INTERVIEWER: ENTERING SECTION 11: HEALTH.

Would your health keep you from working ON A JOB FOR PAY NOW?

(Are you/Would you be) limited in the KIND of work you (could) do on a job for pay because of your health?

(Are you/Would you be) limited in the AMOUNT of work you (could) do because of your health?

(([Would your health keep you from working now?]=1) OR ([Limited in kind of work due to accident or injury?]=1) OR ([Limited in amount of work due to accident or injury?]=1))

COMMENT: Check if R has reported a health limitation which effects work.

([r gender]=1)

COMMENT: Is respondent male?

([time unit for time next child planned]=1) AND ([number of months r plans to have next child]<=9)

COMMENT: Is R currently pregnant?

Is your limitation ENTIRELY due to your current pregnancy?

Since what month and year have you had this limitation [" "/Other than your pregnancy]?

INTERVIEWER: ENTER DATE FROM WHICH R HAS HAD THIS LIMITATION.

How much do you weigh?


(ENTER POUNDS)

([work status last week] = 1)

COMMENT: Is R currently employed

Please tell me how often the following statement about your job(s) is true.

My job(s) require(s) lots of physical effort. Would you say this is true....

My job(s) require(s) lifting heavy loads, stooping, kneeling, crouching, walking, or other types of physical effort. Would you say this is true....

(HAND CARD AA)

Which of the activities on this card do you do regularly on your job(s)?

(SELECT ALL THAT APPLY)

We would like to know a little about your physical activity.

How often do you participate in light physical activity - such as walking, dancing, gardening, bowling, etc.

How often do you participate in vigorous physical exercise or sports - such as aerobics, running, swimming, or bicycling?

How often do you do heavy housework like scrubbing floors or washing windows?

([Total number of employers reported])

COMMENT: Check number of employers on the roster.

Now, I would like to ask you a few questions about any injuries and illnesses you might have received or gotten WHILE you were working on a job.

First, since [Date of last interview], have you had an incident at any job we previously discussed that resulted in an injury or illness to you?

REPEAT([Q11-loop1 counter])

COMMENT: start loop for injuries

(What is the name of the employer you were working for when the [MOST RECENT/MOST SEVERE] incident that resulted in an injury or illness to you occurred?)

(INTERVIEWER: MOVE OR TO THE EMPLOYER R HAS NAMED AND PRESS
<ENTER>. IF THERE IS NO MATCH, ASK R WHICH EMPLOYER LISTED IS THE SAME
AS THE ONE FOR WHICH R IS REPORTING A WORK-RELATED INJURY OR ILLNESS.)

INTERVIEWER: YOU HAVE SELECTED THE EMPLOYER LISTED BELOW AS THE SAME ONE
R IS REPORTING A WORK-RELATED INJURY OR ILLNESS FOR. IF THIS
IS NOT CORRECT, RETURN TO THE PREVIOUS QUESTION BY PRESSING
THE <PAGE-UP> KEY AND SELECT THE CORRECT EMPLOYER.

EMPLOYER: [employer name working when work-related injury/illnesses occurred()].

INTERVIEWER: NO EMPLOYER MATCH WAS FOUND.
RECORD THE EMPLOYER FOR WHICH R IS REPORTING A WORK RELATED
ILLNESS.

In what month and year did the [MOST RECENT/MOST SEVERE] injury or illness happen to you?

(HAND CARD BB)

Which one category on this card best describes the activity you were engaged in at the time of the incident? (CODE ONE ONLY).

Did the incident result in an injury or an illness?

What part of the body was hurt or affected?


(RECORD VERBATIM.)

What part of the body was hurt or affected?


(RECORD VERBATIM.)

(PROBE:) What other part of the body was hurt or affected?

INTERVIEWER: ENTER BELOW THE SECOND PART OF THE BODY THAT WAS HURT OR
AFFECTED.

INTERVIEWER: ENTER BELOW THE SECOND PART OF THE BODY THAT WAS HURT OR
AFFECTED.

(PROBE:) What other part of the body was hurt or affected?

INTERVIEWER: ENTER BELOW THE THIRD PART OF THE BODY THAT WAS HURT OR
AFFECTED.

