Canadian Community Health Survey - Annual component(CCHS) - 2021
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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)
- COVID-19 (COV)
- Height and weight - self reported (HWT)
- Chronic conditions (CCC)
- Activities of daily living (ADL)
- Sleep (SLP)
- Fruit and vegetable consumption (FVC)
- Smoking (SMK)
- Smoking - stages of change 2 (SCH2)
- Tobacco products alternatives 2 (TAL2)
- E-Cigarette and vaping (ECV)
- Alcohol use (ALC)
- Medication use (MED)
- Cannabis use (CAN)
- Drug use (DRG)
- Physical activities - adults 18 years and older (PAA)
- Physical activities for youth (PAY)
- Sedentary behaviours (SBE)
- Maternal experiences (MEX)
- Smoking during maternal experience (MXS)
- Alcohol use during maternal experience (MXA)
- Depression (DEP)
- Social provisions (SPS)
- Primary health care (PHC)
- Home care services - with palliative care (HMC)
- Labour force (LBF)
- Socio-demographic characteristics (SDC)
- Person most knowledgeable about household situation (PMK)
- 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
COVID-19 (COV)
This module collects information about experiences during the COVID-19 pandemic.
Respondents are asked about their mental health during the pandemic compared to their mental health before the pandemic. Respondents are also asked about the precautions they have been taking to protect themselves or others from COVID-19; if they have experienced symptoms of COVID-19 since the beginning of the pandemic; if they have ever been tested, and whether the test result was positive.
Finally, respondents are asked about the COVID-19 vaccine.
COVID-19 (COV) - Question identifier:COV_R005
The next questions are about your experiences during the COVID-19 pandemic.
COVID-19 (COV) - Question identifier:COV_Q005
Compared to before the pandemic started, how would you say your mental health is now? Would you say...?
- 1: Much better now
- 2: Somewhat better now
- 3: About the same
- 4: Somewhat worse now
- 5: Much worse now
- 8: RF
- 9: DK
COVID-19 (COV) - Question identifier:COV_Q010
Which of the following precautions are you taking to protect yourself or others against COVID-19? Do you...?
- 01: Wash hands more frequently
- 02: Wear a mask in public places where physical distancing is difficult
- 03: Keep a 2 meter or 6 foot distance from others
- 04: Avoid crowds and large gatherings
- 05: Avoid leaving the house for non-essential reasons
- 06: Work from home
- 07: Use delivery or curb side pick-up services (e.g., groceries, prescriptions)
- 08: Self-isolate if you have symptoms
- 09: Other precaution
- 10: No precaution taken
- 98: RF
- 99: DK
COVID-19 (COV) - Question identifier:COV_Q015
Since the beginning of the pandemic, have you experienced any of the symptoms that led you to believe that you had COVID-19, such as fever, cough, chills, difficulty breathing or tiredness?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
COVID-19 (COV) - Question identifier:COV_Q020
While you were experiencing these symptoms, did you follow public health recommendations, such as self-isolating and wearing a mask if you had to go out in public?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
COVID-19 (COV) - Question identifier:COV_Q025
Have you ever been tested for COVID-19?
This includes any type of COVID-19 test, such as deep nasal or throat swab, saliva test, etc.
- 1: Yes
- 2: No
- 8: RF
- 9: DK
COVID-19 (COV) - Question identifier:COV_Q030
Was the result of one of your tests positive?
- 1: Yes (Diagnosed with COVID-19)
- 2: No (Not diagnosed with COVID-19)
- 3: Waiting for the results
- 8: RF
- 9: DK
COVID-19 (COV) - Question identifier:COV_Q035
When was your most recent [positive] test done?
- 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
COVID-19 (COV) - Question identifier:COV_N036
What was the year?
- 1: 2020
- 2: 2021
- 8: RF
- 9: DK
COVID-19 (COV) - Question identifier:COV_Q038
Have you been vaccinated against COVID-19?
- 1: Yes, received at least one dose of a vaccine
- 2: No
- 8: RF
- 9: DK
COVID-19 (COV) - Question identifier:COV_Q040
How likely is it that you would get a COVID-19 vaccine? Would you say...?
