Canadian Community Health Survey (CCHS) - 2019
Archived Content
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For Information onlyThis is an electronic survey example for information purposes only. This is not a working questionnaire.
Table of Contents
- Proxy interview (GR)
- Age of respondent (ANC1)
- Sex and Gender (GDR)
- Relationship without confirmation (RNC)
- Main activity (MAC)
- General health (GEN)
- Height and weight - self reported (HWT)
- Chronic conditions (CCC)
- Health utility index (HUI)
- Injuries (INJ)
- Oral health (OHT)
- Changes made to improve health (CIH)
- Fruit and vegetable consumption (FVC)
- Canada's Food Guide use (FGU)
- Smoking (SMK)
- Smoking cessation methods (SCA)
- Tobacco products alternatives (TAL)
- Nicotine dependence (NDE)
- Youth access to cigarettes (YAC)
- Exposure to second hand smoke (ETS)
- Alcohol use (ALC)
- Alcohol use during the past week (ALW)
- Antibiotic medication use (AMU)
- Cannabis use (CAN)
- Severity of cannabis dependence scale (SDS)
- Drug use (DRG)
- Gambling (GAM)
- Physical activities - adults 18 years and older (PAA)
- Physical activities for youth (PAY)
- Sedentary behaviours (SBE)
- Sexual behaviours (SXB)
- Maternal experiences (MEX)
- Smoking during maternal experience (MXS)
- Alcohol use during maternal experience (MXA)
- Driving and safety (DRV)
- Driving while under the influence (DWI)
- Flu shots (FLU)
- Blood pressure check (BPC)
- Pap smear test (PAP)
- Mammography (MAM)
- Prostate cancer screening (PSA)
- Colorectal cancer testing (CCT)
- Spirometry (SPI)
- Diabetes care (DIA)
- Consultations about mental health (CMH)
- Satisfaction with life (SWL)
- Depression (DEP)
- Suicidal thoughts and attempts (SUI)
- Sources of stress (STS)
- Childhood experiences (CEX)
- Social provisions (SPS)
- Primary health care (PHC)
- Medical doctor attachment (MDA)
- Contacts with health professionals - extended block (CP2)
- Contacts with dental professionals (CP3)
- Perceived need for care (PNC)
- Patient satisfaction - community-based care (PSC)
- Consultations with health professionals on smoking (SPC)
- Patient experiences (PEX)
- Home care services - with palliative care (HMC)
- Unmet health care needs (UCN)
- Labour force (LBF)
- Socio-demographic characteristics (SDC)
- Person most knowledgeable about household situation (PMK)
- Health insurance coverage (INS)
- Prescriptions - cost-related non-adherence - short version (PCN2)
- Food security (FSC)
- Administration information (ADM)
- Income (INC)
Proxy interview (GR)
This module identifies the individual who will be providing information for the selected respondent and determines if the interview is to be conducted by proxy if the mental or physical health of the selected member makes it impossible to complete the interview during the collection period.
New since 2013, the interview by proxy could be conducted with a knowledgeable household member, or a non-household member in very rare circumstances.
Proxy interview (GR) - Question identifier:GR_N005
Who is providing the information for this person's component?
- 01: MEMBER1
- 02: MEMBER2
- 03: MEMBER3
- 04: MEMBER4
- 05: MEMBER5
- 06: MEMBER6
- 07: MEMBER7
- 08: MEMBER8
- 09: MEMBER9
- 10: MEMBER10
- 11: MEMBER11
- 12: MEMBER12
- 13: MEMBER13
- 14: MEMBER14
- 15: MEMBER15
- 16: MEMBER16
- 17: MEMBER17
- 18: MEMBER18
- 19: MEMBER19
- 20: MEMBER20
- 88: Not a household member
Proxy interview (GR) - Question identifier:GR_N010
Do you want to complete this component by proxy?
- 1: Yes
- 2: No
Proxy interview (GR) - Question identifier:GR_N015
Record the reason why this component is being completed by proxy. Proxy interviews are to occur only if the mental or physical health of the selected member makes it impossible to complete the interview during the collection period.
- 1: Physical health condition
- 2: Mental health condition
Proxy interview (GR) - Question identifier:GR_N020
Enter the condition.
Long Answer Length = 80
Age of respondent (ANC1)
The actual age of the respondent is very important. It influences which questions will be asked and is key to the analysis of the data.
It is particularly important to confirm the age of 11- or 12-year-olds, as 12 is the lower age limit to determine if the respondent is an out-of-scope to our survey. Similarly, because of the use of a different sampling frame for youth and adults, it is also important to confirm the age of 17- or 18-year-olds, as they are the age limits to determine if the respondent is an out-of-scope to the frame (and therefore, of the survey).
Age of respondent (ANC1) - Question identifier:ANC1_Q01
What is [Name of specific respondent]'s date of birth?
Min = 1; Max = 31
Age of respondent (ANC1) - Question identifier:ANC1_Q02
What is [Name of specific respondent]'s date of birth?
- 01: January
- 02: February
- 03: March
- 04: April
- 05: May
- 06: June
- 07: July
- 08: August
- 09: September
- 10: October
- 11: November
- 12: December
- 98: RF
- 99: DK
Age of respondent (ANC1) - Question identifier:ANC1_Q03
What is [Name of specific respondent]'s date of birth?
Min = 0; Max = 9997
Age of respondent (ANC1) - Question identifier:ANC1_Q04
So [Name of specific respondent]'s age on [Reference system date] was [Age calculated based on the entered date of birth].
Is that correct?
- 1: Yes
- 2: No, return and correct date of birth
- 3: No, collect age
Age of respondent (ANC1) - Question identifier:ANC1_Q05
What is [Name of specific respondent]'s age?
Min = 0; Max = 121
Age of respondent (ANC1) - Question identifier:ANC1_R010
Because you are less than 12 years old, you are not eligible to participate in the Canadian Community Health Survey.
Age of respondent (ANC1) - Question identifier:ANC1_R015
Because you are more than 17 years old, you are not eligible to participate in the Canadian Community Health Survey.
Age of respondent (ANC1) - Question identifier:ANC1_R020
Because you are less than 18 years old, you are not eligible to participate in the Canadian Community Health Survey.
Age of respondent (ANC1) - Question identifier:ANC1_N030
Please confirm the spelling of respondent's first name. Update first name, if necessary.
Original First Name: [First name]
Original Last Name: [Last name]
Long Answer Length = 25
Age of respondent (ANC1) - Question identifier:ANC1_N035
Please confirm the spelling of respondent's last name. Update last name, if necessary.
Original First Name: [First name]
Original Last Name: [Last name]
Long Answer Length = 25
Sex and Gender (GDR)
The gender block is used to collect the gender and sex at birth of the respondent.
Sex and Gender (GDR) - Question identifier:GDR_R005
The following questions are about sex at birth and gender. Sex refers to sex assigned at birth. Gender refers to current gender which may be different from sex assigned at birth and may be different from what is indicated on legal documents.
Sex and Gender (GDR) - Question identifier:GDR_Q005
What was your sex at birth?
- 1: Male
- 2: Female
- 8: RF
- 9: DK
Sex and Gender (GDR) - Question identifier:GDR_Q010
What is your gender?
- 1: Male
- 2: Female
- 3: Or please specify
- 8: RF
- 9: DK
Sex and Gender (GDR) - Question identifier:GDR_R020
This survey asks questions based on sex at birth, such as pregnancy experiences and some cancer screening tests. If specific questions are not relevant to you, we can skip those questions. Thank you for your understanding and for your participation.
Relationship without confirmation (RNC)
The Relationship without Confirmation block is used to collect the relationship of an individual to someone else in the household when any previously collected relationship is not to be confirmed. Surveys may choose the level of detail desired, i.e., which of the sub-questions to ask. For example, one survey may choose to have all six detail questions, another may choose to have only three of them, and a third may choose not to have any. The block should not be called if there is only one person in the household.
Relationship without confirmation (RNC) - Question identifier:RNC_Q1
What is the relationship...
of: [Name of specific respondent] ([Age of specific respondent])
to: [Name of secondary respondent] ([Age of secondary respondent])?
- 01: Husband/wife
- 02: Common-law partner
- 03: Father/mother
- 04: Son/daughter (birth, adopted or step)
- 05: Brother/sister
- 06: Foster father/mother
- 07: Foster son/daughter
- 08: Grandfather/ grandmother
- 09: Grandson/ granddaughter
- 10: In-law
- 11: Other related
- 12: Unrelated
- 98: RF
- 99: DK
Relationship without confirmation (RNC) - Question identifier:RNC_Q2A
Is that a(n)... ?
- 1: Birth father/mother
- 2: Stepfather/stepmother
- 3: Adoptive father/mother
- 8: RF
- 9: DK
Relationship without confirmation (RNC) - Question identifier:RNC_Q2B
Is that a(n)... ?
- 1: Birth son/daughter
- 2: Stepson/stepdaughter
- 3: Adopted son/daughter
- 8: RF
- 9: DK
Relationship without confirmation (RNC) - Question identifier:RNC_Q2C
Is that a(n)... ?
- 1: Full brother/sister
- 2: Half brother/sister
- 3: Stepbrother/stepsister
- 4: Adopted brother/sister
- 5: Foster brother/sister
- 8: RF
- 9: DK
Relationship without confirmation (RNC) - Question identifier:RNC_Q2D
Is that a(n)... ?
- 1: Father-in-law / mother-in-law
- 2: Son-in-law / daughter-in-law
- 3: Brother-in-law / sister-in-law
- 4: Other in-law
- 8: RF
- 9: DK
Relationship without confirmation (RNC) - Question identifier:RNC_Q2E
Is that a(n)... ?
- 1: Uncle/aunt
- 2: Cousin
- 3: Nephew/niece
- 4: Other relative
- 8: RF
- 9: DK
Relationship without confirmation (RNC) - Question identifier:RNC_Q2F
Is that a(n)... ?
- 1: Boyfriend/girlfriend
- 2: Roommate/lodger/ boarder
- 3: Other - Specify
- 8: RF
- 9: DK
Main activity (MAC)
This module collects information about the respondent's main activity in the last week.
If their main activity is not 'caring for children' and they are 15 to 75 years of age, they are asked if they have worked any time in the past 12 months.
If their main activity is not 'going to school' or they are 14 or older, they are asked if they are currently attending school, college, CEGEP or university.
In this module, female respondents aged 15 to 55 are asked if they are pregnant.
Main activity (MAC) - Question identifier:MAC_Q005
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 leave
- 09: Long term illness
- 10: Volunteering
- 11: Care-giving other than for children
- 12: Other
- 98: RF
- 99: DK
Main activity (MAC) - Question identifier:MAC_Q010
Have you worked at a job or business at any time in the past 12 months?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Main activity (MAC) - Question identifier:MAC_Q015
Are you currently attending school, college, CEGEP or university?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Main activity (MAC) - Question identifier:MAC_Q020
Are you enrolled as...?
- 1: A full-time student
- 2: A part-time student
- 3: Both full-time and part-time student
- 8: RF
- 9: DK
Main activity (MAC) - Question identifier:MAC_Q025
To better understand the information you will provide on your health it is important to know if you are pregnant. Are you pregnant?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
General health (GEN)
The general health module is used to collect data on self-perceived health, satisfaction with life, self-perceived mental health, self-perceived stress at work and with life in general, and sense of belonging to local community.
Researchers are interested in these topics because they are good basic measures of health status. They can also be used to predict other aspects of the respondent's health. For example, respondents who describe their health as fair or poor are more likely to have long-term health problems, to suffer from depression and to be heavy users of the health care system.
General health (GEN) - Question identifier:GEN_R005
The next questions are about your 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_Q005
In general, would you say your health is... ?
- 1: Excellent
- 2: Very good
- 3: Good
- 4: Fair
- 5: Poor
- 8: RF
- 9: DK
General health (GEN) - Question identifier:GEN_Q010
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?
0 Very dissatisfied
1 I
2 I
3 I
4 I
5 I
6 I
7 I
8 I
9 V
10 Very satisfied
Min = 0; Max = 10
General health (GEN) - Question identifier:GEN_Q015
In general, would you say your mental health is...?
- 1: Excellent
- 2: Very good
- 3: Good
- 4: Fair
- 5: Poor
- 8: RF
- 9: DK
General health (GEN) - Question identifier:GEN_Q020
Thinking about the amount of stress in your life, would you say that most of your days are...?
- 1: Not at all stressful
- 2: Not very stressful
- 3: A bit stressful
- 4: Quite a bit stressful
- 5: Extremely stressful
- 8: RF
- 9: DK
General health (GEN) - Question identifier:GEN_R025
The next question is about your main job or business in the past 12 months.
General health (GEN) - Question identifier:GEN_Q025
Would you say that most days at work were...?
- 1: Not at all stressful
- 2: Not very stressful
- 3: A bit stressful
- 4: Quite a bit stressful
- 5: Extremely stressful
- 8: RF
- 9: DK
General health (GEN) - Question identifier:GEN_Q030
How would you describe your sense of belonging to your local community? Would you say it is...?
- 1: Very strong
- 2: Somewhat strong
- 3: Somewhat weak
- 4: Very weak
- 8: RF
- 9: DK
Height and weight - self reported (HWT)
In this module, respondents are asked to report their height and weight, and indicate whether they consider themselves overweight, underweight or just about right.
Answers to these questions are used in many ways, including calculating the number of people who are overweight, or obese.
Obesity, especially amongst young people, is a major health problem. It can be associated with a number of major medical problems, including high blood pressure, heart disease and diabetes.
Height and weight - self reported (HWT) - Question identifier:HWT_Q005
The next questions are about height and weight. How tall are you without shoes on?
- 0: Less than 1' / 12" (less than 29.2 cm.)
- 1: 1'0" to 1'11" / 12" to 23" (29.2 to 59.6 cm.)
- 2: 2'0" to 2'11" / 24" to 35" (59.7 to 90.1 cm.)
- 3: 3'0" to 3'11" / 36" to 47" (90.2 to 120.6 cm.)
- 4: 4'0" to 4'11" / 48" to 59" (120.7 to 151.0 cm.)
- 5: 5'0" to 5'11" (151.1 to 181.5 cm.)
- 6: 6'0" to 6'11" (181.6 to 212.0 cm.)
- 7: 7'0" and over (212.1 cm. and over)
- 8: RF
- 9: DK
Height and weight - self reported (HWT) - Question identifier:HWT_N010
Select the exact height.
- 00: Less than or equal to 1'0" / 12" (29.2 to 31.7 cm.)
- 01: 1'1" / 13" (31.8 to 34.2 cm.)
- 02: 1'2" / 14" (34.3 to 36.7 cm.)
- 03: 1'3" / 15" (36.8 to 39.3 cm.)
- 04: 1'4" / 16" (39.4 to 41.8 cm.)
- 05: 1'5" / 17" (41.9 to 44.4 cm.)
- 06: 1'6" / 18" (44.5 to 46.9 cm.)
- 07: 1'7" / 19" (47.0 to 49.4 cm.)
- 08: 1'8" / 20" (49.5 to 52.0 cm.)
- 09: 1'9" / 21" (52.1 to 54.5 cm.)
- 10: 1'10" / 22" (54.6 to 57.1 cm.)
- 11: 1'11" / 23" (57.2 to 59.6 cm.)
- 98: RF
- 99: DK
Height and weight - self reported (HWT) - Question identifier:HWT_N015
Select the exact height.
- 00: 2'0" / 24" (59.7 to 62.1 cm.)
- 01: 2'1" / 25" (62.2 to 64.7 cm.)
- 02: 2'2" / 26" (64.8 to 67.2 cm.)
- 03: 2'3" / 27" (67.3 to 69.8 cm.)
- 04: 2'4" / 28" (69.9 to 72.3 cm.)
- 05: 2'5" / 29" (72.4 to 74.8 cm.)
- 06: 2'6" / 30" (74.9 to 77.4 cm.)
- 07: 2'7" / 31" (77.5 to 79.9 cm.)
- 08: 2'8" / 32" (80.0 to 82.5 cm.)
- 09: 2'9" / 33" (82.6 to 85.0 cm.)
- 10: 2'10" / 34" (85.1 to 87.5 cm.)
- 11: 2'11" / 35" (87.6 to 90.1 cm.)
- 98: RF
- 99: DK
Height and weight - self reported (HWT) - Question identifier:HWT_N020
Select the exact height.
- 00: 3'0" / 36" (90.2 to 92.6 cm.)
- 01: 3'1" / 37" (92.7 to 95.2 cm.)
- 02: 3'2" / 38" (95.3 to 97.7 cm.)
- 03: 3'3" / 39" (97.8 to 100.2 cm.)
- 04: 3'4" / 40" (100.3 to 102.8 cm.)
- 05: 3'5" / 41" (102.9 to 105.3 cm.)
- 06: 3'6" / 42" (105.4 to 107.9 cm.)
- 07: 3'7" / 43" (108.0 to 110.4 cm.)
- 08: 3'8" / 44" (110.5 to 112.9 cm.)
- 09: 3'9" / 45" (113.0 to 115.5 cm.)
- 10: 3'10" / 46" (115.6 to 118.0 cm.)
- 11: 3'11" / 47" (118.1 to 120.6 cm.)
- 98: RF
- 99: DK
Height and weight - self reported (HWT) - Question identifier:HWT_N025
Select the exact height.
- 00: 4'0" / 48" (120.7 to 123.1 cm.)
- 01: 4'1" / 49" (123.2 to 125.6 cm.)
- 02: 4'2" / 50" (125.7 to 128.2 cm.)
- 03: 4'3" / 51" (128.3 to 130.7 cm.)
- 04: 4'4" / 52" (130.8 to 133.3 cm.)
- 05: 4'5" / 53" (133.4 to 135.8 cm.)
- 06: 4'6" / 54" (135.9 to 138.3 cm.)
- 07: 4'7" / 55" (138.4 to 140.9 cm.)
- 08: 4'8" / 56" (141.0 to 143.4 cm.)
- 09: 4'9" / 57" (143.5 to 146.0 cm.)
- 10: 4'10" / 58" (146.1 to 148.5 cm.)
- 11: 4'11" / 59" (148.6 to 151.0 cm.)
- 98: RF
- 99: DK
Height and weight - self reported (HWT) - Question identifier:HWT_N030
Select the exact height.
- 00: 5'0" (151.1 to 153.6 cm.)
- 01: 5'1" (153.7 to 156.1 cm.)
- 02: 5'2" (156.2 to 158.7 cm.)
- 03: 5'3" (158.8 to 161.2 cm.)
- 04: 5'4" (161.3 to 163.7 cm.)
- 05: 5'5" (163.8 to 166.3 cm.)
- 06: 5'6" (166.4 to 168.8 cm.)
- 07: 5'7" (168.9 to 171.4 cm.)
- 08: 5'8" (171.5 to 173.9 cm.)
- 09: 5'9" (174.0 to 176.4 cm.)
- 10: 5'10" (176.5 to 179.0 cm.)
- 11: 5'11" (179.1 to 181.5 cm.)
- 98: RF
- 99: DK
Height and weight - self reported (HWT) - Question identifier:HWT_N035
Select the exact height.
- 00: 6'0" (181.6 to 184.1 cm.)
- 01: 6'1" (184.2 to 186.6 cm.)
- 02: 6'2" (186.7 to 189.1 cm.)
- 03: 6'3" (189.2 to 191.7 cm.)
- 04: 6'4" (191.8 to 194.2 cm.)
- 05: 6'5" (194.3 to 196.8 cm.)
- 06: 6'6" (196.9 to 199.3 cm.)
- 07: 6'7" (199.4 to 201.8 cm.)
- 08: 6'8" (201.9 to 204.4 cm.)
- 09: 6'9" (204.5 to 206.9 cm.)
- 10: 6'10" (207.0 to 209.5 cm.)
- 11: 6'11" (209.6 to 212.0 cm.)
- 98: RF
- 99: DK
Height and weight - self reported (HWT) - Question identifier:HWT_Q040
How much do you weigh?
Min = 1; Max = 575
Height and weight - self reported (HWT) - Question identifier:HWT_N045
Was that in pounds or kilograms?
- 1: Pounds
- 2: Kilograms
Height and weight - self reported (HWT) - Question identifier:HWT_Q050
Do you consider yourself...?
- 1: Overweight
- 2: Underweight
- 3: Just about right
- 8: RF
- 9: DK
Chronic conditions (CCC)
The first set of questions in this module deal with pain in the joints during the past 30 days. The remaining questions deal with long-term health conditions that have lasted or are expected to last at least 6 months. Chronic conditions reported by respondents must have been diagnosed by a health professional.
Answers to these questions can be used to estimate the number of people in Canada suffering from conditions such as diabetes, heart disease, and asthma.
By combining answers from this module with information from other modules, researchers can look at the relationship between chronic conditions and other characteristics, such as use of health care services or use of medications.
Chronic conditions (CCC) - Question identifier:CCC_R015
The following questions are about "long-term health conditions" which are expected to last or have already lasted 6 months or more and that have been diagnosed by a health professional.
Chronic conditions (CCC) - Question identifier:CCC_Q015
Do you have asthma?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q020
Have you had any asthma symptoms or asthma attacks in the past 12 months?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q025
In the past 12 months, have you taken any medicine for asthma such as inhalers (pumps), nebulizers, pills, liquids or injections?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q030
Do you have chronic bronchitis, emphysema or chronic obstructive pulmonary disease or COPD?
Chronic bronchitis is another name for COPD or emphysema. It is characterized by inflammation of the main air passages to the lung characterized by mucous secretion and chronic cough. It is a long-term condition.
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q035
Have you been told by a health professional that you have sleep apnea?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_R045
Remember, we're interested in conditions diagnosed by a health professional and that are expected to last or have already lasted 6 months or more.
Chronic conditions (CCC) - Question identifier:CCC_Q045
Do you have fibromyalgia?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q050
Do you have arthritis, for example osteoarthritis, rheumatoid arthritis, gout or any other type, excluding fibromyalgia?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q060
Do you have osteoporosis?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q065
Do you have high blood pressure?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q070
In the past month, have you taken any medicine for high blood pressure?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q075
Do you have high blood cholesterol or lipids?
Blood cholesterol or lipids are a fatty substance found in blood.
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q080
In the past month, have you taken any medicine for high blood cholesterol or lipids?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q085
Do you have heart disease?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q087
Have you ever been diagnosed with heart disease?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q090
Do you suffer from the effects of a stroke?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q095
Do you have diabetes?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q100
How old were you when this was first diagnosed?
Min = 1; Max = 121
Chronic conditions (CCC) - Question identifier:CCC_Q105
Were you pregnant when you were first diagnosed with diabetes?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q110
Other than during pregnancy, has a health professional ever told you that you have diabetes?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q115
When you were first diagnosed with diabetes, how long was it before you were started on insulin?
- 1: Less than 1 month
- 2: 1 month to less than 2 months
- 3: 2 months to less than 6 months
- 4: 6 months to less than 1 year
- 5: 1 year or more
- 6: Never
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q120
Do you currently take insulin for your diabetes?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q125
In the past month, did you take pills to control your blood sugar?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q130
Do you have cancer?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q135
Have you ever been diagnosed with cancer?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_R140
Remember, we're interested in conditions diagnosed by a health professional and that are expected to last or have already lasted 6 months or more.
Chronic conditions (CCC) - Question identifier:CCC_Q145
Do you have Alzheimer's Disease or any other dementia?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q185
Do you have chronic fatigue syndrome?
Also known as CFS, it is a complex disorder characterized by profound fatigue that is not improved by bed rest. Includes myalgic encephalomyelitis.
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q195
Do you have a mood disorder such as depression, bipolar disorder, mania or dysthymia?
Include manic depression.
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q200
Do you have an anxiety disorder such as a phobia, obsessive-compulsive disorder or a panic disorder?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Health utility index (HUI)
The health utility index provides a description of an individual's overall functional health, based on eight attributes: vision, hearing, speech, mobility (ability to get around), dexterity (use of hands and fingers), emotion (feelings), cognition (memory and thinking) and pain. The version of the index used in CCHS is adapted from the HUI Mark 3 (HUI3). The index is designed to produce both an overall health utility score and eight individual attribute scores. Analysts can use either a single-attribute utility scale or look at the complete health state (levels on all eight attributes) on the overall utility scale to produce a measure of an individual's perceived health related quality of life (HRQL).
The index is appropriate for use to describe and monitor the health of general populations, and has been extensively validated for use in cross-sectional and longitudinal population health studies.
The 8 single-attribute utility scores measure functional capacity within a single attribute, and range from 1.00 (normal) to 0.00 (most disabled). In combination, these scores are used to produce a multi-attribute utility index producing a score ranging from 1.00 (perfect health), through 0.00 (health status equal to death) to -0.36 (health status worse than death).
Health utility index (HUI) - Question identifier:HUI_R001
The next set of questions asks about your day-to-day health.
You may feel that some of these questions do not apply to you, but it is important that we ask the same questions of everyone.
Health utility index (HUI) - Question identifier:HUI_Q005
Are you usually able to see well enough to read ordinary newsprint without glasses or contact lenses?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Health utility index (HUI) - Question identifier:HUI_Q010
Are you usually able to see well enough to read ordinary newsprint with glasses or contact lenses?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Health utility index (HUI) - Question identifier:HUI_Q015
Are you able to see at all?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Health utility index (HUI) - Question identifier:HUI_Q020
Are you able to see well enough to recognize a friend on the other side of the street without glasses or contact lenses?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Health utility index (HUI) - Question identifier:HUI_Q025
Are you usually able to see well enough to recognize a friend on the other side of the street with glasses or contact lenses?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Health utility index (HUI) - Question identifier:HUI_Q030
Are you usually able to hear what is said in a group conversation with at least three other people without a hearing aid?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Health utility index (HUI) - Question identifier:HUI_Q035
Are you usually able to hear what is said in a group conversation with at least three other people with a hearing aid?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Health utility index (HUI) - Question identifier:HUI_Q040
Are you able to hear at all?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Health utility index (HUI) - Question identifier:HUI_Q045
Are you usually able to hear what is said in a conversation with one other person in a quiet room without a hearing aid?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Health utility index (HUI) - Question identifier:HUI_Q050
Are you usually able to hear what is said in a conversation with one other person in a quiet room with a hearing aid?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Health utility index (HUI) - Question identifier:HUI_Q055
Are you usually able to be understood completely when speaking with strangers in your own language?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Health utility index (HUI) - Question identifier:HUI_Q060
Are you able to be understood partially when speaking with strangers?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Health utility index (HUI) - Question identifier:HUI_Q065
Are you able to be understood completely when speaking with those who know you well?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Health utility index (HUI) - Question identifier:HUI_Q070
Are you able to be understood partially when speaking with those who know you well?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Health utility index (HUI) - Question identifier:HUI_Q075
Are you usually able to walk around the neighbourhood without difficulty and without mechanical support such as braces, a cane or crutches?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Health utility index (HUI) - Question identifier:HUI_Q080
Are you able to walk at all?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Health utility index (HUI) - Question identifier:HUI_Q085
Do you require mechanical support such as braces, a cane or crutches to be able to walk around the neighbourhood?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Health utility index (HUI) - Question identifier:HUI_Q090
Do you require the help of another person to be able to walk?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Health utility index (HUI) - Question identifier:HUI_Q095
Do you require a wheelchair to get around?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Health utility index (HUI) - Question identifier:HUI_Q100
How often do you use a wheelchair?
