontists, oral surgeons, dental hygienists, and all
other dental specialists.
0.
1.
2.
3.
4.
5.
6.
DK:
RF:
Never
Within the past year (anytime less than 12 months ago)
Within the last 2 years (1 year but less than 2 years ago)
Within the last 3 years (2 years but less than 3 years ago)
Within the last 5 years (3 years but less than 5 years ago)
Within the last 10 years (5 years but less than 10 years ago)
10 years ago or more
Don't Know
Refused
Skip Instructions: <0-6,RF,DK> [goto DENDL12M_A]
Question ID: DNC.0030.00.2
Variable name: DENDL12M_A
Interview module: DNC(Adult.DNC)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
During the past 12 months, have you DELAYED getting dental care because of
the cost?
Response:
Page 176 of 430
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto DENNG12M_A]
Question ID: DNC.0040.00.2
Variable name: DENNG12M_A
Interview module: DNC(Adult.DNC)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
During the past 12 months, was there any time when you needed dental care,
but DID NOT GET IT because of the cost?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto next section]
Question ID: UTZ.0010.00.1
Variable name: UTZINTRO_A
Interview module: UTZ(Adult.UTZ)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Now, I would like to ask you about your health care, not including dental care.
Enter '1' to continue.
Response:
Page 177 of 430
1.
Enter 1 to Continue
Skip Instructions: <1> [goto LASTDR_A]
Question ID: UTZ.0020.00.1
Variable name: LASTDR_A
Interview module: UTZ(Adult.UTZ)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
About how long has it been since you last saw a doctor or other health
professional about your health? Read if necessary: Include doctors seen while a
patient in a hospital. Read if necessary: Do not include dental care.
0.
1.
2.
3.
4.
5.
6.
DK:
RF:
Never
Within the past year (anytime less than 12 months ago)
Within the last 2 years (1 year but less than 2 years ago)
Within the last 3 years (2 years but less than 3 years ago)
Within the last 5 years (3 years but less than 5 years ago)
Within the last 10 years (5 years but less than 10 years ago)
10 years ago or more
Don't Know
Refused
Skip Instructions: <1-6> [goto WELLNESS_A]
<0,RF,DK> [goto USUALPL_A]
Question ID: UTZ.0030.00.1
Variable name: WELLNESS_A
Interview module: UTZ(Adult.UTZ)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: LASTDR_A IN (1,2,3,4,5,6)
Universe Description: Sample Adults 18+ who have seen a doctor
Question Text:
Was this a wellness visit, physical, or general purpose check-up? Read if
necessary: This kind of visit typically includes: blood pressure, cholesterol, and blood
sugar checks, height and weight measurements, and vaccinations. The doctor or
other health professional may also discuss topics related to your health such as
smoking, alcohol use, diet and exercise. These visits are usually scheduled in
advance and occur when you are not sick or injured. Read if necessary: If a
wellness exam was combined with a sick care visit, include this visit. Read if
Page 178 of 430
necessary: An obstetrician/gynecologist (OB/GYN) may perform this visit.
Response:
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> [goto USUALPL_A]
<2,RF,DK> [goto WELLVIS_A]
Question ID: UTZ.0040.00.1
Variable name: WELLVIS_A
Interview module: UTZ(Adult.UTZ)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: WELLNESS_A IN (2,RF,DK)
Universe Description: Sample Adults 18+ who have seen a doctor, but the last visit was not a
wellness visit or they didn’t know or refused whether it was a wellness
visit
Question Text:
Response:
About how long has it been since you last saw a doctor or other health
professional for a wellness visit, physical, or general purpose check-up?
Read if necessary: This kind of visit typically includes: blood pressure, cholesterol,
and blood sugar checks, height and weight measurements, and vaccinations. The
doctor or other health professional may also discuss topics related to your health
such as smoking, alcohol use, diet and exercise. These visits are usually scheduled
in advance and occur when you are not sick or injured. Read if necessary: If a
wellness exam was combined with a sick care visit, include this visit. Read if
necessary: An obstetrician/gynecologist (OB/GYN) may perform this visit.
0.
1.
2.
Never
Within the past year (anytime less than 12 months ago)
Within the last 2 years (1 year but less than 2 years ago)
Page 179 of 430
3.
4.
5.
6.
DK:
RF:
Within the last 3 years (2 years but less than 3 years ago)
Within the last 5 years (3 years but less than 5 years ago)
Within the last 10 years (5 years but less than 10 years ago)
10 years ago or more
Don't Know
Refused
Skip Instructions: <0-6,RF,DK> [goto USUALPL_A]
Question ID: UTZ.0050.00.1
Variable name: USUALPL_A
Interview module: UTZ(Adult.UTZ)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
Is there a place that you USUALLY go to if you are sick and need health care?
1.
2.
3.
DK:
RF:
Yes
There is NO place
There is MORE THAN ONE place
Don't Know
Refused
Skip Instructions: <1,3,RF,DK> [goto USPLKIND_A]
<2> [goto URGENT12M_A]
Question ID: UTZ.0060.00.1
Variable name: USPLKIND_A
Interview module: UTZ(Adult.UTZ)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: USUALPL_A IN (1,3,RF,DK)
Universe Description: Sample Adults 18+ with 1+ usual place of care or who don't know or refused to
answer if they have a usual place of care
Question Text:
What kind of place ^ISITGOMSTOFT - a doctor's office or health center; an
urgent care center, a clinic in a drug store or grocery store; a hospital
emergency room; a VA Medical Center or VA outpatient clinic; or some other
place? Read if necessary: A doctor's office or health center is a place where you
see the same doctor or the same group of doctors every visit, where you usually need
to make an appointment ahead of time, and where your medical records are on file.
Read if necessary: Urgent care centers and clinics in a drug store or grocery store
Page 180 of 430
are places where you do not need to make an appointment ahead of time, and do not
usually see the same health care provider at each visit.
Response:
Fills:
1.
2.
3.
4.
5.
6.
DK:
RF:
A doctor's office or health center
Urgent care center or clinic in a drug store or grocery store
Hospital emergency room
A VA Medical Center or VA outpatient clinic
Some other place
Does not go to one place most often
Don't Know
Refused
^ISITGOMSTOFT
If USUALPL_A=1 fill "is it";
else fill "do you go to most often"
Skip Instructions: <1-6,RF,DK> [goto URGENT12M_A]
Question ID: UTZ.0070.00.1
Variable name: URGENT12M_A
Interview module: UTZ(Adult.UTZ)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
During the past 12 months, how many times have you gone to an urgent care
center or a clinic in a drug store or grocery store about your health? Enter 96
if number is 96 or greater. Read if necessary: Urgent care centers and clinics in
drug stores or grocery stores are places where you do not need to make an
appointment ahead of time, and do not usually see the same health care provider at
each visit. Read if necessary: This is different from a hospital emergency room.
DK:
RF:
Don't Know
Refused
Page 181 of 430
Skip Instructions: <0-39,RF,DK> [goto EMERGE12M_A]
<40-96> [goto ERR1_URGENT12M_A]
Check Name: ERR1_URGENT12M_A
Text:
{signal ERR1_URGENT12M_A} ^URGENT12M_A is an unusually large number.
Did you visit an urgent care center or clinic in a drug store or grocery
storeabout your health ^URGENT12M_A times in the past 12 months? Please
verify.
Hard / Soft Edit: Soft
Fills:
^URGENT12M_A
fill value from URGENT12M_A
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: URGENT12M_A=40-96
Universe Description: Sample adult reported going to urgent care 40-96 times
Question ID: UTZ.0080.00.1
Variable name: EMERGE12M_A
Interview module: UTZ(Adult.UTZ)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
During the past 12 months, how many times have you gone to a hospital
emergency room about your health? Read if necessary: This includes
emergency room visits that resulted in a hospital admission. Enter 96 if number of
times is 96 or more.
DK:
RF:
Don't Know
Refused
Page 182 of 430
Skip Instructions: <0-39,RF,DK> [goto HOSPONGT_A]
<40-96> [goto ERR1_EMERGE12M_A]
Check Name: ERR1_EMERGE12M_A
Text:
{signal ERR1_EMERGE12M_A} ^EMERGE12M_A is an unusually large number.
Did you visit a hospital emergency room about your health ^EMERGE12M_A
times in the past 12 months? Please verify.
Hard / Soft Edit: Soft
Fills:
^EMERGE12M_A
Fill value from Adult.UTZ.EMERGE12M_A
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: EMERGE12M=40-96
Universe Description: Sample adult reported going to ER 40-96 times
Question ID: UTZ.0090.00.1
Variable name: HOSPONGT_A
Interview module: UTZ(Adult.UTZ)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
During the past 12 months, have you been hospitalized overnight?
^PAST12MER_A
Response:
Page 183 of 430
1.
2.
DK:
RF:
Fills:
Yes
No
Don't Know
Refused
^PAST12MER_A
If ((EMERGE12M_A ge 01 and EMERGE12M_A le
96) or EMERGE12M_A IN (RF,DK): Fill: "Do not
include an overnight stay in the emergency room."
Skip Instructions: <1,2,RF,DK> [goto MEDDL12M_A]
Question ID: UTZ.0100.00.1
Variable name: MEDDL12M_A
Interview module: UTZ(Adult.UTZ)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
During the past 12 months, have you DELAYED getting medical care because
of the cost?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto MEDNG12M_A]
Page 184 of 430
Question ID: UTZ.0110.00.1
Variable name: MEDNG12M_A
Interview module: UTZ(Adult.UTZ)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
During the past 12 months, was there any time when you needed medical care,
but DID NOT GET IT because of the cost?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto next section]
Question ID: TLH.0010.00.1
Variable name: VIRAPP12M_A
Interview module: TLH(Adult.TLH)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
During the past 12 months, have you had an appointment with a doctor, nurse,
or other health professional by video or by phone?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto next section]
Page 185 of 430
Question ID: HIT.0010.00.4
Variable name: ACCSSINT_A
Interview module: HIT(Adult.HIT)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
Do you have access to the Internet?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> [goto ACCSSHOM_A]
<2,RF,DK> [goto next section]
Question ID: HIT.0020.00.4
Variable name: ACCSSHOM_A
Interview module: HIT(Adult.HIT)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: ACCSSINT_A=1
Universe Description: Sample Adults 18+ with access to the Internet
Question Text:
Response:
Do you have access to the Internet from your home?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Page 186 of 430
Skip Instructions: <1,2,RF,DK> [goto HITLOOK_A]
Question ID: HIT.0030.00.4
Variable name: HITLOOK_A
Interview module: HIT(Adult.HIT)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: ACCSSINT_A=1
Universe Description: Sample Adults 18+ with access to the Internet
Question Text:
Response:
During the past 12 months, have you used the Internet for any of the following
reasons? To look for health or medical information.
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto HITCOMM_A]
Question ID: HIT.0040.00.4
Variable name: HITCOMM_A
Interview module: HIT(Adult.HIT)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: ACCSSINT_A=1
Universe Description: Sample Adults 18+ with access to the Internet
Question Text:
Read if necessary: During the past 12 months, have you used the Internet for any of
the following reasons? To communicate with a doctor or doctor's office.
Read if necessary: Include Internet and data use through a computer, tablet,
smartphone, or other electronic device.
Response:
Page 187 of 430
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto HITTEST_A]
Question ID: HIT.0050.00.4
Variable name: HITTEST_A
Interview module: HIT(Adult.HIT)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: ACCSSINT_A=1
Universe Description: Sample Adults 18+ with access to the Internet
Question Text:
Response:
Read if necessary: During the past 12 months, have you used the Internet for any of
the following reasons? To look up medical test results.
Read if necessary:
Include Internet and data use through a computer, tablet, smartphone, or other
electronic device.
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto next section]
Question ID: PMD.0010.00.1
Variable name: RX12M_A
Interview module: PMD(Adult.PMD)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
At any time in the past 12 months, did you take prescription medication?
Response:
Page 188 of 430
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> [goto RXSK12M_A]
<2,RF,DK> [goto RXDG12M_A]
Question ID: PMD.0020.00.1
Variable name: RXSK12M_A
Interview module: PMD(Adult.PMD)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: RX12M_A=1
Universe Description: Sample Adults 18+ who have taken prescription medication in the past 12
months
Question Text:
Response:
During the past 12 months, were any of the following true for you? ...You
skipped medication doses to save money.
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto RXLS12M_A]
Question ID: PMD.0030.00.1
Variable name: RXLS12M_A
Interview module: PMD(Adult.PMD)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: RX12M_A=1
Universe Description: Sample Adults 18+ who have taken prescribed medication in the past 12
months
Question Text:
Read if necessary: During the past 12 months, were any of the following true for
you? ...You took less medication to save money.
Response:
Page 189 of 430
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto RXDL12M_A]
Question ID: PMD.0040.00.1
Variable name: RXDL12M_A
Interview module: PMD(Adult.PMD)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: RX12M_A=1
Universe Description: Sample Adults 18+ who have taken prescribed medication in the past 12
months
Question Text:
Response:
Read if necessary: During the past 12 months, were any of the following true for
you? ...You DELAYED filling a prescription to save money.
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto RXDG12M_A]
Question ID: PMD.0050.00.1
Variable name: RXDG12M_A
Interview module: PMD(Adult.PMD)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
During the past 12 months, was there any time when you needed prescription
medication, but DID NOT GET IT because of the cost?
Response:
Page 190 of 430
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto next section]
Question ID: PRV.0010.00.2
Variable name: BPLAST_A
Interview module: PRV(Adult.PRV)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
When was the last time you had your blood pressure checked by a doctor,
nurse, or other health professional?
0.
1.
2.
3.
4.
5.
6.
DK:
RF:
Never
Within the past year (anytime less than 12 months ago)
Within the last 2 years (1 year but less than 2 years ago)
Within the last 3 years (2 years but less than 3 years ago)
Within the last 5 years (3 years but less than 5 years ago)
Within the last 10 years (5 years but less than 10 years ago)
10 years ago or more
Don't Know
Refused
Skip Instructions: <0-6,RF,DK> [goto CHOLLAST_A]
Page 191 of 430
Question ID: PRV.0020.00.2
Variable name: CHOLLAST_A
Interview module: PRV(Adult.PRV)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
When was the last time you had your cholesterol checked by a doctor, nurse,
or other health professional?
0.
1.
2.
3.
4.
5.
6.
DK:
RF:
Never
Within the past year (anytime less than 12 months ago)
Within the last 2 years (1 year but less than 2 years ago)
Within the last 3 years (2 years but less than 3 years ago)
Within the last 5 years (3 years but less than 5 years ago)
Within the last 10 years (5 years but less than 10 years ago)
10 years ago or more
Don't Know
Refused
Skip Instructions: <0-6,RF,DK> if DIB.DIBEV_A IN (2,RF,DK) [goto DIBLAST1_A]
elseif DIB.DIBEV_A=1 [goto DIBA1CLAST_A]
Question ID: PRV.0030.00.2
Variable name: DIBLAST1_A
Interview module: PRV(Adult.PRV)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: DIB.DIBEV_A IN (2,RF,DK)
Universe Description: Sample Adults 18+ who have not been told they have diabetes
Question Text:
When was the last time you had a blood test for high blood sugar or diabetes
by a doctor, nurse, or other health professional?
Response:
Page 192 of 430
0.
1.
2.
3.
4.
5.
6.
DK:
RF:
Never
Within the past year (anytime less than 12 months ago)
Within the last 2 years (1 year but less than 2 years ago)
Within the last 3 years (2 years but less than 3 years ago)
Within the last 5 years (3 years but less than 5 years ago)
Within the last 10 years (5 years but less than 10 years ago)
10 years ago or more
Don't Know
Refused
Skip Instructions: <0-6,RF,DK> if GEN.AGE_FINAL[PX_A] ge 40 [goto COLORECTEV_A]
elseif (GEN.SEX_FINAL[PX_A]=2 and (GEN.AGE_FINAL[PX_A] lt 40 or
GEN.AGE_FINAL[PX_A] IN (DK,RF)) [goto CERVICEV1_A]
elseif (GEN.SEX_FINAL[PX_A]=1 and (GEN.AGE_FINAL[PX_A] lt 40 or
GEN.AGE_FINAL[PX_A] IN (DK,RF)) or GEN.SEX_FINAL[PX_A] IN (DK,RF)
[goto next section]
Question ID: PRV.0033.00.3
Variable name: DIBA1CLAST_A
Interview module: PRV(Adult.PRV)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: DIB.DIBEV_A=1
Universe Description: Sample Adults 18+ who have been told they have diabetes
Question Text:
Response:
An A-one-C test is used to measure the average level of blood sugar over the
past three months. When was the last time you had your A1C checked by a
doctor, nurse, or other health professional? Read if necessary: A1C values
typically range between 5 and 13.9. For many people with diabetes the goal is to
have an A1C of 7 or less, but your goal may be different depending on what you and
your doctor determine is best for you.
0.
Never
Page 193 of 430
1.
2.
3.
4.
5.
6.
DK:
RF:
Within the past year (anytime less than 12 months ago)
Within the last 2 years (1 year but less than 2 years ago)
Within the last 3 years (2 years but less than 3 years ago)
Within the last 5 years (3 years but less than 5 years ago)
Within the last 10 years (5 years but less than 10 years ago)
10 years ago or more
Don't Know
Refused
Skip Instructions: <1> [goto DIBA1CNUM_A]
<0,2-6,RF,DK> if GEN.AGE_FINAL[PX_A] ge 40 [goto COLORECTEV_A]
elseif (GEN.SEX_FINAL[PX_A]=2 and (GEN.AGE_FINAL[PX_A] lt 40 or
GEN.AGE_FINAL[PX_A] IN (DK,RF)) [goto CERVICEV1_A]
elseif (GEN.SEX_FINAL[PX_A]=1 and (GEN.AGE_FINAL[PX_A] lt 40 or
GEN.AGE_FINAL[PX_A] IN (DK,RF)) or GEN.SEX_FINAL[PX_A] IN (DK,RF)
[goto next section]
Question ID: PRV.0037.00.3
Variable name: DIBA1CNUM_A
Interview module: PRV(Adult.PRV)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: DIBA1CLAST_A=1
Universe Description: Sample Adults 18+ who had their A1C checked in the past 12 months
Question Text:
Response:
About how many times in the past 12 months has a doctor, nurse, or other
health professional checked your A-one-C?
Read if necessary: A1C values
typically range between 5 and 13.9. For many people with diabetes the goal is to
have an A1C of 7 or less, but your goal may be different depending on what you and
your doctor determine is best for you. If respondent reports more than 96 A1C
tests, enter '96'.
DK:
RF:
Don't Know
Refused
Page 194 of 430
Skip Instructions: <1-96,RF,DK> if GEN.AGE_FINAL[PX_A] ge 40 [goto COLORECTEV_A]
elseif (GEN.SEX_FINAL[PX_A]=2 and (GEN.AGE_FINAL[PX_A] lt 40 or
GEN.AGE_FINAL[PX_A] IN (DK,RF)) [goto CERVICEV1_A]
elseif (GEN.SEX_FINAL[PX_A]=1 and (GEN.AGE_FINAL[PX_A] lt 40 or
GEN.AGE_FINAL[PX_A] IN (DK,RF)) or GEN.SEX_FINAL[PX_A] IN (DK,RF)
[goto next section]
Question ID: PRV.0040.00.2
Variable name: COLORECTEV_A
Interview module: PRV(Adult.PRV)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: GEN.AGE_FINAL[PX_A] ge 40
Universe Description: Sample Adults 40+
Question Text:
Response:
These next questions are about colorectal cancer screening. Colonoscopy and
sigmoidoscopy are exams to check for colon cancer. Have you ever had either
of these exams?
Read if necessary: Colonoscopy (colon-OS-copy) and
sigmoidoscopy (sigmoid-OS-copy) are exams in which a doctor inserts a tube into the
rectum to look for polyps or cancer.
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> [goto COLORECTYP_A]
<2,RF,DK> [goto CTCOLEV1_A]
Page 195 of 430
Question ID: PRV.0050.00.2
Variable name: COLORECTYP_A
Interview module: PRV(Adult.PRV)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: GEN.AGE_FINAL[PX_A] ge 40 and COLORECTEV_A=1
Universe Description: Sample Adults 40+ who have had a colonoscopy or sigmoidoscopy or both
Question Text:
Response:
Have you had a colonoscopy, a sigmoidoscopy, or both? Read if necessary:
For a colonoscopy, the doctor checks the entire colon, and you are given medication
through a needle in your arm to make you sleepy, and told to have someone take you
home. For a sigmoidoscopy, the doctor checks only part of the colon and you are fully
awake. Enter 'DK' if respondent has had a colonoscopy or sigmoidoscopy, but
doesn't know which.
1.
2.
3.
DK:
RF:
Colonoscopy
Sigmoidoscopy
Both
Don't Know
Refused
Skip Instructions: <1,3> [goto COLWHEN_A]
<2> [goto SIGWHEN_A]
[goto COLSIGWHEN_A]
[goto CTCOLEV1_A]
Question ID: PRV.0060.00.2
Variable name: COLWHEN_A
Interview module: PRV(Adult.PRV)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: GEN.AGE_FINAL[PX_A] ge 40 and COLORECTYP_A IN (1,3)
Universe Description: Sample Adults 40+ who have ever had a colonoscopy or both a colonoscopy
and a sigmoidoscopy
Question Text:
About how long has it been since your MOST RECENT colonoscopy?
Response:
Page 196 of 430
1.
2.
3.
4.
5.
6.
DK:
RF:
Within the past year (anytime less than 12 months ago)
Within the past 2 years (1 year but less than 2 years ago)
Within the past 3 years (2 years but less than 3 years ago)
Within the past 5 years (3 years but less than 5 years ago)
Within the past 10 years (5 years but less than 10 years ago)
10 years ago or more
Don't Know
Refused
Skip Instructions: <1-6,RF,DK> [goto COLREASON1_A]
Question ID: PRV.0070.00.3
Variable name: COLREASON1_A
Interview module: PRV(Adult.PRV)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: GEN.AGE_FINAL[PX_A] ge 40 and COLORECTYP_A IN (1,3)
Universe Description: Sample Adults 40+ who ever had a colonoscopy or both a colonoscopy and a
sigmoidoscopy
Question Text:
Response:
What was the MAIN reason you had this most recent colonoscopy - was it part
of a routine exam, because of a problem, as a follow-up test of an earlier test or
screening exam, or some other reason?
1.
2.
3.
4.
DK:
RF:
Part of a routine exam
Because of a problem
Follow-up test of an earlier test or screening exam
Other reason
Don't Know
Refused
Skip Instructions: <1-4,RF,DK> if COLORECTYP_A=3 [goto SIGWHEN_A]
else [goto CTCOLEV1_A]
Page 197 of 430
Question ID: PRV.0090.00.2
Variable name: COLSIGWHEN_A
Interview module: PRV(Adult.PRV)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: GEN.AGE_FINAL ge 40 and COLORECTYP_A=DK
Universe Description: Sample Adults 40+ who have ever had a colonoscopy or sigmoidoscopy but
do not know which type
Question Text:
Response:
When was your MOST RECENT colonoscopy or sigmoidoscopy?
1.
2.
3.
4.
5.
6.
DK:
RF:
Within the past year (anytime less than 12 months ago)
Within the past 2 years (1 year but less than 2 years ago)
Within the past 3 years (2 years but less than 3 years ago)
Within the past 5 years (3 years but less than 5 years ago)
Within the past 10 years (5 years but less than 10 years ago)
10 years ago or more
Don't Know
Refused
Skip Instructions: <1-6,RF,DK> [goto CTCOLEV1_A]
Question ID: PRV.0100.00.2
Variable name: SIGWHEN_A
Interview module: PRV(Adult.PRV)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: GEN.AGE_FINAL[PX_A] ge 40 and COLORECTYP_A IN (2,3)
Universe Description: Sample Adults 40+ who have ever had a sigmoidoscopy or both a
colonoscopy and a sigmoidoscopy
Question Text:
When was your MOST RECENT sigmoidoscopy?
Response:
Page 198 of 430
1.
2.
3.
4.
5.
6.
DK:
RF:
Within the past year (anytime less than 12 months ago)
Within the past 2 years (1 year but less than 2 years ago)
Within the past 3 years (2 years but less than 3 years ago)
Within the past 5 years (3 years but less than 5 years ago)
Within the past 10 years (5 years but less than 10 years ago)
10 years ago or more
Don't Know
Refused
Skip Instructions: <1-6,RF,DK> [goto CTCOLEV1_A]
Question ID: PRV.0120.00.2
Variable name: CTCOLEV1_A
Interview module: PRV(Adult.PRV)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: GEN.AGE_FINAL[PX_A] ge 40
Universe Description: Sample Adults 40+
Question Text:
Response:
CT colonography, sometimes called virtual colonoscopy, is a test that looks for
cancer in the colon. Unlike regular colonoscopies, you do not need medication
to make you sleepy during the test. In this test, your colon is filled with air and
you are moved through a donut-shaped X-ray machine as you lie on your back
and then your stomach. Have you ever had a CT colonography or virtual
colonoscopy?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> [goto CTCOLWHEN1_A]
<2,RF,DK> if COLORECTYP_A=1-3 [goto
FITHEV1_A]
Page 199 of 430
Question ID: PRV.0130.00.2
Variable name: CTCOLWHEN1_A
Interview module: PRV(Adult.PRV)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: GEN.AGE_FINAL[PX_A] ge 40 and CTCOLEV1_A=1
Universe Description: Sample Adults 40+ who have had a CT colonography or virtual colonoscopy
Question Text:
Response:
When was your most recent CT colonography or virtual colonoscopy?
1.
2.
3.
4.
5.
6.
DK:
RF:
Within the past year (anytime less than 12 months ago)
Within the past 2 years (1 year but less than 2 years ago)
Within the past 3 years (2 years but less than 3 years ago)
Within the past 5 years (3 years but less than 5 years ago)
Within the past 10 years (5 years but less than 10 years ago)
10 years ago or more
Don't Know
Refused
Skip Instructions: <1-6,RF,DK> [goto FITHEV1_A]
Page 200 of 430
Question ID: PRV.0140.00.2
Variable name: FITHEV1_A
Interview module: PRV(Adult.PRV)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: GEN.AGE_FINAL[PX_A] ge 40
Universe Description: Sample Adults 40+
Question Text:
Response:
The following questions are about the blood stool or fecal occult blood test,
fecal immunochemical or FIT test. These are tests to determine whether you
have blood in your stool or bowel movement and can be done at home using a
kit. You use a stick or brush to obtain a small amount of stool at home and
send it back to the doctor or lab. Have you ever had a blood stool or FIT test,
using a HOME test kit?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> [goto FITHWHEN1_A]
<2,RF,DK> [goto COLOGUARD1_A]
Page 201 of 430
Question ID: PRV.0150.00.2
Variable name: FITHWHEN1_A
Interview module: PRV(Adult.PRV)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: GEN.AGE_FINAL[PX_A] ge 40 and FITHEV1_A=1
Universe Description: Sample Adults 40+ who have ever had a home blood stool or FIT test
Question Text:
Response:
When was your most recent blood stool or FIT test, using a home test kit?
1.
2.
3.
4.
5.
6.
DK:
RF:
Within the past year (anytime less than 12 months ago)
Within the past 2 years (1 year but less than 2 years ago)
Within the past 3 years (2 years but less than 3 years ago)
Within the past 5 years (3 years but less than 5 years ago)
Within the past 10 years (5 years but less than 10 years ago)
10 years ago or more
Don't Know
Refused
Skip Instructions: <1-6,DK,RF> [goto COLOGUARD1_A]
Question ID: PRV.0160.00.3
Variable name: COLOGUARD1_A
Interview module: PRV(Adult.PRV)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: GEN.AGE_FINAL[PX_A] ge 40
Universe Description: Sample Adults 40+
Question Text:
Cologuard or FIT-DNA is a new type of stool test for colon cancer. Unlike other
stool tests, Cologuard looks for changes in DNA in addition to checking for
blood in your stool. The Cologuard test is shipped to your home in a box that
includes a container for your stool sample. Have you ever had a Cologuard
test?
Response:
Page 202 of 430
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> if FITHEV1_A=1 [goto FITCOLG1_A]
elseif FITHEV1_A IN (2,RF,DK) [goto CGUARDWHE1_A]
<2,RF,DK>
if
((COLWHEN_A=1-5
or
SIGWHEN_A=1-4
or
CTCOLWHEN1_A=1-4
or
COLSIGWHEN_A=1-4
or
FITCOLGCUR_FLG_A=1)
and
GEN.SEX_FINAL[PX_A]=1)
[goto
PSATEST_A]
elseif ((COLWHEN_A=1-5 or SIGWHEN_A=1-4 or CTCOLWHEN1_A=1-4 or
COLSIGWHEN_A=1-4
or
FITCOLGCUR_FLG_A=1)
and
GEN.SEX_FINAL[PX_A]=2) [goto CERVICEV1_A]
elseif ((COLWHEN_A=1-5 or SIGWHEN_A=1-4 or CTCOLWHEN1_A=1-4 or
COLSIGWHEN_A=1-4
or
FITCOLGCUR_FLG_A=1)
and
GEN.SEX_FINAL[PX_A] in (RF,DK)) [goto next section]
else [goto COLPROB1_A]
Question ID: PRV.0170.00.3
Variable name: FITCOLG1_A
Interview module: PRV(Adult.PRV)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: GEN.AGE_FINAL[PX_A] ge 40 and FITHEV1_A=1 and COLOGUARD1_A=1
Universe Description: Sample Adults 40+ who ever had a blood stool or FIT test using a home test
kit and ever had a Cologuard test
Question Text:
Was the blood stool or FIT test you reported earlier conducted as part of a
Cologuard test?
Response:
Page 203 of 430
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> if ((COLWHEN_A=1-5 or SIGWHEN_A=1-4 or CTCOLWHEN1_A=1-4 or
COLSIGWHEN_A=1-4
or
FITCOLGCUR_FLG_A=2)
and
GEN.SEX_FINAL[PX_A]=1) [goto PSATEST_A]
elseif ((COLWHEN_A=1-5 or SIGWHEN_A=1-4 or CTCOLWHEN1_A=1-4 or
COLSIGWHEN_A=1-4
or
FITCOLGCUR_FLG_A=2)
and
GEN.SEX_FINAL[PX_A]=2) [goto CERVICEV1_A]
elseif ((COLWHEN_A=1-5 or SIGWHEN_A=1-4 or CTCOLWHEN1_A=1-4 or
COLSIGWHEN_A=1-4
or
FITCOLGCUR_FLG_A=2)
and
GEN.SEX_FINAL[PX_A] IN (RF,DK)) [goto next section]
else [goto COLPROB1_A]
<2,RF,DK> [goto CGUARDWHE1_A]
Question ID: PRV.0180.00.3
Variable name: CGUARDWHE1_A
Interview module: PRV(Adult.PRV)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: GEN.AGE_FINAL[PX_A] ge 40 and COLOGUARD1_A=1 and (FITCOLG1_A
IN (2,RF,DK) or FITHEV1_A IN (2,RF,DK))
Universe Description: Sample Adults 40+ who ever had a Cologuard test and, if they had a home FIT
test, did not say the Cologuard was part of the FIT test or they did not have a
home FIT test or don't know or refused
Question Text:
When did you have your most recent Cologuard test?
Response:
Page 204 of 430
1.
2.
3.
4.
5.
6.
DK:
RF:
Within the past year (anytime less than 12 months ago)
Within the past 2 years (1 year but less than 2 years ago)
Within the past 3 years (2 years but less than 3 years ago)
Within the past 5 years (3 years but less than 5 years ago)
Within the past 10 years (5 years but less than 10 years ago)
10 years ago or more
Don't Know
Refused
Skip Instructions: <1-3> if GEN.SEX_FINAL[PX_A]=1 [goto PSATEST_A]
elseif GEN.SEX_FINAL[PX_A]=2 [goto CERVICEV1_A]
elseif GEN.SEX_FINAL[PX_A] IN (RF,DK) [goto next section]
<4-6,RF,DK> if ((COLWHEN_A=1-5 or SIGWHEN_A IN=1-4 or
CTCOLWHEN1_A=1-4 or COLSIGWHEN_A=1-4 or FITCOLGCUR_FLG_A IN
(1,2)) and GEN.SEX_FINAL[PX_A]=1) [goto PSATEST_A]
elseif ((COLWHEN_A=1-5 or SIGWHEN_A IN=1-4 or CTCOLWHEN1_A=1-4
or COLSIGWHEN_A=1-4 or FITCOLGCUR_FLG_A IN (1,2)) and
GEN.SEX_FINAL[PX_A]=2) [goto CERVICEV1_A]
elseif ((COLWHEN_A=1-5 or SIGWHEN_A IN=1-4 or CTCOLWHEN1_A=1-4
or COLSIGWHEN_A=1-4 or FITCOLGCUR_FLG_A IN (1,2)) and
GEN.SEX_FINAL[PX_A] IN (RF,DK)) [goto next section]
else [goto COLPROB1_A]
Question ID: PRV.0190.00.3
Variable name: COLPROB1_A
Interview module: PRV(Adult.PRV)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: GEN.AGE_FINAL[PX_A] ge 40 and COLWHEN_A IN (empty,6,RF,DK) and
SIGWHEN_A
IN
(empty,5,6,RF,DK)
and
COLSIGWHEN_A
IN
(empty,5,6,RF,DK) and CTCOLWHEN1_A IN (empty,5,6,RF,DK) and
FITCOLGCUR_FLG_A=empty
Universe Description: Sample adults 40+
who never had a colonoscopy or had a colonoscopy over 10 years ago, or
don't know or refused when they had a colonoscopy,
and never had a sigmoidoscopy or had a sigmoidoscopy over 5 years ago, or
don't know or refused when they had a sigmoidoscopy,
or had a sigmoidoscopy or colonoscopy but don't know which over 5 years
ago,
and never had a CT colonography or had a CT colonography over 5 years
Page 205 of 430
ago, or don't know or refused when they had a CT colonography,
and never had a FIT test or had a FIT over 1 year ago and did not, did not
know, or refused to say if they had a Cologuard test, or had a FIT that did not,
don't know, or refused to say if it included a Cologuard test over 1 year ago or
don't know or refused when they had a FIT test or had a FIT test that included
a Cologuard more than 3 years ago or don't know or refused when to say they
had a FIT test
and never had a Cologuard test or had a Cologuard test more than 3 years
ago, or don't know or refused when they had a Cologuard test
Question Text:
Response:
In the past 12 MONTHS, did a doctor or other health professional RECOMMEND
that you be tested to look for problems in your colon or rectum?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> [goto COLTEST_A]
<2,RF,DK> if GEN.SEX_FINAL[PX_A]=1 [goto PSATEST_A]
elseif GEN.SEX_FINAL[PX_A]=2 [goto CERVICEV1_A]
elseif GEN.SEX_FINAL[PX_A] IN (RF,DK) [goto next section]
Question ID: PRV.0200.00.3
Variable name: COLTEST_A
Interview module: PRV(Adult.PRV)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: GEN.AGE_FINAL[PX_A] ge 40 and COLPROB1_A=1
Universe Description: Sample Adults 40+ who had another type of colon test recommended
Question Text:
Which tests to check for colon cancer did the doctor or other health
professional recommend to you? Possible tests include stool blood or fecal
occult blood or FIT test; Cologuard or FIT DNA test; sigmoidoscopy;
colonoscopy; CT colonography or virtual colonoscopy; or other. Enter all that
apply, separate with commas.
Response:
Page 206 of 430
1.
2.
3.
4.
5.
6.
DK:
RF:
Stool blood test/fecal occult blood/FIT test
Cologuard or FIT DNA test
Sigmoidoscopy
Colonoscopy
CT colonography/virtual colonoscopy
Other
Don't Know
Refused
Skip Instructions: <1-6,RF,DK> if GEN.SEX_FINAL[PX_A]=1 [goto PSATEST_A]
elseif GEN.SEX_FINAL[PX_A]=2 [goto CERVICEV1_A]
elseif GEN.SEX_FINAL[PX_A] IN (RF,DK) [goto next section]
Question ID: PRV.0210.00.3
Variable name: PSATEST_A
Interview module: PRV(Adult.PRV)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: GEN.SEX_FINAL[PX_A]=1 and GEN.AGE_FINAL[PX_A] ge 40
Universe Description: Male Sample Adults 40+
Question Text:
Response:
A PSA test is a blood test to detect prostate cancer. It is also called a
prostate-specific antigen test. Have you EVER had a PSA test?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> [goto PSAWHEN_A]
<2,RF,DK> [goto next section]
Page 207 of 430
Question ID: PRV.0220.00.3
Variable name: PSAWHEN_A
Interview module: PRV(Adult.PRV)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: GEN.SEX_FINAL[PX_A]=1
PSATEST_A=1
and
GEN.AGE_FINAL[PX_A]
ge
40
and
Universe Description: Male Sample Adults 40+ who ever had a PSA test
Question Text:
Response:
About how long has it been since your MOST RECENT PSA test?
