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Questions for 2003
C = Core Question
M = Module Question
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| Alcohol Consumption |
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C
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A drink of alcohol is 1 can or bottle of beer, 1 glass of wine, 1 can or bottle of wine cooler, 1 cocktail, or 1 shot of liquor. During the past 30 days, how many days per week or per month did you have at least one drink of any alcoholic beverage? (variable name change)
Variable Name: ALCDAY3
1 __ __=Days per week
2 __ __=Days in past 30
888=No drinks in past 30 days
777=DK/NS
999=Refused
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C
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On the days when you drank, about how many drinks did you drink on the average?
Variable Name: ALCOHOL2
__ __=Number of drinks
77=DK/NS
99=Refused
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C
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A drink of alcohol is 1 can or bottle of beer, 1 glass of wine, 1 can or bottle of wine cooler, 1 cocktail, or 1 shot of liquor. On the days when you drank, about how many drinks did you drink on the average?
Variable Name: AVEDRINK
__ __=Number of drinks
77=DK/NS
99=Refused
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C
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Considering all types of alcoholic beverages, how many times during the past 30 days did you have 5 or more drinks on an occasion?
Variable Name: DRNK2GE5
__ __=Number of times
88=None
77=DK/NS
99=Refused
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| Diabetes |
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M
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About how often do you check your blood for glucose or sugar? Include times when checked by a family member or friend, but do not include times when checked by a health professional.
Variable Name: BLDSUGAR
1__ __ Times per day
2__ __ Times per week
3__ __ Times per month
4__ __ Times per year
888=Never
777=Don't know/Not sure
999=Refused
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M
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A test for hemoglobin "A one C" measures the average level of blood sugar over the past three months. About how many times in the last year has a doctor, nurse, or other health professional checked you for hemoglobin "A one C"?
Variable Name: CHKHEMO2
__ __=Number of times
88=None
98=Never heard of hemoglobin "A one C" test
77=DK/NS
99=Refused
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M
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How old were you when you were told you have diabetes? (Variable name change.)
Variable Name: DIABAGE2
__ __=Age in years
77=DK/NS
99=Refused
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M
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Have you ever taken a course or class in how to manage your diabetes yourself?
Variable Name: DIABEDU
1=Yes
2=No
7=DK/NS
9=Refused
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C
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Have you ever been told by a doctor that you have diabetes? (If "Yes" and female, ask "Was this only when you were pregnant?")
Variable Name: DIABETES
1=Yes
2=Yes, but female told only during pregnancy
3=No
7=DK/Ns
9=Refused
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M
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Has a doctor ever told you that diabetes has affected your eyes or that you had retinopathy?
Variable Name: DIABEYE
1=Yes
2=No
7=DK/NS
9=Refused
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M
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Are you now taking diabetes pills?
Variable Name: DIABPILL
1=Yes
2=No
7=DK/NS
9=Refused
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M
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About how many times in the past 12 months have you seen a doctor, nurse, or other health professional for your diabetes?
Variable Name: DOCTDIAB
__ __=Number of times
88=None
77=DK/NS
99=Refused
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M
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When was the last time you had an eye exam in which the pupils were dilated? This would have made you temporarily sensitive to bright light.
Variable Name: EYEEXAM
1=Within the past month
2=Within the past year
3=Within the past 2 years
4=2 or more years ago
8=Never
7=DK/NS
9=Refused
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M
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About how many times in the past 12 months has a health professional checked your feet for any sores or irritations?
Variable Name: FEETCHK
__ __=Number of times
88=None
77=DK/NS
99=Refused
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M
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About how often do you check your feet for any sores or irritations? (Include times when checked by a family member or friend, but do not include times when checked by a health professional.)
Variable Name: FEETCHK2
1=__ __ Times per day
2=__ __ Times per week
3=__ __ Times per month
4=__ __ Times per year
888=Never
555=No feet
777=DK/NS
999=Refused
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M
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Have you ever had any sores or irritations on your feet that took more than four weeks to heal?
Variable Name: FEETSORE
1=Yes
2=No
7=DK/NS
9=Refused
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M
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Are you now taking insulin?
Variable Name: INSULIN
1=Yes
2=No
9=Refused
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| Health Status |
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C
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Would you say that in general your health is:
Variable Name: GENHLTH
1=Excellent
2=Very good
3=Good
4=Fair
5=Poor
7=DK/NS
9=Refused
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C
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Now thinking about your mental health, which includes stress, depression, and problems with emotions, for how many days during the past 30 days was your mental health not good?
Variable Name: MENTHLTH
__ __=Number of days
88=None
77=DK/NS
99=Refused
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C
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Now thinking about your physical health, which includes physical illness and injury, for how many days during the past 30 days was your physical health not good?
Variable Name: PHYSHLTH
__ __=Number of days
88=None
77=DK/NS
99=Refused
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C
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During the past 30 days, for about how many days did poor physical or mental health keep you from doing your usual activities, such as self-care, work, or recreation?
Variable Name: POORHLTH
__ __=Number of days
88=None
77=DK/NS
99=Refused
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| HIV/AIDS |
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C
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How important do you think it is for people to know their HIV status by getting tested? Would you say:
Variable Name: HIVOPT1B
1=Very important
2=Somewhat important
3=Not at all important
7=DK/NS
9=Refused
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C
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The next few questions are about the national health problem of HIV, the virus that causes AIDS. Please remember that your answers are strictly confidential and that you don't have to answer every question if you don't want to.
I'm going to read two statements about HIV, the virus that causes AIDS. After I read each one, please tell me whether you think it is true or false, or if you don't know.
A pregnant woman with HIV can get treatment to help reduce the chances that she will pass the virus on to her baby.
