Active Transporation, Adult |
c
= CDC Core Question, o = CDC Optional Question, s = State-Added Question
|
During the past 30 days, for about how many days did you walk or bike to get some place such as work, school, church, a store, the bus stop or a restaurant? |
2016sfor
Link to 2016 Data Table for During the past 30 days, for about how many days did you walk or bike to get some place such as work, school, church, a store, the bus stop or a restaurant?
|,
2017sfor
Link to 2017 Data Table for During the past 30 days, for about how many days did you walk or bike to get some place such as work, school, church, a store, the bus stop or a restaurant?
| |
|
Active Transporation, Child |
c
= CDC Core Question, o = CDC Optional Question, s = State-Added Question
|
The next questions is about the “Xth” [CATI: please fill in correct number] child.
In an average school-week, on how many days does the child walk or ride a bike TO school when weather allows [Fill: him/her] to do so? |
|
|
In an average school-week, on how many days does the child walk or ride a bike FROM
school when weather allows [Fill: him/her] to do so? |
|
|
Advance Care Planning |
c
= CDC Core Question, o = CDC Optional Question, s = State-Added Question
|
A durable power of attorney for health care decisions is
a legal document that allows an individual to appoint an agent to make all
decisions regarding health care, including choices regarding health care
providers, medical treatments, and end of life decisions. Do you have a
durable power of attorney for health care decisions? [Interviewer
note: If asked "This is different from a living will"]
|
|
|
Is your family, friends, health care provider, clergy, or
designated agent aware that you have a durable power of attorney for health
care decisions?
|
|
|
Does your health care provider or hospital have a copy of
your durable power of attorney for health care decisions on file with your
medical records? |
|
|
Health care directive or living will is a formal document
in which a person gives instructions regarding his or her own health care
should they become unable to make decision on his or her own such as during
general anesthesia, coma, or mental illness. Do you have a health care directive
or living will? |
|
|
Is your family, friends, health care provider, clergy, or
designated agent aware that you have a health care directive or living will?
|
|
|
Does your health care provider or hospital have a copy of
your health care directive or living will on file with your medical records? |
|
|
Thinking collectively of the usefulness of a durable power
of attorney for health care decisions and health care directives or living
will, would you say that they are:
- Very useful
- Somewhat useful
- Not useful at all
|
|
|
Activity Limitations |
c = CDC Core Question, o = CDC Optional Question, s = State-Added Question
|
Are you blind or do you have serious difficulty seeing, even when wearing glasses? |
|
|
Are you limited in any way
in any activities because of any impairment or health problem? (Asked
of all respondents.)
|
|
|
Are you limited in any way
in any activities because of physical, mental, or emotional problems?
(Asked of all respondents.)
|
2001cfor
Link to 2001 Data Table for Activities Limited by Physical, Mental or
Emotional Problems., 2002sfor
Link to 2002 Data Table for Activities Limited by Physical, Mental or
Emotional Problems.,
2003cfor
Link to 2003 Data Table for Activities Limited by Physical, Mental or
Emotional Problems.,
2004cfor
Link to 2004 Data Table for Activities Limited by Physical, Mental or
Emotional Problems.|, 2005cfor
Are you limited in any way in any activities because of physical, mental,
or emotional problems?, 2006cfor
Are you limited in any way in any activities because of physical, mental,
or emotional problems?, 2007cfor
Are you limited in any way in any activities because of physical, mental,
or emotional problems?, 2008cfor
Are you limited in any way in any activities because of physical, mental,
or emotional problems?, 2009cfor
Are you limited in any way in any activities because of physical, mental,
or emotional problems?, 2010cfor
Are you limited in any way in any activities because of physical, mental,
or emotional problems?, 2011cfor
Are you limited in any way in any activities because of physical, mental,
or emotional problems?, 2012cfor
Are you limited in any way in any activities because of physical, mental,
or emotional problems?, 2013cfor
Are you limited in any way in any activities because of physical, mental,
or emotional problems?
|
|
Are you limited in the kind
or amount of housework you can do because of any impairment or health
problem?
(Asked of respondents who where between the ages
of 18 - 64.) |
1993o,
1994o |
|
Are you limited in the kind
or amount of work you can do because of any impairment or health
problem?
(Asked of respondents who where between the ages
of 18 - 64.) |
1993o,
1994o |
|
Are you limited in the kind
or amount of work you can do because of any impairment or health problem?
(Asked of all respondents.) |
|
|
Are you limited in the kind
or amount of work you could do because of any impairment or health
problem?
(Asked of respondents who where between the ages
of 18 - 64.) |
1993o,
1994o |
|
Because of a physical, mental, or emotional condition, do you have serious difficulty concentrating, remembering, or making decisions? |
|
|
Because of a physical, mental, or emotional condition, do you have difficulty doing errands alone such as visiting a doctor’s office or shopping? |
|
|
Because of any impairment or
health problem, do you have any trouble learning, remembering, or concentrating?
|
|
|
Because of any impairment or
health problem, do you need the help of other persons in handling your
ROUTINE NEEDS, such as everyday household chores, doing necessary business,
shopping, or getting around for other purposes?
(Asked of respondents who where 65 and older.) |
1996s |
|
Because of any impairment or
health problem, do you need the help of other persons in handling your
ROUTINE NEEDS, such as everyday household chores, doing necessary business,
shopping, or getting around for other purposes?
(Asked of all respondents.) |
|
|
Because of any impairment or
health problem, do you need the help of other persons with your PERSONAL
CARE needs, such as eating, bathing, dressing, or getting around the house?
(Asked of respondents who where 65 and older.) |
1996s |
|
Because of any impairment or
health problem, do you need the help of other persons with your PERSONAL
CARE needs, such as eating, bathing, dressing, or getting around the house?
(Asked of all respondents.) |
|
|
Do you have difficulty dressing or bathing? |
|
|
Do you have serious difficulty walking or climbing stairs? |
|
|
Do you now consider yourself
to be a person with a disability? |
1996s,
1997s |
|
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? |
|
|
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? Include occasional
use or use in certain circumstances. |
2003c for
Link to 2003 Data Table for Health Problem That Requires Use Of Special
Equipment,
2004c for
Link to 2004 Data Table for Health Problem That Requires Use Of Special
Equipment |, 2005cfor
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? Include
occasional use or use in certain circumstances., 2006cfor
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? Include
occasional use or use in certain circumstances., 2007cfor
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? Include
occasional use or use in certain circumstances., 2008cfor
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? Include
occasional use or use in certain circumstances., 2009cfor
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? Include
occasional use or use in certain circumstances., 2010cfor
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? Include
occasional use or use in certain circumstances., 2011c for
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? Include
occasional use or use in certain circumstances., 2012c for
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? Include
occasional use or use in certain circumstances. , 2013c for
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? Include
occasional use or use in certain circumstances.
|
|
Do you still experience problems
as a result of a head injury? |
1997s |
|
Does any impairment or health
problem keep you from working at a job or business?
(Asked of respondents who where between the ages
of 18 - 64.) |
1993o,
1994o |
|
Does any impairment or health
problem NOW keep you from doing any housework at all?
(Asked of respondents who where between the ages
of 18 - 64.) |
1993o,
1994o |
|
Does any impairment or health
problem NOW keep you from working at a job or business?
(Asked of respondents who where between the ages
of 18 - 64.) |
1993o,
1994o |
|
During the past 12 months,
have you fallen?
(Asked of respondents who where 65 and older.) |
1996s |
|
During the past 12 months,
have you had to see a doctor or nurse because you were injured when you
fell?
