Section C: State of Health

Section C: State of Health Module of CRELES Wave 1

Label Type Description
C1 Question How would you say your health is now: Excellent, Very Good, Good, Fair, Poor
C2 Question How would you say your health is in comparison with other people of your age? Better, Equal, Worse?
C3 Question SHOW CARD Now we are going to use a card from which you can choose a number from 1 to 7 to evaluate your state of health, wherein 7 signifies excellent health and 1 poor health. Please choose the number which best describes your state of health.
C4 Question Has a physician ever told you that you have high blood pressure (hypertension)?
C5 Question How old were you when you were first told that you had high blood pressure?
C5a Question Age
C5b Question Year
C6 Question When was the last time that you checked your blood pressure?
C7 Question Has a physician ever told you that you have high cholesterol?
C8 Question How old were you when you were first told that you had high cholesterol?
C9 Question When was the last time that you checked your cholesterol?
C10 Question Has a physician ever told you that you have diabetes (high levels of sugar in the blood)?
C11 Question How old were you when you were first told that you had diabetes?
C12 Question Are you taking pills to control your diabetes?
C13 Question Are you using insulin injections to control your diabetes?
C14 Question How often do you measure your blood sugar levels yourself?
C15 Question How often do you have medical check-ups for your diabetes?
C16 Question Did this problem make you change your daily activities in your home or at work?
C17 Question When was the last time that a physician did a test to know if you had sugar in your blood?
C18 Question Has a physician ever told you that you have cancer or a malignant tumor, not including small skin tumors?
C19 Question How old were you when you were first told that you had this disease?
C20 Question In which organ or what part of the body did the cancer begin?
C21 Question Did this problem cause you to change your daily activities at home or at work?
C22 Question Has a physician ever told you that you have a chronic respiratory or pulmonary disease, like emphysema, tuberculosis, asthma or chronic bronchitis?
C23a Question Age
C23b Question Year
C25 Question Has this problem caused you to change your daily activities at home or at work?
C23 Question How old were you when you were first told that you had this respiratory disease?
C24 Question Are you receiving some kind of treatment for your respiratory illness(es)?
C26 Question Has a physician even told you that you have had a heart attack?
C30 Question Third
C29 Question Second
C28 Question First
C27 Question How many heart attacks have you had in all your life?
C31 Question Have these heart problems caused you to make changes to your normal activities at home or work?
C32 Question Has a physician ever told you that you have a heart disease without having a heart attack?
C33 Question How old were you when this heart problem was diagnosed?
C34 Question Has this disease caused you to change your normal activities at home or at work?
C35 Question Has a physician ever told you have had a stroke?
C36 Question How many strokes have you had in your life?
C37 Question First stroke
C38 Question Second stroke
C39 Question Third stroke
C40 Question Have these strokes caused you to change your normal activities at home or at work?
C41 Question Has a physician ever told you that you have arthritis, rheumatism or arthrosis?
C42 Question How old were you when you were diagnosed with arthritis or rheumatism for the first time?
C43 Question Has this problem caused you to change your normal activities at home or at work?
C44 Question Has a physician ever told you that you have osteoporosis (bone fragility)?
C45 Question How old were you when you were diagnosed with osteoporosis?
C46 Question Has this problem caused you to change your daily activities at home or at work?
C47 Question Is there someone in your family who has or had hypertension? [A parent/A sibling/A grandparent]
C48 Question Is there someone in your family who has or had diabetes? [A parent/A sibling/A grandparent]
C49 Question Have you fallen in the last 2 years? (do not include falls due to inebriation)
C50 Question How many times have you fallen in the last 12 months?
C51 Question Have you ever fractured a bone after the age of 60?
C52 Question Have you ever had an operation or surgery due to that fracture, or due to your arthritis, rheumatism or artrosis?
C53 Question What bone or joint was operated on?
C54 Question Do you normally use glasses or contact lenses?
C55 Question Using this card, choose a number from 1 to 7 to describe how your sight is for seeing FAR (with glasses) and to recognize a friend on the other side of the street. (1 is poor and 7 is excellent)
C56 Question Using this card, choose a number from 1 to 7 to describe how your sight is for seeing NEAR (with glasses) and to read the newspaper or to see photographs in a magazine. (1 is poor and 7 is excellent)
C57 Question Has a physician ever told you that you have cataracts?
C58 Question Have you ever had an operation for your cataracts
C59 Question Has this problem caused you to change your daily activities at home or at work?
C60 Question Has a physician ever treated you for glaucoma
C61 Question Has this problem caused you to change your daily activities at home or at work?
C62 Question Do you use some type of auditory apparatus (hearing aide) to hear well?
C63 Question Using this card, choose a number from 1 to 7 to describe how your hearing is in general (with hearing aid). (1 is poor and 7 is excellent)
C64 Question Interviewer only: Until now, was the interviewee able to hear well the things you said to him/her?
C65 Question Are you missing your natural teeth or molars?
C66 Question Do you have bridges, or false teeth or dentures?
C67 Question In the last 12 months, how frequently have you had to eat less or change your food due to problems with your teeth, molars, bridges, or dentures?
C68 Question How old were you when you first had your menstruation?
C69 Question How old were you when you had your last menstruation?
C70 Question How many pregnancies in total did you have in your life?
C71 Question How old were you when you had your first pregnancy?
C72 Question During any of your pregnancies were you told you had diabetes (high levels of blood sugar)?
C73 Question How many abortions did you have in your life?
C74 Question Have you used a contraceptive or have you been sterilized?
C75 Question What kind of contraceptives have you used? (multiple) [Pills or capsules/Injections/Sterilization/Others]
C76 Question Have you had the operation called hysterectomy (surgery to remove the womb/uterus and/or ovaries)?
C77 Question Have you ever used women's hormones (estrogen) to treat menopause in the form of pills, patches or cream for three years or more?
C78 Question Has a physician ever told you that you have an enlarged prostate?
C79 Question Are you currently receiving treatment for your prostate?
C80 Question Do you have a urinary stream that is weak or small?
C81 Question Has a physician ever told you that you have a nervous or psychiatric problem such as depression?
C82 Question How old were you when you were diagnosed with your nervous problem?
C83 Question Has this problem interfered with your daily activities at home or at work?
C84 Question Swelling of your feets or heels
C85 Question Dizziness or fainting
C86 Question Intense thirst
C87 Question Severe fatigue or serious exhaustion
C88 Question Panting
C89 Question Cough
C90 Question Production of phlegm
C91 Question Pain in lower limbs during or after walking
C92 Question Pain in the upper stomach area
C93 Question Involuntary loss of urine
C94 Question Involuntary loss of excrement
C95 Question Urination with great frequency
C96 Question Urination three or more times at night
C97 Question Tingling or burning when urinating
C98 Question Bleeding during urination
C99 Question Bleeding during defecation
C100 Question Problems of insomnia
C101 Question Nausea
C102 Question Vomiting frequently
C103 Question Difficulty breathing while asleep
C104 Question Have you been satisfied with your life?
C105 Question Did you put aside or lessen your activities or the things you like to do?
C106 Question Did you feel that your life is empty?
C107 Question Did you feel bored frequently?
C108 Question Were you in a good mod for the majority of the time?
C109 Question Were you worried or fearing that something bad would happen to you?
C110 Question Did you feel happy most of the time?
C111 Question Did you frequently feel abandoned or unappreciated?
C112 Question Did you prefer to stay home instead of going out and doing things?
C113 Question Did you feel that you had more memory problems than other people of your same age?
C114 Question Did you feel that it is marvelous to be alive?
C115 Question Did you feel useless or that you were worthless in your current situation?
C116 Question Did you feel full of energy?
C117 Question Did you find yourself without hope in facing your current situation?
C118 Question Did you think that other people are in a better situation than you?
C119 Question There is not much sense in planning for the future
C120 Question The very good things that happen to us are because of good luck
C121 Question One is responsible for one's own successes
C122 Question One can do nearly anything one sets one's mind to
C123 Question The majority of problems are due to bad luck
C124 Question One has little control over the bad things that happen
C125 Question The tragedies that happen to us are a result of one's own mistakes
C126 Question One is responsible for one's own shortcomings
C127 Question In general, how do you feel about your life?
C128 Question During the last 12 months, have you had a flu or cold vaccine injection?
C129 Question Sputum test for tuberculosis?
C130 Question Hearing exam?
C131 Question Vision exam?
C132 Question Have you been vaccinated for tetanus?
C133 Question Bone density measurement? Not including x-ray or ultrasound.
C134 Question Mammography or x-ray of the breasts?
C135 Question Have you done a test for urinary tract cancer or cervical cancer (Papanicolaou)?
C136 Question Have you had a blood test for the prostate?
C137 Question Have you done a rectal exam for the prostate?
C138 Question Now, if you will allow me I will check your blood pressure from your arm.