Variable Name: HIVTF1A
1=True
2=False
7=DK/NS
9=Refused
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C
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There are medical treatments available that are intended to help a person who is infected with HIV to live longer.
Variable Name: HIVTF1B
1=True
2=False
7=DK/NS
9=Refused
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C
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Have you ever been tested for HIV? Do not count tests you may have had as part of a blood donation. (Include saliva tests.)
Variable Name: HIVTST3
1=Yes
2=No
7=DK/NS
9=Refused
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C
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Not including blood donations, in what month and year was your last HIV test? (Include saliva tests.)
Variable Name: HIVTSTD2
__ __/__ __ __ __=Code month and year
777777=DK/NS
999999=Refused
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C
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The next question is about sexually transmitted diseases other than HIV, such as syphilis, gonorrhea, chlamydia, or genital herpes. In the past 12 months has a doctor, nurse, or other health professional talked to you about preventing sexually transmitted diseases through condom use?
Variable Name: PCSAIDS2
1=Yes
2=No
7=DK/NS
9=Refused
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C
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I am going to read you a list of reasons why some people have been tested for HIV. Not including blood donations, which of these would you say was the MAIN reason for your last HIV test?
Variable Name: RSNTST4
01=It was required
02=Someone suggested you should be tested
03=You thought you may have gotten HIV through sex or drug use
04=You just wanted to find out whether you had HIV
05=You were worried that you could give HIV to someone
06=IF FEMALE: You were pregnant
07=It was done as part of a routine medical check-up
08=Or you were tested for some other reason
77=DK/NS
99=Refused
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C
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Where did you have your last HIV test - at a private doctor or HMO office, at a couseling and testing site, at a hospital, at a clinic, in a jail or prison, at home, or somewhere else?
Variable Name: WHRTST5
01=Private doctor or HMO
02=Counseling and testing site
03=Hospital
04=Clinic
05=In a jail or prison (or other correctional facility)
06=Home
07=Somewhere else
77=DK/NS
99=Refused
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| Tobacco Use |
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M
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Do you now smoke bidis every day, some days, or not at all?
Variable Name: BIDINOW
1=Every day
2=Some days
3=Not at all
7=DK/NS
9=Refused
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M
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A bidi is a flavored cigarette from India. Have you ever smoked a bidi, even one or two puffs?
Variable Name: BIDISMK
1=Yes
2=No
7=DK/NS
9=Refused
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M
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Have you ever smoked a cigar, even one or two puffs?
Variable Name: CIGAR2
1=Yes
2=No
7=DK/NS
9=Refused
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M
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Do you now smoke cigars every day, some days, or not at all?
Variable Name: CIGARNOW
1=Every day
2=Some days
3=Not at all
7=DK/NS
9=Refused
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M
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Previously you said you have smoked cigarettes. How old were you the first time you smoked a cigarette, even one or two puffs?
Variable Name: FIRSTSMK
__ __=Code age in years
77=DK/NS
99=Refused
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M
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In the past 12 months, have you seen a doctor, nurse, or other health professional to get any kind of care for yourself?
Variable Name: GETCARE
1=Yes
2=No
7=DK/NS
9=Refused
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M
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Which statement best describes the rules about smoking inside your home?
Variable Name: HOUSESMK
1=Smoking is not allowed anywhere inside your home
2=Smoking is allowed in some places or at some times
3=Smoking is allowed anywhere inside the home
4=There are no rules about smoking inside the home
7=DK/NS
9=Refused
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M
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While working at your job, are you indoors most of the time?
Variable Name: INDOORS
1=Yes
2=No
7=DK/NS
9=Refused
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M
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About how long has it been since you last smoked cigarettes regularly?
Variable Name: LASTSMK
1=Within the past month (0 to 1 month ago)
2=Within the past 3 months (1 to 3 months ago)
3=Within the past 6 months (3 to 6 months ago)
4=Within the past year (6 months to 1 year ago)
5=Within the past 5 years (1 year to 5 years ago)
6=Within the past 10 years (5 to 10 years ago)
7=10 or more years ago
77=DK/NS
99=Refused
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M
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Do you now smoke a pipe every day, some days, or not at all?
Variable Name: PIPENOW
1=Every day
2=Some days
3=Not at all
7=DK/NS
9=Refused
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M
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Have you ever smoked tobacco in a pipe, even one or two puffs?
Variable Name: PIPESMK
1=Yes
2=No
7=DK/NS
9=Refused
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M
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In the past 12 months, has a doctor, nurse, or other health professional advised you to quit smoking?
Variable Name: QUITSMOK
1=Yes
2=No
7=DK/NS
9=Refused
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M
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How old were you when you first started smoking cigarettes regularly?
Variable Name: REGSMK
__ __=Code age in years
88=Never smoked regularly
77=DK/NS
99=Refused
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M
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Which of the following best describes your place of work's official smoking policy for indoor public or common areas, such as lobbies, rest rooms, and lunch rooms?
Variable Name: SMKPUBLC
1=Not allowed in any public areas
2=Allowed in some public areas
3=Allowed in all public areas
4=No official policy
7=DK/NS
9=Refused
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M
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Which of the following best describes your place of work's official smoking policy for work areas?
Variable Name: SMKWORK
1=Not allowed in any work areas
2=Allowed in some work areas
3=Allowed in all work areas
4=No official policy
7=DK/NS
9=Refused
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C
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Have you smoked at least 100 cigarettes in your entire life?
Variable Name: SMOKE100
1=Yes
2=No
7=DK/NS
9=Refused
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C
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Do you now smoke cigarettes everyday, some days, or not at all?
Variable Name: SMOKEDAY
1 Every day
2 Some days
3 Not at all
9 Refused
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C
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During the past 12 months, have you stopped smoking for one day or longer because you were trying to quit smoking?