1.
2.
3.
4.
5.
6.
DK:
RF:
Within the past year (anytime less than 12 months ago)
Within the past 2 years (1 year but less than 2 years ago)
Within the past 3 years (2 years but less than 3 years ago)
Within the past 5 years (3 years but less than 5 years ago)
Within the past 10 years (5 years but less than 10 years ago)
10 years ago or more
Don't Know
Refused
Skip Instructions: <1-6,RF,DK> [goto PSAREASON_A]
Question ID: PRV.0230.00.3
Variable name: PSAREASON_A
Interview module: PRV(Adult.PRV)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: GEN.SEX_FINAL[PX_A]=1
PSATEST_A=1
and
GEN.AGE_FINAL[PX_A]
ge
40
and
Universe Description: Male Sample Adults 40+ who ever had a PSA test
Question Text:
What was the MAIN reason you had this PSA test - was it part of a routine
exam, because of a problem, or some other reason?
Response:
Page 208 of 430
1.
2.
3.
DK:
RF:
Part of a routine exam
Because of a problem
Other reason
Don't Know
Refused
Skip Instructions: <1-3,RF,DK> if PSAWHEN_A IN (1-5,RF,DK) [goto PSA5YR1_A]
else [goto next section]
Question ID: PRV.0250.00.3
Variable name: PSA5YR1_A
Interview module: PRV(Adult.PRV)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: GEN.SEX_FINAL[PX_A]=1 and
PSAWHEN_A IN (1-5,RF,DK)
GEN.AGE_FINAL[PX_A]
ge
40
and
Universe Description: Male Sample Adults 40+ who ever had a PSA test but not more than 10 years
ago or refused or don't know
Question Text:
Response:
How many PSA tests have you had in the LAST 5 years?
0.
1.
2.
3.
4.
5.
6.
DK:
RF:
0 tests
1 test
2 tests
3 tests
4 tests
5 tests
6 or more tests
Don't Know
Refused
Skip Instructions: <0-6,RF,DK> [goto next section]
Page 209 of 430
Question ID: PRV.0280.00.2
Variable name: CERVICEV1_A
Interview module: PRV(Adult.PRV)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: GEN.SEX_FINAL[PX_A]=2
Universe Description: Female Sample Adults 18+
Question Text:
Response:
There are two different kinds of tests to check for cervical cancer. One is a Pap
smear or Pap test and the other is the HPV or Human Papillomavirus test.
Have you EVER HAD a test or tests to check for cervical cancer? Read if
necessary: These are routine tests for women in which a doctor or other health
professional takes a sample from the cervix with a swab or brush and sends it to the
lab.
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> [goto CERVICWHEN_A]
<2,RF,DK> [goto HYSTEV2_A]
Question ID: PRV.0290.00.2
Variable name: CERVICWHEN_A
Interview module: PRV(Adult.PRV)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: GEN.SEX_FINAL[PX_A]=2 and CERVICEV1_A=1
Universe Description: Female Sample Adults 18+ who have ever had a cervical cancer test
Question Text:
When did you have your MOST RECENT test to check for cervical cancer?
Response:
Page 210 of 430
1.
2.
3.
4.
5.
6.
DK:
RF:
Within the past year (anytime less than 12 months ago)
Within the past 2 years (1 year but less than 2 years ago)
Within the past 3 years (2 years but less than 3 years ago)
Within the past 5 years (3 years but less than 5 years ago)
Within the past 10 years (5 years but less than 10 years ago)
10 years ago or more
Don't Know
Refused
Skip Instructions: <1-6,RF,DK> [goto HYSTEV2_A]
Question ID: PRV.0350.00.2
Variable name: HYSTEV2_A
Interview module: PRV(Adult.PRV)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: GEN.SEX_FINAL[PX_A]=2
Universe Description: Female Sample Adults 18+
Question Text:
Response:
A hysterectomy is when the uterus or womb is removed, this is different from
having your tubes tied. Have you had a hysterectomy?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> if GEN.AGE_FINAL[PX_A] ge 30 [goto MAMEV_A]
elseif GEN.AGE_FINAL[PX_A] lt 30 or GEN.AGE_FINAL IN (RF,DK) [goto
next section]
Page 211 of 430
Question ID: PRV.0360.00.2
Variable name: MAMEV_A
Interview module: PRV(Adult.PRV)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: GEN.AGE_FINAL[PX_A] ge 30 and GEN.SEX_FINAL[PX_A]=2
Universe Description: Female Sample Adults 30+
Question Text:
Response:
Have you EVER HAD a mammogram? Read if necessary: A mammogram is an
x-ray taken only of the breast by a machine that presses against the breast.
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> [goto MAMWHEN_A]
<2> [goto MAMNOT1_A]
[goto next section]
Question ID: PRV.0370.00.2
Variable name: MAMWHEN_A
Interview module: PRV(Adult.PRV)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: GEN.AGE_FINAL[PX_A]
MAMEV_A=1
ge
30
and
GEN.SEX_FINAL[PX_A]=2
and
Universe Description: Female Sample Adults 30+ who have had a mammogram
Question Text:
About how long has it been since your MOST RECENT mammogram?
Response:
Page 212 of 430
1.
2.
3.
4.
5.
6.
DK:
RF:
Within the past year (anytime less than 12 months ago)
Within the past 2 years (1 year but less than 2 years ago)
Within the past 3 years (2 years but less than 3 years ago)
Within the past 5 years (3 years but less than 5 years ago)
Within the past 10 years (5 years but less than 10 years ago)
10 years ago or more
Don't Know
Refused
Skip Instructions: <1-6,RF,DK> [goto MAMREASON_A]
Question ID: PRV.0390.00.3
Variable name: MAMREASON_A
Interview module: PRV(Adult.PRV)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: GEN.SEX_FINAL[PX_A]=2
MAMEV_A=1
and
GEN.AGE_FINAL[PX_A]
ge
30
and
Universe Description: Female Sample Adults 30+ who have ever had a mammogram
Question Text:
Response:
What was the MAIN reason you had this mammogram - was it part of a routine
exam, because of a problem, or some other reason?
1.
2.
3.
DK:
RF:
Part of a routine exam
Because of a problem
Other reason
Don't Know
Refused
Skip Instructions: <1-3,RF,DK> if (MAMEV_A=2 or MAMWHEN_A=3-6) [goto MAMNOT1_A]
else [goto MRIHAD_A]
Page 213 of 430
Question ID: PRV.0410.00.3
Variable name: MAMNOT1_A
Interview module: PRV(Adult.PRV)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: GEN.SEX_FINAL[PX_A]=2 and GEN.AGE_FINAL[PX_A]
(MAMEV_A=2 or MAMWHEN_A=3-6)
ge
30
and
Universe Description: Female Sample Adults 30+ who never had a mammogram or had a
mammogram more than 2 years ago
Question Text:
Response:
Fills:
What is the most important reason why you have ^MAMNEVER2YEARS_A?
Do not read choices, select answer category based on respondent's answer.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
DK:
RF:
No reason/never thought about it
Didn't need it/didn't know I needed this type of test
Doctor didn't order it/didn't say I needed it
Haven't had any problems
Put it off/didn't get around to it
Too expensive/no insurance/cost
Too painful, unpleasant, or embarrassing
Don't have a doctor
I am too old
I am too young
Other
Don't Know
Refused
^MAMNEVER2YEARS_AIf MAMEV_A=2, fill "NEVER had a mammogram"
elseif MAMWHEN_AIN (3-6), fill: "NOT had a
mammogram in the past 2 years"
Skip Instructions: <1-11,RF,DK> [goto MRIHAD_A]
Page 214 of 430
Question ID: PRV.0420.00.3
Variable name: MRIHAD_A
Interview module: PRV(Adult.PRV)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: GEN.AGE_FINAL[PX_A] ge 30 and GEN.SEX_FINAL[PX_A]=2
Universe Description: Female Sample Adults 30+
Question Text:
Response:
A breast MRI, or magnetic resonance image, shows what is inside the breast,
like a mammogram, but does not require squeezing the breast. Before getting a
breast MRI, you are given a dye through a needle in the arm. During the test,
you lie on your stomach and the bed moves into a tunnel-shaped machine.
Have you EVER HAD a breast MRI?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> [goto MRIWHEN_A]
<2,RF,DK> [goto next section]
Question ID: PRV.0430.00.3
Variable name: MRIWHEN_A
Interview module: PRV(Adult.PRV)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: GEN.AGE_FINAL[PX_A]
MRIHAD_A=1
ge
30
and
GEN.SEX_FINAL[PX_A]=2
Universe Description: Female Sample Adults 30+ who have had a breast MRI
Question Text:
About how long has it been since your MOST RECENT breast MRI?
Response:
Page 215 of 430
and
1.
2.
3.
4.
5.
6.
DK:
RF:
Within the past year (anytime less than 12 months ago)
Within the past 2 years (1 year but less than 2 years ago)
Within the past 3 years (2 years but less than 3 years ago)
Within the past 5 years (3 years but less than 5 years ago)
Within the past 10 years (5 years but less than 10 years ago)
10 years ago or more
Don't Know
Refused
Skip Instructions: <1-6,RF,DK> [goto MRIREA_A]
Question ID: PRV.0440.00.3
Variable name: MRIREA_A
Interview module: PRV(Adult.PRV)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: GEN.SEX_FINAL[PX_A]=2
MRIHAD_A=1
and
GEN.AGE_FINAL[PX_A]
ge
30
and
Universe Description: Female Sample Adults 30+ who have ever had a breast MRI
Question Text:
Response:
What was the MAIN reason you had this breast MRI?
correct category below.
1.
2.
3.
4.
5.
DK:
RF:
Enter response into
A follow up of an abnormal mammogram
Because of a breast problem
I am high risk due to family history, genetic test, or another reason
Part of a routine exam
Other
Don't Know
Refused
Skip Instructions: <1-5,RF,DK> [goto next section]
Page 216 of 430
Question ID: GCT.0010.00.3
Variable name: GTPOSS1_A
Interview module: GCT(Adult.GCT)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
The next few questions refer to genetic TESTING for cancer risk. This is testing
to see if you carry genes which may predict a greater chance of developing
cancer at some point in your life. This does NOT include tests to determine if
you have cancer now. For example, a common genetic test is for mutations or
changes in BRCA genes to determine risk for breast and ovarian cancer.
Have you EVER DISCUSSED the possibility of getting a genetic test for cancer
risk with a doctor or other health care professional?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto GTGRISK_A]
Question ID: GCT.0020.00.3
Variable name: GTGRISK_A
Interview module: GCT(Adult.GCT)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Have you EVER HAD a genetic test to determine if you are at greater risk of
developing cancer in the FUTURE? Include any genetic testing for cancer
done by a medical provider or genetic counselor, or from genetic health tests,
such as 23andMe or Color Genomics ordered online or bought in stores.
Response:
Page 217 of 430
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto next section]
Question ID: FHC.0010.00.3
Variable name: FHCANEV_A
Interview module: FHC(Adult.FHC)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
These next questions are about your family history of cancer. When answering
these questions, only think about relatives who you are related to biologically
or by blood and do not include those who you are related to by marriage. Have
any of your biological parents, sisters, brothers or children ever been
diagnosed with cancer, other than skin cancer?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto FHBCANEV_A]
Question ID: FHC.0020.00.3
Variable name: FHBCANEV_A
Interview module: FHC(Adult.FHC)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Have any of your biological parents, sisters, brothers or children ever been
diagnosed with breast cancer?
Response:
Page 218 of 430
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> [goto FHBCANNUM_A]
<2,RF,DK> [goto FHOVCANEV_A]
Question ID: FHC.0030.00.3
Variable name: FHBCANNUM_A
Interview module: FHC(Adult.FHC)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: FHBCANEV_A=1
Universe Description: Sample Adults 18+ whose family members have ever been diagnosed with
breast cancer
Question Text:
Response:
How many of your biological parents, sisters, brothers or children have been
diagnosed with breast cancer?
1.
2.
3.
DK:
RF:
1 relative
2 relatives
3 or more relatives
Don't Know
Refused
Skip Instructions: <1-3> [goto FHBCAN50_A]
[goto FHOVCANEV_A]
Page 219 of 430
Question ID: FHC.0040.00.3
Variable name: FHBCAN50_A
Interview module: FHC(Adult.FHC)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: FHBCANNUM_A=1-3
Universe Description: Sample Adults 18+ who have 1 or more family members diagnosed with
breast cancer
Question Text:
Response:
How many of them were diagnosed with breast cancer before the age of 50?
0.
1.
2.
3.
DK:
RF:
0 relatives
1 relative
2 relatives
3 or more relatives
Don't Know
Refused
Skip Instructions: <0-3,RF,DK> [goto FHOVCANEV_A]
Check Name: ERR_FHBCAN50_A
Text:
{signal ERR_FHBCAN50_A} Number of relatives having been diagnosed with
breast cancer before the age of 50 exceeds the number of relatives diagnosed with
breast cancer. Please verify.
Hard / Soft Edit: Soft
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: (FHBCANNUM_A=1 and FHBCAN50_A=2)) or (FHBCANNUM_A lt3 and
FHBCAN50_A=3))
Universe Description: Number of relatives diagnosed with breast cancer before age 50 exceeds the
number of relatives diagnosed with breast cancer.
Page 220 of 430
Question ID: FHC.0050.00.3
Variable name: FHOVCANEV_A
Interview module: FHC(Adult.FHC)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
Has your biological mother, sisters, or daughters ever been diagnosed with
ovarian cancer?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> [goto FHOVCANNUM_A]
<2,RF,DK> [goto FHCANRISK_A]
Question ID: FHC.0060.00.3
Variable name: FHOVCANNUM_A
Interview module: FHC(Adult.FHC)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: FHOVCANEV_A=1
Universe Description: Sample Adults 18+ whose family members have ever been diagnosed with
ovarian cancer
Question Text:
Response:
Including your biological sisters, daughters, and mother, how many have been
diagnosed with ovarian cancer?
1.
2.
1 relative
2 relatives
Page 221 of 430
3.
DK:
RF:
3 or more relatives
Don't Know
Refused
Skip Instructions: <1-3,RF,DK> [goto FHCANRISK_A]
Question ID: FHC.0070.00.3
Variable name: FHCANRISK_A
Interview module: FHC(Adult.FHC)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
Have you ever talked with your doctor or other health care provider about what
your family history of cancer might mean for your own health and cancer risk?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto next section]
Question ID: IMS.0010.00.3
Variable name: PREGFLUYR_A
Interview module: IMS(Adult.IMS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: GEN.SEX_FINAL[PX_A]=2
and
((GEN.AGE_FINAL[PX_A]=18-49
or
GEN.AGE_FINAL[PX_A] IN (RF,DK)) and (Adult.BMI.PREGNOW_A IN (2,DK)
OR (Adult.BMI.PREGNOW_A=1 and GEN.INTERVIEW_MONTH IN (4,5,6,7)))
Universe Description: Female sample adults 18-49 years or age is refused or don't know and who
are not currently pregnant or don't know if they are currently pregnant or who
are currently pregnant and the interview occurred between April-July
Question Text:
Were you pregnant any time ^AUGUSTYEAR?
Response:
Page 222 of 430
1.
2.
DK:
RF:
Fills:
Yes
No
Don't Know
Refused
^AUGUSTYEAR
If INTERVIEW_MONTH=1-3, fill "since August 1st,
^LASTYEAR"
elseif INTERVIEW_MONTH=4-7, fill "from August
^LASTYEAR through March ^YEAR"
elseif INTERVIEW_MONTH=8-12, fill "since August
1st, ^YEAR"
Skip Instructions: <1,2,DK> [goto LIVEBIRTH_A]
[goto FLUINTRO_A]
Question ID: IMS.0020.00.3
Variable name: LIVEBIRTH_A
Interview module: IMS(Adult.IMS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: GEN.SEX_FINAL=2
and
(GEN.AGE_FINAL[PX_A]=18-49
or
GEN.AGE_FINAL[PX_A] IN (RF,DK)) and Adult.BMI.PREGNOW_A ne RF
and PREGFLUYR_A ne RF
Universe Description: Female sample adults aged 18-49 of age or age is refused or don't know who
did not refuse to answer if they are currently pregnant or if they were pregnant
in between August and March
Question Text:
Response:
During the past 12 months, did you have a pregnancy that ended in a live birth?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Page 223 of 430
Skip Instructions: <1,2,RF,DK> [goto FLUINTRO_A]
Question ID: IMS.0025.00.1
Variable name: FLUINTRO_A
Interview module: IMS(Adult.IMS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
There are currently vaccines available for seasonal influenza and coronavirus
or COVID-19. I will first ask you questions about seasonal flu vaccination and
then about coronavirus or COVID-19 vaccination. Enter '1' to continue.
1.
Enter 1 to Continue
Skip Instructions: <1> [goto SHTFLU12M_A]
Question ID: IMS.0030.00.1
Variable name: SHTFLU12M_A
Interview module: IMS(Adult.IMS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
There are two types of flu vaccinations. One is a shot and the other is a spray,
mist, or drop in the nose. During the past 12 months, have you had a flu
vaccination? Read if necessary: A flu vaccination is usually given in the fall and
protects against influenza for the flu season.
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Page 224 of 430
Skip Instructions: <1> [goto SHTFLUM_A]
<2,RF,DK> [goto SHTCVD191_A]
Question ID: IMS.0040.01.1
Variable name: SHTFLUM_A
Interview module: IMS(Adult.IMS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: SHTFLU12M_A=1
Universe Description: Sample Adults 18+ who had a flu shot in the past 12 months
Question Text:
Response:
1 of 2 During what month and year did you receive your most recent flu
vaccine?
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
DK:
RF:
January
February
March
April
May
June
July
August
September
October
November
December
Don't Know
Refused
Skip Instructions: <1-12,DK> [goto SHTFLUY_A]
if Adult.BMI.PREGNOW_A=1 and GEN.INTERVIEW_MONTH IN
(1,2,3,8,9,10,11,12) [goto FLUPREG_A]
elseif PREGFLUYR_A=1 [goto FLUPREG2_A]
else [goto SHTCVD191_A]
Page 225 of 430
Question ID: IMS.0040.02.1
Variable name: SHTFLUY_A
Interview module: IMS(Adult.IMS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: SHTFLUM_A IN (1-12,DK)
Universe Description: Sample Adults 18+ who gave a month for their last flu shot or who didn't know
the month
Question Text:
Response:
2 of 2
Enter year of most recent flu vaccine.
DK:
RF:
Don't Know
Refused
Skip Instructions:
if SHTFLUM_A and SHTFLUY_A=a future date [goto ERR1_SHTFLUY_A]
elseif SHTFLUM_A and SHTFLUY_A=a date before 12 months ago [goto
ERR2_SHTFLUY_A]
elseif
PREGNOW_A=1
and
GEN.INTERVIEW_MONTH
IN
(1,2,3,8,9,10,11,12) [goto FLUPREG_A]
elseif PREGFLUYR_A=1 [goto FLUPREG2_A]
else [goto SHTCVD191_A]
Check Name: ERR1_SHTFLUY_A
Text:
{check ERR1_SHTFLUY_A}
Future date invalid.
Please correct.
Hard / Soft Edit: Hard
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: SHTFLUM_A + SHTFLUY_A=future date
Universe Description: Future date
Page 226 of 430
Check Name: ERR2_SHTFLUY_A
Text:
{check ERR2_SHTFLUY_A}
Date more than 12 months ago.
Please correct.
Hard / Soft Edit: Hard
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: SHTFLUM_A + SHTFLUY_A=a date before 12 months ago
Question ID: IMS.0050.00.3
Variable name: FLUPREG_A
Interview module: IMS(Adult.IMS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: GEN.SEX_FINAL[PX_A]=2
and
(GEN.AGE_FINAL[PX_A]=18-49
or
GEN.AGE_FINAL[PX_A] IN (RF,DK)) and Adult.BMI.PREGNOW_A=1 and
SHTFLU12M_A=1 and GEN.INTERVIEW_MONTH IN (1,2,3,8,9,10,11,12)
Universe Description: Female Sample Adults 18-49 or refused or don't know their age who are
currently pregnant and received a flu vaccination in the past 12 months and
the interview takes place in Jan-March or Aug-Dec
Question Text:
Response:
Did you get a flu vaccination before or during your current pregnancy?
1.
2.
DK:
RF:
Before pregnancy
During pregnancy
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto SHTCVD191_A]
Page 227 of 430
Question ID: IMS.0060.00.3
Variable name: FLUPREG2_A
Interview module: IMS(Adult.IMS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: GEN.SEX_FINAL[PX_A]=2
and
(GEN.AGE_FINAL[PX_A]=18-49
GEN.AGE_FINAL[PX_A] IN (RF,DK)) and PREGFLUYR_A=1
SHTFLU12M_A=1
or
and
Universe Description: Female Sample Adults 18-49 years of age or refused or don't know their age
who reported a pregnancy during August-March and received a flu vaccination
in the past 12 months
Question Text:
Response:
Fills:
Earlier you said you were pregnant sometime ^AUGUSTYEAR. Did you get a
flu vaccination before, during, or after your pregnancy?
1.
2.
3.
DK:
RF:
Before pregnancy
During pregnancy
After pregnancy
Don't Know
Refused
^AUGUSTYEAR
If INTERVIEW_MONTH=1-3, fill "since August 1st,
^LASTYEAR"
elseif INTERVIEW_MONTH=4-7, fill "from August
^LASTYEAR through March ^YEAR"
elseif INTERVIEW_MONTH=8-12, fill "since August
1st, ^YEAR"
Skip Instructions: <1-3,RF,DK> [goto SHTCVD191_A]
Page 228 of 430
Question ID: IMS.0061.00.3
Variable name: SHTCVD191_A
Interview module: IMS(Adult.IMS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
The next questions are about coronavirus or COVID-19 vaccination. Have you
had at least one dose of a COVID-19 vaccination?
Read if necessary: The
COVID-19 vaccination has been available since 2020.
Read if necessary: There
are four vaccines for COVID-19 approved for use in the United States. The first is
made by Pfizer, is called Comirnaty® (koe-mir'-na-tee), and requires two initial
shots. The second is made by Moderna, is called Spikevax®, and also requires two
initial shots. The third is made by Johnson and Johnson and requires one initial shot.
The fourth is made by Novavax and requires two initial shots.
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> [goto SHTCVD19NM_A]
<2,RF,DK> [goto SHTPNUEV_A]
Question ID: IMS.0062.00.3
Variable name: SHTCVD19NM_A
Interview module: IMS(Adult.IMS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: SHTCVD191_A=1
Universe Description: Sample Adults 18+ who have received a COVID-19 vaccination
Question Text:
How many COVID-19 vaccinations have you received?
Response:
Page 229 of 430
1.
2.
3.
4.
DK:
RF:
1 vaccination
2 vaccinations
3 vaccinations
4 or more vaccinations
Don't Know
Refused
Skip Instructions: <1-4> [goto SHOTTYPE1_A]
[goto SHTPNUEV_A]
Page 230 of 430
Question ID: IMS.0063.01.3
Variable name: CVDVAC1M_A
Interview module: IMS(Adult.IMS.CVDVAC1M_A)
Inherited Universe: (GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(SHTCVD19NM_A=1-4)
Universe: SHTCVD19NM_A=1-4
Universe Description: Sample Adults 18+ who have had one or more COVID-19 vaccinations
Question Text:
Response:
1 of 2 During what month and year did you receive your most recent COVID-19
vaccination? Enter month of most recent COVID-19 vaccination.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
DK:
RF:
January
February
March
April
May
June
July
August
September
October
November
December
Don't Know
Refused
Skip Instructions: <1-12,DK> [goto CVDVAC1Y_A]
if SHTCVD19NM_A IN (2,3,4) [goto CVDVAC2M_A]
elseif SHTCVD19NM_A=1 [goto SHOTTYPE_A]
Page 1 of 1
Question ID: IMS.0064.02.3
Variable name: CVDVAC2Y_A
Interview module: IMS(Adult.IMS.CVDVAC2Y_A)
Inherited Universe: (GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(CVDVAC2M_A=1-12,DK)
Universe: CVDVAC2M_A=1-12,DK
Universe Description: Sample Adults 18+ who gave month of second COVID-19 vaccination or don't
know
Question Text:
Response:
2 of 2
DK:
RF:
Enter year of next most recent COVID-19 vaccination.
Don't Know
Refused
Skip Instructions: [goto SHOTTYPE_A]
if CVDVAC2M_A and CVDVAC2Y_A=date in the future [goto
ERR1_CVDVAC2Y_A]
if CVDVAC2M_A and CVDVAC2Y_A=date prior to birth [goto
ERR2_CVDVAC2Y_A]
if CVDVAC2Y_A lt 2020 [goto ERR3_CVDVAC2Y_A]
if CVDVAC2M_A and CVDVAC2Y_A=date more recent than answer given in
CVDVAC1M_A and CVDVAC1Y_A [goto ERR4_CVDVAC2Y_A]
if CVDVAC2M_A=1-11 and CVDVAC2Y=2020 [goto ERR5_CVDVAC2Y_A]
Page 1 of 1
Question ID: IMS.0065.00.3
Variable name: SHOTTYPE1_A
Interview module: IMS(Adult.IMS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: SHTCVD19NM_A=1-4
Universe Description: Sample Adults 18+ who had at least one COVID-19 vaccination
Question Text:
Response:
Fills:
^FIRST_A brand of COVID-19 vaccine did you receive? Read if necessary:
There are four vaccines for COVID-19 approved for use in the United States. The first
is made by Pfizer, is called Comirnaty® (koe-mir'-na-tee), and requires two initial
shots. The second is made by Moderna, is called Spikevax®, and also requires two
initial shots. The third is made by Johnson and Johnson and requires one initial shot.
The fourth is made by Novavax and requires two initial shots.
1.
2.
3.
4.
5.
6.
DK:
RF:
Pfizer-BioNTech Comirnaty® shot
Moderna Spikevax® shot
Johnson and Johnson (Janssen) shot
Novavax shot
One of the brands that requires two initial shots, but not sure which brand
None of these brands
Don't Know
Refused
^FIRST_A
If SHTCVD19NM_A=2-4, fill: "For your first shot,
which"
else fill "Which"
Skip Instructions: <1-5,RF,DK> [goto SHTPNUEV_A]
Question ID: IMS.0070.00.1
Variable name: SHTPNUEV_A
Interview module: IMS(Adult.IMS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
A pneumonia shot is also known as a pneumococcal vaccine. Have you EVER
had a pneumonia shot? Read if necessary: There are two types of pneumonia
shots: polysaccharide, also known as Pneumovax®, and conjugate, also known as
Prevnar® or Vaxneuvance®.
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> [goto SHTPNEUNB_A]
<2,RF,DK> if GEN.AGE_FINAL[PX_A] ge 50 or ISN.MEDRXTRT_A=1 or
ISN.HLTHCOND_A=1 [goto SHTSHINGL1_A]
elseif (GEN.AGE_FINAL[PX_A] le 49 or GEN.AGE_FINAL[PX_A] IN (DK,RF))
and LIVEBIRTH_A=1 [goto TDAPPREG_A]
elseif GEN.AGE_FINAL[PX_A] ge 32 [goto SHTHEPB1_A]
elseif GEN.AGE_FINAL[PX_A] lt 32 and SCE.HEPEV_A=2,RF,DK [goto
LIVEHEP_A]
else [goto WORKHEALTH_A]
Page 231 of 430
Question ID: IMS.0080.00.1
Variable name: SHTPNEUNB_A
Interview module: IMS(Adult.IMS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: SHTPNUEV_A=1
Universe Description: Sample Adults 18+ who ever had a pneumonia shot
Question Text:
Response:
How many pneumonia shots have you ever had?
1.
2.
3.
DK:
RF:
One pneumonia shot
Two pneumonia shots
More than two pneumonia shots
Don't Know
Refused
Skip Instructions: <1-3,RF,DK> if GEN.AGE_FINAL[PX_A] ge 50 or ISN.MEDRXTRT_A=1 or
ISN.HLTHCOND_A=1 [goto SHTSHINGL1_A]
elseif LIVEBIRTH_A=1 [goto TDAPPREG_A]
elseif GEN.AGE_FINAL[PX_A] ge 32 [goto SHTHEPB1_A]
elseif GEN.AGE_FINAL[PX_A] lt 32 and SCE.HEPEV_A=2,RF,DK [goto
LIVEHEP_A]
else [goto WORKHEALTH_A]
Question ID: IMS.0090.00.3
Variable name: SHTSHINGL1_A
Interview module: IMS(Adult.IMS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: GEN.AGE_FINAL[PX_A]
ISN.HLTHCOND_A=1
ge
50
or
ISN.MEDRXTRT_A=1
or
Universe Description: Sample Adults 50+ or adults 18+ who have a weakened immune system
Question Text:
Have you had a vaccine for shingles? Read if necessary: Shingles is an illness
that results in a rash or blisters on the skin, and is usually painful. There are two
vaccines that have been used to prevent shingles. The first was Zostavax®, which
was available in the U.S. from 2006 through 2020 and required one shot. The other
is Shingrix®, which has been available since 2017 and requires two shots.
Response:
Page 232 of 430
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> [goto SHINGYEAR_A]
<2,RF,DK> if (GEN.AGE_FINAL[PX_A] le 49 or GEN.AGE_FINAL[PX_A] IN
(DK,RF)) and LIVEBIRTH_A=1 [goto TDAPPREG_A]
elseif GEN.AGE_FINAL[PX_A] ge 32 [goto SHTHEPB1_A]
elseif GEN.AGE_FINAL[PX_A] lt 32 and SCE.HEPEV_A=2,RF,DK [goto
LIVEHEP_A]
else [goto WORKHEALTH_A]
Question ID: IMS.0100.00.3
Variable name: SHINGYEAR_A
Interview module: IMS(Adult.IMS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: (GEN.AGE_FINAL[PX_A]
ge
50
or
ISN.HLTHCOND_A=1) and SHTSHINGL1_A=1
ISN.MEDRXTRT_A=1
or
Universe Description: Sample Adults 50+ or adults 18+ who have a weakened immune system who
had a shingles vaccine
Question Text:
Response:
What year did you get your most recent shingles vaccine?
DK:
RF:
Don't Know
Refused
Skip Instructions: <1900-2016> if date prior to birth [goto ERR2_SHINGYEAR_A]
elseif date prior to 2006 [goto ERR3_SHINGYEAR_A]
else if (GEN.AGE_FINAL[PX_A] le 49 or GEN.AGE_FINAL[PX_A] IN (DK,RF))
and LIVEBIRTH_A=1 [goto TDAPPREG_A]
elseif GEN.AGE_FINAL[PX_A] ge 32 [goto SHTHEPB1_A]
elseif GEN.AGE_FINAL[PX_A] lt 32 and SCE.HEPEV_A=2,RF,DK [goto
LIVEHEP_A]
else [goto WORKHEALTH_A]
<2017-2020> [goto SHINGRIX3_A]
<2021-2030> if gt current year [goto ERR1_SHINGYEAR_A]
else [goto SHINGRIXFS1_A]
[goto SHINGWHEN1_A]
Page 233 of 430
Check Name: ERR1_SHINGYEAR_A
Text:
{check ERR1_SHINGYEAR_A}
Future date invalid.
Please correct.
Hard / Soft Edit: Hard
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: SHINGYEAR_A gt current year
Universe Description: Future date
Check Name: ERR2_SHINGYEAR_A
Text:
{check ERR2_SHINGYEAR_A}
Adult's birth. Please correct.
Date of most recent shinglesshot is prior to Sample
Hard / Soft Edit: Hard
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: SHINGYEAR_A=a date before Sample Adult's birth
Universe Description: Date of most recent shingles shot is prior to Sample Adult's birth
Page 234 of 430
Check Name: ERR3_SHINGYEAR_A
Text:
{signal ERR3_SHINGYEAR_A}
Please verify.
Date of most recent shinglesshot is prior to 2006.
Hard / Soft Edit: Soft
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: SHINGYEAR_A lt 2006
Universe Description: Year of shingles shot is before 2006
Question ID: IMS.0110.00.3
Variable name: SHINGWHEN1_A
Interview module: IMS(Adult.IMS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: (GEN.AGE_FINAL[PX_A]
ge
50
or
(ISN.MEDRXTRT_A=1
ISN.HLTHCOND_A=1)) and SHINGYEAR_A IN (RF,DK)
or
Universe Description: Sample Adults 50+ or adults 18+ who have a weakened immune system who
had a shingles vaccination and refused or don't know the year they had it
Question Text:
Response:
Was it before 2017?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> if (GEN.AGE_FINAL[PX_A] le 49 or GEN.AGE_FINAL[PX_A] IN (DK,RF))
and LIVEBIRTH_A=1 [goto TDAPPREG_A]
elseif GEN.AGE_FINAL[PX_A] ge 32 [goto SHTHEPB1_A]
elseif GEN.AGE_FINAL[PX_A] lt 32 and SCE.HEPEV_A=2,RF,DK [goto
LIVEHEP_A]
else [goto WORKHEALTH_A]
<2,RF,DK> [goto SHINGRIX3_A]
Page 235 of 430
Question ID: IMS.0120.00.3
Variable name: SHINGRIX3_A
Interview module: IMS(Adult.IMS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: (GEN.AGE_FINAL[PX_A]
ge
50
or
ISN.MEDRXTRT_A=1
ISN.HLTHCOND_A=1)
and
(SHINGWHEN1_A
IN
(2,RF,DK)
SHINGYEAR_A=2017-2020)
or
or
Universe Description: Sample Adults 50+ or adults 18+ who have a weakened immune system who
had a shingles vaccine from 2017 through 2020
Question Text:
Response:
There are two vaccines that have been used to prevent shingles. The first was
Zostavax®, which was available in the U.S. from 2006 through 2020 and
required one shot. The other is Shingrix®, which has been available since 2017
and requires two shots. Have you ever had any Shingrix® shots?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> [goto SHINGRIXN3_A]
<2,RF,DK> if (GEN.AGE_FINAL[PX_A] le 49 or GEN.AGE_FINAL[PX_A] IN
(DK,RF)) and LIVEBIRTH_A=1 [goto TDAPPREG_A]
elseif GEN.AGE_FINAL[PX_A] ge 32 [goto SHTHEPB1_A]
elseif GEN.AGE_FINAL[PX_A] lt 32 and SCE.HEPEV_A=2,RF,DK [goto
LIVEHEP_A]
else [goto WORKHEALTH_A]
Page 236 of 430
Question ID: IMS.0140.00.3
Variable name: SHINGRIXN3_A
Interview module: IMS(Adult.IMS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: (GEN.AGE_FINAL[PX_A]
ge
50
or
ISN.HLTHCOND_A=1) and SHINGRIX3_A=1
ISN.MEDRXTRT_A=1
or
Universe Description: Sample Adults 50+ or adults 18+ who have a weakened immune system who
had a Shingrix vaccine
Question Text:
Response:
How many Shingrix® shots have you ever had?
1.
2.
DK:
RF:
One shot
Two shots
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> if (GEN.AGE_FINAL[PX_A] le 49 or GEN.AGE_FINAL[PX_A] IN
(DK,RF)) and LIVEBIRTH_A=1 [goto TDAPPREG_A]
elseif GEN.AGE_FINAL[PX_A] ge 32 [goto SHTHEPB1_A]
elseif GEN.AGE_FINAL[PX_A] lt 32 and SCE.HEPEV_A=2,RF,DK [goto
LIVEHEP_A]
else [goto WORKHEALTH_A]
Question ID: IMS.0150.00.3
Variable name: SHINGRIXFS1_A
Interview module: IMS(Adult.IMS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: (GEN.AGE_FINAL[PX_A]
ge
50
or
ISN.MEDRXTRT_A=1
ISN.HLTHCOND_A=1) and SHINGYEAR_A ge 2021
or
Universe Description: Sample Adults 50+ or adults 18+ who have a weakened immune system who
had a most recent shingles vaccine in or after 2021
Question Text:
Shingrix® is the only shingles vaccine that has been available in the U.S.
since 2021 and requires two shots. Was your most recent Shingrix® shot in
^SHINGYEAR_A your first or second Shingrix® shot?
Read if necessary:
There are two vaccines that have been used to prevent shingles. The first was
Zostavax®, which was available in the U.S. from 2006 through 2020 and required
one shot. The other is Shingrix®, which has been available since 2017 and requires
two shots.
Page 237 of 430
Response:
Fills:
1.
2.