- 1: Very likely
- 2: Somewhat likely
- 3: Somewhat unlikely
- 4: Very unlikely
- 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)
This module deals 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 high blood pressure.
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_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_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_Q055
Do you have back problems, excluding scoliosis, fibromyalgia and arthritis?
- 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_Q190
Do you suffer from multiple chemical sensitivities?
Multiple chemical sensitivity (MCS) is a chronic condition where people are sensitive to low levels of multiple unrelated chemicals such as smoke or perfume - levels that do not cause symptoms in most people. He/she may experience symptoms such as fatigue, asthma, blocked nose or sore eyes.
- 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
Activities of daily living (ADL)
This module looks at the impact of a physical or mental condition or health problem on common activities of daily living such as preparing meals, running errands, and doing housework.
It is very important to ask all questions of everyone in order to compare those with activity limitations and those without.
Activities of daily living (ADL) - Question identifier:ADL_R001
The next few questions are about common daily activities. These questions may not apply to you, but we need to ask the same questions of everyone.
Activities of daily living (ADL) - Question identifier:ADL_Q005
Because of any physical condition, mental condition or health problem, do you have any difficulty:
with preparing meals?
- 1: No, you have no difficulty
- 2: Yes, you have difficulty, but do not require help of others
- 3: Yes, you have difficulty, but can do it with the help of others
- 4: [You] cannot do it at all
- 8: RF
- 9: DK
Activities of daily living (ADL) - Question identifier:ADL_Q010
Because of any physical condition, mental condition or health problem, do you have any difficulty:
with running errands such as shopping for groceries?
- 1: No, you have no difficulty
- 2: Yes, you have difficulty, but do not require help of others
- 3: Yes, you have difficulty, but can do it with the help of others
- 4: [You] cannot do it at all
- 8: RF
- 9: DK
Activities of daily living (ADL) - Question identifier:ADL_Q015
Because of any physical condition, mental condition or health problem, do you have any difficulty:
with doing everyday housework?
- 1: No, you have no difficulty
- 2: Yes, you have difficulty, but do not require help of others
- 3: Yes, you have difficulty, but can do it with the help of others
- 4: [You] cannot do it at all
- 8: RF
- 9: DK
Activities of daily living (ADL) - Question identifier:ADL_Q020
Because of any physical condition, mental condition or health problem, do you have any difficulty:
with personal care such as bathing, dressing, eating or taking medication?
- 1: No, you have no difficulty
- 2: Yes, you have difficulty, but do not require help of others
- 3: Yes, you have difficulty, but can do it with the help of others
- 4: [You] cannot do it at all
- 8: RF
- 9: DK
Activities of daily living (ADL) - Question identifier:ADL_Q025
Because of any physical condition, mental condition or health problem, do you have any difficulty:
with moving about inside the house?
- 1: No, you have no difficulty
- 2: Yes, you have difficulty, but do not require help of others
- 3: Yes, you have difficulty, but can do it with the help of others
- 4: [You] cannot do it at all
- 8: RF
- 9: DK
Activities of daily living (ADL) - Question identifier:ADL_Q030
Because of any physical condition, mental condition or health problem, do you have any difficulty:
with looking after your personal finances such as making bank transactions or paying bills?
- 1: No, you have no difficulty
- 2: Yes, you have difficulty, but do not require help of others
- 3: Yes, you have difficulty, but can do it with the help of others
- 4: [You] cannot do it at all
- 8: RF
- 9: DK
Sleep (SLP)
In this module, respondents are asked a number of questions related to sleep, including number of hours usually spent sleeping, difficulty in going to sleep or staying asleep, how often sleep is refreshing, and difficulty in staying awake.
These questions will be used to examine the links between sleep and other factors, such as poor health and stress.
Sleep (SLP) - Question identifier:SLP_R001
Now a few questions about sleep.
Sleep (SLP) - Question identifier:SLP_Q005
How long do you usually spend sleeping each night?
- 01: Under 2 hours
- 02: 2 hours to less than 3 hours
- 03: 3 hours to less than 4 hours
- 04: 4 hours to less than 5 hours
- 05: 5 hours to less than 6 hours
- 06: 6 hours to less than 7 hours
- 07: 7 hours to less than 8 hours
- 08: 8 hours to less than 9 hours
- 09: 9 hours to less than 10 hours
- 10: 10 hours to less than 11 hours
- 11: 11 hours to less than 12 hours
- 12: 12 hours or more
- 98: RF
- 99: DK
Sleep (SLP) - Question identifier:SLP_Q010
How often do you have trouble going to sleep or staying asleep?