Variable Name: STOPSMK2
1=Yes
2=No
7=DK/NS
9=Refused
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M
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Have you ever used or tried any smokeless tobacco products such as chewing tobacco or snuff?
Variable Name: USEEVER2
1=Yes
2=No
7=DK/NS
9=Refused
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M
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Do you currently use chewing tobacco or snuff every day, some days, or not at all?
Variable Name: USENOW2
1=Every day
2=Some days
3=Not at all
7=DK/NS
9=Refused
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| Women's Health |
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M
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Have you had a hysterectomy? (Change in skip pattern.)
Variable Name: HADHYST2
1=Yes
2=No
7=DK/NS
9=Refused
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M
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A mammogram is an x-ray of each breast to look for breast cancer. Have you ever had a mammogram?
Variable Name: HADMAM
1=Yes
2=No
7=DK/NS
9=Refused
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M
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A Pap smear is a test for cancer of the cervix. Have you ever had a Pap smear?
Variable Name: HADPAP
1=Yes
2=No
7=DK/NS
9=Refused
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M
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How long has it been since you had your last mammogram?
Variable Name: HOWLONG
1=W/in past yr
2=W/in past 2 yrs
3=W/in past 3 yrs
4=W/in the past 5 yrs
5=>5 yrs
7=DK/NS
9=Refused
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M
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How long has it been since you had your last Pap smear?
Variable Name: LASTPAP
1=Within the past year
2=Within the past 2 years
3=Within the past 3 years
4=Within the past 5 years
5=5 or more years ago
7=DK/NS
9=Refused
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M
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How long has it been since your last breast exam?
Variable Name: LENGEXAM
1=Within the past year
2=Within the past 2 years
3=Within the past 3 years
4=Within the past 5 years
5=5 or more years ago
7=DK/NS
9=Refused
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C
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You said your most recent mammogram was [CATI will be used to insert the time frame from the question "How long has it been since you had your last mammogram?"]. How long before THAT mammogram was the last one?
Variable Name: NEXTMAM
1=Less than 12 months before
2=1 year but less than 2 years before
3=2 years but less than 3 years before
4=3 years but less than 5 years before
5=5 or more years before
6=Has only had one mammogram
7=DK/NS
8=Never
9=Refused
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M
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A clinical breast exam is when a doctor, nurse, or other health professional feels the breast for lumps. Have you ever had a clinical breast exam?
Variable Name: PROFEXAM
1=Yes
2=No
7=DK/NS
9=Refused
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M
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Were either of your two most recent mammograms done to check a possible problem?
-or-
Was your most recent mammogram done to check a possible problem?
Variable Name: WHYDONE3
1=Yes
2=No
7=DK/NS
9=Refused
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| Oral Health |
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M
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How long has it been since you had your teeth "cleaned" by a dentist or dental hygienist?
Variable Name: DENCLEAN
1=Within the past year
2=Within the past 2 years
3=Within the past 5 years
4=5 or more years ago
7=DK/NS
8=Never
9=Refused
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M
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How long has it been since you last visited the dentist or a dental clinic for any reason?
Variable Name: LASTDEN2
1=Within the past year
2-Within the past 2 years
3=Within the past 5 years
4=5 or more years ago
7=DK/NS
8=Never
9=Refused
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M
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How many of your permanent teeth have been removed because of tooth decay or gum disease? Do not include teeth lost for other reasons, such as injury or orthodontics.
Variable Name: RMVTEETH
1=1 to 5
2=6 or more but not all
3=All
8=None
7=DK/NS
9=Refused
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| Nutrition/Diet/Fruits and Vegetables |
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C
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How often do you eat carrots?
Variable Name: CARROTS
1_ _=Per Day
2_ _=Per Week
3_ _=Per Month
4_ _=Per Year
555=Never
777=DK/NS
999=Refused
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C
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Not counting juice, how often do you eat fruit?
Variable Name: FRUIT
1_ _=Per Day
2_ _=Per Week
3_ _=Per Month
4_ _=Per Year
555 =Never
777 =DK/NS
999 =Refused
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C
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These next questions are about the foods you usually eat or drink. Please tell me how often you eat or drink each one, for example, twice a week, three times a month, and so forth. Remember, I am only interested in the foods you eat. Include all foods you eat, both at home and away from home. How often do you drink fruit juices such as orange, grapefruit, or tomato?
Variable Name: FRUITJUI
1_ _=Per Day
2_ _=Per Week
3_ _=Per Month
4_ _=Per Year
555 =Never
777 =DK/NS
999 =Refused
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C
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How often do you eat green salad?
Variable Name: GREENSAL
1_ _ =Per Day
2_ _ =Per Week
3_ _ =Per Month
4_ _ =Per Year
555=Never
777=DK/NS
999=Refused
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C
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How often do you eat potatoes not including french fries, fried potatoes, or potato chips?
Variable Name: POTATOES
1_ _=Per Day
2_ _=Per Week
3_ _=Per Month
4_ _=Per Year
555 =Never
777 =DK/NS
999 =Refused
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C
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Not counting carrots, potatoes, or salad, how many servings of vegetables do you usually eat? (For example, a serving of vegetables at both lunch and dinner would be two servings.)
Variable Name: VEGETABL
1_ _=Per Day
2_ _=Per Week
3_ _=Per Month
4_ _=Per Year
555 =Never
777 =DK/NS
999 =Refused
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| Quality Of Life |
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C
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Are you limited in any way in any activities because of physical, mental, or emotional problems?
Variable Name: QLACTLM2
1=Yes
2=No
7=Don't know/Not sure
9=Refused
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| Cholesterol (Awareness) |
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C
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Blood cholesterol is a fatty substance found in the blood. Have you ever had your blood cholesterol checked?
Variable Name: BLOODCHO
1=Yes
2=No
7=DK/NS
9=Refused
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C
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About how long has it been since you last had your blood cholesterol checked?
Variable Name: CHOLCHK
1=Within past yr
2=Within past 2 yrs
3=Within past 5 yrs
4=5 yrs or more
7=DK/NS
9=Refused`
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C
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Have you every been told by a doctor, nurse, or other health professional that your blood cholesterol is high? (Change in variable name.)
Variable Name: TOLDHI2
1=Yes
2=No
7=DK/NS
9=Refused
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| Hypertension (Awareness) |
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C
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Have you ever been told by a doctor, nurse, or other health professional that you have high blood pressure?
Variable Name: BPHIGH3
1=Yes
2=Yes, but female told only during pregnancy
3=No
7=DK/NS
9=Refused
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C
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Are you currently taking medicine for your high blood pressure?
Variable Name: BPMEDS
1=Yes
2=No
7=DK/NS
9=Refused
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| Exercise/Physical Activity |
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C
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During the past month, other than your regular job, did you participate in any physical activities or exercise such as running, calisthenics, golf, gardening, or walking for exercise?
Variable Name: EXERANY2
1=Yes
2=No
7=DK/NS
9=Refused
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C
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When you are at work, which of the following best describes what you do? Would you say:
Variable Name: JOBACTIV
1=Mostly sitting or standing
2=Mostly walking
3=Mostly heavy labor or physically demanding work
7=DK/NS
9=Refused
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C
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We are interested in two types of physical activity: vigorous and moderate. Vigorous activities cause large increases in breathing or heart rate while moderate activities cause small increases in breathing or heart rate. Now, thinking about the moderate physical activities you do in a usual week, do you do moderate activities for at least 10 minutes at a time, such as brisk walking, bicycling, vacuuming, gardening, or anything else that causes small increases in breathing or heart rate?
Variable Name: MODPACT
1=Yes
2=No
7=DK/NS
9=Refused
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C
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How many days per week do you do these moderate activities for at least 10 minutes at a time?
Variable Name: MODPADAY
__ __=Days per week
88=Do not do any moderate physical activity for at least 10 minutes at a time
77=DK/NS
99=Refused
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C
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On days when you do moderate activities for at least 10 minutes at a time, how much total time per day do you spend doing these activities?
Variable Name: MODPATIM
__:__ __=Hours and minutes per day
777=DK/NS
999=Refused
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C
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Now thinking about the vigorous physical activities you do in a usual week, do you do vigorous activities for at least 10 minutes at a time, such as running, aerobics, heavy yard work, or anything else that causes large increases in breathing or heart rate?
Variable Name: VIGPACT
1=Yes
2=No
7=DK/NS
9=Refused
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C
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How many days per week do you do these vigorous activities for at least 10 minutes at a time?
Variable Name: VIGPADAY
__ __=Days per week
88=Do not do any vigorous physical activities for least 10 minutes at a time
77=DK/NS
99=Refused
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C
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On days when you do vigorous activities for at least 10 minutes at a time, how much total time per day do you spend doing these activities?
Variable Name: VIGPATIM
__:__ __=Hours and minutes per day
777=DK/NS
999=Refused
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| Health Care Coverage/Access |
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C
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Do you have any kind of health care coverage, including health insurance, prepaid plans such as HMOs, or government plans such as Medicare?
Variable Name: HLTHPLAN
1=Yes
2=No
7=DK/NS
9=Refused
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C
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Was there a time in the last 12 months when you needed to see a doctor, but could not because of the cost?
Variable Name: MEDCOST
1=Yes
2=No
7=DK/NS
9=Refused
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C
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Do you have one person you think of as your personal doctor or health care provider?
Variable Name: PERSDOC2
1=Yes, only one
2=More than one
3=No
7=DK/NS
9=Refused
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| Arthritis |
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C
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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?
Variable Name: ARTHDIS2
1=Yes
2=No
7=DK/NS
9=Refused
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M
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Have you ever taken an educational course or class to teach you how to manage problems related to your arthritis or joint symptoms?
Variable Name: ARTHEDU
1=Yes
2=No
7=Don't know/Not sure
9=Refused
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M
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Has a doctor or other health professional ever suggested physical activity or exercise to help your arthritis or joint symptoms?
Variable Name: ARTHEXER
1=Yes
2=No
7=Don't know/Not sure
9=Refused
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M
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Has a doctor or other health professional ever suggested losing weight to help your arthritis or joint symptoms?
Variable Name: ARTHWGT
1=Yes
2=No
7=Don't know/Not sure
9=Refused
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M
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Thinking about your arthritis or joint symptoms, which of the following best describes you TODAY?
Variable Name: ARTTODAY
1=I can do everything I would like to do
2=I can do most things I would like to do
3=I can do some things I would like to do
4=I can hardly do anything I would like to do
7=DK/NS
9=Refused
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C
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Have you ever been told by a doctor that you have some form of arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia?
Variable Name: HAVARTH2
1=Yes
2=No
7=Don't know/Not sure
9=Refused
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C
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Have you ever seen a doctor or other health professional for these joint symptoms?
Variable Name: JOINTRT2
1=Yes
2=No
7=DK/NS
9=Refused
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C
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Did your joints symptoms FIRST begin more than 3 months ago?
Variable Name: JOINTSYM
1=Yes
2=No
7=DK/NS
9=Refused
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C
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Are you now limited in any of your usual activities because of arthritis or joint symptoms?
Variable Name: LMTJOIN2
1=Yes
2=No
7=Don't know/Not sure
9=Refused
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|
C
|
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?
Variable Name: PAIN30DY
1=Yes
2=No
7=DK/NS
9=Refused
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| Cardiovascular Disease/Heart Attack and Stroke |
|
M
|
Do you have a health problem or condition that makes taking aspirin unsafe for you?
Variable Name: ASPUNSAF
1=Yes, not stomach related
2=Yes, stomach problems
3=No
7=DK/NS
9=Refused
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|
M
|
Do you take aspirin daily or every other day?
Variable Name: CVDASPRN
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
(Has a doctor, nurse, or other health professional ever told you that you had) angina or coronary heart disease?
Variable Name: CVDCRHD2
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
(To lower your risk of developing heart disease or stroke, are you) more physically active?
Variable Name: CVDEXR03
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
(Within the past 12 months, has a doctor, nurse, or other health professional told you to) be more physically active?
Variable Name: CVDEXRS2
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
To lower your risk of developing heart disease or stroke, are you eating fewer high fat or high cholesterol foods?
Variable Name: CVDFAT02
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
Within the past 12 months, has a doctor, nurse, or other health professional told you to eat fewer high fat or high cholesterol foods?
Variable Name: CVDFATR2
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
(Within the past 12 months, has a doctor, nurse, or other health professional told you to) eat more fruits and vegetables?
Variable Name: CVDFVEG
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
(To lower your risk of developing heart disease or stroke, are you) eating more fruits and vegetables?
Variable Name: CVDFVG01
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
Has a doctor, nurse, or other health professional ever told you that you had any of the following? A heart attack, also called a myocardial infarction?
Variable Name: CVDINFR2
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
After you left the hospital following your heart attack or stroke, did you go to any kind of outpatient rehabilitation? This is sometimes called "rehab."
Variable Name: CVDREHAB
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
(Has a doctor, nurse, or other health professional ever told you that you had) a stroke?
Variable Name: CVDSTRK2
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
If you thought someone was having a heart attack or a stroke, what is the first thing you would do?
Variable Name: FIRSTAID
1=Take them to the hospital
2=Tell them to call their doctor
3=Call 911
4=Call their spouse or a family member
5=Do something else
7=DK/NS
9=Refused
|
|
M
|
Now I would like to ask you about your knowledge of the signs and symptoms of a heart attack and stroke. Which of the following do you think is a symptom of a heart attack? For each, tell me yes, no, or you're not sure. Do you think pain or discomfort in the jaw, neck, or back are symptoms of a heart attack?
Variable Name: HASYMP1
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
Do you think feeling weak, lightheaded, or faint are symptoms of a heart attack?
Variable Name: HASYMP2
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
(Do you think) chest pain or discomfort (are symptoms of a heart attack?)
Variable Name: HASYMP3
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
(Do you think) sudden trouble seeing in one or both eyes (is a symptom of a heart attack?)
Variable Name: HASYMP4
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
(Do you think) pain or discomfort in the arms or shoulder (are symptoms of a heart attack?)
Variable Name: HASYMP5
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
(Do you think) shortness of breath (is a symptom of a heart attack?)
Variable Name: HASYMP6
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
At what age did you have your first heart attack?
Variable Name: HATTKAGE
__ __=Code age in years
07=DK/NS
09=Refused
|
|
M
|
At what age did you have your first stroke?
Variable Name: STROKAGE
__ __=Code age in years
07=DK/NS
09=Refused
|
|
M
|
Which of the following do you think is a symptom of a stroke? For each, tell me yes, no, or you're not sure. Do you think sudden confusion or trouble speaking are symptoms of a stroke?
Variable Name: STRSYMP1
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
Do you think sudden numbness or weakness of face, arm, or leg, especially on one side, are symptoms of a stroke?
Variable Name: STRSYMP2
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
(Do you think) sudden trouble seeing in one or both eyes (is a symptom of a stroke?)
Variable Name: STRSYMP3
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
(Do you think) sudden chest pain or discomfort (are symptoms of a stroke?)
Variable Name: STRSYMP4
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
(Do you think) sudden trouble walking, dizziness, or loss of balance (are symptoms of a stroke?)
Variable Name: STRSYMP5
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
(Do you think) severe headache with no known cause (is a symptom of a stroke?)
Variable Name: STRSYMP6
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
Why do you take aspirin? To relieve pain?
Variable Name: WHYASPAN
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
(Why do you take aspirin?) To reduce the chance of a heart attack?
Variable Name: WHYASPHA
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
(Why do you take aspirin?) To reduce the chance of a stroke?
Variable Name: WHYASPSK
1=Yes
2=No
7=DK/NS
9=Refused
|
| Asthma |
|
M
|
During the past 12 months, how many days were you unable to work or carry out your usual activities because of your asthma?
Variable Name: ASACTLIM
__ __ __=Number of days
888=None
777=DK/NS
999=Refused
|
|
M
|
During the past 12 months, have you had an episode of asthma or an asthma attack?
Variable Name: ASATTACK
1=Yes
2=No
7=DN/NS
9=Refused
|
|
M
|
(Besides those emergency room visits,) During the past 12 months, how many times did you see a doctor, nurse, or other health professional for urgent treatment of worsening asthma symptoms?
Variable Name: ASDRVIST
__ __=Number of visits
88=None
98=DK/NS
99=Refused
|
|
M
|
During the past 12 months, how many times did you visit an emergency room or urgent care center because of your asthma?
Variable Name: ASERVIST
__ __=Number of visits
88=None
98=DK/NS
99=Refused
|
|
M
|
During the past 30 days, how many days did symptoms of asthma make it difficult for you to stay asleep?
Variable Name: ASNOSLEP
8=None
1=One or two
2=Three to four
3=Five
4=Six to ten
5=More than 10
7=DK/NS
9=Refused
|
|
M
|
During the past 12 months, how many times did you see a doctor, nurse, or other health professional for a routine checkup for your asthma?
Variable Name: ASRCHKUP
__ __=Number of visits
88=None
98=DK/NS
99=Refused
|
|
C
|
Have you ever been told by a doctor, nurse, or other health professional that you had asthma?
Variable Name: ASTHMA2
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
Previously you said you were told by a doctor, nurse, or other health professional that you had asthma. How old were you when you were first told by a doctor, nurse, or other health professional that you had asthma?
Variable Name: ASTHMAGE
__ __=Age in years 11 or older
97=Age 10 or younger
98=DK/NS
99=Refused
|
|
M
|
During the past 30 days how often did you take asthma medication that was prescribed or given to you by a doctor? This includes using an inhaler.
Variable Name: ASTHMEDS
8=Didn't take any
1=Less than once a week
2=Once or twice a week
3=More than 2 times a week, but not every day
4=Once every day
5=2 or more times every day
7=DK/NS
9=Refused
|
|
C
|
Do you still have asthma?
Variable Name: ASTHNOW
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
Symptoms of asthma include cough, wheezing, shortness of breath, chest tightness and phlegm production when you don't have a cold or respiratory infection. During the past 30 days, how often did you have any symptoms of asthma? Would you say:
Variable Name: ASYMPTOM
8=Not at any time
1=Less than once a week
2=Once or twice a week
3=More than 2 times a week, but not every day
4=Every day, but not all the time
5=Every day, all the time
7=DK/NS
9=Refused
|
|
M
|
Earlier you said there were [fill in number from core] children age 17 or younger living in your household. How many of these children have ever been diagnosed with asthma?
Variable Name: CASTHDX
__ __=Number of children
88=None
77=DK/NS
99=Refused
|
|
M
|
(Does this child/How many of these children) still have asthma?
Variable Name: CASTHNOW
__ __=Number of children
88=None
77=Don't know
99=Refused
|
| Prostate Cancer Screening |
|
M
|
A digital rectal exam is an exam in which a doctor, nurse, or other health professional places a gloved finger into the rectum to feel the size, shape, and hardness of the prostate gland. Have you ever had a digital rectal exam?
Variable Name: DIGRECEX
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
How long has it been since your last digital rectal exam?
Variable Name: DRETIME
1=Within the past year
2=Within the past 2 years
3=Within the past 3 years
4=Within the past 5 years
5=5 or more years ago
7=DK/NS
9=Refused
|
|
M
|
Have you ever been told by a doctor, nurse, or other health professional that you had prostate cancer?
Variable Name: PROSTATE
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
A Prostate-Specific Antigen test, also called a PSA test, is a blood test used to check men for prostate cancer. Have you ever had a PSA test?
Variable Name: PSATEST
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
How long has it been since you had your last PSA test?
Variable Name: PSATIME
1=Within the past year
2=Within the past 2 years
3=Within the past 3 years
4=Within the past 5 years
5=5 or more years ago
7=DK
9=Refused
|
| Colorectal Cancer Screening |
|
M
|
A blood stool test is a test that may use a special kit at home to determine whether the stool contains blood. Have you ever had this test using a home kit?
Variable Name: BLDSTOOL
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
Sigmoidoscopy and colonoscopy are exams in which a tube is inserted in the rectum to view the bowel for signs of cancer or other health problems. Have you ever had either of these exams?
Variable Name: HADSIGM2
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
How long has it been since you had your last sigmoidoscopy or colonoscopy?
Variable Name: LASTSIG2
1=Within the past year
2=Within the past 2 years
3=Within the past 5 years
4=Within the past 10 years
5=10 or more years ago
7=DK/NS
9=Refused
|
|
M
|
How long has it been since you had your last blood stool test using a home kit?
Variable Name: LSTBLDS2
1=Within the past year
2=Within the past 2 years
3=Within the past 5 years
4=5 or more years ago
7=Don't know/Not sure
8=Never
9=Refused
|
| Immunization |
|
M
|
At what kind of place did you get your last flu shot?
Variable Name: FLUPRO2
01=A doctor's office or health maintenance organization
02=A health department
03=Another type of clinic or health center [Example: a community health center]
04=A senior, recreation, or community center
05=A store [Examples: supermarket, drug store]
06=A hospital or emergency room
07=Workplace
08=Some other kind of place
77=DK/NS
99=Refused
|
|
C
|
During the past 12 months, have you had a flu shot?
Variable Name: FLUSHOT
1=Yes
2=No
7=DK/NS
9=Refused
|
|
C
|
Have you ever had a pneumonia shot? This shot is usually given only once or twice in a person's lifetime and is different from the flu shot. It is also called the pneumococcal vaccine.
Variable Name: PNEUVAC2
1=Yes
2=No
7=DK/NS
9=Refused
|
| Injury/Residential Fire |
|
M
|
Have you (and your household) designed a fire escape plan?
Variable Name: FIRESCP3
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
In your home fire escape plan, have you thought about (your household discussed) at least one way to exit every room?
Variable Name: FIREXIT
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
In your home fire escape plan, have you identifies a specific place outside of your residence to go (for household members to meet) after escaping a fire?
Variable Name: FRPEXLOC
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
How often do you (and your household) practice your fire escape plan? Would you say:
Variable Name: FRPLANDO
1=Never
2=Less than once a year
3=Once a year
4=Once every six months
5=Once a month
6=More than once a month
7=Don't know/not sure
9=Refused
|
|
M
|
When was the last time you or someone else deliberately tested all of the smoke detectors in your home?