DK:
RF:
First shot
Second shot
Don't Know
Refused
^SHINGYEAR_A
Fill value from IMS.SHINGYEAR_A
Skip Instructions: <1,2,RF,DK> if (GEN.AGE_FINAL[PX_A] le 49 or GEN.AGE_FINAL[PX_A] IN
(DK,RF)) and LIVEBIRTH_A=1 [goto TDAPPREG_A]
elseif GEN.AGE_FINAL[PX_A] ge 32 [goto SHTHEPB1_A]
elseif GEN.AGE_FINAL[PX_A] lt 32 and SCE.HEPEV_A=2,RF,DK [goto
LIVEHEP_A]
else [goto WORKHEALTH_A]
Question ID: IMS.0170.00.3
Variable name: TDAPPREG_A
Interview module: IMS(Adult.IMS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: GEN.SEX_FINAL[PX_A]=2
and
(GEN.AGE_FINAL[PX_A]=18-49
GEN.AGE_FINAL[PX_A] IN (RF,DK)) and LIVEBIRTH_A=1
or
Universe Description: Female Sample Adults 18-49 or age is refused or don't know who had a live
birth in the past 12 months
Question Text:
Response:
A Tdap vaccination is a tetanus booster shot that also includes pertussis
(per-TUH-sis) or whooping cough vaccine. Earlier you said that you had a
pregnancy that ended in a live birth during the past 12 months. Did you receive
a Tdap vaccine during this pregnancy?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Page 238 of 430
Skip Instructions: <1,2,RF,DK> if GEN.AGE_FINAL[PX_A] ge 32 [goto SHTHEPB1_A]
elseif GEN.AGE_FINAL[PX_A] lt 32 and SCE.HEPEV_A=2,RF,DK [goto
LIVEHEP_A]
else [goto WORKHEALTH_A]
Question ID: IMS.0180.00.3
Variable name: SHTHEPB1_A
Interview module: IMS(Adult.IMS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: GEN.AGE_FINAL[PX_A] ge 32
Universe Description: Sample Adults 32+
Question Text:
Response:
The hepatitis B vaccine is given in two or three separate doses. Although it
can be given as a combination vaccination with hepatitis A, it is different from
the hepatitis A vaccine. Have you EVER received the hepatitis B vaccine?
Read if necessary: The hepatitis B vaccine has been available since 1982 for
newborn infants, adolescents, and people who may be exposed to the Hepatitis B
virus. Since 2022, it is recommended for all persons under age 60, and for persons
aged 60 years and older who may be exposed to the Hepatitis B virus.
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> if SCE.HEPEV_A=1 [goto WORKHEALTH_A]
else [goto LIVEHEP_A]
Page 239 of 430
Question ID: IMS.0190.00.3
Variable name: LIVEHEP_A
Interview module: IMS(Adult.IMS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: SCE.HEPEV_A IN (2,RF,DK)
Universe Description: Sample Adults 18+ who did not ever have hepatitis or refused or don't know
Question Text:
Response:
Have you ever lived with someone who had hepatitis?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto WORKHEALTH_A]
Question ID: IMS.0220.00.3
Variable name: WORKHEALTH_A
Interview module: IMS(Adult.IMS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
In your work or volunteer activities, do you provide direct medical care to
patients, such as being a doctor, nurse, dentist, therapist, home health care
worker, or emergency responder?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Page 240 of 430
Skip Instructions: <1> [goto TRAVEL_A]
<2,RF,DK> [goto WRKHLTHFC_A]
Question ID: IMS.0230.00.3
Variable name: WRKHLTHFC_A
Interview module: IMS(Adult.IMS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: WORKHEALTH_A IN (2,RF,DK)
Universe Description: Sample Adults 18+ who do not provide medical care to patients or refused or
don't know
Question Text:
Response:
Even if you do not provide direct medical care to patients, do you do any kind
of work or volunteer activities in a health care facility, such as in a hospital,
doctor's office, dentist's office, clinic, nursing home, or residential care home?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto TRAVEL_A]
Question ID: IMS.0240.00.3
Variable name: TRAVEL_A
Interview module: IMS(Adult.IMS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Since 1995, have you traveled to any countries OTHER than Japan, Australia,
New Zealand, Canada, and those in Europe?
Response:
Page 241 of 430
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto next section]
Question ID: PTC.0010.00.2
Variable name: EYEEX12M_A
Interview module: PTC(Adult.PTC)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
During the past 12 months, have you had an eye exam from an eye specialist
such as an optometrist, ophthalmologist, or eye doctor?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto THERA12M_A]
Question ID: PTC.0020.00.2
Variable name: THERA12M_A
Interview module: PTC(Adult.PTC)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
During the past 12 months, did you receive physical therapy, speech therapy,
rehabilitative therapy, or occupational therapy? Read if necessary: Do not
include mental health therapy.
Response:
Page 242 of 430
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto HOMEHC12M_A]
Question ID: PTC.0030.00.2
Variable name: HOMEHC12M_A
Interview module: PTC(Adult.PTC)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
During the past 12 months, did you receive care at home from a nurse or other
health professional?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto next section]
Question ID: ANX.0010.00.1
Variable name: ANXFREQ_A
Interview module: ANX(Adult.ANX)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
How often do you feel worried, nervous or anxious? Would you say daily,
weekly, monthly, a few times a year, or never? If respondent asks whether they
are to answer about their emotional states after taking mood-regulating medications,
say: "Please answer based on your usual use of medication."
Response:
Page 243 of 430
1.
2.
3.
4.
5.
DK:
RF:
Daily
Weekly
Monthly
A few times a year
Never
Don't Know
Refused
Skip Instructions: <1-5,RF,DK> [goto ANXMED_A]
Question ID: ANX.0020.00.1
Variable name: ANXMED_A
Interview module: ANX(Adult.ANX)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
Do you take prescription medication for these feelings?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,RF,DK> [goto ANXLEVEL_A]
<2> if ANXFREQ_A=5 [goto next section]
else [goto ANXLEVEL_A]
Question ID: ANX.0030.00.1
Variable name: ANXLEVEL_A
Interview module: ANX(Adult.ANX)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: ANXFREQ_A IN (1,2,3,4,RF,DK) or ANXMED_A IN (1,RF,DK)
Universe Description: Sample Adults 18+ who feel worried, anxious, or nervous daily, weekly,
monthly, a few times a year or don't know or refused how often OR who do
take medication for these feelings or don't know or refused if they take
medication for these feelings
Question Text:
Thinking about the last time you felt worried, nervous or anxious, how would
you describe the level of these feelings? Would you say a little, a lot, or
somewhere in between?
Page 244 of 430
Response:
1.
2.
3.
DK:
RF:
A little
A lot
Somewhere in between a little and a lot
Don't Know
Refused
Skip Instructions: <1-3,RF,DK> [goto next section]
Question ID: DEP.0010.00.1
Variable name: DEPFREQ_A
Interview module: DEP(Adult.DEP)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
How often do you feel depressed? Would you say daily, weekly, monthly, a few
times a year, or never? If respondent asks whether they are to answer about their
emotional states after taking mood-regulating medications, say: "Please answer
based on your usual use of medication."
1.
2.
3.
4.
5.
DK:
RF:
Daily
Weekly
Monthly
A few times a year
Never
Don't Know
Refused
Skip Instructions: <1-5,RF,DK> [goto DEPMED_A]
Page 245 of 430
Question ID: DEP.0020.00.1
Variable name: DEPMED_A
Interview module: DEP(Adult.DEP)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
Do you take prescription medication for depression?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,RF,DK> [goto DEPLEVEL_A]
<2> if DEPFREQ_A=5 [goto next section]
else [goto DEPLEVEL_A]
Question ID: DEP.0030.00.1
Variable name: DEPLEVEL_A
Interview module: DEP(Adult.DEP)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: DEPFREQ_A IN (1,2,3,4,RF,DK) or DEPMED_A IN (1,RF,DK)
Universe Description: Sample Adults 18+ who feel depressed daily, weekly, monthly, a few times a
year or refused or don't know how often they feel depressed OR who do take
medication or refused or don't know if they take medication for depression.
Question Text:
Response:
Thinking about the last time you felt depressed, how depressed did you feel?
Would you say a little, a lot, or somewhere in between?
1.
A little
Page 246 of 430
2.
3.
DK:
RF:
A lot
Somewhere in between a little and a lot
Don't Know
Refused
Skip Instructions: <1-3,RF,DK> [goto next section]
Question ID: MHC.0010.00.1
Variable name: MHRX_A
Interview module: MHC(Adult.MHC)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: ANX.ANXMED_A IN (2,RF,DK) and DEP.DEPMED_A IN (2,RF,DK)
Universe Description: Sample Adults 18+ who have not taken medication for worry or don't know or
refused if they have and have not taken medication for depression or don't
know or refused if they have
Question Text:
Response:
During the past 12 months, did you take prescription medication to help you
with any other emotions or with your concentration, behavior or mental health?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto MHTHRPY_A]
Question ID: MHC.0020.00.1
Variable name: MHTHRPY_A
Interview module: MHC(Adult.MHC)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
During the past 12 months, did you receive counseling or therapy from a
mental health professional such as a psychiatrist, psychologist, psychiatric
nurse, or clinical social worker?
Response:
Page 247 of 430
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,RF,DK> [goto MHTPYNOW_A]
<2> [goto MHTHDLY_A]
Question ID: MHC.0030.00.1
Variable name: MHTPYNOW_A
Interview module: MHC(Adult.MHC)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: MHTHRPY_A IN (1,RF,DK)
Universe Description: Sample Adults 18+ who have received, or refused to answer or don't know if
they have received counseling or therapy from a mental health professional in
the past 12 months
Question Text:
Response:
Are you currently receiving counseling or therapy from a mental health
professional?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto MHTHDLY_A]
Page 248 of 430
Question ID: MHC.0040.00.1
Variable name: MHTHDLY_A
Interview module: MHC(Adult.MHC)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
During the past 12 months, have you DELAYED getting counseling or therapy
from a mental health professional because of the cost?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto MHTHND_A]
Question ID: MHC.0050.00.1
Variable name: MHTHND_A
Interview module: MHC(Adult.MHC)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
During the past 12 months, was there any time when you needed counseling or
therapy from a mental health professional, but DID NOT GET IT because of the
cost?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto next section]
Page 249 of 430
Question ID: MHA.0010.00.4
Variable name: PHQINTRO_A
Interview module: MHA(2023 Future Content.Adult.MHA
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
Now I'm going to ask you about several problems. Please tell me how often you
have been bothered, over the last 2 weeks, by any of the following problems.
For each problem there are 4 possible answers: not at all, several days, more
than half of the days, or nearly every day. Enter '1' to continue.
1.
Enter 1 to Continue
Skip Instructions: <1> [goto PHQ41_A]
Question ID: MHA.0020.00.4
Variable name: PHQ41_A
Interview module: MHA(2023 Future Content.Adult.MHA
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
Over the last two weeks, how often have you been bothered by ...Little interest
or pleasure in doing things? Would you say not at all, several days, more
than half the days, or nearly every day?
1.
2.
3.
4.
DK:
RF:
Not at all
Several days
More than half the days
Nearly every day
Don't Know
Refused
Page 1 of 3
Skip Instructions: <1-4,RF,DK> [goto PHQ42_A]
Question ID: MHA.0030.00.2
Variable name: PHQ42_A
Interview module: MHA(2023 Future Content.Adult.MHA
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
Over the last two weeks, how often have you been bothered by ...Feeling down,
depressed, or hopeless? Would you say not at all, several days, more than half
the days, or nearly every day?
1.
2.
3.
4.
DK:
RF:
Not at all
Several days
More than half the days
Nearly every day
Don't Know
Refused
Skip Instructions: <1-4,RF,DK> [goto PHQ43_A]
Question ID: MHA.0040.00.4
Variable name: PHQ43_A
Interview module: MHA(2023 Future Content.Adult.MHA
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Read if necessary: Over the last two weeks, how often have you been bothered by
...Feeling nervous, anxious, or on edge? Read if necessary: Would you say, not
at all, several days, more than half the days, or nearly every day?
Response:
Page 2 of 3
1.
2.
3.
4.
DK:
RF:
Not at all
Several days
More than half the days
Nearly every day
Don't Know
Refused
Skip Instructions: <1-4,RF,DK> [goto PHQ44_A]
Question ID: MHA.0050.00.4
Variable name: PHQ44_A
Interview module: MHA(2023 Future Content.Adult.MHA
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
Read if necessary: Over the last two weeks, how often have you been bothered by
...Not being able to stop or control worrying? Read if necessary: Would you
say, not at all, several days, more than half the days, or nearly every day?
1.
2.
3.
4.
DK:
RF:
Not at all
Several days
More than half the days
Nearly every day
Don't Know
Refused
Skip Instructions: <1-4,RF,DK> [goto next section]
Page 3 of 3
Question ID:
Variable name: DISCRIM1_A
Interview module: EDS(Adult.EDS)
Inherited Universe: (EDS_FLG=1) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(EDS_FLG=1))
Universe Description: Sample Adults 18+
Question Text:
Response:
In your day-to-day life how often have any of the following things happened to
you? You are treated with less courtesy or respect than other people. Would
you say at least once a week, a few times a month, a few times a year, less than
once a year, or never?
1.
2.
3.
4.
5.
DK:
RF:
At least once a week
A few times a month
A few times a year
Less than once a year
Never
Don't Know
Refused
Skip Instructions: <1-5,RF,DK> [goto next section]
Page 250 of 430
Question ID: EDS.0020.00.4
Variable name: DISCRIM2_A
Interview module: EDS(Adult.EDS)
Inherited Universe: (EDS_FLG=1) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(EDS_FLG=1))
Universe Description: Sample Adults 18+
Question Text:
Response:
Read if necessary: In your day-to-day life how often have any of the following things
happened to you? You receive poorer service than other people at restaurants
or stores. Would you say at least once a week, a few times a month, a few times
a year, less than once a year, or never?
1.
2.
3.
4.
5.
DK:
RF:
At least once a week
A few times a month
A few times a year
Less than once a year
Never
Don't Know
Refused
Skip Instructions: <1-5,RF,DK> [goto DISCRIM3_A]
Page 251 of 430
Question ID: EDS.0030.00.4
Variable name: DISCRIM3_A
Interview module: EDS(Adult.EDS)
Inherited Universe: (EDS_FLG=1) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(EDS_FLG=1))
Universe Description: Sample Adults 18+
Question Text:
Response:
Read if necessary: In your day-to-day life how often have any of the following things
happened to you? People act as if they think you are not smart. Read if
necessary: Would you say at least once a week, a few times a month, a few times a
year, less than once a year, or never?
1.
2.
3.
4.
5.
DK:
RF:
At least once a week
A few times a month
A few times a year
Less than once a year
Never
Don't Know
Refused
Skip Instructions: <1-5,RF,DK> [goto DISCRIM4_A]
Question ID: EDS.0040.00.4
Variable name: DISCRIM4_A
Interview module: EDS(Adult.EDS)
Inherited Universe: (EDS_FLG=1) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(EDS_FLG=1))
Universe Description: Sample Adults 18+
Question Text:
Read if necessary: In your day-to-day life how often have any of the following things
happened to you? People act as if they are afraid of you. Read if necessary:
Would you say at least once a week, a few times a month, a few times a year, less
than once a year, or never?
Response:
Page 252 of 430
1.
2.
3.
4.
5.
DK:
RF:
At least once a week
A few times a month
A few times a year
Less than once a year
Never
Don't Know
Refused
Skip Instructions: <1-5,RF,DK> [goto DISCRIM5_A]
Question ID: EDS.0050.00.4
Variable name: DISCRIM5_A
Interview module: EDS(Adult.EDS)
Inherited Universe: (EDS_FLG=1) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(EDS_FLG=1))
Universe Description: Sample Adults 18+
Question Text:
Response:
Read if necessary: In your day-to-day life how often have any of the following things
happened to you? You are threatened or harassed. Read if necessary: Would
you say at least once a week, a few times a month, a few times a year, less than
once a year, or never?
1.
2.
3.
4.
5.
DK:
RF:
At least once a week
A few times a month
A few times a year
Less than once a year
Never
Don't Know
Refused
Skip Instructions: <1-5,RF,DK> [goto next section]
Page 253 of 430
Question ID: HVS.0010.00.4
Variable name: VIGIL1_A
Interview module: HVS(Adult.HVS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
In your day-to day life, how often do you try to prepare for possible insults from
other people before leaving home? Would you say almost every day, at least
once a week, a few times a month, a few times a year, less than once a year, or
never?
1.
2.
3.
4.
5.
6.
DK:
RF:
Almost everyday
At least once a week
A few times a month
A few times a year
Less than once a year
Never
Don't Know
Refused
Skip Instructions: <1-6,RF,DK> [goto VIGIL2_A]
Question ID: HVS.0020.00.4
Variable name: VIGIL2_A
Interview module: HVS(Adult.HVS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Read if necessary: In your day-to-day life, how often do you... Feel that you always
have to be very careful about your appearance to get good service or avoid
being harassed? Read if necessary: Would you say almost every day, at least
once a week, a few times a month, a few times a year, less than once a year, or
never?
Response:
Page 254 of 430
1.
2.
3.
4.
5.
6.
DK:
RF:
Almost everyday
At least once a week
A few times a month
A few times a year
Less than once a year
Never
Don't Know
Refused
Skip Instructions: <1-6,RF,DK> [goto VIGIL3_A]
Question ID: HVS.0030.00.4
Variable name: VIGIL3_A
Interview module: HVS(Adult.HVS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
Read if necessary: In your day-to-day life, how often do you... Carefully watch
what you say and how you say it? Read if necessary: Would you say almost
every day, at least once a week, a few times a month, a few times a year, less than
once a year, or never?
1.
2.
3.
4.
5.
6.
DK:
RF:
Almost everyday
At least once a week
A few times a month
A few times a year
Less than once a year
Never
Don't Know
Refused
Skip Instructions: <1-6,RF,DK> [goto VIGIL4_A]
Page 255 of 430
Question ID: HVS.0040.00.4
Variable name: VIGIL4_A
Interview module: HVS(Adult.HVS)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
Read if necessary: In your day-to-day life, how often do you... Try to avoid certain
social situations and places? Read if necessary: Would you say almost every
day, at least once a week, a few times a month, a few times a year, less than once a
year, or never? Read if necessary: These could be situations like social gatherings
but they could also be places like stores, banks, or hospitals or even governmental
offices like the Department of Motor Vehicles.
1.
2.
3.
4.
5.
6.
DK:
RF:
Almost everyday
At least once a week
A few times a month
A few times a year
Less than once a year
Never
Don't Know
Refused
Skip Instructions: <1-6,RF,DK> [goto next section]
Question ID: PAI.0010.00.2
Variable name: PAIINTRO_A
Interview module: PAI(Adult.PAI)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
The next question is about pain you may have had in the past three months.
Enter '1' to continue.
Response:
Page 256 of 430
1.
Enter 1 to Continue
Skip Instructions: <1> [goto PAIFRQ3M_A]
Question ID: PAI.0020.00.2
Variable name: PAIFRQ3M_A
Interview module: PAI(Adult.PAI)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
In the past three months, how often did you have pain? Would you say never,
some days, most days, or every day? If respondent asks whether they are to
answer about their pain when taking their medications, say: "Please answer based on
your usual use of medication."
1.
2.
3.
4.
DK:
RF:
Never
Some days
Most days
Every day
Don't Know
Refused
Skip Instructions: <1,RF,DK> [goto next section]
<2,3,4> [goto PAIAMNT_A]
Question ID: PAI.0030.00.2
Variable name: PAIAMNT_A
Interview module: PAI(Adult.PAI)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: PAIFRQ3M_A IN (2,3,4)
Universe Description: Sample Adults 18+ who had pain some days, most days, or every day in the
past 3 months
Question Text:
Thinking about the last time you had pain, how much pain did you have? Would
you say a little, a lot, or somewhere in between?
Response:
Page 257 of 430
1.
2.
3.
DK:
RF:
A little
A lot
Somewhere in between a little and a lot
Don't Know
Refused
Skip Instructions: <1-3,RF,DK> [goto PAIWKLM3M_A]
Question ID: PAI.0040.00.2
Variable name: PAIWKLM3M_A
Interview module: PAI(Adult.PAI)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: PAIFRQ3M_A IN (2,3,4)
Universe Description: Sample Adults 18+ who had pain some days, most days, or every day in the
past 3 months
Question Text:
Response:
Over the past three months, how often did your pain limit your life or work
activities? Would you say never, some days, most days, or every day?
1.
2.
3.
4.
DK:
RF:
Never
Some days
Most days
Every day
Don't Know
Refused
Skip Instructions: <1-4,RF,DK> [goto PAIAFFM3M_A]
Page 258 of 430
Question ID: PAI.0050.00.2
Variable name: PAIAFFM3M_A
Interview module: PAI(Adult.PAI)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: PAIFRQ3M_A IN (2,3,4)
Universe Description: Sample Adults 18+ who had pain some days, most days, or every day in the
past 3 months
Question Text:
Response:
Over the past three months, how often did YOUR pain affect your family and
significant others? Would you say never, some days, most days, or every day?
1.
2.
3.
4.
DK:
RF:
Never
Some days
Most days
Every day
Don't Know
Refused
Skip Instructions: <1-4,RF,DK> [goto PAIBACK3M_A]
Question ID: PAI.0060.00.2
Variable name: PAIBACK3M_A
Interview module: PAI(Adult.PAI)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: PAIFRQ3M_A IN (2,3,4)
Universe Description: Sample Adults 18+ who had pain some days, most days, or every day in the
past 3 months
Question Text:
The next set of questions are about the amount of pain you experience in
different locations. Over the past three months, how much have you been
bothered by ...Back pain? Would you say not at all, a little, a lot, or somewhere
in between?
Response:
Page 259 of 430
1.
2.
3.
4.
DK:
RF:
Not at all
A little
A lot
Somewhere in between a little and a lot
Don't Know
Refused
Skip Instructions: <1-4,RF,DK> [goto PAIULMB3M_A]
Question ID: PAI.0070.00.2
Variable name: PAIULMB3M_A
Interview module: PAI(Adult.PAI)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: PAIFRQ3M_A IN (2,3,4)
Universe Description: Sample Adults 18+ who had pain some days, most days, or every day in the
past 3 months
Question Text:
Response:
Read if necessary: Over the past three months, how much have you been bothered
by ...Pain in your hands, arms, or shoulders? Read if necessary: Would you
say not at all, a little, a lot, or somewhere in between?
1.
2.
3.
4.
DK:
RF:
Not at all
A little
A lot
Somewhere in between a little and a lot
Don't Know
Refused
Skip Instructions: <1-4,RF,DK> [goto PAILLMB3M_A]
Page 260 of 430
Question ID: PAI.0080.00.2
Variable name: PAILLMB3M_A
Interview module: PAI(Adult.PAI)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: PAIFRQ3M_A IN (2,3,4)
Universe Description: Sample Adults 18+ who had pain some days, most days, or every day in the
past 3 months
Question Text:
Response:
Read if necessary: Over the past three months, how much have you been bothered
by ...Pain in your hips, knees, or feet? Read if necessary: Would you say not at
all, a little, a lot, or somewhere in between?
1.
2.
3.
4.
DK:
RF:
Not at all
A little
A lot
Somewhere in between a little and a lot
Don't Know
Refused
Skip Instructions: <1-4,RF,DK> [goto PAIHDFC3M_A]
Question ID: PAI.0090.00.2
Variable name: PAIHDFC3M_A
Interview module: PAI(Adult.PAI)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: PAIFRQ3M_A IN (2,3,4)
Universe Description: Sample Adults 18+ who had pain some days, most days, or every day in the
past 3 months
Question Text:
Read if necessary: Over the past three months, how much have you been bothered
by ...Headache or migraine? Read if necessary: Would you say not at all, a little,
a lot, or somewhere in between?
Response:
Page 261 of 430
1.
2.
3.
4.
DK:
RF:
Not at all
A little
A lot
Somewhere in between a little and a lot
Don't Know
Refused
Skip Instructions: <1-4,RF,DK> [goto PAIAPG3M_A]
Question ID: PAI.0100.00.2
Variable name: PAIAPG3M_A
Interview module: PAI(Adult.PAI)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: PAIFRQ3M_A IN (2,3,4)
Universe Description: Sample Adults 18+ who had pain some days, most days, or every day in the
past 3 months
Question Text:
Response:
Read if necessary: Over the past three months, how much have you been bothered
by ...Abdominal, pelvic, or genital pain? Read if necessary: Would you say not
at all, a little, a lot, or somewhere in between?
1.
2.
3.
4.
DK:
RF:
Not at all
A little
A lot
Somewhere in between a little and a lot
Don't Know
Refused
Skip Instructions: <1-4,RF,DK> [goto PAITOOTH_A]
Page 262 of 430
Question ID: PAI.0110.00.2
Variable name: PAITOOTH3M_A
Interview module: PAI(Adult.PAI)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: PAIFRQ3M_A IN (2,3,4)
Universe Description: Sample Adults 18+ who had pain some days, most days, or every day in the
past 3 months
Question Text:
Response:
Read if necessary: Over the past three months, how much have you been bothered
by ...Toothache or jaw pain? Read if necessary: Would you say not at all, a little,
a lot, or somewhere in between?
1.
2.
3.
4.
DK:
RF:
Not at all
A little
A lot
Somewhere in between a little and a lot
Don't Know
Refused
Skip Instructions: <1-4,RF,DK> [goto next section]
Question ID: REP.0010.00.2
Variable name: REPSTRAIN_A
Interview module: REP(Adult.REP)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
The next set of questions asks about injuries. The first question is about
repetitive strain injuries. By this, we mean injuries caused by repeating the
same movement over an extended period. Examples include carpal tunnel
syndrome, tennis elbow, or tendonitis. During the past 3 months, did you have
any injuries due to repetitive strain?
Response:
Page 263 of 430
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> [goto REPLIMIT_A]
<2,RF,DK> [goto next section]
Question ID: REP.0020.00.2
Variable name: REPLIMIT_A
Interview module: REP(Adult.REP)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: REPSTRAIN_A=1
Universe Description: Sample Adults 18+ with a repetitive strain injury in the past 3 months
Question Text:
Response:
Were any repetitive strain injuries serious enough to limit your usual activities
for at least 24 hours?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> [goto REPSAWDOC_A]
<2,RF,DK> [goto next section]
Question ID: REP.0030.00.2
Variable name: REPSAWDOC_A
Interview module: REP(Adult.REP)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: REPLIMIT_A=1
Universe Description: Sample Adults 18+ who were limited in usual activities for at least 24 hours
because of repetitive strain injury
Question Text:
For the next questions, please think only about the repetitive strain injuries that
limited your usual activities for at least 24 hours after the injury occurred.
During the past 3 months, did you talk to or see a doctor or other health
professional about your repetitive strain injuries?
Page 264 of 430
Response:
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto REPWRKDAYS_A]
Question ID: REP.0040.00.2
Variable name: REPWRKDAYS_A
Interview module: REP(Adult.REP)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: REPLIMIT_A=1
Universe Description: Sample Adults 18+ who were limited in usual activities for at least 24 hours
because of repetitive strain injury
Question Text:
Response:
During the past 3 months, how many days of work did you miss because of
your repetitive strain injuries? If respondent says none, no, or 0 days, ask: Did
you work at all the past 3 months? Enter '90' if respondent says they missed every
day of work in the past 3 months. Enter '91' if respondent says they did not work in
the past 3 months.
DK:
RF:
Don't Know
Refused
Skip Instructions: <1-90,DK> [goto REPFUTWORK_A]
<0,RF> [goto REPSTOPCHG_A]
<91> [goto REPWRKCAUS_A]
Page 265 of 430
Question ID: REP.0050.00.2
Variable name: REPFUTWRK_A
Interview module: REP(Adult.REP)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: REPWRKDAYS_A IN (1-90,DK)
Universe Description: Sample Adults 18+ who missed at least one day of work due to repetitive
strain injury in past 3 months or don't know
Question Text:
Response:
Do you expect to miss any more days of work because of your repetitive strain
injuries?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto REPSTOPCHG_A]
Question ID: REP.0060.00.2
Variable name: REPSTOPCHG_A
Interview module: REP(Adult.REP)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: REPWRKDAYS_A IN (0-90,RF,DK)
Universe Description: Sample Adults 18+ who missed 0 or more days of work due to repetitive strain
injury in past 3 months or refused or don't know
Question Text:
During the past 3 months, did you stop working or change jobs because of
your repetitive strain injuries? Enter 'no' if respondent says they did not work in
the past 3 months.
Response:
Page 266 of 430
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto REPREDUCE_A]
Question ID: REP.0070.00.2
Variable name: REPREDUCE_A
Interview module: REP(Adult.REP)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: REPWRKDAYS_A IN (0-90,RF,DK)
Universe Description: Sample Adults 18+ who missed 0 or more days of work due to repetitive strain
injury in past 3 months or refused or don't know
Question Text:
Response:
During the past 3 months, did you make a major change in your work activities,
such as taking on fewer hours or lighter duties, because of your repetitive
strain injuries? Enter 'no' if respondent says they did not work in the past 3
months.
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto REPWRKCAUS_A]
Page 267 of 430
Question ID: REP.0080.00.2
Variable name: REPWRKCAUS_A
Interview module: REP(Adult.REP)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: REPLIMIT_A=1
Universe Description: Sample Adults 18+ who were limited in usual activities for at least 24 hours
because of repetitive strain injury
Question Text:
Response:
Have you ever been told by a doctor or other health professional that any of
your repetitive strain injuries were likely to be work-related?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto next section]
Question ID: INJ.0010.00.2
Variable name: INJINTRO_A
Interview module: INJ(Adult.INJ)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
The next set of questions asks about SUDDEN injuries. People can be injured
accidentally or on purpose. They may hurt themselves or others may cause
them to be hurt. Enter '1' to continue.
1.
Enter 1 to Continue
Page 268 of 430
Skip Instructions: <1> [goto ANYINJURY_A]
Question ID: INJ.0020.00.2
Variable name: ANYINJURY_A
Interview module: INJ(Adult.INJ)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
Fills:
^NOTREPS the past 3 months, did you have an accident or an injury where any
part of your body was hurt?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
^NOTREPS
If REP.REPSTRAIN_A=1, fill: "NOT INCLUDING
ANY OF THE REPETITIVE STRAIN INJURIES YOU
JUST MENTIONED, during"
If REP.REPSTRAIN_A=2,RF,DK, "During"
Skip Instructions: <1> [goto INJLIMIT_A]
<2,RF,DK> [goto next section]
Question ID: INJ.0030.00.2
Variable name: INJLIMIT_A
Interview module: INJ(Adult.INJ)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: ANYINJURY_A=1
Universe Description: Sample Adults 18+ who reported sudden injury in past 3 months
Question Text:
Did any of these injuries limit your usual activities for at least 24 hours after the
injury occurred?
Response:
Page 269 of 430
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> [goto NUMINJ_A]
<2,RF,DK> [goto next section]
Question ID: INJ.0040.00.2
Variable name: NUMINJ_A
Interview module: INJ(Adult.INJ)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: INJLIMIT_A=1
Universe Description: Sample Adults 18+ who reported sudden injury in past 3 months which limited
activities for at least 24 hours
Question Text:
Response:
Fills:
For the next questions, please think only about the significant injuries that
occurred during the past 3 months. By significant, I mean those injuries that
limited your usual activities for at least 24 hours after the injury occurred.
^NOTREPS the past 3 months, how many times did these accidents or injury
events occur? Enter '96' if number is 96 or greater.
DK:
RF:
Don't Know
Refused
^NOTREPS
If REP.REPSTRAIN_A=1, fill: "NOT INCLUDING
ANY OF THE REPETITIVE STRAIN INJURIES YOU
JUST MENTIONED, during"
If REP.REPSTRAIN_A=2,RF,DK, "During"
Skip Instructions: <1-9,RF,DK> [goto INJHOME_A]
<10-96> [goto ERR1_NUMINJ_A], then [goto INJHOME_A]
Page 270 of 430
Check Name: ERR1_NUMINJ_A
Text:
{signal ERR1_NUMINJ_A}
verify.
^NUMINJ_A is an unusually large number. Please
Hard / Soft Edit: Soft
Fills:
^NUMINJ_A
number of injuries
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: NUMINJ_A=10-96
Universe Description: Respondent reported 10-96 injuries
Question ID: INJ.0050.00.2
Variable name: INJHOME_A
Interview module: INJ(Adult.INJ)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: INJLIMIT_A=1
Universe Description: Sample Adults 18+ who reported sudden injury in past 3 months which limited
activities for at least 24 hours
Question Text:
Response:
During the past 3 months, did ^siginj_A occur while you were at your home?
Read if necessary: Include the yards, garage, basement, and other places on the
home property.
1.
Yes
Page 271 of 430
2.
DK:
RF:
Fills:
No
Don't Know
Refused
^siginj_A
If INJ.NUMINJ_A=1, fill: "your significant injury"
If INJ.NUMINJ_A IN (2-96,RF,DK), fill: "any of your
significantinjuries"
Skip Instructions: <1> if NUMINJ_A=1 [goto INJSPORTS_A]
elseif NUMINJ_A=2-96,RF,DK [goto INJWORK_A]
<2,RF,DK> [goto INJWORK_A]
Question ID: INJ.0060.00.2
Variable name: INJWORK_A
Interview module: INJ(Adult.INJ)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: (NUMINJ_A IN (2-96,RF,DK) or (NUMINJ_A=1 and INJHOME_A IN
(2,RF,DK)))
Universe Description: Sample Adults 18+ who reported more than 1 injury in the past 3 months or
don't know or who reported 1 injury in the past 3 months but did not report an
injury at home
Question Text:
Response:
Fills:
During the past 3 months, did ^siginj_A occur while you were working at a job
or business? Enter 'no' if respondent says they did not work in the past 3 months.
1.
2.
DK:
RF:
^siginj_A
Yes
No
Don't Know
Refused
If INJ.NUMINJ_A=1, fill: "your significant injury"
If INJ.NUMINJ_A IN (2-96,RF,DK), fill: "any of your
significantinjuries"
Page 272 of 430
Skip Instructions: <1,2,RF,DK> [goto INJSPORTS_A]
Question ID: INJ.0070.00.2
Variable name: INJSPORTS_A
Interview module: INJ(Adult.INJ)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: INJLIMIT_A=1
Universe Description: Sample Adults 18+ who reported sudden injury in past 3 months which limited
activities for at least 24 hours
Question Text:
Response:
Fills:
During the past 3 months, did ^siginj_A occur while you were playing sports or
exercising, including walking, biking, or running, playing baseball, basketball,
football or doing any other physical activity? Read if necessary: Include
recreational sports such as skating, skiing, tennis, golf, bowling, or fishing.
1.
2.
DK:
RF:
^siginj_A
Yes
No
Don't Know
Refused
If INJ.NUMINJ_A=1, fill: "your significant injury"
If INJ.NUMINJ_A IN (2-96,RF,DK), fill: "any of your
significantinjuries"
Skip Instructions: <1,2,RF,DK> [goto INJFALL_A]
Page 273 of 430
Question ID: INJ.0080.00.2
Variable name: INJFALL_A
Interview module: INJ(Adult.INJ)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: INJLIMIT_A=1
Universe Description: Sample Adults 18+ who reported sudden injury in past 3 months which limited
activities for at least 24 hours
Question Text:
Response:
Fills:
During the past 3 months, did ^siginj_A occur as a result of a fall or falling?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
^siginj_A
If INJ.NUMINJ_A=1, fill: "your significant injury"
If INJ.NUMINJ_A IN (2-96,RF,DK), fill: "any of your
significantinjuries"
Skip Instructions: <1> if NUMINJ_A=1 [goto INJMOTOR_A]
elseif NUMINJ_A IN (2-96,RF,DK) and INJHOME_A=1 [goto INJFALLHOM_A]
elseif NUMINJ_A IN (2-96,RF,DK) and INJWORK_A=1 [goto INJFALLWRK_A]
else [goto INJMOTOR_A]
<2,RF,DK> [goto INJMOTOR_A]
Question ID: INJ.0090.00.2
Variable name: INJFALLHOM_A
Interview module: INJ(Adult.INJ)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: NUMINJ_A IN (2-96,RF,DK) and INJFALL_A=1 and INJHOME_A=1
Universe Description: Sample Adults 18+ who had more than 1 significant injury or don't know or
refused, and were injured as a result of a fall or falling, and who were injured
at home
Question Text:
Did any fall occur while you were at your home?