(Asked of respondents who where 65 and older.) |
1996s |
|
During the past 30 days, for
about how many days did PAIN make it hard for you to do your usual activities,
such as self-care, work, or recreation? |
|
|
During the past 30 days, for
about how many days have you felt SAD, BLUE, or DEPRESSED? |
|
|
During the past 30 days, for
about how many days have you felt that you did not get ENOUGH REST or
SLEEP? |
|
|
During the past 30 days, for
about how many days have you felt VERY HEALTHY and FULL OF ENERGY? |
|
|
During the past 30 days, for
about how many days have you felt WORRIED, TENSE, or ANXIOUS? |
1995o,
1997o, 1998o,
1999sfor
Link to 1999 Data Table for Number of Days You Felt You Worried, Tense,
or Anxious ,
2000ofor
Link to 2000 Data Table for Number of Days You Felt You Worried, Tense,
or Anxious ,
2001ofor
Link to 2001 Data Table for Number of Days You Felt You Worried, Tense,
or Anxious | |
|
During the past 5 years, have
you been admitted to a hospital?
(Asked of respondents who where 65 and older.) |
1996s |
|
During the past 5 years, were
you ever admitted to a nursing home?
(Asked of respondents who where 65 and older.) |
1996s |
|
During the past week, have
you needed to change your clothes or bed sheets because you lost control
of your bladder?
(Asked of respondents who where 65 and older.) |
1996s |
|
During the past week, have
you needed to change your clothes or bed sheets because you lost control
of your bowels?
(Asked of respondents who where 65 and older.) |
1996s |
|
Earlier you reported that due
to your impairment you need some assistance from another person with your
PERSONAL CARE needs. Who usually helps you with your personal care needs,
such as eating, bathing, dressing, or getting around the house? |
|
|
Earlier you reported that due
to your impairment you need some assistance from another person with your
ROUTINE needs. Who usually helps you with handling your routine needs,
such as everyday household chores, shopping, or getting around for other
purposes? |
|
|
For HOW LONG have your activities
been limited because of your major impairment or health problem? |
|
|
Has a doctor or other health
professional given you information about community or self-help resources
that can help you manage your condition? |
1996s |
|
Have you ever had a head injury
which caused you to lose consciousness or completely black out? |
1997s |
|
Have you ever sustained a spinal
cord injury? |
1997s |
|
How often do you get the social
and emotional support you need? |
|
|
How old are these people? |
1998s,
1999s, 2000s, 2001s |
|
If you use special equipment
or help from others to get around, what type do you use? |
|
|
In general, how satisfied are
you with your life? |
|
|
Including yourself, how many
people in your household have received medical care or are limited in
any way in any activities as a result of an injury to their head or brain? |
|
|
Is the assistance you receive
to meet your personal care needs: Usually
adequate, Sometimes adequate, Rarely adequate |
|
|
Is the assistance you receive
to meet your routine needs: Usually adequate, Sometimes adequate, Rarely
adequate |
|
|
Is there anyone [insert "else"
if respondent already indicated that they have a limitation] in your household
who is LIMITED in any way in any activities because of any impairment
or health problem? |
|
|
Is this impairment or health
problem the result of a work-related illness or injury? |
|
|
Using special equipment or
help, what is the farthest distance that you can go? |
|
|
What is the farthest distance
you can walk by yourself, without any special equipment or help from others? |
|
|
What is the MAJOR impairment
or health problem that limits your activities? |
|
|
What were you doing MOST of
the past 12 months?
(Asked of respondents who where between the ages
of 18 - 64.) |
1993o,
1994o |
|
|
c
= CDC Core Question, o = CDC Optional Question, s = State-Added Question
|
Did you live with anyone who was depressed, mentally ill, or suicidal?
|
|
|
Did you live with anyone who was a problem drinker or alcoholic?
|
|
|
Did you live with anyone who used illegal street drugs or who abused prescription medications?
|
|
|
Did you live with anyone who served time or was sentenced to serve time in a prison, jail, or other correctional facility?
|
|
|
Were your parents separated or divorced?
|
|
|
How often did your parents or adults in your home ever slap, hit, kick, punch or beat each other up? Would you say...
- Never
- Once
- More than once
|
|
|
Before age 18, how often did a parent or adult in your home ever hit, beat, kick, or physically hurt you in any way? Do not include spanking. Would you say...
- Never
- Once
- More than once
|
|
|
How often did a parent or adult in your home ever swear at you, insult you, or put you down? Would you say...
- Never
- Once
- More than once
|
|
|
How often did anyone at least 5 years older than you or an adult, ever touch you sexually? Would you say...
- Never
- Once
- More than once
|
|
|
How often did anyone at least 5 years older than you or an adult, try to make you touch them sexually? Would you say...
- Never
- Once
- More than once
|
|
|
How often did anyone at least 5 years older than you or an adult, force you to have sex? Would you say...
- Never
- Once
- More than once
|
|
|
Agricultural Burning in Kansas, Large Scale (May through December Only) |
c
= CDC Core Question, o = CDC Optional Question, s = State-Added Question
|
Each April in Kansas land owner’s burn thousands of acres of grassland as part of pasture
management. Smoke from burning grassland can cause poor outdoor air quality. Thinking
back to April of 2013, did you have an illness or symptom that you think was caused by poor
outdoor air quality from burning?
|
|
|
Thinking back to April of 2013, how many times did you reduce or change your outdoor
activity level because you thought the air quality was bad or was affecting how well you felt?
Please do not include times when you made changes because of high pollen or other allergens.
|
|
|
Alcohol Consumption
|
c
= CDC Core Question, o = CDC Optional Question, s = State-Added Question
|
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 often have
you had at least one drink of any alcoholic beverage? |
|
|
A drink 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? |
|
|
Considering all types of alcoholic beverages, how many times during
the past 30 days did you have:
[WOMEN]: 4 or more drinks on an occasion?
[MEN]: 5 or more drinks on an occasion?
|
2007c for
Link to 2007 Data Table for Considering All Types of Alcoholic Beverages,
How Many Times in the Past 30 Days have You had 5 or More Drinks |,
2008c for
Link to 2008 Data Table for Considering All Types of Alcoholic Beverages,
How Many Times in the Past 30 Days have You had 5 or More Drinks |,
2009c for
Link to 2009 Data Table for Considering All Types of Alcoholic Beverages,
How Many Times in the Past 30 Days have You had 5 or More Drinks |,
2010c for
Link to 2010 Data Table for Considering All Types of Alcoholic Beverages,
How Many Times in the Past 30 Days have You had 5 or More Drinks |,
2011c for
Link to 2011 Data Table for Considering All Types of Alcoholic Beverages,
How Many Times in the Past 30 Days have You had 5 or More Drinks | ,
2012c for
Link to 2012 Data Table for Considering All Types of Alcoholic Beverages,
How Many Times in the Past 30 Days have You had 5 or More Drinks | ,
2013c for
Link to 2013 Data Table for Considering All Types of Alcoholic Beverages,
How Many Times in the Past 30 Days have You had 5 or More Drinks |,
2014c for
Link to 2014 Data Table for Considering All Types of Alcoholic Beverages,
How Many Times in the Past 30 Days have You had 5 or More Drinks |,
2015c for
Link to 2015 Data Table for Considering All Types of Alcoholic Beverages,
How Many Times in the Past 30 Days have You had 5 or More Drinks | ,
2016c for
Link to 2016 Data Table for Considering All Types of Alcoholic Beverages,
How Many Times in the Past 30 Days have You had 5 or More Drinks |,
2017c for
Link to 2017 Data Table for Considering All Types of Alcoholic Beverages,
How Many Times in the Past 30 Days have You had 5 or More Drinks |
|
|
Considering all types of alcoholic
beverages, how many times during the past month did you have 5 or more
drinks on an occasion? |
1993c,
1994o, 1995c, 1997c,
1999cfor
Link to 1999 Data Table for Considering All Types of Alcoholic Beverages,
How Many Times in the Past Month have You had 5 or More Drinks ,
2002cfor
Link to 2002 Data Table for Considering All Types of Alcoholic Beverages,
How Many Times in the Past Month have You had 5 or More Drinks ,
2005cfor
Link to 2005 Data Table for Considering All Types of Alcoholic Beverages,
How Many Times in the Past Month have You had 5 or More Drinks , 2006c | |
|
During the past 30 days, have
you had at least one drink of any alcoholic beverage such as beer, wine,
a malt beverage or liquor? |
2005cfor
Link to 2005 Data Table for During the past 30 days, have you
had at least
one drink of any alcoholic beverage such as beer, wine, a malt beverage
or liquor?, 2006cfor
Link to 2006 Data Table for During the past 30 days, have you
had at least
one drink of any alcoholic beverage such as beer, wine, a malt beverage
or liquor?, 2007cfor
Link to 2007 Data Table for During the past 30 days, have you
had at least
one drink of any alcoholic beverage such as beer, wine, a malt beverage
or liquor?, 2008cfor
Link to 2008 Data Table for During the past 30 days, have you
had at least
one drink of any alcoholic beverage such as beer, wine, a malt beverage
or liquor?, 2009cfor
Link to 2009 Data Table for During the past 30 days, have
you had at least
one drink of any alcoholic beverage such as beer, wine, a malt beverage
or liquor?, 2010cfor
Link to 2010 Data Table for During the past 30 days, have
you had at least
one drink of any alcoholic beverage such as beer, wine, a malt beverage
or liquor?, 2011cfor
Link to 2011 Data Table for During the past 30 days, have
you had at least
one drink of any alcoholic beverage such as beer, wine, a malt beverage
or liquor?, 2012cfor
Link to 2012 Data Table for During the past 30 days, have
you had at least
one drink of any alcoholic beverage such as beer, wine, a malt beverage
or liquor?
|
|
During the past month, have
you had at least one drink of any alcoholic beverage such as beer, wine,
wine coolers, or 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? |
2005cfor
Link to 2005 Data Table for During the past 30 days, how many days per
week or per month did you have at least one drink of any alcoholic beverage?,
2006cfor
Link to 2006 Data Table for During the past 30 days, how many days per
week or per month did you have at least one drink of any alcoholic beverage?,
2007cfor
Link to 2007 Data Table for During the past 30 days, how many days per
week or per month did you have at least one drink of any alcoholic beverage?,
2008cfor
Link to 2008 Data Table for During the past 30 days, how many days per
week or per month did you have at least one drink of any alcoholic beverage?,
2009cfor
Link to 2009 Data Table for During the past 30 days, how many days per
week or per month did you have at least one drink of any alcoholic beverage?,
2010cfor
Link to 2010 Data Table for During the past 30 days, how many days per
week or per month did you have at least one drink of any alcoholic beverage? |
|
During the past 30 days, how many days per week or per month did you have at least one drink of any alcoholic beverage such as beer, wine, a malt beverage or liquor? |
2013cfor
Link to 2013 Data Table for During the past 30 days, how many days per week
or per month did you have at least one drink of any alcoholic beverage such
as beer, wine, a malt beverage or liquor?,
2014cfor
Link to 2014 Data Table for During the past 30 days, how many days per week
or per month did you have at least one drink of any alcoholic beverage such
as beer, wine, a malt beverage or liquor?,
2015cfor
Link to 2015 Data Table for During the past 30 days, how many days per week
or per month did you have at least one drink of any alcoholic beverage such
as beer, wine, a malt beverage or liquor?,
2016cfor
Link to 2016 Data Table for During the past 30 days, how many days per week
or per month did you have at least one drink of any alcoholic beverage such
as beer, wine, a malt beverage or liquor?,
2017cfor
Link to 2017 Data Table for During the past 30 days, how many days per week
or per month did you have at least one drink of any alcoholic beverage such
as beer, wine, a malt beverage or liquor?
|
|
During the past month, how many days per week or per month did you
drink any alcoholic beverages, on the average?
|
|
|
During the past 30 days, how
many times have you driven when you've had perhaps too much to drink? |
2002cfor
Link to 2002 Data Table for During the Past 30 Days, How Many Times Have
You Driven When You Have Had Perhaps Too Much To Drink ,
2004cfor
Link to 2004 Data Table for During the Past 30 Days, How Many Times Have
You Driven When You Have Had Perhaps Too Much To Drink |
,
2006cfor
Link to 2006 Data Table for During the Past 30 Days, How Many Times Have
You Driven When You Have Had Perhaps Too Much To Drink |
,
2008cfor
Link to 2008 Data Table for During the Past 30 Days, How Many Times Have
You Driven When You Have Had Perhaps Too Much To Drink |,
2010cfor
Link to 2010 Data Table for During the Past 30 Days, How Many Times Have
You Driven When You Have Had Perhaps Too Much To Drink ,
2012cfor
Link to 2012 Data Table for During the Past 30 Days, How Many Times Have
You Driven When You Have Had Perhaps Too Much To Drink |
|
During the past month, how
many times have you driven when you've had perhaps too much to drink? |
|
|
During the past month, how
many times have you ridden with a driver who has had perhaps too much
to drink? |
1993c |
|
During the past 30 days, what
is the largest number of drinks you had on any occasion? |
2005cfor
Link to 2005 Data Table for During the past 30 days, what is the
largest
number of drinks you had on any occasion? , 2006cfor
Link to 2006 Data Table for During the past 30 days, what is the largest
number of drinks you had on any occasion? , 2007cfor
Link to 2007 Data Table for During the past 30 days, what is the largest
number of drinks you had on any occasion? , 2008cfor
Link to 2008 Data Table for During the past 30 days, what is the largest
number of drinks you had on any occasion? , 2009cfor
Link to 2009 Data Table for During the past 30 days, what is the largest
number of drinks you had on any occasion? , 2010cfor
Link to 2010 Data Table for During the past 30 days, what is the largest
number of drinks you had on any occasion? , 2011cfor
Link to 2011 Data Table for During the past 30 days, what is the largest
number of drinks you had on any occasion? , 2012cfor
Link to 2012 Data Table for During the past 30 days, what is the largest
number of drinks you had on any occasion? , 2013cfor
Link to 2013 Data Table for During the past 30 days, what is the largest
number of drinks you had on any occasion? , 2014cfor
Link to 2014 Data Table for During the past 30 days, what is the largest
number of drinks you had on any occasion? , 2015cfor
Link to 2015 Data Table for During the past 30 days, what is the largest
number of drinks you had on any occasion? , 2016cfor
Link to 2016 Data Table for During the past 30 days, what is the largest
number of drinks you had on any occasion? , 2017cfor
Link to 2017 Data Table for During the past 30 days, what is the largest
number of drinks you had on any occasion?
|
|
(Has a doctor or other health
professional ever talked with you) about alcohol use? |
|
|
On the days when you drank,
about how many drinks did you drink on the average? |
|
|
One drink is equivalent to
a 12-ounce beer, a 5-ounce glass of wine, or a drink with one shot of
liquor. During the past 30 days, on the days when you drank, about how
many drinks did you drink on the average? |
2005cfor
Link to 2005 Data Table for One drink is equivalent to a 12-ounce
beer,
a 5-ounce glass of wine, or a drink with one shot of liquor. During the
past 30 days, on the days when you drank, about how many drinks
did you
drink on the average?, 2006cfor
Link to 2006 Data Table for One drink is equivalent to a 12-ounce beer,
a 5-ounce glass of wine, or a drink with one shot of liquor. During the
past 30 days, on the days when you drank, about how many drinks did
you
drink on the average?, 2007cfor
Link to 2007 Data Table for One drink is equivalent to a 12-ounce beer,
a 5-ounce glass of wine, or a drink with one shot of liquor. During the
past 30 days, on the days when you drank, about how many drinks did
you
drink on the average?,
2008cfor
Link to 2008 Data Table for One drink is equivalent to a 12-ounce beer,
a 5-ounce glass of wine, or a drink with one shot of liquor. During the
past 30 days, on the days when you drank, about how many drinks did you
drink on the average?,
2009cfor
Link to 2009 Data Table for One drink is equivalent to a 12-ounce beer,
a 5-ounce glass of wine, or a drink with one shot of liquor. During the
past 30 days, on the days when you drank, about how many drinks did you
drink on the average?,
2010cfor
Link to 2010 Data Table for One drink is equivalent to a 12-ounce beer,
a 5-ounce glass of wine, or a drink with one shot of liquor. During the
past 30 days, on the days when you drank, about how many drinks did you
drink on the average?,
2011cfor
Link to 2011 Data Table for One drink is equivalent to a 12-ounce beer,
a 5-ounce glass of wine, or a drink with one shot of liquor. During the
past 30 days, on the days when you drank, about how many drinks did you
drink on the average?,
2012cfor
Link to 2012 Data Table for One drink is equivalent to a 12-ounce beer,
a 5-ounce glass of wine, or a drink with one shot of liquor. During the
past 30 days, on the days when you drank, about how many drinks did you
drink on the average?,
2013cfor
Link to 2013 Data Table for One drink is equivalent to a 12-ounce beer,
a 5-ounce glass of wine, or a drink with one shot of liquor. During the
past 30 days, on the days when you drank, about how many drinks did you
drink on the average?,
2014cfor
Link to 2014 Data Table for One drink is equivalent to a 12-ounce beer,
a 5-ounce glass of wine, or a drink with one shot of liquor. During the
past 30 days, on the days when you drank, about how many drinks did you
drink on the average?,
2015cfor
Link to 2015 Data Table for One drink is equivalent to a 12-ounce beer,
a 5-ounce glass of wine, or a drink with one shot of liquor. During the
past 30 days, on the days when you drank, about how many drinks did you
drink on the average?,
2016cfor
Link to 2016 Data Table for One drink is equivalent to a 12-ounce beer,
a 5-ounce glass of wine, or a drink with one shot of liquor. During the
past 30 days, on the days when you drank, about how many drinks did you
drink on the average?,
2017cfor
Link to 2017 Data Table for One drink is equivalent to a 12-ounce beer,
a 5-ounce glass of wine, or a drink with one shot of liquor. During the
past 30 days, on the days when you drank, about how many drinks did you
drink on the average?
|
|
Alcohol Counseling
|
c
= CDC Core Question, o = CDC Optional Question, s = State-Added Question
|
The next question is about counseling services related to prevention that you
might have received from a doctor, nurse, or other health professional.
Has a doctor or other health professional ever talked with you about alcohol use? |
|
|
Alcohol Screening & Brief Intervention (ASBI) |
c
= CDC Core Question, o = CDC Optional Question, s = State-Added Question
|
You told me earlier that your
last routine checkup was [within the past year/within the past 2 years]. At that checkup, were you asked in person or on a form if you drink alcohol? |
|
|
Did the health care provider ask you in person or on a form how much you drink? |
|
|
Did the healthcare provider
specifically ask whether you drank [If Male then fill “5” for
men or Women then fill “4” for women] or more
alcoholic drinks on an occasion? |
|
|
Were you offered advice about what level of drinking is harmful or risky for your health? |
|
|
If M5.1, M5.2 OR M5.3 = 1 (Yes); continue. Otherwise, go to next module.
Healthcare providers may also advise patients to drink less for various reasons. At your last routine checkup, were you advised to reduce or quit your drinking? |
|
|
Animal Ownership |
c
= CDC Core Question, o = CDC Optional Question, s = State-Added Question
|
How many cats do you have? |
|
|
How many dogs do you have? |
|
|
How many ferrets do you have? |
|
|
How many hamsters, gerbils,
guinea pigs, or chinchillas do you have? |
|
|
How many horses or livestock
do you have?
[Examples of livestock: cows, goats, pigs or sheep] |
|
|
How many lizards do you have?
[Examples: iguanas, dragons, geckos, skinks, anoles, monitors, chameleons
or uromastyx] |
|
|
How many non-human primates
such as monkeys or chimpanzees do you have?
[Examples: monkeys, chimpanzees, maqueques or capuchins] |
|
|
How many other reptiles or
amphibians do you have?
[Examples: frogs, toads, mantellas, tortoises, salmanders, newts or caecillians] |
|
|
How many pet birds do you have? |
|
|
How many pet pigs do you have? |
|
|
How many prairie dogs do you
have? |
|
|
How many rabbits do you have? |
|
|
How many rats or mice do you
have? |
|
|
How many (show specific other
response) do you have? |
|
|
How many small exotic cats
do you have?
[Examples: bengals, geoffroys, Asian leopards or African servals] |
|
|
How many snakes do you have?
[Examples: pythons, boa constrictors, asps, vipers, etc] |
|
|
How many turtles do you have? |
|
|
How many wild animals do you
have?
[Examples: raccoons, skunks, possums, bats, coyotes, wolves, foxes, bobcats,
mountain lions, lynx, squirrels, wood chucks or ground hogs] |
|
|
How many wild birds do you
have?
[Examples: eagles, hawks, sparrows or birds that are being rehabilitated]
|
|
|
What type of animals are kept
as pets in or around your home? |
|
|
Anxiety and Depression
(also see Depressive Disorder, Depression
Treatment & Mental
Illness & Stigma) |
c
= CDC Core Question, o = CDC Optional Question, s = State-Added Question
|
Are you now taking medicine or receiving treatment from a doctor or other health professional for any type of mental health condition or emotional problem? |
|
|
Has a doctor or other healthcare
provider EVER told you that you had an anxiety disorder (including acute
stress disorder, anxiety, generalized anxiety disorder, obsessive-compulsive
disorder, panic disorder, phobia, posttraumatic stress disorder, or social
anxiety disorder)? |
2006o
for ink to 2006 Data Table for Has a doctor
or other healthcare provider EVER told you that you had an anxiety disorder
(including acute stress disorder, anxiety, generalized anxiety disorder,
obsessive-compulsive disorder, panic disorder, phobia, posttraumatic stress
disorder, or social anxiety disorder)? |,
2008o
for ink to 2008 Data Table for Has a doctor
or other healthcare provider EVER told you that you had an anxiety disorder
(including acute stress disorder, anxiety, generalized anxiety disorder,
obsessive-compulsive disorder, panic disorder, phobia, posttraumatic stress
disorder, or social anxiety disorder)? |,
2010o
for ink to 2010 Data Table for Has a doctor
or other healthcare provider EVER told you that you had an anxiety disorder
(including acute stress disorder, anxiety, generalized anxiety disorder,
obsessive-compulsive disorder, panic disorder, phobia, posttraumatic stress
disorder, or social anxiety disorder)? |,
2011o
for ink to 2011 Data Table for Has a doctor
or other healthcare provider EVER told you that you had an anxiety disorder
(including acute stress disorder, anxiety, generalized anxiety disorder,
obsessive-compulsive disorder, panic disorder, phobia, posttraumatic stress
disorder, or social anxiety disorder)? |
|
|
Has a doctor or other healthcare
provider EVER told you that you have a depressive disorder (including
depression, major depression, dysthymia, or minor depression)? |
2006ofor
Link to 2006 Data Table for Has a doctor or other healthcare provider
EVER told you that you have a depressive disorder (including depression,
major depression, dysthymia, or minor depression)?,
2008ofor
Link to 2008 Data Table for Has a doctor or other healthcare provider
EVER told you that you have a depressive disorder (including depression,
major depression, dysthymia, or minor depression)?,
2010ofor
Link to 2010 Data Table for Has a doctor or other healthcare provider
EVER told you that you have a depressive disorder (including depression,
major depression, dysthymia, or minor depression)? |
|
Has a doctor, nurse,
or other health professional EVER told you that you had any of the following?
