YHEA-100 [] | Section: Health |
Now I would like to ask you some questions about your health.
In general, how is your health?
| 1 Excellent |
| 2 Very good |
| 3 Good |
| 4 Fair |
| 5 Poor |
YHEA-500A [] | Section: Health |
(REFER TO SHOWCARD TT )
In a typical week, how many times do you eat fruit? (Do not count fruit juice.)
| 1 I do not typically eat fruit |
| 2 1 to 3 times |
| 3 4 to 6 times |
| 4 1 time per day |
| 5 2 times per day |
| 6 3 times per day |
| 7 4 or more times per day |
YHEA-500B [] | Section: Health |
(REFER TO SHOWCARD UU )
In a typical week, how many times do you eat vegetables other than french fries or potato chips?
| 1 I do not typically eat vegetables |
| 2 1 to 3 times |
| 3 4 to 6 times |
| 4 1 time per day |
| 5 2 times per day |
| 6 3 times per day |
| 7 4 or more times per day |
YHEA-500C [] | Section: Health |
How often when you eat a food item would you say you are aware of its nutritional content or ingredients, for example, by having read the label?
| 1 Always |
| 2 Often |
| 3 Sometimes |
| 4 Rarely |
| 5 Never |
| 0 Don't buy food |
YHEA-500DAA [] | 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?
YHEA-500DAB [] | Section: Health |
SELECT PER DAY/WEEK
YHEA-500DBA [] | Section: Health |
(In the past seven days, how many times did you...)
Eat a snack between meals?
YHEA-500DBB [] | Section: Health |
SELECT PER DAY/WEEK
YHEA-500DCA [] | Section: Health |
(In the past seven days, how many times did you...)
Skip a meal?
YHEA-500DCB [] | Section: Health |
SELECT PER DAY/WEEK
YHEA-500DDA [] | Section: Health |
(In the past seven days, how many times did you...)
Have a fruit juice, soft drink or soda that contained sugar? (Do not include diet soft drinks or soda, or carbonated water.)
YHEA-500DDB [] | Section: Health |
SELECT PER DAY/WEEK
YHEA-500DE [] | Section: Health |
(In the past seven days, how many days did you...)
Try to control the number of calories you took in for the day?
YHEA-500EAA [] | Section: Health |
During a usual week, how many times do you brush your teeth?
YHEA-500EAB [] | Section: Health |
SELECT PER DAY/WEEK
YHEA-500EBA [] | Section: Health |
(During a usual week, how many times do you...)
use dental floss?
YHEA-500EBB [] | Section: Health |
SELECT PER DAY/WEEK
YHEA-600AA [] | 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? You may do these activities for exercise, for work, or for some other reason.
| 1 SELECT TO ENTER POSITIVE AMOUNT ...(Go To YHEA-600ABA) |
| 2 R IS UNABLE TO DO THIS TYPE OF ACTIVITY |
| 0 NEVER |
YHEA-600ABA [] | 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?)
YHEA-600ABB [] | Section: Health |
SELECT FREQUENCY
| 1 PER DAY |
| 2 PER WEEK |
| 3 PER MONTH |
| 4 PER YEAR |
YHEA-600ACA [] | Section: Health |
About how long do you do these vigorous activities each time?
YHEA-600ACB [] | Section: Health |
SELECT MINUTES/HOURS
YHEA-600BA [] | Section: Health |
How often do you do light or moderate activities for at least 10 minutes that cause only slight sweating or slight to moderate increase in breathing or heart rate?
PROBE IF NEEDED: You may do these activities for exercise, for work, or for some other reason.
| 1 SELECT TO ENTER POSITIVE AMOUNT ...(Go To YHEA-600BBA) |
| 2 R IS UNABLE TO DO THIS TYPE OF ACTIVITY |
| 0 NEVER |
YHEA-600BBA [] | Section: Health |
(How often do you do light or moderate activities for at least 10 minutes that cause only slight sweating or slight to moderate increase in breathing or heart rate?)
YHEA-600BBB [] | Section: Health |
SELECT FREQUENCY
| 1 PER DAY |
| 2 PER WEEK |
| 3 PER MONTH |
| 4 PER YEAR |
YHEA-600BCA [] | Section: Health |
About how long do you do these light or moderate activities each time?
YHEA-600BCB [] | Section: Health |
SELECT MINUTES/HOURS
YHEA-600CA [] | 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.)
| 1 SELECT TO ENTER POSITIVE AMOUNT ...(Go To YHEA-600CBA) |
| 2 R IS UNABLE TO DO THIS TYPE OF ACTIVITY |
| 0 NEVER |
YHEA-600CBA [] | 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.))
YHEA-600CBB [] | Section: Health |
SELECT FREQUENCY
| 1 PER DAY |
| 2 PER WEEK |
| 3 PER MONTH |
| 4 PER YEAR |
YHEA-600CCA [] | Section: Health |
About how long do you do these physical activities each time?
YHEA-600CCB [] | Section: Health |
SELECT MINUTES/HOURS
YHEA-610 [] | Section: Health |
In a typical week, how many hours total do you use a computer?
| 1 None |
| 2 Less than 1 hour a week |
| 3 1 to 3 hours a week |
| 4 4 to 6 hours a week |
| 5 7 to 9 hours a week |
| 6 10 hours or more a week |
YHEA-620 [] | Section: Health |
In a typical week, how many hours do you watch television?
| 1 Less than 2 hours per week |
| 2 3 to 10 hours a week |
| 3 11 to 20 hours a week |
| 4 21 to 30 hours a week |
| 5 31 to 40 hours a week |
| 6 More than 40 hours a week |
YHEA-650 [] | Section: Health |
On a typical week night, how many hours of sleep do you usually get?
YHEA-810 [] | Section: Health |
During the past 30 days, how many times did you drive a car or other vehicle when you had been drinking alcohol?
| 1 0 times |
| 2 1 time |
| 3 2 or 3 times |
| 4 4 or 5 times |
| 5 6 or more times |
| 6 I DID NOT DRIVE IN THE PAST 30 DAYS |
YHEA-820 [] | Section: Health |
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?
| 1 0 times |
| 2 1 time |
| 3 2 or 3 times |
| 4 4 or 5 times |
| 5 6 or more times |
| 6 I HAVE NOT BEEN A PASSENGER IN THE PAST 30 DAYS |
YHEA-1005 [] | Section: Health |
{YHEA_LIMTXT1} limited in the kind of work you {YHEA_LIMTXT2} do on a job for pay because of your health?
YHEA-1006 [] | Section: Health |
{YHEA_LIMTXT1} limited in the amount of work you {YHEA_LIMTXT2} do because of your health?
YHEA-1880A [] | Section: Health |
During the past 12 months, how many times were you physically injured or ill and had to be treated by a doctor or nurse?
| 1 None |
| 2 1 time |
| 3 2 times |
| 4 3 times |
| 5 4 or more times |
YHEA-1890A [] | Section: Health |
Some injuries are not treated by a doctor or nurse. During the past 12 months, how many times were you physically 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?
| 1 None |
| 2 1 time |
| 3 2 times |
| 4 3 times |
| 5 4 or more times |
YHEA-1891 [] | Section: Health |
During the past 12 months, how many times did you have an emotional, mental or psychiatric problem and were treated by a mental health professional?
| 1 None |
| 2 1 time |
| 3 2 times |
| 4 3 times |
| 5 4 or more times |
YHEA-1892 [] | Section: Health |
Some conditions are not treated by a professional. During the past 12 months, how many times did you have an emotional, mental or psychiatric problem so that you missed at least one full day of usual activities such as work or school, but were not treated by a professional?
| 1 None |
| 2 1 time |
| 3 2 times |
| 4 3 times |
| 5 4 or more times |
YHEA-1893 [] | Section: Health |
How many times did you miss work because you were just not feeling right – for example, you were ‘too blue' to get up in the morning, or feeling too anxious to conduct your usual activities? Please do not include times that you missed work that you've already told me about.
| 1 None |
| 2 1 time |
| 3 2 times |
| 4 3 times |
| 5 4 or more times |
YHEA-1910 [] | Section: Health |
Do you have any kind of health care coverage, including health insurance, prepaid plans such as HMOs, or government plans such as Medicaid?
YHEA-1912 [] | Section: Health |
(INTERVIEWER: IF R PROVIDES NAMES OF HMOs OR INSURANCE COMPANIES, PROBE FOR THE SOURCE OF FUNDING.)
What is the source of your primary health or hospitalization plan? Is it from a policy from your current or previous employer, [/a policy from your spouse or partner] a policy bought directly from a medical insurance company, is it Medicaid or an alternative Medicaid provider, or is it from some other source?
| 1 1. Policy from your CURRENT Employer |
| 2 2. Policy from a PREVIOUS Employer |
| 3 3. Policy from spouse's or partner's CURRENT employer |
| 4 4. Policy from spouse's or partner's PREVIOUS employer |
| 8 8. Policy from your parents or another family member |
| 5 5. Policy you or your spouse or partner bought directly from medical insurance company |
| 6 6. Medicaid or Medicaid provider/Medi-Cal/Medical Assist/Welfare/Medical Service |
| 7 7. Other (SPECIFY) |
YHEA-1913 [] | Section: Health |
Who else in your family is covered by this plan?
(SELECT ALL THAT APPLY.)
| 1 Spouse |
| 2 Partner |
| 3 Residential children |
| 4 Your non-residential biological/adopted children |
| 5 Your spouse/partner's non-residential biological/adopted children |
| 6 Other dependents |
| 7 Your parents or siblings |
| 99 No other person |
YHEA-1914 [] | Section: Health |
([YHEA-1910] == 0 || [YHEAINSSOURCE] != 3) && ([KEY_MARSTAT] ==1 || [YOUTH_PARTNER]==1)
COMMENT: R has no health insurance Or R is not covered by spouse/partner's current employer AND R has a spouse or partner
If Answer = 1 Then Go To YHEA-1915
YHEA-1915 [] | Section: Health |
Can you obtain coverage from a health plan from your [spouse/partner]?
YHEA-1917 [] | Section: Health |
[YHEA-1910] == 1
COMMENT: R currently has health insurance
If Answer = 1 Then Go To YHEA-1920
YHEA-1920 [] | Section: Health |
Since [LINTDATE~X], was there any time that you did not have any health insurance or coverage?
YHEA-1930 [] | Section: Health |
Since [LINTDATE~X], was there any time that you had health coverage?
YHEA-1940A [] | Section: Health |
In the past twelve months, have you visited a doctor for a routine checkup?