- 1: Always
- 2: Often
- 3: Sometimes
- 4: Never
- 8: RF
- 9: DK
Health utility index (HUI) - Question identifier:HUI_Q105
Do you need the help of another person to get around in the wheelchair?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Health utility index (HUI) - Question identifier:HUI_Q110
Are you usually able to grasp and handle small objects such as a pencil or scissors?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Health utility index (HUI) - Question identifier:HUI_Q115
Do you require the help of another person because of limitations in the use of your hands or fingers?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Health utility index (HUI) - Question identifier:HUI_Q120
Do you require the help of another person with...?
- 1: Some tasks
- 2: Most tasks
- 3: Almost all tasks
- 4: All tasks
- 8: RF
- 9: DK
Health utility index (HUI) - Question identifier:HUI_Q125
Do you require special equipment, for example, devices to assist in dressing, because of limitations in the use of your hands or fingers?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Health utility index (HUI) - Question identifier:HUI_Q130
Would you describe yourself as being usually...?
- 1: Happy and interested in life
- 2: Somewhat happy
- 3: Somewhat unhappy
- 4: Unhappy with little interest in life
- 5: So unhappy, that life is not worthwhile
- 8: RF
- 9: DK
Health utility index (HUI) - Question identifier:HUI_Q135
How would you describe your usual ability to remember things?
- 1: Able to remember most things
- 2: Somewhat forgetful
- 3: Very forgetful
- 4: Unable to remember anything at all
- 8: RF
- 9: DK
Health utility index (HUI) - Question identifier:HUI_Q140
How would you describe your usual ability to think and solve day-to-day problems?
- 1: Able to think clearly and solve problems
- 2: Having a little difficulty
- 3: Having some difficulty
- 4: Having a great deal of difficulty
- 5: Unable to think or solve problems
- 8: RF
- 9: DK
Health utility index (HUI) - Question identifier:HUI_R145
The next set of questions asks about the level of pain or discomfort you usually experience. They are not about illnesses like colds that affect people for short periods of time.
Health utility index (HUI) - Question identifier:HUI_Q145
Are you usually free of pain or discomfort?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Health utility index (HUI) - Question identifier:HUI_Q150
How would you describe the usual intensity of your pain or discomfort?
- 1: Mild
- 2: Moderate
- 3: Severe
- 8: RF
- 9: DK
Health utility index (HUI) - Question identifier:HUI_Q155
How many activities does your pain or discomfort prevent?
- 1: None
- 2: A few
- 3: Some
- 4: Most
- 8: RF
- 9: DK
Injuries (INJ)
This module begins with a series of questions on repetitive strain injuries. These are injuries caused by overuse or by repeating the same movement over a long period of time.
The rest of the module deals with the causes, the nature, frequency, and treatment of all other types of injuries, such as broken bones, cuts, burns or poisonings. This part of the module deals with injuries that are serious enough to limit normal activities, and all questions refer to the most serious injury suffered in the past 12 months.
To put effective injury prevention in place, health planners need to know which types and causes of injuries are most common and which groups of people are most likely to be injured.
Injuries (INJ) - Question identifier:INJ_R001
Now, questions on repetitive strain injuries. By this we mean injuries to muscles, tendons or nerves caused by overuse or repeating the same movement over an extended period. For example, carpal tunnel syndrome, tennis elbow or tendonitis.
Injuries (INJ) - Question identifier:INJ_Q005
In the past 12 months, did you have any injuries due to repetitive strain?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Injuries (INJ) - Question identifier:INJ_Q010
Were these injuries serious enough to limit your normal activities?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Injuries (INJ) - Question identifier:INJ_Q015
Thinking about the most serious repetitive strain injury, what part of the body was affected?
- 01: Head
- 02: Neck
- 03: Shoulder, upper arm
- 04: Elbow, lower arm
- 05: Wrist
- 06: Hand
- 07: Hip
- 08: Thigh
- 09: Knee, lower leg
- 10: Ankle, foot
- 11: Upper back or upper spine (excluding neck)
- 12: Lower back or lower spine
- 13: Chest (excluding back and spine)
- 14: Abdomen or pelvis (excluding back and spine)
- 98: RF
- 99: DK
Injuries (INJ) - Question identifier:INJ_Q020
What type of activity caused this repetitive strain injury?
- 01: Walking
- 02: Sports or physical exercise (including school activities and running)
- 03: Leisure or hobby (include volunteering)
- 04: Household chores, outdoor yard maintenance, home renovations or other unpaid work
- 05: Computer use or typing
- 06: Driving a motor vehicle
- 07: Lifting or carrying an object or person
- 08: Other
- 98: RF
- 99: DK
Injuries (INJ) - Question identifier:INJ_Q025
Was the activity something you did while working at your job or business (excluding travel to or from work)?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Injuries (INJ) - Question identifier:INJ_R030
For the next questions, think about other injuries which occurred in the past 12 months, and were serious enough to limit your normal activities at least 24 hours after the injury occurred. For example, a broken bone, a bad cut, a burn or a sprain.
Injuries (INJ) - Question identifier:INJ_Q030
Not counting [repetitive strain injuries or] food poisoning, in the past 12 months, that is, from [Date one year ago] to yesterday, were you injured?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Injuries (INJ) - Question identifier:INJ_Q035
How many times were you injured?
Min = 1; Max = 30
Injuries (INJ) - Question identifier:INJ_Q040
[Thinking about the most serious injury,] in which month did it happen?
- 01: January
- 02: February
- 03: March
- 04: April
- 05: May
- 06: June
- 07: July
- 08: August
- 09: September
- 10: October
- 11: November
- 12: December
- 98: RF
- 99: DK
Injuries (INJ) - Question identifier:INJ_Q045
Was that this year or last year?
- 1: This year
- 2: Last year
- 8: RF
- 9: DK
Injuries (INJ) - Question identifier:INJ_Q050
What type of injury did you have? For example, a broken bone or burn.
- 01: Multiple serious injuries (excluding multiple minor injuries)
- 02: Broken or fractured bones
- 03: Burn, scald, chemical burn
- 04: Dislocation
- 05: Sprain or strain (including torn ligaments and muscles)
- 06: Cut, puncture, animal or human bite (open wound)
- 07: Scrape(s), bruise(s), blister(s) (including multiple minor injuries)
- 08: Concussion or other brain injury
- 09: Poisoning (excluding food poisoning, poison ivy, other contact dermatitis, and allergies)
- 10: Injury to internal organs
- 11: Other - Specify
- 98: RF
- 99: DK
Injuries (INJ) - Question identifier:INJ_Q055
What part of the body was injured?
- 01: Multiple sites
- 02: Eyes (excluding fracture of facial bones around the eye)
- 03: Head (including facial bones)
- 04: Neck
- 05: Shoulder, upper arm
- 06: Elbow, lower arm
- 07: Wrist
- 08: Hand
- 09: Hip
- 10: Thigh
- 11: Knee, lower leg
- 12: Ankle, foot
- 13: Upper back or upper spine (excluding neck)
- 14: Lower back or lower spine
- 15: Chest (excluding back and spine)
- 16: Abdomen or pelvis (excluding back and spine)
- 17: Other
- 98: RF
- 99: DK
Injuries (INJ) - Question identifier:INJ_Q060
Where were you when you were injured? For example, someone's house, an office building, construction site.
- 01: In a home or its surrounding area (including respondent's home or other homes)
- 02: Residential institution (e.g., nursing home, long term care)
- 03: School, college, university (exclude sports areas)
- 04: Sports or athletics area of school, college, university
- 05: Other sports or athletics area (exclude school sports areas)
- 06: Other institution (e.g., church, hospital, theatre, civic building)
- 07: Street, highway, sidewalk
- 08: Commercial area (e.g., store, restaurant, office building, transport terminal)
- 09: Industrial or construction area
- 10: Farm (exclude farmhouse and its surrounding area)
- 11: Countryside, forest, lake, ocean, mountains, prairie, etc.
- 12: Other
- 98: RF
- 99: DK
Injuries (INJ) - Question identifier:INJ_Q065
What were you doing when you were injured?
- 01: Organized sports involving coaching and competitions
- 02: Leisure sports or physical exercise, including school activities and running
- 03: Non-sport leisure or hobby (including volunteering)
- 04: Working at a job or business (excluding travel to and from work)
- 05: Household chores, outdoor yard maintenance, home renovations or other unpaid work
- 06: Sleeping, eating, personal care
- 07: Going up and down stairs
- 08: Driver or passenger in/on road motor vehicle (including motorcycles and trucks)
- 09: Driver or passenger in/on off-road motor vehicle (including boat, ATV, snowmobile)
- 10: Walking
- 11: Other - Specify
- 98: RF
- 99: DK
Injuries (INJ) - Question identifier:INJ_Q070
Was the injury the result of a fall?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Injuries (INJ) - Question identifier:INJ_Q075
How did you fall?
- 01: While skating, skiing or snowboarding
- 02: While engaged in other sport or physical exercise (including school activities and running)
- 03: Going up or down stairs / steps (icy or not)
- 04: Slip, trip or stumble, or loss of balance while walking on ice or snow
- 05: Slip, trip or stumble, or loss of balance while walking on any other surface
- 06: From furniture or while rising from furniture (e.g., bed, chair)
- 07: From elevated position (e.g., ladder, tree, scaffolding)
- 08: Due to health problems (e.g., faint, weakness, dizziness, hip/knee gave out, seizure)
- 09: Other - Specify
- 98: RF
- 99: DK
Injuries (INJ) - Question identifier:INJ_Q080
What caused the injury? For example, wrong movement, accidental contact with an object, transportation accident.
- 01: Transportation accident
- 02: Accidentally bumped, pushed, bitten, etc. by a person or animal
- 03: Accidentally struck or crushed by object(s)
- 04: Accidental contact with sharp object, tool or machine
- 05: Smoke, fire, flames
- 06: Accidental contact with hot object, liquid or gas
- 07: Extreme weather or natural disaster
- 08: Overexertion or strenuous movement
- 09: Physical assault
- 10: Intentional self-inflicted injury
- 11: Other - Specify
- 98: RF
- 99: DK
Injuries (INJ) - Question identifier:INJ_Q085
At what time of day did your injury occur?
- 1: Morning (06:00-11:59)
- 2: Afternoon (12:00-17:59)
- 3: Evening (18:00-23:59)
- 4: Night (00:00-05:59)
- 8: RF
- 9: DK
Injuries (INJ) - Question identifier:INJ_Q090
Did you receive any medical attention for the injury from a health professional in the 48 hours following the injury?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Injuries (INJ) - Question identifier:INJ_Q095
Where did you initially go to receive treatment within the first 48 hours following the injury?
- 01: Doctor's office
- 02: Hospital emergency room
- 03: Hospital outpatient clinic (e.g., day surgery)
- 04: Other clinic (e.g., walk-in, appointment, sports)
- 05: Physiotherapist or massage therapist's office
- 06: Community health centre / CLSC
- 07: Chiropractor's office
- 08: Where the injury happened/on-site (workplace, school, sports field, hotel, ski hill)
- 09: Other
- 98: RF
- 99: DK
Injuries (INJ) - Question identifier:INJ_Q100
Were you admitted to a hospital overnight because of this injury?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Injuries (INJ) - Question identifier:INJ_Q105
At the present time, are you getting follow-up care from a health professional because of this injury?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Injuries (INJ) - Question identifier:INJ_Q110
In the past 12 months, [excluding injuries previously mentioned,] did have any other injuries that were treated by a health professional, but did not limit your normal activities?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Injuries (INJ) - Question identifier:INJ_Q115
How many injuries?
Min = 1; Max = 30
Oral health (OHT)
This module asks the respondent to describe the health of their mouth and teeth (or dentures), and rate their satisfaction with their appearance. Respondent's also identify any discomfort they have with eating and how often they experience pain in their mouth, if they avoid eating particular foods, and how often they've experienced any other persistent or on-going pain in their mouth.
The health of a person's teeth and mouth is related to many other aspects of their health. For example, poor teeth and poor nutrition are related to each other.
Data from this module could be used to identify groups with the greatest need for improved dental health services.
Oral health (OHT) - Question identifier:OHT_R001
Now, some questions about the health of your mouth, including your teeth or dentures, tongue, gums, lips and jaw joints.
Oral health (OHT) - Question identifier:OHT_Q005
In general, would you say the health of your mouth is...?
- 1: Excellent
- 2: Very good
- 3: Good
- 4: Fair
- 5: Poor
- 8: RF
- 9: DK
Oral health (OHT) - Question identifier:OHT_Q010
How satisfied are you with the appearance of your teeth and/or dentures?
- 1: Very satisfied
- 2: Satisfied
- 3: Neither satisfied nor dissatisfied
- 4: Dissatisfied
- 5: Very dissatisfied
- 8: RF
- 9: DK
Oral health (OHT) - Question identifier:OHT_Q015
In the past 12 months, how often have you found it uncomfortable to eat any food because of problems with your mouth?
- 1: Often
- 2: Sometimes
- 3: Rarely
- 4: Never
- 8: RF
- 9: DK
Oral health (OHT) - Question identifier:OHT_Q020
(In the past 12 months,) how often have you avoided eating particular foods because of problems with your mouth?
- 1: Often
- 2: Sometimes
- 3: Rarely
- 4: Never
- 8: RF
- 9: DK
Oral health (OHT) - Question identifier:OHT_Q025
Remember, by mouth we mean teeth, dentures, tongue, gums, lips and jaw joints.
In the past 12 months, how often have you had any other persistent or on-going pain anywhere in your mouth?
- 1: Often
- 2: Sometimes
- 3: Rarely
- 4: Never
- 8: RF
- 9: DK
Oral health (OHT) - Question identifier:OHT_Q030
Do you have at least one of your own teeth?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Oral health (OHT) - Question identifier:OHT_Q035
Do you wear dentures, dental prosthesis or false teeth?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Oral health (OHT) - Question identifier:OHT_Q040
In the past 12 months, how often have you had bleeding gums, including while brushing or flossing your teeth?
- 1: Often
- 2: Sometimes
- 3: Rarely
- 4: Never
- 8: RF
- 9: DK
Oral health (OHT) - Question identifier:OHT_Q045
(In the past 12 months,) how often have you had persistent dry mouth?
- 1: Often
- 2: Sometimes
- 3: Rarely
- 4: Never
- 8: RF
- 9: DK
Oral health (OHT) - Question identifier:OHT_Q050
(In the past 12 months,) how often have you had persistent bad breath?
- 1: Often
- 2: Sometimes
- 3: Rarely
- 4: Never
- 8: RF
- 9: DK
Changes made to improve health (CIH)
Respondents are asked a number of questions related to changes in behaviour that they have made in the past year (and intentions for the future) to improve their health, including losing weight, stopping smoking and increasing exercise.
The module also asks about things that have stopped the respondent from making a change, including lack of time and lack of will power.
The results from this module are very valuable in designing programs to promote healthy living. For example, local health region planners might find that a large number of people want to do more exercise but find that lack of time is stopping them from doing so. Programs might be put in place to remind people of ways to include exercise in their everyday activities.
Changes made to improve health (CIH) - Question identifier:CIH_Q005
Now, some questions about changes made to improve health.
In the past 12 months, did you do anything to improve your health? (For example, lost weight, quit smoking, increased exercise.)
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Changes made to improve health (CIH) - Question identifier:CIH_Q010
What is the single most important change you have made?
- 01: Increased exercise, sports / physical activity
- 02: Lost weight
- 03: Changed diet / improved eating habits
- 04: Quit smoking / reduced amount smoked
- 05: Drank less alcohol
- 06: Reduced stress level
- 07: Received medical treatment
- 08: Took vitamins
- 09: Other
- 98: RF
- 99: DK
Changes made to improve health (CIH) - Question identifier:CIH_Q015
Do you think there is [anything / anything else] you should do to improve your physical health?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Changes made to improve health (CIH) - Question identifier:CIH_Q020
What is the most important thing?
- 01: Start / Increase exercise, sports / physical activity
- 02: Lose weight
- 03: Change diet / improve eating habits
- 04: Quit smoking / reduce amount smoked
- 05: Drink less alcohol
- 06: Reduce stress level
- 07: Receive medical treatment
- 08: Take vitamins
- 09: Other
- 98: RF
- 99: DK
Changes made to improve health (CIH) - Question identifier:CIH_Q025
Is there anything stopping you from making this improvement?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Changes made to improve health (CIH) - Question identifier:CIH_Q030
What is that?
- 01: Lack of will power / self-discipline
- 02: Family responsibilities
- 03: Work schedule
- 04: Addiction to drugs / alcohol
- 05: Disability / health condition
- 06: Too stressed
- 07: Too costly / financial constraints
- 08: Not available in area
- 09: Transportation problems
- 10: Weather problems
- 11: Other
- 98: RF
- 99: DK
Changes made to improve health (CIH) - Question identifier:CIH_Q035
Is there anything you intend to do to improve your physical health in the next year?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Changes made to improve health (CIH) - Question identifier:CIH_Q040
What is that?
- 01: Start / Increase exercise, sports / physical activity
- 02: Lose weight
- 03: Change diet / improve eating habits
- 04: Quit smoking / reduce amount smoked
- 05: Drink less alcohol
- 06: Reduce stress level
- 07: Receive medical treatment
- 08: Take vitamins
- 09: Other
- 98: RF
- 99: DK
Fruit and vegetable consumption (FVC)
The health benefits of vegetable and fruit consumption are popular topics in nutrition promotion programs and research. Among the research findings, there is thought to be a link between increased consumption of vegetables and fruit and a reduction in the risk of many cancers.
Fruit and vegetable consumption (FVC) - Question identifier:FVC_R001
These next questions are about the fruits and vegetables you ate or drank during the last month. Think about all meals and snacks, at home and away from home.
Fruit and vegetable consumption (FVC) - Question identifier:FVC_Q004
In the last month, did you drink 100% PURE fruit juices, such as pure orange juice, apple juice or pure juice blends? Exclude fruit-flavored drinks with added sugar or fruit punch.
DO NOT include fruit drinks like reconstituted powdered drink, lemonade, cranberry cocktail or yogurt drinks.
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Fruit and vegetable consumption (FVC) - Question identifier:FVC_Q005
How many times? You can report per day, per week or per month.
Min = 1; Max = 300
Fruit and vegetable consumption (FVC) - Question identifier:FVC_N005A
Select the reporting period that corresponds to FVC_Q005.
- 1: Per day
- 2: Per week
- 3: Per month
Fruit and vegetable consumption (FVC) - Question identifier:FVC_Q009
In the last month, not counting juice, did you eat fruit? Please remember to include frozen, dried or canned fruit.
INCLUDE fruit you added to yogurt, cereal and other meal items. DO NOT include fruit jam, jelly or fruit preserves as well as baked goods containing fruit like banana bread.
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Fruit and vegetable consumption (FVC) - Question identifier:FVC_Q010
How many times? (You can report per day, per week or per month.)
Min = 1; Max = 300
Fruit and vegetable consumption (FVC) - Question identifier:FVC_N010A
Select the reporting period that corresponds to FVC_Q010.
- 1: Per day
- 2: Per week
- 3: Per month
Fruit and vegetable consumption (FVC) - Question identifier:FVC_Q014
In the last month, did you eat dark green vegetables such as broccoli, green beans, peas and green peppers or dark leafy greens including romaine or spinach? Please remember to include (frozen or canned vegetables and) vegetables that were cooked in soups or mixed in salad.
DO NOT include Iceberg lettuce if respondent specifies type of lettuce. DO NOT include cucumber, celery and common cabbage.
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Fruit and vegetable consumption (FVC) - Question identifier:FVC_Q015
How many times? (You can report per day, per week or per month.)
Min = 1; Max = 300
Fruit and vegetable consumption (FVC) - Question identifier:FVC_N015A
Select the reporting period that corresponds to FVC_Q015.
- 1: Per day
- 2: Per week
- 3: Per month
Fruit and vegetable consumption (FVC) - Question identifier:FVC_Q019
In the last month, did you eat orange-coloured vegetables such as carrots, orange bell pepper, sweet potatoes, pumpkin or squash? (Please remember to include frozen or canned vegetables and vegetables that were cooked in soups or mixed in salad).
INCLUDE all forms of sweet potatoes including baked, mashed or in casserole. INCLUDE pumpkin in soup or pie.
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Fruit and vegetable consumption (FVC) - Question identifier:FVC_Q020
How many times? (You can report per day, per week or per month.)
Min = 1; Max = 300
Fruit and vegetable consumption (FVC) - Question identifier:FVC_N020A
Select the reporting period that corresponds to FVC_Q020.
- 1: Per day
- 2: Per week
- 3: Per month
Fruit and vegetable consumption (FVC) - Question identifier:FVC_Q024
In the last month, did you eat potatoes that are not deep fried?
INCLUDE potatoes with any peel colour (white, red, yellow, blue). DO NOT include sweet potatoes as they should have already been reported.
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Fruit and vegetable consumption (FVC) - Question identifier:FVC_Q025
How many times? (You can report per day, per week or per month.)
Min = 1; Max = 300
Fruit and vegetable consumption (FVC) - Question identifier:FVC_N025A
Select the reporting period that corresponds to FVC_Q025.
- 1: Per day
- 2: Per week
- 3: Per month
Fruit and vegetable consumption (FVC) - Question identifier:FVC_Q029
[Excluding the green and orange vegetables as well as the potatoes you have already reported,] in the last month, did you eat OTHER vegetables? Examples include cucumber, celery, corn, cabbage and vegetable juice.
INCLUDE tomato juice and V-8 type vegetable juice. DO NOT include condiments such as ketchup, salsa, chutney and relish.
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Fruit and vegetable consumption (FVC) - Question identifier:FVC_Q030
How many times? (You can report per day, per week or per month.)
Min = 1; Max = 300
Fruit and vegetable consumption (FVC) - Question identifier:FVC_N030A
Select the reporting period that corresponds to FVC_Q030.
- 1: Per day
- 2: Per week
- 3: Per month
Canada's Food Guide use (FGU)
This module collects information on the population's knowledge and use of the Canada Food Guide.
Specifically, this module asks if the respondent is aware of the Canada Food Guide, and whether the information in the guide was ever used.
This information can be used to better understand the link between the use of Canada's Food Guide and eating habits and health behaviours.
Canada's Food Guide use (FGU) - Question identifier:FGU_Q005
Have you ever seen or heard of Canada's Food Guide?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Canada's Food Guide use (FGU) - Question identifier:FGU_Q010
Have you ever used information from Canada's Food Guide?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Canada's Food Guide use (FGU) - Question identifier:FGU_Q015
What did you use the information for?
- 1: To choose foods for you or household members
- 2: To determine how much you or household members need to eat every day
- 3: To plan meals or to help with grocery shopping
- 4: To assess how well you or household members are eating
- 5: Other
- 6: None of the above
- 8: RF
- 9: DK
Smoking (SMK)
Cigarette smoking is a major cause of heart disease and lung disease. The economic cost of illnesses and deaths caused by smoking is a major concern to health care planners and administrators.
The number of people who smoke varies significantly between health regions, between men and women and among age groups.
This module includes a series of questions about current and past smoking habits.
The results of this module can be used to develop smoking prevention and cessation programs for the groups that need them most.
Smoking (SMK) - Question identifier:SMK_R001
The next questions are about cigarette smoking.
Smoking (SMK) - Question identifier:SMK_Q005
At the present time, do you smoke cigarettes every day, occasionally or not at all?
- 1: Daily
- 2: Occasionally
- 3: Not at all
- 8: RF
- 9: DK
Smoking (SMK) - Question identifier:SMK_Q010
In the past 30 days, did you smoke any cigarettes?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Smoking (SMK) - Question identifier:SMK_Q015
During the past 30 days, did you smoke every day?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Smoking (SMK) - Question identifier:SMK_Q020
Have you smoked more than 100 cigarettes (about 4 packs) in your life?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Smoking (SMK) - Question identifier:SMK_Q025
Have you ever smoked a whole cigarette?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Smoking (SMK) - Question identifier:SMK_Q030
Have you ever smoked cigarettes daily?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Smoking (SMK) - Question identifier:SMK_Q035
At what age did you smoke your first whole cigarette?
Min = 5; Max = 121
Smoking (SMK) - Question identifier:SMK_Q040
At what age did you begin to smoke cigarettes daily?
Min = 5; Max = 121
Smoking (SMK) - Question identifier:SMK_Q045
How many cigarettes do you smoke each day now?
Min = 1; Max = 99
Smoking (SMK) - Question identifier:SMK_Q050
On the days that you do smoke, how many cigarettes do you usually smoke?
Min = 1; Max = 99
Smoking (SMK) - Question identifier:SMK_Q055
In the past month, on how many days have you smoked one or more cigarettes?
Min = 0; Max = 31
Smoking (SMK) - Question identifier:SMK_Q060
When did you stop smoking? Was it...?
- 1: Less than one year ago
- 2: 1 year to less than 2 years ago
- 3: 2 years to less than 3 years ago
- 4: 3 or more years ago
- 8: RF
- 9: DK
Smoking (SMK) - Question identifier:SMK_Q065
In what month did you stop?
