C. Health
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Module C. Health of MHAS 2015
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
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
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
========================================================================
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
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
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
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
If Has a doctor or medical personnel (ever/in the last two years) diagnosed you with hypertension or high blood pressure? (C4) = 1 Yes »
| ========================================================================
|
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
ARE YOU CURRENTLY TAKING ANY MEDICATION TO LOWER YOUR BLOOD PRESSURE?
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
========================================================================
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
HAS A DOCTOR OR MEDICAL PERSONNEL (EVER/IN THE LAST TWO YEARS) DIAGNOSED YOU WITH DIABETES?
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
If Has a doctor or medical personnel (ever/in the last two years) diagnosed you with diabetes? (C6) = 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
ARE YOU CURRENTLY TAKING ANY ORAL MEDICATION IN ORDER TO CONTROL YOUR DIABETES?
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
| ========================================================================
|
C8
Are you currently using insulin shots?
ARE YOU CURRENTLY USING INSULIN SHOTS?
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
ARE YOU CURRENTLY USING INSULIN SHOTS?
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
| ========================================================================
|
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
DO YOU FOLLOW A SPECIAL DIET TO CONTROL YOUR DIABETES?
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
| ========================================================================
|
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
IN GENERAL, IS YOUR DIABETES UNDER CONTROL NOW?
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
| ========================================================================
|
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
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
DURING THE LAST TWO YEARS, HAS A DOCTOR OR MEDICAL PERSONNEL EVER DIAGNOSED YOU WITH CANCER?
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
If During the last two years, Has a doctor or medical personnel ever diagnosed you with cancer? (C12) = 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
IN TOTAL, HOW MANY CANCERS IN DIFFERENT PLACES OR ORGANS HAVE YOU EVER HAD?
- - - - - - - - - - - - - - - - - - - - - - - - -
______ Number of Cancers
88 RF
99 DK
| ========================================================================
|
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
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
| ========================================================================
|
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
IN THE LAST TWO YEARS, HAVE YOU CONSULTED A DOCTOR OR MEDICAL PERSONNEL ABOUT YOUR CANCER?
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
| ========================================================================
|
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
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
| ========================================================================
|
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
ARE YOU CURRENTLY RECEIVING TREATMENT FOR YOUR CANCER?
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
| ========================================================================
|
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
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
(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
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? (C19) = 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
ARE YOU CURRENTLY TAKING MEDICATION OR USING ANOTHER TREATMENT FOR YOUR RESPIRATORY ILLNESS?
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
| ========================================================================
|
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
ARE YOU RECEIVING OXYGEN FOR YOUR PULMONARY DISEASE?
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
| ========================================================================
|
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
DOES THIS CONDITION LIMIT YOUR DAILY ACTIVITIES SUCH AS HOUSEHOLD CHORES OR YOUR JOB?
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
========================================================================
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
HAS A DOCTOR OR MEDICAL PERSONNEL EVER TOLD YOU THAT YOU HAVE HAD A HEART ATTACK?
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
If Has a doctor or medical personnel ever told you that you have had a heart attack? (C22A) = 1 Yes »
| ========================================================================
|
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
IN WHAT YEAR OR AT ABOUT WHAT AGE DID YOU HAVE YOUR (MOST RECENT) HEART ATTACK?
- - - - - - - - - - - - - - - - - - - - - - - - -
______ Year or age
8888 RF
9999 DK
| ========================================================================
|
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
ARE YOU CURRENTLY TAKING MEDICATION FOR YOUR HEART CONDITION?
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
| ========================================================================
|
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
DO YOU CARRY ANY MEDICINE WITH YOU FOR CHEST PAIN?
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
| ========================================================================
|
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
DOES THIS HEART PROBLEM LIMIT YOUR DAILY ACTIVITIES SUCH AS HOUSEHOLD CHORES OR YOUR JOB?