For each, tell me “Yes,” “No,” or you’re
“Not sure.”
(Ever told) you have a depressive disorder (including depression, major depression, dysthymia, or minor depression)? |
2011cfor (Ever told) you have a depressive disorder (including depression, major depression, dysthymia, or minor depression)?,
2012cfor (Ever told) you have a depressive disorder (including depression, major depression, dysthymia, or minor depression)?,
2013cfor (Ever told) you have a depressive disorder (including depression, major depression, dysthymia, or minor depression)?,
2014cfor (Ever told) you have a depressive disorder (including depression, major depression, dysthymia, or minor depression)?
|
|
Over the last 2 weeks, how
many days have you felt down, depressed or hopeless? |
2006ofor
Link to 2006 Data Table for Over the last 2 weeks, how many days have
you felt down, depressed or hopeless?|, 2008ofor
Link to 2008 Data Table for Over the last 2 weeks, how many days have
you felt down, depressed or hopeless?|, 2010ofor
Link to 2010 Data Table for Over the last 2 weeks, how many days have
you felt down, depressed or hopeless?| 2011ofor
Link to 2010 Data Table for Over the last 2 weeks, how many days have
you felt down, depressed or hopeless?| |
|
Over the last 2 weeks, how
many days have you had little interest or pleasure in doing things? |
|
|
Over the last 2 weeks, how
many days have you had trouble falling asleep or staying asleep or sleeping
too much? |
|
|
Over the last 2 weeks, how
many days have you felt bad about yourself or that you were a failure
or had let yourself or your family down? |
|
|
Over the last 2 weeks, how
many days have you felt tired or had little energy? |
|
|
Over the last 2 weeks, how
many days have you had a poor appetite or ate too much? |
|
|
Over the last 2 weeks, how
many days have you had trouble concentrating on things, such as reading
the newspaper or watching the TV? |
2006ofor
Link to 2006 Data Table for Over the last 2 weeks, how many days have
you had trouble concentrating on things, such as reading the newspaper
or watching the TV? ,
2008ofor
Link to 2008 Data Table for Over the last 2 weeks, how many days have
you had trouble concentrating on things, such as reading the newspaper
or watching the TV? |,
2010ofor
Link to 2010 Data Table for Over the last 2 weeks, how many days have
you had trouble concentrating on things, such as reading the newspaper
or watching the TV? |,
2011ofor
Link to 2011 Data Table for Over the last 2 weeks, how many days have
you had trouble concentrating on things, such as reading the newspaper
or watching the TV? |
|
|
Over the last 2 weeks, how
many days have you moved or spoken so slowly that other people could have
noticed? Or the opposite - being so fidgety or restless that you were
moving around a lot more than usual? |
|
|
Arthritis |
c
= CDC Core Question, o = CDC Optional Question, s = State-Added Question
|
Are you currently being treated
by a doctor for arthritis? |
|
|
Are you now limited in any
way in any activities because of joint symptoms? |
|
|
Are you now limited in any
way in any of your usual activities because of arthritis or joint symptoms?
[NOTE: If respondent question arises about medication, then interviewer
should reply: "Please answer the question based on how you are when
you are taking any of the medications or treatments you might use."] |
|
|
Did your joint symptoms FIRST
begin more than 3 months ago? |
|
|
Do you currently participate
in any support group to help manage problems related to your arthritis
or joint symptoms? |
|
|
Do you currently participate
in physical activity or exercise to help manage problems related to your
arthritis or joint symptoms? |
|
|
During the past 12 months,
have you had pain, aching, stiffness or swelling in or around a joint? |
|
|
DURING THE PAST 30 DAYS, have
you had
any symptoms of pain, aching, or stiffness in or around a joint? (Please
do NOT include the back or neck.) |
2003cfor
Link to 2003 Data Table for In Past 30 Days, Had Pain, Aching, Stiffness
or Swelling In or Around a Joint ,
2005cfor
Link to 2005 Data Table for In Past 30 Days, Had Pain, Aching, Stiffness
or Swelling In or Around a Joint |,
2007cfor
Link to 2007 Data Table for In Past 30 Days, Had Pain, Aching, Stiffness
or Swelling In or Around a Joint | |
|
During the past 30 days, to what extent has your arthritis or joint symptoms interfered with your normal social
activities, such as going shopping, to the movies, or to religious or social gatherings? Would you say...
- A lot
- A little
- Not at all
INTERVIEWER INSTRUCTION: If a question arises about medications or treatments, then the interviewer should
say: "Please answer the question based on your current experiences, regardless of whether you are taking any
medication or treatment." |
2009cfor
Link to 2009 Data Table for During the past 30 days, to what extent has your arthritis or joint symptoms interfered with your normal social
activities, such as going shopping, to the movies, or to religious or social gatherings? ,
2010sfor
Link to 2010 Data Table for During the past 30 days, to what extent has your arthritis or joint symptoms interfered with your normal social
activities, such as going shopping, to the movies, or to religious or social gatherings? ,
2011cfor
Link to 2011 Data Table for During the past 30 days, to what extent has your arthritis or joint symptoms interfered with your normal social
activities, such as going shopping, to the movies, or to religious or social gatherings? ,
2013cfor
Link to 2013 Data Table for During the past 30 days, to what extent has your arthritis or joint symptoms interfered with your normal social
activities, such as going shopping, to the movies, or to religious or social gatherings? ,
2015cfor
Link to 2015 Data Table for During the past 30 days, to what extent has your arthritis or joint symptoms interfered with your normal social
activities, such as going shopping, to the movies, or to religious or social gatherings? ,
2017cfor
Link to 2017 Data Table for During the past 30 days, to what extent has your arthritis or joint symptoms interfered with your normal social
activities, such as going shopping, to the movies, or to religious or social gatherings?
|
|
Earlier you indicated that you had arthritis or joint symptoms. Thinking
about your arthritis or joints symptoms, which of the following best
describes you TODAY?
- I can do everything I would like to do
- I can do most things I like to do
- I can do some things I would like to do
- I can hardly do anything I would like to do
|
2003o for
Link to 2003 Data Table for Thinking About Your Arthritis or Joints Symptoms,
Which of the Following Best Describes You TODAY ,
2005o for
Link to 2005 Data Table for Thinking About Your Arthritis or Joints Symptoms,
Which of the Following Best Describes You TODAY |,
2009o for
Link to 2009 Data Table for Thinking About Your Arthritis or Joints Symptoms,
Which of the Following Best Describes You TODAY |,
2011o for
Link to 2011 Data Table for Thinking About Your Arthritis or Joints Symptoms,
Which of the Following Best Describes You TODAY |,
2013ofor
Link to 2013 Data Table for Thinking About Your Arthritis or Joints Symptoms,
Which of the Following Best Describes You TODAY |,
2015cfor
Link to 2015 Data Table for Earlier you indicated that you had arthritis or joint symptoms. Thinking about your arthritis or joint symptoms, which of the following best describes you today?|,
2017ofor
Link to 2017 Data Table for Earlier you indicated that you had arthritis or joint symptoms. Thinking about your arthritis or joint symptoms, which of the following best describes you today?|
|
|
Has a doctor or health professional
EVER suggested losing weight to help your arthritis or joint symptoms? |
|
|
Has a doctor or other health
professional EVER suggested physical activity or exercise to help your
arthritis of joint symptoms? [NOTE: If the respondent is unclear about
whether this means an increase or decrease in physical activity, this
means increase.] |
|
|
Has a doctor or other health
professional ever suggested you participate in an Arthritis Foundation
program to help manage problems related to your arthritis or joint symptoms? |
|
|
Have you ever seen a doctor,
nurse, or other health professional for these joint symptoms? |
|
|
Have you EVER seen a doctor
or other health professional for these joint symptoms? |
|
|
Have you ever been told by
a doctor that you have arthritis? |
|
|
Have you EVER been told by
a doctor or other health professional that you have some form of arthritis,
rheumatoid arthritis, gout, lupus, or fibromyalgia?
Arthritis diagnoses include:
- rheumatism, polymyalgia gheumatica
- osteoarthritis (not osteoporosis)
- tendonitis, bursitis, bunion, tennis elbow
- carpal tunnel syndrome, tarsal tunnel syndrome
- joint infection, Reiter's syndrome
- ankylosing spondylitis; spondylosis
- rotator cuff syndrome
- connective tissue disease, scleroderma, polymyositis, Raynaud's
syndrome
- vasculitis (giant cell arteritis, henoch-Schonlein purpura, Wegener's
granulomatosis, polyarteritis nodosa)
|
2003cfor
Link to 2003 Data Table for EVER Been Told by a Doctor or Other Health
Professional that You Have Some Form of Arthritis, Rheumatoid Arthritis,
Gout, Lupus, or Fibromyalgia ,
2005cfor
Link to 2005 Data Table for EVER Been Told by a Doctor or Other Health
Professional that You Have Some Form of Arthritis, Rheumatoid Arthritis,
Gout, Lupus, or Fibromyalgia |,
2007cfor
Link to 2007 Data Table for EVER Been Told by a Doctor or Other Health
Professional that You Have Some Form of Arthritis, Rheumatoid Arthritis,
Gout, Lupus, or Fibromyalgia |,
2009cfor
Link to 2009 Data Table for EVER Been Told by a Doctor or Other Health
Professional that You Have Some Form of Arthritis, Rheumatoid Arthritis,
Gout, Lupus, or Fibromyalgia |,
2010ofor
Link to 2009 Data Table for EVER Been Told by a Doctor or Other Health
Professional that You Have Some Form of Arthritis, Rheumatoid Arthritis,
Gout, Lupus, or Fibromyalgia | |
|
Has a doctor, nurse,
or other health professional EVER told you that you had any of the following?
For each, tell me “Yes,” “No,” or you’re
“Not sure.”
(Ever told) you have some form of arthritis, rheumatoid arthritis, gout,
lupus, or fibromyalgia?
INTERVIEWER NOTE: Arthritis diagnoses include:
- rheumatism, polymyalgia gheumatica
- osteoarthritis (not osteoporosis)
- tendonitis, bursitis, bunion, tennis elbow
- carpal tunnel syndrome, tarsal tunnel syndrome
- joint infection, Reiter's syndrome
- ankylosing spondylitis; spondylosis
- rotator cuff syndrome
- connective tissue disease, scleroderma, polymyositis, Raynaud's
syndrome
- vasculitis (giant cell arteritis, henoch-Schonlein purpura, Wegener's
granulomatosis, polyarteritis nodosa)
|
2011cfor (Ever told) you have some form of arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia?,
2012cfor (Ever told) you have some form of arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia?,
2012cfor (Ever told) you have some form of arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia?,
2013cfor (Ever told) you have some form of arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia?,
2014cfor (Ever told) you have some form of arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia?,
2015cfor (Ever told) you have some form of arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia?,
2016cfor (Ever told) you have some form of arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia?,
2017cfor (Ever told) you have some form of arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia?
|
|
Have you EVER taken an educational
course or class to teach you how to manage problems related to your arthritis
or joint symptoms? |
|
|
Have you EVER taken a physical
activity class to teach you how to manage problems related to your arthritis or joint symptoms? |
|
|
If Core Demograpics Section: Employment Question equals: 1 (Employed for wages) or 2 (Self-employed), then continue.
OR
If State-Added Module Average Hours Worked Question is greater than
zero and Core Demograpics Section: Employment Question equals: 5 (A
homemaker), 6 (A student) or 7 (Retired), then continue.
Otherwise, Go To Next Section.
Is your arthritis or joint symptoms MADE WORSE by duties in your CURRENT job? |
|
|
If Core Demograpics Section: Employment Question equals: 1 (Employed for wages) or 2 (Self-employed), then continue.
OR
If State-Added Module Average Hours Worked Question is greater than
zero and Core Demograpics Section: Employment Question equals: 5 (A
homemaker), 6 (A student) or 7 (Retired), then continue.
Otherwise, Go To Next Section.
In the past 30 days, how many days of work did you miss because of arthritis or joint symptoms? |
|
|
In the next question we are
referring to work for pay.
Do arthritis or joint symptoms now effect whether you work, the type of
work you do, or the amount of work you do?
[NOTE: If respondent says he/she is retired or out-of-work, reply: "Did
arthritis or joint symptoms cause you to stop working? That is, did it
affect whether you work or not?"] |
2003cfor
Link to 2003 Data Table for Arthritis or Joint Symptoms Now Effect Whether
You Work, the Type of, or the Amount of, Work You Do |,
2009cfor
Link to 2009 Data Table for Arthritis or Joint Symptoms Now Effect Whether
You Work, the Type of, or the Amount of, Work You Do |,
2010sfor
Link to 2010 Data Table for Arthritis or Joint Symptoms Now Effect Whether
You Work, the Type of, or the Amount of, Work You Do |,
2011cfor
Link to 2013 Data Table for Arthritis or Joint Symptoms Now Effect Whether
You Work, the Type of, or the Amount of, Work You Do |,
2013cfor
Link to 2013 Data Table for Arthritis or Joint Symptoms Now Effect Whether
You Work, the Type of, or the Amount of, Work You Do |,
2015cfor
Link to 2015 Data Table for Arthritis or Joint Symptoms Now Effect Whether
You Work, the Type of, or the Amount of, Work You Do |,
2017cfor
Link to 2017 Data Table for Arthritis or Joint Symptoms Now Effect Whether
You Work, the Type of, or the Amount of, Work You Do |
|
|
Please think about the past 30 days, keeping in mind all of your joint pain or aching and
whether or not you have taken medication. DURING THE PAST 30 DAYS, how bad
was your joint pain ON AVERAGE? Please answer on a scale of 0 to 10 where 0 is no
pain or aching and 10 is pain or aching as bad as it can be. |
2009s for
Link to 2010 Data Table for Please think about the past 30 days, keeping in mind all of your joint pain or aching and
whether or not you have taken medication. DURING THE PAST 30 DAYS, how bad
was your joint pain ON AVERAGE? Please answer on a scale of 0 to 10 where 0 is no
pain or aching and 10 is pain or aching as bad as it can be.