INTERVIEWER: ENTER BELOW THE THIRD PART OF THE BODY THAT WAS HURT OR
AFFECTED.

(INTERVIEWER: FOR ([Q11-20()]) ASK:) What kind of [illness/injury()] was it?


(RECORD VERBATIM.)

(INTERVIEWER: FOR ([Q11-20()]) ASK:) What kind of [illness/injury()] was it?


(RECORD VERBATIM.)

([Q11-21()]=1)

COMMENT: is there another part of the body to ask about?

(INTERVIEWER: FOR ([Q11-22()]) ASK:) What kind of [illness/injury()] was it?


(RECORD VERBATIM.)

(INTERVIEWER: FOR ([Q11-22()]) ASK:) What kind of [illness/injury()] was it?


(RECORD VERBATIM.)

([Q11-23()]=1)

COMMENT: is there another part of the body to ask about?

(INTERVIEWER: FOR ([Q11-24()]) ASK:) What kind of [illness/injury()] was it?


(RECORD VERBATIM.)

(INTERVIEWER: FOR ([Q11-24()]) ASK:) What kind of [illness/injury()] was it?


(RECORD VERBATIM.)

Did the [illness/injury()] cause you to miss one or more scheduled days of work, not counting the day of the incident?

Not counting the day of the incident, how many days was this?

Did the [illness/injury()] cause you ...

to be assigned to another job on a temporary basis?

Did the [illness/injury()] cause you ...

to work at your regular job less than full time?

Did the [illness/injury()] cause you ...

to work at your regular job, but be unable to perform all of the normal duties of the job?

(([Q11-32()]=1) OR ([Q11-33()]=1) OR ([Q11-34()]=1))

COMMENT: Check if any of the three preceding q's contain a 'yes'

Not counting the day of the incident, how many days altogether was this?

Did the [illness/injury()] (also) cause you...

to be laid off?

Did the [illness/injury()] (also) cause you...

to quit?

Did the [illness/injury()] (also) cause you...

to be fired?

Did the [illness/injury()] (also) cause you...

to change occupations?

Did you lose any wages because of the [illness/injury()]?

Did you or your employer fill out a worker's compensation form for this [illness/injury()]?

Have you collected any worker's compensation benefits for this [illness/injury()]?

Is there a worker's compensation claim pending for this [illness/injury()]?

Is the [illness/injury()] we've just discussed the MOST SEVERE injury or illness that you have received or gotten since [Date of last interview] while you were working at any job we have already talked about?

UNTIL ([Q11-loop1 counter],([Q11-loop1 counter]=2) OR ([Q11-45()]=1))

Now we have a few questions about health care and hospitalization plans.

First, are you covered by any kind of private or governmental health or hospitalization plans or health maintenance organization (HMO) plans?

(PROBE IF NECESSARY:) Examples of health and hospitalization insurance plans include Blue Cross, Blue Shield, (Medicaid/Medi-Cal/Medical Assistance/Welfare/Medical Services).

(HAND CARD CC)

What is the source of your health or hospitalization plan? Is it from a policy from your current or previous employer, ...

... (a policy from (your) [Spouse/partner's name]'s current or previous employer), a policy bought directly from a medical insurance company, is it (Medicaid/Medi-Cal/Medical Assistance/Welfare/Medical Services), or is it
from some other source?

(READ CATEGORIES AS NECESSARY AND CODE ALL THAT APPLY.)

I want to ask you about your primary insurance plan. That is the plan that pays most of the cost of your doctor and hospital bills.

Is this plan a Health Maintenance Organization, HMO, network or Point of Service plan?

Is this a Preferred Provider Organization or a PPO? That is do you get increased benefits or lower co-pay if you use a participating provider.

Does this plan require you to get authorization from a primary care provider before seeing a medical specialist?

Have you (or your employer) set up a medical savings account (msa) to help pay your health care expenses?

Since [Date of last interview], were there any months when you were NOT covered by health insurance?

Which months?

(MARK ALL THAT APPLY)

(ENTER MONTHS IN 1998 ON NEXT SCREEN)

(Which months?)

(MARK ALL THAT APPLY)

(ENTER MONTHS IN 1998 BELOW)

When was the most recent time you were covered by insurance?