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
========================================================================
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
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
========================================================================
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
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
If Has a doctor or medical personnel (ever/in the last two years) told you that you had a stroke? (C26) = 1 Yes »
| ========================================================================
|
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
...WEAKNESS IN THE ARMS AND/OR LEGS, OR THE CAPACITY TO MOVE THEM HAS DIMINISHED
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
| ========================================================================
|
C27_2
...difficulties when speaking or eating
...DIFFICULTIES WHEN SPEAKING OR EATING
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
...DIFFICULTIES WHEN SPEAKING OR EATING
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
| ========================================================================
|
C27_3
...difficulties with sight or vision
...DIFFICULTIES WITH SIGHT OR VISION
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
...DIFFICULTIES WITH SIGHT OR VISION
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
| ========================================================================
|
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
...DIFFICULTIES WHEN THINKING OR SAYING WHAT YOU WANT
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
| ========================================================================
|
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
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
| ========================================================================
|
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
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
| ========================================================================
|
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
IN WHAT YEAR OR AT ABOUT WHAT AGE DID YOU HAVE YOUR (MOST RECENT) STROKE?
- - - - - - - - - - - - - - - - - - - - - - - - -
______ Year or age
8888 RF
9999 DK
| ========================================================================
|
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
HAS THIS STROKE LIMITED YOUR DAILY ACTIVITIES SUCH AS HOUSEHOLD CHORES OR YOUR JOB?
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
========================================================================
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
HAS A DOCTOR OR MEDICAL PERSONNEL EVER DIAGNOSED YOU WITH ARTHRITIS OR RHEUMATISM?
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
If Has a doctor or medical personnel ever diagnosed you with arthritis or rheumatism? (C32) = 1 Yes »
| ========================================================================
|
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
DO YOU FEEL PAIN, STIFFNESS, OR SWELLING IN YOUR JOINTS?
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
| ========================================================================
|
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
ARE YOU TAKING MEDICATION OR ARE YOU RECEIVING OTHER TREATMENT FOR YOUR ARTHRITIS OR RHEUMATISM?
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
| ========================================================================
|
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
ARE YOUR DAILY ACTIVITIES SUCH AS HOUSEHOLD CHORES OR YOUR JOB LIMITED BECAUSE OF YOUR ARTHRITIS?
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
========================================================================
C36_1
Kidney infection
KIDNEY INFECTION
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
KIDNEY INFECTION
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
========================================================================
C36_2
Liver infection
LIVER INFECTION
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
LIVER INFECTION
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
========================================================================
C36_3
========================================================================
========================================================================
C36_5
Herpes or Herpes Zoster?
HERPES OR HERPES ZOSTER?
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
HERPES OR HERPES ZOSTER?
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
========================================================================
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
HAVE YOU FALLEN DOWN IN THE LAST TWO YEARS?
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
If Have you fallen down in the last two years? (C37) = 1 Yes »
| ========================================================================
|
C38
Approximately how many times has this happened?
APPROXIMATELY HOW MANY TIMES HAS THIS HAPPENED?
- - - - - - - - - - - - - - - - - - - - - - - - -
______ Number of Times
88 RF
99 DK
APPROXIMATELY HOW MANY TIMES HAS THIS HAPPENED?
- - - - - - - - - - - - - - - - - - - - - - - - -
______ Number of Times
88 RF
99 DK
| ========================================================================
|
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
HAVE YOU HURT YOURSELF IN THESE FALLS BADLY ENOUGH TO NEED MEDICAL TREATMENT?
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
========================================================================
C41
Do you usually wear glasses?
DO YOU USUALLY WEAR GLASSES?
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
DO YOU USUALLY WEAR GLASSES?
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
========================================================================
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
HOW IS YOUR VISION (WITH GLASSES)?
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Excellent
2 Very good
3 Good
4 Fair
5 Poor
8 RF
9 DK
========================================================================
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
DO YOU USUALLY USE A HEARING AID OR AUDITORY DEVICE?