|,
2010s for
Link to 2010 Data Table for Please think about the past 30 days, keeping in mind all of your joint pain or aching and
whether or not you have taken medication. DURING THE PAST 30 DAYS, how bad
was your joint pain ON AVERAGE? Please answer on a scale of 0 to 10 where 0 is no
pain or aching and 10 is pain or aching as bad as it can be. |,
2011c for
Link to 2011 Data Table for Please think about the past 30 days, keeping in mind all of your joint pain or aching and
whether or not you have taken medication. DURING THE PAST 30 DAYS, how bad
was your joint pain ON AVERAGE? Please answer on a scale of 0 to 10 where 0 is no
pain or aching and 10 is pain or aching as bad as it can be. |,
2013c for
Link to 2013 Data Table for Please think about the past 30 days, keeping in mind all of your joint pain or aching and
whether or not you have taken medication. DURING THE PAST 30 DAYS, how bad
was your joint pain ON AVERAGE? Please answer on a scale of 0 to 10 where 0 is no
pain or aching and 10 is pain or aching as bad as it can be. |,
2015c for
Link to 2015 Data Table for Please think about the past 30 days, keeping in mind all of your joint pain or aching and
whether or not you have taken medication. DURING THE PAST 30 DAYS, how bad
was your joint pain ON AVERAGE? Please answer on a scale of 0 to 10 where 0 is no
pain or aching and 10 is pain or aching as bad as it can be. |,
2017c for
Link to 2017 Data Table for Please think about the past 30 days, keeping in mind all of your joint pain or aching and
whether or not you have taken medication. DURING THE PAST 30 DAYS, how bad
was your joint pain ON AVERAGE? Please answer on a scale of 0 to 10 where 0 is no
pain or aching and 10 is pain or aching as bad as it can be. |
|
|
To your knowledge, are there
educational courses or classes available in your community that could
teach you how to manage problems related to your arthritis or joint symptoms? |
|
|
Were these symptoms present
on most days for at least one month? |
|
|
What type of arthritis did
the doctor say you have? |
|
|
Arthritis Management (Asked of respondents with doctor diagnosed form of arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia.) |
c = CDC Core Question, o = CDC Optional Question, s = State-Added Question |
Earlier you indicated that you had arthritis or joint symptoms. Thinking about your arthritis or joint symptoms, which of the following best describes you today? |
2003o for
Link to 2003 Data Table for Thinking About Your Arthritis or Joints Symptoms,
Which of the Following Best Describes You TODAY ,
2005o for
Link to 2005 Data Table for Thinking About Your Arthritis or Joints Symptoms,
Which of the Following Best Describes You TODAY |,
2009o for
Link to 2009 Data Table for Thinking About Your Arthritis or Joints Symptoms,
Which of the Following Best Describes You TODAY |,
2011o for
Link to 2011 Data Table for Thinking About Your Arthritis or Joints Symptoms,
Which of the Following Best Describes You TODAY |,
2013ofor
Link to 2013 Data Table for Thinking About Your Arthritis or Joints Symptoms,
Which of the Following Best Describes You TODAY |,
2015cfor
Link to 2015 Data Table for Earlier you indicated that you had arthritis or joint symptoms. Thinking about your arthritis or joint symptoms, which of the following best describes you today?|,
2017ofor
Link to 2017 Data Table for Earlier you indicated that you had arthritis or joint symptoms. Thinking about your arthritis or joint symptoms, which of the following best describes you today?|
|
|
Has a doctor or other health professional EVER suggested losing weight to help your arthritis or joint symptoms? |
|
|
Has a doctor or other health professional ever suggested physical activity or exercise to help your arthritis or joint symptoms? |
|
|
Have you EVER taken an educational course or class to teach you how to manage problems related to your arthritis or joint symptoms? |
|
|
Arthritis Related Issues |
c
= CDC Core Question, o = CDC Optional Question, s = State-Added Question
|
Have you EVER taken an educational
course or class to teach you how to manage problems related to your arthritis
or joint symptoms? |
|
|
Have you EVER taken a physical
activity class to teach you how to manage problems related to your arthritis or joint symptoms? |
|
|
If Core Demograpics Section: Employment Question equals: 1 (Employed for wages) or 2 (Self-employed), then continue.
OR
If State-Added Module Average Hours Worked Question is greater than
zero and Core Demograpics Section: Employment Question equals: 5 (A
homemaker), 6 (A student) or 7 (Retired), then continue.
Otherwise, Go To Next Section.
Is your arthritis or joint symptoms MADE WORSE by duties in your CURRENT job? |
|
|
If Core Demograpics Section: Employment Question equals: 1 (Employed for wages) or 2 (Self-employed), then continue.
OR
If State-Added Module Average Hours Worked Question is greater than
zero and Core Demograpics Section: Employment Question equals: 5 (A
homemaker), 6 (A student) or 7 (Retired), then continue.
Otherwise, Go To Next Section.
In the past 30 days, how many days of work did you miss because of arthritis or joint symptoms? |
|
|
Aspirin Use (CVH) |
c
= CDC Core Question, o = CDC Optional Question, s = State-Added Question
|
I would like to ask you a few questions about aspirin use.
Do you take aspirin daily or every other day? |
|
|
Do you have a health problem or condition that makes taking aspirin unsafe for you?
Interviewer Note: If "Yes", ask "Is this a stomach condition?" Code
upset stomach as 2 "Yes, stomach problems". |
|
|
Asthma, Adult |
c
= CDC Core Question, o = CDC Optional Question, s = State-Added Question
|
A peak flow meter is a hand
held device used to measure how well a person is breathing. Have you been
instructed in the use of a peak flow meter? |
1998s |
|
[If one or more visits to Q1
or Q3, fill in (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? |
|
|
Did a doctor ever tell you
that you had asthma? |
|
|
Do you currently have asthma? |
1998s |
|
Do you still have asthma? |
2000cfor
Link to 2000 Data Table for still have asthma,
2001cfor
Link to 2001 Data Table for still have asthma,
2002cfor
Link to 2002 Data Table for still have asthma,
2003cfor
Link to 2003 Data Table for still have asthma,
2004cfor
Link to 2004 Data Table for still have asthma,
2005cfor
Link to 2005 Data Table for still have asthma,
2006cfor
Link to 2006 Data Table for still have asthma,
2007cfor
Link to 2007 Data Table for still have asthma,
2008cfor
Link to 2008 Data Table for still have asthma,
2009cfor
Link to 2009 Data Table for still have asthma,
2010cfor
Link to 2010 Data Table for still have asthma,
2011cfor
Do you still have asthma?,
2012cfor
Do you still have asthma?,
2013cfor
Do you still have asthma?,
2014cfor
Do you still have asthma?,
2015cfor
Do you still have asthma?,
2016cfor
Do you still have asthma?,
2017cfor
Do you still have asthma?