(When was the most recent time you were covered by insurance?)

(ENTER MONTH AND YEAR)

Can you tell me how long ago the most recent time you were covered by insurance was?

(ENTER AMOUNT BELOW AND TIME UNIT - "WEEKS", "MONTHS", ETC. IN NEXT SCREEN.)

(Can you tell me how long ago the most recent time you were covered by insurance was?)

(ENTER TIME UNIT BELOW)

(((([marital status code]=1) OR ([marital status code]=5) OR ([marital status code]=4)) AND ([spouse in hh?]=1)) OR
([partner in hh?]=1) OR ([partner in hh (flag #2)]=1))

COMMENT: Is current marital status "married" or "remarried" and there is a spouse listed on the household roster or is a partner listed?

Is [Spouse/partner's name] covered by any kind of private or governmental health or hospitalization plans or health maintenance organization (HMO) plans?

(PROBE IF NECESSARY:) Examples of health and hospitalization insurance plans include Blue Cross, Blue Shield, (Medicaid/Medi-Cal/Medical Assistance/Welfare/Medical Services).

(HAND CARD CC)

What is the source of [Spouse/partner's name]'s health or hospitalization plan? (READ AS NECESSARY) Is it from a policy from your current or previous employer, ...

... a policy from [Spouse/partner's name]'s current or previous employer, a policy bought directly from a medical insurance company, is it (Medicaid/Medi-Cal/Medical Assistance/Welfare/Medical Services), or is it from some other source?

(READ CATEGORIES AS NECESSARY AND CODE ALL THAT APPLY.)

([total bio children reported] > 0)

COMMENT: ANY BIOLOGICAL CHILDREN REPORTED?

REPEAT([Q11-loop2 counter])

([usual residence of biological child()]=1) OR ([usual residence of biological child()]=9) OR ([usual residence of biological child()]=10)

UNTIL ([Q11-loop2 counter], ([Q11-loop2 counter]=[total bio children reported] OR [Q11-86A()]=1))

(Is/Are) your (child/children) covered by any kind of private or governmental health or hospitalization plans or health maintenance organization (HMO) plans?

(PROBE IF NECESSARY:) Examples of health and hospitalization insurance plans include Blue Cross, Blue Shield, (Medicaid/Medi-Cal/Medical Assistance/Welfare/Medical Services).

(HAND CARD CC)

What is the source of your (child/children)'s health or hospitalization plan? (READ AS NECESSARY) Is it from a policy from your current or previous employer, ...

... (a policy from (your) [Spouse/partner's name]'s current or previous employer), a policy bought directly from a medical insurance company, is it (Medicaid/Medi-Cal/Medical Assistance/Welfare/Medical Services), or is it
from some other source?

(READ CATEGORIES AS NECESSARY AND CODE ALL THAT APPLY.)

([R's age] >= 40)

Now I am going to read a list of the ways that you might have felt or behaved recently. After each statement, please tell me how often you felt this way during the past week.

During the past week.....

I did not feel like eating; my appetite was poor.

During the past week....

I had trouble keeping my mind on what I was doing.

During the past week....

I felt depressed.

During the past week....

I felt that everything I did was an effort.

During the past week....

My sleep was restless.

During the past week....

I felt sad.

During the past week....

I could not get "going".

CESD - SCORE

I would like to know about your most recent visit(s) to a health care professional.

When was the last time you visited a health care professional for any reason?

(ENTER MONTH AND YEAR)

When did you last visit a health care professional for a general physical exam?

(ENTER MONTH AND YEAR)

This next series of questions asks about your biological parent's health.

Is your biological father still alive?

What caused your biological father's death?

How old was he when he died?

(ENTER AGE)

(Does/did) your father have any major health problems?

What (are/were) these problems?


(RECORD VERBATIM.)

What (are/were) these problems?


(RECORD VERBATIM.)

What (are/were) these problems?


(RECORD VERBATIM.)

What (are/were) these problems?


(RECORD VERBATIM.)

What (are/were) these problems?


(RECORD VERBATIM.)

Is your biological mother still alive?

What caused your biological mother's death?

How old was she when she died?

(ENTER AGE)

(Does/did) your mother have any major health problems?