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
========================================================================
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
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
========================================================================
C45
Do you often suffer from pain?
DO YOU OFTEN SUFFER FROM PAIN?
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
DO YOU OFTEN SUFFER FROM PAIN?
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
If Do you often suffer from pain? (C45) = 1 Yes »
| ========================================================================
|
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
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
| ========================================================================
|
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
DOES THIS PAIN LIMIT YOUR USUAL ACTIVITIES SUCH AS HOUSEHOLD CHORES OR YOUR JOB?
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
========================================================================
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
COLONOSCOPY, SIGMOIDOSCOPY OR OTHER TEST FOR COLON CANCER
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
========================================================================
C48B
Cholesterol blood test
CHOLESTEROL BLOOD TEST
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
CHOLESTEROL BLOOD TEST
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
========================================================================
C48C
Tuberculosis test
TUBERCULOSIS TEST
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
TUBERCULOSIS TEST
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
========================================================================
C48D
========================================================================
C48E
Blood pressure test
BLOOD PRESSURE TEST
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
BLOOD PRESSURE TEST
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
========================================================================
========================================================================
C48G
Pneumonia vaccine
PNEUMONIA VACCINE
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
PNEUMONIA VACCINE
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
If RESPONDENT IS NOT MALE »
| ========================================================================
|
C48H
Monthly self-breast exam?
MONTHLY SELF-BREAST EXAM?
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
MONTHLY SELF-BREAST EXAM?
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
| ========================================================================
|
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
HAD YOU HAD A MAMMOGRAM OR X-RAY TO CHECK FOR BREAST CANCER?
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
| ========================================================================
|
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
HAVE YOU HAD A PAP SMEAR TO CHECK FOR UTERINE CANCER?
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
| ========================================================================
|
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
HOW OLD WERE YOU WHEN YOU FINISHED PASSING THROUGH MENOPAUSE, I.E., YOUR LAST MENSTRAL CYCLE?
- - - - - - - - - - - - - - - - - - - - - - - - -
______ Age
997 Still menstruate
888 RF
999 DK
|
If How old were you when you finished passing through menopause, i.e., your last menstral cycle? (C48K) = 888 or How old were you when you finished passing through menopause, i.e., your last menstral cycle? (C48K) = 999 »
| | ========================================================================
| |
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
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
| ========================================================================
|
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
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
========================================================================
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
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
========================================================================
C49_1
You felt depressed?
YOU FELT DEPRESSED?
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
YOU FELT DEPRESSED?
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
========================================================================
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
YOU FELT EVERYTHING YOU DID WAS AN EFFORT?
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
========================================================================
C49_3
Had restless sleep?
HAD RESTLESS SLEEP?
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
HAD RESTLESS SLEEP?
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
========================================================================
C49_4
========================================================================
C49_5
========================================================================
C49_6
Felt you enjoyed life?
FELT YOU ENJOYED LIFE?
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
FELT YOU ENJOYED LIFE?
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
========================================================================
========================================================================
C49_8
========================================================================
C49_9
Felt very energetic?
FELT VERY ENERGETIC?
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
FELT VERY ENERGETIC?
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
========================================================================
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
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
========================================================================
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
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
========================================================================
C51
Have you ever smoked cigarettes?
HAVE YOU EVER SMOKED CIGARETTES?
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
HAVE YOU EVER SMOKED CIGARETTES?
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
If Have you ever smoked cigarettes? (C51) = 1 Yes »
| ========================================================================
|
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
ABOUT HOW OLD WERE YOU WHEN YOU STARTED SMOKING?AGE OR YEAR STARTED SMOKING OR STARTED SMOKING [YY] YEARS AGO......
- - - - - - - - - - - - - - - - - - - - - - - - -
88 RF
99 DK
| ========================================================================
|
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
HAVE YOU SMOKED CIGARETTES IN THE LAST TWO YEARS?