- 01: January
- 02: February
- 03: March
- 04: April
- 05: May
- 06: June
- 07: July
- 08: August
- 09: September
- 10: October
- 11: November
- 12: December
- 98: RF
- 99: DK
Smoking (SMK) - Question identifier:SMK_Q070
How many years ago was it?
Min = 3; Max = 121
Smoking (SMK) - Question identifier:SMK_Q075
When you smoked every day, how many cigarettes did you usually smoke each day?
Min = 1; Max = 99
Smoking (SMK) - Question identifier:SMK_Q080
When did you stop smoking daily? Was it...?
- 1: Less than one year ago
- 2: 1 year to less than 2 years ago
- 3: 2 years to less than 3 years ago
- 4: 3 or more years ago
- 8: RF
- 9: DK
Smoking (SMK) - Question identifier:SMK_Q085
In what month did you stop?
- 01: January
- 02: February
- 03: March
- 04: April
- 05: May
- 06: June
- 07: July
- 08: August
- 09: September
- 10: October
- 11: November
- 12: December
- 98: RF
- 99: DK
Smoking (SMK) - Question identifier:SMK_Q090
How many years ago was it?
Min = 3; Max = 121
Smoking (SMK) - Question identifier:SMK_Q095
Was that when you completely quit smoking?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Smoking (SMK) - Question identifier:SMK_Q100
When did you stop smoking completely? Was it...?
- 1: Less than one year ago
- 2: 1 year to less than 2 years ago
- 3: 2 years to less than 3 years ago
- 4: 3 or more years ago
- 8: RF
- 9: DK
Smoking (SMK) - Question identifier:SMK_Q105
In what month did you stop?
- 01: January
- 02: February
- 03: March
- 04: April
- 05: May
- 06: June
- 07: July
- 08: August
- 09: September
- 10: October
- 11: November
- 12: December
- 98: RF
- 99: DK
Smoking (SMK) - Question identifier:SMK_Q110
How many years ago was it?
Min = 3; Max = 121
Smoking cessation methods (SCA)
In this module, people who smoke and people who have stopped smoking within the past year are asked about their use of various aids to reduce or quit smoking, and their usefulness. These methods include nicotine patches, nicotine gum or candy and medications such as Zyban.
Information about the use of smoking cessation aids is useful in understanding the effectiveness of these different methods in reducing or stopping smoking. This can be used to design effective programs that encourage people to stop smoking.
Smoking cessation methods (SCA) - Question identifier:SCA_Q005
In the past 12 months, did you try a nicotine patch to reduce or quit smoking?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Smoking cessation methods (SCA) - Question identifier:SCA_Q010
How useful was that in helping you reduce or quit smoking?
- 1: Very useful
- 2: Somewhat useful
- 3: Not very useful
- 4: Not useful at all
- 8: RF
- 9: DK
Smoking cessation methods (SCA) - Question identifier:SCA_Q015
In the past 12 months, did you use nicotine gum such as 'Nicorette' to reduce or quit smoking?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Smoking cessation methods (SCA) - Question identifier:SCA_Q020
How useful was that in helping you reduce or quit smoking?
- 1: Very useful
- 2: Somewhat useful
- 3: Not very useful
- 4: Not useful at all
- 8: RF
- 9: DK
Smoking cessation methods (SCA) - Question identifier:SCA_Q025
In the past 12 months, did you try medication such as Zyban, Wellbutrin or Champix to reduce or quit smoking?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Smoking cessation methods (SCA) - Question identifier:SCA_Q030
How useful was that in helping you reduce or quit smoking?
- 1: Very useful
- 2: Somewhat useful
- 3: Not very useful
- 4: Not useful at all
- 8: RF
- 9: DK
Smoking cessation methods (SCA) - Question identifier:SCA_Q035
In the past 12 months, did you stop smoking for at least 24 hours because you were trying to reduce or quit?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Smoking cessation methods (SCA) - Question identifier:SCA_Q040
In the past 12 months, did you try any of the following to reduce or quit smoking:
a nicotine patch?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Smoking cessation methods (SCA) - Question identifier:SCA_Q045
(In the past 12 months, did you try any of the following to reduce or quit smoking:)
nicotine gum such as Nicorette?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Smoking cessation methods (SCA) - Question identifier:SCA_Q050
(In the past 12 months, did you try any of the following to reduce or quit smoking:)
medication such as Zyban, Wellbutrin or Champix?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Tobacco products alternatives (TAL)
This module deals with the use of cigars, cigarillos, electronic cigarettes, pipes, snuff, chewing tobacco, pinch, and water pipes, all of which are not included in the Smoking module.
These alternatives to cigarettes have different implications for health.
The module will be used to understand which groups are most likely to use these products.
Tobacco products alternatives (TAL) - Question identifier:TAL_R001
Now, I would like to ask you a few questions about tobacco products, other than cigarettes.
Tobacco products alternatives (TAL) - Question identifier:TAL_Q005
In the past 30 days, did you smoke any little cigars or cigarillos?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Tobacco products alternatives (TAL) - Question identifier:TAL_Q010
Were these (little cigars or cigarillos) plain, flavoured or both?
- 1: Plain
- 2: Flavoured
- 3: Both
- 8: RF
- 9: DK
Tobacco products alternatives (TAL) - Question identifier:TAL_Q015
In the past 30 days, did you smoke any cigars other than little cigars or cigarillos?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Tobacco products alternatives (TAL) - Question identifier:TAL_Q020
In the past 30 days, did you use an electronic cigarette, also known as an 'e-cigarette'?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Tobacco products alternatives (TAL) - Question identifier:TAL_Q025
(In the past 30 days,) did you smoke a pipe?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Tobacco products alternatives (TAL) - Question identifier:TAL_Q030
(In the past 30 days,) did you use any chewing tobacco, pinch or snuff?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Tobacco products alternatives (TAL) - Question identifier:TAL_Q035
In the past 30 days, did you smoke a tobacco water-pipe, also known as a hookah, shisha, nargeelay, hubble-bubble or gouza to smoke tobacco?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Nicotine dependence (NDE)
In this module, current smokers are asked a series of questions related to how dependent they are on cigarettes.
Knowing how dependent people are on cigarettes can help health region planners to develop appropriate programs to discourage smoking.
Nicotine dependence (NDE) - Question identifier:NDE_Q005
How soon after you wake up do you smoke your first cigarette?
- 1: Within 5 minutes
- 2: 6 - 30 minutes after waking
- 3: 31 - 60 minutes after waking
- 4: More than 60 minutes after waking
- 8: RF
- 9: DK
Nicotine dependence (NDE) - Question identifier:NDE_Q010
Do you find it difficult to refrain from smoking in places where it is forbidden?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Nicotine dependence (NDE) - Question identifier:NDE_Q015
Which cigarette would you most hate to give up?
- 1: The first one of the day
- 2: Another one
- 8: RF
- 9: DK
Nicotine dependence (NDE) - Question identifier:NDE_Q020
Do you smoke more frequently during the first hours after waking, compared with the rest of the day?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Nicotine dependence (NDE) - Question identifier:NDE_Q025
Do you smoke even if you are so ill that you are in bed most of the day?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Youth access to cigarettes (YAC)
Smoking by teenagers is a major public health issue.
Initially, we ask all current smokers where they usually get their cigarettes. Then the remaining questions are asked only of respondents aged 12-17 and deal with where and how youth obtain cigarettes.
The results of this module may be used to develop regulations concerning the purchase of cigarettes by young people.
Youth access to cigarettes (YAC) - Question identifier:YAC_Q005
Where do you usually get your cigarettes?
(Do you buy them, or does someone usually give them to you? Where do you buy them? Who do you get them from?)
- 01: Buy from - Vending machine
- 02: Buy from - Small grocery / corner store
- 03: Buy from - Supermarket
- 04: Buy from - Drug store
- 05: Buy from - Gas station
- 06: Buy from - Other store
- 07: Buy from or through - Friend or someone else
- 08: Given them by - Brother or sister
- 09: Given them by - Mother or father
- 10: Given them by - Friend or someone else
- 11: Take them from - Mother, father or sibling
- 12: Buy from - a First Nations Reserve (i.e. delivery service)
- 13: Buy on - a First Nations Reserve
- 14: Other
- 98: RF
- 99: DK
Youth access to cigarettes (YAC) - Question identifier:YAC_Q010
In the past 12 months, have you bought or tried to buy cigarettes from a store?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Youth access to cigarettes (YAC) - Question identifier:YAC_Q015
In the past 12 months, have you been asked for ID when buying cigarettes in a store?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Youth access to cigarettes (YAC) - Question identifier:YAC_Q020
(In the past 12 months), has anyone in a store refused to sell you cigarettes?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Youth access to cigarettes (YAC) - Question identifier:YAC_Q025
(In the past 12 months), have you asked anyone to buy cigarettes for you?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Exposure to second hand smoke (ETS)
Exposure to second-hand smoke is known to have a variety of negative effects on health, including lung disease and childhood asthma.
This module includes questions about the number of people who smoke regularly inside the home (including household members and regular visitors), and questions about smoking restrictions in the home. These questions are asked of all respondents.
Respondents who do not smoke are asked how often they have been exposed to second-hand smoke in vehicles, the workplace, school and in public places in the past month.
Exposure to second hand smoke (ETS) - Question identifier:ETS_R001
The next questions are about exposure to second-hand smoke.
Exposure to second hand smoke (ETS) - Question identifier:ETS_Q005
Including both household members and regular visitors, does anyone smoke inside your home, every day or almost every day?
Include cigarettes, cigars and pipes. Smoking inside the home excludes smoking inside the garage, whether attached or detached.
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Exposure to second hand smoke (ETS) - Question identifier:ETS_Q010
How many people smoke inside your home every day or almost every day?
Min = 1; Max = 15
Include household members and regular visitors. Include cigarettes, cigars and pipes.
Exposure to second hand smoke (ETS) - Question identifier:ETS_Q015
Is smoking allowed inside your home?
Include cigarettes, cigars and pipes. Smoking inside the home excludes smoking inside the garage, whether attached or detached.
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Exposure to second hand smoke (ETS) - Question identifier:ETS_Q020
Is smoking inside your home restricted in any way?
Include cigarettes, cigars and pipes. Smoking inside the home excludes smoking inside the garage, whether attached or detached.
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Exposure to second hand smoke (ETS) - Question identifier:ETS_Q025
How is smoking restricted inside your home?
- 1: Allowed in certain rooms only
- 2: Restricted in the presence of young children
- 3: Allowed only if windows are open or with another type of ventilation
- 4: Other restriction(s)
- 8: RF
- 9: DK
Exposure to second hand smoke (ETS) - Question identifier:ETS_Q030
In the past month, were you exposed to second-hand smoke, every day or almost every day, at your workplace or at school?
Include cigarettes, cigars and pipes.
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Exposure to second hand smoke (ETS) - Question identifier:ETS_Q035
In the past month, were you exposed to second-hand smoke, every day or almost every day, in a car or other private vehicle?
Include cigarettes, cigars and pipes.
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Exposure to second hand smoke (ETS) - Question identifier:ETS_Q040
In the past month, were you exposed to second-hand smoke, every day or almost every day, in public places (such as bars, restaurants, shopping malls, arenas, bingo halls, bowling alleys)?
Include cigarettes, cigars and pipes.
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Alcohol use (ALC)
Consumption of alcohol has a number of implications for health. Excessive drinking is related to a number of diseases and social and mental health problems. Drinking is also a leading cause of accidents and injuries.
This module includes questions about how often and how much alcohol the respondent has drunk in the past 12 months, and if they have ever had a drink in their life.
This module will help researchers and health planners to understand patterns of alcohol consumption. For example, which groups are more likely to binge drink, i.e., drink 4 (or 5 in the case of males) or more drinks on one occasion.
Alcohol use (ALC) - Question identifier:ALC_R001
Now, some questions about your alcohol consumption.
A 'drink' refers to:
- a bottle or small can of beer, cider or cooler with 5% alcohol content, or a small draft;
- a glass of wine with 12% alcohol content;
- a glass or cocktail containing 1½ oz. of a spirit with 40% alcohol content.
Alcohol use (ALC) - Question identifier:ALC_Q005
Have you ever had a drink in your lifetime?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Alcohol use (ALC) - Question identifier:ALC_Q010
During the past 12 months, that is, from [Date one year ago] to yesterday, have you had a drink of beer, wine, liquor or any other alcoholic beverage?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Alcohol use (ALC) - Question identifier:ALC_Q015
During the past 12 months, how often did you drink alcoholic beverages?
- 1: Less than once a month
- 2: Once a month
- 3: 2 to 3 times a month
- 4: Once a week
- 5: 2 to 3 times a week
- 6: 4 to 6 times a week
- 7: Every day
- 8: RF
- 9: DK
Alcohol use (ALC) - Question identifier:ALC_Q020
How often in the past 12 months have you had [4 / 5] or more drinks on one occasion?
- 1: Never
- 2: Less than once a month
- 3: Once a month
- 4: 2 to 3 times a month
- 5: Once a week
- 6: More than once a week
- 8: RF
- 9: DK
Alcohol use during the past week (ALW)
This module asks those who had a drink in the past 12 months about their drinking consumption on each day of the past week.
This module will be used to see how the population abides by the Low Risk Drinking Guidelines.
Alcohol use during the past week (ALW) - Question identifier:ALW_Q005
Thinking back over the past week, that is, from last [Day of the week 7 days ago] to yesterday, did you have a drink of beer, wine, liquor or any other alcoholic beverage?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Alcohol use during the past week (ALW) - Question identifier:ALW_Q010
Starting with yesterday, that is [Day 1], how many drinks did you have?
Min = 0; Max = 99
Alcohol use during the past week (ALW) - Question identifier:ALW_Q015
How many drinks did you have:
on [Day 2]?
Min = 0; Max = 99
Alcohol use during the past week (ALW) - Question identifier:ALW_Q020
How many drinks did you have:
on [Day 3]?
Min = 0; Max = 99
Alcohol use during the past week (ALW) - Question identifier:ALW_Q025
How many drinks did you have:
on [Day 4]?
Min = 0; Max = 99
Alcohol use during the past week (ALW) - Question identifier:ALW_Q030
How many drinks did you have:
on [Day 5]?
Min = 0; Max = 99
Alcohol use during the past week (ALW) - Question identifier:ALW_Q035
How many drinks did you have:
on [Day 6]?
Min = 0; Max = 99
Alcohol use during the past week (ALW) - Question identifier:ALW_Q040
How many drinks did you have:
on [Day 7]?
Min = 0; Max = 99
Antibiotic medication use (AMU)
This module collects information about the use of oral antibiotics that are prescribed in Canada. In this module, oral antibiotic prescriptions include those prescribed by physicians and pharmacists, and those received in a hospital for later use. It excludes antibiotics that are administered to patients while they are in the hospital.
Data collected by this module include: the number of prescriptions per respondent and the medical reason for the prescription; the place the prescription originated (e.g., physician's office, pharmacy, dentist); patient adherence to the prescribed antibiotic treatment; and ways of discarding leftover antibiotics.
The overuse of antibiotics, the use of non-prescribed antibiotics, or non-adherence to prescribed treatment (e.g., not completing all the medication) may be contributing to an increase in antibiotic-resistant bacteria. The data from this module will be used to assess the different types of antibiotic-use behaviour.
Antibiotic medication use (AMU) - Question identifier:AMU_R005
The next questions are about oral antibiotics that have been prescribed to you in the past 12 months, including those received at a hospital for later use. Please exclude the antibiotics administered to you while in the hospital.
Oral antibiotics are taken by mouth and are used to treat infections.
Antibiotic medication use (AMU) - Question identifier:AMU_Q005
In the past 12 months, have you been prescribed any oral antibiotics?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Antibiotic medication use (AMU) - Question identifier:AMU_Q010
In the past 12 months, were you prescribed more than one (oral antibiotic)?
- 1: Yes
- 2: No, just one
- 8: RF
- 9: DK
Antibiotic medication use (AMU) - Question identifier:AMU_Q015
[Thinking of the last time you were prescribed an oral antibiotic (in the past 12 months)], what medical reason was your prescription for?
- 1: Chest infection (e.g., bronchitis, bronchiolitis, pneumonia, chest cough)
- 2: Ear, nose, throat, sinus, eye infection (e.g., strep throat, pink eye, sinusitis, sore throat, pharyngitis, tonsillitis)
- 3: Urinary tract infection - UTI (e.g., bladder, kidney, urethra infection)
- 4: Skin infection (e.g., acne, cellulitis, abscess, boil, nail infection)
- 5: Gastrointestinal infection (e.g., food poisoning, diarrhea, vomiting, gastritis, ulcer)
- 6: Other (e.g., dental infection, STIs, gonorrhea, chlamydia, blood infection, sepsis, bone infection, osteomyelitis)
- 8: RF
- 9: DK
Antibiotic medication use (AMU) - Question identifier:AMU_Q020
(Thinking about this last oral antibiotic), was it prescribed at a...?
"Another place" can include a medical specialist's office, pharmacy or optometrist's office.
- 1: Walk-in clinic or doctor's office
- 2: Hospital as an outpatient (e.g., emergency ward or day clinic)
- 3: Hospital while you were admitted
- 4: Dentist's office
- 5: Another place
- 8: RF
- 9: DK
Antibiotic medication use (AMU) - Question identifier:AMU_Q025
(Thinking about this last oral antibiotic) did you, or someone on your behalf, receive information from a health care professional, including a pharmacist, on how to take it?
By "how to take it", we mean the frequency and duration of taking them, the reasons why they were prescribed, the consequences of not complying, etc. The information could have been provided verbally or in writing.
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Antibiotic medication use (AMU) - Question identifier:AMU_Q030
(Again, thinking about this last oral antibiotic), did you take it as prescribed?
Taking "as prescribed" means taking the exact amount of antibiotic per day, for the number of days prescribed.
- 1: Yes (took it as prescribed)
- 2: No (did not take it as prescribed)
- 3: Not applicable (did not get prescription filled))
- 4: Still taking it
- 8: RF
- 9: DK
Antibiotic medication use (AMU) - Question identifier:AMU_Q035
In what way did you not take it as prescribed?
"Another way" could include not following other suggested guidelines, such as taking the antibiotic with or without food.
- 1: Incorrect daily dosage, such as missing a dose / taking too many or too few
- 2: Did not finish it
- 3: Another way
- 4: Did not take it at all
- 8: RF
- 9: DK
Antibiotic medication use (AMU) - Question identifier:AMU_Q040
In the past 12 months, thinking of all the oral antibiotics you were prescribed, did you have any left?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Antibiotic medication use (AMU) - Question identifier:AMU_Q045
What did you do with them?
- 1: Threw them in the garbage
- 2: Flushed them down the toilet / sink
- 3: Kept them / did nothing
- 4: Gave them to someone else for their use
- 5: Returned them to the pharmacy
- 6: Other action
- 8: RF
- 9: DK
Cannabis use (CAN)
In 2018, the Canadian government legalized the use of non-medical cannabis, allowing Canadians to legally purchase and consume cannabis for recreational purposes.
The purpose of this module is collect information about the use of cannabis in Canada. Respondents are asked if they have ever tried cannabis and the age of first use; the frequency of cannabis use in the past twelve months, in the past 30 days, and daily consumption. This module asks respondents about medical versus recreational marijuana use, and then asks respondents to report any health, social, legal, or financial impacts of their cannabis use.
This information will be used to gain a better understanding of the scope of cannabis use in Canada, and the impact of cannabis use on the health and well-being of Canadians.
Cannabis use (CAN) - Question identifier:CAN_R005
The next few questions are about the use of cannabis for medical and non-medical purposes. The term "cannabis" refers to marijuana, hashish, hash oil or any other product of the cannabis plant.
Cannabis use (CAN) - Question identifier:CAN_Q005
Have you ever used or tried cannabis?
- 1: Yes, just once
- 2: Yes, more than once
- 3: No
- 8: RF
- 9: DK
Cannabis use (CAN) - Question identifier:CAN_Q010
At what age did you first try cannabis?
Min = 5; Max = 121
Cannabis use (CAN) - Question identifier:CAN_Q015
Have you used cannabis in the past 12 months?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Cannabis use (CAN) - Question identifier:CAN_Q020
How often (did you use cannabis in the past 12 months)?
Please report the average use in the last 12 months.
- 1: Less than once a month
- 2: 1 to 3 times a month
- 3: Once a week
- 4: More than once a week
- 5: Daily or almost daily
- 8: RF
- 9: DK
Cannabis use (CAN) - Question identifier:CAN_Q025
In the past 12 months, which of the following methods did you use most often?
- 1: Smoked
- 2: Vaporized
- 3: Consumed in food or drink
- 4: Other - Specify
- 8: RF
- 9: DK
Cannabis use (CAN) - Question identifier:CAN_Q030
(In the past 12 months), have you used cannabis for...?
- 1: Non-medical purposes only
- 2: Medical purposes only, either with or without a medical document
- 3: Both medical and non-medical purposes
- 8: RF
- 9: DK
Cannabis use (CAN) - Question identifier:CAN_Q035
In the past 12 months, when you used cannabis for medical purposes, which symptoms were you using it for?
- 01: Pain
- 02: Nausea / vomiting
- 03: Lack of appetite / weight loss
- 04: Headaches / migraines
- 05: Muscle spasms or seizures
- 06: Anxiety / depression
- 07: Symptoms of PTSD
- 08: Problems sleeping
- 09: Opioid withdrawal symptoms
- 10: Other - Specify
- 98: RF
- 99: DK
Cannabis use (CAN) - Question identifier:CAN_Q040
Do you have a medical document from a health care professional to use cannabis for medical purposes?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Cannabis use (CAN) - Question identifier:CAN_Q045
In the past 12 months, has your use of cannabis led to health, social, legal or financial problems?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Cannabis use (CAN) - Question identifier:CAN_Q050
At any time in the past 12 months, have you failed to do what was normally expected of you because of your use of cannabis?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Cannabis use (CAN) - Question identifier:CAN_Q055
(In the past 12 months), has a relative, friend, doctor or other health professional been concerned about your use of cannabis or suggested you cut down?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Cannabis use (CAN) - Question identifier:CAN_Q060
In the past 30 days, how often did you use cannabis?
- 1: Never
- 2: 1 day
- 3: 2 or 3 days
- 4: 1 or 2 day(s) per week
- 5: 3 or 4 days per week
- 6: 5 or 6 days per week
- 7: Daily
- 8: RF
- 9: DK
Cannabis use (CAN) - Question identifier:CAN_Q065
At what age did you begin to use cannabis daily or almost daily?
Min = 5; Max = 121
Severity of cannabis dependence scale (SDS)
In 2018, the Canadian government legalized the use of non-medical marijuana, allowing Canadians to legally purchase and consume cannabis for recreational purposes.
The purpose of the severity of cannabis dependence scale is to measure respondents' psychological dependence on cannabis, and it uses five questions to determine this. Each of the 5 questions uses a 4-point scale, which is then totalled, with a higher score indicating a higher level of dependence.
The data collected does not differentiate between medical and recreational cannabis use.
This information will be used to gain a better understanding of the scope of cannabis dependence in Canada.
Severity of cannabis dependence scale (SDS) - Question identifier:SDS_R005
You may feel like some of the following questions do not apply to you; however, it is important that they be asked in this survey.
Severity of cannabis dependence scale (SDS) - Question identifier:SDS_Q005
In the past 12 months, how often do you think your use of cannabis was out of control?
- 1: Never / almost never
- 2: Sometimes
- 3: Often
- 4: Always / nearly always
- 8: RF
- 9: DK
Severity of cannabis dependence scale (SDS) - Question identifier:SDS_Q010
In the past 12 months, how often did the idea of missing a dose of cannabis make you anxious or worried?
- 1: Never / almost never
- 2: Sometimes
- 3: Often
- 4: Always / nearly always
- 8: RF
- 9: DK
Severity of cannabis dependence scale (SDS) - Question identifier:SDS_Q015
(In the past 12 months), how often did you worry about your use of cannabis?
- 1: Never / almost never
- 2: Sometimes
- 3: Often
- 4: Always / nearly always
- 8: RF
- 9: DK
Severity of cannabis dependence scale (SDS) - Question identifier:SDS_Q020
(In the last 12 months), how often did you wish you could stop using cannabis?
- 1: Never / almost never
- 2: Sometimes
- 3: Often
- 4: Always / nearly always
- 8: RF
- 9: DK
Severity of cannabis dependence scale (SDS) - Question identifier:SDS_Q025
How difficult would it be for you to stop or go without using cannabis?
- 1: Not difficult
- 2: Quite difficult
- 3: Very difficult
- 4: Impossible
- 8: RF
- 9: DK
Drug use (DRG)
This module asks about the use of a number of drugs used and whether they were used in the past 12 months, including cocaine, amphetamines, ecstasy, hallucinogens, solvents and non-prescription needle injections.
The answers to these questions will be used to identify which groups could benefit from treatment programs.
Drug use (DRG) - Question identifier:DRG_R005
I am now going to ask questions on your use of various drugs.
Drug use (DRG) - Question identifier:DRG_Q020
Have you ever used or tried cocaine in any form, including crack, freebase, powder or snow?
- 1: Yes, just once
- 2: Yes, more than once
- 3: No
- 8: RF
- 9: DK
Drug use (DRG) - Question identifier:DRG_Q025
Was this in the past 12 months?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Drug use (DRG) - Question identifier:DRG_Q030
Have you ever used or tried amphetamines, speed, methamphetamines or crystal meth?
- 1: Yes, just once
- 2: Yes, more than once
- 3: No
- 8: RF
- 9: DK
Drug use (DRG) - Question identifier:DRG_Q035
Was this in the past 12 months?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Drug use (DRG) - Question identifier:DRG_Q040
Have you ever used or tried ecstasy, also known as MDMA, E, Xtc, Adam or X?
- 1: Yes, just once
- 2: Yes, more than once
- 3: No
- 8: RF
- 9: DK
Drug use (DRG) - Question identifier:DRG_Q045
Was this in the past 12 months?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Drug use (DRG) - Question identifier:DRG_Q050
Have you ever used or tried hallucinogens such as PCP, LSD, acid, magic mushrooms, mescaline or angel dust?