What (are/were) these problems?

(RECORD VERBATIM.)

What (are/were) these problems?

(RECORD VERBATIM.)

What (are/were) these problems?

(RECORD VERBATIM.)

What (are/were) these problems?

(RECORD VERBATIM.)

What (are/were) these problems?

(RECORD VERBATIM.)

COMMENT: SF-12 Physical Component Score for respondents completing Health Module in 1998

COMMENT: SF-12 Mental Component Score for respondents completing Health Module in 1998

Next I will be asking you more specific questions about your health. This information will help keep track of how you feel and how well you are able to do your usual activities.

If you are unsure about how to answer, please give the best answer you can.

In general, would you say your health is ....

The following items are activities you might do during a typical day. Does your health limit you in these activites?

......Moderate activities, such as moving a table, pushing a vacuum cleaner, bowling or playing golf?

..... Climbing several flights of stairs?

During the past 4 weeks, have you had any of the following problems with your work or other regular daily activities as a result of your physical health?

..... Accomplished less than you would like?

.... Were limited in the kind of work or other activities?

During the past 4 weeks, have you had any of the following problems with your work or other regular daily activities as a result of any emotional problems (such as feeling depressed or anxious)? (Please answer YES or NO for each question.)

.... Accomplished less than you would like?

.... Didn't do work or other activities as carefully as usual?

During the past 4 weeks, how much did pain interfere with your normal work (including both work outside of the home and housework)?

The next questions are about how you feel and how things have been with you during the past 4 weeks. for each question, please give the one answer that comes closest to the way you have been feeling. How often during the past 4 weeks....

.... have you felt calm and peaceful?

.... Did you have a lot of energy?

.... Have you felt down-hearted and blue?

During the past 4 weeks, how much of the time has your physical health or emotional problems interfered with your social activities (like visiting with friends, relatives, etc.)?

Has a doctor ever told you that you have high blood pressure or hypertension?

In what month and year was that first diagnosed?

(ENTER MONTH AND YEAR)

Do you have high blood pressure or hypertension at the present time?

Has a doctor ever told you that you have diabetes or high blood sugar?

In what month and year was that first diagnosed?

(ENTER MONTH AND YEAR)

Has a doctor ever told you that you have cancer or malignant tumor of any kind except skin cancer?

How many such cancers have you had?

(ENTER AMOUNT)

REPEAT([Q11-loop3 counter])

COMMENT: Start loop for reported cancers

In what month and year was [most recent/next most recent] cancer diagnosed?

(ENTER MONTH AND YEAR)

In which organ or part of your body did this cancer occur?

(RECORD VERBATIM.)

Do you currently have any such cancer?

UNTIL ([Q11-loop3 counter],([Q11-loop3 counter]=[Number of cancers R reported]))

COMMENT: End loop for reported cancers

Not including asthma, has a doctor ever told you that you have chronic lung disease such as chronic brochitis or emphysema?

Has a doctor ever told you that you had a heart attack, coronary heart disease, angina, congestive heart failure, or other heart problems?

Did you have a heart attack or myocardial infarction?

In what month and year did you have your (last) heart attack or myocardial infarction?

(ENTER MONTH AND YEAR)

Do you currently have any angina or chest pains due to your heart?

Has a doctor ever told you that you have congestive heart failure?

In what month and year was your congestive heart failure?

(ENTER MONTH AND YEAR)

Do you currently have congestive heart failure?

Has a doctor ever told you that you had a stroke?

In what month and year did you last have a stroke?


(ENTER MONTH AND YEAR)

Has a doctor ever told you that you had emotional, nervous, or psychiatric problems?

In what month and year were your emotional, nervous or psychiatric problems diagnosed?


(ENTER MONTH AND YEAR)

During the last 12 months, have you had any emotional, nervous, or psychiatric problems?

Have you ever had, or has a doctor ever told you that you have, arthritis or rheumatism?

In what month and year was your arthritis or rheumatism diagnosed?

(In what month and year was your arthritis or rheumatism diagnosed?)

(ENTER MONTH AND YEAR)

Do you sometimes have pain, stiffness, or swelling in your joints?

Do you have any of the following health problems? (other than problems discussed earlier)

Asthma? (Shortness of breath or chronic cough?)

(Do you have any of the following health problems? (other than problems discussed earlier))

Problems with your back?

(Do you have any of the following health problems? (other than problems discussed earlier))

Problems with your feet and legs?

(Do you have any of the following health problems? (other than problems discussed earlier))

Kidney or bladder problems?

(Do you have any of the following health problems? (other than problems discussed earlier))

Stomach or intestinal ulcers?

(Do you have any of the following health problems? (other than problems discussed earlier))

High cholesterol?

(Do you have any of the following health problems? (other than problems discussed earlier))

Pain or pressure in your chest, palpitation or pounding heart, or heart trouble?

(Do you have any of the following health problems? (other than problems discussed earlier))


Low blood pressure?

(Do you have any of the following health problems? (other than problems discussed earlier))

Chronic or frequent colds, sinus problems, hay fever or allergies?

(Do you have any of the following health problems? (other than problems discussed earlier))

Frequent indigestion, stomach, liver or intestinal trouble, gall bladder trouble or gallstones?

(Do you have any of the following health problems? (other than problems discussed earlier))

Depression or excessive worry or nervous trouble of any kind?

(Do you have any of the following health problems? (other than problems discussed earlier))

Swollen or painful joints, frequent cramps in your legs or bursitis? (arthritis and rheumatism already addressed)

(Do you have any of the following health problems? (other than problems discussed earlier))

Lameness or paralysis (including polio)?

(Do you have any of the following health problems? (other than problems discussed earlier))

Painful or "trick" shoulder or elbow, "trick" or locked knee?

(Do you have any of the following health problems? (other than problems discussed earlier))

Scarlet fever, rheumatic fever, tuberculosis, jaundice or hepatitis?

(Do you have any of the following health problems? (other than problems discussed earlier))

Frequent or severe headaches, dizziness or fainting spells?

(Do you have any of the following health problems? (other than problems discussed earlier))

Eye trouble, other than glasses or contacts?

(Do you have any of the following health problems? (other than problems discussed earlier))

Ear, nose, or throat trouble?

(Do you have any of the following health problems? (other than problems discussed earlier))

Severe tooth or gum trouble?

(Do you have any of the following health problems? (other than problems discussed earlier))

Skin diseases?

(Do you have any of the following health problems? (other than problems discussed earlier))

Thyroid trouble or goiter?

(Do you have any of the following health problems? (other than problems discussed earlier))

Adverse or allergic reaction to any serum, drug or medicine?

(Do you have any of the following health problems? (other than problems discussed earlier))

Tumor, growth, or cyst? (cancerous or non-cancerous, other than those cancers discussed earlier)

(Do you have any of the following health problems? (other than problems discussed earlier))

Bone, joint or other deformity?

(Do you have any of the following health problems? (other than problems discussed earlier))

Loss of finger or toe?

(Do you have any of the following health problems? (other than problems discussed earlier))

Neuritis?

(Do you have any of the following health problems? (other than problems discussed earlier))

Epilepsy or fits?

(Do you have any of the following health problems? (other than problems discussed earlier))

frequent trouble sleeping?

(Do you have any of the following health problems? (other than problems discussed earlier))

Frequent urinary tract infections? (other than kidney problems discussed earlier)

(Do you have any of the following health problems? (other than problems discussed earlier))

Osteoporosis?

(Do you have any of the following health problems? (other than problems discussed earlier))

Ulcer?

(Do you have any of the following health problems? (other than problems discussed earlier))

Hardening of the arteries?

(Do you have any of the following health problems? (other than problems discussed earlier))

Anemia?

([r gender]=2)

(Do you have any of the following health problems? (other than problems discussed earlier))

Have you ever been treated for a female disorder?

(Do you have any of the following health problems? (other than problems discussed earlier))

Have you ever had a change in menstrual patterns?

Have you had a fracture or broken bone in the last 10 years?

In what year did you last break a bone?

(ENTER YEAR)

Have you ever been unconscious due to a head injury?

Are you often troubled with pain?

When the pain is at its worst, is it mild, moderate or severe?

How bad is the pain most of the time: mild, moderate or severe?

Does the pain make it difficult for you to do normal work?