Canadian Social Survey - Well-being, Shared Values and Trust

For Information onlyThis is an electronic survey example for information purposes only. This is not a working questionnaire.

Show all instructions

Table of Contents

Household members and geographic region (DEM)

Household members and geographic region (DEM) - Question identifier:DEM_Q01A

Provide your first and last name.
First name

Long Answer Length = 50

Household members and geographic region (DEM) - Question identifier:DEM_Q01B

Provide your first and last name.
Last name

Long Answer Length = 50

Household members and geographic region (DEM) - Question identifier:DEM_Q05

Including yourself, how many people live in your household?

Number of people

  • 01: 1
  • 02: 2
  • 03: 3
  • 04: 4
  • 05: 5
  • 06: 6
  • 07: 7
  • 08: 8
  • 09: 9
  • 10: 10
  • 11: 11
  • 12: 12
  • 13: 13
  • 14: 14
  • 15: 15
  • 16: 16
  • 17: 17
  • 18: 18
  • 19: 19
  • 20: 20 or more

Household members and geographic region (DEM) - Question identifier:DEM_Q10

Including yourself, how many of these people are [15] years of age or more?

Number of people

  • 00: 0
  • 01: 1
  • 02: 2
  • 03: 3
  • 04: 4
  • 05: 5
  • 06: 6
  • 07: 7
  • 08: 8
  • 09: 9
  • 10: 10
  • 11: 11
  • 12: 12
  • 13: 13
  • 14: 14
  • 15: 15
  • 16: 16
  • 17: 17
  • 18: 18
  • 19: 19
  • 20: 20 or more

Household members and geographic region (DEM) - Question identifier:DEM_Q15

To determine which geographic region you live in, provide your postal code.

Postal code

Long Answer Length = 7

Sex and gender (GDR)

Sex and gender (GDR) - Question identifier:GDR_R05

The following questions are about sex at birth, gender and age.

Sex and gender (GDR) - Question identifier:GDR_Q05

What was your sex at birth?

  • 1: Male
  • 2: Female

Sex and gender (GDR) - Question identifier:GDR_Q10

What is your gender?

  • 1: Male
  • 2: Female
  • 3: Or please specify

Sex and gender (GDR) - Question identifier:GDR_R15

Please verify that all of the information is correct.

If all the information is correct, press the Next button.

To make changes, press the Previous button.

Your information

Sex assigned at birth: [Male/Female/Information not provided]

Gender: [Male/Female/Specify other/Information not provided]

Age (AGE)

Age (AGE) - Question identifier:AGE_Q01A

What is your date of birth?

Year

Min = 0000; Max = 9999

Age (AGE) - Question identifier:AGE_Q01B

What is your date of birth?

Month

  • 01: January
  • 02: February
  • 03: March
  • 04: April
  • 05: May
  • 06: June
  • 07: July
  • 08: August
  • 09: September
  • 10: October
  • 11: November
  • 12: December

Age (AGE) - Question identifier:AGE_Q01C

What is your date of birth?

Day

  • 01: 1
  • 02: 2
  • 03: 3
  • 04: 4
  • 05: 5
  • 06: 6
  • 07: 7
  • 08: 8
  • 09: 9
  • 10: 10
  • 11: 11
  • 12: 12
  • 13: 13
  • 14: 14
  • 15: 15
  • 16: 16
  • 17: 17
  • 18: 18
  • 19: 19
  • 20: 20
  • 21: 21
  • 22: 22
  • 23: 23
  • 24: 24
  • 25: 25
  • 26: 26
  • 27: 27
  • 28: 28
  • 29: 29
  • 30: 30
  • 31: 31

Age (AGE) - Question identifier:AGE_Q02

What is your age?

Age in years

Min = 0; Max = 999

Education 1 (ED)

Education 1 (ED) - Question identifier:ED_Q05

What is the highest certificate, diploma or degree that you have completed?

