C. Health

Module C. Health of MHAS 2012

Label Type Description
C1 Question Now I have some questions about your health. Would you say your health is...
C2a Question Comparing your health now with your health two years ago, would you say your health now is...
C2b Question In the last two years, have you seen a doctor or medical personnel?
C3 Question Compared with other people your age, would you say that currently your health is...?
C4 Question Has a doctor or medical personnel ever diagnosed you with hypertension or high blood pressure?
C5 Question Are you currently taking any medication to lower your blood pressure?
C6 Question Has a doctor or medical personnel ever diagnosed you with diabetes?
C7 Question Are you currently taking any oral medication in order to control your diabetes?
C8 Question Are you currently using insulin shots?
C9 Question Do you follow a special diet to control your diabetes?
C10 Question In general, is your diabetes under control now?
C11 Question How frequently do you measure your blood sugar level or urine-sugar level? INDICATE THE NUMBER OF TIME AND PERIOD
C12 Question Has a doctor or medical personnel ever diagnosed you with cancer?
C13 Question In total, how many cancers in different places or organs have you ever had?
C14 Question What type of cancer? INDICATE ALL THAT APPLY
C15 Question In the last two years, have you consulted a doctor or medical personnel about your cancer?
C16 Question In the last two years, what type of treatments have you received for your cancer? (Other)
C17 Question Are you currently receiving treatment for your cancer?
C18 Question In what year or at what age was your (most recent) cancer diagnosed?
C19 Question Has a doctor or medical personnel ever told/diagnosed you with a respiratory illness, such as asthma or emphysema?
C20a Question Are you currently taking medication or using another treatment for your respiratory illness?
C20b Question Are you receiving oxygen for your pulmonary disease?
C21 Question Does this condition limit your daily activities such as household chores or your job?
C22a Question Has a doctor or medical personnel ever told you that you have had a heart attack?
C22b Question In what year or at about what age did you have your (most recent) heart attack?
C23 Question Are you currently taking medication for your heart condition?
C24 Question Do you carry any medicine with you for chest pain?
C25a Question Does this heart problem limit your daily activities such as household chores or your job?
C25b Question Has a doctor or medical personnel ever told you that you have had heart failure/cardiac failure/congestive heart failure, arrhythmia, or angina?
C26 Question Has a doctor or medical personnel (ever/in the last two years) told you that you had a stroke? [VOL] POSSIBLE STROKE OR TIA (TRANSIENT ISCHEMIC ATTACK)
C27_1 Question Because of your stroke do you have weakness in the arms and/or legs, or the capacity to move them has diminished?
C27_2 Question Because of your stroke do you have difficulties when speaking or eating?
C27_3 Question Because of your stroke do you have difficulties with sight or vision?
C27_4 Question Because of your stroke do you have difficulties when thinking or saying what you want?
C28 Question Are you currently taking any medications because of your stroke or for complications due to the stroke?
C29 Question Are you doing physical therapy or rehabilitation because of the stroke or the complications that resulted from the stroke?
C30 Question In what year or at about what age did you have your (most recent) stroke?
C31 Question Has this stroke limited your daily activities such as household chores or your job?
C.32 Question Has a doctor or medical personnel ever diagnosed you with arthritis or rheumatism?
C33 Question Do you feel pain, stiffness, or swelling in your joints?
C34 Question Are you taking medication or are you receiving other treatment for your arthritis or rheumatism?
C35 Question Are your daily activities such as household chores or your job limited because of your arthritis?
C36_1 Question In the last 2 years, has a doctor or medical personnel told you that you have...Kidney infection
C36_2 Question In the last 2 years, has a doctor or medical personnel told you that you have...Liver infection
C36_3 Question In the last 2 years, has a doctor or medical personnel told you that you have...Tuberculosis
C36_4 Question In the last 2 years, has a doctor or medical personnel told you that you have...Pneumonia
C36_5 Question In the last 2 years, has a doctor or medical personnel told you that you have...Herpes or Zoster herpes
C37 Question Have you fallen down in the last two years?
C38 Question Approximately how many times has this happened?
C39 Question Have you hurt yourself in these falls badly enough to need medical treatment?
C40a Question Since your fiftieth birthday, have you fractured any bone(s) including your hip?
C40b Question In the last 10 years, have you fractured any bone(s) including your hip?
C40c Question Did this fracture occur in the last 2 years?
C41 Question Do you usually wear glasses?
C42 Question How is your vision (with glasses)?
C43 Question Do you usually use a hearing aid or auditory device?
C44 Question How is you hearing/auditory range (using hearing aid or auditory device)?
C45 Question Do you often suffer from pain?
C46 Question How is the pain the majority of the time?
C47 Question Does this pain limit your usual activities such as household chores or your job?
C48a Question In the last two years, have you had any of the following exams or medical procedures? Tetanus vaccine
C48b Question In the last two years, have you had any of the following exams or medical procedures? Cholesterol blood test
C48c Question In the last two years, have you had any of the following exams or medical procedures? Tuberculosis test
C48d Question In the last two years, have you had any of the following exams or medical procedures? Diabetes
C48e Question In the last two years, have you had any of the following exams or medical procedures? Blood pressure test
C48f Question In the last two years, have you had any of the following exams or medical procedures? Flu vaccine
C48g Question In the last two years, have you had any of the following exams or medical procedures? Pneumonia vaccine
C48h Question Monthly self-breast exam?
C48i Question Had you had a mammogram or x-ray to check for breast cancer?
C48j Question Have you had a pap smear to check for uterine cancer?
C48k Question In the last 2 years, have you had an exam or blood test to screen for prostate cancer?
C49_1 Question These questions refer to how you have felt during the past week. For each question please tell me if the majority of the time: Have you felt depressed?
C49_2 Question These questions refer to how you have felt during the past week. For each question please tell me if the majority of the time: Everything you did was difficult to do?
C49_3 Question These questions refer to how you have felt during the past week. For each question please tell me if the majority of the time: Had restless sleep?
C49_4 Question These questions refer to how you have felt during the past week. For each question please tell me if the majority of the time: Felt happy?
C49_5 Question These questions refer to how you have felt during the past week. For each question please tell me if the majority of the time: Felt alone?
C49_6 Question These questions refer to how you have felt during the past week. For each question please tell me if the majority of the time: Felt you enjoyed life?
C49_7 Question These questions refer to how you have felt during the past week. For each question please tell me if the majority of the time: Felt sad?
C49_8 Question These questions refer to how you have felt during the past week. For each question please tell me if the majority of the time: Felt tired?
C49_9 Question These questions refer to how you have felt during the past week. For each question please tell me if the majority of the time: Felt very energetic?
C50a Question In the last 2 years, have you ever felt sad, blue, or depressed for more than two weeks in a row?
C50b Question On average during the last two years, have you exercised or done hard physical work three or more times a week? INCLUDES VARIOUS ACTIVITES SUCH AS SPORTS, HEAVY HOUSEHOLD CHORES, OR OTHER PHYSICAL WORK
C51 Question Have you ever smoked cigarettes? INCLUDE MORE THAN 100 CIGARETTES OR 5 PACKS IN YOUR LIFETIME. DO NOT INCLUDE PIPES OR CIGARS.
C52 Question About how old were you when you started smoking?
C53 Question Have you smoked cigarettes in the last two years?
C54 Question Do you smoke cigarettes now?
C55 Question How often do you smoke?
C56 Question About how many cigarettes or packs do you usually smoke in a day? REGISTER THE AVERAGE AND CONVERT TO CIGARETTES
C57 Question When you were smoking the most, about how many cigarettes or packs did you usually smoke in a day?
C58 Question About how many years ago did you stop smoking? MARK RESPONSE IN CORRESPONDING SPACE
C59a Question Do you ever drink any alcoholic beverages such as beer, wine, liquor, or pulque (drink made from fermented cactus sap)?
C59b Question In the last three months, about how many days a week have you had an alcoholic beverage? NONE, OR LESS THAN ONE PER WEEK MARK "0"
C59c Question On the days that you drank alcoholic beverages in the last three months, about how many drinks did you have per day?
C59d Question In the last three months, on how many days have you had four or more drinks on one occasion?
C59e Question During the last two years, have you had any alcoholic drinks such as beer, wine, liqour, or pulque (drink made from fermented cactus sap)?
C60 Question (When you were drinking), have you ever felt that you should (have) cut down on the quantity of drinks you have (had)?
C61 Question (When you were drinking), have (did) people ever annoy you by criticizing your drinking habits?
C62 Question Have you ever felt bad or guilty about drinking?
C63 Question Have you ever had an alcoholic drink when you woke up in the morning in order to calm your nerves or to get rid of a "hangover"?
C64 Question Compared with two years ago, your weight..
C65 Question In the last two years, have you changed your diet or your exercise habits in order to gain or lose weight?
C66 Question About how much do you weigh now?
C67 Question About how tall are you without shoes?
C68a Question During the last two years have you frequently had any of the following problems or inconveniences? Frequent swelling in the feet or ankles
C68b Question During the last two years have you frequently had any of the following problems or inconveniences? Difficulty breathing , panting or coughing, or phlegm
C68c Question During the last two years have you frequently had any of the following problems or inconveniences? Nausea or fainting
C68d Question During the last two years have you frequently had any of the following problems or inconveniences? Extreme thirst
C68e Question During the last two years have you frequently had any of the following problems or inconveniences? Severe fatigue or exhaustion
C68f Question During the last two years have you frequently had any of the following problems or inconveniences? Stomach pain, indigestion or diarrhea
C68g Question During the last two years have you frequently had any of the following problems or inconveniences? Incontinence when coughing, sneezing, picking something up, or exercising
C68h Question During the last two years have you frequently had any of the following problems or inconveniences? Incontinence when had the urge to urinate, but couldn't reach the bathroom in time
C68i Question During the last two years have you frequently had any of the following problems or inconveniences? Burning sensation when urinating
C69a Question How would you evaluate your hand strength (your dominant hand)? Would you say...
C69b Question How often do you have difficulty with balance? Would you say...
C70 Question In the last two years, have you eaten less because of loss of appetite, digestive problems, and difficulties chewing or swallowing?
C71a Question Have you lost an extremity or part of your feet or arms due to an accident or sickness?
C71b Question Did this loss occur in the last 2 years?
C72 Question Have you ever (or in the last two years) been told by a doctor or medical personnel that you suffer from a health problem caused by your job? INCLUDE WORK ACCIDENTS
C73 Question Due to sickness or injury, during the last 12 months, how many days did you stay in bed for at least half the day? INCLUDE DAYS WHEN YOU WERE IN HOSPITAL
C74 Question How often do you feel really rested when you wake up in the morning? Would you say...
C75 Question asked of interviewer INTERVIEWER: HOW FREQUENTLY DID THE RESPONDENT NEED HELP TO ANSWER SECTION C. HEALTH?