Survey Series on First Nations People, Métis and Inuit - Well-being and Impacts of Rising Prices (SSFNPMI-WIRP)
For Information onlyThis is an electronic survey example for information purposes only. This is not a working questionnaire.
Table of Contents
- Respondent confirmation (RC)
- Indigenous identity (ABM)
- Well-being (WLB)
- Life satisfaction (LSM)
- Sense of meaning and purpose (MP)
- Future outlook (FO)
- General health (GEN)
- Financial well-being (EHA)
- Impacts of rising prices (IRP)
- Impacts of rising housing costs (DWL)
- Impacts of rising housing costs (IRC)
Respondent confirmation (RC)
Respondent confirmation (RC) - Question identifier:RC_R01
The following questions are for [NAME_OR_EMAIL].
Indigenous identity (ABM)
Indigenous identity (ABM) - Question identifier:ABM_Q01
Are you First Nations, Métis or Inuk (Inuit)?
- 1: No, not First Nations, Métis or Inuk (Inuit)
- 2: Yes, First Nations
- 3: Yes, Métis
- 4: Yes, Inuk (Inuit)
Well-being (WLB)
Well-being (WLB) - Question identifier:WLB_R01
An important part of measuring quality of life is gaining an understanding of how First Nations people, Métis and Inuit experience their own well-being. Self-reported well-being provides insight on how life is going in general and helps to understand differences between gender, age and population groups.
The next few questions ask about different aspects of well-being.
Life satisfaction (LSM)
Life satisfaction (LSM) - Question identifier:LSM_Q01
Using a scale of 0 to 10, where 0 means "Very dissatisfied" and 10 means "Very satisfied", how do you feel about your life as a whole right now?
- 00: 0 - Very dissatisfied
- 01: 1
- 02: 2
- 03: 3
- 04: 4
- 05: 5
- 06: 6
- 07: 7
- 08: 8
- 09: 9
- 10: 10 - Very satisfied
Sense of meaning and purpose (MP)
Sense of meaning and purpose (MP) - Question identifier:MP_Q01
Using a scale of 0 to 10, where 0 means "Not at all" and 10 means "Completely", to what extent do you feel the things you do in your life are worthwhile?
Would you say:
- 00: 0 Not at all
- 01: 1
- 02: 2
- 03: 3
- 04: 4
- 05: 5
- 06: 6
- 07: 7
- 08: 8
- 09: 9
- 10: 10 Completely
Future outlook (FO)
Future outlook (FO) - Question identifier:FO_Q01
Thinking about your life in general, how often would you say you have a hopeful view of the future?
Would you say:
- 1: Always
- 2: Often
- 3: Sometimes
- 4: Rarely
- 5: Never
General health (GEN)
General health (GEN) - Question identifier:GEN_R01
The following question is about health. By health, we mean not only the absence of disease or injury but also physical, mental and social well-being.
General health (GEN) - Question identifier:GEN_Q01
In general, how is your health?
- 1: Excellent
- 2: Very good
- 3: Good
- 4: Fair
- 5: Poor
Financial well-being (EHA)
Financial well-being (EHA) - Question identifier:EHA_Q10
In the past 12 months, how difficult or easy was it for your household to meet its financial needs in terms of transportation, housing, food, clothing and other necessary expenses?
- 1: Very difficult
- 2: Difficult
- 3: Neither difficult nor easy
- 4: Easy
- 5: Very easy
Impacts of rising prices (IRP)
Impacts of rising prices (IRP) - Question identifier:IRP_R05
When answering the following questions, please think of recent rising prices. There may be various factors influencing your concerns or decisions, but your responses should focus on recent price increases.
Impacts of rising prices (IRP) - Question identifier:IRP_Q05
Are rising prices affecting your ability to meet day-to-day expenses?
- 1: Yes, a lot
- 2: Yes, somewhat
- 3: No
Impacts of rising prices (IRP) - Question identifier:IRP_Q10
Are you concerned with the impact that rising prices may have on your ability to meet day-to-day expenses over the next 6 months?
- 1: Yes, very concerned
- 2: Yes, somewhat concerned
- 3: No, not concerned
Impacts of rising prices (IRP) - Question identifier:IRP_Q15
Thinking about yourself, family, friends, and people in your community, are you concerned about rising food prices?
- 1: Yes, very concerned
- 2: Yes, somewhat concerned
- 3: No, not concerned
Impacts of rising prices (IRP) - Question identifier:IRP_Q20
Due to rising food prices, do you think you or other household members will have to obtain food, meals or grocery vouchers at no cost to you, from a community organization over the next 6 months?
- 1: Yes, very likely
- 2: Yes, somewhat likely
- 3: No, not likely
Impacts of rising prices (IRP) - Question identifier:IRP_Q22
In the past 6 months, have rising prices impacted you or your household in any of the following ways?
- 01: Limited the amount of healthy, nutritious food you could buy (e.g., fresh fruits and vegetables, whole grain foods)
- 02: Caused you to not have enough food to last the week
- 03: Added to the amount of stress in your household and relationships
- 04: Stopped you from paying rent or mortgage in order to buy food
- 05: Limited you from buying the food you needed in order to pay for rent or mortgage
- 06: Affected the amount of food you ate so that others in the household could eat (e.g., children, the elderly)
- 07: Limited your ability to hunt, fish or trap due to rising prices (e.g., cost of gasoline, ammunition, equipment)
- 08: Other way rising prices have impacted you or your household in the past 6 months
- 09: Rising prices have not impacted you or your household in the past 6 months
Impacts of rising prices (IRP) - Question identifier:IRP_Q40
In the past 6 months, in which area have you been most affected by rising prices?
- 1: Transportation (e.g., gasoline, vehicles, public transportation, ride sharing, taxis, flights)
- 2: Shelter (Include housing costs such as rent, utilities, repairs and renovations.)
- 3: Food (e.g., groceries, dining out, food delivery, take-out)
- 4: Recreation (e.g., cultural activities, ceremonies, other social activities, travelling, sports equipment, movies, music, electronics)
- 5: Household operations (e.g., furniture, appliances, internet, phone, childcare, financial services, pet care, clothing)
- 6: Education (Include tuition and school supplies.)
- 7: Health and medical supplies (e.g., prescription costs, medical devices, supplies for diabetes, injuries or other health and medical conditions)
Impacts of rising prices (IRP) - Question identifier:IRP_Q45
In the past 6 months, what have you started doing, or done more than before, to deal with rising prices?
- 1: Sought out sales and promotions (Include the use of price comparison applications or services.)
- 2: Purchased cheaper alternatives, brands or items
- 3: Delayed a purchase
- 4: Other changes in purchasing habits (e.g., purchasing meat less often, getting take-out food or delivery less often, spending less on recreation and leisure, repairing items instead of replacing them, buying used goods online, reducing overconsumption)
- 5: Used community services (e.g., food banks, thrift stores, community centres, Indigenous friendship centres, band office for grocery vouchers, school programs, faith-based organizations, community gardens)
- 6: None of the above
Impacts of rising prices (IRP) - Question identifier:IRP_Q50
In the past 6 months, due to rising prices, did you have to borrow money to meet day-to-day expenses?
- 1: Yes, often
- 2: Yes, sometimes
- 3: No
Impacts of rising prices (IRP) - Question identifier:IRP_R52
The following questions ask about activities you may have taken part in to supplement your household food in the past 12 months.
Impacts of rising prices (IRP) - Question identifier:IRP_Q52
In the past 12 months, did you personally do any of the following to supplement the food in your household?
Have you:
- 01: Hunted, fished or trapped to supplement household food
- 02: Gathered or foraged for country food (e.g., berries, wild rice, mushrooms, other wild edible plants)
- 03: Accessed a shared community freezer
- 04: Harvested your own fruits or vegetables from personal garden or greenhouse
- 05: Accessed a food bank
- 06: Borrowed money from family or friends to purchase food
- 07: Received or traded food with family, friends or community (e.g., given vegetables by a neighbour, picked up free food advertised on social media)
- 08: Participated in a free school food program (e.g., programs that provide free meals or snacks to students)
- 09: Participated in a paid school food program (e.g., paid programs that provide meals or snacks to students)
- 10: Other methods you used to supplement food for your household in the past 12 months
- 11: Did not supplement food for your household in the past 12 months
Impacts of rising prices (IRP) - Question identifier:IRP_Q53
In the past 12 months, have you hunted, fished, trapped or gathered wild plants?
- 1: Yes
- 2: No
Impacts of rising prices (IRP) - Question identifier:IRP_Q54
Have rising prices impacted your hunting, fishing, trapping or gathering wild plants activities in the past 12 months?
- 1: Yes
- 2: No
Impacts of rising prices (IRP) - Question identifier:IRP_Q56
How have rising prices impacted your hunting, fishing, trapping or gathering wild plants, in the past 12 months?
Have they caused you to:
- 1: Hunt, fish, trap or gather wild plants more often to supplement groceries
- 2: Hunt, fish, trap or gather wild plants less often due to rising costs
- 3: Not hunt, fish, trap or gather wild plants at all due to rising costs
- 4: Other impacts on hunting, fishing, trapping or gathering wild plants
Impacts of rising housing costs (DWL)
Impacts of rising housing costs (DWL) - Question identifier:DWL_R01
The next questions are about where you live.
Impacts of rising housing costs (DWL) - Question identifier:DWL_Q01
Is this dwelling owned by a member of this household?
- 1: Yes, owned, even if it is still being paid for
- 2: No, rented, even if no cash rent is paid
Impacts of rising housing costs (IRC)
Impacts of rising housing costs (IRC) - Question identifier:IRC_Q25
Are you concerned with your ability to afford housing because of rising housing costs or rising rent?
- 1: Yes, very concerned
- 2: Yes, somewhat concerned
- 3: No, not concerned
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