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
|
If Have you smoked cigarettes in the last two years? (C53) = 1 Yes »
| | ========================================================================
| |
C54
Do you smoke cigarettes now?
DO YOU SMOKE CIGARETTES NOW?
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
DO YOU SMOKE CIGARETTES NOW?
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
| |
If Do you smoke cigarettes now? (C54) = 1 Yes »
| | | ========================================================================
| | |
C55
How often do you smoke?
HOW OFTEN DO YOU SMOKE?
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Every day
2 Not every day
8 RF
9 DK
HOW OFTEN DO YOU SMOKE?
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Every day
2 Not every day
8 RF
9 DK
| | |
If How often do you smoke? (C55) = 1 Every day »
| | | | ========================================================================
| | | |
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
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
| ========================================================================
|
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
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
| ========================================================================
|
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
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
========================================================================
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
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
If Do you ever drink any alcoholic beverages such as beer, wine, liquor, or pulque (drink made from fermented cactus sap)? (C59A) != 3 »
|
If Do you ever drink any alcoholic beverages such as beer, wine, liquor, or pulque (drink made from fermented cactus sap)? (C59A) = 1 Yes »
| | ========================================================================
| |
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
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
| |
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 (C59B) != 0 »
| | | ========================================================================
| | |
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
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
| | | ========================================================================
| | |
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
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
|
ElseIf Do you ever drink any alcoholic beverages such as beer, wine, liquor, or pulque (drink made from fermented cactus sap)? (C59A) != 1 Yes »
| | ========================================================================
| |
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
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
========================================================================
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
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
========================================================================
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
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
========================================================================
C66
About how much do you weigh now?
ABOUT HOW MUCH DO YOU WEIGH NOW?
- - - - - - - - - - - - - - - - - - - - - - - - -
______ Kilograms
888 RF
999 DK
ABOUT HOW MUCH DO YOU WEIGH NOW?
- - - - - - - - - - - - - - - - - - - - - - - - -
______ Kilograms
888 RF
999 DK
========================================================================
C67
About how tall are you without shoes?
ABOUT HOW TALL ARE YOU WITHOUT SHOES?
- - - - - - - - - - - - - - - - - - - - - - - - -
______ Meters y Centimeters
8.88 RF
9.99 DK
ABOUT HOW TALL ARE YOU WITHOUT SHOES?
- - - - - - - - - - - - - - - - - - - - - - - - -
______ Meters y Centimeters
8.88 RF
9.99 DK
========================================================================
C68A
Frequent swelling in the feet or ankles
FREQUENT SWELLING IN THE FEET OR ANKLES
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
FREQUENT SWELLING IN THE FEET OR ANKLES
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
========================================================================
C68B
Difficulty breathing , panting or coughing, or phlegm
DIFFICULTY BREATHING , PANTING OR COUGHING, OR PHLEGM
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
DIFFICULTY BREATHING , PANTING OR COUGHING, OR PHLEGM
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
========================================================================
C68C
Nausea or fainting
NAUSEA OR FAINTING
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
NAUSEA OR FAINTING
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
========================================================================
C68D
Extreme thirst
EXTREME THIRST
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
EXTREME THIRST
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
========================================================================
C68E
Severe fatigue or exhaustion
SEVERE FATIGUE OR EXHAUSTION
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
SEVERE FATIGUE OR EXHAUSTION
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
========================================================================
C68F
Stomach pain, indigestion or diarrhea
STOMACH PAIN, INDIGESTION OR DIARRHEA
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
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
INCONTINENCE WHEN COUGHING, SNEEZING, PICKING SOMETHING UP, OR EXERCISING
- - - - - - - - - - - - - - - - - - - - - - - - -
1 Yes
2 No
8 RF
9 DK
========================================================================
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
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
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
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
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
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
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? (C71A) = 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
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
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
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
========================================================================
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
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
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
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
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
========================================================================
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
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
End of C. Health