Response:
Page 274 of 430
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> if INJWORK_A=1 [goto INJFALLWRK_A]
else [goto INJMOTOR_A]
Question ID: INJ.0100.00.2
Variable name: INJFALLWRK_A
Interview module: INJ(Adult.INJ)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: NUMINJ_A IN (2-96,RF,DK) and INJFALL_A=1 and INJWORK_A=1
Universe Description: Sample Adults 18+ who had more than 1 injury or don't know or refused, and
were injured as a result of a fall or falling, and who were injured at work
Question Text:
Response:
Did any fall occur while you were working at a job or business?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto INJMOTOR_A]
Question ID: INJ.0110.00.2
Variable name: INJMOTOR_A
Interview module: INJ(Adult.INJ)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: INJLIMIT_A=1
Universe Description: Sample Adults 18+ who reported sudden injury in past 3 months which limited
activities for at least 24 hours
Question Text:
During the past 3 months, did ^siginj_A occur as a result of being in a motor
vehicle crash or being hit by a motor vehicle while walking or biking? Read if
necessary: Motor vehicles include cars, trucks, vans, buses, motorcycles, motorized
scooters, motorized wheelchairs, motorized carts, tractors, ATVs, snowmobiles, dune
buggies, and other motorized vehicles.
Page 275 of 430
Response:
Fills:
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
^siginj_A
If INJ.NUMINJ_A=1, fill: "your significant injury"
If INJ.NUMINJ_A IN (2-96,RF,DK), fill: "any of your
significantinjuries"
Skip Instructions: <1> [goto INJMVTYPE_A]
<2,RF,DK> [goto INJCHORES_A]
Question ID: INJ.0120.00.2
Variable name: INJMVTYPE_A
Interview module: INJ(Adult.INJ)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: INJMOTOR_A=1
Universe Description: Sample Adults 18+ who reported a significant injury from a motor vehicle
accident
Question Text:
Response:
Were you a driver, passenger, bicyclist, pedestrian, or doing something else
when this occurred?
Enter all that apply, separate with commas.
1.
2.
3.
4.
5.
DK:
RF:
Driver
Passenger
Bicyclist
Pedestrian
Something else
Don't Know
Refused
Skip Instructions: <1-5,RF,DK> [goto INJCHORES_A]
Page 276 of 430
Question ID: INJ.0130.00.2
Variable name: INJCHORES_A
Interview module: INJ(Adult.INJ)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: INJLIMIT_A=1
Universe Description: Sample Adults 18+ who reported sudden injury in past 3 months which limited
activities for at least 24 hours
Question Text:
Response:
Fills:
During the past 3 months, did ^siginj_A occur while you were doing household
activities, such as housework, cooking, home maintenance, or yardwork?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
^siginj_A
If INJ.NUMINJ_A=1, fill: "your significant injury"
If INJ.NUMINJ_A IN (2-96,RF,DK), fill: "any of your
significantinjuries"
Skip Instructions: <1,2,RF,DK> [goto INJSAWDOC_A]
Question ID: INJ.0140.00.2
Variable name: INJSAWDOC_A
Interview module: INJ(Adult.INJ)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: INJLIMIT_A=1
Universe Description: Sample Adults 18+ who reported sudden injury in past 3 months which limited
activities for at least 24 hours
Question Text:
During the past 3 months, did you see or talk to a doctor or other health
professional about ^siginj_A?
Response:
Page 277 of 430
1.
2.
DK:
RF:
Fills:
Yes
No
Don't Know
Refused
^siginj_A
If INJ.NUMINJ_A=1, fill: "your significant injury"
If INJ.NUMINJ_A IN (2-96,RF,DK), fill: "any of your
significantinjuries"
Skip Instructions: <1> if UTZ.EMERGE12M_A IN (1-96,RF,DK) [goto INJER_A]
elseif UTZ.HOSPONGT_A IN (1,RF,DK) [goto INJHOSP_A]
else [goto INJBONES_A]
<2,RF,DK> [goto INJWRKDAYS_A]
Question ID: INJ.0150.00.2
Variable name: INJER_A
Interview module: INJ(Adult.INJ)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: INJSAWDOC_A=1 and UTZ.EMERGE12M_A IN (1-96,RF,DK)
Universe Description: Sample Adults 18+ who saw doctor about their injuries and went to the ER at
least once in the past 12 months or don't know or refused
Question Text:
Response:
Fills:
During the past 3 months, did you go to an emergency room because of
^siginj_A?
1.
2.
DK:
RF:
^siginj_A
Yes
No
Don't Know
Refused
If INJ.NUMINJ_A=1, fill: "your significant injury"
If INJ.NUMINJ_A IN (2-96,RF,DK), fill: "any of your
significantinjuries"
Page 278 of 430
Skip Instructions: <1,2,RF,DK> if UTZ.HOSPONGT_A IN (1,RF,DK) [goto INJHOSP_A]
else [goto INJBONES_A]
Question ID: INJ.0160.00.2
Variable name: INJHOSP_A
Interview module: INJ(Adult.INJ)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: INJSAWDOC_A=1 and UTZ.HOSPONGT_A IN (1,RF,DK)
Universe Description: Sample Adults 18+ who saw doctor about their injuries and reported being
hospitalized at least once in the past 12 months or don't know or refused
Question Text:
Response:
Fills:
During the past 3 months, were you hospitalized overnight because of
^siginj_A?
1.
2.
DK:
RF:
^siginj_A
Yes
No
Don't Know
Refused
If INJ.NUMINJ_A=1, fill: "your significant injury"
If INJ.NUMINJ_A IN (2-96,RF,DK), fill: "any of your
significantinjuries"
Skip Instructions: <1,2,RF,DK> [goto INJBONES_A]
Page 279 of 430
Question ID: INJ.0170.00.2
Variable name: INJBONES_A
Interview module: INJ(Adult.INJ)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: INJSAWDOC_A=1
Universe Description: Sample Adults 18+ who saw a doctor about an injury
Question Text:
Response:
Fills:
During the past 3 months, did you have any broken bones as a result of
^siginj_A?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
^siginj_A
If INJ.NUMINJ_A=1, fill: "your significant injury"
If INJ.NUMINJ_A IN (2-96,RF,DK), fill: "any of your
significantinjuries"
Skip Instructions: <1,2,RF,DK> [goto INJSTITCH_A]
Question ID: INJ.0180.00.2
Variable name: INJSTITCH_A
Interview module: INJ(Adult.INJ)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: INJSAWDOC_A=1
Universe Description: Sample Adults 18+ who saw a doctor about an injury
Question Text:
During the past 3 months, did you get any stitches or staples because of
^siginj_A?
Response:
Page 280 of 430
1.
2.
DK:
RF:
Fills:
Yes
No
Don't Know
Refused
^siginj_A
If INJ.NUMINJ_A=1, fill: "your significant injury"
If INJ.NUMINJ_A IN (2-96,RF,DK), fill: "any of your
significantinjuries"
Skip Instructions: <1,2,RF,DK> [goto INJWRKDAYS_A]
Question ID: INJ.0190.00.2
Variable name: INJWRKDAYS_A
Interview module: INJ(Adult.INJ)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: INJLIMIT_A=1
Universe Description: Sample Adults 18+ who had a significant sudden injury in the past 3 months
that limited their usual activities for at least 24 hours
Question Text:
Response:
Fills:
During the past 3 months, how many days of work did you miss because of
^siginj_A? If respondent says none, no, or 0 days, ask: Did you work at all the
past 3 months? Enter '90' if respondent says they missed every day of work in the
past 3 months. Enter '91' if respondent says they did not work in the past 3 months.
DK:
RF:
^siginj_A
Don't Know
Refused
If INJ.NUMINJ_A=1, fill: "your significant injury"
If INJ.NUMINJ_A IN (2-96,RF,DK), fill: "any of your
significantinjuries"
Page 281 of 430
Skip Instructions: <1-90,DK> [goto INJFUTWRK_A]
<0,RF> [goto INJSTOPCHG_A]
<91> [goto next section]
Question ID: INJ.0200.00.2
Variable name: INJFUTWRK_A
Interview module: INJ(Adult.INJ)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: INJWRKDAYS_A IN (1-90,DK)
Universe Description: Sample Adults 18+ who have missed at least one day of work due to injury in
past 3 months or don't know
Question Text:
Response:
Fills:
Do you expect to miss any more days of work because of ^siginj_A that
occurred during the past 3 months?
1.
2.
DK:
RF:
^siginj_A
Yes
No
Don't Know
Refused
If INJ.NUMINJ_A=1, fill: "your significant injury"
If INJ.NUMINJ_A IN (2-96,RF,DK), fill: "any of your
significantinjuries"
Skip Instructions: <1,2,RF,DK> [goto INJSTOPCHG_A]
Page 282 of 430
Question ID: INJ.0210.00.2
Variable name: INJSTOPCHG_A
Interview module: INJ(Adult.INJ)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: INJWRKDAYS_A IN (0-90,RF,DK)
Universe Description: Sample Adults 18+ who have missed 0 or more days of work due to injury in
past 3 months or refused or don't know
Question Text:
Response:
Fills:
During the past 3 months, did you stop working or change jobs because of
^siginj_A? Enter 'no' if respondent says they did not work in the past 3 months.
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
^siginj_A
If INJ.NUMINJ_A=1, fill: "your significant injury"
If INJ.NUMINJ_A IN (2-96,RF,DK), fill: "any of your
significantinjuries"
Skip Instructions: <1,2,RF,DK> [goto INJREDUCE_A]
Question ID: INJ.0220.00.2
Variable name: INJREDUCE_A
Interview module: INJ(Adult.INJ)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: INJWRKDAYS_A IN (0-90,RF,DK)
Universe Description: Sample Adults 18+ who have missed 0 or more days of work due to injury in
past 3 months or refused or don't know
Question Text:
During the past 3 months, did you make a major change in your work activities,
such as taking on fewer hours or lighter duties, because of ^siginj_A? Enter
'no' if respondent says they did not work in the past 3 months.
Response:
Page 283 of 430
1.
2.
DK:
RF:
Fills:
^siginj_A
Yes
No
Don't Know
Refused
If INJ.NUMINJ_A=1, fill: "your significant injury"
If INJ.NUMINJ_A IN (2-96,RF,DK), fill: "any of your
significantinjuries"
Skip Instructions: <1,2,RF,DK> [goto next section]
Page 284 of 430
Question ID: TBI.0010.05.3
Variable name: TBIINTRO1_A
Interview module: TBI(2023 Future Content.Adult.TBI)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
The next questions are about head injuries that may have occurred in the past
12 months. Please think about all head injuries, for example, from playing
sports, car accidents, falls, or being hit by something or someone that may
have occurred in the past 12 months.
1.
Enter 1 to Continue
Skip Instructions: <1> [goto TBILCDCMG_A]
Question ID: TBI.0020.00.3
Variable name: TBILCDCMG_A
Interview module: TBI(2023 Future Content.Adult.TBI)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
During the past 12 months, as a result of a blow or jolt to the head, have you
been knocked out or lost consciousness, been dazed or confused, or had a gap
in your memory?
Read if necessary: Please think about all head injuries, for
example, from playing sports, car accidents, falls, or being hit by something or
someone that may have occurred in the past 12 months.
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Page 1 of 4
Skip Instructions: <1,2,RF,DK> [goto TBIHLSBMC_A]
Question ID: TBI.0030.00.3
Variable name: TBIHLSBMC_A
Interview module: TBI(2023 Future Content.Adult.TBI)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
During the past 12 months, as a result of a blow or jolt to the head, have you
had headaches, sensitivity to light or noise, balance problems, or changes in
mood or behavior? Read if necessary: Please think about all head injuries, for
example, from playing sports, car accidents, falls, or being hit by something or
someone that may have occurred in the past 12 months.
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> [goto TBISPORT_A]
<2,RF,DK> if TBILCDCMG_A=1 [goto TBISPORT_A]
<2,RF,DK> if TBILCDCMG_A=2,RF,DK [goto next section]
Question ID: TBI.0040.00.3
Variable name: TBISPORT_A
Interview module: TBI(2023 Future Content.Adult.TBI)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: TBILCDCMG_A='1' or TBIHLSBMC_A='1'
Universe Description: Sample Adults 18+ who experienced TBI symptoms from a blow or jolt to the
head over the past 12 months
Question Text:
^CDCMG_A Were you playing a sport or participating in a physical or
recreational activity, such as jogging, biking, or pick-up games, when you
experienced any of these blows or jolts to the head?
Read if necessary:
Include team or league sports competitions or practices. Read if necessary:
Include organized and non-organized sports. Read if necessary: A pick-up game is
when a group of players get together and spontaenously start a game, like basketball
or soccer.
Response:
Page 2 of 4
1.
2.
DK:
RF:
Fills:
Yes
No
Don't Know
Refused
^CDCMG_A
If TBILCDCMG_A=1, fill:"Think about the blows or
jolts to the head that caused you to lose
consciousness, become dazed or confused, or have
a gap in your memory."
If TBILCDCMG_A=2,RF,DK, fill:""
Skip Instructions: <1> [goto TBILEAGUE_A]
<2,RF,DK> [goto TBIEVAL_A]
Question ID: TBI.0050.00.3
Variable name: TBILEAGUE_A
Interview module: TBI(2023 Future Content.Adult.TBI)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: TBISPORT_A='1'
Universe Description: Sample Adults 18+ who experienced TBI symptoms from a blow or jolt to the
head over the past 12 months and had a sports or recreational injury
Question Text:
Response:
Were you participating in an organized team or league sports competition or
practice when you experienced any of these blows or jolts to the head?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto TBIEVAL_A]
Page 3 of 4
Question ID: TBI.0050.00.4
Variable name: TBIEVAL_A
Interview module: TBI(2023 Future Content.Adult.TBI)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: TBILCDCMG_A='1' or TBIHLSBMC_A='1'
Universe Description: Sample Adults 18+ who experienced TBI symptoms from a blow or jolt to the
head over the past 12 months
Question Text:
Response:
During the past 12 months, as a result of a blow or jolt to the head, were you
evaluated for a concussion or brain injury by a doctor, nurse, paramedic,
athletic trainer, or other health professional?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto next section]
Page 4 of 4
Question ID: ART.0010.00.3
Variable name: JNTSYMP_A
Interview module: ART(Adult.ART)
Inherited Universe: (CON.ARTHEV_A=1) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(CON.ARTHEV_A=1))
Universe Description: Sample Adults 18+ who reported arthritis or related condition
Question Text:
Response:
The next questions refer to your joints. Please do NOT include the back or
neck. DURING THE PAST 30 DAYS, have you had any symptoms of pain,
aching, or stiffness in or around a joint?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> [goto JNTPN_A]
<2,RF,DK> [goto ARTHLMT_A]
Page 296 of 430
Question ID: ART.0020.00.3
Variable name: JNTPN_A
Interview module: ART(Adult.ART)
Inherited Universe: (CON.ARTHEV_A=1) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(CON.ARTHEV_A=1))
Universe: JNTSYMP_A=1
Universe Description: Sample Adults 18+ who reported arthritis or related condition and have had
any symptoms of pain, aching, or stiffness in or around a joint during the past
30 days
Question Text:
Response:
Please think about the past 30 days, keeping in mind all of your joint pain or
aching and whether or not you have taken medication. DURING THE PAST 30
DAYS, how bad was your joint pain ON AVERAGE? Please answer on a scale
of 0 to 10 where 0 is no pain or aching and 10 is pain or aching as bad as it can
be.
DK:
RF:
Don't Know
Refused
Skip Instructions: <0-10,RF,DK> [goto ARTHLMT_A]
Question ID: ART.0030.00.3
Variable name: ARTHLMT_A
Interview module: ART(Adult.ART)
Inherited Universe: (CON.ARTHEV_A=1) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(CON.ARTHEV_A=1))
Universe Description: Sample Adults 18+ who reported arthritis or related condition
Question Text:
Earlier, you said that a doctor or other health professional had told you that you
have some form of arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia
(fy-bro-my-AL-jee-uh). Are you now limited in any way in any of your usual
activities because of arthritis or joint symptoms?
Response:
Page 297 of 430
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto ARTHWRK_A]
Question ID: ART.0040.00.3
Variable name: ARTHWRK_A
Interview module: ART(Adult.ART)
Inherited Universe: (CON.ARTHEV_A=1) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(CON.ARTHEV_A=1))
Universe Description: Sample Adults 18+ who reported arthritis or related condition
Question Text:
Response:
In this next question we are referring to work for pay. Do arthritis or joint
symptoms now affect whether you work, the type of work you do, or the
amount of work you do?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto ARTHPH_A]
Question ID: ART.0050.00.3
Variable name: ARTHPH_A
Interview module: ART(Adult.ART)
Inherited Universe: (CON.ARTHEV_A=1) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(CON.ARTHEV_A=1))
Universe Description: Sample Adults 18+ who reported arthritis or related condition
Question Text:
Has a doctor or other health professional EVER suggested physical activity or
exercise to help your arthritis or joint symptoms?
Response:
Page 298 of 430
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto next section]
Question ID: CIG.0010.00.1
Variable name: CIGINTRO_A
Interview module: CIG(Adult.CIG(copy))
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
These next questions are about cigarette smoking.
1.
Enter '1' to continue.
Enter 1 to Continue
Skip Instructions: <1> [goto SMKEV_A]
Question ID: CIG.0020.00.1
Variable name: SMKEV_A
Interview module: CIG(Adult.CIG(copy))
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
Have you smoked at least 100 cigarettes in your ENTIRE LIFE?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Page 299 of 430
Skip Instructions: <1> [goto SMKNOW_A]
<2,RF,DK> [goto ECIGEV_A]
Question ID: CIG.0030.00.1
Variable name: SMKNOW_A
Interview module: CIG(Adult.CIG(copy))
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: SMKEV_A='1'
Universe Description: Sample Adults 18+ who ever smoked 100 cigarettes
Question Text:
Response:
Do you NOW smoke cigarettes every day, some days, or not at all?
1.
2.
3.
DK:
RF:
Every day
Some days
Not at all
Don't Know
Refused
Skip Instructions: <1> [goto CIGNOW_A]
<2> [goto SMK30D_A]
<3,RF,DK> [goto ECIGEV_A]
Question ID: CIG.0040.00.1
Variable name: CIGNOW_A
Interview module: CIG(Adult.CIG(copy))
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: SMKNOW_A='1'
Universe Description: Sample Adults 18+ who are current every day smokers
Question Text:
Response:
On average, about how many cigarettes do you NOW smoke a day?
less than 1 cigarette. Enter '95' if 95 or more cigarettes.
DK:
RF:
Don't Know
Refused
Page 300 of 430
Enter '1' if
Skip Instructions: <1-95,RF,DK> [goto ECIGEV_A]
Question ID: CIG.0050.00.1
Variable name: SMK30D_A
Interview module: CIG(Adult.CIG(copy))
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: SMKNOW_A='2'
Universe Description: Sample Adults 18+ who are current some day smokers
Question Text:
Response:
On how many of the past 30 days did you smoke a cigarette?
None.
DK:
RF:
Enter '0' for
Don't Know
Refused
Skip Instructions: <0> [goto ECIGEV_A]
<1-30,RF,DK> [goto CIG30D_A]
Question ID: CIG.0060.00.1
Variable name: CIG30D_A
Interview module: CIG(Adult.CIG(copy))
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: SMK30D_A IN (1-30,RF,DK)
Universe Description: Sample Adults 18+ who have smoked any time in the past 30 days, or refused
or don't know
Question Text:
Response:
On average, when you smoked during the past 30 days, about how many
cigarettes did you smoke a day? Enter '1' if less than 1. Enter '95' if 95 or
more cigarettes.
DK:
RF:
Don't Know
Refused
Page 301 of 430
Skip Instructions: <1-95,RF,DK> [goto ECIGEV_A]
Question ID: CIG.0070.00.1
Variable name: ECIGEV_A
Interview module: CIG(Adult.CIG(copy))
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
Have you ever used an e-cigarette or other electronic vaping product, even just
one time, in your entire life? Read if necessary: Electronic cigarettes (e-cigarettes)
and other electronic vaping products include JUULs, vape pens, e-cigars, and others.
These products are battery-powered and usually contain nicotine and flavors such as
fruit, mint, or candy. These questions concern electronic vaping products for nicotine
use. Do not include marijuana use.
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> [goto ECIGNOW_A]
<2,RF,DK> [goto next section]
Question ID: CIG.0080.00.1
Variable name: ECIGNOW_A
Interview module: CIG(Adult.CIG(copy))
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: ECIGEV_A=1
Universe Description: Sample Adults 18+ who have ever used e-cigarettes
Question Text:
Do you NOW use e-cigarettes or other electronic vaping products every day,
some days, or not at all? These questions concern electronic vaping products for
nicotine use. Do not include marijuana use.
Response:
Page 302 of 430
1.
2.
3.
DK:
RF:
Every day
Some days
Not at all
Don't Know
Refused
Skip Instructions: <1-3,RF,DK> [goto next section]
Question ID: OTB.0010.00.3
Variable name: CIGAREV_A
Interview module: OTB(Adult.OTB)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample adults 18+
Question Text:
Response:
Have you ever smoked a regular cigar, cigarillo, or a little filtered cigar EVEN
ONE TIME? Read if necessary: "Cigarillos" are medium cigars that sometimes are
sold with plastic or wooden tips. Some common brands are Black and Mild, Swisher
Sweets, Dutch Masters and Phillies Blunts. Cigarillos are usually sold individually or
in packs of 5 or fewer. Little filtered cigars look like cigarettes and are usually brown
in color. Like cigarettes, little filtered cigars have a spongy filter and are sold in packs
of 20. Some common brands are Prime Time and Winchester. Read if necessary:
Do not include electronic cigars or e-cigars.
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> [goto CIGARCUR_A]
<2,RF,DK> [goto PIPEEV_A]
Page 303 of 430
Question ID: OTB.0020.00.3
Variable name: CIGARCUR_A
Interview module: OTB(Adult.OTB)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: CIGAREV_A=1
Universe Description: Sample adults 18+ who have ever smoked a regular cigar, cigarillo, or filtered
cigar
Question Text:
Response:
Do you NOW smoke regular cigars, cigarillos, or little filtered cigars every day,
some days, or not at all?
1.
2.
3.
DK:
RF:
Every day
Some days
Not at all
Don't Know
Refused
Skip Instructions: <1,RF,DK> [goto PIPEEV_A]
<2,3> [goto CIGAR30D_A]
Question ID: OTB.0030.00.3
Variable name: CIGAR30D_A
Interview module: OTB(Adult.OTB)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: CIGARCUR_A IN (2,3)
Universe Description: Sample adults 18+ who now smoke a regular cigar, cigarillo, or little filtered
cigar some days or not at all
Question Text:
Response:
On how many of the past 30 days have you smoked a regular cigar, cigarillo, or
little filtered cigar?
DK:
RF:
Don't Know
Refused
Page 304 of 430
Skip Instructions: <0-30,RF,DK> [goto PIPEEV_A]
Question ID: OTB.0040.00.3
Variable name: PIPEEV_A
Interview module: OTB(Adult.OTB)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample adults 18+
Question Text:
Response:
Have you EVER smoked a pipe filled with tobacco - either a regular pipe, water
pipe, or hookah EVEN ONE TIME? Read if necessary: A hookah is a type of
water pipe. It is sometimes called a "narghile" (NAR-ge-lee) pipe. Do not include
electronic hookah or e-hookahs. Read if necessary: Do not include electronic pipes
or e-pipes. Read if necessary: Do not include pipes filled with substances other than
tobacco.
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> [goto PIPECUR_A]
<2,RF,DK> [goto SMOKELSEV_A]
Question ID: OTB.0050.00.3
Variable name: PIPECUR_A
Interview module: OTB(Adult.OTB)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: PIPEEV_A=1
Universe Description: Sample adults 18+ who have ever smoked a regular pipe, water pipe or
hookah filled with tobacco
Question Text:
Do you NOW smoke pipes filled with tobacco - either regular pipes, water pipes,
or hookahs, every day, some days, or not at all? Read if necessary: Do not
include pipes filled with substances other than tobacco.
Response:
Page 305 of 430
1.
2.
3.
DK:
RF:
Every day
Some days
Not at all
Don't Know
Refused
Skip Instructions: <1-3,RF,DK> [goto SMOKELSEV_A]
Question ID: OTB.0060.00.3
Variable name: SMOKELSEV_A
Interview module: OTB(Adult.OTB)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample adults 18+
Question Text:
Response:
Smokeless tobacco products are placed in the mouth or nose and can include
chewing tobacco, snuff, dip, snus (SNOOSE), or dissolvable tobacco. Have you
ever used smokeless tobacco products EVEN ONE TIME? Read if necessary:
Do not include nicotine replacement therapy products such as patch, gum, lozenge,
or spray, which are considered smoking cessation treatments.
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> [goto SMOKELSCUR_A]
<2,RF,DK> [goto next section]
Page 306 of 430
Question ID: OTB.0070.00.3
Variable name: SMOKELSCUR_A
Interview module: OTB(Adult.OTB)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: SMOKELSEV_A=1
Universe Description: Sample adults 18+ who have ever used smokeless tobacco products
Question Text:
Response:
Do you NOW use smokeless tobacco products every day, some days, or not at
all?
1.
2.
3.
DK:
RF:
Every day
Some days
Not at all
Don't Know
Refused
Skip Instructions: <1-3,RF,DK> [goto next section]
Question ID: SVI.0010.00.3
Variable name: AVISEXAM_A
Interview module: SVI(Adult.SVI)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
When was the last time you had an eye exam in which the pupils were dilated
using eye drops? This may have made you temporarily sensitive to bright
light.
0.
1.
Never
Within the past year (anytime less than 12 months ago)
Page 307 of 430
2.
3.
4.
5.
DK:
RF:
Within the past 2 years (1 year but less than 2 years ago)
Within the past 3 years (2 years but less than 3 years ago)
Within the past 5 years (3 years but less than 5 years ago)
5 years ago or more
Don't Know
Refused
Skip Instructions: <0-5,RF,DK> if VIS.VISIONDF_A IN (2,3,4) [goto AVISREH_A]
else [goto VIMREAD_A]
Question ID: SVI.0020.00.3
Variable name: AVISREH_A
Interview module: SVI(Adult.SVI)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: VIS.VISIONDF_A IN (2,3,4)
Universe Description: Sample Adults 18+ who have difficulty seeing
Question Text:
Response:
Do you use any vision rehabilitation services, such as job training, counseling,
or training in daily living skills and mobility?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto AVISDEV_A]
Page 308 of 430
Question ID: SVI.0030.00.3
Variable name: AVISDEV_A
Interview module: SVI(Adult.SVI)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: VIS.VISIONDF_A IN (2,3,4)
Universe Description: Sample Adults 18+ who have difficulty seeing
Question Text:
Response:
Do you use any assistance or adaptive devices, such as telescopic or other
prescriptive lenses, magnifiers, large print or talking materials, CCTV, white
cane, or guide dog?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> if AVISREH_A=1 [goto VIMREAD_A]
else [goto AVISSADV_A]
<2,RF,DK> [goto AVISSADV_A]
Question ID: SVI.0040.00.3
Variable name: AVISSADV_A
Interview module: SVI(Adult.SVI)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: AVISREH_A IN (2,RF,DK) or AVISDEV_A IN (2,RF,DK)
Universe Description: Sample Adults 18+ who do not use rehabilitation services or assistive devices
Question Text:
Has a health professional EVER advised you that rehabilitation services and
assistive, adaptive, or accessibility devices are available to help with your
vision difficulties?
Response:
Page 309 of 430
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto VIMREAD_A]
Question ID: SVI.0050.00.3
Variable name: VIMREAD_A
Interview module: SVI(Adult.SVI)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
Do you wear eyeglasses or contact lenses to read books or newspapers, write,
or do other things that require you to see up close, such as cooking, sewing or
fixing things?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto VIMDRIVE_A]
Question ID: SVI.0060.00.3
Variable name: VIMDRIVE_A
Interview module: SVI(Adult.SVI)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Do you wear eyeglasses or contact lenses to drive, read road and street signs,
watch TV, or see things in the distance?
Response:
Page 310 of 430
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto next section]
Question ID: SHE.0010.00.3
Variable name: AHEARST1_A
Interview module: SHE(Adult.SHE)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
?[F1] These next questions are about your hearing WITHOUT the use of
hearing aids or other listening devices. Without a hearing aid or other
listening devices, is your hearing excellent, good, a little trouble hearing,
moderate trouble, a lot of trouble, or are you deaf?
1.
2.
3.
4.
5.
6.
DK:
RF:
Excellent
Good
A little trouble hearing
Moderate trouble
A lot of trouble
Deaf
Don't Know
Refused
Skip Instructions: <1-5,RF,DK> [goto HRWHISP_A]
<6> [goto EARINFECT_A]
Page 311 of 430
Question ID: SHE.0020.00.3
Variable name: HRWHISP_A
Interview module: SHE(Adult.SHE)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: AHEARST1_A=1-5,RF,DK
Universe Description: Sample Adults 18+ who are not deaf or refused or don't know
Question Text:
Response:
Without a hearing aid or other listening devices, can you usually HEAR and
UNDERSTAND what a person says without seeing his or her face if that person
WHISPERS to you from across a quiet room?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto EARINFECT_A]
Question ID: SHE.0030.00.3
Variable name: EARINFECT_A
Interview module: SHE(Adult.SHE)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
DURING THE PAST 12 MONTHS, have you had an ear infection accompanied by
earache, or fluid in the ear, and/or temporary hearing loss? Read if necessary:
Temporary hearing loss includes "muffled" hearing.
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Page 312 of 430
Skip Instructions: <1> [goto EARINFECT3_A]
<2,RF,DK> if TBI.TBILCDCMG_A=1
CBALHDNO_A]
else [goto CBALHDINJ_A]
Question ID: SHE.0040.00.3
or
Variable name: EARINFECT3_A
TBI.TBIHLSBMC_A=1
[goto
Interview module: SHE(Adult.SHE)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: EARINFECT_A=1
Universe Description: Sample Adults 18+ who have had an ear infection in the past 12 months
Question Text:
Response:
DURING THE PAST 12 MONTHS, have you had three or more ear infections
accompanied by earache, or fluid in the ear, and/or temporary hearing loss?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> if TBI.TBILCDCMG_A=1
CBALHDNO_A]
else [goto CBALHDINJ_A]
Question ID: SHE.0050.00.3
Variable name: CBALHDINJ_A
or
TBI.TBIHLSBMC_A=1
[goto
Interview module: SHE(Adult.SHE)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: TBI.TBILCDCMG_A=2,RF,DK and TBI.TBIHLSBMC_A=2,RF,DK
Universe Description: Sample Adults 18+ who have not lost consciousness and have not had
symptoms of a head injury in the past 12 months
Question Text:
In your LIFETIME, have you EVER had a significant head injury or concussion?
Response:
Page 313 of 430
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> [goto CBALHDNO_A]
<2,RF,DK> [goto HRTEST_A]
Question ID: SHE.0060.00.3
Variable name: CBALHDNO_A
Interview module: SHE(Adult.SHE)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: TBI.TBILCDCMG_A=1 or TBI.TBIHLSBMC_A=1 or CBALHDINJ_A=1
Universe Description: Sample Adults 18+ who have had a head injury in the past 12 months or
lifetime
Question Text:
Response:
Fills:
^HEADINJ many significant head injuries or concussions have you had in your
LIFETIME?
0.
1.
2.
3.
4.
5.
DK:
RF:
0
1
2
3
4
5 or more
Don't Know
Refused
^HEADINJ
If TBI.TBILCDCMG_C=1 or TBI.TBIHLSBMC_C=1,
fill: "Counting any injuries you told me about earlier,
how"
else, fill: "How"
Page 314 of 430
Skip Instructions: <0-5,RF,DK> [goto HRTEST_A]
Question ID: SHE.0070.00.3
Variable name: HRTEST_A
Interview module: SHE(Adult.SHE)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
A hearing test by a specialist is one that is done in a sound-proof booth or
room, or with headphones. Have you ever had your hearing tested by a hearing
specialist? Read if necessary: Hearing specialists include audiologists, ear nose
and throat (ENT) doctors, and trained technicians or occupational nurses.
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> [goto HRTESTLAST_A]
<2,RF,DK> if HEA.HEARAID_A=1 [goto HRAIDAQR_A]
else [goto BALDIZZ_A]
Question ID: SHE.0080.00.3
Variable name: HRTESTLAST_A
Interview module: SHE(Adult.SHE)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: HRTEST_A=1
Universe Description: Sample Adults 18+ who have had ever had a hearing test
Question Text:
When was the last time you had your hearing tested by a hearing specialist?
Read if necessary: Do not count tests done before 6 months of age.
Response:
Page 315 of 430
1.
2.
3.
4.
5.
DK:
RF:
Less than a year ago
1 to 2 years ago
3 to 4 years ago
5 to 9 years ago
10 or more years ago
Don't Know
Refused
Skip Instructions: <1-5,RF,DK> if HEA.HEARAID_A=1 [goto HRAIDAQR_A]
else [goto BALDIZZ_A]
Question ID: SHE.0090.00.3
Variable name: HRAIDAQR_A
Interview module: SHE(Adult.SHE)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: HEA.HEARAID_A=1
Universe Description: Sample Adults 18+ who wear a hearing aid
Question Text:
Response:
Earlier, you told me that you use a hearing aid. Was that hearing aid fit by a
health care professional, or was it purchased online or over the counter without
assistance from a health care professional?
1.
2.
DK:
RF:
Hearing aid fit by a health care professional
Hearing aid purchased online or over the counter without assistance from
a health care professional
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto BALDIZZ_A]
Page 316 of 430
Question ID: SHE.0100.00.3
Variable name: BALDIZZ_A
Interview module: SHE(Adult.SHE)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
These next questions are about dizziness or balance problems. Do not include
times when drinking alcohol, using recreational drugs, or taking medications
that cause dizziness. DURING THE PAST 12 MONTHS, have you had a problem
with dizziness, vertigo, lightheadedness, blurred vision when moving head,
feeling like you are going to pass out or faint, or with unsteadiness or feeling
off-balance? Read if necessary: Vertigo is a sensation of feeling off-balance from
rotation, rocking, or other motion, such as riding a carousel.
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> [goto BALDPROB_A]
<2,RF,DK> [goto BFALL12M_A]
Question ID: SHE.0110.00.3
Variable name: BALDPROB_A
Interview module: SHE(Adult.SHE)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: BALDIZZ_A=1
Universe Description: Sample Adults 18+ who have had a problem with balance or dizziness in the
past 12 months
Question Text:
DURING THE PAST 12 MONTHS, how much of a problem did you have with
dizziness or balance? Would you say it was... Read answer categories below.
Response:
Page 317 of 430
1.
2.
3.
4.
5.
DK:
RF:
No problem
A small problem
A moderate problem
A big problem
A very big problem
Don't Know
Refused
Skip Instructions: <1-5,RF,DK> [goto BALDHP_A]
Question ID: SHE.0120.00.3
Variable name: BALDHP_A
Interview module: SHE(Adult.SHE)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: BALDIZZ_A=1
Universe Description: Sample Adults 18+ who have had a problem with balance or dizziness in the
past 12 months
Question Text:
Response:
Have you EVER seen a doctor or other health professional for evaluation or
treatment of your difficulties with dizziness or balance?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto BFALL12M_A]
Page 318 of 430
Question ID: SHE.0130.00.3
Variable name: BFALL12M_A
Interview module: SHE(Adult.SHE)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
The next questions are about falling. By falls or falling, we mean unexpectedly
dropping to the floor or ground from a standing, walking, or bending position.
DURING THE PAST 12 MONTHS, have you fallen at least one time?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> [goto BFALLTIMES_A]
<2,RF,DK> [goto HRTINNITUS_A]
Question ID: SHE.0140.00.3
Variable name: BFALLTIMES_A
Interview module: SHE(Adult.SHE)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: BFALL12M_A=1
Universe Description: Sample Adults 18+ who have fallen at least once in the past 12 months
Question Text:
Response:
DURING THE PAST 12 MONTHS, how many times have you fallen?
1.
2.
3.
1 time
2 times
3 to 4 times
Page 319 of 430
4.
5.
DK:
RF:
5 to 7 times
8 or more times
Don't Know
Refused
Skip Instructions: <1-5,RF,DK> [goto HRTINNITUS_A]
Question ID: SHE.0150.00.3
Variable name: HRTINNITUS_A
Interview module: SHE(Adult.SHE)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
DURING THE PAST 12 MONTHS, have you been bothered by ringing, roaring, or
buzzing in your ears or head that lasts for 5 minutes or more? Read if
necessary: Tinnitus (TIN-uh-tus) is the medical term for ringing, roaring or buzzing in
the ears or head.
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> [goto HRTINLNG_A]
<2,RF,DK> [goto HRLOUDJOB_A]
Question ID: SHE.0160.00.3
Variable name: HRTINLNG_A
Interview module: SHE(Adult.SHE)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: HRTINNITUS_A=1
Universe Description: Sample Adults 18+ who have been bothered by ringing, roaring, or buzzing in
ears or head in the past 12 months
Question Text:
How long have you been bothered by this ringing, roaring, or buzzing in your
ears or head?
Response:
Page 320 of 430
1.
2.
3.
4.
5.
DK:
RF:
Less than 1 year
1 to 2 years
3 to 4 years
5 to 9 years
10 years or more
Don't Know
Refused
Skip Instructions: <1-5,RF,DK> [goto HRTINPROB_A]
Question ID: SHE.0170.00.3
Variable name: HRTINPROB_A
Interview module: SHE(Adult.SHE)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: HRTINNITUS_A=1
Universe Description: Sample Adults 18+ who have been bothered by ringing, roaring, or buzzing in
ears or head in the past 12 months
Question Text:
Response:
DURING THE PAST 12 MONTHS, how much of a problem is this ringing,
roaring, or buzzing in your ears or head? Would you say it is... Read answer
categories below.
1.
2.
3.
4.
5.
DK:
RF:
No problem
A small problem
A moderate problem
A big problem
A very big problem
Don't Know
Refused
Skip Instructions: <1-5,RF,DK> [goto HRTINMEDSP_A]
Page 321 of 430
Question ID: SHE.0180.00.3
Variable name: HRTINMEDSP_A
Interview module: SHE(Adult.SHE)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: HRTINNITUS_A=1
Universe Description: Sample Adults 18+ who have been bothered by ringing, roaring, or buzzing in
ears or head in the past 12 months
Question Text:
Response:
IN THE PAST 5 YEARS, have you been evaluated or treated for the ringing,
roaring, or buzzing in your ears or head by a medical specialist in hearing, such
as an Ear, Nose and Throat doctor, audiologist, neurologist, or psychiatrist?
Read if necessary: Include otolaryngologists (oh-toe-lair-in-GAH-luh-gists),
otologists, and neuro-otologists.
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto HRLOUDJOB_A]
Question ID: SHE.0190.00.3
Variable name: HRLOUDJOB_A
Interview module: SHE(Adult.SHE)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
The next few questions are about your current or previous exposure to loud
and very loud sounds or noises. First, we will ask about exposure to loud
noises or sounds you may have had while working. Loud means so loud that
you must speak in a raised voice to be heard. Have you EVER had a job, or
combination of jobs, where you were exposed to loud sounds or noise for 4 or
more hours a day, several days a week?
Response:
Page 322 of 430
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> [goto HRLOUDJBYR_A]
<2,RF,DK> [goto HRFIREEV_A]
Question ID: SHE.0200.00.3
Variable name: HRLOUDJBYR_A
Interview module: SHE(Adult.SHE)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: HRLOUDJOB_A=1
Universe Description: Sample Adults 18+ who have been exposed to loud noise during work
Question Text:
Response:
In your LIFETIME, how many years have you had a job, or combination of jobs,
where you were exposed to LOUD sounds or noise for 4 or more hours a day,
several days a week? Read if necessary: Loud means so loud that you must
speak in a raised voice to be heard.
1.
2.
3.
4.
5.
DK:
RF:
Less than 1 year
1 to 2 years
3 to 4 years
5 to 9 years
10 years or more
Don't Know
Refused
Skip Instructions: <1-5,RF,DK> [goto HRLOUDJB12M_A]
Page 323 of 430
Question ID: SHE.0210.00.3
Variable name: HRLOUDJB12M_A
Interview module: SHE(Adult.SHE)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: HRLOUDJOB_A=1
Universe Description: Sample Adults 18+ who have been exposed to loud noise during work
Question Text:
Response:
DURING THE PAST 12 MONTHS, have you had a job, or combination of jobs,
where you were exposed to LOUD sounds or noise for 4 or more hours a day,
several days a week? Read if necessary: Loud means so loud that you must
speak in a raised voice to be heard.
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> [goto HRJOBPROT_A]
<2,RF,DK> [goto HRFIREEV_A]
Question ID: SHE.0220.00.3
Variable name: HRJOBPROT_A
Interview module: SHE(Adult.SHE)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: HRLOUDJB12M_A=1
Universe Description: Sample Adults 18+ who have been exposed to loud noise at work in the past
12 months
Question Text:
DURING THE PAST 12 MONTHS, how often did you wear hearing protection
such as ear plugs or ear muffs when exposed to LOUD sounds or noise at
work? Would you say... Read answer categories below.
Response:
Page 324 of 430
1.
2.
3.
4.
5.
DK:
RF:
Always
Usually
About half the time
Seldom
Never
Don't Know
Refused
Skip Instructions: <1-5,RF,DK> [goto HRFIREEV_A]
Question ID: SHE.0230.00.3
Variable name: HRFIREEV_A
Interview module: SHE(Adult.SHE)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
Have you EVER used guns or firearms for any reason? Read if necessary:
Include target shooting, hunting, military service, and job-related firearm use. Read
if necessary: Firearms include pistols, shotguns, rifles, and other types of guns. Do
not include BB or pellet guns.
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1>[goto HRFIRETOTR_A]
<2,RF,DK> [goto HRVLOUD12M_A]
Page 325 of 430
Question ID: SHE.0240.00.3
Variable name: HRFIRETOTR_A
Interview module: SHE(Adult.SHE)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: HRFIREEV_A=1
Universe Description: Sample Adults 18+ who have ever used a firearm or gun
Question Text:
Response:
How many total rounds have you EVER fired? Read categories if necessary.
Read if necessary: One round is equal to one shot.
1.
2.
3.
4.
DK:
RF:
Less than 100 rounds
100 to less than 1,000 rounds
1,000 to less than 10,000 rounds
10,000 rounds or more
Don't Know
Refused
Skip Instructions: <1-4,RF,DK> [goto HRFIRE12M_A]
Question ID: SHE.0250.00.3
Variable name: HRFIRE12M_A
Interview module: SHE(Adult.SHE)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: HRFIREEV_A=1
Universe Description: Sample Adults 18+ who have ever used a firearm or gun
Question Text:
DURING THE PAST 12 MONTHS, did you use guns or firearms for any reason?
Read if necessary: Include target shooting, hunting, military service, and job-related
firearm use. Read if necessary: Firearms include pistols, shotguns, rifles, and
other types of guns. Do not include BB or pellet guns.
Response:
Page 326 of 430
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> [goto HRFIREPROT_A]
<2,RF,DK> [goto HRVLOUD12M_A]
Question ID: SHE.0260.00.3
Variable name: HRFIREPROT_A
Interview module: SHE(Adult.SHE)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: HRFIRE12M_A=1
Universe Description: Sample Adults 18+ who have used a firearm or gun in the past 12 months
Question Text:
Response:
DURING THE PAST 12 MONTHS, when shooting firearms how often did you
wear hearing protection, such as ear plugs or ear muffs? Would you say...
Read answer categories below.
1.
2.
3.
4.
5.
DK:
RF:
Always
Usually
About half the time
Seldom
Never
Don't Know
Refused
Skip Instructions: <1-5,RF,DK> [goto HRVLOUD12M_A]
Page 327 of 430
Question ID: SHE.0270.00.3
Variable name: HRVLOUD12M_A
Interview module: SHE(Adult.SHE)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
The next question asks about other VERY LOUD sounds. VERY LOUD means
so loud you must shout in order to be understood by someone standing 3 feet
or arm's length away from you. This includes noise from power tools,
machinery, recreational vehicles, racing or speedways, some sporting events,
and other things. Do not include exposure to very loud noises or sounds you
may have had while working. DURING THE PAST 12 MONTHS, outside of work,
have you been exposed to VERY LOUD sounds or noise 10 or more times?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> [goto HRVLDPROT_A]
<2,RF,DK> [goto next section]
Question ID: SHE.0280.00.3
Variable name: HRVLDPROT_A
Interview module: SHE(Adult.SHE)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: HRVLOUD12M_A=1
Universe Description: Sample Adults 18+ who have been exposed to very loud noise 10 or more
times in the past 12 months
Question Text:
DURING THE PAST 12 MONTHS, how often have you worn earplugs or ear
muffs when exposed to VERY LOUD sounds or noise outside of work? Would
you say... Read answer categories below. Read if necessary: VERY LOUD
means so loud you must shout in order to be understood by someone standing 3 feet
(arm's length) away from you.
Response:
Page 328 of 430
1.
2.
3.
4.
5.
DK:
RF:
Always
Usually
About half the time
Seldom
Never
Don't Know
Refused
Skip Instructions: <1-5,RF,DK> [goto next section]
Question ID: SWE.0010.00.3
Variable name: HRJBEXP12M_A
Interview module: SWE(Adult.SWE)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
DURING THE PAST 12 MONTHS, did you work in a job where you were exposed
to any of the following: solvents, thinners, paints, laquers, industrial glues,
heavy metals, pesticides, or motor engine exhaust? Read if necessary: Solvents
are liquids, not including water, used for dissolving other substances, such as drycleaning fluids, thinners, components of paints, industrial cleaners and paint
removers. Industrial glues are adhesives that include acrylic, epoxy, hot melt,
polyurethane, silicone, thermoset and industrial sealants. Heavy metals include lead,
nickel, mercury, cadmium, arsenic, chromium, zinc and copper.
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> [goto HRJBEXP4HR_A]
<2,RF,DK> [goto HRJBEXPTB_A]
Page 329 of 430
Question ID: SWE.0020.00.3
Variable name: HRJBEXP4HR_A
Interview module: SWE(Adult.SWE)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: HRJBEXP12M_A=1
Universe Description: Sample Adults 18+ who were exposed to solvents and other substances at
work in the past 12 months
Question Text:
Response:
Were you exposed for 4 or more hours a week?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> go to HRJBEXPTB_A
Question ID: SWE.0030.00.3
Variable name: HRJBEXPTB_A
Interview module: SWE(Adult.SWE)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
DURING THE PAST 12 MONTHS, did you work in a job where you were exposed
for 4 or more hours a week to tobacco smoke from other people? Read if
necessary: Tobacco smoke includes cigarette and cigar smoke.
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto next section]
Page 330 of 430
Question ID: ORN.0010.00.1
Variable name: ORNINTRO_A
Interview module: ORN(2023 Future Content.Adult.ORN
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
Next we have some questions about your demographic characteristics,
including sexual orientation, gender identity, income, employment, and veteran
status. Like all your answers, these will be used to understand the health of
different groups in the population and will be kept confidential. Enter '1' to
continue.
1.
Enter 1 to Continue
Skip Instructions: <1> [goto ORIENT_A]
Question ID: ORN.0020.00.1
Variable name: ORIENT_A
Interview module: ORN(2023 Future Content.Adult.ORN
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
Do you think of yourself as ^gaylesbian; straight, that is, not ^gaylesbian;
bisexual; something else; or you don't know the answer?
1.
2.
3.
4.
5.
RF:
^GayLesbian
Straight, that is, not ^gaylesbian
Bisexual
Something else
I don't know the answer
Refused
Page 1 of 3
Fills:
^gaylesbian
If GEN.SEX_FINAL=1 fill "gay";
else if GEN.SEX_FINAL='2',RF,DK fill "lesbian or
gay"
Skip Instructions: <1-3,RF> [goto next section]
<4> [goto ORIENTSP_A]
<5> [goto ORIENTDK_A]
Question ID: ORN.0030.00.1
Variable name: ORIENTDK_A
Interview module: ORN(2023 Future Content.Adult.ORN
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: ORIENT_A=5
Universe Description: Sample Adults 18+ who said don't know the answer to sexual orientation
Question Text:
Response:
By Don't Know, do you mean that...
1.
2.
3.
DK:
RF:
Read answer categories below.
You don't understand the words?
You understand the words, but you have not figured out or are in the
process of figuring out your sexuality?
You mean something else?
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto next section]
<3> [goto ORIENTSP_A]
Page 2 of 3
Question ID: ORN.0040.00.1
Variable name: ORIENTSP_A
Interview module: ORN(2023 Future Content.Adult.ORN
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: ORIENT_A=4 or ORIENTDK_A=3
Universe Description: Sample Adults 18+ who answer something else to sexual orientation
Question Text:
Response:
What do you mean by something else?
DK:
RF:
Don't Know
Refused
Skip Instructions: [goto next section]
Page 3 of 3
Question ID: GNI.0010.00.4
Variable name: GENDER_A
Interview module: GNI(Adult.GNI)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
For this next question you may select more than one answer. Do you currently
describe yourself as male, female, transgender, nonbinary or another gender
identity?
1.
2.
3.
4.
5.
Male
Female
Transgender
Nonbinary
Another gender
DK:
RF:
Don't Know
Refused
Skip Instructions: <1,2> if more than one answer selected [goto ASATB2_A]
else [goto ASATB1_A]
<3,4> [goto ASATB2_A]
<5,RF,DK> [goto GENDSPEC_A]
Page 332 of 430
Question ID: GNI.0020.01.4
Variable name: ASATB1_A
Interview module: GNI(Adult.GNI)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: (GENDER_A=1 and GENDER_A NOT IN (2-4)) or (GENDER_A=2 and
GENDER_A NOT IN (1,3,4))
Universe Description: Sample Adults 18+ where gender is identified as only male or female
Question Text:
Response:
Fills:
Is ^gender the sex you were assigned at birth, on your original birth certificate?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
^gender
If GENDER_A=1, fill "male"
elseif GENDER_A=2, fill "female"
Skip Instructions: <1,RF,DK> [goto next section]
<2> [goto GICHECK1_A]
Question ID: GNI.0030.01.4
Variable name: GENDSPEC_A
Interview module: GNI(Adult.GNI)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: GENDER_A IN (4,RF,DK)
Universe Description: Sample Adults 18+ who identify as another gender identity or don't know or
refused
Question Text:
Response:
What term do you use to describe your gender?
DK:
RF:
Don't Know
Refused
Page 333 of 430
Skip Instructions: [goto ASATB2_A]
Question ID: GNI.0060.01.4
Variable name: ASATB2_A
Interview module: GNI(Adult.GNI)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: (GENDER_A=1 and GENDER_A=2) or GENDER_A IN (3,4,RF,DK)
Universe Description: Sample Adults 18+ where multiple gender categories were selected or where
gender is identified as transgender, nonbinary, another gender identity or
don't know or refused
Question Text:
Response:
What sex were you assigned at birth, on your original birth certificate?
1.
2.
DK:
RF:
Male
Female
Don't Know
Refused
Skip Instructions: <1,2> if GENDER_A IN (1-4) and GENDER_A ne ASATB2_A [goto
GICHECK1_A]
else [goto next section]
[goto next section]
Question ID: GNI.0070.00.4
Variable name: GICHECK1_A
Interview module: GNI(Adult.GNI)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: GICHECK_FLG=empty and (ASATB1_A=2 or (GENDER_A IN (1-4) and
GENDER_A ne ASATB2_A))
Universe Description: Sample Adults 18+ where this is the first time through the gender identity block
and a valid response was provided for sex and gender identity but they do not
match
Question Text:
Just to confirm, your sex assigned at birth is ^sexatbirth and ^genderID_A. Is
that correct?
Response:
Page 334 of 430
1.
2.
DK:
RF:
Fills:
Yes
No
Don't Know
Refused
^genderID_A
if GENDER_A IN (1,2,3,4) "you describe yourselfas
male, female, transgender, andanother gender
identity"
elseif GENDER_A IN (1,2,3), fill "you describe
yourselfas male, female, and transgender"
elseif GENDER_A IN (1,2,4), fill "you describe
yourselfas male, female, andanother gender identity"
elseif GENDER _A IN (2,3,4), fill "you describe
yourselfas female, transgender, andanother gender
identity"
elseif GENDER _A IN (1,3,4), fill "you describe
yourselfas male, transgender, andanother gender
identity"
elseif GENDER_A IN (1,2), fill "you describe
yourselfas male and female"
elseif GENDER_A IN (1,3), fill "you describe
yourselfas male and transgender"
elseifGENDER_A IN (1,4), fill "you describe
yourselfas male andanother gender identity"
elseifGENDER_A IN (2,3), fill "you describe
yourselfas female and transgender"
elseifGENDER_A IN (2,4), fill"you describe
yourselfas female andanother gender identity"
elseifGENDER_A IN (3,4), fill "you describe
yourselfas transgender andanother gender identity"
elseifGENDER_A=1, fill "you describe yourselfas
male"
elseif GENDER_A=2, fill "you describe yourselfas
female"
elseif GENDER_A=3, fill "you describe yourselfas
transgender"
elseif GENDER_A=4 and GENDSPEC_A=response,
fill "you describe yourselfas ^gendspec_A"
elseif GENDER_A=4 and GENDSPEC_A=DK, fill
"when asked if you described yourself, you said don't
know"
elseif GENDER_A=4 and GENDSPEC_A=RF, fill
"when asked if you described yourself, you didn't
wish to tell us"
^sexatbirth
if
(ASATB1_A=2
and
GENDER_A=1)
ASATB2_A=1, fill "male"
elseif (ASATB1_A=2 and GENDER_A=2)
Page 335 of 430
or
or
ASATB2_A=2, fill "female"
Skip Instructions: <1,RF,DK> [goto next section]
<2> [goto GENDER_A]
Question ID: MAR.0010.00.1
Variable name: MARITAL_A
Interview module: MAR(Adult.MAR)
Inherited Universe: (GEN.PAR_FLG_C[PX_A]=empty or (GEN.PAR_FLG_C[PX_A] ne empty and
GEN.SARESPSC_FLG ne 1)) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(GEN.PAR_FLG_C[PX_A]=empty or (GEN.PAR_FLG_C[PX_A] ne empty and
GEN.SARESPSC_FLG ne 1)))
Universe Description: Sample Adults 18+ and the Child PAR section has not been completed for the
Sample Adult or the Child PAR section has been completed for the Sample
Adult and the Sample Adult is not the Sample Child respondent
Question Text:
Response:
The next questions are about marriage and cohabitation. Are you now married,
living with a partner together as an unmarried couple, or neither? If
respondent answers both married and living with a different partner together as an
unmarried couple, enter living with partner.
1.
2.
3.
DK:
RF:
Married
Living with a partner together as an unmarried couple
Neither
Don't Know
Refused
Skip Instructions: <1> [goto SPOUSLIV_A]
<2> if GEN.PCNT16PLUS=1 [got
PARTNERWHO_A]
<3,RF,DK> [goto EVRMARRIED_A]
Page 336 of 430
ERR1_MARITAL_A]
else
[goto
Check Name: ERR1_MARITAL_A
Text:
{signal ERR1_MARITAL_A} Respondent is the only person 16 or older on the
household roster. There is no one else eligible to select.
Hard / Soft Edit: Soft
Inherited Universe: (GEN.PAR_FLG_C[PX_A]=empty or (GEN.PAR_FLG_C[PX_A] ne empty and
GEN.SARESPSC_FLG ne 1)) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(GEN.PAR_FLG_C[PX_A]=empty or (GEN.PAR_FLG_C[PX_A] ne empty and
GEN.SARESPSC_FLG ne 1)))
Universe: MARITAL_A=2 and GEN.PCNT16PLUS=1
Universe Description: SA reports he/she is living with a partner but SA is the only person eligible to
be living with a partner on the household roster
Skip Instructions: Correct: [goto MARITAL_A]
Suppress: [goto EVRMARRIED_A]
Question ID: MAR.0020.00.1
Variable name: SPOUSLIV_A
Interview module: MAR(Adult.MAR)
Inherited Universe: (GEN.PAR_FLG_C[PX_A]=empty or (GEN.PAR_FLG_C[PX_A] ne empty and
GEN.SARESPSC_FLG ne 1)) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(GEN.PAR_FLG_C[PX_A]=empty or (GEN.PAR_FLG_C[PX_A] ne empty and
GEN.SARESPSC_FLG ne 1)))
Universe: MARITAL_A=1
Universe Description: Sample Adults 18+ who are married
Question Text:
Does your spouse live here?
Response:
Page 337 of 430
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> if GEN.PCNT16PLUS=1
SPOUSWHO_A]
<2> [goto SPOUSEP_A]
[goto next section]
[goto
ERR1_SPOUSLIV_C]
else
[goto
Check Name: ERR1_SPOUSLIV_A
Text:
{signal ERR1_SPOUSLIV_A} Respondent is the only person 16 or older on the
household roster. There is no one else eligible to select.
Hard / Soft Edit: Soft
Inherited Universe: (GEN.PAR_FLG_C[PX_A]=empty or (GEN.PAR_FLG_C[PX_A] ne empty and
GEN.SARESPSC_FLG ne 1)) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(GEN.PAR_FLG_C[PX_A]=empty or (GEN.PAR_FLG_C[PX_A] ne empty and
GEN.SARESPSC_FLG ne 1)))
Universe: MARITAL_A=1 and SPOUSLIV_A=1 and GEN.PCNT16PLUS=1
Universe Description: SA is married and says spouse lives in household but SA is the only person
eligible to be married on the household roster
Skip Instructions: Correct: [goto SPOUSLIV_A]
Suppress: [goto next section]
Page 338 of 430
Question ID: MAR.0030.00.1
Variable name: SPOUSWHO_A
Interview module: MAR(Adult.MAR)
Inherited Universe: (GEN.PAR_FLG_C[PX_A]=empty or (GEN.PAR_FLG_C[PX_A] ne empty and
GEN.SARESPSC_FLG ne 1)) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(GEN.PAR_FLG_C[PX_A]=empty or (GEN.PAR_FLG_C[PX_A] ne empty and
GEN.SARESPSC_FLG ne 1)))
Universe: SPOUSLIV_A=1 and GEN.PCNT16PLUS gt 1
Universe Description: Sample Adults 18+ with spouse in household
Question Text:
Response:
Which person is your spouse? Enter line number of spouse. Deleted persons
cannot be selected. Enter '0' if respondent wishes to select a deleted person.
00.
01.
02.
03.
04.
05.
06.
07.
08.
09.
10.
11.
12.
13.
14.
15.
16.
17.
18.
Not on roster
^ALIASNAME[1]
^ALIASNAME[2]
^ALIASNAME[3]
^ALIASNAME[4]
^ALIASNAME[5]
^ALIASNAME[6]
^ALIASNAME[7]
^ALIASNAME[8]
^ALIASNAME[9]
^ALIASNAME[10]
^ALIASNAME[11]
^ALIASNAME[12]
^ALIASNAME[13]
^ALIASNAME[14]
^ALIASNAME[15]
^ALIASNAME[16]
^ALIASNAME[17]
^ALIASNAME[18]
Page 339 of 430
19.
20.
21.
22.
23.
24.
25.
DK:
RF:
^ALIASNAME[19]
^ALIASNAME[20]
^ALIASNAME[21]
^ALIASNAME[22]
^ALIASNAME[23]
^ALIASNAME[24]
^ALIASNAME[25]
Don't Know
Refused
Skip Instructions: <0-25> [goto SPOUSSEX_A]
[goto next section]
Question ID: MAR.0040.00.1
Variable name: SPOUSSEX_A
Interview module: MAR(Adult.MAR)
Inherited Universe: (GEN.PAR_FLG_C[PX_A]=empty or (GEN.PAR_FLG_C[PX_A] ne empty and
GEN.SARESPSC_FLG ne 1)) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(GEN.PAR_FLG_C[PX_A]=empty or (GEN.PAR_FLG_C[PX_A] ne empty and
GEN.SARESPSC_FLG ne 1)))
Universe: SPOUSWHO_A=1-25
Universe Description: Sample Adults 18+ with spouse in household who entered a line number for
their spouse
Question Text:
Response:
Fills:
I previously recorded ^SPOUSENAME's ^spousesex. Is this correct?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
^spousesex
if
GEN.SEX_FINAL[person
selected
at
SPOUSWHO_A]=1, fill "sex is male"
if
GEN.SEX_FINAL[person
selected
at
SPOUSWHO_A]=2, fill "sex is female"
if
GEN.SEX_FINAL[person
selected
at
SPOUSWHO_A] IN (DK,RF), fill "sex was not
provided"
^SPOUSENAME
Fill name of spouse selected at SPOUSWHO_A
Page 340 of 430
Skip Instructions: <1,RF,DK> [goto next section]
<2> [goto SPOUNEWSEX_A]
Question ID: MAR.0050.00.1
Variable name: SPOUNEWSEX_A
Interview module: MAR(Adult.MAR)
Inherited Universe: (GEN.PAR_FLG_C[PX_A]=empty or (GEN.PAR_FLG_C[PX_A] ne empty and
GEN.SARESPSC_FLG ne 1)) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(GEN.PAR_FLG_C[PX_A]=empty or (GEN.PAR_FLG_C[PX_A] ne empty and
GEN.SARESPSC_FLG ne 1)))
Universe: SPOUSSEX_A=2
Universe Description: Sample Adults 18+ with spouse with incorrect sex
Question Text:
Response:
Fills:
Is ^SPOUSENAME male or female?
1.
2.
DK:
RF:
Male
Female
Don't Know
Refused
^SPOUSENAME
Fill name of spouse selected at SPOUSWHO_A
Skip Instructions: <1,2,RF,DK> [goto next section]
Page 341 of 430
Question ID: MAR.0060.00.1
Variable name: SPOUSEP_A
Interview module: MAR(Adult.MAR)
Inherited Universe: (GEN.PAR_FLG_C[PX_A]=empty or (GEN.PAR_FLG_C[PX_A] ne empty and
GEN.SARESPSC_FLG ne 1)) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(GEN.PAR_FLG_C[PX_A]=empty or (GEN.PAR_FLG_C[PX_A] ne empty and
GEN.SARESPSC_FLG ne 1)))
Universe: SPOUSLIV_A=2
Universe Description: Sample Adults 18+ whose spouse does not live in the household
Question Text:
Response:
Does your spouse not live here because you and your spouse are legally
separated?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto next section]
Question ID: MAR.0070.00.1
Variable name: PARTNERWHO_A
Interview module: MAR(Adult.MAR)
Inherited Universe: (GEN.PAR_FLG_C[PX_A]=empty or (GEN.PAR_FLG_C[PX_A] ne empty and
GEN.SARESPSC_FLG ne 1)) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(GEN.PAR_FLG_C[PX_A]=empty or (GEN.PAR_FLG_C[PX_A] ne empty and
GEN.SARESPSC_FLG ne 1)))
Universe: MARITAL_A=2 and GEN.PCNT16PLUS gt 1
Universe Description: Sample Adults 18+ who are living with unmarried partner in household
Question Text:
Which person is your partner? Enter line number of partner. Deleted persons
cannot be selected. Enter '0' if respondent wishes to select a deleted person.
Response:
Page 342 of 430
00.
01.
02.
03.
04.
05.
06.
07.
08.
09.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
DK:
RF:
Not on roster
^ALIASNAME[1]
^ALIASNAME[2]
^ALIASNAME[3]
^ALIASNAME[4]
^ALIASNAME[5]
^ALIASNAME[6]
^ALIASNAME[7]
^ALIASNAME[8]
^ALIASNAME[9]
^ALIASNAME[10]
^ALIASNAME[11]
^ALIASNAME[12]
^ALIASNAME[13]
^ALIASNAME[14]
^ALIASNAME[15]
^ALIASNAME[16]
^ALIASNAME[17]
^ALIASNAME[18]
^ALIASNAME[19]
^ALIASNAME[20]
^ALIASNAME[21]
^ALIASNAME[22]
^ALIASNAME[23]
^ALIASNAME[24]
^ALIASNAME[25]
Don't Know
Refused
Skip Instructions: <0-25> [goto PARTNERSEX_A]
[goto EVRMARRIED_A]
Page 343 of 430
Question ID: MAR.0080.00.1
Variable name: PARTNERSEX_A
Interview module: MAR(Adult.MAR)
Inherited Universe: (GEN.PAR_FLG_C[PX_A]=empty or (GEN.PAR_FLG_C[PX_A] ne empty and
GEN.SARESPSC_FLG ne 1)) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(GEN.PAR_FLG_C[PX_A]=empty or (GEN.PAR_FLG_C[PX_A] ne empty and
GEN.SARESPSC_FLG ne 1)))
Universe: PARTNERWHO_A=1-25
Universe Description: Sample Adults 18+ with partner in household who entered a line number for
their partner
Question Text:
Response:
Fills:
I previously recorded ^PARTNERNAME's ^partnersex. Is this correct?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
^partnersex
if
GEN.SEX_FINAL[person
selected
at
PARTNERWHO_A]=1, fill "sex is male"
if
GEN.SEX_FINAL[person
selected
at
PARTNERWHO_A]=2, fill "sex is female"
if
GEN.SEX_FINAL[person
selected
at
PARTNERWHO_A] IN (DK,RF), fill "sex was not
provided"
^PARTNERNAME
Fill name of partner selected at PARTNERWHO_A
Skip Instructions: <1,RF,DK> [goto EVRMARRIED_A]
<2> [goto PARTNEWSEX_A]
Page 344 of 430
Question ID: MAR.0090.00.1
Variable name: PARTNEWSEX_A
Interview module: MAR(Adult.MAR)
Inherited Universe: (GEN.PAR_FLG_C[PX_A]=empty or (GEN.PAR_FLG_C[PX_A] ne empty and
GEN.SARESPSC_FLG ne 1)) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(GEN.PAR_FLG_C[PX_A]=empty or (GEN.PAR_FLG_C[PX_A] ne empty and
GEN.SARESPSC_FLG ne 1)))
Universe: PARTNERSEX_A=2
Universe Description: Sample Adults 18+ with partner with incorrect sex
Question Text:
Response:
Fills:
Is ^PARTNERNAME male or female?
1.
2.
DK:
RF:
Male
Female
Don't Know
Refused
^PARTNERNAME
Fill name of partner selected at PARTNERWHO_A
Skip Instructions: <1,2,RF,DK> [goto EVRMARRIED_A]
Question ID: MAR.0100.00.1
Variable name: EVRMARRIED_A
Interview module: MAR(Adult.MAR)
Inherited Universe: (GEN.PAR_FLG_C[PX_A]=empty or (GEN.PAR_FLG_C[PX_A] ne empty and
GEN.SARESPSC_FLG ne 1)) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(GEN.PAR_FLG_C[PX_A]=empty or (GEN.PAR_FLG_C[PX_A] ne empty and
GEN.SARESPSC_FLG ne 1)))
Universe: MARITAL_A IN (2,3,RF,DK)
Universe Description: Sample Adults 18+ who are living with unmarried partner or who are not
married or living with an unmarried partner or refused or don't know
Question Text:
Have you ever been married?
Response:
Page 345 of 430
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> if MARITAL_A=2 [goto LEGALSTAT_A]
elseif MARITAL_A=3 [goto WIDIVSEP_A]
else [goto next section]
<2,RF,DK> [goto next section]
Question ID: MAR.0110.00.1
Variable name: LEGALSTAT_A
Interview module: MAR(Adult.MAR)
Inherited Universe: (GEN.PAR_FLG_C[PX_A]=empty or (GEN.PAR_FLG_C[PX_A] ne empty and
GEN.SARESPSC_FLG ne 1)) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(GEN.PAR_FLG_C[PX_A]=empty or (GEN.PAR_FLG_C[PX_A] ne empty and
GEN.SARESPSC_FLG ne 1)))
Universe: EVRMARRIED_A=1 and MARITAL_A=2
Universe Description: Sample Adults 18+ who are living with a partner but have been married
Question Text:
Response:
What is your current legal marital status? Are you married, widowed, divorced,
or separated?
1.
2.
3.
4.
DK:
RF:
Married
Widowed
Divorced
Separated
Don't Know
Refused
Skip Instructions: <1-4,RF,DK> [goto next section]
Page 346 of 430
Question ID: MAR.0120.00.1
Variable name: WIDIVSEP_A
Interview module: MAR(Adult.MAR)
Inherited Universe: (GEN.PAR_FLG_C[PX_A]=empty or (GEN.PAR_FLG_C[PX_A] ne empty and
GEN.SARESPSC_FLG ne 1)) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(GEN.PAR_FLG_C[PX_A]=empty or (GEN.PAR_FLG_C[PX_A] ne empty and
GEN.SARESPSC_FLG ne 1)))
Universe: EVRMARRIED_A=1 and MARITAL_A=3
Universe Description: Sample Adults 18+ who are neither living with a partner nor married, but have
been married
Question Text:
Response:
Are you widowed, divorced, or separated?
1.
2.
3.
DK:
RF:
Widowed
Divorced
Separated
Don't Know
Refused
Skip Instructions: <1-3,RF,DK> [goto FINISH_MAR_A]
Question ID: MAR.0130.00.1
Variable name: FINISH_MAR_A
Interview module: MAR(Adult.MAR)
Inherited Universe: (GEN.PAR_FLG_C[PX_A]=empty or (GEN.PAR_FLG_C[PX_A] ne empty and
GEN.SARESPSC_FLG ne 1)) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(GEN.PAR_FLG_C[PX_A]=empty or (GEN.PAR_FLG_C[PX_A] ne empty and
GEN.SARESPSC_FLG ne 1)))
Universe Description: Sample Adults 18+ and the Child PAR section has not been completed for the
Sample Adult or the Child PAR section has been completed for the Sample
Adult and the Sample Adult is not the Sample Child respondent
Question Text:
The Sample Adult MAR section is now complete.
Response:
Page 347 of 430
Enter '1' to continue.
1.
Enter 1 to Continue
Skip Instructions: <1> [goto next section]
Question ID: VET.0010.00.1
Variable name: AFVET_A
Interview module: VET(Adult.VET)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
Did you ever serve on active duty in the U.S. Armed Forces, military Reserves,
or National Guard?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> [goto AFVETTRN_A]
<2,RF,DK> [goto next section]
Question ID: VET.0020.00.1
Variable name: AFVETTRN_A
Interview module: VET(Adult.VET)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: AFVET_A=1
Universe Description: Sample Adults 18+ who have ever served in the armed forces
Question Text:
Were you on active duty ONLY for training in the Reserves or National Guard?
Response:
Page 348 of 430
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> [goto VADISB_A]
<2,RF,DK> [goto COMBAT_A]
Question ID: VET.0030.00.1
Variable name: COMBAT_A
Interview module: VET(Adult.VET)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: AFVET_A=1 and AFVETTRN_A IN (2,RF,DK)
Universe Description: Sample Adults 18+ who have ever served in the armed forces and who were
not only activated for training in the Reserves or National Guard
Question Text:
Response:
Did you ever serve in a foreign country during a time of armed conflict or on a
humanitarian or peace-keeping mission?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto VADISB_A]
Question ID: VET.0040.00.1
Variable name: VADISB_A
Interview module: VET(Adult.VET)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: AFVET_A=1
Universe Description: Sample Adults 18+ who have ever served in the armed forces
Question Text:
Do you have a VA service-connected disability rating?
Response:
Page 349 of 430
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto VAHOSP_A]
Question ID: VET.0050.00.1
Variable name: VAHOSP_A
Interview module: VET(Adult.VET)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: AFVET_A=1
Universe Description: Sample Adults 18+ who have ever served in the armed forces
Question Text:
Response:
During the past 12 months, did you receive any care at a Veteran's Health
Administration facility or receive any other health care paid for by the VA?
Read if necessary: Veteran's Health Administration facilities include VA hospitals, VA
medical centers, VA outpatient clinics, and VA nursing homes.
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> [goto next section]
<2,RF,DK> if 1 IN Adult.INS.MILSPC_A [goto next section]
else [goto VACAREEV]
Page 350 of 430
Question ID: VET.0060.00.1
Variable name: VACAREEV_A
Interview module: VET(Adult.VET)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: VAHOSP_A IN (2,RF,DK) and 1 NOT IN Adult.INS.MILSPC_A
Universe Description: Sample Adults 18+ who have ever served in the armed forces and did not
receive care at a VHA facility or other health care paid for by the VA in the past
12 months and did not report VA health care when asked about insurance
Question Text:
Response:
Have you ever enrolled in or used VA health care?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto next section]
Question ID: NAT.0010.00.1
Variable name: NATUSBORN_A
Interview module: NAT(Adult.NAT)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
^Askverify_A Were you born in the United States or a U.S. territory?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Page 351 of 430
Fills:
^Askverify_A
If GEN.SARESPSC_FLG=1, fill "*Ask or verify:"
Skip Instructions: <1> [goto NATSTBORN_A]
<2> [goto NATUSYR_A]
[goto next section]
Question ID: NAT.0020.00.1
Variable name: NATSTBORN_A
Interview module: NAT(Adult.NAT)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: NATUSBORN_A=1
Universe Description: Sample Adults 18+ born in the United States or U.S. territory
Question Text:
Response:
In what state or U.S. territory were you born?
DK:
RF:
Don't Know
Refused
Skip Instructions: [goto CITIZEN_A]
else [goto next section]
Question ID: NAT.0040.00.1
Variable name: NATUSYR_A
Interview module: NAT(Adult.NAT)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: NATUSBORN_A=2
Universe Description: Sample Adults 18+ not born in the United States or U.S. territory
Question Text:
Response:
In what year did you come to the United States to stay?
DK:
RF:
Don't Know
Refused
Page 352 of 430
Skip Instructions: <1900-Current Year,RF,DK> if NATUSYR_A is a future year [goto
ERR1_NATUSYR_A]
if NATUSYR_A lt VFY.BYEAR_A [goto ERR2_NATUSYR_A]
else [goto CITIZEN_A]
Check Name: ERR1_NATUSYR_A
Text:
{check ERR1_NATUSYR_A}
Future year invalid. Please correct.
Hard / Soft Edit: Hard
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: NATUSYR_A = future year
Check Name: ERR2_NATUSYR_A
Text:
{check ERR2_NATUSYR_A}
Year is prior to date of birth. Please correct.
Hard / Soft Edit: Hard
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: NATUSYR_A LT VFY.BYEAR_A
Universe Description: Year of naturalization is prior to year of birth
Page 353 of 430
Question ID: NAT.0050.00.1
Variable name: CITIZEN_A
Interview module: NAT(Adult.NAT)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: NATUSBORN_A=2 or NATSTBORN_A=American Samoa
Universe Description: Sample Adults 18+ not born in the United States or U.S. territory or born in
American Samoa
Question Text:
Response:
Are you a citizen of the United States?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> [goto NATCTZN_A]
<2,RF,DK> [goto next section]
Question ID: NAT.0060.00.1
Variable name: NATCTZN_A
Interview module: NAT(Adult.NAT)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: (NATUSBORN_A=2 or NATSTBORN_A=AS) and CITIZEN_A=1
Universe Description: Sample Adults 18+ not born in the United States or a United States territory or
born in the U.S. territory of American Samoa but are U.S. citizens
Question Text:
Were you born abroad to an American parent, born abroad and adopted by an
American parent, or did you become a U.S. citizen by naturalization?
Response:
Page 354 of 430
1.
2.
3.
DK:
RF:
Born abroad to American parent
Born abroad and adopted by an American parent
Became U.S. citizen by naturalization
Don't Know
Refused
Skip Instructions: <1-3,RF,DK> [goto next section]
Question ID: SCH.0010.00.1
Variable name: SCHCURENR_A
Interview module: SCH(Adult.SCH)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
Are you currently enrolled in or attending school? Read if necessary: School
includes high school, college, trade school, and professional school. Students may be
enrolled part-time or full-time.
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> [goto SCHDYSMSS_A]
<2,RF,DK> [goto next section]
Question ID: SCH.0020.00.1
Variable name: SCHDYSMSS_A
Interview module: SCH(Adult.SCH)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: SCHCURENR_A=1
Universe Description: Sample Adults 18+ who are currently enrolled in school
Question Text:
Response:
During the past 12 months, about how many days of school did you miss
because you had an illness, injury, or disability?
DK:
RF:
Don't Know
Refused
Page 355 of 430
Skip Instructions: <0-99,RF,DK> [goto next section]
<100-365> [goto ERR1_SCHDYSMSS_A]
Check Name: ERR1_SCHDYSMSS_A
Text:
{signal ERR1_SCHDYSMSS_A} ^SCHDYSMSS_A is an unusually large number.
Did you miss ^SCHDYSMSS_A days of school because of illness, injury, or
disability? Please verify.
Hard / Soft Edit: Soft
Fills:
^SCHDYSMSS_A
Fill value from SCHDYSMSS_A
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: SCHDYSMSS_A=100-365
Universe Description: Sample adult missed 100 to 365 days of school
Question ID: EMP.0010.00.1
Variable name: EMPLASTWK_A
Interview module: EMP(Adult.EMP)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
LAST WEEK, did you work for pay at a job or business?
If the respondent
says ^heshetheywork, but not for pay, at a family-owned job or business, enter '1' for
yes.
Response:
Page 356 of 430
1.
2.
DK:
RF:
Fills:
Yes
No
Don't Know
Refused
^heshetheywork
elseif GEN.SEX_FINAL=1 fill "he works"
elseif GEN.SEX_FINAL=2 fill "she works"
elseif GEN.SEX_FINAL IN (RF,DK) fill "they work"
Skip Instructions: <1> [goto EMPHOURS_A]
<2> [goto EMPNOWRK_A]
[goto next section]
Question ID: EMP.0020.00.1
Variable name: EMPNOWRK_A
Interview module: EMP(Adult.EMP)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: EMPLASTWK_A=2
Universe Description: Sample Adults 18+ who were not working for pay at a job or business last
week
Question Text:
Response:
Did you have a job or business LAST WEEK, but were temporarily absent due
to illness, vacation, family or maternity leave, or some other reason?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1> [goto EMPHOURS_A]
<2> [goto EMPWHYNOT_A]
[goto next section]
Page 357 of 430
Question ID: EMP.0030.00.1
Variable name: EMPWHYNOT_A
Interview module: EMP(Adult.EMP)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: EMPNOWRK_A=2
Universe Description: Sample Adults 18+ who were not working for pay and were not on temporary
leave from a job or business last week
Question Text:
Response:
What is the MAIN reason you were not working for pay at a job or business last
week? Probe if necessary.
1.
2.
3.
4.
5.
6.
7.
8.
DK:
RF:
Can't find work, laid off, looking for work
Seasonal/contract work
Retired
Unable to work for health reasons/disabled
Taking care of house or family
Going to school
Working at a family-owned job or business not for pay
Other
Don't Know
Refused
Skip Instructions: <1-6,8,RF,DK> [goto EMPWHENWRK_A]
<7> [goto EMPHOURS_A]
Question ID: EMP.0040.00.1
Variable name: EMPWHENWRK_A
Interview module: EMP(Adult.EMP)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: EMPWHYNOT_A IN (1-6,8,RF,DK)
Universe Description: Sample Adults 18+ whose main reason for not working last week was because
they couldn't find work, did seasonal or contract work, were retired, unable to
work for health reasons, taking care of the house/family, going to school, or
some other reason, or refused or don't know
Question Text:
When was the last time you worked for pay at a job or business, even if only for
a few days?
Response:
Page 358 of 430
1.
2.
3.
4.
DK:
RF:
Within the past 12 months
1-5 years ago
Over 5 years ago
Never worked
Don't Know
Refused
Skip Instructions: <1> if EMPWHYNOT_A=2 [goto EMPHOURS_A]
else [goto EMPSICKLV_A]
<2-4,RF,DK> [goto next section]
Question ID: EMP.0050.00.1
Variable name: EMPHOURS_A
Interview module: EMP(Adult.EMP)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: EMPLASTWK_A=1 or EMPNOWRK_A=1 or
(EMPWHYNOT_A=2 and EMPWHENWRK_A=1)
EMPWHYNOT_A=7
or
Universe Description: Sample Adults 18+ who were working at or were on temporary leave from a
paid job or business last week, or worked but not for pay at a family business
or had seasonal/contract work in the past 12 months
Question Text:
Response:
Fills:
^Whenwork many hours do you USUALLY work in total at ALL jobs or
businesses?
DK:
RF:
Don't Know
Refused
^Whenwork
If EMPWHYNOT_A=2 fill "When you aredoing your
seasonal or contract work, how"
else fill "How"
Skip Instructions: <1-94> [goto EMPSICKLV_A]
<95-168> [goto ERR1_EMPHOURS_A], then [goto EMPSICKLV_A]
[goto EMPFULLTIM_A]
Page 359 of 430
Check Name: ERR1_EMPHOURS_A
Text:
{signal ERR1_EMPHOURS_A} ^EMPHOURS_A hours is unusually high. Please
verify. Make corrections if necessary.
Hard / Soft Edit: Soft
Fills:
^EMPHOURS_A
Fill value from Adult.EMP.EMPHOURS_A
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: EMPHOURS_A=95-168
Universe Description: 95-168 hours worked last week/usually work per week
Question ID: EMP.0060.00.1
Variable name: EMPFULLTIM_A
Interview module: EMP(Adult.EMP)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: EMPHOURS_A IN (RF,DK)
Universe Description: Sample Adults 18+ who refused or didn't know how many hours they usually
work
Question Text:
Response:
^WhenworkDo you USUALLY work 35 hours or more per week in total at ALL
jobs or businesses?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Page 360 of 430
Fills:
^WhenworkDo
If EMPWHYNOT_A=2 fill: "When you are doing your
seasonal or contract work, do"
else "Do"
Skip Instructions: <1,2,RF,DK> [goto EMPSICKLV_A]
Question ID: EMP.0070.00.1
Variable name: EMPSICKLV_A
Interview module: EMP(Adult.EMP)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: EMPLASTWK_A=1 or
EMPWHENWRK_A=1
EMPNOWRK_A=1
or
EMPWHYNOT_A=7
or
Universe Description: Sample Adults 18+ who were working at or were on temporary leave from a
paid job or business last week; who work, but not for pay at family business or
who are not currently working but who had some period of employment in the
past 12 months
Question Text:
Response:
Fills:
^LASTJOB paid sick leave available if you ^workneed it?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
^haber_A
Spanish only
^workneed
If EMPWHENWRK_A=1 and EMPWHYNOT_A IN
(1,3,4,5,6,8), fill: "needed";
else fill: "need"
^LASTJOB
If EMPWHENWRK_A=1 and EMPWHYNOT_Ane 2
fill: "When you last worked, was"
else fill: "Regarding your job or business, is"
Page 361 of 430
Skip Instructions: <1,2,RF,DK> [goto EMPHEALINS_A]
Question ID: EMP.0080.00.1
Variable name: EMPHEALINS_A
Interview module: EMP(Adult.EMP)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: EMPLASTWK_A=1 or
EMPWHENWRK_A=1
EMPNOWRK_A=1
or
EMPWHYNOT_A=7
or
Universe Description: Sample Adults 18+ who were working at or were on temporary leave from a
paid job or business last week; who work, but not for pay at family business or
who are not currently working but who had some period of employment in the
past 12 months
Question Text:
Response:
Fills:
^LASTJOB health insurance offered to you through your workplace?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
^LASTJOB
If EMPWHENWRK_A=1 and EMPWHYNOT_Ane 2
fill: "When you last worked, was"
else fill: "Regarding your job or business, is"
Skip Instructions: <1,2,RF,DK> [goto EMPDAYMISS_A]
Page 362 of 430
Question ID: EMP.0090.00.1
Variable name: EMPDAYMISS_A
Interview module: EMP(Adult.EMP)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: EMPLASTWK_A=1 or
EMPWHENWRK_A=1
EMPNOWRK_A=1
or
EMPWHYNOT_A=7
or
Universe Description: Sample Adults 18+ who were working at or were on temporary leave from a
paid job or business last week; who work, but not for pay at family business or
who are not currently working but who had some period of employment in the
past 12 months
Question Text:
Response:
Fills:
During the past 12 months, about how many days of work did you miss
because you had an illness, injury, or disability?
Read if necessary: Do not
include family or ^paternitymaternity leave.
DK:
RF:
Don't Know
Refused
^paternitymaternity
If GEN.SEX_FINAL=1 fill "paternity"
else if GEN.SEX_FINAL=2 fill "maternity"
else if GEN.SEX_FINAL=RF,DK fill "maternity or
paternity"
Skip Instructions: <0-99,RF,DK> [goto next section]
<100-365> [goto ERR1_EMPDAYMISS_A] then [goto next section]
Page 363 of 430
Check Name: ERR1_EMPDAYMISS_A
Text:
{signal ERR1_EMPDAYMISS_A} ^EMPDAYMISS_A days is unusually high. Please
verify. Make corrections if necessary.
Hard / Soft Edit: Soft
Fills:
^EMPDAYMISS_A
Fill value from Adult.EMP.EMPDAYMISS_A
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: EMPDAYMISS_A=100-365
Universe Description: 100-365 days of work missed in the past 12 months
Question ID: EMD.0010.00.2
Variable name: EMDWHOWRK1_A
Interview module: EMD(Adult.EMD)
Inherited Universe: (EMP.EMPLASTWK_A=1
or
EMP.EMPNOWRK_A=1
or
EMP.EMPWHYNOT_A=7 or EMP.EMPWHENWRK_A=1) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(EMP.EMPLASTWK_A=1
or
EMP.EMPNOWRK_A=1
or
EMP.EMPWHYNOT_A=7 or EMP.EMPWHENWRK_A=1))
Universe Description: Sample Adults 18+ who were working at or were on temporary leave from a
paid job or business last week, or who work, but not for pay at a family-owned
job or business, or who did not have a job or business last week but had a job
or business in the past 12 months
Question Text:
Response:
^JOBFOR whom ^dodid you work ^job?
Enter the name of the company,
business or employer. Read if necessary for those with more than one MAIN job or
business: Where ^dodid you work for the most amount of time?
DK:
RF:
Don't Know
Refused
Page 364 of 430
Fills:
^JOBFOR
If
EMP.EMPLASTWK_A=1
or
EMP.EMPNOWRK_A=1 or EMP.EMPWHYNOT_A
IN (2,7) fill: "For"
elseif EMP.EMPWHENWRK_A=1 fill: "Thinking
about the MAIN job you held in the past 12 months,
for"
^dodid
EMP.EMPLASTWK_A=1 or EMP.EMPNOWRK_A=1
or EMP.EMPWHYNOT_A IN (2,7) fill: "do"
If EMP.EMPWHENWRK_A=1, fill: "did"
^job
if
(EMP.EMPLASTWK_A=1
or
EMP.EMPNOWRK_A=1 or EMP.EMPWHYNOT_A
IN (2,7)) fill: "at your MAIN job or business"
else no fill
Skip Instructions: [goto EMDINDUST_A]
Question ID: EMD.0020.00.2
Variable name: EMDINDUST_A
Interview module: EMD(Adult.EMD)
Inherited Universe: (EMP.EMPLASTWK_A=1
or
EMP.EMPNOWRK_A=1
or
EMP.EMPWHYNOT_A=7 or EMP.EMPWHENWRK_A=1) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(EMP.EMPLASTWK_A=1
or
EMP.EMPNOWRK_A=1
or
EMP.EMPWHYNOT_A=7 or EMP.EMPWHENWRK_A=1))
Universe Description: Sample Adults 18+ who were working at or were on temporary leave from a
paid job or business last week, or who work, but not for pay at a family-owned
job or business, or who did not have a job or business last week but had a job
or business in the past 12 months
Question Text:
Response:
What kind of business or industry ^iswas this?
Read if necessary: For
example: hospital, newspaper publishing, mail order house, auto engine
manufacturing, bank.
DK:
RF:
Don't Know
Refused
Page 365 of 430
Fills:
^iswas
If
EMP.EMPLASTWK_A=1
or
EMP.EMPNOWRK_A=1 or EMP.EMPWHYNOT_A
IN (2,7) fill "is"
elseIf EMP.EMPWHENWRK_A=1, fill "was"
Skip Instructions: [goto EMDKIND_A]
Question ID: EMD.0030.00.2
Variable name: EMDKIND1_A
Interview module: EMD(Adult.EMD)
Inherited Universe: (EMP.EMPLASTWK_A=1
or
EMP.EMPNOWRK_A=1
or
EMP.EMPWHYNOT_A=7 or EMP.EMPWHENWRK_A=1) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(EMP.EMPLASTWK_A=1
or
EMP.EMPNOWRK_A=1
or
EMP.EMPWHYNOT_A=7 or EMP.EMPWHENWRK_A=1))
Universe Description: Sample Adults 18+ who were working at or were on temporary leave from a
paid job or business last week, or who work, but not for pay at a family-owned
job or business, or who did not have a job or business last week but had a job
or business in the past 12 months
Question Text:
Response:
Fills:
What kind of work ^arewere you doing? Read if necessary: For example:
registered nurse, personnel manager, supervisor of order department, secretary,
accountant.
DK:
RF:
Don't Know
Refused
^hacer_A
Spanish only
^arewere
If
EMP.EMPLASTWK_A=1
or
EMP.EMPNOWRK_A=1 or EMP.EMPWHYNOT_A
IN (2,7), fill: "are"
If EMP.EMPWHENWRK_A=1, fill: "were"
Page 366 of 430
Skip Instructions: [goto EMDIMPACT1_A]
Question ID: EMD.0040.00.2
Variable name: EMDIMPACT1_A
Interview module: EMD(Adult.EMD)
Inherited Universe: (EMP.EMPLASTWK_A=1
or
EMP.EMPNOWRK_A=1
or
EMP.EMPWHYNOT_A=7 or EMP.EMPWHENWRK_A=1) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(EMP.EMPLASTWK_A=1
or
EMP.EMPNOWRK_A=1
or
EMP.EMPWHYNOT_A=7 or EMP.EMPWHENWRK_A=1))
Universe Description: Sample Adults 18+ who were working at or were on temporary leave from a
paid job or business last week, or who have seasonal/contract work, or who
work, but not for pay, or who did not have a job or business last week but had
a job or business in the past 12 months
Question Text:
Response:
Fills:
What ^arewere your most important activities or duties on this job or
business? Read if necessary: For example: patient care, directing hiring policies,
supervising order clerks, typing and filing, reconciling financial records.
DK:
RF:
^arewere
Don't Know
Refused
If
EMP.EMPLASTWK_A=1
or
EMP.EMPNOWRK_A=1 or EMP.EMPWHYNOT_A
IN (2,7), fill: "are"
If EMP.EMPWHENWRK_A=1, fill: "were"
Skip Instructions: [goto EMDSUPER_A]
Page 367 of 430
Question ID: EMD.0050.00.2
Variable name: EMDSUPER_A
Interview module: EMD(Adult.EMD)
Inherited Universe: (EMP.EMPLASTWK_A=1
or
EMP.EMPNOWRK_A=1
or
EMP.EMPWHYNOT_A=7 or EMP.EMPWHENWRK_A=1) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(EMP.EMPLASTWK_A=1
or
EMP.EMPNOWRK_A=1
or
EMP.EMPWHYNOT_A=7 or EMP.EMPWHENWRK_A=1))
Universe Description: Sample Adults 18+ who were working at or were on temporary leave from a
paid job or business last week, or who work, but not for pay at a family-owned
job or business, or who did not have a job or business last week but had a job
or business in the past 12 months
Question Text:
Response:
Fills:
^DoDid you supervise other employees as part of your job?
1.
2.
DK:
RF:
^DoDid
Yes
No
Don't Know
Refused
If
EMP.EMPLASTWK_A=1
or
EMP.EMPNOWRK_A=1 or EMP.EMPWHYNOT_A
IN (2,7), fill: "Do"
If EMP.EMPWHENWRK_A=1, fill: "Did"
Skip Instructions: <1,2,RF,DK> [goto EMDWRKCAT1_A]
Page 368 of 430
Question ID: EMD.0060.00.2
Variable name: EMDWRKCAT1_A
Interview module: EMD(Adult.EMD)
Inherited Universe: (EMP.EMPLASTWK_A=1
or
EMP.EMPNOWRK_A=1
or
EMP.EMPWHYNOT_A=7 or EMP.EMPWHENWRK_A=1) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(EMP.EMPLASTWK_A=1
or
EMP.EMPNOWRK_A=1
or
EMP.EMPWHYNOT_A=7 or EMP.EMPWHENWRK_A=1))
Universe Description: Sample Adults 18+ who were working at or were on temporary leave from a
paid job or business last week, or who work, but not for pay at a family-owned
job or business, or who did not have a job or business last week but had a job
or business in the past 12 months
Question Text:
Response:
Fills:
Which of these BEST describes your MAIN job or ^WRKCAT?
choices.
1.
2.
3.
4.
5.
6.
DK:
RF:
Read answer
Employee of a PRIVATE company for wages
A FEDERAL government employee
A STATE government employee
A LOCAL government employee
Self-employed in OWN business, professional practice or farm
Working WITHOUT PAY in a family-owned business or farm
Don't Know
Refused
^WRKCAT
If
EMP.EMPLASTWK_A=1
or
EMP.EMPNOWRK_A=1
orEMP.EMPWHYNOT_A
IN (2,7), fill: "work situation"
If EMP.EMPWHENWRK_A=1, fill: "business in the
past 12 months"
Skip Instructions: <1-6,RF,DK> [goto next section]
Page 369 of 430
Question ID: VOL.0010.00.4
Variable name: CEVOLUN1_A
Interview module: VOL(Adult.VOL)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
During the past 12 months, did you spend any time volunteering for any
organization or association?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,RF> [goto next section]
<2,DK> [goto CEVOLUN2_A]
Question ID: VOL.0020.00.4
Variable name: CEVOLUN2_A
Interview module: VOL(Adult.VOL)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: CEVOLUN1_A IN (2,DK)
Universe Description: Sample Adults 18+ who did not spend time volunteering in the past 12 months
or don't know
Question Text:
Response:
Some people don't think of activities they do infrequently or for children's
schools or youth organizations as volunteer activities. During the past 12
months, have you done any of these types of activities?
1.
Yes
Page 370 of 430
2.
DK:
RF:
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto next section]
Question ID: FEM.0010.00.1
Variable name: FEMINTRO_A
Interview module: FEM(Adult.FEM)
Inherited Universe: (GEN.PCNT18UP_A GT 1
AND
((GEN.SAMEFAM_FLG ne 1)
OR (GEN.SAMEFAM_FLG=1 and GEN.FEM_FLG_C=blank)
OR
(GEN.SAMEFAM_FLG=1
and
GEN.FEM_FLG_C=2
and
GEN.SARESPSC_FLG ne 1))) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(GEN.PCNT18UP_A GT 1
AND
((GEN.SAMEFAM_FLG ne 1)
OR (GEN.SAMEFAM_FLG=1 and GEN.FEM_FLG_C=blank)
OR
(GEN.SAMEFAM_FLG=1
and
GEN.FEM_FLG_C=2
and
GEN.SARESPSC_FLG ne 1))))
Universe Description: If Sample Adult lives in a family with at least one other adult AND
(Sample Child and Sample Adult are not in the same family
OR Sample Child and Sample Adult are in the same family AND Sample Child
FEM section has not been completed
OR the Sample Adult and Sample Child are in the same family and every
question asked in the Sample Child FEM section was answered with RF/DK
and the person answering the SC interview and the SA are different people.
Question Text:
Now I'm going to ask you about some of the other members of your family.
Enter '1' to continue.
Response:
Page 371 of 430
1.
Enter 1 to Continue
Skip Instructions: <1>[goto tblFEM_A]
Question ID: FEM.0030.00.1
Variable name: FEMWORK_A
Interview module: FEM(Adult.FEM.tblFEM_A.blkPerson
Inherited Universe: (GEN.HHSTAT_A[PX] ne '1' and (GEN.AGE_FINAL[PX] ge 18 or
Roster.HHC.tblAGE.bPerson.AGE18[PX]=2
or
Roster.HHC.tblAGE.bPerson.AGEGUESS[PX]=2) and FAMILYA_FLG[PX]=1)
AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
((GEN.PCNT18UP_A GT 1
AND
((GEN.SAMEFAM_FLG ne 1)
OR (GEN.SAMEFAM_FLG=1 and GEN.FEM_FLG_C=blank)
OR
(GEN.SAMEFAM_FLG=1
and
GEN.FEM_FLG_C=2
and
GEN.SARESPSC_FLG ne 1))) AND
(GEN.HHSTAT_A[PX] ne '1' and (GEN.AGE_FINAL[PX] ge 18 or
Roster.HHC.tblAGE.bPerson.AGE18[PX]=2
or
Roster.HHC.tblAGE.bPerson.AGEGUESS[PX]=2)
and
FAMILYA_FLG[PX]=1)))
Universe Description: If Sample Adult lives in a family with at least one other adult AND
(Sample Child and Sample Adult are not in the same family
OR Sample Child and Sample Adult are in the same family AND Sample Child
FEM section has not been completed
OR the Sample Adult and Sample Child are in the same family and every
question asked in the Sample Child FEM section was answered with RF/DK
and the person answering the SC interview and the SA are different people.
Question Text:
Does ^ALIASNAME work for pay at a job or business? If the respondent says
^heshetheywork, but not for pay, at a family-owned job or business, enter '1' for yes.
Response:
Page 372 of 430
1.
2.
DK:
RF:
Fills:
Yes
No
Don't Know
Refused
^ALIASNAME
Fill value from Roster.HHC.ALIAS[PX]
^heshetheywork
elseif GEN.SEX_FINAL=1 fill "he works"
elseif GEN.SEX_FINAL=2 fill "she works"
elseif GEN.SEX_FINAL IN (RF,DK) fill "they work"
Skip Instructions: <1> [goto FEMWKFT_A]
<2,RF,DK> if there is another adult in the family [goto FEMWORK_A] for the
next adult 18+
else [goto next section]
Question ID: FEM.0040.00.1
Variable name: FEMWKFT_A
Interview module: FEM(Adult.FEM.tblFEM_A.blkPerson
Inherited Universe: (GEN.HHSTAT_A[PX] ne '1' and (GEN.AGE_FINAL[PX] ge 18 or
Roster.HHC.tblAGE.bPerson.AGE18[PX]=2
or
Roster.HHC.tblAGE.bPerson.AGEGUESS[PX]=2) and FAMILYA_FLG[PX]=1)
AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
((GEN.PCNT18UP_A GT 1
AND
((GEN.SAMEFAM_FLG ne 1)
OR (GEN.SAMEFAM_FLG=1 and GEN.FEM_FLG_C=blank)
OR
(GEN.SAMEFAM_FLG=1
and
GEN.FEM_FLG_C=2
and
GEN.SARESPSC_FLG ne 1))) AND
(GEN.HHSTAT_A[PX] ne '1' and (GEN.AGE_FINAL[PX] ge 18 or
Roster.HHC.tblAGE.bPerson.AGE18[PX]=2
or
Roster.HHC.tblAGE.bPerson.AGEGUESS[PX]=2)
and
FAMILYA_FLG[PX]=1)))
Universe: FEMLSTWK_A[PX]=1
Universe Description: If Sample Adult lives in a family with at least one other adult AND
(Sample Child and Sample Adult are not in the same family
OR Sample Child and Sample Adult are in the same family AND Sample Child
FEM section has not been completed
OR the Sample Adult and Sample Child are in the same family and every
question asked in the Sample Child FEM section was answered with RF/DK
and the person answering the SC interview and the SA are different people.
Page 373 of 430
Question Text:
Response:
Fills:
Does ^ALIASNAME usually work 35 hours or more per week in total at
^hishertheir job or jobs?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
^ALIASNAME
Fill value from Roster.HHC.ALIAS[PX]
^hishertheir
If GEN.SEX_FINAL=1 fill "his";
else if GEN.SEX_FINAL=2 fill "her";
else if GEN.SEX_FINAL IN (DK, RF) fill "their"
Skip Instructions: <1,2,RF,DK> if another adult in the family [goto FEMWORK_A] for the next
adult 18+
else [goto next section]
Question ID: INC.0010.00.1
Variable name: INCINTRO_A
Interview module: INC(Adult.INC)
Inherited Universe: (((GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=blank)
or
(GEN.SAMEFAM_FLG
ne
1)
or
(GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=2 and GEN.SARESPSC_FLG ne 1))) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(((GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=blank)
or
(GEN.SAMEFAM_FLG
ne
1)
or
(GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=2 and GEN.SARESPSC_FLG ne 1))))
Universe Description: Sample Adults 18+ and Sample Adult and Sample Child are in the same family
and the Sample Child INC section has not been completed
OR the Sample Adult and Sample Child are not in the same family
OR Sample Adult and Sample Child are in the same family, Sample Child
respondent answered all questions asked in the INC section with dk/rf and
Sample Adult is not the Sample Child respondent
Question Text:
The next questions are about your total ^FAMILY income in ^LASTYEAR
BEFORE TAXES. ^INCSAFAM Read if necessary: Income is important in
analyzing the health information we collect. For example, with this information, we
can learn whether persons in one income group use certain types of medical services
more or less often than those in another group. Please be assured that, like all other
information you have provided, these answers will remain confidential. Enter '1' to
continue.
Page 374 of 430
Response:
Fills:
1.
Enter 1 to Continue
^FAMILY
If PCNT_A > 1 fill "family"
^LASTYEAR
Fill year prior to current year
^INCSAFAM
If more than one person in the Sample Adult's family,
fill "Based on questions asked earlier we have that
your family consists of^SAFAM."
else no fill
Skip Instructions: <1> [goto INCWRKO_A]
Question ID: INC.0020.00.1
Variable name: INCWRKO_A
Interview module: INC(Adult.INC)
Inherited Universe: (((GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=blank)
or
(GEN.SAMEFAM_FLG
ne
1)
or
(GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=2 and GEN.SARESPSC_FLG ne 1))) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(((GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=blank)
or
(GEN.SAMEFAM_FLG
ne
1)
or
(GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=2 and GEN.SARESPSC_FLG ne 1))))
Universe Description: Sample Adults 18+ and Sample Adult and Sample Child are in the same family
and the Sample Child INC section has not been completed
OR the Sample Adult and Sample Child are not in the same family
OR Sample Adult and Sample Child are in the same family, Sample Child
respondent answered all questions asked in the INC section with dk/rf and
Sample Adult is not the Sample Child respondent
Question Text:
In ^LASTYEAR, did ^YOUFAM18YRS receive income from wages, salaries,
commissions, bonuses, tips, or self-employment? ^INCSAFAMoptional
Response:
Page 375 of 430
1.
2.
DK:
RF:
Fills:
Yes
No
Don't Know
Refused
^YOUFAM18YRS
If PCNT18UP_A=1 fill "you"
else if PCNT18UP_A GT 1 fill "you or any family
members 18 or older"
^INCSAFAMoptional
If more than one person in the Sample Adult's family,
fill"*Read if necessary:For the purpose of this survey,
your family includes ^FAMVERSA_fill."
else no fill
^LASTYEAR
Fill year prior to current year
Skip Instructions: <1,2,RF,DK> [goto INCINTER_A]
Question ID: INC.0030.00.1
Variable name: INCINTER_A
Interview module: INC(Adult.INC)
Inherited Universe: (((GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=blank)
or
(GEN.SAMEFAM_FLG
ne
1)
or
(GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=2 and GEN.SARESPSC_FLG ne 1))) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(((GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=blank)
or
(GEN.SAMEFAM_FLG
ne
1)
or
(GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=2 and GEN.SARESPSC_FLG ne 1))))
Universe Description: Sample Adults 18+ and Sample Adult and Sample Child are in the same family
and the Sample Child INC section has not been completed OR the Sample
Adult and Sample Child are not in the same family OR Sample Adult and
Sample Child are in the same family, Sample Child respondent answered all
questions asked in the INC section with dk/rf and Sample Adult is not the
Sample Child respondent
Question Text:
In ^LASTYEAR, did ^YOUFAMHERE receive income from interest-bearing
accounts or investments, dividends from stocks or mutual funds, net rental
income, royalty income, or income from estates and trusts?
Response:
Page 376 of 430
1.
2.
DK:
RF:
Fills:
Yes
No
Don't Know
Refused
^YOUFAMHERE
If PCNT_A=1 fill "you"
else if PCNT_A GT 1 fill "you or any family
members"
^LASTYEAR
Fill year prior to current year
Skip Instructions: <1,2,DK> [goto INCSSRR_A]
if INCWRKO_A IN (1,2,DK) [goto INCSSRR_A]
else [goto next section]
Question ID: INC.0040.00.1
Variable name: INCSSRR_A
Interview module: INC(Adult.INC)
Inherited Universe: (((GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=blank)
or
(GEN.SAMEFAM_FLG
ne
1)
or
(GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=2 and GEN.SARESPSC_FLG ne 1))) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(((GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=blank)
or
(GEN.SAMEFAM_FLG
ne
1)
or
(GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=2 and GEN.SARESPSC_FLG ne 1))))
Universe: INCINTER_A IN (1,2,DK) or INCWRKO_A IN (1,2,DK)
Universe Description: Sample Adults 18+ and Sample Adult and Sample Child are in the same family
and the INC section has not been completed OR the Sample Adult and
Sample Child are not in the same family OR Sample Adult and Sample Child
are in the same family, Sample Child respondent answered all questions
asked in the INC section with dk/rf and Sample Adult is not the Sample Child
respondent and the Sample Adult did not refuse both the income from wages
and income from accounts questions
Question Text:
Read if necessary: In ^LASTYEAR, did ^YOUFAMHERE receive... Income from
Social Security or Railroad Retirement?
Response:
Page 377 of 430
1.
2.
DK:
RF:
Fills:
Yes
No
Don't Know
Refused
^LASTYEAR
Fill year prior to current year
^YOUFAMHERE
If PCNT_A=1 fill "you"
else if PCNT_A GT 1 fill "you or any family
members"
Skip Instructions: <1,2,RF,DK> [goto INCSSISSDI_A]
Question ID: INC.0050.00.1
Variable name: INCSSISSDI_A
Interview module: INC(Adult.INC)
Inherited Universe: (((GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=blank)
or
(GEN.SAMEFAM_FLG
ne
1)
or
(GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=2 and GEN.SARESPSC_FLG ne 1))) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(((GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=blank)
or
(GEN.SAMEFAM_FLG
ne
1)
or
(GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=2 and GEN.SARESPSC_FLG ne 1))))
Universe: INCINTER_A IN (1,2,DK) or INCWRKO_A IN (1,2,DK)
Universe Description: Sample Adults 18+ and Sample Adult and Sample Child are in the same family
and the INC section has not been completed OR the Sample Adult and
Sample Child are not in the same family OR Sample Adult and Sample Child
are in the same family, Sample Child respondent answered all questions
asked in the INC section with dk/rf and Sample Adult is not the Sample Child
respondent and the Sample Adult did not refuse both the income from wages
and income from accounts questions
Question Text:
Read if necessary: In ^LASTYEAR, did ^YOUFAMHERE receive... Supplemental
Security Income, SSI, or Social Security Disability Income, SSDI, which are
different from Social Security?
Response:
Page 378 of 430
1.
2.
DK:
RF:
Fills:
Yes
No
Don't Know
Refused
^LASTYEAR
Fill year prior to current year
^YOUFAMHERE
If PCNT_A=1 fill "you"
else if PCNT_A GT 1 fill "you or any family
members"
Skip Instructions: <1> [goto SSISSDIBTH_A]
<2,RF,DK> [goto INCWELF_A]
Question ID: INC.0060.00.1
Variable name: SSISSDIBTH_A
Interview module: INC(Adult.INC)
Inherited Universe: (((GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=blank)
or
(GEN.SAMEFAM_FLG
ne
1)
or
(GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=2 and GEN.SARESPSC_FLG ne 1))) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(((GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=blank)
or
(GEN.SAMEFAM_FLG
ne
1)
or
(GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=2 and GEN.SARESPSC_FLG ne 1))))
Universe: INCSSISSDI_A=1
Universe Description: Sample Adults 18+ where someone in the family gets SSI or SSDI and
Sample Adult and Sample Child are in the same family and the Sample Child
INC section has not been completed OR the Sample Adult and Sample Child
are not in the same family OR Sample Adult and Sample Child are in the same
family, Sample Child respondent answered all questions asked in the INC
section with dk/rf and Sample Adult is not the Sample Child respondent
Question Text:
Was this Supplemental Security Income, SSI, Social Security Disability Income,
SSDI, or both?
Response:
Page 379 of 430
1.
2.
3.
DK:
RF:
SSI
SSDI
Both SSI and SSDI
Don't Know
Refused
Skip Instructions: <1-3,RF,DK> [goto SSISSDIDSB_A]
Question ID: INC.0070.00.1
Variable name: SSISSDIDSB_A
Interview module: INC(Adult.INC)
Inherited Universe: (((GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=blank)
or
(GEN.SAMEFAM_FLG
ne
1)
or
(GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=2 and GEN.SARESPSC_FLG ne 1))) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(((GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=blank)
or
(GEN.SAMEFAM_FLG
ne
1)
or
(GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=2 and GEN.SARESPSC_FLG ne 1))))
Universe: INCSSISSDI_A=1
Universe Description: Sample adults 18+ where someone in the family gets SSI or SSDI and
Sample Child and Sample Adult are in the same family and the INC section
has not been completed OR the Sample Adult and Sample Child are not in the
same family OR Sample Adult and Sample Child are in the same family,
Sample Child respondent answered all questions asked in the INC section with
dk/rf and Sample Adult is not the Sample Child respondent
Question Text:
Response:
Was this received as a disability benefit?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Page 380 of 430
Skip Instructions: <1> if GEN.PCNT_A gt 1 [goto SSISSDIP_A]
elseif GEN.PCNT_A=1 [goto INCWELF_A]
<2,RF,DK> [goto INCWELF_A]
Question ID: INC.0090.00.1
Variable name: SSISSDIP_A
Interview module: INC(Adult.INC)
Inherited Universe: (((GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=blank)
or
(GEN.SAMEFAM_FLG
ne
1)
or
(GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=2 and GEN.SARESPSC_FLG ne 1))) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(((GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=blank)
or
(GEN.SAMEFAM_FLG
ne
1)
or
(GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=2 and GEN.SARESPSC_FLG ne 1))))
Universe: SSISSDIDSB_A=1 and GEN.PCNT_A gt 1
Universe Description: Sample Adults 18+ with more than one person in the family where someone in
the family gets SSI or SSDI and SSI/SSDI was received as a disability benefit
and Sample Adult and Sample Child are in the same family and the Sample
Child INC section has not been completed OR the Sample Adult and Sample
Child are not in the same family OR Sample Adult and Sample Child are in the
same family, Sample Child respondent answered all questions asked in the
INC section with dk/rf and Sample Adult is not the Sample Child respondent
Question Text:
Response:
In ^LASTYEAR, who received this disability benefit? Read if necessary: Do
NOT include a benefit received on behalf of someone else. Enter all that apply,
separate with commas.
01.
02.
03.
04.
05.
^ALIASNAME[1]
^ALIASNAME[2]
^ALIASNAME[3]
^ALIASNAME[4]
^ALIASNAME[5]
Page 381 of 430
06.
07.
08.
09.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
DK:
RF:
Fills:
^ALIASNAME[6]
^ALIASNAME[7]
^ALIASNAME[8]
^ALIASNAME[9]
^ALIASNAME[10]
^ALIASNAME[11]
^ALIASNAME[12]
^ALIASNAME[13]
^ALIASNAME[14]
^ALIASNAME[15]
^ALIASNAME[16]
^ALIASNAME[17]
^ALIASNAME[18]
^ALIASNAME[19]
^ALIASNAME[20]
^ALIASNAME[21]
^ALIASNAME[22]
^ALIASNAME[23]
^ALIASNAME[24]
^ALIASNAME[25]
Don't Know
Refused
^LASTYEAR
Fill year prior to current year
Skip Instructions: <1-25,RF,DK> [goto INCWELF_A]
Question ID: INC.0100.00.1
Variable name: INCWELF_A
Interview module: INC(Adult.INC)
Inherited Universe: (((GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=blank)
or
(GEN.SAMEFAM_FLG
ne
1)
or
(GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=2 and GEN.SARESPSC_FLG ne 1))) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(((GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=blank)
or
(GEN.SAMEFAM_FLG
ne
1)
or
(GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=2 and GEN.SARESPSC_FLG ne 1))))
Universe: INCINTER_A IN (1,2,DK) or INCWRKO_A IN (1,2,DK)
Universe Description: Sample Adults 18+ and Sample Adult and Sample Child are in the same family
and the Sample Child INC section has not been completed OR the Sample
Adult and Sample Child are not in the same family OR Sample Adult and
Sample Child are in the same family, Sample Child respondent answered all
questions asked in the INC section with dk/rf and Sample Adult is not the
Page 382 of 430
Sample Child respondent and the Sample Adult did not refuse both the income
from wages and income from accounts questions
Question Text:
Response:
Fills:
In ^LASTYEAR, did ^YOUFAMHERE receive... Any public assistance or welfare
payments from the state or local welfare office?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
^LASTYEAR
Fill year prior to current year
^YOUFAMHERE
If PCNT_A=1 fill "you"
else if PCNT_A GT 1 fill "you or any family
members"
Skip Instructions: <1,2,RF,DK> [goto INCRETIRE_A]
Question ID: INC.0110.00.1
Variable name: INCRETIRE_A
Interview module: INC(Adult.INC)
Inherited Universe: (((GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=blank)
or
(GEN.SAMEFAM_FLG
ne
1)
or
(GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=2 and GEN.SARESPSC_FLG ne 1))) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(((GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=blank)
or
(GEN.SAMEFAM_FLG
ne
1)
or
(GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=2 and GEN.SARESPSC_FLG ne 1))))
Universe: INCINTER_A IN (1,2,DK) or INCWRKO_A IN (1,2,DK)
Universe Description: Sample Adults 18+ and Sample Adult and Sample Child are in the same family
and the Sample Child INC section has not been completed OR the Sample
Adult and Sample Child are not in the same family OR Sample Adult and
Sample Child are in the same family, Sample Child respondent answered all
questions asked in the INC section with dk/rf and Sample Adult is not the
Sample Child respondent and the Sample Adult did not refuse both the income
from wages and income from accounts questions
Question Text:
Read if necessary: In ^LASTYEAR, did ^YOUFAMHERE receive... Income from
retirement, survivor, or disability pensions?
Response:
Page 383 of 430
1.
2.
DK:
RF:
Fills:
Yes
No
Don't Know
Refused
^LASTYEAR
Fill year prior to current year
^YOUFAMHERE
If PCNT_A=1 fill "you"
else if PCNT_A GT 1 fill "you or any family
members"
Skip Instructions: <1,2,RF,DK> [goto INCOTHR_A]
Question ID: INC.0120.00.1
Variable name: INCOTHR_A
Interview module: INC(Adult.INC)
Inherited Universe: (((GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=blank)
or
(GEN.SAMEFAM_FLG
ne
1)
or
(GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=2 and GEN.SARESPSC_FLG ne 1))) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(((GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=blank)
or
(GEN.SAMEFAM_FLG
ne
1)
or
(GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=2 and GEN.SARESPSC_FLG ne 1))))
Universe: INCINTER_A IN (1,2,DK) or INCWRKO_A IN (1,2,DK)
Universe Description: Sample Adults 18+ and Sample Adult and Sample Child are in the same family
and the Sample Child INC section has not been completed OR the Sample
Adult and Sample Child are not in the same family OR Sample Adult and
Sample Child are in the same family, Sample Child respondent answered all
questions asked in the INC section with dk/rf and Sample Adult is not the
Sample Child respondent and the Sample Adult did not refuse both the income
from wages and income from accounts questions
Question Text:
Read if necessary: In ^LASTYEAR, did ^YOUFAMHERE receive... Any other
sources of income such as VA payments from the Veterans Benefits
Administration, unemployment compensation, child support, or alimony?
Response:
Page 384 of 430
1.
2.
DK:
RF:
Fills:
Yes
No
Don't Know
Refused
^YOUFAMHERE
If PCNT_A=1 fill "you"
else if PCNT_A GT 1 fill "you or any family
members"
^LASTYEAR
Fill year prior to current year
Skip Instructions: <1,2,RF,DK> [goto INCTOTAL_A]
Question ID: INC.0130.00.1
Variable name: INCTOTAL_A
Interview module: INC(Adult.INC)
Inherited Universe: (((GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=blank)
or
(GEN.SAMEFAM_FLG
ne
1)
or
(GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=2 and GEN.SARESPSC_FLG ne 1))) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(((GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=blank)
or
(GEN.SAMEFAM_FLG
ne
1)
or
(GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=2 and GEN.SARESPSC_FLG ne 1))))
Universe: INCINTER_A IN (1,2,DK) or INCWRKO_A IN (1,2,DK)
Universe Description: Sample Adults 18+ and Sample Adult and Sample Child are in the same family
and the Sample Child INC section has not been completed OR the Sample
Adult and Sample Child are not in the same family OR Sample Adult and
Sample Child are in the same family, Sample Child respondent answered all
questions asked in the INC section with dk/rf and Sample Adult is not the
Sample Child respondent and the Sample Adult did not refuse both the income
from wages and income from accounts questions
Question Text:
Response:
^INCALLFAM What is your best estimate of ^TOTALINCOME from all sources,
before taxes, in ^LASTYEAR? Enter '999995' if the reported income $999,995 or
greater.
DK:
RF:
Don't Know
Refused
Page 385 of 430
Fills:
^INCALLFAM
IF PCNT_A GT 1 fill "When answering this next
question, please remember to include your income
PLUS the income of all family members living in this
household."
^TOTALINCOME
If PCNT_A=1 fill "your total income" else if PCNT_A
GT 1 fill "the total income of all family members"
^LASTYEAR
Fill year prior to current year
Skip Instructions: <0-999> [goto ERR1_INCTOTAL_A]
<250001-999995> [goto ERR2_INCTOTAL_A]
<1000-250000> [goto next section]
[goto INC250PCT_A]
Check Name: ERR1_INCTOTAL_A
Text:
{signal ERR1_INCTOTAL_A} Do not read to the respondent.
unusually low. Make corrections if necessary.
^INCTOTAL_A is
Hard / Soft Edit: Soft
Fills:
^INCTOTAL_A
Fill value from INCTOTAL_A
Inherited Universe: (((GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=blank)
or
(GEN.SAMEFAM_FLG
ne
1)
or
(GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=2 and GEN.SARESPSC_FLG ne 1))) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(((GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=blank)
or
(GEN.SAMEFAM_FLG
ne
1)
or
(GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=2 and GEN.SARESPSC_FLG ne 1))))
Universe: INCTOTAL_A=0-999
Page 386 of 430
Check Name: ERR2_INCTOTAL_A
Text:
{signal ERR2_INCTOTAL_A} Do not read to the respondent.
unusually high. Make corrections if necessary.
^INCTOTAL_A is
Hard / Soft Edit: Soft
Fills:
^INCTOTAL_A
Fill value from INCTOTAL_A
Inherited Universe: (((GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=blank)
or
(GEN.SAMEFAM_FLG
ne
1)
or
(GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=2 and GEN.SARESPSC_FLG ne 1))) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(((GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=blank)
or
(GEN.SAMEFAM_FLG
ne
1)
or
(GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=2 and GEN.SARESPSC_FLG ne 1))))
Universe: INCTOTAL_A=250001-999995
Question ID: INC.0150.01.1
Variable name: INC250PCT_A
Interview module: INC(Adult.INC)
Inherited Universe: (((GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=blank)
or
(GEN.SAMEFAM_FLG
ne
1)
or
(GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=2 and GEN.SARESPSC_FLG ne 1))) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(((GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=blank)
or
(GEN.SAMEFAM_FLG
ne
1)
or
(GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=2 and GEN.SARESPSC_FLG ne 1))))
Universe: INCTOTAL_A IN (DK,RF)
Universe Description: Sample Adult 18+ who don't know or refuse the total family income and
Sample Adult and Sample Child are in the same family and the Sample Child
INC section has not been completed OR the Sample Adult and Sample Child
are not in the same family OR Sample Adult and Sample Child are in the same
family, Sample Child respondent answered all questions asked in the INC
section with dk/rf and Sample Adult is not the Sample Child respondent
Question Text:
Was your total ^FAMILY income from all sources less than ^250POVERTY_A or
^250POVERTY_A or more?
Page 387 of 430
Response:
Fills:
1.
2.
DK:
RF:
Less than ^250POVERTY_A
^250POVERTY_A or more
Don't Know
Refused
^FAMILY
If PCNT_A > 1 fill "family"
^250POVERTY_A
Fill value stored in Adult.INC.INC250FILL_A
Skip Instructions: <1> [goto INC138PCT_A]
<2> if GEN.PCNT_A=1 or (GEN.PCNT_A=2 and GEN.PCNT66UP_A ge 1)
[goto INC75K_A]
elseif ((GEN.PCNT_A=2 and GEN.PCNT66UP_A=0) or GEN.PCNT_A IN
(3,5)) [goto INC100K_A]
elseif GEN.PCNT_A=4 or GEN.PCNT_A ge 6 [goto INC400PCT_A]
[goto next section]
Question ID: INC.0160.01.1
Variable name: INC138PCT_A
Interview module: INC(Adult.INC)
Inherited Universe: (((GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=blank)
or
(GEN.SAMEFAM_FLG
ne
1)
or
(GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=2 and GEN.SARESPSC_FLG ne 1))) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(((GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=blank)
or
(GEN.SAMEFAM_FLG
ne
1)
or
(GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=2 and GEN.SARESPSC_FLG ne 1))))
Universe: INC250PCT_A=1
Universe Description: Sample Adult 18+ answered less than 250% of poverty threshold and Sample
Adult and Sample Child are in the same family and the Sample Child INC
section has not been completed OR the Sample Adult and Sample Child are
not in the same family OR Sample Adult and Sample Child are in the same
family, Sample Child respondent answered all questions asked in the INC
section with dk/rf and Sample Adult is not the Sample Child respondent
Question Text:
Was your total ^FAMILY income from all sources less than ^138POVERTY_A or
^138POVERTY_A or more?
Response:
Page 388 of 430
1.
2.
DK:
RF:
Fills:
Less than ^138POVERTY_A
^138POVERTY_A or more
Don't Know
Refused
^FAMILY
If PCNT_A > 1 fill "family"
^138POVERTY_A
Fill value stored in Adult.INC.INC138FILL_A
Skip Instructions: <1> [goto INC100PCT_A]
<2> [goto INC200PCT_A]
[goto next section]
Question ID: INC.0170.01.1
Variable name: INC100PCT_A
Interview module: INC(Adult.INC)
Inherited Universe: (((GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=blank)
or
(GEN.SAMEFAM_FLG
ne
1)
or
(GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=2 and GEN.SARESPSC_FLG ne 1))) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(((GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=blank)
or
(GEN.SAMEFAM_FLG
ne
1)
or
(GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=2 and GEN.SARESPSC_FLG ne 1))))
Universe: INC138PCT_A=1
Universe Description: Sample Adults 18+ who answered less than 138% of poverty threshold and
Sample Adult and Sample Child are in the same family and the Sample Child
INC section has not been completed OR the Sample Adult and Sample Child
are not in the same family OR Sample Adult and Sample Child are in the same
family, Sample Child respondent answered all questions asked in the INC
section with dk/rf and Sample Adult is not the Sample Child respondent
Question Text:
Was your total ^FAMILY income from all sources less than ^100POVERTY_A or
^100POVERTY_A or more?
Response:
Page 389 of 430
1.
2.
DK:
RF:
Fills:
Less than ^100POVERTY_A
^100POVERTY_A or more
Don't Know
Refused
^FAMILY
If PCNT_A > 1 fill "family"
^100POVERTY_A
Fill value stored in Adult.INC.INC100FILL_A
Skip Instructions: <1,2,RF,DK> [goto next section]
Question ID: INC.0180.01.1
Variable name: INC200PCT_A
Interview module: INC(Adult.INC)
Inherited Universe: (((GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=blank)
or
(GEN.SAMEFAM_FLG
ne
1)
or
(GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=2 and GEN.SARESPSC_FLG ne 1))) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(((GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=blank)
or
(GEN.SAMEFAM_FLG
ne
1)
or
(GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=2 and GEN.SARESPSC_FLG ne 1))))
Universe: INC138PCT_A=2
Universe Description: Sample Adults 18+ who answered 138% of poverty or more and Sample Adult
and Sample Child are in the same family and the Sample Child INC section
has not been completed OR the Sample Adult and Sample Child are not in the
same family OR Sample Adult and Sample Child are in the same family,
Sample Child respondent answered all questions asked in the INC section with
dk/rf and Sample Adult is not the Sample Child respondent
Question Text:
Was your total ^FAMILY income from all sources less than ^200POVERTY_A or
^200POVERTY_A or more?
Response:
Page 390 of 430
1.
2.
DK:
RF:
Fills:
Less than ^200POVERTY_A
^200POVERTY_A or more
Don't Know
Refused
^FAMILY
If PCNT_A > 1 fill "family"
^200POVERTY_A
Fill value stored in Adult.INC.INC200FILL_A
Skip Instructions: <1> if GEN.PCNT_A=9+ [goto INC100K_A]
else [goto next section]
<2,RF,DK> [goto next section]
Question ID: INC.0190.00.1
Variable name: INC75K_A
Interview module: INC(Adult.INC)
Inherited Universe: (((GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=blank)
or
(GEN.SAMEFAM_FLG
ne
1)
or
(GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=2 and GEN.SARESPSC_FLG ne 1))) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(((GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=blank)
or
(GEN.SAMEFAM_FLG
ne
1)
or
(GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=2 and GEN.SARESPSC_FLG ne 1))))
Universe: INC250PCT_A=2 and (GEN.PCNT_A=1
GEN.PCNT66UP_A ge 1))
or
(GEN.PCNT_A=2
and
Universe Description: Sample Adults 18+ who answered 250% of poverty threshold or more and is
from a 1 person family or is from a 2 person family and at least one adult is
66+ and Sample Adult and Sample Child are in the same family and the
Sample Child INC section has not been completed OR the Sample Adult and
Sample Child are not in the same family OR Sample Adult and Sample Child
are in the same family, Sample Child respondent answered all questions
asked in the INC section with dk/rf and Sample Adult is not the Sample Child
respondent
Question Text:
Was your total ^FAMILY income from all sources less than $75,000 or $75,000
or more?
Response:
Page 391 of 430
1.
2.
DK:
RF:
Fills:
Less than $75,000
$75,000 or more
Don't Know
Refused
^FAMILY
If PCNT_A > 1 fill "family"
Skip Instructions: <1> [goto INC400PCT_A]
<2> [goto INC100K_A]
[goto next section]
Question ID: INC.0200.00.1
Variable name: INC100K_A
Interview module: INC(Adult.INC)
Inherited Universe: (((GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=blank)
or
(GEN.SAMEFAM_FLG
ne
1)
or
(GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=2 and GEN.SARESPSC_FLG ne 1))) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(((GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=blank)
or
(GEN.SAMEFAM_FLG
ne
1)
or
(GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=2 and GEN.SARESPSC_FLG ne 1))))
Universe: INC75K_A=2 or (INC250PCT_A=2 and (GEN.PCNT_A IN (3,5) or
(GEN.PCNT_A=2 and GEN.PCNT66UP_A=0))) or (INC200PCT_A=1 and
GEN.PCNT_A ge 9)
Universe Description: Sample Adults 18+ who answered $75,000 or more OR answered 250% of
poverty threshold or more and is from a 3 or 5 person family or is from a 2
person family and both adults are less than 66 years old OR answered 200%
of poverty threshold and is from a family of 9 or more people and Sample Adult
and Sample Child are in the same family and the Sample Child INC section
has not been completed OR the Sample Adult and Sample Child are not in the
same family OR Sample Adult and Sample Child are in the same family,
Sample Child respondent answered all questions asked in the INC section with
dk/rf and Sample Adult is not the Sample Child respondent
Question Text:
Was your total ^FAMILY income from all sources less than $100,000 or
$100,000 or more?
Response:
Page 392 of 430
1.
2.
DK:
RF:
Fills:
Less than $100,000
$100,000 or more
Don't Know
Refused
^FAMILY
If PCNT_A > 1 fill "family"
Skip Instructions: <1> if GEN.PCNT_A=3 or (GEN.PCNT_A=2 and GEN.PCNT66UP_A=0) [goto
INC400PCT_A]
else [goto next section]
<2> if GEN.PCNT_A IN (1,2,3) [goto INC150K_A]
elseif GEN.PCNT_A=5 [goto INC400PCT_A]
elseif GEN.PCNT_A ge 9 [goto next section]
[goto next section]
Question ID: INC.0210.01.1
Variable name: INC400PCT_A
Interview module: INC(Adult.INC)
Inherited Universe: (((GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=blank)
or
(GEN.SAMEFAM_FLG
ne
1)
or
(GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=2 and GEN.SARESPSC_FLG ne 1))) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(((GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=blank)
or
(GEN.SAMEFAM_FLG
ne
1)
or
(GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=2 and GEN.SARESPSC_FLG ne 1))))
Universe: (INC75K_A=1 or (INC100K_A=1 and (GEN.PCNT_A=3 or (GEN.PCNT_A=2
and GEN.PCNT66UP_A=0))) or (INC100K_A=2 and GEN.PCNT_A=5) or
(INC250PCT_A=2 and (GEN.PCNT_A=4 or GEN.PCNT_A ge 6)))
Universe Description: Sample Adults 18+ and answered less than $75,000
OR
answered less than $100,000 and is from a 3 person family
OR
answered $100,000 or more and is from a 5 person family or 2 person family
and both adults are less than 66 yers old or answered 250% of poverty
threshold or more and is from a 4 or 6+ person family
and Sample Adult and Sample Child are in the same family and the Sample
Child INC section has not been completed OR the Sample Adult and Sample
Child are not in the same family OR Sample Adult and Sample Child are in the
same family, Sample Child respondent answered all questions asked in the
INC section with dk/rf and Sample Adult is not the Sample Child respondent
Question Text:
Was your total ^FAMILY income from all sources less than ^400POVERTY_A or
^400POVERTY_A or more?
Page 393 of 430
Response:
Fills:
1.
2.
DK:
RF:
Less than ^400POVERTY_A
^400POVERTY_A or more
Don't Know
Refused
^FAMILY
If PCNT_A > 1 fill "family"
^400POVERTY_A
Fill value stored in Adult.INC.INC400FILL_A
Skip Instructions: <1> if GEN.PCNT_A IN (7,8) [goto INC150K_A]
else [goto next section]
<2> if GEN.PCNT_A IN (1,2,3) or GEN.PCNT_A ge 6 [goto next section]
else if GEN.PCNT IN (4,5) [goto INC150K_A]
[goto next section]
Question ID: INC.0220.00.1
Variable name: INC150K_A
Interview module: INC(Adult.INC)
Inherited Universe: (((GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=blank)
or
(GEN.SAMEFAM_FLG
ne
1)
or
(GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=2 and GEN.SARESPSC_FLG ne 1))) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(((GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=blank)
or
(GEN.SAMEFAM_FLG
ne
1)
or
(GEN.SAMEFAM_FLG=1
and
GEN.INC_FLG_C=2 and GEN.SARESPSC_FLG ne 1))))
Universe: (INC100K_A=2 and GEN.PCNT_A IN (1,2,3)) or (INC400PCT_A=2 and
GEN.PCNT_A IN (4,5)) or (INC400PCT_A=1 and GEN.PCNT_A IN (7,8))
Universe Description: Sample Adults 18+
answered $100,000 or more and is from 1,2 or 3 person family OR
respondent answered 400% of poverty or more and is from 4 or 5 person
family OR respondent answered less than 400% of poverty and is from a
family of 7 or 8 persons
and Sample Adult and Sample Child are in the same family and the Sample
Child INC section has not been completed OR
the Sample Adult and Sample Child are not in the same family OR
Sample Adult and Sample Child are in the same family, Sample Child
respondent answered all questions asked in the INC section with dk/rf and
Sample Adult is not the Sample Child respondent
Question Text:
Was your total ^FAMILY income from all sources less than $150,000 or
$150,000 or more?
Page 394 of 430
Response:
Fills:
1.
2.
DK:
RF:
Less than $150,000
$150,000 or more
Don't Know
Refused
^FAMILY
If PCNT_A > 1 fill "family"
Skip Instructions: <1,2,RF,DK> [goto next section]
Question ID: FOO.0010.00.1
Variable name: FSNAP12M_A
Interview module: FOO(Adult.FOO)
Inherited Universe: (FINISH_FOO_A ne 1) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(FINISH_FOO_A ne 1))
Universe: ((GEN.SAMEFAM_FLG=1
and
GEN.FOO_FLG_C=blank)
(GEN.SAMEFAM_FLG
ne
1)
or
(GEN.SAMEFAM_FLG=1
GEN.FOO_FLG_C=2 and GEN.SARESPSC_FLG NE 1))
or
and
Universe Description: Sample Adults 18+ where the Sample Adult and Sample Child are in the same
family and the Sample Child FOO section has not been completed OR the
Sample Adult and Sample Child are not in the same family OR Sample Adult
and Sample Child are in the same family and all questions in the Sample Child
FOO section was answered with refused or don't know and the Sample Adult
is not the Sample Child respondent
Question Text:
Response:
At any time in the last 12 months did ^YOUFAMLVHERE_A receive
^FSSNAPNM? Read if necessary: This program puts money on a SNAP EBT card
that you can only use to buy food.
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Page 395 of 430
Fills:
^FSSNAPNM
If AL then fill "Food Assistance Program or food
stamp benefits"
If AK then fill "SNAP or food stamp benefits"
If AZ then fill "Nutrition Assistance or food stamp
benefits"
If AR then fill "SNAP or food stamp benefits"
If CA then fill "CalFresh or food stamp benefits"
If CO then fill "SNAP or food stamp benefits"
If CT then fill "SNAP or food stamp benefits"
If DE then fill "Food Supplement Program or food
stamp benefits"
If DC then fill "SNAP or food stamp benefits"
If FL then fill "SNAP or food stamp benefits"
If GA then fill "Georgia Food Stamp Program or food
stamp benefits"
If HI then fill "SNAP or food stamp benefits"
If ID then fill "SNAP or food stamp benefits"
If IL then fill "SNAP or food stamp benefits"
If IN then fill "SNAP or food stamp benefits"
If IA then fill "SNAP or food stamp benefits"
If KS then fill "Food Assistance Program or food
stamp benefits"
If KY then fill "SNAP or food stamp benefits"
If LA then fill "SNAP or food stamp benefits"
If ME then fill "Food Supplement Program or food
stamp benefits"
If MD then fill "SNAP or food stamp benefits"
If MA then fill "SNAP or food stamp benefits"
If MI then fill "Food Assistance Program (FSP) or
food stamp benefits"
If MN then fill "SNAP or food stamp benefits"
If MS then fill "SNAP or food stamp benefits"
If MO then fill "SNAP or food stamp benefits"
If MT then fill "SNAP or food stamp benefits"
If NE then fill "SNAP or food stamp benefits"
If NV then fill "SNAP or food stamp benefits"
If NH then fill "SNAP or food stamp benefits"
If NJ then fill "NJ SNAP or food stamp benefits"
If NM then fill "SNAP or food stamp benefits"
If NY then fill "SNAP or food stamp benefits"
If NC then fill "Food and Nutrition Services or food
stamp benefits"
If ND then fill "SNAP or food stamp benefits"
If OH then fill "SNAP or food stamp benefits"
If OK then fill "SNAP or food stamp benefits"
If OR then fill "SNAP or food stamp benefits"
If PA then fill "SNAP or food stamp benefits"
Page 396 of 430
If RI then fill "SNAP or food stamp benefits"
If SC then fill "SNAP or food stamp benefits"
If SD then fill "SNAP or food stamp benefits"
If TN then fill "SNAP or food stamp benefits"
If TX then fill "SNAP or food stamp benefits"
If UT then fill "SNAP or food stamp benefits"
If VT then fill "3SquaresVT or food stamp benefits"
If VA then fill "SNAP or food stamp benefits"
If WA then fill "Basic Food or food stamp benefits"
If WV then fill "SNAP or food stamp benefits"
If WI then fill "FoodShare Wisconsin or food stamp
benefits"
If WY then fill "SNAP or food stamp benefits"
^YOUFAMLVHERE_A
If GEN.PCNT_A=1, fill: "you";
elseif
GEN.PCNT_A
gt
1
and
Roster.HHC.tblNAME.bPerson[PX_A].ONOFFCAMP
US ne 1, fill: "any family members living here"
elseif
GEN.PCNT_A
gt
1
and
Roster.HHC.tblNAME.bPerson[PX_A].ONOFFCAMP
US=1, fill "you or any family members living at ^HNO
^HNOSUF ^STRNAME"
Skip Instructions: <1> [goto FSNAP30D_A]
<2,RF,DK> if PCNTF1255_A ge 1 or PCNTC05_A ge 1 [goto FWIC12M_A]
else if PCNTC517_A ge 1 [goto FLUNCH12M1_A]
else [goto FINISH_FOO_A]
Question ID: FOO.0020.00.3
Variable name: FSNAP30D_A
Interview module: FOO(Adult.FOO)
Inherited Universe: (FINISH_FOO_A ne 1) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(FINISH_FOO_A ne 1))
Universe: FSNAP12M_A=1
Universe Description: Sample Adults 18+ living in families where someone received food stamps in
the last 12 months
Question Text:
Did ^YOUFAMLVHERE_A receive ^FSSNAPNM in the LAST 30 days? Read if
necessary: This program puts money on a SNAP EBT card that you can only use to
buy food.
Page 397 of 430
Response:
Fills:
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
^YOUFAMLVHERE_A
If GEN.PCNT_A=1, fill: "you";
elseif
GEN.PCNT_A
gt
1
and
Roster.HHC.tblNAME.bPerson[PX_A].ONOFFCAMP
US ne 1, fill: "any family members living here"
elseif
GEN.PCNT_A
gt
1
and
Roster.HHC.tblNAME.bPerson[PX_A].ONOFFCAMP
US=1, fill "you or any family members living at ^HNO
^HNOSUF ^STRNAME"
^FSSNAPNM
If AL then fill "Food Assistance Program or food
stamp benefits"
If AK then fill "SNAP or food stamp benefits"
If AZ then fill "Nutrition Assistance or food stamp
benefits"
If AR then fill "SNAP or food stamp benefits"
If CA then fill "CalFresh or food stamp benefits"
If CO then fill "SNAP or food stamp benefits"
If CT then fill "SNAP or food stamp benefits"
If DE then fill "Food Supplement Program or food
stamp benefits"
If DC then fill "SNAP or food stamp benefits"
If FL then fill "SNAP or food stamp benefits"
If GA then fill "Georgia Food Stamp Program or food
stamp benefits"
If HI then fill "SNAP or food stamp benefits"
If ID then fill "SNAP or food stamp benefits"
If IL then fill "SNAP or food stamp benefits"
If IN then fill "SNAP or food stamp benefits"
If IA then fill "SNAP or food stamp benefits"
If KS then fill "Food Assistance Program or food
stamp benefits"
If KY then fill "SNAP or food stamp benefits"
If LA then fill "SNAP or food stamp benefits"
If ME then fill "Food Supplement Program or food
stamp benefits"
If MD then fill "SNAP or food stamp benefits"
If MA then fill "SNAP or food stamp benefits"
If MI then fill "Food Assistance Program (FSP) or
food stamp benefits"
If MN then fill "SNAP or food stamp benefits"
If MS then fill "SNAP or food stamp benefits"
If MO then fill "SNAP or food stamp benefits"
If MT then fill "SNAP or food stamp benefits"
Page 398 of 430
If NE then fill "SNAP or food stamp benefits"
If NV then fill "SNAP or food stamp benefits"
If NH then fill "SNAP or food stamp benefits"
If NJ then fill "NJ SNAP or food stamp benefits"
If NM then fill "SNAP or food stamp benefits"
If NY then fill "SNAP or food stamp benefits"
If NC then fill "Food and Nutrition Services or food
stamp benefits"
If ND then fill "SNAP or food stamp benefits"
If OH then fill "SNAP or food stamp benefits"
If OK then fill "SNAP or food stamp benefits"
If OR then fill "SNAP or food stamp benefits"
If PA then fill "SNAP or food stamp benefits"
If RI then fill "SNAP or food stamp benefits"
If SC then fill "SNAP or food stamp benefits"
If SD then fill "SNAP or food stamp benefits"
If TN then fill "SNAP or food stamp benefits"
If TX then fill "SNAP or food stamp benefits"
If UT then fill "SNAP or food stamp benefits"
If VT then fill "3SquaresVT or food stamp benefits"
If VA then fill "SNAP or food stamp benefits"
If WA then fill "Basic Food or food stamp benefits"
If WV then fill "SNAP or food stamp benefits"
If WI then fill "FoodShare Wisconsin or food stamp
benefits"
If WY then fill "SNAP or food stamp benefits"
Skip Instructions: <1,2,RF,DK> if PCNTF1255_A ge 1 or PCNTC05_A ge 1 [goto FWIC12M_A]
else if PCNTC517_A ge 1 [goto FLUNCH12M1_A];
else [goto FINISH_FOO_A]
Page 399 of 430
Question ID: FOO.0030.00.1
Variable name: FWIC12M_A
Interview module: FOO(Adult.FOO)
Inherited Universe: (FINISH_FOO_A ne 1) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(FINISH_FOO_A ne 1))
Universe: (PCNTF1255_A ge 1 or PCNTC05_A ge 1) AND
((GEN.SAMEFAM_FLG=1 and GEN.FOO_FLG_C=blank) or
(GEN.SAMEFAM_FLG ne 1) or
(GEN.SAMEFAM_FLG=1
and
GEN.FOO_FLG_C=2
GEN.SARESPSC_FLG NE 1) or
(GEN.SAMFAM_FLG=1
and
GEN.FOO_FLG_C=1
Child.FOO.FWIC12M_C = EMPTY))
and
and
Universe Description: Sample Adults 18+ living in families with females 12-55 years of age or
children 0-5 years of age AND the Sample Adult and Sample Child are in the
same family and the Sample Child FOO section has not been completed OR
the Sample Adult and Sample Child are not in the same family OR Sample
Adult and Sample Child are in the same family and all questions in the Sample
Child FOO section was answered with refused or don't know and the Sample
Adult is not the sample child respondent OR the Sample Adult and Sample
Child are in the same family and at least one question asked in Sample Child
FOO section has a valid answer (not dk/rf) and the received WIC benefits
question was not asked in the Sample Child FOO section
Question Text:
Response:
Fills:
At any time in the last 12 months did ^YOUFAMLVHERE_A receive benefits
from the WIC program, that is, the Women, Infants, and Children program?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
^YOUFAMLVHERE_A
If GEN.PCNT_A=1, fill: "you";
elseif
GEN.PCNT_A
gt
1
and
Roster.HHC.tblNAME.bPerson[PX_A].ONOFFCAMP
US ne 1, fill: "any family members living here"
elseif
GEN.PCNT_A
gt
1
and
Roster.HHC.tblNAME.bPerson[PX_A].ONOFFCAMP
US=1, fill "you or any family members living at ^HNO
^HNOSUF ^STRNAME"
Page 400 of 430
Skip Instructions: <1,2,RF,DK> if PCNTC517_A ge 1 [goto FLUNCH12M1_A]
else [goto FINISH_FOO_A]
Question ID: FOO.0040.00.1
Variable name: FLUNCH12M1_A
Interview module: FOO(Adult.FOO)
Inherited Universe: (FINISH_FOO_A ne 1) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(FINISH_FOO_A ne 1))
Universe: PCNTC517_A
ge
1
AND
((GEN.SAMEFAM_FLG=1
GEN.FOO_FLG_C=blank)
or
(GEN.SAMEFAM_FLG
ne
1)
(GEN.SAMEFAM_FLG=1
and
GEN.FOO_FLG_C=2
GEN.SARESPSC_FLG NE 1))
and
or
and
Universe Description: Sample Adults 18+ living in families with children between the ages of 5-17
and the Sample Adult and Sample Child are in the same family and the
Sample Child FOO section has not been completed OR the Sample Adult and
Sample Child are not in the same family OR the Sample Adult and Sample
Child are in the same family and all questions in the Sample Child FOO
section was answered with refused or don't know and the sample adult is not
the sample child respondent
Question Text:
Response:
At any time in the last 12 months, did ^SCCHILDFAM_A receive free or
reduced-price breakfasts or lunches at school? Read if necessary: The
National School Lunch Program and the School Breakfast Program provide cash
assistance to states to operate breakfast and lunch programs in schools and
residential childcare institutions. The programs provide low-price or free breakfasts
and lunches to low-income children in kindergarten through 12th grade.
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Page 401 of 430
Fills:
^SCCHILDFAM_A
if PCNT517_A=1, fill: ^ALIASNAME of child in
Sample Adult family,
elseif PCNT517_Agt 1, fill "any child in your family",
Skip Instructions: <1,2,RF,DK> [goto FINISH_FOO_A]
Question ID: FOO.0050.00.1
Variable name: FINISH_FOO_A
Interview module: FOO(Adult.FOO)
Inherited Universe: (FINISH_FOO_A ne 1) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(FINISH_FOO_A ne 1))
Universe: FOO_FINISH_A = EMPTY AND
((GEN.SAMEFAM_FLG=1 and GEN.FOO_FLG_C=blank) or
(GEN.SAMEFAM_FLG ne 1) or
(GEN.SAMEFAM_FLG=1
and
GEN.FOO_FLG_C=2
and
GEN.SARESPSC_FLG NE 1) or
(GEN.SAMFAM_FLG=1
and
GEN.FOO_FLG_C=1
and
Child.FOO.FWIC12M_C = EMPTY and (PCNTF1255_A ge 1 or PCNTC05_A
ge 1) ))
Universe Description: Sample Adults 18+ where the Sample Adult FOO section has not been
completed AND the Sample Adult and Sample Child are in the same family
and the Sample Child FOO section has not been completed OR the Sample
Adult and Sample Child are not in the same family OR Sample Adult and
Sample Child are in the same family and all questions in the Sample Child
FOO section was answered with refused or don't know and the sample adult is
not the sample child respondent the OR Sample Adult and Sample Child are in
the same family and at least one question asked in Sample Child FOO section
has a valid answer (not dk/rf) and the received WIC benefits question was not
asked in the Sample Child FOO section and within the family exist at least one
female 12-55 years of age or child 0-5 years of age
Question Text:
The Sample Adult food related programs section is now complete.
continue.
Response:
Page 402 of 430
Enter '1' to
1.