  • 1: Less than high school diploma or its equivalent
  • 2: High school diploma or a high school equivalency certificate
  • 3: Trades certificate or diploma
  • 4: College, CEGEP or other non-university certificate or diploma (other than trades certificates or diplomas)
  • 5: University certificate or diploma below the bachelor's level
  • 6: Bachelor's degree (e.g., B.A., B.A. (Hons), B.Sc., B.Ed., LL.B.)
  • 7: University certificate, diploma or degree above the bachelor's level

Education 2 (EDU)

Education 2 (EDU) - Question identifier:EDU_Q01A

At any time since September 2021, did you attend school, such as high school, college, CEGEP or university?

  • 1: Yes
  • 2: No, was not attending school at any time since September 2021

Education 2 (EDU) - Question identifier:EDU_Q01B

Since September 2021, what type of educational institution did you attend?

  • 1: Elementary, junior high school or high school
  • 2: College, CEGEP, business school, technical institute, trade school or other non-university institution
  • 3: University

Main activity (MAC)

Main activity (MAC) - Question identifier:MAC_Q05

Last week, was your main activity working at a paid job or business, looking for paid work, going to school, caring for children, household work, retired or something else?

  • 01: Working at a paid job or business
  • 02: Vacation from paid work
  • 03: Looking for paid work
  • 04: Going to school, including vacation from school
  • 05: Caring for children
  • 06: Household work
  • 07: Retired
  • 08: Maternity, paternity or parental leave
  • 09: Long term illness
  • 10: Volunteering
  • 11: Care-giving other than for children
  • 12: Other

Satisfaction with work-life balance (SWL)

Satisfaction with work-life balance (SWL) - Question identifier:SWL_Q01

How satisfied are you with the balance between your job and home life?

  • 1: Very satisfied
  • 2: Satisfied
  • 3: Neither satisfied nor dissatisfied
  • 4: Dissatisfied
  • 5: Very dissatisfied

Satisfaction with division of chores in household (SHC)

Satisfaction with division of chores in household (SHC) - Question identifier:SHC_Q01

How satisfied are you with the way chores are divided in your household?

  • 1: Very satisfied
  • 2: Satisfied
  • 3: Neither satisfied nor dissatisfied
  • 4: Dissatisfied
  • 5: Very dissatisfied
  • 6: Does not apply to my situation

General health (GEN)

General health (GEN) - Question identifier:GEN_R01

The following questions are 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

General health (GEN) - Question identifier:GEN_Q02

In general, how is your mental health?

  • 1: Excellent
  • 2: Very good
  • 3: Good
  • 4: Fair
  • 5: Poor

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

Meaning and purpose (MP)

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?

  • 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

View of the future (FO)

View of the future (FO) - Question identifier:FO_Q01

Thinking about your life in general, how often would you say you have a hopeful view of the future?

  • 1: Always
  • 2: Often
  • 3: Sometimes
  • 4: Rarely
  • 5: Never

Loneliness (LON)

Loneliness (LON) - Question identifier:LON_Q01

How often do you feel lonely?

  • 1: Always
  • 2: Often
  • 3: Sometimes
  • 4: Rarely
  • 5: Never

Sense of belonging (SBL)

Sense of belonging (SBL) - Question identifier:SBL_Q100

How would you describe your sense of belonging to your local community?

  • 1: Very strong
  • 2: Somewhat strong
  • 3: Somewhat weak
  • 4: Very weak
  • 5: No opinion

Sense of belonging (SBL) - Question identifier:SBL_Q400

How would you describe your sense of belonging to Canada?

  • 1: Very strong
  • 2: Somewhat strong
  • 3: Somewhat weak
  • 4: Very weak
  • 5: No opinion

Someone to count on (RES)

Someone to count on (RES) - Question identifier:RES_Q06

How often would you say you have people you can depend on to help you when you really need it?

  • 1: Always
  • 2: Often
  • 3: Sometimes
  • 4: Rarely
  • 5: Never

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

Trust in people (PCT)

Trust in people (PCT) - Question identifier:PCT_Q10

Generally speaking, would you say that most people can be trusted or that you cannot be too careful in dealing with people?

  • 1: Most people can be trusted
  • 2: You cannot be too careful in dealing with people

Trust in different groups of people (TIP)

Trust in different groups of people (TIP) - Question identifier:TIP_Q10

Using a scale of 1 to 5, where 1 means "Cannot be trusted at all" and 5 means "Can be trusted completely", what is your level of trust in each of the following groups of people?
People in your family

  • 1: 1 - Cannot be trusted at all
  • 2: 2
  • 3: 3
  • 4: 4
  • 5: 5 - Can be trusted completely

Trust in different groups of people (TIP) - Question identifier:TIP_Q15

Using a scale of 1 to 5, where 1 means "Cannot be trusted at all" and 5 means "Can be trusted completely", what is your level of trust in each of the following groups of people?
People in your neighbourhood

  • 1: 1 - Cannot be trusted at all
  • 2: 2
  • 3: 3
  • 4: 4
  • 5: 5 - Can be trusted completely

Trust in different groups of people (TIP) - Question identifier:TIP_Q20

Using a scale of 1 to 5, where 1 means "Cannot be trusted at all" and 5 means "Can be trusted completely", what is your level of trust in each of the following groups of people?
People you work with

  • 1: 1 - Cannot be trusted at all
  • 2: 2
  • 3: 3
  • 4: 4
  • 5: 5 - Can be trusted completely

Trust in different groups of people (TIP) - Question identifier:TIP_Q21

Using a scale of 1 to 5, where 1 means "Cannot be trusted at all" and 5 means "Can be trusted completely", what is your level of trust in each of the following groups of people?
People you go to school with

  • 1: 1 - Cannot be trusted at all
  • 2: 2
  • 3: 3
  • 4: 4
  • 5: 5 - Can be trusted completely

Trust in different groups of people (TIP) - Question identifier:TIP_Q22

Using a scale of 1 to 5, where 1 means "Cannot be trusted at all" and 5 means "Can be trusted completely", what is your level of trust in each of the following groups of people?
People who speak a different language than you

  • 1: 1 - Cannot be trusted at all
  • 2: 2
  • 3: 3
  • 4: 4
  • 5: 5 - Can be trusted completely

Trust in different groups of people (TIP) - Question identifier:TIP_Q23

Using a scale of 1 to 5, where 1 means "Cannot be trusted at all" and 5 means "Can be trusted completely", what is your level of trust in each of the following groups of people?
People with a different religion than you

  • 1: 1 - Cannot be trusted at all
  • 2: 2
  • 3: 3
  • 4: 4
  • 5: 5 - Can be trusted completely

Trust in different groups of people (TIP) - Question identifier:TIP_Q24

Using a scale of 1 to 5, where 1 means "Cannot be trusted at all" and 5 means "Can be trusted completely", what is your level of trust in each of the following groups of people?
People with a different ethnic or cultural background than you

  • 1: 1 - Cannot be trusted at all
  • 2: 2
  • 3: 3
  • 4: 4
  • 5: 5 - Can be trusted completely

Trust in different groups of people (TIP) - Question identifier:TIP_Q25

Using a scale of 1 to 5, where 1 means "Cannot be trusted at all" and 5 means "Can be trusted completely", what is your level of trust in each of the following groups of people?
Strangers

  • 1: 1 - Cannot be trusted at all
  • 2: 2
  • 3: 3
  • 4: 4
  • 5: 5 - Can be trusted completely

Trust in neighbourhood people (TNP)

Trust in neighbourhood people (TNP) - Question identifier:TNP_Q10

How many people do you trust in your neighbourhood?

  • 1: Most of the people
  • 2: Many of the people
  • 3: A few of the people
  • 4: Nobody

Confidence in institutions (CII)

Confidence in institutions (CII) - Question identifier:CII_R10

Using a scale of 1 to 5 where 1 means "No confidence at all" and 5 means "A great deal of confidence", please answer the following questions.

Confidence in institutions (CII) - Question identifier:CII_Q10

How much confidence do you have in the following institutions?
The police

  • 1: 1 - No confidence at all
  • 2: 2
  • 3: 3
  • 4: 4
  • 5: 5 - A great deal of confidence

Confidence in institutions (CII) - Question identifier:CII_Q15

How much confidence do you have in the following institutions?
The justice system and courts

  • 1: 1 - No confidence at all
  • 2: 2
  • 3: 3
  • 4: 4
  • 5: 5 - A great deal of confidence

Confidence in institutions (CII) - Question identifier:CII_Q30

How much confidence do you have in the following institutions?
The school system

  • 1: 1 - No confidence at all
  • 2: 2
  • 3: 3
  • 4: 4
  • 5: 5 - A great deal of confidence

Confidence in institutions (CII) - Question identifier:CII_Q40

How much confidence do you have in the following institutions?
The Federal Parliament

  • 1: 1 - No confidence at all
  • 2: 2
  • 3: 3
  • 4: 4
  • 5: 5 - A great deal of confidence

Reasons for choosing the place of residence (BG)

Reasons for choosing the place of residence (BG) - Question identifier:BG_Q14

Why did you choose to live in your current city?

  • 01: Your spouse, partner or other family members live here
  • 02: Your friends live here
  • 03: Many people from your country or ethnic group live here
  • 04: Your job or possible job is located here
  • 05: Business prospects are located here
  • 06: Education prospects are located here
  • 07: You have previous knowledge of this city or area
  • 08: The climate
  • 09: The lifestyle
  • 10: The languages spoken here
  • 11: Housing (e.g., purchase price, rent cost)
  • 12: Low taxes
  • 13: For some other reason

Ethnic and cultural origins (ETH)

Ethnic and cultural origins (ETH) - Question identifier:ETH_Q10A

What were the ethnic or cultural origins of your ancestors?
Specify as many origins as applicable

Long Answer Length = 30

Ethnic and cultural origins (ETH) - Question identifier:ETH_Q10B

What were the ethnic or cultural origins of your ancestors?
Specify as many origins as applicable

Long Answer Length = 30

Ethnic and cultural origins (ETH) - Question identifier:ETH_Q10C

What were the ethnic or cultural origins of your ancestors?
Specify as many origins as applicable

Long Answer Length = 30

Ethnic and cultural origins (ETH) - Question identifier:ETH_Q10D

What were the ethnic or cultural origins of your ancestors?
Specify as many origins as applicable

Long Answer Length = 30

Ethnic and cultural origins (ETH) - Question identifier:ETH_Q20

How important are your ethnic or cultural origins to the way you live your life?

  • 1: Very important
  • 2: Somewhat important
  • 3: Not very important
  • 4: Not at all important

Shared values (SVR)

Shared values (SVR) - Question identifier:SVR_R01

The next questions ask about the extent to which you agree with a number of Canadian values.

Shared values (SVR) - Question identifier:SVR_Q01

To what extent do you personally agree with the following values?
Human rights

  • 1: To a great extent
  • 2: To a moderate extent
  • 3: To a small extent
  • 4: Not at all

Shared values (SVR) - Question identifier:SVR_Q02

To what extent do you personally agree with the following values?
Respect for the law

  • 1: To a great extent
  • 2: To a moderate extent
  • 3: To a small extent
  • 4: Not at all

Shared values (SVR) - Question identifier:SVR_Q03

To what extent do you personally agree with the following values?
Gender equality

  • 1: To a great extent
  • 2: To a moderate extent
  • 3: To a small extent
  • 4: Not at all

Shared values (SVR) - Question identifier:SVR_Q04

To what extent do you personally agree with the following values?
English and French as Canada's official languages

  • 1: To a great extent
  • 2: To a moderate extent
  • 3: To a small extent
  • 4: Not at all

Shared values (SVR) - Question identifier:SVR_Q05

To what extent do you personally agree with the following values?
Ethnic and cultural diversity

  • 1: To a great extent
  • 2: To a moderate extent
  • 3: To a small extent
  • 4: Not at all

Shared values (SVR) - Question identifier:SVR_Q06

To what extent do you personally agree with the following values?
Respect for Indigenous (First Nations, Métis or Inuit) culture

  • 1: To a great extent
  • 2: To a moderate extent
  • 3: To a small extent
  • 4: Not at all

Discrimination or unfair treatment in Canada (DIS)

Discrimination or unfair treatment in Canada (DIS) - Question identifier:DIS_R05

The next questions are about your possible experiences with discrimination or unfair treatment in Canada.

Discrimination or unfair treatment in Canada (DIS) - Question identifier:DIS_Q05

In the past 5 years, have you experienced discrimination or been treated unfairly by others in Canada because of any of the following?

  • 01: Your Indigenous identity
  • 02: Your ethnicity or culture
  • 03: Your race or skin colour
  • 04: Your religion
  • 05: Your language
  • 06: Your accent
  • 07: Your physical appearance (Include discrimination on the basis of weight, height, hair style or colour, clothing, jewelry, tattoos and other physical characteristics. Exclude discrimination on the basis of skin colour.)
  • 08: Your sex (Sex refers to sex assigned at birth.)
  • 09: Your sexual orientation (e.g., heterosexual, lesbian, gay, bisexual)
  • 10: Your gender identity or expression (Include gender diverse identities such as two-spirit or nonbinary.)
  • 11: Your age
  • 12: A physical or mental disability
  • 13: Some other reason
  • 14: Did not experience discrimination

Discrimination or unfair treatment in Canada (DIS) - Question identifier:DIS_Q10

In what types of situations have you experienced discrimination in Canada in the past 5 years?

  • 01: In a store, bank or restaurant
  • 02: When attending school or classes
  • 03: On the Internet, including social media platforms
  • 04: At work or when applying for a job or promotion
  • 05: When seeking or applying for housing (e.g., buying or renting)
  • 06: When interacting with the police
  • 07: When interacting with the courts
  • 08: When crossing the border into Canada (Exclude incidents of discrimination upon leaving Canada.)
  • 09: While attending social gatherings or by or among friends or family
  • 10: While using public areas, such as parks and sidewalks
  • 11: While using public transit, such as buses, trains or taxis
  • 12: When seeing a medical health professional or in other health care settings (Medical health professionals may include doctors, nurses, physiotherapists, etc.
    In health care settings may include at hospitals, clinics, dental offices, etc.)
  • 13: Any other situation

Marital status (MS)

Marital status (MS) - Question identifier:MS_Q01

What is your marital status?

  • 1: Married (For Quebec residents only, select the "Married" category if your marital status is "civil union".)
  • 2: Living common law (Two people who live together as a couple but who are not legally married to each other.)
  • 3: Never married and not living common law
  • 4: Separated and not living common law
  • 5: Divorced and not living common law
  • 6: Widowed and not living common law

Language (LAN)

Language (LAN) - Question identifier:LAN_Q01

Can you speak English or French well enough to conduct a conversation?

  • 1: English only
  • 2: French only
  • 3: Both English and French
  • 4: Neither English nor French

Language (LAN) - Question identifier:LAN_Q02

What language do you currently speak most often at home?

  • 1: English
  • 2: French
  • 3: Other

Language (LAN) - Question identifier:LAN_Q10

What language did you speak most often at home five years ago, that is in [month and year from 5 years before collection date]?

  • 1: English
  • 2: French
  • 3: Other

Language (LAN) - Question identifier:LAN_Q04

What is the language that you first learned at home in childhood and still understand?

  • 1: English
  • 2: French
  • 3: Other

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 (North American Indian)
  • 3: Yes, Métis
  • 4: Yes, Inuk (Inuit)

Sociodemographic characteristics (PG)

Sociodemographic characteristics (PG) - Question identifier:PG_Q05

The following question collects information in accordance with the Employment Equity Act and its Regulations and Guidelines to support programs that promote equal opportunity for everyone to share in the social, cultural, and economic life of Canada.

  • 01: White
  • 02: South Asian (e.g., East Indian, Pakistani, Sri Lankan)
  • 03: Chinese
  • 04: Black
  • 05: Filipino
  • 06: Arab
  • 07: Latin American
  • 08: Southeast Asian (e.g., Vietnamese, Cambodian, Laotian, Thai)
  • 09: West Asian (e.g., Iranian, Afghan)
  • 10: Korean
  • 11: Japanese
  • 12: Other

Place of birth, immigration and citizenship (DEM1)

Place of birth, immigration and citizenship (DEM1) - Question identifier:DEM1_Q05A

Where were you born?

  • 1: Born in Canada
  • 2: Born outside Canada

Place of birth, immigration and citizenship (DEM1) - Question identifier:DEM1_Q05B

Are you a Canadian citizen?

  • 1: Yes, a Canadian citizen by birth
  • 2: Yes, a Canadian citizen by naturalization (Canadian citizen by naturalization refers to an immigrant who was granted citizenship of Canada under the Citizenship Act.)
  • 3: No, not a Canadian citizen

Place of birth, immigration and citizenship (DEM1) - Question identifier:DEM1_Q05C

Are you a landed immigrant or permanent resident?

  • 1: No
  • 2: Yes

Place of birth, immigration and citizenship (DEM1) - Question identifier:DEM1_Q10

In what year did you first become a landed immigrant or a permanent resident?

If exact year is not known, enter best estimate.

Year of immigration

Min = 0; Max = 9999

Long-term conditions (LTC)

Long-term conditions (LTC) - Question identifier:LTC_R05

The following questions are about any long-term conditions you may have.

Long-term conditions (LTC) - Question identifier:LTC_Q05

Do you have any of the following difficulties?

  • 1: Difficulty seeing even when wearing glasses or contact lenses
  • 2: Difficulty hearing even when using a hearing aid or cochlear implant
  • 3: Difficulty walking, using stairs, using your hands or fingers or doing other physical activities
  • 4: Difficulty learning, remembering or concentrating
  • 5: Emotional, psychological or mental health conditions (e.g., anxiety, depression, bipolar disorder, substance abuse, anorexia)
  • 6: Other health problem or long-term condition that has lasted or is expected to last for six or more months
  • 7: I do not have any difficulty or long-term condition that has lasted or is expected to last for six or more months

Long-term conditions (LTC) - Question identifier:LTC_Q10

Do you identify as a person with a disability?

  • 1: Yes
  • 2: No

Sexual orientation (SOR)

Sexual orientation (SOR) - Question identifier:SOR_Q01

What is your sexual orientation?

  • 1: Heterosexual
  • 2: Lesbian or gay
  • 3: Bisexual
  • 4: Or please specify

Future surveys (UCE)

Future surveys (UCE) - Question identifier:UCE_R05

Statistics Canada is planning a series of short, 15-20 minute surveys about important social topics. These surveys will be sent out every month or two and will ask about a wide variety of issues that affect Canadian society. By participating in this survey series, you will be able to share your opinions and thoughts on these issues and compare your ideas with those of other Canadians.

Future surveys (UCE) - Question identifier:UCE_Q05

Would you like to sign-up for future surveys?

  • 1: Yes
  • 2: No (Note: Your household will remain eligible for other Statistics Canada surveys.)

Future surveys (UCE) - Question identifier:UCE_Q10A

Please provide the following information so we can email or text you to participate in this survey series.
Email address

Long Answer Length = 80

Future surveys (UCE) - Question identifier:UCE_Q10B

Please provide the following information so we can email or text you to participate in this survey series.
Cellular number

Long Answer Length = 10

Future surveys (UCE) - Question identifier:UCE_R10

Thank you for signing up. We will contact you soon.

Date modified: