Are you Hispanic or Latino?
What is your race?(SELECT ALL THAT APPLY.)
Now I would like to ask you some questions about your health.In general, how is your health?
(HAND R SHOWCARD TT )In a typical week, how many times do you eat fruit? (Do not count fruit juice.)
(HAND R SHOWCARD UU )In a typical week, how many times do you eat vegetables other than french fries or potato chips?
In a typical week, how many days do you engage in exercise that lasts 30 minutes or more?
In a typical week, how many hours total do you use a computer?
In a typical week, how many hours do you watch television?
On a typical week night, how many hours of sleep do you usually get?
During the past 30 days, how many times did you drive a car or other vehicle when you had been drinking alcohol?
During the past 30 days, how many times did you ride in a car or other vehicle driven by someone who had been drinking alcohol?
Have you ever had an eating disorder, a learning or emotional problem or a mental condition that has limited your ability to attend school regularly, do regular school work, or work at a job for pay?
What (is/are) the condition(s)?(SELECT ALL THAT APPLY)
INLIST ([YHEA-1020], 5)COMMENT: Other was selected in YHEA-1020
Please describe this other condition.
REPEAT ([genetic condition loop])COMMENT: loop through all general conditions
([genetic condition loop] =5)COMMENT: this is loop 5
INLIST ([YHEA-1020], 5)COMMENT: The Other category was chosen in YHEA-1020
INLIST ([YHEA-1020], [genetic condition loop])COMMENT: This condition was chosen
How old were you when the [genetic condition] was first noticed?(INTERVIEWER: ENTER "0" IF RESPONDENT HAS HAD THIS CONDITION SINCE BIRTH.)
Does the [genetic condition] currently limit your activities?
UNTIL ([genetic condition loop], ([genetic condition loop] = 5))
Have you ever had trouble seeing, hearing or speaking?
What (is/are) the condition(s)?(SELECT ALL THAT APPLY.)
INLIST ([YHEA-1120], 7)COMMENT: Other was selected in YHEA-1120
REPEAT ([sensory condition loop])COMMENT: loop through all general conditions
([sensory condition loop] =7)COMMENT: this is loop 7
INLIST ([YHEA-1120], 7)COMMENT: The Other category was chosen in YHEA-1120
INLIST ([YHEA-1120], [sensory condition loop])COMMENT: This condition was chosen
How old were you when the [sensory condition] was first noticed?(INTERVIEWER: ENTER "0" IF RESPONDENT HAS HAD THIS CONDITION SINCE BIRTH.)
Does the [sensory condition] currently limit your activities?
UNTIL ([sensory condition loop], ([sensory condition loop] = 7))
Have you ever had a part of your body that was deformed or missing?
INLIST ([YHEA-1220], 4)COMMENT: Other was selected in YHEA-1220
REPEAT ([deformity loop])COMMENT: loop through all general conditions
([deformity loop] =4)COMMENT: this is loop 4
INLIST ([YHEA-1220], 4)COMMENT: The Other category was chosen in YHEA-1220
INLIST ([YHEA-1220], [deformity loop])COMMENT: This condition was chosen
How old were you when the [deformity] was first noticed?(INTERVIEWER: ENTER "0" IF RESPONDENT HAS HAD THIS CONDITION SINCE BIRTH.)
Does the [deformity] currently limit your activities?
UNTIL ([deformity loop], ([deformity loop] = 4))
(HAND R SHOWCARD V V)Have you ever been diagnosed with any other chronic health condition or life threatening disease such as the ones listed on this card?
What conditions have you been diagnosed with?(SELECT ALL THAT APPLY)
INLIST ([YHEA-1320], 9)COMMENT: Other was selected in YHEA-1320
REPEAT ([chronic condition loop])COMMENT: loop through all chronic conditions
([chronic condition loop] =9)COMMENT: this is loop 9
INLIST ([YHEA-1320], 9)COMMENT: The Other category was chosen in YHEA-1320
INLIST ([YHEA-1320], [chronic condition loop])COMMENT: This condition was chosen
How old were you when the [chronic condition] was first diagnosed?(INTERVIEWER: ENTER "0" IF RESPONDENT HAS HAD THIS CONDITION SINCE BIRTH.)
Does the [chronic condition] currently limit your activities?
UNTIL ([chronic condition loop], ([chronic condition loop] = 9))
During the past 12 months, how many times were you injured or ill and had to be treated by a doctor or nurse?
Some injuries are not treated by a doctor or nurse. During the past 12 months, how many times were you injured or ill so that you missed at least one full day of usual activities such as work or school, but were not treated by a doctor or nurse?
Do you have any kind of health care coverage, including health insurance, prepaid plans such as HMOs, or government plans such as Medicare?
During the past 12 months, was there any time that you did not have any health insurance or coverage?
During the past 12 months, was there any time that you had health coverage?
(HAND R SHOWCARD WW)About how long has it been since you last visited a doctor for a routine checkup?
Now we are going to ask you about events you may have experienced in the last five years.
In the last five years, that is since you were [R's age 5 yrs ago] years old, has a close relative of yours died?
Was the person who died your...?(SELECT ALL THAT APPLY)
REPEAT ([deceased relative loop])COMMENT: loop through all relatives who died
INLIST ([YHEA-2320], [deceased relative loop])COMMENT: This condition was chosen
About how old were you when your [deceased relative] died?
UNTIL ([deceased relative loop], ([deceased relative loop] =6))
In the last five years, have you been the victim of a violent crime, for example, physical or sexual assault, robbery, or arson?
How old were you when you were the victim of a violent crime? If you have been victimized more than once, please tell me your age the last time you were a victim.
In the last five years, have you been homeless or lived in a shelter for the homeless for two or more nights in a row?
At what age did you last become homeless?
In the last five years, has a member of your household stayed in a hospital for at least one week for treatment of illness or injury?
Was the person who was hospitalized your...?(SELECT ALL THAT APPLY)
REPEAT ([hospitalized relative loop])COMMENT: loop through any parent, child, or spouse-partners who were hospitalized
INLIST ([YHEA-2720], [hospitalized relative loop])COMMENT: This condition was chosen
How many nights in total since [date of last interview] did your [hospitalized relative] stay in a hospital for treatment of illness or injury?
How old were you the last time your [hospitalized relative] went into a hospital for treatment of illness or injury?
UNTIL ([hospitalized relative loop], ([hospitalized relative loop] =8))
In the last five years, has an adult member of your household (other than yourself) been sent to jail or prison?
Was the person sent to jail or prison your¿?(SELECT ALL THAT APPLY)
REPEAT ([incarcerated relative loop])COMMENT: loop through all parents or partner-spouses who were incarcerated
INLIST ([YHEA-2820], [incarcerated relative loop])COMMENT: This condition was chosen
How old were you when your [incarcerated relative] went to jail or prison? If they went to jail or prison more than one time, please give me your age the last time they were incarcerated.
UNTIL ([incarcerated relative loop], ([incarcerated relative loop] =4))
In the last five years, has an adult member of your household (other than yourself) experienced one or more periods of unemployment lasting at least six months?
Was the person who was unemployed your¿?(SELECT ALL THAT APPLY)
REPEAT ([unemployed relative loop])COMMENT: loop through parent or partner-spouses only who were unemployed
INLIST ([YHEA-2920], [unemployed relative loop])COMMENT: This condition was chosen
How old were you when your [unemployed relative] last became unemployed?
UNTIL ([unemployed relative loop], ([unemployed relative loop] = 4))
In the last five years, have your parents divorced, either from each other or from their former spouse?
Who divorced?(SELECT ALL THAT APPLY)
INLIST ([YHEA-3020], 1)COMMENT: R's bio or adoptive parents divorced
How old were you when your parents divorced?
INLIST ([YHEA-3020], 2)COMMENT: R's mother got divorced from step-father
INLIST ([YHEA-3020], 3)COMMENT: R's father got divorced from step-mother
How old were you the last time one of your parents got divorced?
([age as of 12/31/96] =13)COMMENT: Check if sample member is 13 years old as of December 31, 1996
The next questions ask for your opinions on the effects of using different substances.Does smoking one or more packs of cigarettes per day, INCREASE THE RISK (chance) of ...... getting heart disease?
... getting AIDS?
Does having 5 or more drinks of alcohol once or twice each week, INCREASE THE RISK (chance) of .... . . damaging the liver?
... getting heart disease?
... getting arthritis?
... becoming addicted to alcohol?
... harming an unborn child?
(HAND R SHOWCARD X )Here are three of the many methods of preventing pregnancy.Which of these three is the most effective for preventing pregnancy?
(HAND R SHOWCARD X )Which of these same three methods is the most effective for preventing sexually transmitted diseases like AIDS or gonorrhea:
(HAND R SHOWCARD Y )When during the female monthly cycle of menstrual periods is pregnancy most likely to occur?Please look at the card and tell me the number corresponding to your answer.
([age as of 12/31/96] >15)COMMENT: Check if sample member is at least 16 years old as of December 31, 1996
What is the percent chance that you will die from any cause -- crime, illness, accident, and so on, in the next year?
What is the percent chance that you will die (from any cause -- crime, illness, accident, and so on) in the next five years?