Q11-1AAA [T30226.00] | Section: Health |
([total number of employers reported] >= 1)
COMMENT: Is there at least one employer listed?
If Answer = 1 Then Go To Q11-1B
Q11-1B [T30227.00] | Section: Health |
{*employer.curflag(1)*}==1
COMMENT: STATUS (Merged,%datevar%,1 WAS R WORKING IN WEEK BEFORE INTERVIEW WEEK?
If Answer = 1 Then Go To Q11-4
Q11-3 [T30228.00] | Section: Health |
(INTERVIEWER: ENTERING HEALTH SECTION)
Would your health keep you from working on a job for pay now?
Q11-4 [T30229.00] | Section: Health |
(Are you/Would you be) limited in the kind of work you (could) do on a job for pay because of your health?
Q11-5 [T30230.00] | Section: Health |
(Are you/Would you be) limited in the amount of work you (could) do because of your health?
Q11-5A [T30231.00] | Section: Health |
(([Would your health keep you from working now?]==1) || ([Limited in kind of work due to accident or injury?]==1) || ([Limited in amount of work due to accident or injury?]==1))
COMMENT: Check if R has reported a health limitation which affects work.
If Answer = 1 Then Go To Q11-5B
Q11-5B [T30232.00] | Section: Health |
([RESPONDENT GENDER]==1)
COMMENT: Is respondent male?
If Answer = 1 Then Go To Q11-7
Q11-5C [T30233.00] | Section: Health |
([time unit for time next child planned]==1) && ([number of months r plans to have next child]<=9)
COMMENT: Is R currently pregnant?
If Answer = 1 Then Go To Q11-6
Q11-6 [T30234.00] | Section: Health |
Is your limitation entirely due to your current pregnancy?
Q11-7 [T30235.00] | Section: Health |
Since what month and year have you had this limitation [" "/Other than your pregnancy]?
| 1 SELECT TO ENTER DATE ...(Go To Q11-8) |
| 0 IF VOLUNTEERED: 'ALL MY LIFE' |
Q11-8 [T30236.00] | Section: Health |
INTERVIEWER: ENTER DATE FROM WHICH R HAS HAD THIS LIMITATION.
Q11-ASTHMA-CHK1 [T30237.00] | Section: Health |
{r_asthma}==1
If Answer = 1 Then Go To Q11-ASTHMA-9_A
Q11-ASTHMA-9_A [T30238.00] | Section: Health |
VAREXIST ([DATE RESPONDENT STOPPED WORKING FOR EMPLOYER(1)])
COMMENT: Was R employed since last interview?
If Answer = 1 Then Go To Q11-ASTHMA-9_B
Q11-ASTHMA-9_B [T30239.00] | Section: Health |
DATE2DAY([DATE RESPONDENT STOPPED WORKING FOR EMPLOYER(1)]) >= DATE2DAY([12 months before reference date])
COMMENT: Has R been employed in the past 12 months?
If Answer = 0 Then Go To Q11-CARE-1
Q11-ASTHMA-10 [T30240.00] | Section: Health |
When we talked to you on [lintdate~X], you reported that you had asthma.
During the past 12 months, how many days of work did you miss due to your asthma?
Q11-CARE-1 [T30241.00] | Section: Health |
Is anyone in your household (besides you) disabled or chronically ill?
Q11-CARE-2 [T31509.00] | Section: Health |
Which household member is this?
(INTERVIEWER: PROBE IF THERE IS MORE THAN ONE HOUSEHOLD MEMBER: "Is there anyone else?")
(INTERVIEWER: PLEASE SELECT ALL THAT APPLY.)
| 1 Household member #1 |
| 2 Household member #2 |
| 3 Household member #3 |
| 4 Household member #4 |
| 5 Household member #5 |
| 6 Household member #6 |
| 7 Household member #7 |
| 8 Household member #8 |
| 9 Household member #9 |
| 10 Household member #10 |
| 11 Household member #11 |
| 12 Household member #12 |
| 13 Household member #13 |
| 14 Household member #14 |
| 15 Household member #15 |
Q11-CARE-3 [T30243.00] | Section: Health |
Do you regularly spend time helping or taking care of [this person/these people]?
Q11-CARE-3B [T30244.00] | Section: Health |
About how many hours per week do you spend doing this?
Q11-CARE-4 [T30245.00] | Section: Health |
Do you regularly spend time helping or taking care of a relative or friend who does not live in your household?
Q11-CARE-4B [T30246.00] | Section: Health |
About how many hours per week do you spend doing this?
Q11-9 [T30247.00] | Section: Health |
How much do you weigh?
(ENTER POUNDS)
Q11-10_A [T30248.00] | Section: Health |
How tall are you?
(INTERVIEWER: IF R ANSWERS ONLY IN FEET OR ONLY IN INCHES, LEAVE OTHER FIELD BLANK.)
Q11-10_B [T30249.00] | Section: Health |
Q11-GENHLTH_1A_1 [T30249.01] | Section: Health |
How often do you do vigorous activities for at least 10 minutes that cause heavy sweating or large increases in breathing or heart rate?
(INTERVIEWER: IF R UNABLE TO DO THIS TYPE OF ACTIVITY, ENTER "996" IN "FREQUENCY". IF R NEVER DOES THIS TYPE OF ACTIVITY, ENTER "0" IN "FREQUENCY".)
Q11-GENHLTH_1A_2 [T30250.00] | Section: Health |
CHOOSE TIME UNIT:
| 1 Per day |
| 2 Per week |
| 3 Per month |
| 4 Per year |
| 5 Unable to do this activity |
Q11-GENHLTH_1B [T30251.00] | Section: Health |
([frequency of vigorous exercise]==0 || [frequency of vigorous exercise]==996)
COMMENT: If R is unable or never does physical activities then skip question about how long
If Answer = 1 Then Go To Q11-GENHLTH_2A_1
Q11-GENHLTH_1C_1 [T30251.01] | Section: Health |
About how long do you do these vigorous activities each time?
Q11-GENHLTH_1C_2 [T30252.00] | Section: Health |
SELECT TIME UNIT:
Q11-GENHLTH_2A_1 [T30252.01] | Section: Health |
How often do you do light or moderate activities for at least 10 minutes that cause only light sweating or slight to moderate increase in breathing or heart rate?
(INTERVIEWER: IF R UNABLE TO DO THIS TYPE OF ACTIVITY, ENTER "996" IN "FREQUENCY". IF R NEVER DOES THIS TYPE OF ACTIVITY, ENTER "0" IN "FREQUENCY".)
Q11-GENHLTH_2A_2 [T30253.00] | Section: Health |
SELECT TIME UNIT:
| 1 Per day |
| 2 Per week |
| 3 Per month |
| 4 Per year |
| 5 Unable to do this activity |
Q11-GENHLTH_2B [T30254.00] | Section: Health |
([frequency of moderate exercise]==0 || [frequency of moderate exercise]==996)
COMMENT: If R is unable or never does physical activities then skip question about how long
If Answer = 1 Then Go To Q11-GENHLTH_3A_1
Q11-GENHLTH_2C_1 [T30254.01] | Section: Health |
About how long do you do these light or moderate activities each time?
Q11-GENHLTH_2C_2 [T30255.00] | Section: Health |
SELECT TIME UNIT:
Q11-GENHLTH_3A_1 [T30255.01] | Section: Health |
How often do you do physical activities specifically designed to strengthen your muscles such as lifting weights or doing calisthenics? (Include all such activities even if you have mentioned them before.)
(INTERVIEWER: IF R UNABLE TO DO THIS TYPE OF ACTIVITY, ENTER "996" IN "FREQUENCY". IF R NEVER DOES THIS TYPE OF ACTIVITY, ENTER "0" IN "FREQUENCY".)
Q11-GENHLTH_3A_2 [T30256.00] | Section: Health |
SELECT TIME UNIT:
| 1 Per day |
| 2 Per week |
| 3 Per month |
| 4 Per year |
| 5 Unable to do this activity |
Q11-GENHLTH-PRV1 [T30257.00] | Section: Health |
Do you have a health care provider that you can see when you are sick or need advice about your health?
Q11-GENHLTH-PRV2 [T30258.00] | Section: Health |
What kind of place do you go to most often for this care—is it a clinic, doctor's office, emergency room, or some other place?
| 1 Clinic or health center |
| 2 Doctor’s office or HMO |
| 3 Hospital emergency room |
| 4 Some other place |
| 5 Don’t go to one place most often |
Q11-GENHLTH_4A [T30259.00] | Section: Health |
About how long has it been since your last general physical exam or routine checkup by a medical doctor or other health professional? Do not include a visit about a specific problem.
Has it been...(READ CATEGORIES AS NECESSARY)?
| 0 Never |
| 1 A year ago or less |
| 2 More than 1 year but not more than 2 years |
| 3 More than 2 years but not more than 3 years |
| 4 More than 3 years but not more than 5 years |
| 5 Over 5 years ago |
Q11-GENHLTH_4B [T30260.00] | Section: Health |
{resp_gender}
COMMENT: If R is unable or never does physical activities then skip question about how long
If Answer = 1 Then Go To Q11-GENHLTH_4C_M
Q11-GENHLTH_4C_M [T30261.00] | Section: Health |
During the past 24 months, that is since [refdate_24mo~X], have you had any of the following medical tests or procedures?
| - A flu shot? |
| - A blood test for cholesterol? |
| - A blood test for diabetes or blood sugar levels? |
| - An examination of your prostate to screen for cancer? |
| - A colonoscopy or other test to screen for colorectal cancer? |
| - An electrocardiogram (EKG or ECG) or stress test? |
| - Have you had your blood pressure measured? |
Q11-GENHLTH_4D_M [T30262.00] | Section: Health |
Are you currently taking...
| - ...aspirin regularly to lower the risk of a heart attack or other cardiovascular event? |
| - ...any medications to control your blood sugar level? |
| - ...any medications to control your blood pressure? |
Q11-GENHLTH_4E_M [T30263.00] | Section: Health |
During the past 24 months, that is since [refdate_24mo~X], have you seen or talked to either of the following types of doctors?
| - A dentist for a routine check-up or exam? |
| - An optician or opthamologist for a routine eye exam? |
Q11-GENHLTH_4C_F [T30264.00] | Section: Health |
During the past 24 months, that is since [refdate_24mo~X], have you had any of the following medical tests or procedures?
| - A flu shot? |
| - A blood test for cholesterol? |
| - A blood test for diabetes or blood sugar levels? |
| - A mammogram or x-ray of the breast to search for cancer? |
| - A PAP smear? |
| - A bone density test to screen for osteoporosis? |
| - A colonoscopy or other test to screen for colorectal cancer? |
| - An electrocardiogram (EKG or ECG) or stress test? |
| - Have you had your blood pressure measured? |
Q11-GENHLTH_4D_F [T30265.00] | Section: Health |
Are you currently taking...
| - ...aspirin regularly to lower the risk of a heart attack or other cardiovascular event? |
| - ...any medications to control your blood sugar level? |
| - ...any medications to control your blood pressure? |
| - ...any hormone replacement therapy or "HRT" medications? |
Q11-GENHLTH_4E_F [T30266.00] | Section: Health |
During the past 24 months, that is since [refdate_24mo~X], have you seen or talked to any of the following types of doctors?
| - An obstetrician, gynecologist or other doctor who specializes in women's health? |
| - A dentist for a routine check-up or exam? |
| - An optician or opthamologist for a routine eye exam? |
Q11-GENHLTH_4F [T30267.00] | Section: Health |
Are you currently taking any medications to control or lower your cholesterol level?
Q11-GENHLTH_4G [T30268.00] | Section: Health |
Are any of those medications known as "statins"?
Q11-GENHLTH_5A_1 [T30269.00] | Section: Health |
Do you have any of your own, natural teeth?
Q11-GENHLTH_5A_2 [T30270.00] | Section: Health |
During a usual week, how many times do you....
...Brush your teeth?
Q11-GENHLTH_5A_3 [T30271.00] | Section: Health |
...Use dental floss?
Q11-GENHLTH_6A [T30272.00] | Section: Health |
Are you now trying to lose weight, gain weight, stay about the same, or are you not trying to do anything about your weight?
| 1 Lose weight |
| 2 Gain weight |
| 3 Stay about the same |
| 4 Not trying to do anything |
Q11-GENHLTH_7A [T30273.00] | Section: Health |
When you buy a food item for the first time, how often would you say you read the nutritional information sometimes listed on the label - would you say always, often, sometimes, rarely or never?
| 0 Don't buy food |
| 1 Always |
| 2 Often |
| 3 Sometimes |
| 4 Rarely |
| 5 Never |
Q11-GENHLTH_7B [T30274.00] | Section: Health |
When you buy a food item for the first time, how often would you say you read the ingredient list on the package - (would you say always, often, sometimes, rarely or never)?
| 0 Don't buy food |
| 1 Always |
| 2 Often |
| 3 Sometimes |
| 4 Rarely |
| 5 Never |
Q11-GENHLTH_7C_1 [T30275.00] | Section: Health |
In the past seven days, how many times did you...
...Eat food from a fast food restaurant such as McDonalds, Kentucky Fried Chicken, Pizza Hut, or Taco Bell?
Q11-GENHLTH_7C_2 [T30276.00] | Section: Health |
(INTERVIEWER: ENTER "PER DAY" OR "PER WEEK".)
Q11-GENHLTH_7D_1 [T30277.00] | Section: Health |
(In the past seven days, how many times did you...)
...Eat a snack between meals?
Q11-GENHLTH_7D_2 [T30278.00] | Section: Health |
(INTERVIEWER: ENTER "PER DAY" OR "PER WEEK".)
Q11-GENHLTH_7E_1 [T30279.00] | Section: Health |
(In the past seven days, how many times did you...)
...Skip a meal?
Q11-GENHLTH_7E_2 [T30280.00] | Section: Health |
(INTERVIEWER: ENTER "PER DAY" OR "PER WEEK".)
Q11-GENHLTH_7F_1 [T30281.00] | Section: Health |
(In the past seven days, how many times did you...)
...Have a soft drink or soda that contained sugar? (Do not include diet soft drinks or sodas, or carbonated water.)
Q11-GENHLTH_7F_2 [T30282.00] | Section: Health |
(INTERVIEWER: ENTER "PER DAY" OR "PER WEEK".)
Q11-HLTHPLN-INTCHK [T30286.00] | Section: Health |
{haschild_ins}==1 || {hassp_ins}==1
If Answer = 1 Then Go To Q11-HLTHPLN-INTRO
Q11-HLTHPLN-INTRO [] | Section: Health |
The next questions are about health insurance. We would first like to find out about your own health insurance coverage. We will then ask about coverage of your [spintro] [hlth_and] [childins].
Q11-79 [T30287.00] | Section: Health |
Are you covered by any kind of health insurance or some other kind of health care plan? (Include health insurance obtained through employment or purchased directly as well as government programs like Medicaid that provide medical care or help pay medical bills.)
Q11-80B [T30288.00] | Section: Health |
What kind of health insurance or health care coverage do you have?
(INTERVIEWER: SELECT ALL THAT APPLY.)
| 1 Private health insurance through your own current or former employer |
| 2 [IF MARRIED] private health insurance through your spouse’s current or former employer |
| 3 Private health insurance through a union or professional association |
| 4 Private health insurance purchased directly through the insurer |
| 6 Medi-Gap |
| 7 Medicaid |
| 8 Military health care such as TRICARE, CHAMPUS or CHAMPVA |
| 9 Other state-sponsored or government plan (not Medicaid) |
| 10 Single service plan covering one type of service such as dental, vision, or prescription |
| 12 No coverage of any kind |
Q11-80F [T30290.00] | Section: Health |
Have you (or your employer) set up a health savings account, medical savings account, or health-related flexible savings account to help pay your health care expenses?
Q11-HLTHPLN-3CHK [T30291.00] | Section: Health |
{Q11-79}==0 || {Q11-80B}==1
COMMENT: /* Respondent reports no health insurance coverage, or coverage not specified in response categories. */
If Answer = 1 Then Go To Q11-80G
Q11-80G [T30292.00] | Section: Health |
There is a program called Medicaid that pays for health care for persons in need. In [RESPONDENT STATE] it is also called [Medicaid or a Medicaid alternative plan such as [name of state Medicaid Program]]. Are you covered by Medicaid?
(INTERVIEWER: GENERALLY, IF R OR EMPLOYER DO NOT HAVE TO PAY, THE INSURANCE IS MEDICAID OR A MEDICAID ALTERNATIVE. PLEASE SEE HELP SCREEN FOR LIST OF MEDICAID ALTERNATIVE PROVIDERS AND PLANS FOR [RESPONDENT STATE].)
Q11-81C_1 [T30293.00] | Section: Health |
Not including single service plans, about how long has it been since you last had health care coverage?
| 0 6 months or less |
| 1 More than 6 months, but less than 1 year |
| 2 More than 1 year, but not more than 3 years |
| 3 More than 3 years |
| 4 Never |
Q11-HLTHPLN-5CHK [T30294.00] | Section: Health |
{Q11-80B}==1
COMMENT: /* Respondent reports some type of health insurance */
If Answer = 1 Then Go To Q11-HLTHPLN-6CHK
Q11-81A [T30295.00] | Section: Health |
In the past 12 months, have you ever been without coverage?
Q11-81B_1 [T30296.00] | Section: Health |
About how many months were you without coverage?
Q11-HLTHPLN-6CHK [T30297.00] | Section: Health |
{Q11-79}==0 || {Q11-80B}==1 || {Q11-81A}==1
COMMENT: /* Respondent reports no health insurance coverage or coverage not specified in response categories or some non-coverage in the last 12 months */
If Answer = 0 Then Go To Q11-HLTHPLN-7CHK
Q11-81G [T30298.00] | Section: Health |
Which of these are the reasons you do/did not have health insurance?
(INTERVIEWER: SELECT ALL THAT APPLY.)
| 1 Person in family with health insurance lost job or changed employers |
| 2 Got divorced or separated/death of spouse or partner |
| 3 Employer does not offer coverage/or not eligible for coverage |
| 4 Cost is too high |
| 5 Insurance company refused coverage |
| 6 [FEMALE ONLY] Medicaid/Medical plan stopped after pregnancy |
| 7 Lost Medicaid/Medical Plan because of new job or increase in income |
| 8 Lost Medicaid (other) |
| 9 Other (specify) |
Q11-HLTHPLN-7CHK [T30299.00] | Section: Health |
{hassp_ins}==1
COMMENT: /* Respondent reported a spouse */
If Answer = 1 Then Go To Q11-83
Q11-83 [T30300.00] | Section: Health |
Is [Spouse/partner's name] covered by any kind of health insurance or some other kind of health care plan? (Include health insurance obtained through employment or purchased directly as well as government programs like Medicaid that provide medical care or help pay medical bills.)
(PROBE IF NECESSARY:) Examples of health and hospitalization insurance plans include Blue Cross, Blue Shield, [Medicaid or a Medicaid alternative plan such as [name of state Medicaid Program]].
Q11-84B [T30301.00] | Section: Health |
What kind of health insurance or health care coverage does [Spouse/partner's name] have?
(INTERVIEWER: SELECT ALL THAT APPLY.)
| 1 Private health insurance through (his/her) own current or former employer |
| 2 Private health insurance through respondent’s current or former employer |
| 3 Other private health insurance |
| 6 Medi-Gap |
| 7 Medicaid |
| 8 Military health care such as TRICARE, CHAMPUS or CHAMPVA |
| 9 Other state-sponsored or government plan (not Medicaid) |
| 10 Single service plan covering one type of service such as dental, vision, or prescription |
| 12 No coverage of any kind |
Q11-HLTHPLN-8CHK [T30302.00] | Section: Health |
{haschild_ins}==1
If Answer = 1 Then Go To Q11-87
Q11-87 [T30303.00] | Section: Health |
{childins_intro} covered by any kind of health insurance or some other kind of health care plan? (Include health insurance obtained through employment or purchased directly as well as government programs like Medicaid that provide medical care or help pay medical bills.)
(PROBE IF NECESSARY:) Examples of health and hospitalization insurance plans include Blue Cross, Blue Shield, {medicaid_name}.
Q11-88B [T30304.00] | Section: Health |
What kind of health insurance or health care coverage [does your child/do your children] have?
(INTERVIEWER: SELECT ALL THAT APPLY.)
| 1 Private health insurance through (his/her) own current or former employer |
| 2 Private health insurance through respondent’s current or former employer |
| 3 Other private health insurance |
| 4 SCHIP (CHIP/Children's Health Insurance Program) |
| 7 Medicaid |
| 8 Military health care such as TRICARE, CHAMPUS or CHAMPVA |
| 9 Other state-sponsored or government plan (not Medicaid) |
| 10 Single service plan covering one type of service such as dental, vision, or prescription |
| 12 No coverage of any kind |
Q11-RESP_AGE2 [T30305.00] | Section: Health |
{birthdate~Y} >= 1961 && {birthdate~Y} <= 1962
If Answer = 1 Then Go To COGNITION-C1
COGNITION-C1 [T30306.00] | Section: Health |
Part of this study is concerned with people's memory, and ability to think about things. First, how would you rate your memory at the present time? Would you say it is excellent, very good, good, fair or poor?
| 1 Excellent |
| 2 Very Good |
| 3 Good |
| 4 Fair |
| 5 Poor |
COGNITION-C2 [T30307.00] | Section: Health |
Compared to (two years ago/[year before current year]), would you say your memory is better now, about the same, or worse now than it was then?
| 1 better |
| 2 about the same |
| 3 worse |
COGNITION-3_TEST1 [T30308.00] | Section: Health |
I'll read a set of 10 words and ask you to recall as many as you can. We have purposely made the list long so that it will be difficult for anyone to recall all the words. Most people recall just a few. Please listen carefully as I read the set of words because I cannot repeat them. When I finish, I will ask you to recall aloud as many of the words as you can, in any order. Is this clear?
(INTERVIEWER: PROBE AS NEEDED FOR UNDERSTANDING OF TASK. READ ITEMS ON FOLLOWING SCREEN AT A SLOW STEADY RATE, AS THEY FLASH ON THE SCREEN.
IF R REFUSES DURING OR AFTER THE INTRODUCTION AND BEFORE ANY WORDS ARE READ, SELECT "REFUSED WORD LIST" BELOW AND SELECT <SUBMIT AND CONTINUE> TO PROCEED.)
| 1 CONTINUE WITH WORD LIST |
| 2 REFUSED WORD LIST ...(Go To COGNITION-6) |
COG_RANDOM_TEST1 [T30309.00] | Section: Health |
INT(RAND(0)*5)
If Answer = 1 Then Go To COG_LIST1A_TEST1_M1
If Answer = 2 Then Go To COG_LIST2A_TEST1_M2
If Answer = 3 Then Go To COG_LIST3A_TEST1_M3
If Answer = 4 Then Go To COG_LIST4A_TEST1_M4
COG_LIST1A_TEST1_M1 [T30310.00] | Section: Health |
(INTERVIEWER: DOUBLE CLICK START ARROW TO START WORD LIST. READ WORDS AS THEY FLASH ON THE SCREEN.
AFTER READING WORDS, ASK:)
Now please tell me the words you can recall.
(INTERVIEWER: PERMIT AS MUCH TIME AS THE R WISHES UP TO ABOUT 2 MINUTES. SELECT "RECALLED" FOR WORDS R RECALLED, AND "NOT RECALLED" FOR WORDS THE R DID NOT RECALL.
SELECT <SUBMIT AND CONTINUE> TO ENTER WRONG WORDS ONTO THE ROSTER ON NEXT SCREEN. BY SELECTING <ADD ROW> AND TYPING THE WORD.)
| - Hotel |
| - River |
| - Tree |
| - Skin |
| - Gold |
| - Market |
| - Paper |
| - Child |
| - King |
| - Book |
| 1 RECALLED |
| 0 NOT RECALLED |
COGNITION-4A_2 [] | Section: Health |
(INTERVIEWER: ENTER WRONG WORDS "RECALLED" ON ROSTER BELOW BY SELECTING <ADD ROW> AND TYPING THE WORD.)
COG_LIST2A_TEST1_M2 [T30311.00] | Section: Health |
(INTERVIEWER: DOUBLE CLICK START ARROW TO START WORD LIST. READ WORDS AS THEY FLASH ON THE SCREEN.
AFTER READING WORDS, ASK:)
Now please tell me the words you can recall.
(INTERVIEWER: PERMIT AS MUCH TIME AS THE R WISHES UP TO ABOUT 2 MINUTES. SELECT "RECALLED" FOR WORDS R RECALLED, AND "NOT RECALLED" FOR WORDS THE R DID NOT RECALL.
SELECT <SUBMIT AND CONTINUE> TO ENTER WRONG WORDS ONTO THE ROSTER ON NEXT SCREEN. BY SELECTING <ADD ROW> AND TYPING THE WORD.)
| - Sky |
| - Ocean |
| - Flag |
| - Dollar |
| - Wife |
| - Machine |
| - Home |
| - Earth |
| - College |
| - Butter |
| 1 RECALLED |
| 0 NOT RECALLED |
COGNITION-4B_2 [] | Section: Health |
(INTERVIEWER: ENTER WRONG WORDS "RECALLED" ON ROSTER BELOW BY SELECTING <ADD ROW> AND TYPING THE WORD.)
COG_LIST3A_TEST1_M3 [T30312.00] | Section: Health |
(INTERVIEWER: DOUBLE CLICK START ARROW TO START WORD LIST. READ WORDS AS THEY FLASH ON THE SCREEN.
AFTER READING WORDS, ASK:)
Now please tell me the words you can recall.
(INTERVIEWER: PERMIT AS MUCH TIME AS THE R WISHES UP TO ABOUT 2 MINUTES. SELECT "RECALLED" FOR WORDS R RECALLED, AND "NOT RECALLED" FOR WORDS THE R DID NOT RECALL.
SELECT <SUBMIT AND CONTINUE> TO ENTER WRONG WORDS ONTO THE ROSTER ON NEXT SCREEN. BY SELECTING <ADD ROW> AND TYPING THE WORD.)
| - Woman |
| - Rock |
| - Blood |
| - Corner |
| - Shoes |
| - Letter |
| - Girl |
| - House |
| - Valley |
| - Engine |
| 1 RECALLED |
| 0 NOT RECALLED |
COGNITION-4C_2 [] | Section: Health |
(INTERVIEWER: ENTER WRONG WORDS "RECALLED" ON ROSTER BELOW BY SELECTING <ADD ROW> AND TYPING THE WORD.)
COG_LIST4A_TEST1_M4 [T30313.00] | Section: Health |
(INTERVIEWER: DOUBLE CLICK START ARROW TO START WORD LIST. READ WORDS AS THEY FLASH ON THE SCREEN.
AFTER READING WORDS, ASK:)
Now please tell me the words you can recall.
(INTERVIEWER: PERMIT AS MUCH TIME AS THE R WISHES UP TO ABOUT 2 MINUTES. SELECT "RECALLED" FOR WORDS R RECALLED, AND "NOT RECALLED" FOR WORDS THE R DID NOT RECALL.
SELECT <SUBMIT AND CONTINUE> TO ENTER WRONG WORDS ONTO THE ROSTER ON NEXT SCREEN. BY SELECTING <ADD ROW> AND TYPING THE WORD.)
| - Water |
| - Church |
| - Doctor |
| - Palace |
| - Fire |
| - Garden |
| - Sea |
| - Village |
| - Baby |
| - Table |
| 1 RECALLED |
| 0 NOT RECALLED |
COGNITION-4D_2 [] | Section: Health |
(INTERVIEWER: ENTER WRONG WORDS "RECALLED" ON ROSTER BELOW BY SELECTING <ADD ROW> AND TYPING THE WORD.)
COGNITION-4_CHK4 [T30325.00] | Section: Health |
(INTERVIEWER: PLEASE INDICATE WHETHER ANY OF THE FOLLOWING PROBLEMS OCCURRED IN RELATION TO WORD RECALL.)
(SELECT ALL THAT APPLY.)
| 1 R HAD DIFFICULTY HEARING ANY OF THE WORDS |
| 2 INTERRUPTION OCCURRED WHILE YOU WERE READING LIST |
| 3 OTHER PROBLEM (PLEASE SPECIFY) |
| 4 NO PROBLEMS OCCURRED |
COGNITION-6 [T30326.00] | Section: Health |
For this next question, please try to count backward as quickly as you can from the number I will give you. I will tell you when to stop.
Please start with: 20
(INTERVIEWER: ALLOW R TO START OVER IF S/HE WISHES TO DO SO. SELECT <CONTINUE WITH BACKWARD COUNTING> AS SOON AS YOU READ THE NUMBER.)
| 1 CONTINUE WITH BACKWARD COUNTING |
If Answer >= -2 AND Answer <= -1 Then Go To COGNITION-6G
COGNITION-6A [T30327.00] | Section: Health |
INTERVIEWER: SELECT <CONTINUE WITH BACKWARD COUNTING> AS SOON AS R HAS COUNTED 10 NUMBERS, OR STOPS, OR ASKS TO START OVER.
R CAN CORRECTLY COUNT DOWN FROM 19 TO 10 OR FROM 20 TO 11.
| 1 CONTINUE WITH BACKWARD COUNTING |
If Answer >= -2 AND Answer <= -1 Then Go To COGNITION-6G
COGNITION-6C [T30328.00] | Section: Health |
You may stop now. Thank you.
(INTERVIEWER: SELECT <CORRECT> IF R COUNTED BACKWARDS FROM 19 TO 10 OR FROM 20 TO 11 WITHOUT ERROR. SELECT <REFUSED> IF R REFUSED TO TRY THE TASK. DON'T KNOW IS NOT AN ACCEPTABLE RESPONSE.)
| 1 CORRECT |
| 5 INCORRECT |
| 6 WANTS TO START OVER ...(Go To COGNITION-6D) |
| 97 REFUSED |
COGNITION-6D [] | Section: Health |
Let's try again.
The number to count backward from is : 20
(INTERVIEWER: SELECT <CONTINUE WITH BACKWARD COUNTING> AS SOON AS YOU READ THE NUMBER.)
| 1 CONTINUE WITH BACKWARD COUNTING |
If Answer >= -2 AND Answer <= -1 Then Go To COGNITION-6G
COGNITION-6D_Y1 [] | Section: Health |
INTERVIEWER: SELECT <CONTINUE WITH BACKWARD COUNTING> AS SOON AS R HAS COUNTED 10 NUMBERS, OR STOPS.
| 1 CONTINUE WITH BACKWARD COUNTING |
If Answer >= -2 AND Answer <= -1 Then Go To COGNITION-6G
COGNITION-6F [] | Section: Health |
You may stop now. Thank you.
(INTERVIEWER: SELECT <CORRECT> IF R COUNTED BACKWARDS FROM 19 TO 10 OR FROM 20 TO 11 WITHOUT ERROR. SELECT <REFUSED> IF R REFUSED TO TRY THE TASK. DON'T KNOW IS NOT AN ACCEPTABLE RESPONSE.)
| 1 CORRECT |
| 5 INCORRECT |
| 97 REFUSED |
COGNITION-6G [T30329.00] | Section: Health |
Now please try counting backward from a different number. Remember to count as quickly as you can from the number I mention.
Please start with: 86
(INTERVIEWER: ALLOW R TO START OVER IF S/HE WISHES TO DO SO. SELECT <CONTINUE WITH BACKWARD COUNTING> AS SOON AS YOU READ THE NUMBER.)
| 1 CONTINUE WITH BACKWARD COUNTING |
If Answer >= -2 AND Answer <= -1 Then Go To COGNITION-7A
COGNITION-6G_Y1 [T30330.00] | Section: Health |
INTERVIEWER: SELECT <CONTINUE WITH BACKWARD COUNTING> AS SOON AS R HAS COUNTED 10 NUMBERS, OR STOPS, OR ASKS TO START OVER.
R CAN CORRECTLY COUNT DOWN FROM 86 TO 77 OR FROM 85 TO 76.
| 1 CONTINUE WITH BACKWARD COUNTING |
If Answer >= -2 AND Answer <= -1 Then Go To COGNITION-7A
COGNITION-6J [T30331.00] | Section: Health |
You may stop now. Thank you.
(INTERVIEWER: SELECT <CORRECT> IF R COUNTED BACKWARDS FROM 85 TO 76 OR FROM 86 TO 77 WITHOUT ERROR. SELECT <REFUSED> IF R REFUSED TO TRY THE TASK. ALLOW R TO START OVER IF S/HE WISHES TO DO SO.)
| 1 CORRECT |
| 5 INCORRECT |
| 6 WANTS TO START OVER ...(Go To COGNITION-6K) |
| 97 REFUSED |
COGNITION-6K [T30332.00] | Section: Health |
Let's try again.
The number to count backward from is : 86
(INTERVIEWER: SELECT <CONTINUE WITH BACKWARD COUNTING> AS SOON AS YOU READ THE NUMBER.)
| 1 CONTINUE WITH BACKWARD COUNTING |
If Answer >= -2 AND Answer <= -1 Then Go To COGNITION-7A
COGNITION-6K_Y1 [T30333.00] | Section: Health |
INTERVIEWER: SELECT <CONTINUE WITH BACKWARD COUNTING> AS SOON AS R HAS COUNTED 10 NUMBERS, OR STOPS.
| 1 CONTINUE WITH BACKWARD COUNTING |
If Answer >= -2 AND Answer <= -1 Then Go To COGNITION-7A
COGNITION-6N [T30334.00] | Section: Health |
You may stop now. Thank you.
(INTERVIEWER: SELECT <CORRECT> IF R COUNTED BACKWARDS FROM 85 TO 76 OR FROM 86 TO 77 WITHOUT ERROR. SELECT <REFUSED> IF R REFUSED TO TRY THE TASK. DON'T KNOW IS NOT AN ACCEPTABLE RESPONSE.)
| 1 CORRECT |
| 5 INCORRECT |
| 97 REFUSED |
COGNITION-7A [T30335.00] | Section: Health |
Now let's try some subtraction of numbers. One hundred minus 7 equals what?
(INTERVIEWER: IF R ADDS 7 INSTEAD, YOU MAY REPEAT THE QUESTION. IF DON'T KNOW OR REFUSED ANY NUMBER, SELECT <SUBMIT AND CONTINUE> TO PROCEED.)
COGNITION-7B [T30336.00] | Section: Health |
And 7 from that?
COGNITION-7C [T30337.00] | Section: Health |
And 7 from that?
COGNITION-7D [T30338.00] | Section: Health |
And 7 from that?
COGNITION-7E [T30339.00] | Section: Health |
And 7 from that?
COGNITION-8_CHK [] | Section: Health |
{word_list_refused1} == 2 || {correct_words_cnt1} > 0
If Answer = 0 Then Go To Q11-H50-2
COGNITION-CHK4 [] | Section: Health |
{cog_word_list_flag}
If Answer = 1 Then Go To COGNITION-8A_1
If Answer = 2 Then Go To COGNITION-8B_1
If Answer = 3 Then Go To COGNITION-8C_1
If Answer = 4 Then Go To COGNITION-8D_1
COGNITION-8A_1 [T30340.00] | Section: Health |
A little while ago, I read you a list of words and you repeated the ones you could remember. Please tell me any of the words that you remember now.
(INTERVIEWER: PERMIT AS MUCH TIME AS THE R WISHES UP TO ABOUT 2 MINUTES. SELECT "RECALLED" FOR WORDS R RECALLED, AND "NOT RECALLED" FOR WORDS THE R DID NOT RECALL.
SELECT <SUBMIT AND CONTINUE> TO ENTER WRONG WORDS ONTO THE ROSTER ON NEXT SCREEN. BY SELECTING <ADD ROW> AND TYPING THE WORD.)
| - Hotel |
| - River |
| - Tree |
| - Skin |
| - Gold |
| - Market |
| - Paper |
| - Child |
| - King |
| - Book |
| 1 RECALLED |
| 0 NOT RECALLED |
COGNITION-8A_2 [] | Section: Health |
(INTERVIEWER: ENTER WRONG WORDS "RECALLED" ON ROSTER BELOW BY SELECTING <ADD ROW> AND TYPING THE WORD.)
COGNITION-8B_1 [T30341.00] | Section: Health |
A little while ago, I read you a list of words and you repeated the ones you could remember. Please tell me any of the words that you remember now.
(INTERVIEWER: PERMIT AS MUCH TIME AS THE R WISHES UP TO ABOUT 2 MINUTES. SELECT "RECALLED" FOR WORDS R RECALLED, AND "NOT RECALLED" FOR WORDS THE R DID NOT RECALL.
SELECT <SUBMIT AND CONTINUE> TO ENTER WRONG WORDS ONTO THE ROSTER ON NEXT SCREEN. BY SELECTING <ADD ROW> AND TYPING THE WORD.)
| - Sky |
| - Ocean |
| - Flag |
| - Dollar |
| - Wife |
| - Machine |
| - Home |
| - Earth |
| - College |
| - Butter |
| 1 RECALLED |
| 0 NOT RECALLED |
COGNITION-8B_2 [] | Section: Health |
(INTERVIEWER: ENTER WRONG WORDS "RECALLED" ON ROSTER BELOW BY SELECTING <ADD ROW> AND TYPING THE WORD.)
COGNITION-8C_1 [T30342.00] | Section: Health |
A little while ago, I read you a list of words and you repeated the ones you could remember. Please tell me any of the words that you remember now.
(INTERVIEWER: PERMIT AS MUCH TIME AS THE R WISHES UP TO ABOUT 2 MINUTES. SELECT "RECALLED" FOR WORDS R RECALLED, AND "NOT RECALLED" FOR WORDS THE R DID NOT RECALL.
SELECT <SUBMIT AND CONTINUE> TO ENTER WRONG WORDS ONTO THE ROSTER ON NEXT SCREEN. BY SELECTING <ADD ROW> AND TYPING THE WORD.)
| - Woman |
| - Rock |
| - Blood |
| - Corner |
| - Shoes |
| - Letter |
| - Girl |
| - House |
| - Valley |
| - Engine |
| 1 RECALLED |
| 0 NOT RECALLED |
COGNITION-8C_2 [] | Section: Health |
(INTERVIEWER: ENTER WRONG WORDS "RECALLED" ON ROSTER BELOW BY SELECTING <ADD ROW> AND TYPING THE WORD.)
COGNITION-8D_1 [T30343.00] | Section: Health |
A little while ago, I read you a list of words and you repeated the ones you could remember. Please tell me any of the words that you remember now.
(INTERVIEWER: PERMIT AS MUCH TIME AS THE R WISHES UP TO ABOUT 2 MINUTES. SELECT "RECALLED" FOR WORDS R RECALLED, AND "NOT RECALLED" FOR WORDS THE R DID NOT RECALL.
SELECT <SUBMIT AND CONTINUE> TO ENTER WRONG WORDS ONTO THE ROSTER ON NEXT SCREEN. BY SELECTING <ADD ROW> AND TYPING THE WORD.)
| - Water |
| - Church |
| - Doctor |
| - Palace |
| - Fire |
| - Garden |
| - Sea |
| - Village |
| - Baby |
| - Table |
| 1 RECALLED |
| 0 NOT RECALLED |
COGNITION-8D_2 [] | Section: Health |
(INTERVIEWER: ENTER WRONG WORDS "RECALLED" ON ROSTER BELOW BY SELECTING <ADD ROW> AND TYPING THE WORD.)
Q11-H50-2 [T30352.00] | Section: Health |
{birthdate~Y} <= 1960
If Answer = 1 Then Go To Q11-H50-2A
Q11-H50-2A [T30353.00] | Section: Health |
([r complete 40+ health module?]==1)
COMMENT: Did this respondent go through the extended health questions in round 18, round 19, round 20 or round 21? If yes, skip out
If Answer = 1 Then Go To CIG_CHK1
Q11-H50CESD [T30354.00] | Section: Health |
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. |
| - I felt that I could not shake off the blues, even with help from my family or friends. |
| - I had trouble keeping my mind on what I was doing. |
| - I felt depressed. |
| - I felt that everything I did was an effort. |
| - My sleep was restless. |
| - I felt lonely. |
| - I felt sad. |
| - I could not get "going". |
| 0 Rarely/None of the time/1 Day |
| 1 Some/A little of the time/1-2 Days |
| 2 Occasionally/Moderate amount of the time/3-4 Days |
| 3 Most/All of the time/5-7 Days |
Q11-H50BPARCHK1 [T30355.00] | Section: Health |
{fath_alive}
If Answer = 0 Then Go To Q11-H50BPARCHK2
Q11-H50BPAR-1 [T30356.00] | Section: Health |
This next series of questions asks about your biological parent's health.
Is your biological father still alive?
If Answer >= -2 AND Answer <= -1 Then Go To Q11-H50BPAR-6
Q11-H50BPAR-2 [T30357.00] | Section: Health |
What caused your biological father's death?
| 1 Heart Attack/Stroke |
| 2 Accident |
| 3 Cancer |
| 4 Old Age |
| 5 Emphysema |
| 6 Other (specify) |
Q11-H50BPAR-3 [T30358.00] | Section: Health |
How old was he when he died?
Q11-H50BPAR-4 [T30359.00] | Section: Health |
{Did_does_fath} your father have any major health problems?
Q11-H50BPAR-5 [] | Section: Health |
What [are/were_fath] these problems?
Q11-H50BPARCHK2 [T30360.00] | Section: Health |
{moth_alive}
If Answer = 0 Then Go To Q11-H50SF12-1
Q11-H50BPAR-6 [T30361.00] | Section: Health |
Is your biological mother still alive?
If Answer >= -2 AND Answer <= -1 Then Go To Q11-H50SF12-1
Q11-H50BPAR-7 [T30362.00] | Section: Health |
What caused your biological mother's death?
| 1 Heart Attack/Stroke |
| 2 Accident |
| 3 Cancer |
| 4 Old Age |
| 5 Emphysema |
| 6 Other (specify) |
Q11-H50BPAR-8 [T30363.00] | Section: Health |
How old was she when she died?
Q11-H50BPAR-9 [T30364.00] | Section: Health |
{did_does_moth} your mother have any major health problems?
Q11-H50BPAR-10 [] | Section: Health |
What [are/were_moth] these problems?
Q11-H50SF12-1 [] | Section: Health |
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.
Q11-H50SF12-2 [T30367.00] | Section: Health |
In general, would you say your health is ....
| 1 Excellent |
| 2 Very Good |
| 3 Good |
| 4 Fair |
| 5 Poor |
Q11-H50SF12-3 [T30368.00] | Section: Health |
The following items are activities you might do during a typical day. Does your health limit you in these activities?
......Moderate activities, such as moving a table, pushing a vacuum cleaner, bowling or playing golf?
| 3 Yes, Limited a Lot |
| 2 Yes, Limited a Little |
| 1 No, Not Limited at All |
Q11-H50SF12-3B [T30369.00] | Section: Health |
..... Climbing several flights of stairs?
| 3 Yes, Limited a Lot |
| 2 Yes, Limited a Little |
| 1 No, Not Limited at All |
Q11-H50SF12-4 [T30370.00] | Section: Health |
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?
Q11-H50SF12-4B [T30371.00] | Section: Health |
.... Were limited in the kind of work or other activities?
Q11-H50SF12-5 [T30372.00] | Section: Health |
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)?
.... Accomplished less than you would like?
Q11-H50SF12-5B [T30373.00] | Section: Health |
.... Didn't do work or other activities as carefully as usual?
Q11-H50SF12-6 [T30374.00] | Section: Health |
During the past 4 weeks, how much did pain interfere with your normal work (including both work outside of the home and housework)?
| 1 Not at all |
| 2 A little bit |
| 3 Moderately |
| 4 Quite a bit |
| 5 Extremely |
Q11-H50SF12-7 [T30375.00] | Section: Health |
Thinking only of the past 4 weeks, 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?
| 1 All the time |
| 2 Most of the time |
| 3 A good bit of the time |
| 4 Some of the time |
| 5 A little of the time |
| 6 None of the time |
Q11-H50SF12-7B [T30376.00] | Section: Health |
.... Did you have a lot of energy?
| 1 All the time |
| 2 Most of the time |
| 3 A good bit of the time |
| 4 Some of the time |
| 5 A little of the time |
| 6 None of the time |
Q11-H50SF12-7C [T30377.00] | Section: Health |
.... Have you felt down-hearted and blue?
| 1 All the time |
| 2 Most of the time |
| 3 A good bit of the time |
| 4 Some of the time |
| 5 A little of the time |
| 6 None of the time |
Q11-H50SF12-8 [T30378.00] | Section: Health |
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.)?
| 1 All the time |
| 2 Most of the time |
| 3 A good bit of the time |
| 4 Some of the time |
| 5 A little of the time |
| 6 None of the time |
Q11-H50CHRC_CHK1 [T30379.00] | Section: Health |
{h40_bp_ht}==1
COMMENT: Did this respondent go through the extended health questions in round 18, round 19, round 20 or round 21? If yes, skip out
If Answer = 1 Then Go To Q11-H50CHRC-1B
Q11-H50CHRC-1 [T30380.00] | Section: Health |
Has a doctor ever told you that you have high blood pressure or hypertension?
Q11-H50CHRC-1A [T30381.00] | Section: Health |
In what month and year was that first diagnosed?
(ENTER MONTH AND YEAR)
Q11-H50CHRC-1B [T30382.00] | Section: Health |
Do you have high blood pressure or hypertension at the present time?
Q11-H50CHRC_CHK2 [T30383.00] | Section: Health |
{h40_diabetes_hbs}==1
COMMENT: Did this respondent go through the extended health questions in round 18, round 19, round 20 or round 21? If yes, skip out
If Answer = 1 Then Go To Q11-H50CHRC-2B
Q11-H50CHRC-2 [T30384.00] | Section: Health |
Has a doctor ever told you that you have diabetes or high blood sugar?
Q11-H50CHRC-2A [T30385.00] | Section: Health |
In what month and year was that first diagnosed?
Q11-H50CHRC-2B [T30386.00] | Section: Health |
Has a doctor ever told you that you had skin cancer?
Q11-H50CHRC-3 [T30387.00] | Section: Health |
{h50_cancer_text1} a doctor ever told you that you have cancer or malignant tumor of any kind except skin cancer?
Q11-H50CHRC-3A [T30388.00] | Section: Health |
How many such cancers have you [Had/had since (date of 40+ Health Module)]?
If Answer = 0 Then Go To Q11-H50CHRC_CHK3
Q11-H50CHRC-3AB [] | Section: Health |
REPEAT
Q11-H50CHRC-3B [T30389.00] | Section: Health |
In what month and year was [most recent/next most recent] cancer diagnosed?
Q11-H50CHRC-3C [] | Section: Health |
In which organ or part of your body did this cancer occur?
Q11-H50CHRC-3D [T30392.00] | Section: Health |
Do you currently have any such cancer?
Q11-H50CHRC-3DB [] | Section: Health |
UNTIL ([Q11-loop3 counter]==[Number of cancers R reported] || [Number of cancers R reported]==0)
Q11-H50CHRC_CHK3 [T30395.00] | Section: Health |
{r_asthma}==1
COMMENT: Did this respondent go through the extended health questions in round 18, round 19, round 20 or round 21? If yes, skip out
If Answer = 1 Then Go To Q11-H50CHRC_CHK4
Q11-H50CHRC-3E [T30396.00] | Section: Health |
Do you currently suffer from asthma?
Q11-H50CHRC_CHK4 [T30397.00] | Section: Health |
{h40_nonasthma_chroniclung}==1
COMMENT: Did this respondent go through the extended health questions in round 18, round 19, round 20 or round 21? If yes, skip out
If Answer = 1 Then Go To Q11-H50CHRC-5
Q11-H50CHRC-4 [T30398.00] | Section: Health |
Not including asthma, has a doctor ever told you that you have chronic lung disease such as chronic bronchitis or emphysema?
Q11-H50CHRC-5 [T30399.00] | Section: Health |
{h50_heart_text1} a doctor ever told you that you had a heart attack, coronary heart disease, angina, congestive heart failure, or other heart problems?
Q11-H50CHRC-5A [T30400.00] | Section: Health |
{h50_heart_text2} you have a heart attack or myocardial infarction?
Q11-H50CHRC-5B [T30401.00] | Section: Health |
In what month and year did you have your [last] heart attack or myocardial infarction?
Q11-H50CHRC-5C [T30402.00] | Section: Health |
Do you currently have any angina or chest pains due to your heart?
Q11-H50CHRC-6 [T30403.00] | Section: Health |
Has a doctor ever told you that you have congestive heart failure?
Q11-H50CHRC-6A [T30404.00] | Section: Health |
In what month and year was your congestive heart failure?
Q11-H50CHRC-7 [T30405.00] | Section: Health |
{h50_stroke_text1} a doctor ever told you that you had a stroke?
Q11-H50CHRC-7A [T30406.00] | Section: Health |
In what month and year did you last have a stroke?
Q11-H50CHRC-7B [T30407.00] | Section: Health |
Has a doctor ever diagnosed you as suffering from depression?
Q11-H50CHRC-7C [T30408.00] | Section: Health |
In what month and year was your depression diagnosed?
Q11-H50CHRC-7D [T30409.00] | Section: Health |
During the last 12 months, have you suffered from depression?
Q11-H50CHRC_CHK6 [T30410.00] | Section: Health |
{h40_psychiatric}==1
COMMENT: Did this respondent go through the extended health questions in round 18, round 19, round 20 or round 21? If yes, skip out
If Answer = 1 Then Go To Q11-H50CHRC_CHK7
Q11-H50CHRC-8 [T30411.00] | Section: Health |
Has a doctor ever told you that you had emotional, nervous, or psychiatric problems other than depression?
Q11-H50CHRC-8A [T30412.00] | Section: Health |
In what month and year were your emotional, nervous or psychiatric problems diagnosed?
Q11-H50CHRC-8B [T30413.00] | Section: Health |
During the last 12 months, have you had any emotional, nervous, or psychiatric problems?
Q11-H50CHRC_CHK7 [T30414.00] | Section: Health |
{h40_arthritis}==1
COMMENT: Did this respondent go through the extended health questions in round 18, round 19, round 20 or round 21? If yes, skip out
If Answer = 1 Then Go To Q11-H50CHRC-9B
Q11-H50CHRC-9 [T30415.00] | Section: Health |
Have you ever had, or has a doctor ever told you that you have, arthritis or rheumatism?
Q11-H50CHRC-9A [T30416.00] | Section: Health |
In what month and year was your arthritis or rheumatism diagnosed?
Q11-H50CHRC-9AB [T30417.00] | Section: Health |
(In what month and year was your arthritis or rheumatism diagnosed?)
Q11-H50CHRC-9B [T30418.00] | Section: Health |
Do you sometimes have pain, stiffness, or swelling in your joints?
Q11-H50CHRC-9C [T30419.00] | Section: Health |
Has a doctor ever told you that you had osteoporosis?
Q11-H50FL-1 [T30420.00] | Section: Health |
Do you currently use any special equipment to aid you in your usual activities? By this we mean things such as hearing aids, wheelchairs, scooters, canes, protheses, or special telephones. Please do not include eyeglasses or false teeth.
Q11-H50FL-2 [T30421.00] | Section: Health |
We are interested in how much difficulty people have with various activities because of a health or physical problem. How difficult is it for you to…
| - ... Run a mile? |
| - … Walk several blocks? |
| - … Walk one block? |
| - ... Sit for about 2 hours? |
| - ... Get up from a chair after sitting for long periods? |
| - ... Climb several flights of stairs without resting? |
| - ... Climb one flight of stairs without resting? |
| - ... Lift or carry weights OVER 10 pounds, like a heavy bag of groceries? |
| - ... Stoop, kneel, or crouch? |
| - ... Pick up a dime from a table? |
| - ... Reach or extend your arms above shoulder level? |
| - ... Pull or push large objects like a living room chair? |
| 1 Not at all difficult for you |
| 2 A little difficult |
| 3 Somewhat difficult |
| 4 Very difficult/can't do |
| 5 Don't do |
Q11-H50SLP-1 [T30422.00] | Section: Health |
How much sleep do you usually get at night (or in your main sleep period) on weekdays or workdays?
Q11-H50SLP-1B [T30423.00] | Section: Health |
Q11-H50SLP-2 [T30424.00] | Section: Health |
How much sleep do you usually get at night (or in your main sleep period) on weekends or your nonworkdays?
Q11-H50SLP-2B [T30425.00] | Section: Health |
Q11-H50SLP-3 [T30426.00] | Section: Health |
How long does it usually take you to fall asleep at bedtime?
Q11-H50SLP-3B [T30427.00] | Section: Health |
Q11-H50SLP-4 [T30428.00] | Section: Health |
During a usual week, how many times do you nap for 5 minutes or more?
Q11-H50SLP-5 [T30429.00] | Section: Health |
How often do you…
| - … have trouble falling asleep? |
| - … wake up during the night and have trouble going back to sleep? |
| - … wake up too early in the morning and be unable to get back to sleep? |
| - … feel unrested during the day, no matter how many hours of sleep you had? |
| 1 Almost always (4+ times per week) |
| 2 Often (2-3 times per week) |
| 3 Sometimes (2-4 times per month) |
| 4 Rarely or never (once a month or less) |
Q11-H50OPEN-1 [T30430.00] | Section: Health |
Is there anything else you want to tell us about your health?
Q11-H50OPEN-1A [] | Section: Health |
(INTERVIEWER: RECORD VERBATIM RESPONSE.)