Salvia is also considered to be an hallucinogen.
- 1: Yes, just once
- 2: Yes, more than once
- 3: No
- 8: RF
- 9: DK
Drug use (DRG) - Question identifier:DRG_Q055
Was this in the past 12 months?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Drug use (DRG) - Question identifier:DRG_Q060
Have you ever sniffed glue, gasoline or other solvents to get high?
- 1: Yes, just once
- 2: Yes, more than once
- 3: No
- 8: RF
- 9: DK
Drug use (DRG) - Question identifier:DRG_Q065
Was this in the past 12 months?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Drug use (DRG) - Question identifier:DRG_Q070
Have you ever used a needle to inject or be injected with a drug not prescribed by a doctor?
- 1: Yes, just once
- 2: Yes, more than once
- 3: No
- 8: RF
- 9: DK
Drug use (DRG) - Question identifier:DRG_Q075
Was this in the past 12 months?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Drug use (DRG) - Question identifier:DRG_Q080
Which of the following drugs have you injected using a needle?
- 1: Cocaine
- 2: Heroin or opium
- 3: Methamphetamine
- 4: Steroids
- 5: Other
- 6: I have never injected a drug using a needle
- 8: RF
- 9: DK
Gambling (GAM)
In this module, respondents are asked about the type and frequency of various online and in-person gambling activities such as lotteries, organized betting, and casual wagers that have occurred in the past 12 months.
Questions related to attitudes and experiences of gambling are then asked and respondents are asked to indicate any financial, social, or mental health consequences they may have experienced in relation to their gambling activities.
This information will be used to gain a better understanding of the frequency of various types of gambling and the extent to which gambling interferes with people's lives.
Gambling (GAM) - Question identifier:GAM_R001
The following questions are about various types of gambling activities. Please think about all forms of gambling done either in person or online, including lotteries, organized betting and casual wagers with friends.
Gambling (GAM) - Question identifier:GAM_Q005
In the past 12 months, how often have you purchased or played instant lottery tickets, such as scratch, break-open or pull-tabs, or played instant online games?
Include instant games only (exclude lotteries such as Lotto Max, 6/49 etc.).
- 1: Never
- 2: Less than once a month
- 3: Once a month
- 4: Two or three times a month
- 5: Once a week
- 6: Several times a week
- 8: RF
- 9: DK
Gambling (GAM) - Question identifier:GAM_Q010
And how often have you played or spent money on lottery or raffle tickets, excluding sports lottery tickets (in the past 12 months)?
This includes Lotto 6/49, Lotto Max, Daily Grand, provincial/regional lotteries, hospital lotteries, 50-50 tickets.
- 1: Never
- 2: Less than once a month
- 3: Once a month
- 4: Two or three times a month
- 5: Once a week
- 6: Several times a week
- 8: RF
- 9: DK
Gambling (GAM) - Question identifier:GAM_Q015
In the past 12 months, how often have you bet or spent money on electronic gambling machines, such as slot machines, VLTs, electronic blackjack, electronic roulette or video poker, either in person or online?
This refers to stand-alone machines and also includes electronic bingo machines, electronic craps, electronic keno machines, electronic racing machines. Include playing at any location, in any country.
- 1: Never
- 2: Less than once a month
- 3: Once a month
- 4: Two or three times a month
- 5: Once a week
- 6: Several times a week
- 8: RF
- 9: DK
Gambling (GAM) - Question identifier:GAM_Q020
Now, excluding electronic machine versions, how often in the past 12 months have you bet or spent money on casino table games like poker, blackjack, baccarat, or roulette? Please include any location, whether at a casino, a private residence, online or anywhere else.
This also includes, craps, mah-jong, sic bo, pai gow.
- 1: Never
- 2: Less than once a month
- 3: Once a month
- 4: Two or three times a month
- 5: Once a week
- 6: Several times a week
- 8: RF
- 9: DK
Gambling (GAM) - Question identifier:GAM_Q025
In the past 12 months, how often have you bet money on sports such as hockey, football, horseracing, billiards or golf including pools, sports lottery, and bets made with friends?
Includes sport lottery tickets (Proline, Sports Select, Mise-O-Jeu); e-sports (professional video game competitions); fantasy sports (point totals from a 'fantasy team' composed of players selected from different teams); virtual sports (computer generated competitions); and sports the person participates in themselves (e.g., billiards or pool, bowling, golf, darts).
- 1: Never
- 2: Less than once a month
- 3: Once a month
- 4: Two or three times a month
- 5: Once a week
- 6: Several times a week
- 8: RF
- 9: DK
Gambling (GAM) - Question identifier:GAM_Q030
In the past 12 months, how often have you spent money playing Bingo, excluding instant Bingo games?
This includes Bingo played while the numbers are drawn, such as at a bingo hall, excluding instant Bingo games like scratch tickets or electronic machine versions.
- 1: Never
- 2: Less than once a month
- 3: Once a month
- 4: Two or three times a month
- 5: Once a week
- 6: Several times a week
- 8: RF
- 9: DK
Gambling (GAM) - Question identifier:GAM_Q035
How often in the past 12 months have you bet or spent money on any other forms of gambling that have not been mentioned?
Examples include keno, animal fights, dog racing, non-casino card or dice games such as rummy or backgammon, video games, board games, television events (e.g., reality show winners), political events.
- 1: Never
- 2: Less than once a month
- 3: Once a month
- 4: Two or three times a month
- 5: Once a week
- 6: Several times a week
- 8: RF
- 9: DK
Gambling (GAM) - Question identifier:GAM_Q040
In the past 12 months, how often have you engaged in any speculative financial market activities such as day trading, penny stocks, shorting, options, currency futures, etc.?
Also includes betting on the direction or future value of a financial index (e.g., TSX, currency value) on a gambling website.
- 1: Never
- 2: Less than once a month
- 3: Once a month
- 4: Two or three times a month
- 5: Once a week
- 6: Several times a week
- 8: RF
- 9: DK
Gambling (GAM) - Question identifier:GAM_Q045
For the types of gambling that you reported participating in, has your involvement been in-person, online, or both?
Also includes online purchase of lottery tickets.
- 1: Online
- 2: In person
- 3: Both
- 8: RF
- 9: DK
Gambling (GAM) - Question identifier:GAM_R050
You may feel like some of the following questions do not apply to you; however, it is important that they are asked in this survey.
Gambling (GAM) - Question identifier:GAM_Q050
In the past 12 months, how often have you bet more than you could really afford to lose?
- 1: Never
- 2: Sometimes
- 3: Most of the time
- 4: Almost always
- 8: RF
- 9: DK
Gambling (GAM) - Question identifier:GAM_Q055
In the past 12 months, how often have you needed to gamble with larger amounts of money to get the same feeling of excitement?
- 1: Never
- 2: Sometimes
- 3: Most of the time
- 4: Almost always
- 8: RF
- 9: DK
Gambling (GAM) - Question identifier:GAM_Q060
(In the past 12 months), when you gambled, how often did you go back another day to try to win back the money you lost?
- 1: Never
- 2: Sometimes
- 3: Most of the time
- 4: Almost always
- 8: RF
- 9: DK
Gambling (GAM) - Question identifier:GAM_Q065
(In the past 12 months), have you borrowed money or sold anything to get money to gamble?
- 1: Never
- 2: Sometimes
- 3: Most of the time
- 4: Almost always
- 8: RF
- 9: DK
Gambling (GAM) - Question identifier:GAM_Q070
(In the past 12 months), how often has your gambling caused any financial problems for you or your household?
- 1: Never
- 2: Sometimes
- 3: Most of the time
- 4: Almost always
- 8: RF
- 9: DK
Gambling (GAM) - Question identifier:GAM_Q075
(In the past 12 months), how often have you felt that you might have a problem with gambling?
- 1: Never
- 2: Sometimes
- 3: Most of the time
- 4: Almost always
- 8: RF
- 9: DK
Gambling (GAM) - Question identifier:GAM_Q080
(In the past 12 months), how often has your gambling caused you any health problems, including stress or anxiety?
- 1: Never
- 2: Sometimes
- 3: Most of the time
- 4: Almost always
- 8: RF
- 9: DK
Gambling (GAM) - Question identifier:GAM_Q085
(In the past 12 months), how often have people criticized your betting or told you that you had a gambling problem, regardless of whether or not you thought it was true?
- 1: Never
- 2: Sometimes
- 3: Most of the time
- 4: Almost always
- 8: RF
- 9: DK
Gambling (GAM) - Question identifier:GAM_Q090
(In the past 12 months), how often have you felt guilty about the way you gamble or what happens when you gamble?
- 1: Never
- 2: Sometimes
- 3: Most of the time
- 4: Almost always
- 8: RF
- 9: DK
Physical activities - adults 18 years and older (PAA)
Answers to this module are used to determine how active respondents, 18 years of age and older, have been in the last seven days.
Respondents are asked if they have spent a minimum of 10 minutes of physical activity, and on which days of the week, doing various activities, such as walking or cycling to get to places, sports or recreational activities that caused sweating or heavy breathing. They are also asked how much time in total was spent doing vigorous activities.
Higher levels of activity are widely thought to be associated with better health.
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_R001
The following questions are about various types of physical activities done in the last 7 days. I want you to only think of activities you did for a minimum of 10 continuous minutes.
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_Q005
In the last 7 days, that is from last [Day of the week 7 days ago] to yesterday, did you use active ways like walking or cycling to get to places such as work, school, the bus stop, the shopping centre or to visit friends?
Do not include walking, cycling or other activities done purely for leisure. These activities will be asked about later.
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_Q010
In the last 7 days, on which days did you do these activities?
- 1: Monday
- 2: Tuesday
- 3: Wednesday
- 4: Thursday
- 5: Friday
- 6: Saturday
- 7: Sunday
- 8: RF
- 9: DK
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_Q015
How much time in total, in the last 7 days, did you spend doing these activities? Please only include activities that lasted a minimum of 10 continuous minutes.
Min = 0; Max = 168
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_N020
Enter number of minutes.
Min = 0; Max = 9995
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_Q030
[Not including activities you just reported,] in the last 7 days, did you do sports, fitness or recreational physical activities, organized or non-organized, that lasted a minimum of 10 continuous minutes?
Examples are walking, home or gym exercise, swimming, cycling, running, skiing, dancing and all team sports.
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_Q035
Did any of these recreational physical activities make you sweat at least a little and breathe harder?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_Q040
In the last 7 days, on which days did you do these recreational activities that made you sweat at least a little and breathe harder?
- 1: Monday
- 2: Tuesday
- 3: Wednesday
- 4: Thursday
- 5: Friday
- 6: Saturday
- 7: Sunday
- 8: RF
- 9: DK
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_Q045
In the last 7 days, how much time in total did you spend doing these activities that made you sweat at least a little and breathe harder?
Min = 0; Max = 168
Include only those physical activities that lasted at least 10 minutes at a time, including rest periods.
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_N050
Enter number of minutes.
Min = 0; Max = 9995
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_Q060
In the last 7 days, did you do any other physical activities while at work, in or around your home or while volunteering?
Examples are carrying heavy loads, shoveling, and household chores such as vacuuming or washing windows. Please remember to only include activities that lasted a minimum of 10 continuous minutes.
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_Q065
Did any of these other physical activities make you sweat at least a little and breathe harder?
Exclude physical activities already reported
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_Q070
In the last 7 days, on which days did you do these other activities that made you sweat at least a little and breathe harder?
- 1: Monday
- 2: Tuesday
- 3: Wednesday
- 4: Thursday
- 5: Friday
- 6: Saturday
- 7: Sunday
- 8: RF
- 9: DK
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_Q075
In the last 7 days, how much time in total did you spend doing these activities that made you sweat at least a little and breathe harder?
Min = 0; Max = 168
Include only those physical activities that lasted at least 10 minutes at a time, including rest periods.
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_N080
Enter number of minutes.
Min = 0; Max = 9995
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_Q095
You have reported a total of [Total number of minutes] minutes of physical activity. Of these activities, were there any of vigorous intensity, meaning they caused you to be out of breath?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_Q100
In the last 7 days, how much time in total did you spend doing vigorous activities that caused you to be out of breath?
Min = 0; Max = 168
Include only those physical activities that lasted at least 10 minutes at a time, including rest periods.
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_N105
Enter number of minutes.
Min = 0; Max = 9995
Physical activities for youth (PAY)
Answers to this module are used to determine how active respondents, aged 12 to 17, have been in the last seven days.
Respondents are asked on which days of the week they have been active, and for how long, doing various activities such as walking or cycling (to get to school, work, the shopping centre or to visit friends), or participating in sports or recreational activities or other activities that caused sweating or heavy breathing. They are also asked how much time in total was spent doing vigorous activities.
Higher levels of activity are widely thought to be associated with better health.
Physical activities for youth (PAY) - Question identifier:PAY_R001
The following questions are about various types of physical activities that you have done each day in the past week.
Physical activities for youth (PAY) - Question identifier:PAY_Q005
During the last 7 days, that is from last [Day of the week 7 days ago] to yesterday, did you...?
- 1: Attend school
- 2: Attend a day camp
- 3: Attend paid or unpaid work
- 4: None of the above
- 8: RF
- 9: DK
Physical activities for youth (PAY) - Question identifier:PAY_Q010
In the last 7 days, did you use active ways like walking or cycling to get to places such [school,] the bus stop, the shopping centre, [work] or to visit friends?
Do not include walking, cycling or other activities done purely for leisure. These activities will be asked about later.
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Physical activities for youth (PAY) - Question identifier:PAY_Q015
How much time did you spend using active ways to get to places...
...yesterday?
...on [2 days ago]?
...on [3 days ago]?
...on [4 days ago]?
...on [5 days ago]?
...on [6 days ago]?
...on [7 days ago]?
Min = 0; Max = 10080
Physical activities for youth (PAY) - Question identifier:PAY_Q025
In the last 7 days, did you do sports, fitness or recreational physical activities while at [school [or day camp], including during physical education classes, during your breaks and any other time you played indoors or outdoors / day camp, including any time you played indoors or outdoors]?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Physical activities for youth (PAY) - Question identifier:PAY_Q030
Did any of these activities make you sweat at least a little and breathe harder?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Physical activities for youth (PAY) - Question identifier:PAY_Q035
How much time did you spend doing these activities at [school / day camp / school or day camp] that made you sweat at least a little and breathe harder...
...yesterday?
...on [2 days ago]?
...on [3 days ago]?
...on [4 days ago]?
...on [5 days ago]?
...on [6 days ago]?
...on [7 days ago]?
Min = 0; Max = 10080
Physical activities for youth (PAY) - Question identifier:PAY_Q045
In the last 7 days, did you do physical activities in your leisure time including exercising, playing an organized or non-organized sport or playing with your friends?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Physical activities for youth (PAY) - Question identifier:PAY_Q050
Did any of these leisure-time activities make you sweat at least a little and breathe harder?
Exclude physical activities already reported.
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Physical activities for youth (PAY) - Question identifier:PAY_Q055
How much time did you spend doing these leisure-time activities that made you sweat at least a little and breathe harder...
...yesterday?
...on [2 days ago]?
...on [3 days ago]?
...on [4 days ago]?
...on [5 days ago]?
...on [6 days ago]?
...on [7 days ago]?
Min = 0; Max = 10080
Physical activities for youth (PAY) - Question identifier:PAY_Q065
In the last 7 days, did you do any other physical activities [that you have not already reported], for example, while you were [doing paid or unpaid work or] helping your family with chores?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Physical activities for youth (PAY) - Question identifier:PAY_Q070
Did any of these other physical activities make you sweat at least a little and breathe harder?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Physical activities for youth (PAY) - Question identifier:PAY_Q075
How much time did you spend doing these other physical activities that made you sweat at least a little and breathe harder...
...yesterday?
...on [2 days ago]?
...on [3 days ago]?
...on [4 days ago]?
...on [5 days ago]?
...on [6 days ago]?
...on [7 days ago]?
Min = 0; Max = 10080
Physical activities for youth (PAY) - Question identifier:PAY_Q090
You have reported a total of [Total number of minutes] minutes of physical activity. Of these activities, were there any of vigorous intensity, meaning they caused you to be out of breath?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Physical activities for youth (PAY) - Question identifier:PAY_Q095
In the last 7 days, on which days did you do these vigorous activities that caused you to be out of breath?
- 1: Yesterday
- 2: [2 days ago]
- 3: [3 days ago]
- 4: [4 days ago]
- 5: [5 days ago]
- 6: [6 days ago]
- 7: [7 days ago]
- 8: RF
- 9: DK
Physical activities for youth (PAY) - Question identifier:PAY_Q100
In the last 7 days, how much time in total did you spend doing vigorous activities that caused you to be out of breath?
Min = 0; Max = 168
Physical activities for youth (PAY) - Question identifier:PAY_N105
Enter number of minutes.
Min = 0; Max = 9995
Sedentary behaviours (SBE)
Sedentary behaviour refers to time spent seated with little or no physical activity. In this module, respondents are asked how many hours of their free time, in the last seven days, they spent watching television or a screen on any electronic device while sitting or lying down. The answers to these questions are important in understanding overall health because too much sedentary time can be associated with lack of physical exercise, poor nutrition and other health problems.
Sedentary behaviours (SBE) - Question identifier:SBE_R001
The next questions are about the time you spent sitting in the last 7 days.
Sedentary behaviours (SBE) - Question identifier:SBE_Q005
On a school or work day, how much of your free time did you spend watching television or a screen on any electronic device while sitting or lying down?
- 1: 2 hours or less per day
- 2: More than 2 hours but less than 4 hours
- 3: 4 hours to less than 6 hours
- 4: 6 hours to less than 8 hours
- 5: 8 hours or more per day
- 6: Was not at work or school
- 8: RF
- 9: DK
Sedentary behaviours (SBE) - Question identifier:SBE_Q010
On a day that was not a school or workday, how much of your free time did you spend watching television or a screen on any electronic device while sitting or lying down?
- 1: 2 hours or less per day
- 2: More than 2 hours but less than 4 hours
- 3: 4 hours to less than 6 hours
- 4: 6 hours to less than 8 hours
- 5: 8 hours or more per day
- 8: RF
- 9: DK
Sexual behaviours (SXB)
Understanding sexual behaviours is a very important part of understanding population health. These questions will help monitor important public health issues such as risk of sexually transmitted infections and unintended pregnancies.
Some respondents may find the questions very personal and may not be comfortable answering some or all of the questions. Responses of "don't know" and "refuse" are acceptable responses for all questions in the module.
This module asks respondents (aged 15 to 64) about sexual activity during the past 12 months. It deals with vaginal and anal sex; sex with male and female partners; condom use and other methods of protection; and pregnancy avoidance.
Sexual behaviours (SXB) - Question identifier:SXB_R001
The next questions are about sexual behaviours. Some questions may sound sensitive to you, but they are included in this survey because they will help monitor important public health issues such as risk of sexually transmitted infections and unintended pregnancies.
Sexual behaviours (SXB) - Question identifier:SXB_Q005
Have you ever had sex? Please include vaginal and anal sex.
Exclude oral sex. Vaginal sex implies that the penis is inserted in the vagina and anal sex implies that the penis is inserted in the anus.
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Sexual behaviours (SXB) - Question identifier:SXB_Q030
In the past 12 months, have you had sex with a female?
Include vaginal and anal sex.
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Sexual behaviours (SXB) - Question identifier:SXB_Q060
In the past 12 months, have you had sex with a male?
Include vaginal and anal sex.
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Sexual behaviours (SXB) - Question identifier:SXB_Q075
Was your last sex partner a male or female?
Include vaginal and anal sex.
- 1: Male
- 2: Female
- 3: Both male and female (at same time)
- 8: RF
- 9: DK
Sexual behaviours (SXB) - Question identifier:SXB_Q080
Did you or your partner use a condom the last time you had sex?
Include vaginal and anal sex.
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Sexual behaviours (SXB) - Question identifier:SXB_Q095
What other methods of protection did you and your partner use the last time you had sex?
Mark all that apply. Include vaginal and anal sex.
- 01: Withdrawal or pulling out
- 02: Vasectomy or tubal sterilization ("tubes tied")
- 03: Birth control pill
- 04: Injection (e.g., Depo-Provera)
- 05: Spermicidal foam, jelly, cream, film, suppository
- 06: Hormonal implant
- 07: Rhythm method (tracking ovulation cycle)
- 08: Contraceptive Patch (e.g., Ortho-Evra)
- 09: Vaginal contraceptive ring (e.g., Nuva-ring)
- 10: Intrauterine Device (IUD) (e.g., Mirena), coil, loop
- 11: None
- 12: Other - Specify
- 98: RF
- 99: DK
Sexual behaviours (SXB) - Question identifier:SXB_R150
I'm going to read you a statement about pregnancy. Please tell me if you strongly agree, agree, neither agree nor disagree, disagree, or strongly disagree.
Sexual behaviours (SXB) - Question identifier:SXB_Q150
It is important to me to avoid getting pregnant right now.
- 1: Strongly agree
- 2: Agree
- 3: Neither agree nor disagree
- 4: Disagree
- 5: Strongly disagree
- 8: RF
- 9: DK
Maternal experiences (MEX)
Increasingly, health promotion programs are targeted at very young children. Researchers believe that children who have a good start in life become healthier teenagers and adults.
The focus of the next 3 modules is the behaviour of new mothers (aged 15 to 55) of babies under 6 years old.
The questions in the first module cover topics such as folic acid and iron supplements, weight gain, breastfeeding, sleeping arrangements for the child, and the child's diet.
The results of this module can be used to identify which groups of women could benefit from educational programs that promote healthier babies.
Maternal experiences (MEX) - Question identifier:MEX_R001
The next questions are specific to women's health.
Maternal experiences (MEX) - Question identifier:MEX_Q005
Are you taking a vitamin supplement containing folic acid?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q010
Have you given birth in the past 5 years?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q015
What is the name of your last born child?
Long Answer Length = 50
Maternal experiences (MEX) - Question identifier:MEX_Q020
What is [your last child]'s date of birth?
Min = 1; Max = 31
Maternal experiences (MEX) - Question identifier:MEX_Q025
What is [your last child]'s date of birth?
- 01: January
- 02: February
- 03: March
- 04: April
- 05: May
- 06: June
- 07: July
- 08: August
- 09: September
- 10: October
- 11: November
- 12: December
- 98: RF
- 99: DK
Maternal experiences (MEX) - Question identifier:MEX_Q030
What is [your last child]'s date of birth?
Min = 2010; Max = 2099
Maternal experiences (MEX) - Question identifier:MEX_R040
The next questions are about your maternal experiences related to [your last child].
Maternal experiences (MEX) - Question identifier:MEX_Q040
In the three months before you got pregnant with [your last child], did you take a folic acid supplement or a multivitamin containing folic acid?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q045
Did you take it every day or almost every day?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q050
During the first three months of your pregnancy (with [your last child]), did you take a folic acid supplement or a multivitamin containing folic acid?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q055
Did you take it every day or almost every day?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q060
Before your pregnancy (with [your last child]), were you aware that taking folic acid before becoming pregnant can help prevent some birth defects?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q065
During your pregnancy (with [your last child]), did you take a vitamin supplement containing iron?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q070
Just before your pregnancy (with [your last child]), how much did you weigh?
Min = 1; Max = 700
Maternal experiences (MEX) - Question identifier:MEX_N075
Was that in pounds or kilograms?
- 1: Pounds
- 2: Kilograms
Maternal experiences (MEX) - Question identifier:MEX_Q080
How much weight did you gain during that pregnancy?
Min = -50; Max = 199
Maternal experiences (MEX) - Question identifier:MEX_N085
Was that in pounds or kilograms?
- 1: Pounds
- 2: Kilograms
Maternal experiences (MEX) - Question identifier:MEX_Q090
[How often does [your last child]/When [your last child] was less than one year old, how often did he/she] sleep in the same bed with you or anyone else?
- 1: Every day or almost every day
- 2: Once or twice a week
- 3: A few times a month
- 4: Less than once a month
- 5: Never
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q095
What is the main reason [your last child] [is/was] sleeping in the same bed with you or someone else?
- 1: To breastfeed
- 2: So the baby would sleep / So I could get some sleep
- 3: Did not have room for a crib
- 4: Could not afford a crib
- 5: Believe that bedsharing was best for my child
- 6: Child was sick
- 7: Other
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q100
Was [your last child] breastfed or given breast milk even for a short time?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q105
What is the main reason that you did not breastfeed or give breast milk?
- 1: Bottle feeding is easier
- 2: Formula is as good as breast milk
- 3: Breastfeeding is unappealing
- 4: Medical condition - mother
- 5: Other - Specify
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q110
Are you still breastfeeding or giving breast milk to [your last child]?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q115
How long did you breastfeed or give breast milk to [your last child]?
Min = 1; Max = 730
Maternal experiences (MEX) - Question identifier:MEX_N115A
Was this time in days, weeks, months or years?
- 1: Days
- 2: Weeks
- 3: Months
- 4: Years
Maternal experiences (MEX) - Question identifier:MEX_Q120
What is the main reason that you stopped breastfeeding or giving breast milk?
- 01: Not enough breast milk
- 02: Baby was ready for solid foods
- 03: Inconvenience / fatigue due to breastfeeding
- 04: Difficulty with breastfeeding (e.g., sore nipples, engorged breasts, mastitis)
- 05: Medical condition - mother
- 06: Medical condition - baby
- 07: Planned to stop at this time
- 08: Child weaned him / herself (e.g., baby refusing breast, lack of interest)
- 09: Returned to work / school
- 10: Other - Specify
- 98: RF
- 99: DK
Maternal experiences (MEX) - Question identifier:MEX_Q125
[Are you giving [your last child] a vitamin D supplement? / When [your last child] was [less than a year old / less than one year old and fed breast milk / fed breast milk], did you give him/her a vitamin D supplement?]
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q130
[Now that [your last child] is more than a year old, are you still giving [him/her] a vitamin D supplement?/When [your last child] was older than one and fed breast milk, did you continue to give [him/her] a vitamin D supplement?]
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q140
Overall, how often [do / did] you give [your last child] a supplement containing vitamin D?
- 1: Every day
- 2: Almost every day
- 3: Once or twice a week
- 4: Less than once a week
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q150
[While you were still breastfeeding, had / Have] liquids such as milk, formula, water, juice, tea or herbal mixture been introduced to [your last child]'s feeds?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q155
How old was your last child when other liquids were first added to the feeds?
Min = 1; Max = 730
Maternal experiences (MEX) - Question identifier:MEX_N160
Was this time in days, weeks, months or years?
- 1: Days
- 2: Weeks
- 3: Months
- 4: Years
Maternal experiences (MEX) - Question identifier:MEX_Q170
Have solid foods such as cereals, mashed up or pureed meat, vegetables or fruits been introduced to the baby's feeds?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q175
How old was [your last child] when solid foods (such as cereals, mashed up or pureed meat, vegetables or fruits) were first added to their feeds?
Min = 1; Max = 730
Maternal experiences (MEX) - Question identifier:MEX_N180
Was this time in days, weeks, months or years?
- 1: Days
- 2: Weeks
- 3: Months
- 4: Years
Maternal experiences (MEX) - Question identifier:MEX_Q190
What was the first solid food added to [your last child]'s feeds?
- 1: Infant cereals
- 2: Meat, fish or poultry
- 3: Meat alternatives (includes eggs, tofu, legumes, peas or lentils)
- 4: Fruits or vegetables
- 5: Other
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q195
What is the main reason [other liquids / solid foods / other liquids and solid foods] were first added to [your last child]'s feeds?
- 01: Not enough breast milk
- 02: [Baby was ready for solid foods]
- 03: Inconvenience / fatigue due to breastfeeding
- 04: Difficulty with breastfeeding (e.g., sore nipples, engorged breasts, mastitis)
- 05: Medical condition - mother
- 06: Medical condition - baby
- 07: Advice from health professional / family
- 08: Returned to work / school
- 09: Formula equally healthy for baby
- 10: Other - Specify
- 98: RF
- 99: DK
Smoking during maternal experience (MXS)
This module explores whether women smoked cigarettes before or during their pregnancy, and whether they were exposed on a regular basis to second-hand smoke during the pregnancy.
The results of this module can be used to identify which groups of women could benefit from educational programs that promote healthier babies.
Smoking during maternal experience (MXS) - Question identifier:MXS_Q005
In the three months before your pregnancy with [your last child], or before you realized you were pregnant, did you smoke cigarettes?
- 1: Everyday
- 2: Almost everyday
- 3: About 2 or 3 times a week
- 4: About once a week
- 5: Once or twice
- 6: Never
- 8: RF
- 9: DK
Smoking during maternal experience (MXS) - Question identifier:MXS_Q010
Once you found out you were pregnant (with [your last child]), did you smoke?
- 1: Everyday
- 2: Almost everyday
- 3: About 2 or 3 times a week
- 4: About once a week
- 5: Once or twice
- 6: Never
- 8: RF
- 9: DK
Smoking during maternal experience (MXS) - Question identifier:MXS_Q015
During the last 3 months of your pregnancy (with [your last child]), did you smoke?
- 1: Everyday
- 2: Almost everyday
- 3: About 2 or 3 times a week
- 4: About once a week
- 5: Once or twice
- 6: Never
- 8: RF
- 9: DK
Smoking during maternal experience (MXS) - Question identifier:MXS_Q020
Did anyone regularly smoke in your presence during your pregnancy with [your last child]?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Alcohol use during maternal experience (MXA)
This module explores whether women drank alcohol before or during their pregnancy or while they were breastfeeding.
The results of this module can be used to identify which groups of women could benefit from educational programs that promote healthier babies.
Alcohol use during maternal experience (MXA) - Question identifier:MXA_Q005
In the three months before your pregnancy with [your last child], or before you realized you were pregnant, did you drink any alcohol?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Alcohol use during maternal experience (MXA) - Question identifier:MXA_Q010
How often did you drink?
- 1: Less than once per month
- 2: Once per month
- 3: 2 to 3 times per month
- 4: Once a week
- 5: 2 to 3 times per week
- 6: 4 to 6 times per week
- 7: Everyday
- 8: RF
- 9: DK
Alcohol use during maternal experience (MXA) - Question identifier:MXA_Q015
Once you found out you were pregnant with [your last child], did you drink any alcohol?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Alcohol use during maternal experience (MXA) - Question identifier:MXA_Q020
How often did you drink?
- 1: Less than once per month
- 2: Once per month
- 3: 2 to 3 times per month
- 4: Once a week
- 5: 2 to 3 times per week
- 6: 4 to 6 times per week
- 7: Everyday
- 8: RF
- 9: DK
Alcohol use during maternal experience (MXA) - Question identifier:MXA_Q025
During the last 3 months of your pregnancy (with [your last child]), did you drink any alcohol?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Alcohol use during maternal experience (MXA) - Question identifier:MXA_Q030
How often did you drink?
- 1: Less than once per month
- 2: Once per month
- 3: 2 to 3 times per month
- 4: Once a week
- 5: 2 to 3 times per week
- 6: 4 to 6 times per week
- 7: Everyday
- 8: RF
- 9: DK
Alcohol use during maternal experience (MXA) - Question identifier:MXA_Q035
While you were breastfeeding ([your last child]), did you drink any alcohol?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Alcohol use during maternal experience (MXA) - Question identifier:MXA_Q040
How often did you drink?
- 1: Less than once per month
- 2: Once per month
- 3: 2 to 3 times per month
- 4: Once a week
- 5: 2 to 3 times per week
- 6: 4 to 6 times per week
- 7: Everyday
- 8: RF
- 9: DK
Driving and safety (DRV)
Understanding the safety behaviours of drivers and passengers is an essential part of reducing deaths and injuries caused by road accidents and collisions.
In this module, respondents who have driven in the past 12 months are asked about a number of topics including their use of cell phones (with and without a hands-free device), and use of non-hands free devices to text, use social media, view maps, etc., while driving a motor vehicle. The module also includes questions about tiredness while driving, and helmet use for passengers or drivers of ATVs and snowmobiles.
Driving and safety (DRV) - Question identifier:DRV_R001
The next questions are about the use of a motor vehicle.
Driving and safety (DRV) - Question identifier:DRV_Q005
In the past 12 months, excluding motorcycles and off-road vehicles, have you driven a motor vehicle such as a car, truck or a van?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Driving and safety (DRV) - Question identifier:DRV_Q010
In the past 12 months, how often did you use a hands-free device such as Bluetooth when talking on the cell phone while driving a motor vehicle?
Exclude motorcycles and off-road vehicles.
- 1: Often
- 2: Sometimes
- 3: Rarely
- 4: Never
- 5: Does not possess or have access to a cell phone
- 8: RF
- 9: DK
Driving and safety (DRV) - Question identifier:DRV_Q015
In the past 12 months, excluding hands-free use, how often did you talk on a cell phone while driving a motor vehicle?
Exclude motorcycles and off-road vehicles.
- 1: Often
- 2: Sometimes
- 3: Rarely
- 4: Never
- 5: Does not possess or have access to a cell phone
- 8: RF
- 9: DK
Driving and safety (DRV) - Question identifier:DRV_Q020
In the past 12 months, how often did you text on a cell phone while driving a motor vehicle?
Exclude motorcycles and off-road vehicles.
- 1: Often
- 2: Sometimes
- 3: Rarely
- 4: Never
- 5: Does not possess or have access to a cell phone
- 8: RF
- 9: DK
Driving and safety (DRV) - Question identifier:DRV_Q025
In the past 12 months, how often did you use a cell phone for any other reason while driving a motor vehicle, for example, to send or receive emails, use social media, look at maps, etc.?
Exclude motorcycles and off-road vehicles.
- 1: Often
- 2: Sometimes
- 3: Rarely
- 4: Never
- 5: Does not possess or have access to a cell phone
- 8: RF
- 9: DK
Driving and safety (DRV) - Question identifier:DRV_Q030
In the past 12 months, have you driven a motorcycle?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Driving and safety (DRV) - Question identifier:DRV_Q035
In the past 12 months, how often did you drive [any vehicule] when you were feeling tired?
- 1: Often
- 2: Sometimes
- 3: Rarely
- 4: Never
- 8: RF
- 9: DK
Driving and safety (DRV) - Question identifier:DRV_Q070
In the past 12 months, have you been the driver of, or a passenger on, an ATV (all-terrain vehicle) or a snowmobile?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Driving and safety (DRV) - Question identifier:DRV_Q075
How often do you wear a helmet when on an ATV or a snowmobile?
- 1: Always
- 2: Most of the time
- 3: Rarely
- 4: Never
- 8: RF
- 9: DK
Driving while under the influence (DWI)
Understanding the safety behaviours of drivers and passengers is an essential part of reducing injuries and deaths caused by road accidents and collisions.
In this module, respondents who have driven or been passengers in a motor vehicle (car, motorbike, van or truck) in the past 12 months are asked about the driver's alcohol and cannabis consumption in the two hours prior to driving.
Driving while under the influence (DWI) - Question identifier:DWI_R005
The next questions are about motor vehicles driven after using alcohol or cannabis.
Driving while under the influence (DWI) - Question identifier:DWI_Q005
During the past 12 months, have you been a passenger in a motor vehicle driven by someone who had two or more drinks of alcohol in the previous 2 hours?
- 1: Yes, once
- 2: Yes, more than once
- 3: No
- 8: RF
- 9: DK
Driving while under the influence (DWI) - Question identifier:DWI_Q010
During the past 12 months, have you been a passenger in a motor vehicle driven by someone who had been using cannabis in the previous 2 hours?
- 1: Yes, once
- 2: Yes, more than once
- 3: No
- 8: RF
- 9: DK
Driving while under the influence (DWI) - Question identifier:DWI_Q015
During the past 12 months, have you been a passenger in a motor vehicle driven by someone who had been using both alcohol and cannabis in the previous 2 hours?
- 1: Yes, once
- 2: Yes, more than once
- 3: No
- 8: RF
- 9: DK
Driving while under the influence (DWI) - Question identifier:DWI_Q020
During the past 12 months, have you driven a motor vehicle such as a car, motorbike, van or truck?
Exclude off-road vehicles such as snowmobiles, ATVs, motocross, boats, planes or non-motorized vehicles such as bicycles.
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Driving while under the influence (DWI) - Question identifier:DWI_Q025
During the past 12 months, have you driven a motor vehicle after having 2 or more drinks in the previous 2 hours?
- 1: Yes, once
- 2: Yes, more than once
- 3: No
- 8: RF
- 9: DK
Driving while under the influence (DWI) - Question identifier:DWI_Q030
During the past 12 months, have you driven a motor vehicle within 2 hours of using cannabis?
- 1: Yes, once
- 2: Yes, more than once
- 3: No
- 8: RF
- 9: DK
Driving while under the influence (DWI) - Question identifier:DWI_Q035
During the past 12 months, have you driven a motor vehicle after using both alcohol and cannabis in the previous 2 hours?
- 1: Yes, once
- 2: Yes, more than once
- 3: No
- 8: RF
- 9: DK
Flu shots (FLU)
Respondents are asked when they last had a flu shot, excluding the H1N1 shot. Respondents who have not had a shot in the past year are asked the reasons why they did not receive one.
Influenza is a serious illness for certain groups, including the elderly. For all groups, the flu is a major cause of days lost from work, school and other activities.
Results of this module will be used to identify groups of people who are less likely to have a flu shot. This information may be useful in planning and designing new programs to promote immunization.
Flu shots (FLU) - Question identifier:FLU_R001
Now a few questions about your use of various health care services.
Flu shots (FLU) - Question identifier:FLU_Q005
Have you ever had a seasonal flu shot, excluding the H1N1 flu shot?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Flu shots (FLU) - Question identifier:FLU_Q010
When did you have your last seasonal flu shot?
- 1: Less than 1 year ago
- 2: 1 year to less than 2 years ago
- 3: 2 years ago or more
- 8: RF
- 9: DK
Flu shots (FLU) - Question identifier:FLU_Q015
In which month did you have your last seasonal flu shot?
- 01: January
- 02: February
- 03: March
- 04: April
- 05: May
- 06: June
- 07: July
- 08: August
- 09: September
- 10: October
- 11: November
- 12: December
- 98: RF
- 99: DK
Flu shots (FLU) - Question identifier:FLU_Q020
Was that this year or last year?
- 1: This year
- 2: Last year
- 8: RF
- 9: DK
Flu shots (FLU) - Question identifier:FLU_Q025
What are the reasons that you have not had a seasonal flu shot in the past year?
- 01: Lack of time
- 02: Respondent - did not think it was necessary
- 03: Doctor - did not think it was necessary
- 04: Not available - at time required
- 05: Did not know where to go / uninformed
- 06: Feelings of fear or discomfort
- 07: Bad reaction to previous flu shot
- 08: Bad reaction to previous vaccine other than flu shot
- 09: Unsure of / does not believe in benefits of vaccine
- 10: Does not want vaccine for fear of what it contains
- 11: Other
- 98: RF
- 99: DK
Blood pressure check (BPC)
Heart disease is one of the leading causes of death in Canada. Regular blood pressure checks are an effective way of diagnosing hypertension, which is very strongly related to heart disease.
In this module, respondents are asked if they have had their blood pressure checked in the past 2 years and, if so, when, and if not, why not. As well, females aged 15 to 55 are asked if they were pregnant the last time their blood pressure was measured.
By looking at reasons why certain groups do not have their blood pressure checked as recommended, health region planners and others can develop promotional campaigns to remind people of the benefits.
Blood pressure check (BPC) - Question identifier:BPC_R001
Now, a few questions about blood pressure measurement.
Blood pressure check (BPC) - Question identifier:BPC_Q005
Have you ever had your blood pressure measured by a health professional?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Blood pressure check (BPC) - Question identifier:BPC_Q010
When was the last time you had your blood pressure measured (by a health professional)?
- 1: Less than 1 year to 1 year ago
- 2: More than 1 year to 2 years ago
- 3: More than 2 years to 3 years ago
- 4: More than 3 years to 5 years ago
- 5: More than 5 years ago
- 8: RF
- 9: DK
Blood pressure check (BPC) - Question identifier:BPC_Q015
What are the reasons that you have not had your blood pressure measured (by a health professional) in the past 2 years?
- 1: Lack of time
- 2: Respondent did not think it was necessary
- 3: Doctor did not think it was necessary
- 4: Feelings of fear or discomfort
- 5: Don't have a doctor
- 6: Other
- 8: RF
- 9: DK
Blood pressure check (BPC) - Question identifier:BPC_Q020
Were you pregnant the last time your blood pressure was measured (by a health professional)?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Pap smear test (PAP)
Cervical cancer is a leading type of cancer among Canadian women. Regular Pap smear tests are an effective way of detecting this cancer early enough for treatment to be effective.
In this module, female respondents aged 18 to 70 are asked if they have had a Pap smear test in the past 3 years and, if not, why not.
Pap smear test (PAP) - Question identifier:PAP_Q005
Have you ever had a Pap smear test?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Pap smear test (PAP) - Question identifier:PAP_Q010
When was the last time?
- 1: Less than 1 year to 1 year ago
- 2: More than 1 year to 2 years ago
- 3: More than 2 years to 3 years ago
- 4: More than 3 years to 5 years ago
- 5: More than 5 years ago
- 8: RF
- 9: DK
Pap smear test (PAP) - Question identifier:PAP_Q015
What are the reasons that you have not had a Pap smear test in the past 3 years?
- 1: Lack of time
- 2: Respondent did not think it was necessary
- 3: Doctor did not think it was necessary/ he never brought it up
- 4: Feelings of fear or discomfort
- 5: Don't have a doctor
- 6: [Had a complete hysterectomy]
- 7: Other
- 8: RF
- 9: DK
Pap smear test (PAP) - Question identifier:PAP_Q020
How often do you usually have this test?
- 1: It was the first time
- 2: More than once a year
- 3: Between once a year to less than every 3 years
- 4: Every 3 years
- 5: Less often than every 3 years
- 6: No fixed frequency
- 8: RF
- 9: DK
Mammography (MAM)
Mammography, or an x-ray of the breast, is an important tool for detecting breast cancer.
In this module, female respondents aged 40 to 74 are asked if they have ever had a mammography exam and, if so, when, and if not in the past 3 years, why not.
Mammography (MAM) - Question identifier:MAM_Q005
Have you ever had a mammogram, that is, a breast x-ray?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Mammography (MAM) - Question identifier:MAM_Q010
When was the last time?
- 1: Less than 1 year to 1 year ago
- 2: More than 1 year to 2 years ago
- 3: More than 2 years to 3 years ago
- 4: More than 3 years to 5 years ago
- 5: More than 5 years ago
- 8: RF
- 9: DK
Mammography (MAM) - Question identifier:MAM_Q015
What were the reasons for having this mammogram?
- 01: Family history of breast cancer
- 02: Part of regular check-up / routine screening
- 03: Age
- 04: Previously detected lump
- 05: Follow-up of breast cancer treatment
- 06: On hormone replacement therapy
- 07: Breast problem
- 08: Other
- 98: RF
- 99: DK
Mammography (MAM) - Question identifier:MAM_Q020
What are the reasons you have not had a mammogram [in the past 3 years]?
- 1: Lack of time
- 2: Respondent did not think it was necessary
- 3: Doctor did not think it was necessary/ he never brought it up
- 4: Feelings of fear or discomfort
- 5: Don't have a doctor
- 6: Had a bilateral mastectomy (both breasts were removed)
- 7: Other
- 8: RF
- 9: DK
Mammography (MAM) - Question identifier:MAM_Q025
How often do you usually have this test?
- 1: It was the first time
- 2: More than once a year
- 3: Between once a year to less than every 3 years
- 4: Every 3 years
- 5: Less often than every 3 years
- 6: No fixed frequency
- 8: RF
- 9: DK
Prostate cancer screening (PSA)
This module includes questions about two common methods of screening for prostate cancer:
1. A PSA blood test involves taking a small sample of blood and testing the level of a specific chemical, prostate specific antigen. A high level indicates that the patient may have a higher than normal risk of prostate cancer and further tests are usually ordered.
2. A digital rectal exam involves a doctor inserting a gloved finger into the rectum to feel whether the prostate gland is enlarged.
Results from this module can be used to plan prostate cancer screening programs and to identify which groups of men might benefit the most from campaigns to raise awareness of the importance of early prostate cancer detection.
The questions are asked to male respondents aged 35 and older.
Prostate cancer screening (PSA) - Question identifier:PSA_R001
Now, a few questions related to prostate exams.
Prostate cancer screening (PSA) - Question identifier:PSA_Q005
Have you ever had a prostate specific antigen test for prostate cancer, that is, a PSA blood test?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Prostate cancer screening (PSA) - Question identifier:PSA_Q010
When was the last time?
- 1: Less than 1 year to 1 year ago
- 2: More than 1 year to 2 years ago
- 3: More than 2 years to 3 years ago
- 4: More than 3 years to 5 years ago
- 5: More than 5 years ago
- 8: RF
- 9: DK
Prostate cancer screening (PSA) - Question identifier:PSA_Q015
Why did you have it?
- 1: Family history of prostate cancer
- 2: Part of regular check-up / routine screening
- 3: Age
- 4: Race
- 5: Follow-up of problem
- 6: Follow-up of prostate cancer treatment
- 7: Other
- 8: RF
- 9: DK
Prostate cancer screening (PSA) - Question identifier:PSA_Q020
A Digital Rectal Exam is an exam in which a gloved finger is inserted into the rectum in order to feel the prostate gland.
Have you ever had this exam?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Prostate cancer screening (PSA) - Question identifier:PSA_Q025
When was the last time?
- 1: Less than 1 year to 1 year ago
- 2: More than 1 year to 2 years ago
- 3: More than 2 years to 3 years ago
- 4: More than 3 years to 5 years ago
- 5: More than 5 years ago
- 8: RF
- 9: DK
Colorectal cancer testing (CCT)
Colorectal cancer is one of the most common and serious types of cancer in Canada. In this module, respondents aged 40 to 74 are asked about three common methods of screening for colorectal cancer:
1. A fecal test, also called FOBT or FIT, which checks for blood in the stool.
2. A colonoscopy, which involves inserting a tube into the rectum to examine the entire colon in order to detect signs of cancer or other health problems.
3. A sigmoidoscopy, which is similar to the colonoscopy, but only examines the first section of the colon and requires less preparation. Results from this module can be used to plan colorectal cancer screening programs and to identify which groups might benefit the most from campaigns to raise awareness of the importance of early detection of colorectal cancer.
Colorectal cancer testing (CCT) - Question identifier:CCT_R001
Now a few questions about colorectal tests.
Colorectal cancer testing (CCT) - Question identifier:CCT_Q005
A fecal test is a test to check for blood in the stool, in which a stick is used to smear a small stool sample on a special card.
Have you ever had this test?
The fecal test is also called FOBT or FIT. FOBT stands for "Fecal Occult Blood Test". FIT stands for "Fecal Immunochemical Test".
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Colorectal cancer testing (CCT) - Question identifier:CCT_Q010
When was the last time?
- 1: 6 months ago or less
- 2: More than 6 months to 1 year ago
- 3: More than 1 year to 2 years ago
- 4: More than 2 years to 5 years ago
- 5: More than 5 years ago
- 8: RF
- 9: DK
Colorectal cancer testing (CCT) - Question identifier:CCT_Q015
What are the reasons you did not have a fecal test [in the past 2 years]?
- 01: Lack of time
- 02: No access to test (distance, clinic hours or cost)
- 03: Respondent did not think it was necessary
- 04: Doctor did not think it was necessary/ he never brought it up
- 05: Feelings of fear or discomfort
- 06: Don't have a doctor
- 07: Had a colonoscopy or sigmoidoscopy instead
- 08: Did not know it existed/it was a possibility
- 09: Other
- 98: RF
- 99: DK
Colorectal cancer testing (CCT) - Question identifier:CCT_Q020
How often do you usually have this test?
- 1: It was the first time
- 2: More than once a year
- 3: Every year
- 4: Every 2 years
- 5: Less than once every 2 years
- 6: No fixed frequency
- 8: RF
- 9: DK
Colorectal cancer testing (CCT) - Question identifier:CCT_R025
A sigmoidoscopy and a colonoscopy are two tests in which a tube is inserted into the rectum in order to detect signs of cancer or other health problems.
A colonoscopy examines the entire colon, while a sigmoidoscopy only examines the first section of the colon. The sigmoidoscopy requires less preparation.
Colorectal cancer testing (CCT) - Question identifier:CCT_Q025
Have you ever had either one of these tests?
The sigmoidoscopy can be performed by a nurse or non-specialist physician. The colonoscopy preparation requires fasting for a 36-hour period and drinking a large quantity of liquid to empty the colon.
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Colorectal cancer testing (CCT) - Question identifier:CCT_Q030
What are the reasons you have not had these tests?
- 01: Lack of time
- 02: No access to test (distance, clinic hours or cost)
- 03: Respondent did not think it was necessary
- 04: Doctor did not think it was necessary/ he never brought it up
- 05: Feelings of fear or discomfort
- 06: Don't have a doctor
- 07: Had a fecal test instead
- 08: Did not know it existed/it was a possibility
- 09: Other
- 98: RF
- 99: DK
Colorectal cancer testing (CCT) - Question identifier:CCT_Q035
Which of these tests have you had[, a colonoscopy, a sigmoidoscopy or both]?
- 1: Colonoscopy
- 2: Sigmoidoscopy
- 3: Both
- 8: RF
- 9: DK
Colorectal cancer testing (CCT) - Question identifier:CCT_Q040
When was the last time you had a sigmoidoscopy?
- 1: 1 year ago or less
- 2: More than 1 year to 2 years ago
- 3: More than 2 years to 5 years ago
- 4: More than 5 years to 10 years ago
- 5: More than 10 years ago
- 8: RF
- 9: DK
Colorectal cancer testing (CCT) - Question identifier:CCT_Q045
What are the reasons you have not had this test in the past 10 years?
- 01: Lack of time
- 02: No access to test (distance, clinic hours or cost)
- 03: Respondent did not think it was necessary
- 04: Doctor did not think it was necessary/ he never brought it up
- 05: Feelings of fear or discomfort
- 06: Don't have a doctor
- 07: Had a different colorectal test instead
- 08: Did not know it existed/it was a possibility
- 09: Other
- 98: RF
- 99: DK
Colorectal cancer testing (CCT) - Question identifier:CCT_Q050
How often do you usually have this test?
- 1: It was the first time
- 2: More than once every 5 years
- 3: Every 5 years
- 4: Less than once every 5 years
- 5: No fixed frequency
- 8: RF
- 9: DK
Colorectal cancer testing (CCT) - Question identifier:CCT_Q055
When was the last time you had a colonoscopy?
- 1: 1 year ago or less
- 2: More than 1 year to 2 years ago
- 3: More than 2 years to 5 years ago
- 4: More than 5 years to 10 years ago
- 5: More than 10 years ago
- 8: RF
- 9: DK
Colorectal cancer testing (CCT) - Question identifier:CCT_Q065
What are the reasons you have not had this test in the past 10 years?
- 01: Lack of time
- 02: No access to test (distance, clinic hours or cost)
- 03: Respondent did not think it was necessary
- 04: Doctor did not think it was necessary/ he never brought it up
- 05: Feelings of fear or discomfort
- 06: Don't have a doctor
- 07: Had a different colorectal test instead
- 08: Did not know it existed/it was a possibility
- 09: Other
- 98: RF
- 99: DK
Colorectal cancer testing (CCT) - Question identifier:CCT_Q070
How often do you usually have this test?
- 1: It was the first time
- 2: More than once every 10 years
- 3: Every 10 years
- 4: Less than once every 10 years
- 5: No fixed frequency
- 8: RF
- 9: DK
Colorectal cancer testing (CCT) - Question identifier:CCT_Q075
Was the colonoscopy or sigmoidoscopy a follow-up of the results of a fecal test?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Colorectal cancer testing (CCT) - Question identifier:CCT_Q080
Were you prescribed [a colonoscopy / a sigmoidoscopy / one of these tests] because of a family history, an inflammatory bowel disease, a colorectal cancer follow-up or other symptoms?
For example, you previously had colorectal cancer or polyps, have a history of colorectal cancer in at least one first degree blood relative, have an inflammatory bowel disease, have other symptoms indicating a predisposition to colorectal cancer.
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Spirometry (SPI)
In this module, respondents are asked if they have ever had this common lung function test. If they have, they are asked when the last time was.
These questions will be used to examine the proportion of the population who had the Spirometry test and the characteristics of this population. Early diagnosis of common lung diseases helps in managing their progression and consequences.
Spirometry (SPI) - Question identifier:SPI_Q005
Spirometry is a common lung function test that consists of blowing into a small tube attached to a machine.
Have you ever had this test?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Spirometry (SPI) - Question identifier:SPI_Q010
When was the last time?
- 1: Less than 6 months ago
- 2: 6 months to less than 1 year ago
- 3: 1 year to less than 2 years ago
- 4: 2 years to less than 5 years ago
- 5: 5 or more years ago
- 8: RF
- 9: DK
Diabetes care (DIA)
In this module, respondents who have diabetes (non gestational) are asked about various aspects of the care of their diabetes.
They are asked about:
· tests or examinations done by health professionals, such as a haemoglobin "A-one-C" test, a check of the feet, a urine test, an eye examination and nutrition therapy
· tests or examinations done by themselves or other nonprofessionals, such as a glucose check and a check of the feet
· medications they may be taking.
Diabetes is a growing health problem in Canada. Answers to these questions can be used to study the care that people in Canada are getting to help manage their diabetes.
Diabetes care (DIA) - Question identifier:DIA_R001
You reported earlier that you have diabetes. The following questions are about diabetes care.
Diabetes care (DIA) - Question identifier:DIA_Q005
In the past 12 months, has a health care professional tested you for haemoglobin "A-one-C"? (An "A-one-C" haemoglobin test measures the average level of blood sugar over a 3-month period.)
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Diabetes care (DIA) - Question identifier:DIA_Q010
How many times? (In the past 12 months, has a health care professional tested you for haemoglobin "A-one-C"?)
Min = 1; Max = 99
Diabetes care (DIA) - Question identifier:DIA_Q015
In the past 12 months, has a health care professional checked your feet for any sores or irritations?
- 1: Yes
- 2: No
- 3: No feet
- 8: RF
- 9: DK
Diabetes care (DIA) - Question identifier:DIA_Q020
How many times? (In the past 12 months, has a health care professional checked your feet for any sores or irritations?)
Min = 1; Max = 99
Diabetes care (DIA) - Question identifier:DIA_Q025
In the past 12 months, has a health care professional tested your urine for protein (i.e., Microalbumin)?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Diabetes care (DIA) - Question identifier:DIA_Q030
Have you ever had an eye exam where the pupils of your eyes were dilated? (This procedure would have made you temporarily sensitive to light.)
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Diabetes care (DIA) - Question identifier:DIA_Q035
When was the last time?
- 1: Less than 1 year ago
- 2: 1 year to less than 2 years ago
- 3: 2 or more years ago
- 8: RF
- 9: DK
Diabetes care (DIA) - Question identifier:DIA_Q040
In the past 12 months, has a dietitian provided you with nutrition therapy adapted for people with diabetes? Please exclude advice received by a nurse.
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Diabetes care (DIA) - Question identifier:DIA_R045
Now, some questions about diabetes care not provided by a health care professional.
Diabetes care (DIA) - Question identifier:DIA_Q045
How often do you usually have your blood checked for glucose or sugar by yourself or by a family member or friend?
Min = 0; Max = 365
Diabetes care (DIA) - Question identifier:DIA_N045A
Select the reporting period.
- 1: Per day
- 2: Per week
- 3: Per month
- 4: Per year
Diabetes care (DIA) - Question identifier:DIA_Q050
How often do you usually have your feet checked for any sores or irritations by yourself or by a family member or friend?
Min = 0; Max = 365
Diabetes care (DIA) - Question identifier:DIA_N050A
Select the reporting period.
- 1: Per day
- 2: Per week
- 3: Per month
- 4: Per year
Diabetes care (DIA) - Question identifier:DIA_R055
Now, a few questions about medication.
Diabetes care (DIA) - Question identifier:DIA_Q055
In the past month, have you taken any medicine for high blood pressure?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Diabetes care (DIA) - Question identifier:DIA_Q060
In the past month, have you taken any medicine for high blood cholesterol or lipids?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Consultations about mental health (CMH)
This module deals with the number of times in the past 12 months that the respondents have consulted with mental health professionals to discuss their emotional or mental health, and which professionals they saw or talked to.
The results will help planners to understand how existing mental health services are being used and to target new services to the groups that need them the most.
Consultations about mental health (CMH) - Question identifier:CMH_R001
Now I would like to ask you some questions about mental and emotional well-being.
Consultations about mental health (CMH) - Question identifier:CMH_Q005
In the past 12 months, that is, from [date one year ago] to yesterday, have you seen or talked to a health professional about your emotional or mental health?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Consultations about mental health (CMH) - Question identifier:CMH_Q010
How many times (in the past 12 months)?
Min = 1; Max = 366
Consultations about mental health (CMH) - Question identifier:CMH_Q015
Whom did you see or talk to?
- 1: Family doctor or general practitioner
- 2: Psychiatrist
- 3: Psychologist
- 4: Nurse
- 5: Social worker or counsellor
- 6: Other - Specify
- 8: RF
- 9: DK
Satisfaction with life (SWL)
This module includes questions about the respondent's level of satisfaction with various aspects of their life, including their job, their experiences, their financial situation, themselves, their relationships, their housing and their neighbourhood.
Researchers are interested in the connection between satisfaction with life and overall physical and mental health and well-being.
Satisfaction with life (SWL) - Question identifier:SWL_R001
Now, I'd like to ask about your satisfaction with various aspects of your life. For each question, please tell me whether you are very satisfied, satisfied, neither satisfied nor dissatisfied, dissatisfied or very dissatisfied.
Satisfaction with life (SWL) - Question identifier:SWL_Q005
How satisfied are you with your job or main activity?
- 1: Very satisfied
- 2: Satisfied
- 3: Neither satisfied nor dissatisfied
- 4: Dissatisfied
- 5: Very dissatisfied
- 8: RF
- 9: DK
Satisfaction with life (SWL) - Question identifier:SWL_Q010
How satisfied are you with your leisure activities?
- 1: Very satisfied
- 2: Satisfied
- 3: Neither satisfied nor dissatisfied
- 4: Dissatisfied
- 5: Very dissatisfied
- 8: RF
- 9: DK
Satisfaction with life (SWL) - Question identifier:SWL_Q015
How satisfied are you with your financial situation?
- 1: Very satisfied
- 2: Satisfied
- 3: Neither satisfied nor dissatisfied
- 4: Dissatisfied
- 5: Very dissatisfied
- 8: RF
- 9: DK
Satisfaction with life (SWL) - Question identifier:SWL_Q020
How satisfied are you with yourself?
- 1: Very satisfied
- 2: Satisfied
- 3: Neither satisfied nor dissatisfied
- 4: Dissatisfied
- 5: Very dissatisfied
- 8: RF
- 9: DK
Satisfaction with life (SWL) - Question identifier:SWL_Q025
How satisfied are you with the way your body looks?
- 1: Very satisfied
- 2: Satisfied
- 3: Neither satisfied nor dissatisfied
- 4: Dissatisfied
- 5: Very dissatisfied
- 8: RF
- 9: DK
Satisfaction with life (SWL) - Question identifier:SWL_Q030
How satisfied are you with your relationships with family members?
- 1: Very satisfied
- 2: Satisfied
- 3: Neither satisfied nor dissatisfied
- 4: Dissatisfied
- 5: Very dissatisfied
- 8: RF
- 9: DK
Satisfaction with life (SWL) - Question identifier:SWL_Q035
How satisfied are you with your relationships with friends?
- 1: Very satisfied
- 2: Satisfied
- 3: Neither satisfied nor dissatisfied
- 4: Dissatisfied
- 5: Very dissatisfied
- 8: RF
- 9: DK
Satisfaction with life (SWL) - Question identifier:SWL_Q040
How satisfied are you with your housing?
- 1: Very satisfied
- 2: Satisfied
- 3: Neither satisfied nor dissatisfied
- 4: Dissatisfied
- 5: Very dissatisfied
- 8: RF
- 9: DK
Satisfaction with life (SWL) - Question identifier:SWL_Q045
How satisfied are you with your neighbourhood?
- 1: Very satisfied
- 2: Satisfied
- 3: Neither satisfied nor dissatisfied
- 4: Dissatisfied
- 5: Very dissatisfied
- 8: RF
- 9: DK
Depression (DEP)
Many people feel depressed at one time or another, to varying degrees. However, long-lasting depression is a serious mental and physical health concern.
This module consists of a series of detailed questions about depression. The answers will be combined to determine how likely it is that the respondent is depressed.
This module gathers information on the length, timing and consequences of depressive episodes.
Depression (DEP) - Question identifier:DEP_R001
The following questions deal with problems you may have had during the last two weeks.
Depression (DEP) - Question identifier:DEP_Q005
Over the last two weeks, how often have you:
had little interest or pleasure in doing things?
- 1: Not at all
- 2: Several days
- 3: More than half the days
- 4: Nearly every day
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q010
Over the last two weeks, how often have you:
felt down, depressed, or hopeless?
- 1: Not at all
- 2: Several days
- 3: More than half the days
- 4: Nearly every day
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q015
Over the last two weeks, how often have you:
had trouble falling or staying asleep, or sleeping too much?
- 1: Not at all
- 2: Several days
- 3: More than half the days
- 4: Nearly every day
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q020
Over the last two weeks, how often have you:
felt tired or had little energy?
- 1: Not at all
- 2: Several days
- 3: More than half the days
- 4: Nearly every day
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q025
Over the last two weeks, how often have you:
had poor appetite or overate?
- 1: Not at all
- 2: Several days
- 3: More than half the days
- 4: Nearly every day
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q030
Over the last two weeks, how often have you:
felt bad about yourself, or that you are a failure or have let yourself or your family down?
- 1: Not at all
- 2: Several days
- 3: More than half the days
- 4: Nearly every day
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q035
Over the last two weeks, how often have you:
had trouble concentrating on things, such as reading the newspaper or watching television?
- 1: Not at all
- 2: Several days
- 3: More than half the days
- 4: Nearly every day
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q040
Over the last two weeks, how often have you:
been moving or speaking so slowly that other people could have noticed? Or the opposite, being so fidgety or restless that you have been moving around a lot more than usual?
- 1: Not at all
- 2: Several days
- 3: More than half the days
- 4: Nearly every day
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q045
Over the last two weeks, how often have you:
had thoughts that you would be better off dead, or of hurting yourself?
- 1: Not at all
- 2: Several days
- 3: More than half the days
- 4: Nearly every day
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q050
How difficult have these problems made it for you to do your work, take care of things at home, or get along with other people?
- 1: Not difficult at all
- 2: Somewhat difficult
- 3: Very difficult
- 4: Extremely difficult
- 8: RF
- 9: DK
Suicidal thoughts and attempts (SUI)
Suicide is an important and growing concern in society today.
This module collects information on respondents' suicidal thoughts and attempts, including whether or not they've made a plan to attempt suicide in the past 12 months, the age when they last contemplated and/or planned and/or attempted suicide, the number of attempts in their lifetime and whether they required medical attention for the most recent attempt.
The questions are asked only of respondents aged 15 and older.
Suicidal thoughts and attempts (SUI) - Question identifier:SUI_R001
The following questions may be sensitive to some people, but we have to ask the same questions of everyone.
Suicidal thoughts and attempts (SUI) - Question identifier:SUI_Q005
Have you ever seriously contemplated suicide?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Suicidal thoughts and attempts (SUI) - Question identifier:SUI_Q010
Has this happened in the past 12 months?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Suicidal thoughts and attempts (SUI) - Question identifier:SUI_Q015
How old were you the last time this experience happened?
Min = 6; Max = 129
Suicidal thoughts and attempts (SUI) - Question identifier:SUI_Q020
Have you ever made a plan to seriously attempt suicide?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Suicidal thoughts and attempts (SUI) - Question identifier:SUI_Q025
Has this happened in the past 12 months?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Suicidal thoughts and attempts (SUI) - Question identifier:SUI_Q030
How old were you the last time this experience happened?
Min = 6; Max = 129
Suicidal thoughts and attempts (SUI) - Question identifier:SUI_Q035
Have you ever seriously attempted suicide?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Suicidal thoughts and attempts (SUI) - Question identifier:SUI_Q040
How many times did you seriously attempt suicide in your lifetime?
Min = 1; Max = 901
Suicidal thoughts and attempts (SUI) - Question identifier:SUI_Q045
Did this happen in the past 12 months?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Suicidal thoughts and attempts (SUI) - Question identifier:SUI_Q050
How old were you [when/the last time] this experience happened?
Min = 6; Max = 129
Suicidal thoughts and attempts (SUI) - Question identifier:SUI_Q055
Following your most recent experience, did you require medical attention?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Sources of stress (STS)
The relationship between stress and health is complicated. For example, stress may be the cause of certain health problems and the effect of others.
Health planners will be able to use the results of this module to identify the most common sources of stress and develop programs that promote healthy ways of dealing with stress.
This module covers a range of issues related to stress, including the ability to deal with unexpected and difficult problems, the ability to deal with everyday demands, and the main source of day-to-day stress.
Sources of stress (STS) - Question identifier:STS_R001
Now a few questions about the stress in your life.
Sources of stress (STS) - Question identifier:STS_Q005
In general, how would you rate your ability to handle unexpected and difficult problems, for example, a family or personal crisis? Would you say your ability is...?
- 1: Excellent
- 2: Good
- 3: Fair
- 4: Poor
- 8: RF
- 9: DK
Sources of stress (STS) - Question identifier:STS_Q010
In general, how would you rate your ability to handle the day-to-day demands in your life, for example, handling work, family and volunteer responsibilities? Would you say your ability is...?
- 1: Excellent
- 2: Good
- 3: Fair
- 4: Poor
- 8: RF
- 9: DK
Sources of stress (STS) - Question identifier:STS_Q015
Thinking about stress in your day-to-day life, what would you say is the most important thing contributing to feelings of stress you may have?
- 01: Work
- 02: Financial concerns
- 03: Family
- 04: School work
- 05: Time pressures / not enough time
- 06: Health
- 07: Other - Specify
- 08: None
- 98: RF
- 99: DK
Childhood experiences (CEX)
This module is asked of respondents 25 years and older, and asks them to report events that have happened to them (at school, in their neighbourhood or at home), prior to the age of 16, including incidents of physical violence, unwanted sexual activity, and any involvement with a child protection organization.
Childhood experiences (CEX) - Question identifier:CEX_R001
The next few questions are about things that may have happened to you before you were 16 in your school, in your neighbourhood, or in your family. Your responses are important whether or not you have had any of these experiences. Remember that all information provided is strictly confidential.
Childhood experiences (CEX) - Question identifier:CEX_Q005
Before age 16, how many times did you see or hear any one of your parents, step-parents or guardians hit each other or another adult in your home? By adult, I mean anyone 18 years and over.
- 1: Never
- 2: 1 or 2 times
- 3: 3 to 5 times
- 4: 6 to 10 times
- 5: More than 10 times
- 8: RF
- 9: DK
Childhood experiences (CEX) - Question identifier:CEX_Q010
Before age 16, how many times did an adult slap you on the face, head or ears or hit or spank you with something hard to hurt you?
- 1: Never
- 2: 1 or 2 times
- 3: 3 to 5 times
- 4: 6 to 10 times
- 5: More than 10 times
- 8: RF
- 9: DK
Childhood experiences (CEX) - Question identifier:CEX_Q015
Before age 16, how many times did an adult push, grab, shove or throw something at you to hurt you?
- 1: Never
- 2: 1 or 2 times
- 3: 3 to 5 times
- 4: 6 to 10 times
- 5: More than 10 times
- 8: RF
- 9: DK
Childhood experiences (CEX) - Question identifier:CEX_Q020
Before age 16, how many times did an adult kick, bite, punch, choke, burn you or physically attack you in some way?
- 1: Never
- 2: 1 or 2 times
- 3: 3 to 5 times
- 4: 6 to 10 times
- 5: More than 10 times
- 8: RF
- 9: DK
Childhood experiences (CEX) - Question identifier:CEX_Q025
Before age 16, how many times did an adult force you, or attempt to force you into any unwanted sexual activity, by threatening you, holding you down or hurting you in some way?
- 1: Never
- 2: 1 or 2 times
- 3: 3 to 5 times
- 4: 6 to 10 times
- 5: More than 10 times
- 8: RF
- 9: DK
Childhood experiences (CEX) - Question identifier:CEX_Q030
Before age 16, how many times did an adult touch you against your will in any sexual way? By this, I mean anything from unwanted touching or grabbing, to kissing or fondling.
- 1: Never
- 2: 1 or 2 times
- 3: 3 to 5 times
- 4: 6 to 10 times
- 5: More than 10 times
- 8: RF
- 9: DK
Childhood experiences (CEX) - Question identifier:CEX_Q035
Before age 16, did you ever see or talk to anyone from a child protection organization about difficulties at home?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Social provisions (SPS)
The relationships an individual has with friends, family, co-workers and others can have a strong impact on their own mental and physical health.
This module consists of a series of questions about the respondent's level of emotional security and well-being; guidance; reassurance of worth; social integration; and reliable alliance.
Social provisions (SPS) - Question identifier:SPS_R001
The next questions are about your current relationships with friends, family members, co-workers, community members, and so on. Please indicate to what extent each statement describes your current relationships with other people.
Social provisions (SPS) - Question identifier:SPS_Q015
I have close relationships that provide me with a sense of emotional security and wellbeing.
- 1: Strongly agree
- 2: Agree
- 3: Disagree
- 4: Strongly disagree
- 8: RF
- 9: DK
Social provisions (SPS) - Question identifier:SPS_Q020
There is someone I could talk to about important decisions in my life.
- 1: Strongly agree
- 2: Agree
- 3: Disagree
- 4: Strongly disagree
- 8: RF
- 9: DK
Social provisions (SPS) - Question identifier:SPS_Q025
I have relationships where my competence and skill are recognized.
- 1: Strongly agree
- 2: Agree
- 3: Disagree
- 4: Strongly disagree
- 8: RF
- 9: DK
Social provisions (SPS) - Question identifier:SPS_Q035
I feel part of a group of people who share my attitudes and beliefs.
- 1: Strongly agree
- 2: Agree
- 3: Disagree
- 4: Strongly disagree
- 8: RF
- 9: DK
Social provisions (SPS) - Question identifier:SPS_Q050
There are people I can count on in an emergency.
- 1: Strongly agree
- 2: Agree
- 3: Disagree
- 4: Strongly disagree
- 8: RF
- 9: DK
Primary health care (PHC)
Primary health care is often the first point of entry into the Canadian health care system. It incorporates diagnosis, treatment and management of health problems.
This module covers a number of topics related to the use of primary health care, including whether the respondent has a usual place to go for immediate care for minor health problems, whether the respondent has a regular health care provider, language spoken during appointments, and the types of health care professionals that are involved in the care of the respondent.
This module has a number of uses for governments, health care planners and researchers. For example, results could be used to compare how different groups-such as men and women, young and old, urban and rural-use health services. It will also track the change over time as to where Canadians go to and whom they chose to see when they need care.
Primary health care (PHC) - Question identifier:PHC_R001
Now I'd like to ask about your primary health care. It is often the first point of entry to the Canadian health system. It incorporates diagnosis, treatment and management of health problems.
Primary health care (PHC) - Question identifier:PHC_Q005
Is there a place that you usually go to when you need immediate care for a minor health problem?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Primary health care (PHC) - Question identifier:PHC_Q010
What kind of place is it?
- 1: A doctor's office
- 2: A hospital outpatient clinic
- 3: A community health centre [or CLSC]
- 4: A walk-in clinic
- 5: A hospital emergency room
- 6: Some other place
- 8: RF
- 9: DK
Primary health care (PHC) - Question identifier:PHC_Q015
Is this...?
- 1: An office with one doctor working in a solo practice
- 2: An office with several health care professionals working together as a team, that may include a dietician, nurse, social worker or psychologist
- 3: An office with several doctors working independently of each other, who may share one or more nurses
- 4: Other
- 8: RF
- 9: DK
Primary health care (PHC) - Question identifier:PHC_Q020
Do you have have a regular health care provider? By this, we mean one health professional that you regularly see or talk to when you need care or advice for your health.
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Primary health care (PHC) - Question identifier:PHC_Q025
What are the reasons why you do not have a regular health care provider?
- 1: Do not need one in particular, but you have a usual place of care
- 2: No one available in the area
- 3: No one in the area is taking new patients
- 4: [You] have not tried to find one
- 5: Had one who left or retired
- 6: Other
- 8: RF
- 9: DK
Primary health care (PHC) - Question identifier:PHC_Q030
Is that regular health care provider a...?
- 1: Family doctor or general practitioner
- 2: Medical specialist such as a cardiologist or a pediatrician
- 3: Nurse practitioner
- 4: Other
- 8: RF
- 9: DK
Primary health care (PHC) - Question identifier:PHC_Q035
When you need immediate care for a minor health problem, how long do you usually have to wait before you can have an appointment with this [family physician / specialist / nurse practitioner / regular health care provider] [or another care provider from the same office?]
- 1: On the same day
- 2: The next day
- 3: In 2 to 3 days
- 4: In 4 to 6 days
- 5: In 1 to 2 weeks
- 6: Between 2 weeks and one month
- 7: One month or more
- 8: RF
- 9: DK
Primary health care (PHC) - Question identifier:PHC_Q040
Do you usually speak in English, in French or in another language with this [family physician / specialist / nurse practitioner / regular health care provider?]
- 1: English
- 2: French
- 3: English and French
- 4: English and another language
- 5: French and another language
- 6: Another language
- 8: RF
- 9: DK
Primary health care (PHC) - Question identifier:PHC_Q045
Is there one or more nurses working with your [family physician / specialist / nurse practitioner / regular health care provider] who are regularly involved in your health care?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Primary health care (PHC) - Question identifier:PHC_Q050
Other than doctors and nurses, are there other health professionals like nutritionists working in the same office where you get your regular health care?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Primary health care (PHC) - Question identifier:PHC_Q055
Other than from your [family physician / specialist / nurse practitioner / regular health care provider], who do you receive regular health care from?
- 01: Another family doctor or general practitioner
- 02: Specialist doctor
- 03: Nurse / Nurse practitioner
- 04: Chiropractor
- 05: Registered dietician
- 06: Pharmacist
- 07: Physiotherapist
- 08: Psychologist / Mental Health Professional
- 09: Social Worker
- 10: Other
- 11: None
- 98: RF
- 99: DK
Primary health care (PHC) - Question identifier:PHC_Q060
In general, how would you rate the level of coordination between your [family physician / specialist / nurse practitioner / regular health care provider] and other health professionals who provide you with regular care? Would you say the coordination is...?
- 1: Excellent
- 2: Very good
- 3: Good
- 4: Fair
- 5: Poor
- 6: Not applicable
- 8: RF
- 9: DK
Medical doctor attachment (MDA)
This module provides information on the level of attachment of Canadians to their doctor. If they have a family doctor or general practitioner (GP), it asks about the length of time they have had their doctor. If they don't have a doctor, it asks if they are looking for one.
If they have a 'usual place of care' where there is more than one doctor, it asks about the number of doctors they can see, and how often they are taken care of by the same doctor.
The data collected will enable researchers to get a sense of whether Canadians are followed-up by a regular doctor.
Medical doctor attachment (MDA) - Question identifier:MDA_Q005
How long have you had your family doctor or general practitioner for?
- 1: Less than 6 months
- 2: 6 months to less than 1 year
- 3: 1 year to less than 2 years
- 4: 2 years or more
- 8: RF
- 9: DK
Medical doctor attachment (MDA) - Question identifier:MDA_Q010
Are you currently looking for a family doctor or general practitioner?
- 1: Yes
- 2: No
- 3: Not applicable; [I already have one]
- 8: RF
- 9: DK
Medical doctor attachment (MDA) - Question identifier:MDA_Q015
Earlier you said that you have a usual place to go when you need care for a minor health problem. In this place, is there more than one medical doctor who you can see?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Medical doctor attachment (MDA) - Question identifier:MDA_Q020
When you go to that usual place, how often are you taken care of by the same medical doctor?
- 1: Always
- 2: Often
- 3: Sometimes
- 4: Rarely
- 5: Never
- 6: Not applicable
- 8: RF
- 9: DK
Contacts with health professionals - extended block (CP2)
The objective of this module is to gather information on the place and frequency of contact with various health professionals during the past 12 months for physical, emotional or mental health.
Questions pertain to the following health professionals:
chiropractor, physiotherapist, psychologist, social worker/counsellor, audiologist/speech or occupational therapist, dietician/nutritionist, and pharmacist.
Contacts with health professionals - extended block (CP2) - Question identifier:CP2_Q005
[Not counting when you were an overnight patient,] in the past 12 months, have you seen or talked to any of the following health professionals about your physical, emotional or mental health:
a chiropractor?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Contacts with health professionals - extended block (CP2) - Question identifier:CP2_Q010
How many times (in the past 12 months)?
Min = 1; Max = 366
Contacts with health professionals - extended block (CP2) - Question identifier:CP2_Q015
[Not counting when you were an overnight patient,] in the past 12 months, have you seen or talked to
a physiotherapist?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Contacts with health professionals - extended block (CP2) - Question identifier:CP2_Q020
How many times (in the past 12 months)?
Min = 1; Max = 366
Contacts with health professionals - extended block (CP2) - Question identifier:CP2_Q025
[Not counting when you were an overnight patient,] in the past 12 months, have you seen or talked to
a psychologist (about your physical, emotional or mental health)?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Contacts with health professionals - extended block (CP2) - Question identifier:CP2_Q030
How many times (in the past 12 months)?
Min = 1; Max = 366
Contacts with health professionals - extended block (CP2) - Question identifier:CP2_Q035
[Not counting when you were an overnight patient,] in the past 12 months, have you seen or talked to:
a social worker or counsellor?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Contacts with health professionals - extended block (CP2) - Question identifier:CP2_Q040
How many times (in the past 12 months)?
Min = 1; Max = 366
Contacts with health professionals - extended block (CP2) - Question identifier:CP2_Q045
[Not counting when you were an overnight patient,] in the past 12 months, have you seen or talked to
an audiologist, a speech or occupational therapist?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Contacts with health professionals - extended block (CP2) - Question identifier:CP2_Q050
How many times (in the past 12 months)?
Min = 1; Max = 200
Contacts with health professionals - extended block (CP2) - Question identifier:CP2_Q055
[Not counting when you were an overnight patient,] in the past 12 months, have you seen or talked to
a dietician or nutritionist?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Contacts with health professionals - extended block (CP2) - Question identifier:CP2_Q060
How many times (in the past 12 months)?
Min = 1; Max = 366
Contacts with health professionals - extended block (CP2) - Question identifier:CP2_Q065
[Not counting when you were an overnight patient,] in the past 12 months, have you consulted with or sought advice from a pharmacist?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Contacts with health professionals - extended block (CP2) - Question identifier:CP2_Q070
How many times (in the past 12 months)?
Min = 1; Max = 366
Contacts with dental professionals (CP3)
The objective of this module is to gather information about contacts with dental health professionals in the past 12 months.
Contacts with dental professionals (CP3) - Question identifier:CP3_R001
Now I'd like to ask about your contacts with dental health professionals during the past 12 months, that is, from [date one year ago] to yesterday.
Contacts with dental professionals (CP3) - Question identifier:CP3_Q005
In the past 12 months, have you seen or talked to a dental professional, such as a dentist, a dental hygienist or a denturologist?
Include both face to face and telephone contacts. Other dental professionals include orthodontist, periodontist, dental surgeon and dental therapist.
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Contacts with dental professionals (CP3) - Question identifier:CP3_Q010
How many times (in the past 12 months)?
Min = 1; Max = 99
Perceived need for care (PNC)
This module asks about the different kinds of help respondents received or thought they needed for problems with their emotions, mental health or use of alcohol or drugs in the past 12 months.
Unmet health care needs have potential health implications. The information gathered will be useful in identifying the reasons why some individuals do not get the help they need.
Perceived need for care (PNC) - Question identifier:PNC_R01
The following questions deal with the different kinds of help you received, or thought you needed, for problems with your emotions, mental health or use of alcohol or drugs.
Perceived need for care (PNC) - Question identifier:PNC_Q01
During the past 12 months, did you receive the following kinds of help because of problems with your emotions, mental health or use of alcohol or drugs?
- 1: Information about these problems, treatments or available services
- 2: Medication
- 3: Counselling, therapy, or help for problems with personal relationships
- 4: Other type of help
- 5: None
- 8: RF
- 9: DK
Perceived need for care (PNC) - Question identifier:PNC_Q02A
You mentioned that you received:
[information about these problems, treatments or available services / medication / counselling, therapy, or help for problems with personal relationships / other help].
Do you think you got as much of [each of these kinds / this kind] of help as you needed (during the past 12 months)?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Perceived need for care (PNC) - Question identifier:PNC_Q02B
Which kind of help did you need more of (during the past 12 months)?
- 1: Information about these problems, treatments or available services
- 2: Medication
- 3: Counselling, therapy, or help for problems with personal relationships
- 4: Other
- 8: RF
- 9: DK
Perceived need for care (PNC) - Question identifier:PNC_Q03A
Why didn't you get [more information about these problems, treatments or available services / more medication / more counselling, therapy, or help for problems with personal relationships / more of the other kind of help you mentioned] (during the past 12 months)?
- 01: You preferred to manage yourself
- 02: You didn't know how or where to get this kind of help
- 03: You haven't gotten around to it (e.g., too busy)
- 04: Your job interfered (e.g., workload, hours of work or no cooperation from supervisor)
- 05: Help was not readily available
- 06: You didn't have confidence in health care system or social services
- 07: You couldn't afford to pay
- 08: Insurance did not cover
- 09: You were afraid of what others would think of you
- 10: Language problems
- 11: Help is ongoing
- 12: Other
- 98: RF
- 99: DK
Perceived need for care (PNC) - Question identifier:PNC_Q03B
Which of the following best describes why you preferred to manage yourself rather than seek help (during the past 12 months)?
- 01: You didn't think they knew how to help
- 02: You were uncomfortable talking about these problems
- 03: You relied on faith and spirituality
- 04: You relied on family and friends
- 05: You felt you'd be treated differently if people thought you had these problems
- 06: You didn't feel ready to seek help
- 07: You couldn't get this kind of help where you live
- 08: Other
- 98: RF
- 99: DK
Perceived need for care (PNC) - Question identifier:PNC_Q04A
You mentioned that you did not receive:
[Information about these problems, treatments or available services / medication / counselling, therapy, or help for problems with personal relationships / other help].
Do you think you needed [this kind / any of these kinds] of help (during the past 12 months)?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Perceived need for care (PNC) - Question identifier:PNC_Q04B
Which kind of help did you need (during the past 12 months)?
- 1: Information about these problems, treatments or available services
- 2: Medication
- 3: Counselling, therapy, or help for problems with personal relationships
- 8: RF
- 9: DK
Perceived need for care (PNC) - Question identifier:PNC_Q05A
Why didn't you get [more information about these problems, treatments or available services / more medication / more counselling, therapy, or help for problems with personal relationships / more of the other kind of help you mentioned] (during the past 12 months)?
- 01: You preferred to manage yourself
- 02: You didn't know how or where to get this kind of help
- 03: You haven't gotten around to it (e.g., too busy)
- 04: Your job interfered (e.g., workload, hours of work or no cooperation from supervisor)
- 05: Help was not readily available
- 06: You didn't have confidence in health care system or social services
- 07: You couldn't afford to pay
- 08: Insurance did not cover
- 09: You were afraid of what others would think of you
- 10: Language problems
- 11: Help is ongoing
- 12: Other
- 98: RF
- 99: DK
Perceived need for care (PNC) - Question identifier:PNC_Q05B
Which of the following best describes why you preferred to manage yourself rather than seek help (during the past 12 months)?
- 01: You didn't think they knew how to help
- 02: You were uncomfortable talking about these problems
- 03: You relied on faith and spirituality
- 04: You relied on family and friends
- 05: You felt you'd be treated differently if people thought you had these problems
- 06: You didn't feel ready to seek help
- 07: You couldn't get this kind of help where you live
- 08: Other
- 98: RF
- 99: DK
Patient satisfaction - community-based care (PSC)
This module assesses whether respondents received any community-based health care services in the past 12 months (outside of a hospital or doctor's office), and includes their rating of the quality and satisfaction with the care received.
Examples of community-based health care services are: home nursing care, home-based counselling or therapy, personal care and community walk-in clinics.
Patient satisfaction - community-based care (PSC) - Question identifier:PSC_R001
The next questions are about community-based health care which include other health care services received outside of a hospital or doctor's office.
Examples are: home nursing care, home-based counselling or therapy, personal care and community health clinics.
Patient satisfaction - community-based care (PSC) - Question identifier:PSC_Q005
In the past 12 months, have you received any community-based care?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Patient satisfaction - community-based care (PSC) - Question identifier:PSC_Q010
Overall, how would you rate the quality of the community-based care you received? Would you say it was...?
- 1: Excellent
- 2: Good
- 3: Fair
- 4: Poor
- 8: RF
- 9: DK
Patient satisfaction - community-based care (PSC) - Question identifier:PSC_Q015
Using a scale of 0 to 5, where 0 means "Very dissatisfied" and 5 means "Very satisfied", overall, how satisfied were you with the way community-based care was provided?
- 0: Very dissatisfied
- 1: |
- 2: |
- 3: |
- 4: V
- 5: Very satisfied
- 8: RF
- 9: DK
Patient satisfaction - community-based care (PSC) - Question identifier:PSC_Q020
In the past 12 months, have you received any home nursing care?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Patient satisfaction - community-based care (PSC) - Question identifier:PSC_Q025
Overall, how would you rate the quality of the home nursing care you received? Would you say it was...?
- 1: Excellent
- 2: Good
- 3: Fair
- 4: Poor
- 8: RF
- 9: DK
Patient satisfaction - community-based care (PSC) - Question identifier:PSC_Q030
Using a scale of 0 to 5, where 0 means "Very dissatisfied" and 5 means "Very satisfied", overall, how satisfied were you with the way the home nursing care was provided?
- 0: Very dissatisfied
- 1: |
- 2: |
- 3: |
- 4: V
- 5: Very satisfied
- 8: RF
- 9: DK
Patient satisfaction - community-based care (PSC) - Question identifier:PSC_Q035
In the past 12 months, have you received any home-based counselling or therapy?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Patient satisfaction - community-based care (PSC) - Question identifier:PSC_Q040
Overall, how would you rate the quality of the home-based counselling or therapy you received? Would you say it was...?
- 1: Excellent
- 2: Good
- 3: Fair
- 4: Poor
- 8: RF
- 9: DK
Patient satisfaction - community-based care (PSC) - Question identifier:PSC_Q045
Using a scale of 0 to 5, where 0 means "Very dissatisfied" and 5 means "Very satisfied", overall, how satisfied were you with the way the home-based counselling or therapy was provided?
- 0: Very dissatisfied
- 1: |
- 2: |
- 3: |
- 4: V
- 5: Very satisfied
- 8: RF
- 9: DK
Patient satisfaction - community-based care (PSC) - Question identifier:PSC_Q050
In the past 12 months, have you received any personal care services?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Patient satisfaction - community-based care (PSC) - Question identifier:PSC_Q055
Overall, how would you rate the quality of the personal care service you received? Would you say it was...?
- 1: Excellent
- 2: Good
- 3: Fair
- 4: Poor
- 8: RF
- 9: DK
Patient satisfaction - community-based care (PSC) - Question identifier:PSC_Q060
Using a scale of 0 to 5, where 0 means "Very dissatisfied" and 5 means "Very satisfied", overall, how satisfied were you with the way the personal care service was provided?
- 0: Very dissatisfied
- 1: |
- 2: |
- 3: |
- 4: V
- 5: Very satisfied
- 8: RF
- 9: DK
Patient satisfaction - community-based care (PSC) - Question identifier:PSC_Q065
In the past 12 months, have you received any services from a community walk-in clinic?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Patient satisfaction - community-based care (PSC) - Question identifier:PSC_Q070
Overall, how would you rate the quality of the service you received at the community walk-in clinic? Would you say it was...?
- 1: Excellent
- 2: Good
- 3: Fair
- 4: Poor
- 8: RF
- 9: DK
Patient satisfaction - community-based care (PSC) - Question identifier:PSC_Q075
Using a scale of 0 to 5, where 0 means "Very dissatisfied" and 5 means "Very satisfied", overall, how satisfied were you with the way the community walk-in clinic service was provided?
- 0: Very dissatisfied
- 1: |
- 2: |
- 3: |
- 4: V
- 5: Very satisfied
- 8: RF
- 9: DK
Consultations with health professionals on smoking (SPC)
In this module, respondents who smoke are asked whether their regular health care provider or dentist knows that they smoke, or has advised them to stop or reduce smoking. Questions about the type of help, if any, provided by the regular health care provider, dentist and pharmacist are also asked.
The results of this module will be used to understand what role regular health care providers, dentists and pharmacists can play in helping people reduce smoking.
Consultations with health professionals on smoking (SPC) - Question identifier:SPC_Q005
Does your [family physician/specialist/nurse practitioner/regular health care provider?] know that you [smoke / smoked] cigarettes?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Consultations with health professionals on smoking (SPC) - Question identifier:SPC_Q010
In the past 12 months, did your [family physician/specialist/nurse practitioner/regular health care provider?] advise you to reduce or quit smoking?
- 1: Yes
- 2: No
- 3: Did not see or talk to him or her
- 8: RF
- 9: DK
Consultations with health professionals on smoking (SPC) - Question identifier:SPC_Q015
In the past 12 months, did your [family physician/specialist/nurse practitioner/regular health care provider?] give you any specific help or information to reduce or quit smoking?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Consultations with health professionals on smoking (SPC) - Question identifier:SPC_Q020
What type of help did the [family physician/specialist/nurse practitioner/regular health care provider?] give?
- 01: Referral to a one-on-one cessation program
- 02: Referral to a group cessation program
- 03: Recommended use of nicotine patch or nicotine gum
- 04: Recommended Zyban or other medication
- 05: Provided self-help information (e.g., pamphlet, referral to website)
- 06: Referral to a 1-800 telephone quit line or other smoker help lines
- 07: Family physician offered counselling
- 08: Other
- 98: RF
- 99: DK
Consultations with health professionals on smoking (SPC) - Question identifier:SPC_Q025
Does your dental professional know that you [smoke / smoked] cigarettes?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Consultations with health professionals on smoking (SPC) - Question identifier:SPC_Q030
In the past 12 months, did your dental professional advise you to reduce or quit smoking?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Consultations with health professionals on smoking (SPC) - Question identifier:SPC_Q035
In the past 12 months, did your dental professional give you any specific help or information to reduce or quit smoking?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Consultations with health professionals on smoking (SPC) - Question identifier:SPC_Q040
What type of help did the dental professional give?
- 01: Referral to a one-on-one cessation program
- 02: Referral to a group cessation program
- 03: Recommended use of nicotine patch or nicotine gum
- 04: Recommended Zyban or other medication
- 05: Provided self-help information (e.g., pamphlet, referral to website)
- 06: Referral to a 1-800 telephone quit line or other smoker help lines
- 07: Dentist offered counselling
- 08: Other
- 98: RF
- 99: DK
Consultations with health professionals on smoking (SPC) - Question identifier:SPC_Q045
In the past 12 months, have you asked a pharmacist for advice to help you to reduce or quit smoking?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Consultations with health professionals on smoking (SPC) - Question identifier:SPC_Q050
What type of help did the pharmacist give?
- 1: Referral to a one-on-one cessation program
- 2: Referral to a group cessation program
- 3: Recommended use of nicotine patch or nicotine gum
- 4: Recommended Zyban or other medication
- 5: Provided self-help information (e.g., pamphlet, referral to website)
- 6: Referral to a 1-800 telephone quit line or other smoker help lines
- 7: Other
- 8: RF
- 9: DK
Patient experiences (PEX)
This module asks questions about the respondent's last consultation with a health professional, in person or over the phone. It excludes overnight hospital stays, dental care visits, accidents or emergency care, care received in their home or alternative health care. It also evaluates the quality of the time spent with the health professional and asks for the respondent's overall rating of the consultation.
The information from this module will be used to identify areas where patient's experience with the health system can be improved.
Patient experiences (PEX) - Question identifier:PEX_R001
The next questions are about your last consultation with a health professional.
Patient experiences (PEX) - Question identifier:PEX_Q005
When was the last time that you had a consultation with any health professional about your own health? Exclude care you got when you stayed overnight in a hospital, dental care visits, accident or emergency care, or care received in your home.
Include both consultations over the phone or in person. Health professionals may include family doctor, medical specialist, nurse, physiotherapist, pharmacist or dietitian, but do not include alternative health practitioners like naturopaths, acupuncture or Chinese medicine.
- 1: In the last 30 days
- 2: Between 1 and 3 months ago
- 3: More than 3 but less than 6 months ago
- 4: Between 6 and 12 months ago
- 5: Between 1 and 2 years ago
- 6: More than 2 years ago
- 8: RF
- 9: DK
Patient experiences (PEX) - Question identifier:PEX_Q010
Thinking about this last consultation, who did you receive care from?
- 1: A general practitioner or family doctor
- 2: A medical specialist
- 3: A nurse
- 4: Another health professional, such as a physiotherapist, psychologist or a speech therapist
- 8: RF
- 9: DK
Patient experiences (PEX) - Question identifier:PEX_Q015
Where did this last consultation take place?
- 01: At a doctor's office working in solo practice
- 02: At a doctor's office working in a team practice
- 03: At an office with many doctors working independently
- 04: At a hospital outpatient clinic
- 05: At a community health centre [or CLSC/null]
- 06: At a walk-in clinic
- 07: At a hospital emergency room
- 08: Over the telephone (for example [Info-Santé/Telehealth Ontario/HealthLinks/Health-Line/Telecare/on a health info line])
- 09: Other
- 98: RF
- 99: DK
Patient experiences (PEX) - Question identifier:PEX_Q020
Is this the place that you usually go to for most of your immediate care for a minor health problem?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Patient experiences (PEX) - Question identifier:PEX_Q025
Did you need to make an appointment to obtain this last consultation?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Patient experiences (PEX) - Question identifier:PEX_Q030
How quickly did you get this appointment?
- 1: On the same day
- 2: The next day
- 3: In 2 to 3 days
- 4: In 4 to 6 days
- 5: In 1 to 2 weeks
- 6: Between 2 weeks and one month
- 7: One month or more
- 8: RF
- 9: DK
Patient experiences (PEX) - Question identifier:PEX_Q035
Was the time you waited for the appointment a problem for you?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Patient experiences (PEX) - Question identifier:PEX_Q040
Were you seen by the [general practitioner / medical specialist / nurse / health professional] at the scheduled time of your appointment?
- 1: Appointment was on time or sooner than scheduled
- 2: Appointment was late
- 8: RF
- 9: DK
Patient experiences (PEX) - Question identifier:PEX_Q045
How long did you wait between the time of your appointment and the time you were seen by the [general practitioner / medical specialist / nurse / health professional]?
- 1: Less than 15 minutes
- 2: 15 to less than 30 minutes
- 3: 30 minutes to less than one hour
- 4: 1 to less than 2 hours
- 5: 2 hours or more
- 8: RF
- 9: DK
Patient experiences (PEX) - Question identifier:PEX_Q050
Was the time you waited a problem for you?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Patient experiences (PEX) - Question identifier:PEX_Q055
Did the [general practitioner / medical specialist / nurse / health professional] spend enough time with you during this last consultation?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Patient experiences (PEX) - Question identifier:PEX_Q060
Was your blood pressure measured (during this last consultation)?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Patient experiences (PEX) - Question identifier:PEX_Q065
Did this [general practitioner / medical specialist / nurse / health professional] explain things in a way that was easy to understand?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Patient experiences (PEX) - Question identifier:PEX_Q070
Did this [general practitioner / medical specialist / nurse / health professional] give you an opportunity to ask questions or raise concerns about your care or recommended treatment?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Patient experiences (PEX) - Question identifier:PEX_Q075
Did this [general practitioner / medical specialist / nurse / health professional] involve you as much as you could have been in decisions about your care or treatment?
- 1: Yes
- 2: No
- 3: Did not want to be involved
- 8: RF
- 9: DK
Patient experiences (PEX) - Question identifier:PEX_Q080
Did this [general practitioner / medical specialist / nurse / health professional] tell you how much the recommended treatment would cost, or whether any lower cost alternatives were available?
- 1: Yes
- 2: No
- 3: Not applicable, no recommended treatment or no cost implications
- 8: RF
- 9: DK
Patient experiences (PEX) - Question identifier:PEX_Q085
Overall, how would you rate the quality of this consultation?
- 1: Excellent
- 2: Very good
- 3: Good
- 4: Fair
- 5: Poor
- 8: RF
- 9: DK
Patient experiences (PEX) - Question identifier:PEX_R090
Now, a question about prescriptions for medicine.
Patient experiences (PEX) - Question identifier:PEX_Q090
During the last 12 months, was there a time when you did not fill or collect a prescription for medicine, or you skipped doses of your medicine because of the cost?
- 1: Yes
- 2: No
- 3: Not applicable, I had no medication prescription to fill in the last 12 months
- 8: RF
- 9: DK
Home care services - with palliative care (HMC)
This module asks respondents aged 18 and over if they received any home care services, such as nursing care, meal preparation, help with bathing or housework, and palliative care, either for themselves or for someone else in their household.
Respondents are also asked about the length of services, cost and payment, level of satisfaction with care, unmet care needs, reasons for not getting the services, and where they tried to obtain services.
Home care is considered to be an important part of health care reform. Both the health care system and the patient may benefit if some types of care are provided in the home instead of in a hospital or institution.
This module can be used to identify which groups are receiving home care and which are not. The health status of these groups and how they use other health services can be compared. This can help researchers understand whether home care is working as planned.
Home care services - with palliative care (HMC) - Question identifier:HMC_R005
Now some questions on home care services that you [or anyone in the household] may have received because of a health condition or a limitation in daily activities. These include services provided in your own home such as nursing care, meal preparation, someone to help with bathing or housework, etc. Do not include the help from family, friends or neighbours.
Home care services - with palliative care (HMC) - Question identifier:HMC_Q005
In the past 12 months, what type of home care services have you [or anyone in the household] received?
- 1: Nursing care (e.g., dressing changes, preparing
medications, V.O.N. visits) - 2: Other health care services (e.g., physiotherapy,
occupational or speech therapy, nutrition counselling) - 3: Medical equipment or supplies (e.g., wheelchair, pads for incontinence, help with using a ventilator or oxygen equipment)
- 4: Personal or home support (such as bathing, housekeeping, meal preparation)
- 5: Palliative or end-of-life care
- 6: Other services (such as transportation, meals-on-wheels)
- 7: No one in the household received any home care services
- 8: RF
- 9: DK
Home care services - with palliative care (HMC) - Question identifier:HMC_Q010
Were [the nursing care / the other health care / the medical equipment or supplies / the personal or home support / the palliative care / the other] services provided for yourself or someone else living in the household?
- 1: Home care provided to selected respondent only
- 2: Home care provided to other household member only
- 3: Home care provided to selected respondent and other household member
- 8: RF
- 9: DK
Home care services - with palliative care (HMC) - Question identifier:HMC_R015
For the next two questions please only report for the home care services provided for you.
Home care services - with palliative care (HMC) - Question identifier:HMC_Q015
How long have [you / other household members] been receiving [the nursing care / the other health care / the medical equipment or supplies / the personal or home support / the palliative care / the other] services?
- 1: Less than 1 month
- 2: 1 month to less than 3 months
- 3: 3 months to less than 6 months
- 4: 6 months to less than 1 year
- 5: 1 year to 3 years
- 6: More than 3 years
- 8: RF
- 9: DK
Home care services - with palliative care (HMC) - Question identifier:HMC_Q020
In a typical month over the past 12 months, how much have [you / other household members] paid for [the nursing care / the other health care / the medical equipment or supplies / the personal or home support / the palliative care / the other] services?
- 01: $0
- 02: $1 to less than $50
- 03: $50 to less than $100
- 04: $100 to less than $200
- 05: $200 to less than $300
- 06: $300 to less than $400
- 07: $400 to less than $1000
- 08: $1000 and more
- 98: RF
- 99: DK
Home care services - with palliative care (HMC) - Question identifier:HMC_Q025
Who paid for these services?
- 1: Out of your / their own pocket
- 2: Family or friend living in the same household
- 3: Someone living outside the household (e.g., family, friends, volunteer organization)
- 4: Insurance
- 5: Government
- 6: Other
- 8: RF
- 9: DK
Home care services - with palliative care (HMC) - Question identifier:HMC_Q030
Overall, how satisfied [were you / were the other household members] with the home care services received?
[were you / were the other household members]...?
- 1: Very satisfied
- 2: Somewhat satisfied
- 3: Neither satisfied nor dissatisfied
- 4: Somewhat dissatisfied
- 5: Very dissatisfied
- 8: RF
- 9: DK
Home care services - with palliative care (HMC) - Question identifier:HMC_Q035
What are the reasons why [you were / the other household members were] not satisfied?
- 1: Poor quality (i.e. concerns about provider competence, reliability of services, etc.)
- 2: Services did not address perceived needs
- 3: Services provided were insufficient
- 4: Long wait times to receive services
- 5: Other reason
- 8: RF
- 9: DK
Home care services - with palliative care (HMC) - Question identifier:HMC_Q040
During the past 12 months, was there ever a time when [you or anyone in your household] felt that home care services were needed but were not received?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Home care services - with palliative care (HMC) - Question identifier:HMC_Q045
Were these (home care) services needed for yourself or someone else living in the household?
- 1: Selected Respondent only
- 2: Other household member only
- 3: Selected respondent and other household member
- 8: RF
- 9: DK
Home care services - with palliative care (HMC) - Question identifier:HMC_R050
For the following questions, please only report for the home care services you (personally) needed.
Home care services - with palliative care (HMC) - Question identifier:HMC_Q050
Thinking of the most recent time, what type of home care was needed?
- 1: Nursing care (e.g., dressing changes, preparing
medications, V.O.N. visits) - 2: Other health care services (e.g., physiotherapy,
occupational or speech therapy, nutrition counselling) - 3: Medical equipment or supplies (e.g., wheelchair, pads for incontinence, help with using a ventilator or oxygen equipment)
- 4: Personal or home support (such as bathing, housekeeping, meal preparation)
- 5: Palliative or end-of-life care
- 6: Other services (such as transportation, meals-on-wheels)
- 8: RF
- 9: DK
Home care services - with palliative care (HMC) - Question identifier:HMC_Q055
Again, thinking of the most recent time, why didn't [you / they] get these services?
- 01: Not available in the area
- 02: Not available at time required (e.g., inconvenient hours)
- 03: Waiting time too long
- 04: Cost
- 05: Didn't get around to it / didn't bother
- 06: Didn't know where to go / call
- 07: Language barrier
- 08: Decided not to seek services
- 09: Doctor did not think it was necessary
- 10: Not eligible for home care
- 11: Still waiting for home care
- 12: Other
- 98: RF
- 99: DK
Home care services - with palliative care (HMC) - Question identifier:HMC_Q060
Where did [you / they] try to get these home care services?
- 1: A government Home Care Program (e.g., CLSC in Quebec, CCAC in Ontario, Extramural Program in New Brunswick)
- 2: A private agency
- 3: A family member, friend or neighbour
- 4: A volunteer organization
- 5: Nowhere - did not try to get service
- 6: Other
- 8: RF
- 9: DK
Unmet health care needs (UCN)
The purpose of this module is to identify respondents who needed health care (other than home care services) in the last 12 months but did not receive it. Questions are asked about the type of care they needed, whether they actively tried to obtain the health care, where they went to get care, and why they didn't receive it.
Data will be used to assess the extent of unmet health care needs, identify geographic areas where improvements could be made and determine why these needs are not fulfilled.
Unmet health care needs (UCN) - Question identifier:UCN_Q005
During the past 12 months, was there ever a time when you felt that you needed health care, other than homecare services, but you did not receive it?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Unmet health care needs (UCN) - Question identifier:UCN_Q010
Thinking of the most recent time you felt this way, why didn't you get care?
- 01: Care not available in the area
- 02: Care not available at time required (e.g., doctor busy, away from office or no longer at that practice, inconvenient hours)
- 03: Do not have a regular health care provider
- 04: Waiting time too long
- 05: Appointment was cancelled
- 06: Felt would receive inadequate care
- 07: Cost
- 08: Decided not to seek care
- 09: Doctor didn't think it was necessary
- 10: Transportation issue
- 11: Other
- 98: RF
- 99: DK
Unmet health care needs (UCN) - Question identifier:UCN_Q015
Again, thinking of the most recent time, what was the type of care that was needed?
- 01: Treatment of a chronic physical health condition diagnosed by a health professional
- 02: Treatment of a chronic mental health condition diagnosed by a health professional
- 03: Treatment of an acute infectious disease (e.g., cold, flu and stomach flu)
- 04: Treatment of an acute physical condition (non-infectious)
- 05: Treatment of an acute mental health condition (e.g., acute stress reaction)
- 06: A regular check-up (including pre-natal care)
- 07: Care of an injury
- 08: Dental care
- 09: Medication / Prescription refill
- 10: Other
- 98: RF
- 99: DK
Unmet health care needs (UCN) - Question identifier:UCN_Q020
Did you actively try to obtain the health care that was needed?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Unmet health care needs (UCN) - Question identifier:UCN_Q025
Where did you try to get the service you were seeking?
- 1: A doctor's office
- 2: A hospital outpatient clinic
- 3: A community health centre [or CLSC]
- 4: A walk-in clinic
- 5: An emergency department or emergency room
- 6: Other
- 8: RF
- 9: DK
Labour force (LBF)
There are many relationships between work and health. For example, unemployment can cause various stress-related illnesses while some occupations are more likely to cause repetitive strain injuries.
This module includes questions about the respondent's current labour force activities during the past week, including job status and absenteeism, job classification (employee or self-employed), industry, occupation and main activities, number of jobs, and usual hours worked per week.
The concepts and definitions are, for the most part, the same as those used in the Labour Force Survey.
The module is asked of respondents aged between 15 and 75. Not all questions will be asked of all respondents - pay attention to the skip patterns.
Labour force (LBF) - Question identifier:LBF_Q005A
Many of the following questions concern your activities last week. By last week, I mean the week beginning on [First day of reference week], and ending [Last day of reference week].
Last week, did you work at a job or business? (regardless of the number of hours)
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Labour force (LBF) - Question identifier:LBF_Q005B
Last week, did you have a job or business from which you were absent?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Labour force (LBF) - Question identifier:LBF_Q005C
What was the main reason you were absent from work last week?
- 01: Own illness or disability
- 02: Caring for own children
- 03: Caring for elder relative (60 years of age or older)
- 04: Maternity or parental leave
- 05: Other personal or family responsibilities
- 06: Vacation
- 07: Labour dispute (strike or lockout) (Employees only)
- 08: Temporary layoff due to business conditions (Employees only)
- 09: Seasonal layoff (Employees only)
- 10: Casual job, no work available (Employees only)
- 11: Work schedule (e.g., shift work) (Employees only)
- 12: Self-employed, no work available (Self-employed only)
- 13: Seasonal business (Excluding employees)
- 14: Other - Specify
- 98: RF
- 99: DK
Labour force (LBF) - Question identifier:LBF_R010
The next questions are about your current job or business.
Labour force (LBF) - Question identifier:LBF_Q010
Were you an employee or self-employed?
- 1: Employee
- 2: Self-employed
- 3: Working in a family business without pay
- 8: RF
- 9: DK
Labour force (LBF) - Question identifier:LBF_Q015A
What was the name of your business?
Long Answer Length = 50
Labour force (LBF) - Question identifier:LBF_Q015B
For whom did you work?
Long Answer Length = 50
Labour force (LBF) - Question identifier:LBF_Q015C
What kind of business, industry or service was this?
Long Answer Length = 50
Labour force (LBF) - Question identifier:LBF_Q020A
What was your work or occupation?
Long Answer Length = 50
Labour force (LBF) - Question identifier:LBF_Q020B
In this work, what were your main activities?
Long Answer Length = 50
Labour force (LBF) - Question identifier:LBF_Q025
On average, how many hours do you usually work per week?
Min = 0.0; Max = 168.0
Labour force (LBF) - Question identifier:LBF_Q030
Did you have more than one job or business last week?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Labour force (LBF) - Question identifier:LBF_Q035
On average, how many hours do you usually work per week at your other job(s)?
Min = 1; Max = 168
Socio-demographic characteristics (SDC)
Very important knowledge of understanding the health of Canadians is obtained by comparing the health of different groups. For example, do recent immigrants to Canada use health care services more or less than people born in Canada? Are people from European ethnic groups more likely to have certain chronic conditions than other groups?
In this module, important social and demographic information is collected, including immigrant status, country/province of birth, ethnic origin, aboriginal status, racial/cultural group, military service language, dwelling type and sexual orientation.
Socio-demographic characteristics (SDC) - Question identifier:SDC_R001
Now, some general questions which will help us compare the health of people in Canada.
Socio-demographic characteristics (SDC) - Question identifier:SDC_Q005A
In what country were you born?
- 1: Search
- 3: Other - Specify
- 8: RF
- 9: DK
Socio-demographic characteristics (SDC) - Question identifier:SDC_Q005B
In which province or territory were you born?
- 10: Newfoundland and Labrador
- 11: Prince Edward Island
- 12: Nova Scotia
- 13: New Brunswick
- 24: Quebec
- 35: Ontario
- 46: Manitoba
- 47: Saskatchewan
- 48: Alberta
- 59: British Columbia
- 60: Yukon
- 61: Northwest Territories
- 62: Nunavut
- 98: RF
- 99: DK
Socio-demographic characteristics (SDC) - Question identifier:SDC_Q005C
Are you now, or have you ever been a landed immigrant in Canada?
A landed immigrant, or permanent resident, is a person who has been granted the right to live in Canada permanently by immigration authorities.
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Socio-demographic characteristics (SDC) - Question identifier:SDC_Q005D
In what year did you first become a landed immigrant in Canada?
Min = 1870; Max = 2100
Socio-demographic characteristics (SDC) - Question identifier:SDC_Q010
To which ethnic or cultural groups did your ancestors belong? (For example: French, Scottish, Chinese, East Indian)
- 01: Canadian
- 02: French
- 03: English
- 04: German
- 05: Scottish
- 06: Irish
- 07: Italian
- 08: Ukrainian
- 09: Dutch (Netherlands)
- 10: Chinese
- 11: Jewish
- 12: Polish
- 13: Portuguese
- 14: South Asian (e.g., East Indian, Pakistani, Sri Lankan)
- 15: Norwegian
- 16: Welsh
- 17: Swedish
- 18: First Nations (North American Indian)
- 19: Métis
- 20: Inuit
- 21: Other - Specify
- 98: RF
- 99: DK
Socio-demographic characteristics (SDC) - Question identifier:SDC_Q015A
Are you an Aboriginal person, that is, First Nations, Métis or Inuk (Inuit)? First Nations includes Status and Non-Status Indians.
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Socio-demographic characteristics (SDC) - Question identifier:SDC_Q015B
Are you First Nations, Métis or Inuk (Inuit)?
- 1: First Nations (North American Indian)
- 2: Métis
- 3: Inuk (Inuit)
- 8: RF
- 9: DK
Socio-demographic characteristics (SDC) - Question identifier:SDC_Q020
You may belong to one or more racial or cultural groups on the following list. Are you... ?
- 01: White
- 02: South Asian (e.g., East Indian, Pakistani, Sri Lankan)
- 03: Chinese
- 04: Black
- 05: Filipino
- 06: Latin American
- 07: Arab
- 08: Southeast Asian (e.g., Vietnamese, Cambodian,
Malaysian, Laotian) - 09: West Asian (e.g., Iranian, Afghan)
- 10: Korean
- 11: Japanese
- 12: Other - Specify
- 98: RF
- 99: DK
Socio-demographic characteristics (SDC) - Question identifier:SDC_Q025A
Of English or French, which language(s) do you speak well enough to conduct a conversation? Is it... ?
- 1: English only
- 2: French only
- 3: Both English and French
- 4: Neither English nor French
- 8: RF
- 9: DK
Socio-demographic characteristics (SDC) - Question identifier:SDC_Q025B
What language do you speak most often at home?
Long Answer Length = 80
Socio-demographic characteristics (SDC) - Question identifier:SDC_Q025C
What is the language that you first learned at home in childhood and still understand?
Long Answer Length = 80
Socio-demographic characteristics (SDC) - Question identifier:SDC_Q027
Have you ever served in the Canadian military?
Canadian military service includes service with the Regular Force or Reserve Force as an Officer or a Non-Commissioned Member. It does not include service with the Cadets.
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Socio-demographic characteristics (SDC) - Question identifier:SDC_R030
Now a question about the dwelling in which you live.
Socio-demographic characteristics (SDC) - Question identifier:SDC_Q030
Is this dwelling...?
- 1: Owned by you or a member of this household, even if it is still being paid for
- 2: Rented, even if no cash rent is paid
- 8: RF
- 9: DK
Socio-demographic characteristics (SDC) - Question identifier:SDC_R035
Now, one additional background question which will help us compare the health of people in Canada.
Socio-demographic characteristics (SDC) - Question identifier:SDC_Q037
What is your sexual orientation?
Heterosexual means having sexual relations with people of the opposite sex. Homosexual means having sexual relations with people of your own sex. Bisexual means having sexual relations with people of both sexes.
- 1: Heterosexual
- 2: Homosexual
- 3: Bisexual
- 4: Or please specify
- 8: RF
- 9: DK
Person most knowledgeable about household situation (PMK)
The purpose of this module is to identify someone who may be more knowledgeable and better prepared than the 12-17 year-old selected respondent to answer household level questions such as income, insurance and food security questions.
Person most knowledgeable about household situation (PMK) - Question identifier:PMK_R010
For the last few questions, I would like to speak with someone who would be best able to answer questions about the entire household such as household income and food purchases.
Person most knowledgeable about household situation (PMK) - Question identifier:PMK_Q010
Who would this person be?
- 01: MEMBER1
- 02: MEMBER2
- 03: MEMBER3
- 04: MEMBER4
- 05: MEMBER5
- 06: MEMBER6
- 07: MEMBER7
- 08: MEMBER8
- 09: MEMBER9
- 10: MEMBER10
- 11: MEMBER11
- 12: MEMBER12
- 13: MEMBER13
- 14: MEMBER14
- 15: MEMBER15
- 16: MEMBER16
- 17: MEMBER17
- 18: MEMBER18
- 19: MEMBER19
- 20: MEMBER20
Person most knowledgeable about household situation (PMK) - Question identifier:PMK_Q015
Is [MEMBER#] available?
- 1: Yes
- 2: No
- 3: Person most knowledgeable about household refuses to participate.
Person most knowledgeable about household situation (PMK) - Question identifier:PMK_R025
This completes your portion of the interview. On behalf of Statistics Canada, I would like to thank you very much for your time.
Person most knowledgeable about household situation (PMK) - Question identifier:PMK_R030
This completes your portion of the interview. On behalf of Statistics Canada, I would like to thank you very much for your time. I would now like to try and find the best time to speak with [MEMBER#].
Person most knowledgeable about household situation (PMK) - Question identifier:PMK_R035
This completes your portion of the interview. On behalf of Statistics Canada, I would like to thank you very much for your time. I would now like to speak with [MEMBER#].
Person most knowledgeable about household situation (PMK) - Question identifier:PMK_R040
Hello, My name is... I've just completed the main portion of the interview with <Respondent's name>. At this point I need to finish the interview with a few general questions on your household's situation. <Respondent's name> said you would be the best person to answer these types of questions.
Health insurance coverage (INS)
In this module, respondents are asked whether they have insurance to cover all or part of the cost of prescription medications, home care or long-term care.
Respondents should include any private, government, association or employer-paid insurance plans.
The results of this module will be used to get an overall picture of which groups have various types of insurance. Researchers will be able to study this in combination with levels of health and use of health care services.
Health insurance coverage (INS) - Question identifier:INS_R001
Now, turning to your health insurance coverage. Please include any private, government or employer-paid plans.
Health insurance coverage (INS) - Question identifier:INS_Q005
Do you have insurance that covers all or part of the cost of your prescription medications?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Health insurance coverage (INS) - Question identifier:INS_Q010
Is it...?
- 1: A government-sponsored plan
- 2: An employer-sponsored benefit plan
- 3: A plan sponsored through an association such as a union, trade association or student organization
- 4: Other, such as your own private plan purchased from an insurance company
- 8: RF
- 9: DK
Health insurance coverage (INS) - Question identifier:INS_Q015
Do you have insurance that covers all or part of your long-term care costs, including home care?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Health insurance coverage (INS) - Question identifier:INS_Q020
Is it...?
- 1: A government-sponsored plan
- 2: An employer-sponsored benefit plan
- 3: A plan sponsored through an association such as a union, trade association or student organization
- 4: Other, such as your own private plan purchased from an insurance company
- 8: RF
- 9: DK
Prescriptions - cost-related non-adherence - short version (PCN2)
This module collects data on non-adherence to prescription medication due to cost. Non-adherence can be defined by behaviours such as failing to fill, collect or take prescribed medication, reducing or skipping the medication dosage, or delaying filling prescriptions.
The data collected will be used to identify the segment of the Canadian population who engage in cost-related non-adherence to prescription medication, and identify the percentage who have insurance for prescription medication.
Prescriptions - cost-related non-adherence - short version (PCN2) - Question identifier:PCN2_Q003
Do you have insurance that covers all or part of the cost of your prescription medications? Please include any private, government or employer-paid plans.
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Prescriptions - cost-related non-adherence - short version (PCN2) - Question identifier:PCN2_Q005
During the last 12 months, was there a time when you did not fill or collect a prescription for your medicine, or you skipped doses of your medicine because of the cost?
- 1: Yes
- 2: No
- 3: Not applicable, [I] had no medication prescription to fill in the last 12 months
- 8: RF
- 9: DK
Prescriptions - cost-related non-adherence - short version (PCN2) - Question identifier:PCN2_Q010
In the last 12 months, was there a time when you reduced the dosage of your medication or delayed filling your prescription, because of the cost?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Food security (FSC)
This module asks respondents if anyone in the household has experienced any issues associated with food security in the previous 12 months, (the ability to afford the purchase of sufficient nutritious food), with specific questions about the actions and needs of the adults who are responsible for children.
Even in households that appear to have high incomes, budget constraints may make it difficult to purchase nutritious foods. Food security questions will be asked of all respondents regardless of income.
Food security (FSC) - Question identifier:FSC_R010
The following questions are about the food situation for your household in the past 12 months. I'm going to read you several statements that may be used to describe the food situation for a household. Please tell me if the statement was often true, sometimes true, or never true for you [and other household members] in the past 12 months.
Food security (FSC) - Question identifier:FSC_Q010
The first statement is: You [and other household members] worried that food would run out before you got money to buy more. Was that often true, sometimes true, or never true in the past 12 months?
- 1: Often true
- 2: Sometimes true
- 3: Never true
- 8: RF
- 9: DK
Food security (FSC) - Question identifier:FSC_Q015
The food that you [and other household members] bought just didn't last, and there wasn't any money to get more. Was that often true, sometimes true, or never true in the past 12 months?
- 1: Often true
- 2: Sometimes true
- 3: Never true
- 8: RF
- 9: DK
Food security (FSC) - Question identifier:FSC_Q020
You [and other household members] couldn't afford to eat balanced meals. In the past 12 months was that often true, sometimes true, or never true?
- 1: Often true
- 2: Sometimes true
- 3: Never true
- 8: RF
- 9: DK
Food security (FSC) - Question identifier:FSC_R025
Now, I'm going to read a few statements that may describe the food situation for households with children.
Food security (FSC) - Question identifier:FSC_Q025
You [or other adults in your household] relied on only a few kinds of low-cost food to feed [the children] because you were running out of money to buy food. Was that often true, sometimes true, or never true in the past 12 months?
- 1: Often true
- 2: Sometimes true
- 3: Never true
- 8: RF
- 9: DK
Food security (FSC) - Question identifier:FSC_Q030
You [or other adults in your household] couldn't feed [the children] a balanced meal, because you couldn't afford it. Was that often true, sometimes true, or never true in the past 12 months?
- 1: Often true
- 2: Sometimes true
- 3: Never true
- 8: RF
- 9: DK
Food security (FSC) - Question identifier:FSC_Q035
[The children were] not eating enough because you [or other adults in your household] just couldn't afford enough food. Was that often, sometimes, or never true in the past 12 months?
- 1: Often true
- 2: Sometimes true
- 3: Never true
- 8: RF
- 9: DK
Food security (FSC) - Question identifier:FSC_R040
The following few questions are about the food situation in the past 12 months for you or any other adults in your household.
Food security (FSC) - Question identifier:FSC_Q040
In the past 12 months, since last [current month], did you [or other adults in your household] ever cut the size of your meals or skip meals because there wasn't enough money for food?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Food security (FSC) - Question identifier:FSC_Q045
How often did this happen? Was it...?
- 1: Almost every month
- 2: Some months but not every month
- 3: Only 1 or 2 months
- 8: RF
- 9: DK
Food security (FSC) - Question identifier:FSC_Q050
In the past 12 months, did you (personally) ever eat less than you felt you should because there wasn't enough money to buy food?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Food security (FSC) - Question identifier:FSC_Q055
In the past 12 months, were you (personally) ever hungry but didn't eat because you couldn't afford enough food?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Food security (FSC) - Question identifier:FSC_Q060
In the past 12 months, did you (personally) ever lose weight because you didn't have enough money for food?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Food security (FSC) - Question identifier:FSC_Q065
In the past 12 months, did [you or other adults in your household] ever not eat for a whole day because there wasn't enough money for food?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Food security (FSC) - Question identifier:FSC_Q070
How often did this happen? Was it...?
- 1: Almost every month
- 2: Some months but not every month
- 3: Only 1 or 2 months
- 8: RF
- 9: DK
Food security (FSC) - Question identifier:FSC_R075
Now, a few questions on the food experiences for children in your household.
Food security (FSC) - Question identifier:FSC_Q075
In the past 12 months, did you [or other adults in your household] ever cut the size of [any of the children's] meals because there wasn't enough money for food?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Food security (FSC) - Question identifier:FSC_Q080
In the past 12 months, did [any of the children] ever skip meals because there wasn't enough money for food?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Food security (FSC) - Question identifier:FSC_Q085
How often did this happen? Was it...?
- 1: Almost every month
- 2: Some months but not every month
- 3: Only 1 or 2 months
- 8: RF
- 9: DK
Food security (FSC) - Question identifier:FSC_Q090
In the past 12 months, [were any of the children] ever hungry but you just couldn't afford more food?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Food security (FSC) - Question identifier:FSC_Q095
In the past 12 months, did [any of the children] ever not eat for a whole day because there wasn't enough money for food?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Administration information (ADM)
In this module, respondents are informed that their information may be used for data linkage. Respondents are asked to provide their provincial or territorial health number.
Respondents are also asked to give their permission to share their reported data and their tax data with health partners.
Administration information (ADM) - Question identifier:ADM_Q005
Statistics Canada will combine your responses with information from the tax data of all members of your household. Statistics Canada, your [provincial / territorial] ministry of health [and the "Institut de la Statistique du Québec] may also add information from other surveys or administrative sources.
Administrative sources may include information on past and continuing use of health services such as visits to hospitals, clinics and doctors' offices.
- 1: Continue (Go to ADM_D010A)
- 2: Respondent does not want his or her responses combined with other sources
- 3: Other [e.g., respondent hung up, interview suspended or interrupted]
Administration information (ADM) - Question identifier:ADM_Q010
Having a provincial or territorial health number will assist us in linking to this other information.
Do you have [a/an] [Name of province/territory] health number?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Administration information (ADM) - Question identifier:ADM_Q015
For which province or territory is your health number?
- 10: Newfoundland and Labrador
- 11: Prince Edward Island
- 12: Nova Scotia
- 13: New Brunswick
- 24: Quebec
- 35: Ontario
- 46: Manitoba
- 47: Saskatchewan
- 48: Alberta
- 59: British Columbia
- 60: Yukon
- 61: Northwest Territories
- 62: Nunavut
- 88: Does not have a Canadian health number
- 98: RF
- 99: DK
Administration information (ADM) - Question identifier:ADM_Q020
What is your health number?
Long Answer Length = 12
Administration information (ADM) - Question identifier:ADM_R025
To avoid duplication of surveys, Statistics Canada has signed agreements to share the data from this survey with provincial and territorial ministries of health, Health Canada and the Public Health Agency of Canada.
Provincial ministries of health may make the data available to local health authorities. With the exception of postal code, names, addresses, telephone numbers [and health numbers] will not be provided.
Administration information (ADM) - Question identifier:ADM_R030
To avoid duplication of surveys, Statistics Canada has signed agreements to share the data from this survey with provincial and territorial ministries of health, the "Institut de la Statistique du Québec", Health Canada and the Public Health Agency of Canada.
The "Institut de la Statistique du Québec" and provincial ministries of health may make this data available to local health authorities. With the exception of postal code, names, addresses, telephone numbers [and health numbers] will not be provided.
Administration information (ADM) - Question identifier:ADM_Q035
These organizations have agreed to keep the data confidential and use it only for statistical purposes.
Do you agree to share the data provided?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Administration information (ADM) - Question identifier:ADM_Q037
To reduce the number of questions in this questionnaire, Statistics Canada will use information from your tax forms submitted to the Canada Revenue Agency. With your consent Statistics Canada will share this information from your tax forms with provincial and territorial ministries of health, [the "Institut de la Statistique du Québec",] Health Canada and the Public Health Agency of Canada. These organizations have agreed to keep the information confidential and to use it only for statistical and research purposes.
Do you give Statistics Canada permission to share your tax information to provincial and territorial ministries of health, [the "Institut de la Statistique du Québec",] Health Canada and the Public Health Agency of Canada?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Income (INC)
In this module, respondents are asked to provide the amount of their household income, all sources of income, and their main sources of household income, for the last calendar year. The respondent is also asked if the total household income includes a supplement for people with disabilities, for certain types of income.
Although income is a sensitive topic, this information is very important for studying the link between income and health.
Although many health care costs in Canada are covered by insurance, income still plays an important role in people's health. People living in households with lower incomes are more likely to have poorer health. People living in households with varying income levels also tend to use the health care system differently.
Income (INC) - Question identifier:INC_R001
Although many health expenses are covered by health insurance, there is still an important relationship between health and income. Please be assured that, like all other information you have provided, these answers will be kept strictly confidential.
Income (INC) - Question identifier:INC_Q005
Thinking about the total income for all household members, from which of the following sources did your household receive any income in the year ending December 31, [Past year]?
- 01: Wages and salaries
- 02: Income from self-employment
- 03: Dividends and interest (e.g., on bonds, savings)
- 04: Employment insurance
- 05: Workers' compensation
- 06: Benefits from Canada or Quebec Pension Plan
- 07: Job-related retirement pensions, superannuation and annuities
- 08: RRSP/RRIF (Registered Retirement Savings Plan/Registered Retirement Income Fund)
- 09: Old Age Security and Guaranteed Income Supplement
- 10: Provincial or municipal social assistance or welfare
- 11: Child Tax Benefit or family allowances
- 12: Child support
- 13: Alimony
- 14: Other (e.g., rental income, scholarships)
- 15: None
- 98: RF
- 99: DK
Income (INC) - Question identifier:INC_Q010
Does this amount include a supplement for people with disabilities?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Income (INC) - Question identifier:INC_Q015
What was the main source of household income?
- 01: Wages and salaries
- 02: Income from self-employment
- 03: Dividends and interest (e.g., on bonds, savings)
- 04: Employment insurance
- 05: Workers' compensation
- 06: Benefits from Canada or Quebec Pension Plan
- 07: Job-related retirement pensions, superannuation and annuities
- 08: RRSP/RRIF (Registered Retirement Savings Plan/Registered Retirement Income Fund)
- 09: Old Age Security and Guaranteed Income Supplement
- 10: Provincial or municipal social assistance or welfare
- 11: Child Tax Benefit or family allowances
- 12: Child support
- 13: Alimony
- 14: Other (e.g., rental income, scholarships)
- 15: None
- 98: RF
- 99: DK
Income (INC) - Question identifier:INC_Q021
Now a question about your total household income.
What is your best estimate of your total household income received by all household members, from all sources, before taxes and deductions, during the year ending December 31, [Past year] ?
Income can come from various sources such as from work, investments, pensions or government. Examples include Employment Insurance, Social Assistance, Child Tax Benefit and other income such as child support, spousal support (alimony) and rental income.
Min = -9000000; Max = 90000000
Income (INC) - Question identifier:INC_Q022
Can you estimate in which of the following groups your household income falls? Was the total household income during the year ending December 31, [Past year]... ?
- 1: Less than $50,000, including income loss
- 2: $50,000 and more
- 8: RF
- 9: DK
Income (INC) - Question identifier:INC_Q023
Please stop me when I have read the category which applies to your household.
Was it... ?
- 1: Less than $5,000
- 2: $5,000 to less than $10,000
- 3: $10,000 to less than $15,000
- 4: $15,000 to less than $20,000
- 5: $20,000 to less than $30,000
- 6: $30,000 to less than $40,000
- 7: $40,000 to less than $50,000
- 8: RF
- 9: DK
Income (INC) - Question identifier:INC_Q024
Please stop me when I have read the category which applies to your household.
Was it... ?
- 1: $50,000 to less than $60,000
- 2: $60,000 to less than $70,000
- 3: $70,000 to less than $80,000
- 4: $80,000 to less than $90,000
- 5: $90,000 to less than $100,000
- 6: $100,000 to less than $150,000
- 7: $150,000 and over
- 8: RF
- 9: DK
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