- 1: Never
- 2: Rarely
- 3: Sometimes
- 4: Most of the time
- 5: All of the time
- 8: RF
- 9: DK
Sleep (SLP) - Question identifier:SLP_Q015
How often do you find your sleep refreshing?
- 1: Never
- 2: Rarely
- 3: Sometimes
- 4: Most of the time
- 5: All of the time
- 8: RF
- 9: DK
Sleep (SLP) - Question identifier:SLP_Q020
How often do you find it difficult to stay awake when you want to?
- 1: Never
- 2: Rarely
- 3: Sometimes
- 4: Most of the time
- 5: All of the time
- 8: RF
- 9: 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
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 - stages of change 2 (SCH2)
In this module, current smokers are asked whether they intend to quit smoking in the next 6 months. The respondent is also asked if they stopped smoking in the past 12 months for at least 24 hours because they were trying to reduce or quit smoking.
When health region planners develop programs to encourage people to stop smoking, it is very helpful to know which groups are more ready to quit and may need only some encouragement, and which groups need different types of programs or education.
Smoking - stages of change 2 (SCH2) - Question identifier:SCH2_Q005
Are you seriously considering quitting smoking within the next 6 months?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Smoking - stages of change 2 (SCH2) - Question identifier:SCH2_Q015
In the past 12 months, did you stop smoking for at least 24 hours because you were trying to cut back or quit?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Tobacco products alternatives 2 (TAL2)
This module deals with the use of cigars, cigarillos, 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 2 (TAL2) - Question identifier:TAL2_R001
Now, I would like to ask you a few questions about tobacco products, other than cigarettes.
Tobacco products alternatives 2 (TAL2) - Question identifier:TAL2_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 2 (TAL2) - Question identifier:TAL2_Q010
Were these (little cigars or cigarillos) plain, flavoured or both?
- 1: Plain
- 2: Flavoured
- 3: Both
- 8: RF
- 9: DK
Tobacco products alternatives 2 (TAL2) - Question identifier:TAL2_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 2 (TAL2) - Question identifier:TAL2_Q025
(In the past 30 days), did you smoke a pipe?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Tobacco products alternatives 2 (TAL2) - Question identifier:TAL2_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 2 (TAL2) - Question identifier:TAL2_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
E-Cigarette and vaping (ECV)
This module includes a series of questions on electronic cigarettes and vaping devices, excluding vaping cannabis. Respondents are asked if they have ever tried an e-cigarette or vaping device, and, if so, at what age they first tried it, and how often in the past 30 days.
E-Cigarette and vaping (ECV) - Question identifier:ECV_R005
The following questions are about electronic cigarettes (e-cigarettes) or vaping devices. Please exclude vaping cannabis.
E-Cigarette and vaping (ECV) - Question identifier:ECV_Q005
Have you ever tried an e-cigarette or vaping device?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
E-Cigarette and vaping (ECV) - Question identifier:ECV_Q010
At what age did you first use an e-cigarette or vaping device?
Min = 5; Max = 121
E-Cigarette and vaping (ECV) - Question identifier:ECV_Q015
Which did you try first, an e-cigarette / vaping device or a cigarette?
- 1: E-cigarette / vaping device
- 2: Cigarette
- 8: RF
- 9: DK
E-Cigarette and vaping (ECV) - Question identifier:ECV_Q020
In the past 30 days, how often did you use an e-cigarette or vaping device?
- 1: Daily
- 2: Less than once a day, but at least once a week
- 3: Less than once a week, but at least once in the past month
- 4: Not at all
- 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
Medication use (MED)
This module deals with the use of prescription and non-prescription medications in the past 12 months, including different pain relievers, stimulants and sedatives.
The results of this module will be used to create a picture of which medications are taken by various groups. Researchers will use the results to examine the relationship between health problems, use of medications, and use of other health care services.
Medication use (MED) - Question identifier:MED_R001
The next series of questions are about various medications.
The first series of questions are about your use of various pain relievers. By pain relievers, we mean products that contain opioids such as codeine or morphine, or related drugs. Most of these products require a prescription, although some codeine products are available without a prescription, for example, Tylenol #1 or 222s.
We are not interested in pain relievers such as Aspirin, Advil, regular Tylenol, Celebrex, etc.
Medication use (MED) - Question identifier:MED_Q005
During the past 12 months, have you used any codeine products like Tylenol #3, Tylenol #1, 292s or 222s?
Tylenol Regular and Extra-strength do not contain codeine and are not counted. Tylenol 1, 2, 3, and 4 contain codeine and are counted.
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Medication use (MED) - Question identifier:MED_Q010
During the past 12 months, have you used any oxycodone products such as Percocet or Percodan?
Include Oxycontin and oxy-neo.
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Medication use (MED) - Question identifier:MED_Q015
During the past 12 months, have you used any other opioid products such as hydromorphone, Dilaudid, Hydromorph Contin, morphine, MS Contin, or Demerol?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Medication use (MED) - Question identifier:MED_Q020
During the past 12 months, how often did you use any such pain relievers? Would you say...?
- 01: Once or twice
- 02: 3 to 11 times a year
- 03: About once a month
- 04: 2 or 3 times a month
- 05: About once or twice a week
- 06: 3 or 4 times a week
- 07: Daily or almost daily
- 08: As needed, or following surgery
- 98: RF
- 99: DK
Medication use (MED) - Question identifier:MED_Q025
Thinking about all the pain relievers you have used during the past 12 months, were they prescribed for you?
- 1: No, none were prescribed
- 2: Yes, they all were prescribed
- 3: Some were prescribed and others were not
- 8: RF
- 9: DK
Medication use (MED) - Question identifier:MED_Q030
Sometimes people do not take their pills as directed by a physician or pharmacist. Thinking about all the pain relievers you have used during the past 12 months, did you ever take more pills, or take them more often than you were supposed to?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Medication use (MED) - Question identifier:MED_Q035
During the past 12 months, did you ever use pain relievers only for the experience, the feeling they caused or to get high?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Medication use (MED) - Question identifier:MED_Q040
During the past 12 months, did you ever use pain relievers for reasons other than pain relief, for example, to feel better (improve mood), to cope with stress or problems, or any other reason?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Medication use (MED) - Question identifier:MED_Q045
During the past 12 months, did you ever tamper with a pain reliever product before taking it, for example, by crushing tablets to swallow, snort or inject [, not counting for ease of swallowing or to take a lower dose]?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Medication use (MED) - Question identifier:MED_R050
The next few questions are about your use of various stimulants.
By stimulants, we mean products prescribed by a doctor to help people who have attention or concentration problems (such as ADHD). Examples of stimulants include Ritalin, Concerta, Adderall, Dexedrine or others.
Medication use (MED) - Question identifier:MED_Q050
During the past 12 months, have you used any stimulants?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Medication use (MED) - Question identifier:MED_Q055
During the past 12 months, how often did you use any stimulants? Would you say...?
- 01: Once or twice
- 02: 3 to 11 times a year
- 03: About once a month
- 04: 2 or 3 times a month
- 05: About once or twice a week
- 06: 3 or 4 times a week
- 07: Daily or almost daily
- 08: As needed, or following surgery
- 98: RF
- 99: DK
Medication use (MED) - Question identifier:MED_Q060
Thinking about all the stimulants you used during the past 12 months, were they prescribed for you?
- 1: No, none were prescribed
- 2: Yes, they all were prescribed
- 3: Some were prescribed and others were not
- 8: RF
- 9: DK
Medication use (MED) - Question identifier:MED_Q065
Sometimes people do not take their pills as directed by a physician or pharmacist. Thinking about all the stimulants you have used during the past 12 months, did you ever take more pills or take them more often than you were supposed to?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Medication use (MED) - Question identifier:MED_Q070
During the past 12 months, did you ever use stimulants only for the experience, the feeling they caused or to get high?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Medication use (MED) - Question identifier:MED_Q075
During the past 12 months, did you ever use stimulants for reasons other than why they were prescribed, for example, to study, to stay alert, to decrease your appetite or for any other reason?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Medication use (MED) - Question identifier:MED_R080
The next few questions are about your use of various sedatives or anti-anxiety medications.
By sedatives, we mean products that can be obtained from a doctor such as diazepam, Valium, lorazepam, Ativan, alprazolam, Xanax, clonazepam, Rivotril or others.
Sedatives are sometimes prescribed to help people sleep, calm down, or to relax their muscles.
Medication use (MED) - Question identifier:MED_Q080
During the past 12 months, have you used any sedatives?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Medication use (MED) - Question identifier:MED_Q085
During the past 12 months, how often did you use any sedatives? Would you say...?
- 01: Once or twice
- 02: 3 to 11 times a year
- 03: About once a month
- 04: 2 or 3 times a month
- 05: About once or twice a week
- 06: 3 or 4 times a week
- 07: Daily or almost daily
- 08: As needed, or following surgery
- 98: RF
- 99: DK
Medication use (MED) - Question identifier:MED_Q090
Thinking about all the sedatives you have used during the past 12 months, were they prescribed for you?
- 1: No, none were prescribed
- 2: Yes, they all were prescribed
- 3: Some were prescribed and others were not
- 8: RF
- 9: DK
Medication use (MED) - Question identifier:MED_Q095
Sometimes people do not take their pills as directed by a physician or pharmacist. Thinking about all the sedatives you have used during the past 12 months, did you ever take more pills or take them more often than you were supposed to?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Medication use (MED) - Question identifier:MED_Q100
During the past 12 months, did you ever use sedatives only for the experience, the feeling they caused or to get high?
- 1: Yes
- 2: No
- 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
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
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
Enter the number of hours
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.
Enter the number of hours.
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.
Enter the number of hours.
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.
Enter the number of hours.
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 = 24
Enter the number of hours.
Physical activities for youth (PAY) - Question identifier:PAY_N020
Enter number of minutes.
Min = 0; Max = 960
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 = 24
Enter the number of hours.
Physical activities for youth (PAY) - Question identifier:PAY_N040
Enter number of minutes.
Min = 0; Max = 960
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 = 24
Enter the number of hours.
Physical activities for youth (PAY) - Question identifier:PAY_N060
Enter number of minutes.
Min = 0; Max = 960
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 = 24
Enter the number of hours.
Physical activities for youth (PAY) - Question identifier:PAY_N080
Enter number of minutes.
Min = 0; Max = 960
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 / 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
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
Enter the day.
Maternal experiences (MEX) - Question identifier:MEX_Q025
What is [your last child]'s date of birth?
Enter the month.
- 01: January
- 02: February
- 03: March
- 04: April
- 05: May
- 06: June
- 07: July
- 08: August
- 09: September
- 10: October
- 11: November
- 12: December
- 98: RF
- 99: DK
Maternal experiences (MEX) - Question identifier:MEX_Q030
What is [your last child]'s date of birth?
Min = 2010; Max = 2099
Enter a four-digit year.
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
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
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
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_Q037
Thinking of the home care services that [you / the other household members / you and the other household members] received in the past 12 months, how helpful were they in allowing [you / the other household members / you and the other household members] to stay at home?
By "stay at home" we mean that it enabled the person to stay out of a hospital, nursing home, hospice, or assisted living facility.
- 1: Very helpful
- 2: Somewhat helpful
- 3: Not helpful
- 4: Reason for homecare was unrelated to staying at home (e.g., wound care)
- 8: RF
- 9: DK
Home care services - with palliative care (HMC) - Question identifier:HMC_Q038
Why didn't the home care services help [you / the other household members / you and the other household members] to stay at home?
- 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 (coverage, frequency, etc.)
- 4: Long wait times to receive services
- 5: Cost of services was too high
- 6: 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
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.
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.
Data shared with your ministry of health may also include your identifiers such as name, address, telephone number and health card number. Health Canada, the Public Health Agency of Canada, and local health authorities, would receive only your survey responses and postal code.
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.
Data shared with your ministry of health may also include your identifiers such as name, address, telephone number and health card number. Health Canada, the Public Health Agency of Canada, and local health authorities, would receive only your survey responses and postal code.
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 income 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
- Date modified: