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.
Table of Contents
- Household members and geographic region (DEM)
- Sex and gender (GDR)
- Age (AGE)
- Education 1 (ED)
- Education 2 (EDU)
- Main activity (MAC)
- Satisfaction with work-life balance (SWL)
- Satisfaction with division of chores in household (SHC)
- General health (GEN)
- Life satisfaction (LSM)
- Meaning and purpose (MP)
- View of the future (FO)
- Loneliness (LON)
- Sense of belonging (SBL)
- Someone to count on (RES)
- Financial well-being (EHA)
- Trust in people (PCT)
- Trust in different groups of people (TIP)
- Trust in neighbourhood people (TNP)
- Confidence in institutions (CII)
- Reasons for choosing the place of residence (BG)
- Ethnic and cultural origins (ETH)
- Shared values (SVR)
- Discrimination or unfair treatment in Canada (DIS)
- Marital status (MS)
- Language (LAN)
- Indigenous identity (ABM)
- Sociodemographic characteristics (PG)
- Place of birth, immigration and citizenship (DEM1)
- Long-term conditions (LTC)
- Sexual orientation (SOR)
- Future surveys (UCE)
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.
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