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Start of C. Health
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C1 Now I have some questions about your health. Would you say your health is...
NOW I HAVE SOME QUESTIONS ABOUT YOUR HEALTH. WOULD YOU SAY YOUR HEALTH IS...
1 Excellent
2 Very Good
3 Good
4 Fair
5 Poor
8 RF
9 DK
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C2A Comparing your health now with your health two years ago, would you say your health now is...
COMPARING YOUR HEALTH NOW WITH YOUR HEALTH TWO YEARS AGO, WOULD YOU SAY YOUR HEALTH NOW IS...
1 Much better
2 Somewhat better
3 More or less the same
4 Somewhat worse
5 Much worse
8 RF
9 DK
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C2B In the last two years, have you seen a doctor or medical personnel?
IN THE LAST TWO YEARS, HAVE YOU SEEN A DOCTOR OR MEDICAL PERSONNEL?
1 Yes
2 No
8 RF
9 DK
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C3 Compared with other people your age, would you say that currently your health is...?
COMPARED WITH OTHER PEOPLE YOUR AGE, WOULD YOU SAY THAT CURRENTLY YOUR HEALTH IS...?
1 Better
2 More or less the same
3 Worse
8 RF
9 DK
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C4 Has a doctor or medical personnel (ever/in the last two years) diagnosed you with hypertension or high blood pressure?
HAS A DOCTOR OR MEDICAL PERSONNEL (EVER/IN THE LAST TWO YEARS) DIAGNOSED YOU WITH HYPERTENSION OR HIGH BLOOD PRESSURE?
1 Yes
2 No
8 RF
9 DK
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If Has a doctor or medical personnel (ever/in the last two years) diagnosed you with hypertension or high blood pressure? = 1 Yes »
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C5 Are you currently taking any medication to lower your blood pressure?
ARE YOU CURRENTLY TAKING ANY MEDICATION TO LOWER YOUR BLOOD PRESSURE?
1 Yes
2 No
8 RF
9 DK
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C6 Has a doctor or medical personnel (ever/in the last two years) diagnosed you with diabetes?
HAS A DOCTOR OR MEDICAL PERSONNEL (EVER/IN THE LAST TWO YEARS) DIAGNOSED YOU WITH DIABETES?
1 Yes
2 No
8 RF
9 DK
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If Has a doctor or medical personnel (ever/in the last two years) diagnosed you with diabetes? = 1 Yes »
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C7 Are you currently taking any oral medication in order to control your diabetes?
ARE YOU CURRENTLY TAKING ANY ORAL MEDICATION IN ORDER TO CONTROL YOUR DIABETES?
1 Yes
2 No
8 RF
9 DK
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C8 Are you currently using insulin shots?
ARE YOU CURRENTLY USING INSULIN SHOTS?
1 Yes
2 No
8 RF
9 DK
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C9 Do you follow a special diet to control your diabetes?
DO YOU FOLLOW A SPECIAL DIET TO CONTROL YOUR DIABETES?
1 Yes
2 No
8 RF
9 DK
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C10 In general, is your diabetes under control now?
IN GENERAL, IS YOUR DIABETES UNDER CONTROL NOW?
1 Yes
2 No
8 RF
9 DK
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C11 How frequently do you measure your blood sugar level or urine-sugar level?
HOW FREQUENTLY DO YOU MEASURE YOUR BLOOD SUGAR LEVEL OR URINE-SUGAR LEVEL?
______ Number of Times
1 Week
2 Month
3 Year
5 Never
88/8 RF
99/9 DK
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C12 During the last two years, Has a doctor or medical personnel ever diagnosed you with cancer?
DURING THE LAST TWO YEARS, HAS A DOCTOR OR MEDICAL PERSONNEL EVER DIAGNOSED YOU WITH CANCER?
1 Yes
2 No
8 RF
9 DK
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If During the last two years, Has a doctor or medical personnel ever diagnosed you with cancer? = 1 Yes »
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C13 In total, how many cancers in different places or organs have you ever had?
IN TOTAL, HOW MANY CANCERS IN DIFFERENT PLACES OR ORGANS HAVE YOU EVER HAD?
______ Number of Cancers
88 RF
99 DK
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C14 What type of cancer?
WHAT TYPE OF CANCER?
01 Breast
02 Cervical/Cervix
03 Endometrial/Uterine
04 Liver
05 Stomach
06 Pancreas
07 Prostate
08 Colorectal
09 Lung
10 Other
88 RF
99 DK
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C15 In the last two years, have you consulted a doctor or medical personnel about your cancer?
IN THE LAST TWO YEARS, HAVE YOU CONSULTED A DOCTOR OR MEDICAL PERSONNEL ABOUT YOUR CANCER?
1 Yes
2 No
8 RF
9 DK
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C16 In the last two years, what type of treatments have you received for your cancer?
IN THE LAST TWO YEARS, WHAT TYPE OF TREATMENTS HAVE YOU RECEIVED FOR YOUR CANCER?
1 Chemotherapy/Medication
2 Surgery or biopsy
3 Radiation or X-ray
4 Medication or treatment for symptoms (Pain, nausea rash)
5 None
7 Other (specify)
8 RF
9 DK
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C17 Are you currently receiving treatment for your cancer?
ARE YOU CURRENTLY RECEIVING TREATMENT FOR YOUR CANCER?
1 Yes
2 No
8 RF
9 DK
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C18 In what year or at what age was your (most recent) cancer diagnosed?
IN WHAT YEAR OR AT WHAT AGE WAS YOUR (MOST RECENT) CANCER DIAGNOSED?
______ Year or age
8888 RF
9999 DK
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C19 (In the last two years/ever) Has a doctor or medical personnel told diagnosed you with a respiratory illness, such as asthma or emphysema?
(IN THE LAST TWO YEARS/EVER) HAS A DOCTOR OR MEDICAL PERSONNEL TOLD DIAGNOSED YOU WITH A RESPIRATORY ILLNESS, SUCH AS ASTHMA OR EMPHYSEMA?
1 Yes
2 No
8 RF
9 DK
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If (In the last two years/ever) Has a doctor or medical personnel told diagnosed you with a respiratory illness, such as asthma or emphysema? = 1 Yes »
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C20A Are you currently taking medication or using another treatment for your respiratory illness?
ARE YOU CURRENTLY TAKING MEDICATION OR USING ANOTHER TREATMENT FOR YOUR RESPIRATORY ILLNESS?
1 Yes
2 No
8 RF
9 DK
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C20B Are you receiving oxygen for your pulmonary disease?
ARE YOU RECEIVING OXYGEN FOR YOUR PULMONARY DISEASE?
1 Yes
2 No
8 RF
9 DK
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C21 Does this condition limit your daily activities such as household chores or your job?
DOES THIS CONDITION LIMIT YOUR DAILY ACTIVITIES SUCH AS HOUSEHOLD CHORES OR YOUR JOB?
1 Yes
2 No
8 RF
9 DK
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C22A Has a doctor or medical personnel ever told you that you have had a heart attack?
HAS A DOCTOR OR MEDICAL PERSONNEL EVER TOLD YOU THAT YOU HAVE HAD A HEART ATTACK?
1 Yes
2 No
8 RF
9 DK
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If Has a doctor or medical personnel ever told you that you have had a heart attack? = 1 Yes »
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C22B In what year or at about what age did you have your (most recent) heart attack?
IN WHAT YEAR OR AT ABOUT WHAT AGE DID YOU HAVE YOUR (MOST RECENT) HEART ATTACK?
______ Year or age
8888 RF
9999 DK
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C23 Are you currently taking medication for your heart condition?
ARE YOU CURRENTLY TAKING MEDICATION FOR YOUR HEART CONDITION?
1 Yes
2 No
8 RF
9 DK
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C24 Do you carry any medicine with you for chest pain?
DO YOU CARRY ANY MEDICINE WITH YOU FOR CHEST PAIN?
1 Yes
2 No
8 RF
9 DK
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C25A Does this heart problem limit your daily activities such as household chores or your job?
DOES THIS HEART PROBLEM LIMIT YOUR DAILY ACTIVITIES SUCH AS HOUSEHOLD CHORES OR YOUR JOB?
1 Yes
2 No
8 RF
9 DK
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C25B Has a doctor or medical personnel ever told you that you have had heart failure/cardiac failure/congestive heart failure, arrhythmia, or angina?
HAS A DOCTOR OR MEDICAL PERSONNEL EVER TOLD YOU THAT YOU HAVE HAD HEART FAILURE/CARDIAC FAILURE/CONGESTIVE HEART FAILURE, ARRHYTHMIA, OR ANGINA?
1 Yes
2 No
8 RF
9 DK
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C26 Has a doctor or medical personnel (ever/in the last two years) told you that you had a stroke?
HAS A DOCTOR OR MEDICAL PERSONNEL (EVER/IN THE LAST TWO YEARS) TOLD YOU THAT YOU HAD A STROKE?
1 Yes
2 No
8 RF
9 DK
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If Has a doctor or medical personnel (ever/in the last two years) told you that you had a stroke? = 1 Yes »
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C27_1 ...weakness in the arms and/or legs, or the capacity to move them has diminished
...WEAKNESS IN THE ARMS AND/OR LEGS, OR THE CAPACITY TO MOVE THEM HAS DIMINISHED
1 Yes
2 No
8 RF
9 DK
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C27_2 ...difficulties when speaking or eating
...DIFFICULTIES WHEN SPEAKING OR EATING
1 Yes
2 No
8 RF
9 DK
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C27_3 ...difficulties with sight or vision
...DIFFICULTIES WITH SIGHT OR VISION
1 Yes
2 No
8 RF
9 DK
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C27_4 ...difficulties when thinking or saying what you want
...DIFFICULTIES WHEN THINKING OR SAYING WHAT YOU WANT
1 Yes
2 No
8 RF
9 DK
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C28 Are you currently taking any medications because of your stroke or for complications due to the stroke?
ARE YOU CURRENTLY TAKING ANY MEDICATIONS BECAUSE OF YOUR STROKE OR FOR COMPLICATIONS DUE TO THE STROKE?
1 Yes
2 No
8 RF
9 DK
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C29 Are you doing physical therapy or rehabilitation because of the stroke or the complications that resulted from the stroke?
ARE YOU DOING PHYSICAL THERAPY OR REHABILITATION BECAUSE OF THE STROKE OR THE COMPLICATIONS THAT RESULTED FROM THE STROKE?
1 Yes
2 No
8 RF
9 DK
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C30 In what year or at about what age did you have your (most recent) stroke?
IN WHAT YEAR OR AT ABOUT WHAT AGE DID YOU HAVE YOUR (MOST RECENT) STROKE?
______ Year or age
8888 RF
9999 DK
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C31 Has this stroke limited your daily activities such as household chores or your job?
HAS THIS STROKE LIMITED YOUR DAILY ACTIVITIES SUCH AS HOUSEHOLD CHORES OR YOUR JOB?
1 Yes
2 No
8 RF
9 DK
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C32 Has a doctor or medical personnel ever diagnosed you with arthritis or rheumatism?
HAS A DOCTOR OR MEDICAL PERSONNEL EVER DIAGNOSED YOU WITH ARTHRITIS OR RHEUMATISM?
1 Yes
2 No
8 RF
9 DK
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If Has a doctor or medical personnel ever diagnosed you with arthritis or rheumatism? = 1 Yes »
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C33 Do you feel pain, stiffness, or swelling in your joints?
DO YOU FEEL PAIN, STIFFNESS, OR SWELLING IN YOUR JOINTS?
1 Yes
2 No
8 RF
9 DK
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C34 Are you taking medication or are you receiving other treatment for your arthritis or rheumatism?
ARE YOU TAKING MEDICATION OR ARE YOU RECEIVING OTHER TREATMENT FOR YOUR ARTHRITIS OR RHEUMATISM?
1 Yes
2 No
8 RF
9 DK
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C35 Are your daily activities such as household chores or your job limited because of your arthritis?
ARE YOUR DAILY ACTIVITIES SUCH AS HOUSEHOLD CHORES OR YOUR JOB LIMITED BECAUSE OF YOUR ARTHRITIS?
1 Yes
2 No
8 RF
9 DK
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C36_1 Kidney infection
KIDNEY INFECTION
1 Yes
2 No
8 RF
9 DK
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C36_2 Liver infection
LIVER INFECTION
1 Yes
2 No
8 RF
9 DK
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C36_3 Tuberculosis
TUBERCULOSIS
1 Yes
2 No
8 RF
9 DK
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C36_4 Pneumonia
PNEUMONIA
1 Yes
2 No
8 RF
9 DK
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C36_5 Herpes or Herpes Zoster?
HERPES OR HERPES ZOSTER?
1 Yes
2 No
8 RF
9 DK
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C37 Have you fallen down in the last two years?
HAVE YOU FALLEN DOWN IN THE LAST TWO YEARS?
1 Yes
2 No
8 RF
9 DK
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If Have you fallen down in the last two years? = 1 Yes »
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C38 Approximately how many times has this happened?
APPROXIMATELY HOW MANY TIMES HAS THIS HAPPENED?
______ Number of Times
88 RF
99 DK
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C39 Have you hurt yourself in these falls badly enough to need medical treatment?
HAVE YOU HURT YOURSELF IN THESE FALLS BADLY ENOUGH TO NEED MEDICAL TREATMENT?
1 Yes
2 No
8 RF
9 DK
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C41 Do you usually wear glasses?
DO YOU USUALLY WEAR GLASSES?
1 Yes
2 No
8 RF
9 DK
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C42 How is your vision (with glasses)?
HOW IS YOUR VISION (WITH GLASSES)?
1 Excellent
2 Very good
3 Good
4 Fair
5 Poor
8 RF
9 DK
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C43 Do you usually use a hearing aid or auditory device?
DO YOU USUALLY USE A HEARING AID OR AUDITORY DEVICE?
1 Yes
2 No
8 RF
9 DK
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C44 How is you hearing/auditory range (using hearing aid or auditory device)?
HOW IS YOU HEARING/AUDITORY RANGE (USING HEARING AID OR AUDITORY DEVICE)?
1 Excellent
2 Very good
3 Good
4 Fair
5 Poor
8 RF
9 DK
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C45 Do you often suffer from pain?
DO YOU OFTEN SUFFER FROM PAIN?
1 Yes
2 No
8 RF
9 DK
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If Do you often suffer from pain? = 1 Yes »
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C46 How is the pain the majority of the time?
HOW IS THE PAIN THE MAJORITY OF THE TIME?
1 Mild
2 Moderate
3 Severe
8 RF
9 DK
1 Yes
2 No
8 RF
9 DK
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C47 Does this pain limit your usual activities such as household chores or your job?
DOES THIS PAIN LIMIT YOUR USUAL ACTIVITIES SUCH AS HOUSEHOLD CHORES OR YOUR JOB?
1 Yes
2 No
8 RF
9 DK
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C48A Colonoscopy, sigmoidoscopy or other test for colon cancer
COLONOSCOPY, SIGMOIDOSCOPY OR OTHER TEST FOR COLON CANCER
1 Yes
2 No
8 RF
9 DK
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C48B Cholesterol blood test
CHOLESTEROL BLOOD TEST
1 Yes
2 No
8 RF
9 DK
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C48C Tuberculosis test
TUBERCULOSIS TEST
1 Yes
2 No
8 RF
9 DK
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C48D Diabetes test
DIABETES TEST
1 Yes
2 No
8 RF
9 DK
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C48E Blood pressure test
BLOOD PRESSURE TEST
1 Yes
2 No
8 RF
9 DK
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C48F Flu vaccine
FLU VACCINE
1 Yes
2 No
8 RF
9 DK
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C48G Pneumonia vaccine
PNEUMONIA VACCINE
1 Yes
2 No
8 RF
9 DK
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If RESPONDENT IS NOT MALE »
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C48H Monthly self-breast exam?
MONTHLY SELF-BREAST EXAM?
1 Yes
2 No
8 RF
9 DK
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C48I Had you had a mammogram or x-ray to check for breast cancer?
HAD YOU HAD A MAMMOGRAM OR X-RAY TO CHECK FOR BREAST CANCER?
1 Yes
2 No
8 RF
9 DK
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C48J Have you had a pap smear to check for uterine cancer?
HAVE YOU HAD A PAP SMEAR TO CHECK FOR UTERINE CANCER?
1 Yes
2 No
8 RF
9 DK
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C48K How old were you when you finished passing through menopause, i.e., your last menstral cycle?
HOW OLD WERE YOU WHEN YOU FINISHED PASSING THROUGH MENOPAUSE, I.E., YOUR LAST MENSTRAL CYCLE?
______ Age
997 Still menstruate
888 RF
999 DK
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If How old were you when you finished passing through menopause, i.e., your last menstral cycle? = 888 or How old were you when you finished passing through menopause, i.e., your last menstral cycle? = 999 »
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C48K_1 Were you...
WERE YOU...
1 Less than 45 years old
2 More or less 50 years old
3 More than 55 years old
8 RF
9 DK
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C48L Have you had a hysterectomy, i.e., surgery to remove the womb (uterus) and ovaries, or womb (uterus) only?
HAVE YOU HAD A HYSTERECTOMY, I.E., SURGERY TO REMOVE THE WOMB (UTERUS) AND OVARIES, OR WOMB (UTERUS) ONLY?
1 Yes
2 No
8 RF
9 DK
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C48M In the last 2 years, have you had an exam or blood test to screen for prostate cancer?
IN THE LAST 2 YEARS, HAVE YOU HAD AN EXAM OR BLOOD TEST TO SCREEN FOR PROSTATE CANCER?
1 Yes
2 No
3 Already had operation
8 RF
9 DK
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C49_1 You felt depressed?
YOU FELT DEPRESSED?
1 Yes
2 No
8 RF
9 DK
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C49_2 You felt everything you did was an effort?
YOU FELT EVERYTHING YOU DID WAS AN EFFORT?
1 Yes
2 No
8 RF
9 DK
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C49_3 Had restless sleep?
HAD RESTLESS SLEEP?
1 Yes
2 No
8 RF
9 DK
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C49_4 Felt happy?
FELT HAPPY?
1 Yes
2 No
8 RF
9 DK
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C49_5 Felt alone?
FELT ALONE?
1 Yes
2 No
8 RF
9 DK
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C49_6 Felt you enjoyed life?
FELT YOU ENJOYED LIFE?
1 Yes
2 No
8 RF
9 DK
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C49_7 Felt sad?
FELT SAD?
1 Yes
2 No
8 RF
9 DK
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C49_8 Felt tired?
FELT TIRED?
1 Yes
2 No
8 RF
9 DK
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C49_9 Felt very energetic?
FELT VERY ENERGETIC?
1 Yes
2 No
8 RF
9 DK
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C50A In the last 2 years, have you ever felt sad, blue, or depressed for more than two weeks in a row?
IN THE LAST 2 YEARS, HAVE YOU EVER FELT SAD, BLUE, OR DEPRESSED FOR MORE THAN TWO WEEKS IN A ROW?
1 Yes
2 No
8 RF
9 DK
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C50B On average during the last two years, have you exercised or done hard physical work three or more times a week?
ON AVERAGE DURING THE LAST TWO YEARS, HAVE YOU EXERCISED OR DONE HARD PHYSICAL WORK THREE OR MORE TIMES A WEEK?
1 Yes
2 No
8 RF
9 DK
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C51 Have you ever smoked cigarettes?
HAVE YOU EVER SMOKED CIGARETTES?
1 Yes
2 No
8 RF
9 DK
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If Have you ever smoked cigarettes? = 1 Yes »
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C52 About how old were you when you started smoking?Age or Year started smoking or Started smoking [yy] years ago......
ABOUT HOW OLD WERE YOU WHEN YOU STARTED SMOKING?AGE OR YEAR STARTED SMOKING OR STARTED SMOKING [YY] YEARS AGO......
88 RF
99 DK
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C53 Have you smoked cigarettes in the last two years?
HAVE YOU SMOKED CIGARETTES IN THE LAST TWO YEARS?
1 Yes
2 No
8 RF
9 DK
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If Have you smoked cigarettes in the last two years? = 1 Yes »
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C54 Do you smoke cigarettes now?
DO YOU SMOKE CIGARETTES NOW?
1 Yes
2 No
8 RF
9 DK
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If Do you smoke cigarettes now? = 1 Yes »
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C55 How often do you smoke?
HOW OFTEN DO YOU SMOKE?
1 Every day
2 Not every day
8 RF
9 DK
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If How often do you smoke? = 1 Every day »
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C56 About how many cigarettes or packs do you usually smoke in a day?
ABOUT HOW MANY CIGARETTES OR PACKS DO YOU USUALLY SMOKE IN A DAY?
______ Cigarettes/Day or Packs/Day
87 87 or more cigarettes
88 RF
99 DK
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C57 When you were smoking the most, about how many cigarettes or packs did you usually smoke in a day?
WHEN YOU WERE SMOKING THE MOST, ABOUT HOW MANY CIGARETTES OR PACKS DID YOU USUALLY SMOKE IN A DAY?
______ Cigarettes/Day or Packs/Day
87 87 or more cigarettes
88 RF
99 DK
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C58 About how many years ago did you stop smoking?
ABOUT HOW MANY YEARS AGO DID YOU STOP SMOKING?
______ Years ago or Year when stopped smoking or Age when stopped smoking
88 RF
99 DK
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C59A Do you ever drink any alcoholic beverages such as beer, wine, liquor, or pulque (drink made from fermented cactus sap)?
DO YOU EVER DRINK ANY ALCOHOLIC BEVERAGES SUCH AS BEER, WINE, LIQUOR, OR PULQUE (DRINK MADE FROM FERMENTED CACTUS SAP)?
1 Yes
2 No
8 RF
9 DK
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If Do you ever drink any alcoholic beverages such as beer, wine, liquor, or pulque (drink made from fermented cactus sap)? != 3 »
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If Do you ever drink any alcoholic beverages such as beer, wine, liquor, or pulque (drink made from fermented cactus sap)? = 1 Yes »
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C59B 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" AND GO TO C.64
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" AND GO TO C.64
______ Number of days
8 RF
9 DK
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If 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" AND GO TO C.64 != 0 »
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C59C On the days that you drank alcoholic beverages in the last three months, about how many drinks did you have per day?
ON THE DAYS THAT YOU DRANK ALCOHOLIC BEVERAGES IN THE LAST THREE MONTHS, ABOUT HOW MANY DRINKS DID YOU HAVE PER DAY?
______ Number of drinks
88 RF
99 DK
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C59D In the last three months, on how many days have you had four or more drinks on one occasion?
IN THE LAST THREE MONTHS, ON HOW MANY DAYS HAVE YOU HAD FOUR OR MORE DRINKS ON ONE OCCASION?
______ Number of days
00 None
87 87 or more days
88 RF
99 DK
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ElseIf Do you ever drink any alcoholic beverages such as beer, wine, liquor, or pulque (drink made from fermented cactus sap)? != 1 Yes »
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C59E During the last two years, have you had any alcoholic drinks such as beer, wine, liqour, or pulque (drink made from fermented cactus sap)?
DURING THE LAST TWO YEARS, HAVE YOU HAD ANY ALCOHOLIC DRINKS SUCH AS BEER, WINE, LIQOUR, OR PULQUE (DRINK MADE FROM FERMENTED CACTUS SAP)?
1 Yes
2 No
8 RF
9 DK
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C64 Compared with two years ago, your weight..
COMPARED WITH TWO YEARS AGO, YOUR WEIGHT..
1 Has increased 5 kilograms or more
2 Has decreased 5 kilograms or more
3 Has remained more or less the same
8 RF
9 DK
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C65 In the last two years, have you changed your diet or your exercise habits in order to gain or lose weight?
IN THE LAST TWO YEARS, HAVE YOU CHANGED YOUR DIET OR YOUR EXERCISE HABITS IN ORDER TO GAIN OR LOSE WEIGHT?
1 Yes
2 No
8 RF
888 RF
999 DK
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C66 About how much do you weigh now?
ABOUT HOW MUCH DO YOU WEIGH NOW?
______ Kilograms
888 RF
999 DK
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C67 About how tall are you without shoes?
ABOUT HOW TALL ARE YOU WITHOUT SHOES?
______ Meters y Centimeters
8.88 RF
9.99 DK
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C68A Frequent swelling in the feet or ankles
FREQUENT SWELLING IN THE FEET OR ANKLES
1 Yes
2 No
8 RF
9 DK
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C68B Difficulty breathing , panting or coughing, or phlegm
DIFFICULTY BREATHING , PANTING OR COUGHING, OR PHLEGM
1 Yes
2 No
8 RF
9 DK
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C68C Nausea or fainting
NAUSEA OR FAINTING
1 Yes
2 No
8 RF
9 DK
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C68D Extreme thirst
EXTREME THIRST
1 Yes
2 No
8 RF
9 DK
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C68E Severe fatigue or exhaustion
SEVERE FATIGUE OR EXHAUSTION
1 Yes
2 No
8 RF
9 DK
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C68F Stomach pain, indigestion or diarrhea
STOMACH PAIN, INDIGESTION OR DIARRHEA
1 Yes
2 No
8 RF
9 DK
|
|
C68G Incontinence when coughing, sneezing, picking something up, or exercising
INCONTINENCE WHEN COUGHING, SNEEZING, PICKING SOMETHING UP, OR EXERCISING
1 Yes
2 No
8 RF
9 DK
|
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C68H Incontinence when had the urge to urinate, but couldn't reach the bathroom in time
INCONTINENCE WHEN HAD THE URGE TO URINATE, BUT COULDN'T REACH THE BATHROOM IN TIME
1 Yes
2 No
8 RF
9 DK
|
|
C68I Burning sensation when urinating
BURNING SENSATION WHEN URINATING
1 Yes
2 No
8 RF
9 DK
|
|
C69A How would you evaluate your hand strength (your dominant hand)? Would you say...
HOW WOULD YOU EVALUATE YOUR HAND STRENGTH (YOUR DOMINANT HAND)? WOULD YOU SAY...
1 Very strong
2 Somewhat strong
3 Somewhat weak
4 Very weak
8 RF
9 DK
|
|
C69B How often do you have difficulty with balance? Would you say...
HOW OFTEN DO YOU HAVE DIFFICULTY WITH BALANCE? WOULD YOU SAY...
1 Often
2 Sometimes
3 Rarely
4 Never
8 RF
9 DK
|
|
C70 In the last two years, have you eaten less because of loss of appetite, digestive problems, and difficulties chewing or swallowing?
IN THE LAST TWO YEARS, HAVE YOU EATEN LESS BECAUSE OF LOSS OF APPETITE, DIGESTIVE PROBLEMS, AND DIFFICULTIES CHEWING OR SWALLOWING?
1 Often
2 Sometimes
3 Rarely
8 RF
9 DK
|
|
C71A Have you lost an extremity or part of your feet or arms due to an accident or sickness?
HAVE YOU LOST AN EXTREMITY OR PART OF YOUR FEET OR ARMS DUE TO AN ACCIDENT OR SICKNESS?
1 Yes
2 No
8 RF
9 DK
|
|
If Have you lost an extremity or part of your feet or arms due to an accident or sickness? = 1 Yes »
|
|
|
|
|
C71B Did this loss occur in the last 2 years?
DID THIS LOSS OCCUR IN THE LAST 2 YEARS?
1 Yes
2 No
8 RF
9 DK
|
|
|
C72 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?
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?
1 Yes
2 No
3 Never worked
8 RF
9 DK
|
|
C73 Due to sickness or injury, during the last 12 months, how many days did you stay in bed for at least half the day?
DUE TO SICKNESS OR INJURY, DURING THE LAST 12 MONTHS, HOW MANY DAYS DID YOU STAY IN BED FOR AT LEAST HALF THE DAY?
______ Number of days
000 None
888 RF
999 DK
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|
C74A How often do you have difficulty falling asleep? Would you say that...
HOW OFTEN DO YOU HAVE DIFFICULTY FALLING ASLEEP? WOULD YOU SAY THAT...
1 Most of the time
2 Sometimes
3 Rarely or never
8 RF
9 DK
|
|
C74B How often do you wake up during the night after falling asleep? Would you say that...
HOW OFTEN DO YOU WAKE UP DURING THE NIGHT AFTER FALLING ASLEEP? WOULD YOU SAY THAT...
1 Most of the time
2 Sometimes
3 Rarely or never
8 RF
9 DK
|
|
C74C How often do you wake up early and are not able to go back to sleep? Would you say that...
HOW OFTEN DO YOU WAKE UP EARLY AND ARE NOT ABLE TO GO BACK TO SLEEP? WOULD YOU SAY THAT...
1 Most of the time
2 Sometimes
3 Rarely or never
8 RF
9 DK
|
|
C74D How often do you feel relaxed when you wake up in the morning?
HOW OFTEN DO YOU FEEL RELAXED WHEN YOU WAKE UP IN THE MORNING?
1 Most of the time
2 Sometimes
3 Rarely or never
8 RF
9 DK
|
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C75 INTERVIEWER: How frequently did the respondent need help to answer Section C. Health?
INTERVIEWER: HOW FREQUENTLY DID THE RESPONDENT NEED HELP TO ANSWER SECTION C. HEALTH?
1 Never
2 A few times
3 Most or all of the time
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End of C. Health
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