Enter 1 to Continue
Skip Instructions: <1> [goto next section]
Question ID: FDS.0010.00.3
Variable name: FDSINTRO_A
Interview module: FDS(Adult.FDS)
Inherited Universe: (((GEN.SAMEFAM_FLG ne 1)
OR (GEN.SAMEFAM_FLG=1 and GEN.FDS_FLG_C=empty)
OR
(GEN.SAMEFAM_FLG=1
and
GEN.FDS_FLG_C=2
and
GEN.SARESPSC_FLG ne 1))) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(((GEN.SAMEFAM_FLG ne 1)
OR (GEN.SAMEFAM_FLG=1 and GEN.FDS_FLG_C=empty)
OR
(GEN.SAMEFAM_FLG=1
and
GEN.FDS_FLG_C=2
and
GEN.SARESPSC_FLG ne 1))))
Universe Description: Sample Child and Sample Adult are not in the same family
OR Sample Child and Sample Adult are in the same family AND Sample Child
FDS section has not been completed
OR the Sample Adult and Sample Child are in the same family and every
question asked in the Sample Child FDS section was answered with RF/DK
and the person answering the SC interview and the SA are different people.
Question Text:
Response:
Fills:
These next questions are about whether ^youyourfamily_A ^waswere always
able to afford the food you needed in the last 30 days. I'm going to read you
several 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 ^youyourfamily_A in the last 30 days. Enter '1' to
continue.
1.
Enter 1 to Continue
^youyourfamily_A
If PCNT_A=1 "you"
else "your family"
^waswere
If PCNT_A=1 "were"
else "was"
Page 403 of 430
Skip Instructions: <1> [goto FDSRUNOUT_A]
Question ID: FDS.0020.00.3
Variable name: FDSRUNOUT_A
Interview module: FDS(Adult.FDS)
Inherited Universe: (((GEN.SAMEFAM_FLG ne 1)
OR (GEN.SAMEFAM_FLG=1 and GEN.FDS_FLG_C=empty)
OR
(GEN.SAMEFAM_FLG=1
and
GEN.FDS_FLG_C=2
and
GEN.SARESPSC_FLG ne 1))) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(((GEN.SAMEFAM_FLG ne 1)
OR (GEN.SAMEFAM_FLG=1 and GEN.FDS_FLG_C=empty)
OR
(GEN.SAMEFAM_FLG=1
and
GEN.FDS_FLG_C=2
and
GEN.SARESPSC_FLG ne 1))))
Universe Description: The Sample Child and Sample Adult are not in the same family
OR Sample Child and Sample Adult are in the same family AND Sample Child
FDS section has not been completed
OR the Sample Adult and Sample Child are in the same family and every
question asked in the Sample Child FDS section was answered with RF/DK
and the person answering the SC interview and the SA are different people.
Question Text:
Response:
Fills:
The first statement is "^IWe_A worried whether ^myour_A food would run out
before ^Iwe_A got money to buy more." Was that often true, sometimes true,
or never true for ^youyourfamily_A in the last 30 days?
1.
2.
3.
DK:
RF:
Often true
Sometimes true
Never true
Don't Know
Refused
^preocupar_A
Spanish only
^youyourfamily_A
If PCNT_A=1 "you"
else "your family"
^IWe_A
If PCNT_A=1 fill: "I"
else fill:"We"
^myour_A
If PCNT_A=1 fill: "my"
else fill: "our"
^Iwe_A
If PCNT_A=1 fill "I"
else fill "we"
Page 404 of 430
Skip Instructions: <1-3,RF,DK> [goto FDSLAST_A]
Question ID: FDS.0030.00.3
Variable name: FDSLAST_A
Interview module: FDS(Adult.FDS)
Inherited Universe: (((GEN.SAMEFAM_FLG ne 1)
OR (GEN.SAMEFAM_FLG=1 and GEN.FDS_FLG_C=empty)
OR
(GEN.SAMEFAM_FLG=1
and
GEN.FDS_FLG_C=2
and
GEN.SARESPSC_FLG ne 1))) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(((GEN.SAMEFAM_FLG ne 1)
OR (GEN.SAMEFAM_FLG=1 and GEN.FDS_FLG_C=empty)
OR
(GEN.SAMEFAM_FLG=1
and
GEN.FDS_FLG_C=2
and
GEN.SARESPSC_FLG ne 1))))
Universe Description: The Sample Child and Sample Adult are not in the same family
OR Sample Child and Sample Adult are in the same family AND Sample Child
FDS section has not been completed
OR the Sample Adult and Sample Child are in the same family and every
question asked in the Sample Child FDS section was answered with RF/DK
and the person answering the SC interview and the SA are different people.
Question Text:
Response:
Fills:
"The food that ^Iwe_A bought just didn't last, and ^Iwe_A didn't have money to
get more." Was that often true, sometimes true, or never true for
^youyourfamily_A in the last 30 days?
1.
2.
3.
DK:
RF:
Often true
Sometimes true
Never true
Don't Know
Refused
^comprar_A
Spanish Only
^TENER_A
Spanish Only
^youyourfamily_A
If PCNT_A=1 "you"
else "your family"
^Iwe_A
If PCNT_A=1 fill "I"
else fill "we"
Page 405 of 430
Skip Instructions: <1-3,RF,DK> [goto FDSBALANCE_A]
Question ID: FDS.0040.00.3
Variable name: FDSBALANCE_A
Interview module: FDS(Adult.FDS)
Inherited Universe: (((GEN.SAMEFAM_FLG ne 1)
OR (GEN.SAMEFAM_FLG=1 and GEN.FDS_FLG_C=empty)
OR
(GEN.SAMEFAM_FLG=1
and
GEN.FDS_FLG_C=2
and
GEN.SARESPSC_FLG ne 1))) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(((GEN.SAMEFAM_FLG ne 1)
OR (GEN.SAMEFAM_FLG=1 and GEN.FDS_FLG_C=empty)
OR
(GEN.SAMEFAM_FLG=1
and
GEN.FDS_FLG_C=2
and
GEN.SARESPSC_FLG ne 1))))
Universe Description: The Sample Child and Sample Adult are not in the same family
OR Sample Child and Sample Adult are in the same family AND Sample Child
FDS section has not been completed
OR the Sample Adult and Sample Child are in the same family and every
question asked in the Sample Child FDS section was answered with RF/DK
and the person answering the SC interview and the SA are different people.
Question Text:
Response:
Fills:
^IWe_A couldn't afford to eat balanced meals." Was that often true, sometimes
true, or never true for ^youyourfamily_A in the last 30 days?
1.
2.
3.
DK:
RF:
Often true
Sometimes true
Never true
Don't Know
Refused
^TENER_A
Spanish Only
^youyourfamily_A
If PCNT_A=1 "you"
else "your family"
^IWe_A
If PCNT_A=1 fill: "I"
else fill:"We"
Page 406 of 430
Skip Instructions: <1-2> [goto FDSSKIP_A]
<3,RF,DK> if FDSRUNOUT_A IN (1,2) OR FDSLAST_A IN (1,2) [goto
FDSSKIP_A];
else [goto next section]
Question ID: FDS.0050.00.3
Variable name: FDSSKIP_A
Interview module: FDS(Adult.FDS)
Inherited Universe: (((GEN.SAMEFAM_FLG ne 1)
OR (GEN.SAMEFAM_FLG=1 and GEN.FDS_FLG_C=empty)
OR
(GEN.SAMEFAM_FLG=1
and
GEN.FDS_FLG_C=2
and
GEN.SARESPSC_FLG ne 1))) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(((GEN.SAMEFAM_FLG ne 1)
OR (GEN.SAMEFAM_FLG=1 and GEN.FDS_FLG_C=empty)
OR
(GEN.SAMEFAM_FLG=1
and
GEN.FDS_FLG_C=2
and
GEN.SARESPSC_FLG ne 1))))
Universe: FDSRUNOUT_A IN (1,2) or FDSLAST_A IN (1,2) or FDSBALANCE_A IN (1,2)
Universe Description: The Sample Child and Sample Adult are not in the same family
OR Sample Child and Sample Adult are in the same family AND Sample Child
FDS section has not been completed
OR the Sample Adult and Sample Child are in the same family and every
question asked in the Sample Child FDS section was answered with RF/DK
and the person answering the SC interview and the SA are different people
and respondent answered often true or sometimes true in the last 30 days they
worried that food would run out before they got money to buy more, or that the
food that was bought didn't last and they didn't have money to get more or
couldn't afford to eat balanced meals
Question Text:
In the last 30 days, did ^youorother_A ever cut the size of your meals or skip
meals because there wasn't enough money for food?
Response:
Page 407 of 430
1.
2.
DK:
RF:
Fills:
Yes
No
Don't Know
Refused
^youorother_A
If PCNT18UP_A=1: fill "you"
else "you or other adults in your family"
^dejar_A
Spanish only
Skip Instructions: <1> [goto FDSSKIPDYS_A]
<2,RF,DK> [goto FDSLESS_A]
Question ID: FDS.0060.00.3
Variable name: FDSSKIPDYS_A
Interview module: FDS(Adult.FDS)
Inherited Universe: (((GEN.SAMEFAM_FLG ne 1)
OR (GEN.SAMEFAM_FLG=1 and GEN.FDS_FLG_C=empty)
OR
(GEN.SAMEFAM_FLG=1
and
GEN.FDS_FLG_C=2
and
GEN.SARESPSC_FLG ne 1))) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(((GEN.SAMEFAM_FLG ne 1)
OR (GEN.SAMEFAM_FLG=1 and GEN.FDS_FLG_C=empty)
OR
(GEN.SAMEFAM_FLG=1
and
GEN.FDS_FLG_C=2
and
GEN.SARESPSC_FLG ne 1))))
Universe: FDSSKIP_A=1
Universe Description: The Sample Child and Sample Adult are not in the same family
OR Sample Child and Sample Adult are in the same family AND Sample Child
FDS section has not been completed
OR the Sample Adult and Sample Child are in the same family and every
question asked in the Sample Child FDS section was answered with RF/DK
and the person answering the SC interview and the SA are different people
and respondent said that they or other adults in their family cut the size of their
meals or skipped meals due to cost.
Question Text:
Response:
In the last 30 days, how many days did this happen?
DK:
RF:
Don't Know
Refused
Page 408 of 430
Skip Instructions: <1-30,RF,DK> [goto FDSLESS_A]
Question ID: FDS.0070.00.3
Variable name: FDSLESS_A
Interview module: FDS(Adult.FDS)
Inherited Universe: (((GEN.SAMEFAM_FLG ne 1)
OR (GEN.SAMEFAM_FLG=1 and GEN.FDS_FLG_C=empty)
OR
(GEN.SAMEFAM_FLG=1
and
GEN.FDS_FLG_C=2
and
GEN.SARESPSC_FLG ne 1))) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(((GEN.SAMEFAM_FLG ne 1)
OR (GEN.SAMEFAM_FLG=1 and GEN.FDS_FLG_C=empty)
OR
(GEN.SAMEFAM_FLG=1
and
GEN.FDS_FLG_C=2
and
GEN.SARESPSC_FLG ne 1))))
Universe: FDSRUNOUT_A IN (1,2) or FDSLAST_A IN (1,2) or FDSBALANCE_A IN (1,2)
Universe Description: The Sample Child and Sample Adult are not in the same family
OR Sample Child and Sample Adult are in the same family AND Sample Child
FDS section has not been completed
OR the Sample Adult and Sample Child are in the same family and every
question asked in the Sample Child FDS section was answered with RF/DK
and the person answering the SC interview and the SA are different people
and respondent answered often true or sometimes true that in the last 30 days
they worried that food would run out before they got money to buy more, or
that the food that was bought didn't last and they didn't have money to get
more or couldn't afford to eat balanced meals.
Question Text:
Response:
In the last 30 days, did ^youorother_A ever eat less than you felt you should
because there wasn't enough money for food?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Page 409 of 430
Fills:
^COMER_A
Spanish Only
^pensar_A
Spanish only
^youorother_A
If PCNT18UP_A=1: fill "you"
else "you or other adults in your family"
Skip Instructions: <1,2,RF,DK> [goto FDSHUNGRY_A]
Question ID: FDS.0080.00.3
Variable name: FDSHUNGRY_A
Interview module: FDS(Adult.FDS)
Inherited Universe: (((GEN.SAMEFAM_FLG ne 1)
OR (GEN.SAMEFAM_FLG=1 and GEN.FDS_FLG_C=empty)
OR
(GEN.SAMEFAM_FLG=1
and
GEN.FDS_FLG_C=2
and
GEN.SARESPSC_FLG ne 1))) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(((GEN.SAMEFAM_FLG ne 1)
OR (GEN.SAMEFAM_FLG=1 and GEN.FDS_FLG_C=empty)
OR
(GEN.SAMEFAM_FLG=1
and
GEN.FDS_FLG_C=2
and
GEN.SARESPSC_FLG ne 1))))
Universe: FDSRUNOUT_A IN (1,2) or FDSLAST_A IN (1,2) or FDSBALANCE_A IN (1,2)
Universe Description: The Sample Child and Sample Adult are not in the same family
OR Sample Child and Sample Adult are in the same family AND Sample Child
FDS section has not been completed
OR the Sample Adult and Sample Child are in the same family and every
question asked in the Sample Child FDS section was answered with RF/DK
and the person answering the SC interview and the SA are different people
and respondent answered often true or sometimes true that in the last 30 days
they worried that food would run out before they got money to buy more, or
that the food that was bought didn't last and they didn't have money to get
more or couldn't afford to eat balanced meals.
Question Text:
In the last 30 days, were ^youorother_A ever hungry but didn't eat because
there wasn't enough money for food?
Response:
Page 410 of 430
1.
2.
DK:
RF:
Fills:
Yes
No
Don't Know
Refused
^estar_A
Spanish Only
^youorother_A
If PCNT18UP_A=1: fill "you"
else "you or other adults in your family"
^COMER_A
Spanish Only
Skip Instructions: <1,2,RF,DK> [goto FDSWEIGHT_A]
Question ID: FDS.0090.00.3
Variable name: FDSWEIGHT_A
Interview module: FDS(Adult.FDS)
Inherited Universe: (((GEN.SAMEFAM_FLG ne 1)
OR (GEN.SAMEFAM_FLG=1 and GEN.FDS_FLG_C=empty)
OR
(GEN.SAMEFAM_FLG=1
and
GEN.FDS_FLG_C=2
and
GEN.SARESPSC_FLG ne 1))) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(((GEN.SAMEFAM_FLG ne 1)
OR (GEN.SAMEFAM_FLG=1 and GEN.FDS_FLG_C=empty)
OR
(GEN.SAMEFAM_FLG=1
and
GEN.FDS_FLG_C=2
and
GEN.SARESPSC_FLG ne 1))))
Universe: FDSRUNOUT_A IN (1,2) or FDSLAST_A IN (1,2) or FDSBALANCE_A IN (1,2)
Universe Description: The Sample Child and Sample Adult are not in the same family
OR Sample Child and Sample Adult are in the same family AND Sample Child
FDS section has not been completed
OR the Sample Adult and Sample Child are in the same family and every
question asked in the Sample Child FDS section was answered with RF/DK
and the person answering the SC interview and the SA are different people
and respondent answered often true or sometimes true that in the last 30 days
they worried that food would run out before they got money to buy more, or
that the food that was bought didn't last and they didn't have money to get
more or couldn't afford to eat balanced meals.
Question Text:
In the last 30 days, did ^youorother_A lose weight because there wasn't
enough money for food?
Page 411 of 430
Response:
Fills:
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
^perder_A
Spanish only
^youorother_A
If PCNT18UP_A=1: fill "you"
else "you or other adults in your family"
Skip Instructions: <1> [goto FDSNOTEAT_A]
<2,RF,DK> if FDSSKIP_A=1 or FDSLESS_A=1 or FDSHUNGRY_A=1 [goto
FDSNOTEAT_A]; else [goto next section]
Question ID: FDS.0100.00.3
Variable name: FDSNOTEAT_A
Interview module: FDS(Adult.FDS)
Inherited Universe: (((GEN.SAMEFAM_FLG ne 1)
OR (GEN.SAMEFAM_FLG=1 and GEN.FDS_FLG_C=empty)
OR
(GEN.SAMEFAM_FLG=1
and
GEN.FDS_FLG_C=2
and
GEN.SARESPSC_FLG ne 1))) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(((GEN.SAMEFAM_FLG ne 1)
OR (GEN.SAMEFAM_FLG=1 and GEN.FDS_FLG_C=empty)
OR
(GEN.SAMEFAM_FLG=1
and
GEN.FDS_FLG_C=2
and
GEN.SARESPSC_FLG ne 1))))
Universe: (FDSSKIP_A=1
or
FDSWEIGHT_A=1)
FDSLESS_A=1
or
FDSHUNGRY_A=1
or
Universe Description: The Sample Child and Sample Adult are not in the same family
OR Sample Child and Sample Adult are in the same family AND Sample Child
FDS section has not been completed
OR the Sample Adult and Sample Child are in the same family and every
question asked in the Sample Child FDS section was answered with RF/DK
and the person answering the SC interview and the SA are different people
and respondent answered they cut the size of the meals, skipped meals, were
hungry but didn't eat, or lost weight in the last 30 days because there wasn't
enough money for food.
Question Text:
In the last 30 days, did ^youorother_A ever not eat for a whole day because
there wasn't enough money for food?
Response:
Page 412 of 430
1.
2.
DK:
RF:
Fills:
Yes
No
Don't Know
Refused
^pasar_A
Spanish only
^youorother_A
If PCNT18UP_A=1: fill "you"
else "you or other adults in your family"
Skip Instructions: <1> [goto FDSNEDAYS_A]
<2,RF,DK> [goto next section]
Question ID: FDS.0110.00.3
Variable name: FDSNEDAYS_A
Interview module: FDS(Adult.FDS)
Inherited Universe: (((GEN.SAMEFAM_FLG ne 1)
OR (GEN.SAMEFAM_FLG=1 and GEN.FDS_FLG_C=empty)
OR
(GEN.SAMEFAM_FLG=1
and
GEN.FDS_FLG_C=2
and
GEN.SARESPSC_FLG ne 1))) AND
((GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces) AND
(((GEN.SAMEFAM_FLG ne 1)
OR (GEN.SAMEFAM_FLG=1 and GEN.FDS_FLG_C=empty)
OR
(GEN.SAMEFAM_FLG=1
and
GEN.FDS_FLG_C=2
and
GEN.SARESPSC_FLG ne 1))))
Universe: FDSNOTEAT_A=1
Universe Description: The Sample Child and Sample Adult are not in the same family
OR Sample Child and Sample Adult are in the same family AND Sample Child
FDS section has not been completed
OR the Sample Adult and Sample Child are in the same family and every
question asked in the Sample Child FDS section was answered with RF/DK
and the person answering the SC interview and the SA are different people
and respondent didn't eat for a whole day in last 30 days because there wasn't
enough money for food
Question Text:
Response:
In the last 30 days, how many days did this happen?
DK:
RF:
Don't Know
Refused
Page 413 of 430
Skip Instructions: <1-30,RF,DK> [goto next section]
Question ID: HOU.0010.00.1
Variable name: HOUYRSLIV_A
Interview module: HOU(Adult.HOU)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
Fills:
About how long ^YRSLIV?
1.
2.
3.
4.
5.
DK:
RF:
^YRSLIV
Less than 1 year
1 to 3 years
4 to 10 years
11 to 20 years
21 years or more
Don't Know
Refused
If
Roster.HHC.tblname.bPerson[PX_A]ONOFFCAMPU
S=1 fill "have you lived at ^HNO ^HNOSUF
^STRNAME"
else fill "have you lived in this house/apartment"
Skip Instructions: <1-5,RF,DK> if ((GEN.SAMEFAM_FLG=1 and GEN.HOU_FLG_C=empty) or
(GEN.SAMEFAM_FLG
ne
1)
or
(GEN.SAMEFAM_FLG=1
and
GEN.HOU_FLG_C=2
and
GEN.SARESPSC_FLG
ne
1))[goto
HOUTENURE_A]
else [goto next section]
If
GEN.AGE_FINAL[PX_A]
ERR1_HOUYRSLIV_A]
lt
Page 414 of 430
21
and
HOUYRSLIV_A=5
[goto
Check Name: ERR1_HOUYRSLIV_A
Text:
{check ERR1_HOUYRSLIV_A} Years in house/apartment exceed^SANAME's age.
Please correct.
Hard / Soft Edit: Hard
Fills:
^SANAME
Sample Adult's name
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: AGE_FINAL LT 21 and HOUYRSLIV_A=5
Question ID: HOU.0020.00.1
Variable name: HOUTENURE_A
Interview module: HOU(Adult.HOU)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: ((GEN.SAMEFAM_FLG=1
and
GEN.HOU_FLG_C=blank)
(GEN.SAMEFAM_FLG
ne
1)
or
(GEN.SAMEFAM_FLG=1
GEN.HOU_FLG_C=2 and GEN.SARESPSC_FLG ne 1)
or
and
Universe Description: Sample Adults 18+ and Sample Adult and Sample Child are in the same family
and the HOU section has not been completed OR the Sample Adult and
Sample Child are not in the same family OR Sample Adult and Sample Child
are in the same family and Sample child respondent answered refused or don't
know to all questions in the sample child HOU section and the sample child
respondent is not the sample adult respondent.
Question Text:
^HOUTEN owned or rented by you ^SOMEFAM_A?
record as owned.
Response:
Page 415 of 430
If house has a mortgage,
1.
2.
3.
DK:
RF:
Fills:
Owned or being bought
Rented
Other arrangement
Don't Know
Refused
^HOUTEN
If
Roster.HHC.tblName.bPerson[PX_A].ONOFFCAMP
US=1, fill "Is the house/apartment at ^HNO
^HNOSUF ^STRNAME"
else fill "Is this house/apartment"
^SOMEFAM_A
If PCNT18UP_A=1 fill: blank
If PCNT18UP_A gt1 fill: "or someone in your family"
Skip Instructions: <1,3,RF,DK> [goto next section]
<2> [goto HOUGVASST_A]
Question ID: HOU.0030.00.1
Variable name: HOUGVASST_A
Interview module: HOU(Adult.HOU)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: HOUTENURE_A=2 and ((SAMEFAM_FLG=1 and HOU_FLG_C=blank) or
(SAMEFAM_FLG ne 1) or (SAMEFAM_FLG=1 and HOU_FLG_C=2 and
SARESPSC_FLG ne 1))
Universe Description: Sample Adults 18+ with a house/apartment that is being rented AND Sample
Adult and Sample Child are in the same family and the house/apartment is
being owned/rented and the HOU section has not been completed OR the
Sample Adult and Sample Child are not in the same family section
Question Text:
^HOUGVT paying lower rent because the Federal, State, or local government is
paying part of the cost? Read if necessary: Federal, State, or Local government
housing programs for persons with low income may take many forms. Government
housing assistance could come from monetary assistance to help pay rent, a program
called "Section 8," direct payments to landlords, vouchers, or other types of
assistance from a local housing authority. Living in public housing is considered
housing assistance from the government.
Response:
Page 416 of 430
1.
2.
DK:
RF:
Fills:
Yes
No
Don't Know
Refused
^HOUGVT
If
Roster.HHC.tblName.bPerson[PX_A].ONOFFCAMP
US ne 1 and GEN.PCNT18UP_A=1, fill "Are you"
elseif
Roster.HHC.tblName.bPerson[PX_A].ONOFFCAMP
US ne 1 and PCNT18UP_A gt 1, fill "Are you or
anyone in your family"
elseif
Roster.HHC.tblNAME.bPerson[PX_A].ONOFFCAMP
US=1, fill "Is your family at ^HNO ^HNOSUF
^STRNAME"
Skip Instructions: <1,2,RF,DK> [goto next section]
Question ID: SDH.0010.00.4
Variable name: HOUSEINSC_A
Interview module: SDH(Adult.SDH)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
DURING THE PAST 12 MONTHS, was there a time when you were not able to
pay your mortgage, rent or utility bills?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Page 417 of 430
Skip Instructions: <1,2,RF,DK> [goto next section]
Question ID: TBH.0010.00.4
Variable name: TRANSPOR_A
Interview module: TBH(Adult.TBH)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
In the past 12 months, has a lack of reliable transportation kept you from
medical appointments, meetings, work, or from getting things you needed for
daily living?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto next section]
Question ID: CIV.0010.00.4
Variable name: CEMMETNG_A
Interview module: CIV(Adult.CIV)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
During the past 12 months, did you attend a public meeting, such as a zoning
or school board meeting, that discussed a local issue?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Page 418 of 430
Skip Instructions: <1,2,RF,DK> [goto CEVOTELC_A]
Question ID: CIV.0020.00.4
Variable name: CEVOTELC_A
Interview module: CIV(Adult.CIV)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
Did you vote in the LAST LOCAL elections, such as for mayor,
councilmembers, or school board?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1,2,RF,DK> [goto next section]
Question ID: REC.0010.00.1
Variable name: LNKFNAME_A
Interview module: REC(Adult.REC)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
Ask or verify: What is your full name?
DK:
RF:
Don't Know
Refused
Skip Instructions: [goto LNKMNAME_A]
Page 419 of 430
Enter first name.
Question ID: REC.0020.00.1
Variable name: LNKMNAME_A
Interview module: REC(Adult.REC)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
Enter middle name.
name.
DK:
RF:
Press "Enter" to skip to last name if respondent has no middle
Don't Know
Refused
Skip Instructions: [goto LNKLNAME_A]
Question ID: REC.0030.00.1
Variable name: LNKLNAME_A
Interview module: REC(Adult.REC)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
Enter last name.
DK:
RF:
Don't Know
Refused
Skip Instructions: [goto next section]
Page 420 of 430
Question ID: TEL.0010.00.1
Variable name: TELCURWRK_A
Interview module: TEL(Adult.TEL)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: ((GEN.SAMEFAM_FLG=1
and
TELCURWRK_C=empty)
((GEN.SAMEFAM_FLG=1
and
TELCURWRK_C
IN
(DK,RF)
GEN.SARESPSC_FLG ne 1) or (GEN.SAMEFAM_FLG ne 1))
or
and
Universe Description: Sample Adults 18+ where the Sample Adult and Sample Child are in the same
family but TELCURWRK_C has not been asked OR Sample Adult and Sample
Child are in the same family, TELCURWRK_C was answered don't know or
refused and the Sample Adult is not the Sample Child Respondent or where
the Sample Adult does not live in same family as Sample Child
Question Text:
Response:
Fills:
Is there at least one telephone INSIDE ^HOME that is currently working and is
not a cell phone?
1.
2.
DK:
RF:
^HOME
Yes
No
Don't Know
Refused
If
Roster.HHC.tblNAME.bPerson[PX_A].ONOFFCAMP
US=1, fill "your home at ^HNO ^HNOSUF
^STRNAME"
else fill "your home"
Skip Instructions: <1,2,RF,DK> [goto TELCEL_A]
Page 421 of 430
Question ID: TEL.0020.00.1
Variable name: TELCEL_A
Interview module: TEL(Adult.TEL)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
Do you have a working cell phone?
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Skip Instructions: <1>
if
TELCURWRK_A=1
or
(TELCURWRK_C=1
GEN.SAMEFAM_FLG=1)[goto PHONEUSE_A]
else[goto TLNO_TEL_SA]
and
<2,RF,DK> if (GEN.SAMEFAM_FLG=1 and PHONELIVE_C=empty) or
(GEN.SAMEFAM_FLG=1
and
PHONELIVE_C
IN
(RF,DK)
and
GEN.SARESPSC_A ne 1) or (GEN.SAMEFAM_FLG ne 1)) and GEN.PCNT_A
gt 1 [goto PHONELIVE_A]
else [goto TLNO_TEL_SA]
Question ID: TEL.0030.00.1
Variable name: PHONELIVE_A
Interview module: TEL(Adult.TEL)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: TELCEL_A
IN
(2,RF,DK)
and
((GEN.SAMEFAM_FLG=1
and
PHONELIVE_C=blank) or (GEN.SAMEFAM_FLG=1 and PHONELIVE_C IN
(DK,RF) and GEN.SARESPSC_FLG ne 1) or (GEN.SAMEFAM_FLG ne 1))
and GEN.PCNT_A gt 1
Universe Description: Sample Adults 18+ in a family with at least one other person without working
cell phones where Sample Adult does not live in same family as Sample Child
or Sample Adult and Sample Child are in the same family but PHONELIVE_C
has not been asked OR Sample Adult and Sample Child are in the same
family, PHONELIVE_C was answered dk/rf and the Sample Adult is not the
Sample Child Respondent.
Question Text:
Do you live with anyone ^ATHOME who has a working cell phone?
Response:
Page 422 of 430
1.
2.
DK:
RF:
Fills:
Yes
No
Don't Know
Refused
^ATHOME
If
Roster.HHC.tblNAME.bPerson[PX_A].ONOFFCAMP
US=1, fill "at your home at ^HNO ^HNOSUF
^STRNAME"
else leave blank
Skip Instructions: <1,2,RF,DK> [goto TLNO_TEL_SA]
Question ID: TEL.0040.00.1
Variable name: PHONEUSE_A
Interview module: TEL(Adult.TEL)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: TELCEL_A=1 and ((GEN.SAMEFAM_FLG=1 and TELCURWRK_C=1) or
(TELCURWRK_A=1))
Universe Description: Sample Adults 18+ with working personal cell phone and who said they have a
working land-line in household or in the same family as sample child
respondent who said they have a working landline in the household.
Question Text:
Response:
Of all the telephone calls that you answer, are all or almost all on your cell
phones, some on your cell phone and some on your home phone, or very few
or none on your cell phones?
1.
2.
3.
DK:
RF:
All or almost all calls on cell phone
Some on cell phone and some on home phone
Very few or none on cell phone
Don't Know
Refused
Page 423 of 430
Skip Instructions: <1-3,RF,DK> [goto TLNO_TEL_SA]
Page 424 of 430
Skip Instructions: <1> [goto SSN4_A]
Question ID: LNK.0020.00.1
Variable name: SSN4_A
Interview module: LNK(Adult.LNK)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Question Text:
Response:
?[F1] What are the last four digits of your Social Security Number? Read if
necessary: Providing this information is voluntary. There will be no effect on your
benefits if you do not provide this information. Federal laws authorize us to ask for
this information. Like all other information you have provided, these answers will
remain confidential. Read if asked about specific laws: The specific federal laws
protecting your privacy and the confidentiality of your data are the Public Health
Service Act, which is Title 42, U.S.C., Section 242m(d); the Confidential Information
Protection and Statistical Efficiency Act of 2018, which is Title III of Public Law No.
115-435; and the Privacy Act of 1974, which is 5 U.S.C. § 552a. In addition to
the above cited laws, NCHS complies with the Federal Cybersecurity
Enhancement Act of 2015 (6 U.S.C. §§ 151 and 151 note) which protects
Federal information systems from cybersecurity risks by screening their
networks
Enter 'N' for no Social Security Number.
DK:
RF:
Don't Know
Refused
Skip Instructions: if SSN4_A=000-999 [goto ERR2_SSN4_A]
elseif SSN4_A NOT IN (N,RF,DK,000-999,0001-9999) [goto ERR3_SSN4_A]
<0001-9999> if.Adult.INS.HIKIND_A=2 or Adult.INS.MCAREPRB_A=1 [goto
LAST4C_A]
else [goto next section]
if Adult.INS.HIKIND_A=2 or Adult.INS.MCAREPRB_A=1 [goto
LAST4C_A]
else [goto RLINK_A]
Page 425 of 430
Check Name: ERR2_SSN4_A
Text:
{check ERR2_SSN4_A} You must enter all four of the last four digits of the Social
Security Number. Please correct.
Hard / Soft Edit: Hard
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: SSN4_A=000-999
Universe Description: Entered less than four digits
Check Name: ERR3_SSN4_A
Text:
{check ERR3_SSN4_A} The last 4 digits of a SSN should be between 0001-9999.
For a respondent who does not want to provide the SSN, enter 'Ctrl D' or 'Ctrl R' for
'Don't Know' or 'Refused.' If a respondent does not have a SSN, enter 'N'. Please
correct.
Hard / Soft Edit: Hard
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: SSN4_A NOT IN (N,RF,DK,000-999,0001-9999)
Universe Description: SSN last four digits are 0000 or a letter other than N
Page 426 of 430
Question ID: LNK.0040.00.1
Variable name: LAST4C_A
Interview module: LNK(Adult.LNK)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: 02 IN INS.HIKIND_A or INS.MCAREPRB_A=1
Universe Description: Sample adults 18+ who have Medicare
Question Text:
Response:
?[F1] 1 of 2 What are the last four characters of your Medicare or Health
Insurance Claim Number? Read if necessary: Providing this information is
voluntary. There will be no effect on your benefits if you do not provide this
information. Federal laws authorize us to ask for this information. Like all other
information you have provided, these answers will remain confidential. Read if
asked about specific laws: The specific federal laws protecting your privacy and the
confidentiality of your data are the Public Health Service Act, which is Title 42,
U.S.C., Section 242m(d); the Confidential Information Protection and Statistical
Efficiency Act of 2018, which is Title III of Public Law No. 115-435; and the Privacy
Act of 1974, which is 5 U.S.C. § 552a. In addition to the above cited laws,
NCHS complies with the Federal Cybersecurity Enhancement Act of 2015 (6
U.S.C. §§ 151 and 151 note) which protects Federal information systems from
cybersecurity risks by screening their networks Reports from memory are
acceptable if the Medicare card (or some other form of documentation) is not
available. Enter the last four characters, which should be letter-letter-numbernumber.
DK:
RF:
Don't Know
Refused
Skip Instructions: if anything lt 4 alphanumeric characters [goto ERR1_LAST4C_A]
elseif SSN4_A IN (N,RF,DK) or LAST4C_A IN (RF,DK) [goto RLINK_A]
else [goto next section]
Page 427 of 430
Check Name: ERR1_LAST4C_A
Text:
{checkERR1_LAST4C_A} You must enter all four of the last four alphanumeric
characters of the Medicare number. Please correct.
Hard / Soft Edit: Hard
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: LAST4C_A = lt 4 alphanumeric characters
Question ID: LNK.0060.00.1
Variable name: RLINK_A
Interview module: LNK(Adult.LNK)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe: SSN4_A IN (N,RF,DK) or LAST4C_A IN (RF,DK)
Universe Description: Sample adults 18+ who answered no SSN or refused or don't know last 4
digits of SSN or who answered refused or don't know at last 4 of Medicare
number
Question Text:
Response:
?[F1] May we try to link your survey data without a ^SSNMEDNUM?
Read if
necessary: Any data obtained are protected by strict federal laws, including the Public
Health Service Act, which is Title 42, U.S.C., Section 242m(d); the Confidential
Information Protection and Statistical Efficiency Act of 2018, which is Title III of Public
Law No. 115-435; and the Privacy Act of 1974, which is 5 U.S.C. § 552a.
1.
2.
DK:
RF:
Yes
No
Don't Know
Refused
Page 428 of 430
Fills:
^SSNMEDNUM
if (SSN4_A IN (N,RF,DK) and ((Adult.INS.HIKIND_A
ne
2and
Adult.INS.MCAREPRB_A
ne
1)
or(MCNO4_Age 001and MCNO4_A le 9999) or
(LAST4C_A NOT IN (empty,RF, DK)))) fill= "social
security number"
elseif ((SSN4_A ge 0001 and SSN4_A le 9999) and
(Adult.INS.HIKIND_A= 2or Adult.INS.MCAREPRB_A
=1) and (MCNO4_AIN (RF, DK) or (LAST4C_A IN
(RF,DK))) fill = "Medicare or Health Insurance Claim
Number"
else fill = "social security number, Medicare or Health
Insurance Claim Number"
Skip Instructions: <1,2,RF,DK>[goto next section]
Question ID: THX.0080.00.1
Variable name: THANKS_A
Interview module: THX(Adult.THX)
Inherited Universe: GEN.PX_A gt 0 and GEN.PCNT gt 0 and GEN.PCNT18PLUS gt 0 and
GEN.PCNT gt GEN.PCNTAGEGUESS and not all household members in the
armed forces
Universe Description: Sample Adults 18+
Question Text:
Response:
Thank respondent for answering these questions. If there is a Sample Child interview
to complete, ask for appropriate person to respond to these questions. Enter '1' to
continue.
1.
Enter 1 to Continue
Skip Instructions: <1> [goto next section]
Page 429 of 430
Check Name: Adult parallel tab finished
Text:
You have finished the Adult parallel tab. Press "Enter" or click OK to go back to the
main interview path. Then press the "END" key to jump to the next unanswered
question.
Hard / Soft Edit: Soft
Inherited Universe: (GEN.PX_A gt 0 and GEN.PCNT gt
GEN.PCNT gt GEN.PCNTAGEGUESS
armed forces) AND
(GEN.PX_A gt 0 and GEN.PCNT gt
GEN.PCNT gt GEN.PCNTAGEGUESS
armed forces)
0 and GEN.PCNT18PLUS gt 0 and
and not all household members in the
0 and GEN.PCNT18PLUS gt 0 and
and not all household members in the
Skip Instructions: Closing the box takes the user to the CASESTATUS screen
Page 430 of 430
| File Type | application/pdf |
| File Modified | 2022-10-13 |
| File Created | 2022-09-05 |