Variable Name: SMKDETE3
1=Within the past month
2=Within the past 6 months
3=Within the past year
4=One or more years ago
5=Never
6=No smoke detectors in home
7=DK/NS
9=Refused
|
| Sexual Behavior |
|
C
|
I'm going to read you a list. When I'm done, please tell me if any of the situations apply to you. You don't need to tell me which one.
You have used intravenous drugs in the past year.
You have been treated for a sexually transmitted or venereal disease in the past year.
You have given or received money or drugs in exchange for sex in the past year.
You had anal sex without a condom in the past year.
Do any of these situations apply to you?
Variable Name: HIVRISK2
1=Yes
2=No
7=Don't know/Not sure
9=Refused
|
| Demographics |
|
C
|
What is your age?
Variable Name: AGE
__ __=Code age in years
7=DK/NS
9-Refused
|
|
C
|
How many children less than 18 years of age live in your household?
Variable Name: CHILDREN
__ __=Number of children
88=None
99=Refused
|
|
C
|
What county do you live in?
Variable Name: CTYCODE
__ __ __=FIPS county code
777=DK/NS
999=Refused
|
|
C
|
What is the highest grade or year of school you completed?
Variable Name: EDUCA
1=Never attended school or only attended kindergarten
2=Grades 1 through 8 (Elementary)
3=Grades 9 through 11 (Some high school)
4=Grade 12 or GED (High school graduate)
5=College 1 year to 3 years (Some college or technical school)
6=College 4 years or more (College graduate)
9=Refused
|
|
C
|
Are you currently:
Variable Name: EMPLOY
1=Employed for wages
2=Self-employed
3=Out of work for more than 1 year
4=Out of work for less than 1 year
5=Homemaker
6=Student
7=Retired
8=Unable to work
9=Refused
|
|
C
|
About how tall are you without shoes?
Variable Name: HEIGHT
__/__ __=Height (ft/inches)
777=DK/NS
999=Refused
|
|
C
|
Are you Hispanic or Latino?
Variable Name: HISPANC2
1=Yes
2=No
7=DK/NS
9=Refused
|
|
C
|
Is your annual household income from all sources: (Variable name change.)
Variable Name: INCOME2
4=Less than $25,000
($20,000 to less than $25,000)
3=Less than $20,000
($15,000 to less than $20,000)
2=Less than $15,000
($10,000 to less than $15,000)
1=Less than $10,000
5=Less than $35,000
($25,000 to less than $35,000)
6=Less than $50,000
($35,000 to less than $50,000)
7=Less than $75,000
($50,000 to less than $75,000)
8=$75,000 or more
77=Don't know/Not sure
99=Refused
|
|
C
|
Are you: (marital status)
Variable Name: MARITAL
1=Married
2=Divorced
3=Widowed
4=Separated
5=Never married
6=A member of an unmarried couple
9=Refused
|
|
C
|
Which one or more of the following would you say is your race?
Variable Name: MRACE
1=White
2=Black or African American
3=Asian
4=Native Hawaiian or Other Pacific Islander
5=American Indian, Alaska Native
6=Other: (specify)__________
8=No additional choices
7=DK/NS
9=Refused
|
|
C
|
Do you have more than one telephone number in your household? (Do not include cell phones or numbers that are only used by a computer or fax machine.)
Variable Name: NUMHHOL2
1=Yes
2=No
7=DK/NS
9=Refused
|
|
C
|
How many of these are residential numbers?
Variable Name: NUMPHON2
__=Residential telephone numbers
7=DK/NS
9=Refused
|
|
C
|
Which one of these groups would you say best represents your race?
Variable Name: ORACE2
1=White
2=Black or African American
3=Asian
4=Native Hawaiian or Other Pacific Islander
5=American Indian, Alaska Native
6=Other: (specify)__________
7=DK/NS
9=Refused
|
|
C
|
To your knowledge, are you now pregnant?
(Note: This question was previously in the Women's Health section. This question was only asked to female respondents.)
Variable Name: PREGNANT
1=Yes
2=No
7=DK/NS
9=Refused
|
|
C
|
Indicate sex of respondent.
Variable Name: SEX
1=Male
2=Female
|
|
C
|
During the past 12 months, has your household been without telephone service for 1 week or more?
Variable Name: TELSERV
1=Yes
2=No
7=DK/NS
9=Refused
|
|
C
|
The next question relates to military service in the United States Armed Forces, either in the regular military or in a National Guard or Reserve unit.
Have you ever served on active duty in the United States Armed Forces, either in the regular military or in a National Guard or military reserve unit?
Variable Name: VETERAN
1=Yes
2=No
7=DK/NS
9=Refused
|
|
C
|
Which of the following best describes your service in the United States military?
Variable Name: VETSTAT2
1=Currently on active duty
2=Currently in a National Guard or Reserve unit
3=Retired from military service
4=Medically discharged from military service
5=Discharged from military service
7=DK/NS
9=Refused
|
|
C
|
About how much do you weigh without shoes?
Variable Name: WEIGHT
__ __ __=Weight (pounds)
777=DK/NS
999=Refused
|
|
C
|
How much would you like to weigh?
Variable Name: WTDESIRE
__ __ __=Weight pounds
777=DK/NS
999=Refused
|
| Weight Control |
|
C
|
In the past 12 months, has a doctor, nurse or other health professional given you advice about your weight?
Variable Name: DRADVICE
1=Yes, lose weight
2=Yes, gain weight
3=Yes, maintain current weight
4=No
7=DK/NS
9=Refused
|
|
C
|
Are you eating fewer calories or less fat to lose weight, or to keep from gaining weight?
Variable Name: FEWCAL
1=Yes, fewer calories
2=Yes, less fat
3=Yes, fewer calories and less fat
4=No
7=DK/NS
9=Refused
|
|
C
|
Are you now trying to lose weight?
Variable Name: LOSEWT
1=Yes
2=No
7=DK/NS
9=Refused
|
|
C
|
Are you now trying to maintain your current weight, that is to keep from gaining weight?
Variable Name: MAINTAIN
1=Yes
2=No
7=DK/NS
9=Refused
|
|
C
|
Are you using physical activity or exercise to...
...lose weight [if "yes" to "Are you now trying to lose weight?"]
...keep from gaining weight? [If "yes" to "are you now trying to maintain your current weight?"]
Variable Name: PHYACT
1=Yes
2=No
7=DK/NS
9=Refused
|
| Folic Acid |
|
M
|
Do any of the vitamin pills or supplements you take contain folic acid?
Variable Name: FOLICACD
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
(Do you currently take any vitamin pills or supplements?) Are any of these a multivitamin?
Variable Name: MULTIVIT
1=Yes
2=No
7=DK/NS
9=Refused
|
|
M
|
Some health experts recommend that women take 400 micrograms of the B vitamin folic acid, for which one of the following reasons...
Variable Name: RECOMMEN
1=To make strong bones
2=To prevent birth defects
3=To prevent high blood pressure
4=Some other reason
7=DK/NS
9=Refused
|
|
M
|
(Do any of the vitamin pills or supplements you take contain folic acid?) How often do you take this vitamin pill or supplement?
Variable Name: TAKEVIT
1=__ __ times per day
2=__ __ times per day
3=__ __ times per month
777=DK/NS
999=Refused
|
|
M
|
Do you currently take any vitamin pills or supplements?
Variable Name: VITAMINS
1=Yes
2=No
7=DK/NS
9=Refused
|
| Activity Limitations/Disability |
|
C
|
Do you now have any health problem that requires you to use special equipment, such as a cane, a wheelchair, a special bed, or a special telephone?
Variable Name: USEEQUIP
1=Yes
2=No
7=DK/NS
9=Refused
|
| Binge Drinking |
|
M
|
Did you drive a motor vehicle, such as a car, truck, or motorcycle, during or within a couple of hours after this occasion?
Variable Name: BINGEDRV
1=Yes
2=No
7=Don't know/not sure
9=Refused
|
|
M
|
During this most recent occasion, how did you get most of the alcohol?
Variable Name: BUYALCH
1=Someone else bought it for me or gave it to me
2=I bought it at a store, such as a liquor store, convenience store, or grocery store
3=I bought it at a restaurant, bar, or public place
4=Other
7=Don't know/not sure
9=Refused
|
|
M
|
[Ask if the response to "Considering all types of alchoholic beverages, how many times during the past 30 days did you have 5 or more drinks on an occasion" = 1-30 (or does not equal "None", "Don't know/not sure", or "Refused")]
The next questions are about the most recent occasion when you had 5 or more alcoholic beverages. One alcoholic beverage is equal to a 12-ounce beer, a 4-ounce glass of wine, or a drink with 1 shot of liquor.
During this most recent occasion, where were you when you did most of your drinking?
Variable Name: DRINKLOC
1=At your home, for example, your house, apartment, condominium, or dorm room
2=At another person's house
3=At a restaurant or banquet hall
4=At a bar or club
5=At a public place, such as at a park, concert, or sporting event
6=Other
7=Don't know/not sure
9=Refused
|
|
M
|
[Ask if the response to "Considering all types of alchoholic beverages, how many times during the past 30 days did you have 5 or more drinks on an occasion" = 1-30 (or does not equal "None", "Don't know/not sure", or "Refused")]
The next questions are about the most recent occasion when you had 5 or more alcoholic beverages. One alcoholic beverage is equal to a 12-ounce beer, a 4-ounce glass of wine, or a drink with 1 shot of liquor.
During the most recent occasion when you had 5 or more alcoholic beverages, about how many beers, including malt liquor, did you drink? (Round up)
Variable Name: DRNKBEER
__ __=number
88=None
77=Don't know/not sure
99=Refused
|
|
M
|
[Ask if the response to "Considering all types of alchoholic beverages, how many times during the past 30 days did you have 5 or more drinks on an occasion" = 1-30 (or does not equal "None", "Don't know/not sure", or "Refused")]
The next questions are about the most recent occasion when you had 5 or more alcoholic beverages. One alcoholic beverage is equal to a 12-ounce beer, a 4-ounce glass of wine, or a drink with 1 shot of liquor.
During the same occasion, about how many drinks of liquor, including cocktails, did you have? (Round up)
Variable Name: DRNKLIQR
__ __=Number
88=None
77=Don't know/not sure
99=Refused
|
|
M
|
([Ask if the response to "Considering all types of alchoholic beverages, how many times during the past 30 days did you have 5 or more drinks on an occasion" = 1-30 (or does not equal "None", "Don't know/not sure", or "Refused")]
The next questions are about the most recent occasion when you had 5 or more alcoholic beverages. One alcoholic beverage is equal to a 12-ounce beer, a 4-ounce glass of wine, or a drink with 1 shot of liquor.)
During the same occasion, about how many glasses of wine, including wine coolers, hard lemonade, or hard cider, did you drink? (Round up)
Variable Name: DRNKWINE
__ __=Number
88=None
77=Don't know/not sure
99=Refused
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C
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The next question asks about a recent fall. By a fall, we mean when a person unintentionally comes to rest on the ground or another lower level. In the past 3 months, have you had a fall?
Variable Name: FALL3MN
1=Yes
2=No
7=Don't know/not sure
9=Refused
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C
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Were you injured?
(Note: This question is to be asked only of respondants who answered "Yes" to "In the past 3 months, have you had a fall?")
Variable Name: FALLINJ
1=Yes
2=No
7=Don't know/not sure
9=Refused
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