|
|
Does anyone, including household
members or guests, smoke inside your home? |
1998s |
|
During the past 12 months,
have you had an episode of asthma or an asthma attack? |
|
|
During the past 12 months have
you taken predisone or another steroid as a pill, capsule, or injection
to help control your asthma? This does not include inhaled steroids. |
1998s |
|
During the past 12 months have
you visited a hospital emergency room or urgent care center because of
difficulty breathing? |
1998s |
|
During the past 12 months,
how many days were you unable to work or carry out your usual activities
because of your asthma? |
|
|
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? |
|
|
During the past 12 months,
how many times did you visit an emergency room or urgent care center because
of your asthma? |
|
|
During the past 30 days, for
about how many days did your asthma limit you in your usual activities,
such as self-care, work, or recreation? |
1998s |
|
During the past 30 days, how
many days did symptoms of asthma make it difficult for you to stay asleep? |
|
|
During the past 30 days, how
many days did you take a prescription asthma medication to PREVENT an
asthma attack from occurring? |
|
|
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. |
|
|
During the past 30 days, how
often did you use a prescription inhaler DURING AN ATTACK to stop it? |
|
|
Has a doctor ever counseled
you about how to make changes in your medication to control your asthma? |
1998s |
|
Has a doctor ever counseled
you about not permitting anyone to smoke in your home? |
1998s |
|
Have you ever been told by
a doctor, nurse, or other health professional that you had asthma? |
2001cfor
Link to 2001 Data Table for ever been told by a doctor, nurse, or other
health professional that you had asthma,
2002cfor
Link to 2002 Data Table for ever been told by a doctor, nurse, or other
health professional that you had asthma,
2003cfor
Link to 2003 Data Table for ever been told by a doctor, nurse, or other
health professional that you had asthma,
2004cfor
Link to 2004 Data Table for ever been told by a doctor, nurse, or other
health professional that you had asthma,
2005cfor
Link to 2005 Data Table for ever been told by a doctor, nurse, or other
health professional that you had asthma,
2006cfor
Link to 2006 Data Table for ever been told by a doctor, nurse, or other
health professional that you had asthma,
2007cfor
Link to 2007 Data Table for ever been told by a doctor, nurse, or other
health professional that you had asthma,
2008cfor
Link to 2008 Data Table for ever been told by a doctor, nurse, or other
health professional that you had asthma,
2009cfor
Link to 2009 Data Table for ever been told by a doctor, nurse, or other
health professional that you had asthma,
2010cfor
Link to 2010 Data Table for ever been told by a doctor, nurse, or other
health professional that you had asthma |
|
Has a doctor, nurse,
or other health professional EVER told you that you had any of the following?
For each, tell me “Yes,” “No,” or you’re
“Not sure.”
(Ever told) you had asthma? |
|
|
Have you ever been told by a doctor that you have asthma?
|
1998s |
|
Have you taken any medications
for asthma during the past twelve months? |
1998s |
|
How old were you when you were
first told by a doctor, nurse, or other health professional that you had
asthma? |
|
|
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? |
|
|
Asthma, Child |
c
= CDC Core Question, o = CDC Optional Question, s = State-Added Question
|
Does the [randomly selected child] still have asthma?
|
|
|
Does the child still have asthma?
|
2005o
for Link to 2005 Data Table for Does the
child still have asthma? |,
2006ofor Link to 2006 Data Table for Does the child still have asthma?
|, 2007o, 2008ofor Link to 2008 Data Table for Does the child still have asthma?
|, 2009ofor Link to 2008 Data Table for Does the child still have asthma?
|, 2010ofor Link to 2010 Data Table for Does the child still have asthma?
|, 2011ofor Link to 2011 Data Table for Does the child still have asthma?
|, 2012ofor Link to 2012 Data Table for Does the child still have asthma?
|, 2013ofor Link to 2013 Data Table for Does the child still have asthma?
|, 2014ofor Link to 2014 Data Table for Does the child still have asthma?
|, 2015ofor Link to 2015 Data Table for Does the child still have asthma?
|, 2016ofor Link to 2016 Data Table for Does the child still have asthma?
|, 2017ofor Link to 2017 Data Table for Does the child still have asthma?
|
|
|
During the past 12 months, how many days has the [randomly selected
child] missed school or day care because of [his/her] asthma?
|
|
|
Has the [randomly selected child] ever been diagnosed with asthma?
|
|
|
Has a doctor, nurse, or other health professional EVER said that the
child has asthma?
|
2005o
for Link to 2005 Data Table for Has a doctor,
nurse, or other health professional EVER said that the child has asthma?
| , 2006ofor
Link to 2006 Data Table for Has a doctor, nurse, or other health professional
EVER said that the child has asthma? |,
2007o, 2008o
for
Link to 2008 Data Table for Has a doctor, nurse, or other health professional
EVER said that the child has asthma? |, 2009o
for
Link to 2008 Data Table for Has a doctor, nurse, or other health professional
EVER said that the child has asthma? |,
2010o
for
Link to 2010 Data Table for Has a doctor, nurse, or other health professional
EVER said that the child has asthma? |,
2011o
for
Link to 2011 Data Table for Has a doctor, nurse, or other health professional
EVER said that the child has asthma? |,
2012o
for
Link to 2012 Data Table for Has a doctor, nurse, or other health professional
EVER said that the child has asthma? |,
2013o
for
Link to 2013 Data Table for Has a doctor, nurse, or other health professional
EVER said that the child has asthma? |,
2014o
for
Link to 2014 Data Table for Has a doctor, nurse, or other health professional
EVER said that the child has asthma? |,
2015o
for
Link to 2015 Data Table for Has a doctor, nurse, or other health professional
EVER said that the child has asthma? |,
2016o
for
Link to 2016 Data Table for Has a doctor, nurse, or other health professional
EVER said that the child has asthma? |,
2017o
for
Link to 2017 Data Table for Has a doctor, nurse, or other health professional
EVER said that the child has asthma? |
|
|
How are you related to the [randomly selected child]?
|
|
|
Is the [randomly selected child] child Hispanic or Latino?
|
|
|
Previously, you indicated there were [number of children from core]
children under age 18 in your household. What is the age of the [randomly
selected child - oldest, second oldest, etc.] child?
|
|
|
What is the gender of this child?
|
|
|
Which one of these groups would you say best represents the race of
the [randomly selected child]?
|
|
|
Average Hours Worked |
c
= CDC Core Question, o = CDC Optional Question, s = State-Added Question
|
If Core Employement Question = 1 (Employed for Wages), 2
(Self-Employed), 5 (A Homemaker), 6 (A Student) or 7 (Retired); skip
out of the Demographics Core Section to ask the State-Added Average
Hours Worked Module.
Previously, you indicated you were (a) [insert
response from core reported employment status].
On the average, how many hours per week, if any, do you work at a job
or business?
|
2003s
for Link to 2003 Data Table for On the average, how many hours per week, if any, do you work at a job or business?,
2004s
for Link to 2004 Data Table for On the average, how many hours per week, if any, do you work at a job or business?,
2005s
for Link to 2005 Data Table for On the average, how many hours per week, if any, do you work at a job or business?,
2006s
for Link to 2006 Data Table for On the average, how many hours per week, if any, do you work at a job or business?,
2007s
for Link to 2007 Data Table for On the average, how many hours per week, if any, do you work at a job or business?,
2008s
for Link to 2008 Data Table for On the average, how many hours per week, if any, do you work at a job or business?,
2009s
for Link to 2009 Data Table for On the average, how many hours per week, if any, do you work at a job or business?,
2010s
for Link to 2010 Data Table for On the average, how many hours per week, if any, do you work at a job or business?,
2011s
for Link to 2011 Data Table for On the average, how many hours per week, if any, do you work at a job or business?,
2012s
for Link to 2012 Data Table for On the average, how many hours per week, if any, do you work at a job or business?,
2013s
for Link to 2013 Data Table for On the average, how many hours per week, if any, do you work at a job or business?,
2014s
for Link to 2014 Data Table for On the average, how many hours per week, if any, do you work at a job or business?,
2015s
for Link to 2015 Data Table for On the average, how many hours per week, if any, do you work at a job or business?,
2016s
for Link to 2016 Data Table for On the average, how many hours per week, if any, do you work at a job or business?,
2017s
for Link to 2017 Data Table for On the average, how many hours per week, if any, do you work at a job or business?
|
|