Canadian Community Health Survey (CCHS) - Annual Component - 2022

Respondent availability (TR) - Question identifier:TR_Q01

May I speak to [First name of household contact] [Last name of household contact]?

Respondent availability

• 1: Yes, speaking to respondent
• 2: Yes, respondent available
• 3: No, respondent unable to complete this survey
• 4: No, respondent not available at this time

The proxy respondent (PRX) - Question identifier:PRX_Q01

What is the reason [First name of household contact] is unable to complete this survey?

• 1: Respondent does not speak English or French (Language barrier)
• 2: Respondent unable to answer because of a health condition, a physical or mental disability, or problems related to aging
• 3: Respondent absent for the duration of the collection period
• 4: Other

The proxy respondent (PRX) - Question identifier:PRX_Q02

Is there someone [Minimum age of person providing proxy interview] or older who could provide us with some information on behalf [First name of household contact]? We would like to ask this person questions about [First name of household contact]'s health status, factors that affect their health and their use of health care services.

• 1: Yes
• 2: No

The proxy respondent (PRX) - Question identifier:PRX_Q03A

What is the first name of this person?

Long Answer Length = 80

First name

The proxy respondent (PRX) - Question identifier:PRX_Q03B

What is the last name of this person?

Long Answer Length = 80

Last name

Verification (VER2) - Question identifier:VER2_Q05

Are you [First name of specific respondent] [Last name of specific respondent]?

• 1: Yes
• 2: No

Verification (VER2) - Question identifier:VER2_Q07C

What is your date of birth?
Year

Min = 2000; Max = 2022

Verification (VER2) - Question identifier:VER2_Q07B

What is your date of birth?
Month

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

Verification (VER2) - Question identifier:VER2_Q07A

What is your date of birth?
Day

Min = 1; Max = 31

Verification (VER2) - Question identifier:VER2_Q08

In which province or territory do you currently live?

• 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

Date of birth (AGE) - Question identifier:AGE_Q01A

What is [your] date of birth?
Year

Min = 1897; Max = 2022

Date of birth (AGE) - Question identifier:AGE_Q01B

What is [your] date of birth?
Month

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

Date of birth (AGE) - Question identifier:AGE_Q01C

What is [your] date of birth?
Day

Min = 1; Max = 31

Sex and gender (GDRA) - Question identifier:GDRA_R05

The following questions are about sex at birth and gender.

Sex and gender (GDRA) - Question identifier:GDRA_Q05

What was [your] sex at birth?

Sex refers to sex assigned at birth.

• 1: Male
• 2: Female

Sex and gender (GDRA) - Question identifier:GDRA_Q10

What is [your] gender?

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.

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

Sex and gender (GDRA) - Question identifier:GDRA_R15

Please verify that all of the information is correct.

[Your]

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

If all the information is correct, press the Next button.
To make changes, press the Previous button.

Relationship with confirmation (RWC) - Question identifier:RWC_Q05

What is the relationship of the following [people/person] to you?

[First name of household member] [Last name of household member] [Age]

• 01: Husband or wife
• 02: Common-law partner
• 03: Father or mother
• 04: Son or daughter
• 05: Brother or sister
• 06: In-law
• 07: Other related
• 08: Unrelated

Main activity (MAC) - Question identifier:MAC_Q05

In the past 12 months, was your main activity working at a job or business?

• 1: Yes
• 2: No

Main activity (MA) - Question identifier:MA_Q02

During the past 12 months, what was your main activity?

If the main activity was "sickness" or "short-term illness", indicate the usual main activity.

• 01: Looking for paid work
• 02: Going to school
• 03: Caring for your children
• 04: Household work
• 05: Retired
• 06: Maternity, paternity or parental leave
• 07: Long term illness
• 08: Volunteering or care-giving other than for your children
• 09: Other

Main activity (MA) - Question identifier:MA_Q03

In the past 7 days, did you work at a job or business?

• 1: Yes
• 2: No

Main activity (EDC) - Question identifier:EDC_Q10

Are you currently attending a school, college, CEGEP or university?

Report only attendance for courses that can be used as credits towards a certificate, diploma or degree. Distance learning for credit is included.

• 1: Yes
• 2: No

Main activity (EDC) - Question identifier:EDC_Q20

Are you enrolled as a full-time or part-time student?

Each educational institution classifies students as full-time or part-time depending on the type of program, and the number of courses, credits or hours of instruction.

• 1: Full-time student
• 2: Part-time student

General health (GEN) - Question identifier:GEN_R01

The following question is about health. By health, we mean not only the absence of disease or injury but also physical, mental and social well-being.

General health (GEN) - Question identifier:GEN_Q01

In general, how is your health?

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

General health (GEN) - Question identifier:GEN_Q05

In general, how is your mental health?

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

General health (GEN) - Question identifier:GEN_Q10

Thinking about the amount of stress in your life, how would you describe most of your days?

• 1: Not at all stressful
• 2: Not very stressful
• 3: A bit stressful
• 4: Quite a bit stressful
• 5: Extremely stressful

General health (GEN) - Question identifier:GEN_R15

The next question is about your main job or business in the past 12 months.

General health (GEN) - Question identifier:GEN_Q15

How would you describe most days at work?

• 1: Not at all stressful
• 2: Not very stressful
• 3: A bit stressful
• 4: Quite a bit stressful
• 5: Extremely stressful

General health (GEN) - Question identifier:GEN_Q20

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

• 1: Very strong
• 2: Somewhat strong
• 3: Somewhat weak
• 4: Very weak

Life satisfaction measures (LSM) - Question identifier:LSM_Q01

Using a scale of 0 to 10, where 0 means "Very dissatisfied" and 10 means "Very satisfied", how do you feel aboutyour life as a whole right now?

• 00: Very dissatisfied
• 01: |
• 02: |
• 03: |
• 04: |
• 05: |
• 06: |
• 07: |
• 08: |
• 09: V
• 10: Very satisfied

Pregnancy (PRS) - Question identifier:PRS_R05

To better understand your health information, it is important to know if you are pregnant.

Pregnancy (PRS) - Question identifier:PRS_Q05

Are you pregnant?

• 1: Yes
• 2: No

Height and weight (HWT) - Question identifier:HWT_Q05A

How tall are you without shoes on?
Feet

Min = 0; Max = 9

Report the height to the nearest inch or centimetre.

Height and weight (HWT) - Question identifier:HWT_Q05B

How tall are you without shoes on?
Inches

Min = 0; Max = 99

Report the height to the nearest inch or centimetre.

Height and weight (HWT) - Question identifier:HWT_Q05C

How tall are you without shoes on?
Centimetres

Min = 0; Max = 999

Report the height to the nearest inch or centimetre.

Height and weight (HWT) - Question identifier:HWT_Q40A

How much do you weigh?
Weight

Min = 0; Max = 999

Report the weight to the nearest pound or kilogram.

Height and weight (HWT) - Question identifier:HWT_Q40B

How much do you weigh?
Pounds or kilograms

Report the weight to the nearest pound or kilogram.

• 1: Pounds
• 2: Kilograms

Weight perception (WTP) - Question identifier:WTP_Q50

Do you consider yourself overweight, underweight or just about right?

• 1: Overweight
• 2: Underweight
• 3: Just about right

COVID-19 (COV2) - Question identifier:COV2_R005

The next questions are about your experiences during the COVID-19 pandemic.

COVID-19 (COV2) - Question identifier:COV2_Q005

Compared to before the pandemic started, how would you say your mental health is now?

• 1: Much better now
• 2: Somewhat better now
• 3: About the same
• 4: Somewhat worse now
• 5: Much worse now

COVID-19 (COV2) - Question identifier:COV2_Q010

Which of the following precautions are you taking to protect yourself or others against COVID-19?

Select all that apply.

• 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

COVID-19 (COV2) - Question identifier:COV2_Q015

In the last 3 months, have you experienced any of the symptoms that led you to believe that you had COVID-19, such as fever, headache, sore throat, runny nose, difficulty breathing or tiredness?

• 1: Yes
• 2: No

COVID-19 (COV2) - Question identifier:COV2_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

COVID-19 (COV2) - Question identifier:COV2_Q038

Have you been vaccinated against COVID-19?

• 1: Yes, received at least one dose of a vaccine
• 2: No

COVID-19 (COV2) - Question identifier:COV2_Q030

Does the vaccine you received require one or two doses?

Certain types of vaccines require more than one dose to protect against COVID-19.

If you needed a second dose, you would have been informed of this at the time of your vaccination. Please do not include an additional dose, also known as a third dose or a booster dose.

• 1: One dose
• 2: Two doses

COVID-19 (COV2) - Question identifier:COV2_Q035

How many doses of the COVID-19 vaccine have you received so far?

• 1: One dose
• 2: Two doses
• 3: Three doses
• 4: Four doses or more

COVID-19 (COV2) - Question identifier:COV2_Q041

What is the main reason why you haven't been vaccinated against COVID-19?

• 01: I do not want to be vaccinated at this time
• 02: I do not want to be vaccinated at all
• 03: I don't have confidence in the vaccine that was offered to me
• 04: I have an appointment in the future
• 05: I have not been able to get an appointment yet
• 06: I don't know where to go to get vaccinated
• 07: I was sick at the time the vaccine was offered to me
• 08: The vaccine is not recommended for me (e.g., a pre-existing medical condition)
• 09: I have already had COVID-19
• 10: I haven't had the time
• 11: I don't think it is necessary, the risks of having COVID-19 are now low
• 12: Other reason

COVID-19 (COV2) - Question identifier:COV2_Q045

Why don't you want to be vaccinated against COVID-19?

Select all that apply.

• 01: I am not at high risk of getting COVID-19
• 02: If I get COVID-19, I will not be very sick
• 03: The severity of the pandemic has been overstated
• 04: Vaccines in general are not effective in preventing diseases
• 05: Vaccines in general are not safe
• 06: I do not trust the effectiveness of the COVID-19 vaccines
• 07: I do not trust the safety of the COVID-19 vaccines
• 08: Philosophical or religious reasons
• 09: Other reason

COVID-19 (COV2) - Question identifier:COV2_Q040

How likely is it that you would get a COVID-19 vaccine?

• 1: Very likely
• 2: Somewhat likely
• 3: Somewhat unlikely
• 4: Very unlikely

COVID-19 (COV2) - Question identifier:COV2_Q055A

What is the main reason why you haven't received your second dose?

• 01: One dose is enough to protect me against COVID-19
• 02: I was not aware that I needed a second dose
• 03: I had a bad reaction to the first dose
• 04: I have concerns about side effects associated with the second dose
• 05: The vaccine I want to receive for my second dose is not available
• 06: I have an appointment in the future
• 07: It's too much trouble getting a second appointment
• 08: I have already had COVID-19
• 09: I don't think it is necessary, the risks of having COVID-19 are now low
• 10: Other reason

COVID-19 (COV2) - Question identifier:COV2_Q060

How likely is it that you would get your second dose?

• 1: Very likely
• 2: Somewhat likely
• 3: Somewhat unlikely
• 4: Very unlikely

Vaccination passeport COVID-19 (PVC) - Question identifier:PVC_Q005

Some public health authorities are considering establishing a COVID-19 vaccination passport or have already done so.

Is such a passport a motivation for you to get vaccinated?

A vaccine passport is a document certifying that a person is immunized following vaccination against a disease, for example COVID-19.

• 1: Yes, definitely
• 2: Yes, possibly
• 3: No

COVID-19 (COV3) - Question identifier:COV3_Q005

If an additional dose of the COVID-19 vaccine is offered to stimulate your immune system or to fight against variants, how likely is it that you would get it?

An additional dose is also known as a third dose or a booster dose.

A variant is a mutation of the COVID-19 virus that can cause a change in transmission or a more severe infection, for example the Delta variant.

• 1: Very likely
• 2: Somewhat likely
• 3: Somewhat unlikely
• 4: Very unlikely

Chronic conditions (CCC) - Question identifier:CCC_R01

The next questions are about long-term health conditions. These are 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_Q05

Do you have diabetes?

Include type 1, type 2 or gestational diabetes.

Exclude prediabetes.

• 1: Yes
• 2: No

Chronic conditions (CCC) - Question identifier:CCC_Q10

How old were you when this was first diagnosed?

Min = 0; Max = 999

Chronic conditions (CCC) - Question identifier:CCC_Q15

Were you pregnant when you were first diagnosed with diabetes?

• 1: Yes
• 2: No

Chronic conditions (CCC) - Question identifier:CCC_Q20

Other than during pregnancy, has a health professional ever told you that you have diabetes?

• 1: Yes
• 2: No

Chronic conditions (CCC) - Question identifier:CCC_Q25

Were you diagnosed with type 1 or type 2 diabetes?

• 1: Type 1 - Insulin dependent diabetes
• 2: Type 2 - Non-Insulin dependent diabetes
• 3: Both types

Chronic conditions (CCC) - Question identifier:CCC_Q30

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

Chronic conditions (CCC) - Question identifier:CCC_Q35

Do you currently take insulin for your diabetes?

• 1: Yes
• 2: No

Chronic conditions (CCC) - Question identifier:CCC_Q40

In the past month, did you take pills to control your blood sugar?

• 1: Yes
• 2: No

Chronic conditions (CCC) - Question identifier:CCC_Q45

Have you ever been diagnosed with cancer?

• 1: Yes
• 2: No

Chronic conditions (CCC) - Question identifier:CCC_Q50

How old were you when this was first diagnosed?

Min = 0; Max = 999

Chronic conditions (CCC) - Question identifier:CCC_Q55

Have you received treatment for cancer in the past 12 months?

• 1: Yes
• 2: No

Chronic conditions (CCC) - Question identifier:CCC_Q60

What type of cancer were you diagnosed with?

Select all that apply.

• 01: Breast
• 02: Prostate
• 03: Colorectal
• 04: Skin - Melanoma
• 05: Skin - Non-melanoma
• 06: Ovarian
• 07: Cervical
• 08: Uterine
• 09: Lung
• 10: Other - specify

Chronic conditions (CCC) - Question identifier:CCC_Q65

Do you have heart disease?

• 1: Yes
• 2: No

Chronic conditions (CCC) - Question identifier:CCC_Q70

How old were you when this was first diagnosed?

Min = 0; Max = 999

Chronic conditions (CCC) - Question identifier:CCC_Q75

[Have you] ever been told by a health professional that you have had a heart attack?

• 1: Yes
• 2: No

Chronic conditions (CCC) - Question identifier:CCC_Q80

Do you have high blood pressure?

• 1: Yes
• 2: No

Chronic conditions (CCC) - Question identifier:CCC_Q85

In the past month, have you taken any medicine for high blood pressure?

• 1: Yes
• 2: No

Chronic conditions (CCC) - Question identifier:CCC_Q90

[Have you] ever been told by a health professional that your blood cholesterol was high?

• 1: Yes
• 2: No

Chronic conditions (CCC) - Question identifier:CCC_Q95

Do you suffer from the effects of a stroke?

• 1: Yes
• 2: No

Chronic conditions (CCC) - Question identifier:CCC_Q100

Do you have osteoporosis?

• 1: Yes
• 2: No

Chronic conditions (CCC) - Question identifier:CCC_R105

We are 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_Q105

Do you have fibromyalgia?

• 1: Yes
• 2: No

Chronic conditions (CCC) - Question identifier:CCC_Q110

How old were you when the first symptoms appeared?

Min = 0; Max = 999

Chronic conditions (CCC) - Question identifier:CCC_Q115

How old were you when this was first diagnosed?

Min = 0; Max = 999

Chronic conditions (CCC) - Question identifier:CCC_Q120

Do you have arthritis?

e.g., osteoarthritis, rheumatoid arthritis, gout

Exclude fibromyalgia.

• 1: Yes
• 2: No

Chronic conditions (CCC) - Question identifier:CCC_Q125

Do you have back problems?

Exclude scoliosis, fibromyalgia and arthritis.

• 1: Yes
• 2: No

Chronic conditions (CCC) - Question identifier:CCC_Q130

Was this diagnosed by a health professional?

• 1: Yes
• 2: No

Chronic conditions (CCC) - Question identifier:CCC_Q135

Do you have a mood disorder?

Include depression, bipolar disorder, mania, dysthymia or manic depression.

• 1: Yes
• 2: No

Chronic conditions (CC1) - Question identifier:CC1_R140

We are interested in conditions diagnosed by a health professional and that are expected to last or have already lasted 6 months or more.

Chronic conditions (CC1) - Question identifier:CC1_Q140

Do you have an anxiety disorder?

Include phobia, panic disorder or generalized anxiety disorder.
Exclude obsessive-compulsive disorder.

• 1: Yes
• 2: No

Chronic conditions (CC1) - Question identifier:CC1_Q145

Do you have post-traumatic stress disorder (PTSD)?

• 1: Yes
• 2: No

Chronic conditions (CC1) - Question identifier:CC1_Q150

Do you have Alzheimer's disease or any other dementia?

• 1: Yes
• 2: No

Chronic conditions (CC1) - Question identifier:CC1_Q155

Do you have chronic fatigue syndrome (CFS)?

Include myalgic encephalomyelitis.

• 1: Yes
• 2: No

Chronic conditions (CC1) - Question identifier:CC1_Q160

How old were you when the first symptoms appeared?

Age in years

Min = 0; Max = 999

Chronic conditions (CC1) - Question identifier:CC1_Q165

How old were you when this was first diagnosed?

Age in years

Min = 0; Max = 999

Chronic conditions (CC1) - Question identifier:CC1_Q170

Do you have multiple chemical sensitivities (MCS)?

• 1: Yes
• 2: No

Chronic conditions (CC1) - Question identifier:CC1_Q175

How old were you when the first symptoms appeared?

Age in years

Min = 0; Max = 999

Chronic conditions (CC1) - Question identifier:CC1_Q180

How old were you when this was first diagnosed?

Age in years

Min = 0; Max = 999

Abilities (WDM) - Question identifier:WDM_R01

The next set of questions asks about your ability to do different activities.

Abilities (WDM) - Question identifier:WDM_Q05

Do you have difficulty doing any of these activities?
Difficulty seeing, even if wearing glasses

• 1: No difficulty
• 2: Some difficulty
• 3: A lot of difficulty
• 4: Cannot do at all or unable to do

Abilities (WDM) - Question identifier:WDM_Q10

Do you have difficulty doing any of these activities?
Difficulty hearing, even if using a hearing aid

• 1: No difficulty
• 2: Some difficulty
• 3: A lot of difficulty
• 4: Cannot do at all or unable to do

Abilities (WDM) - Question identifier:WDM_Q15

Do you have difficulty doing any of these activities?
Difficulty walking or climbing steps

• 1: No difficulty
• 2: Some difficulty
• 3: A lot of difficulty
• 4: Cannot do at all or unable to do

Abilities (WDM) - Question identifier:WDM_Q20

Do you have difficulty doing any of these activities?
Difficulty remembering or concentrating

• 1: No difficulty
• 2: Some difficulty
• 3: A lot of difficulty
• 4: Cannot do at all or unable to do

Abilities (WDM) - Question identifier:WDM_Q25

Do you have difficulty doing any of these activities?
Difficulty with self-care

Such as washing all over or dressing.

• 1: No difficulty
• 2: Some difficulty
• 3: A lot of difficulty
• 4: Cannot do at all or unable to do

Abilities (WDM) - Question identifier:WDM_Q30

Do you have difficulty doing any of these activities?
Difficulty communicating when using your usual language

For example understanding or being understood.

• 1: No difficulty
• 2: Some difficulty
• 3: A lot of difficulty
• 4: Cannot do at all or unable to do

Injuries (INJ) - Question identifier:INJ_Q05A

In the past 12 months, have you had any of the following injuries?
A head injury or concussion

• 1: Yes
• 2: No

Injuries (INJ) - Question identifier:INJ_Q05AA

How many times in the past 12 months?

Min = 0; Max = 99

Injuries (INJ) - Question identifier:INJ_Q05B

In the past 12 months, have you had any of the following injuries?
A broken or fractured bone

• 1: Yes
• 2: No

Injuries (INJ) - Question identifier:INJ_Q05BA

How many times in the past 12 months?

Min = 0; Max = 99

Injuries (INJ) - Question identifier:INJ_Q05C

In the past 12 months, have you had any of the following injuries?
A serious cut or puncture

Exclude surgery or operation.

• 1: Yes
• 2: No

Injuries (INJ) - Question identifier:INJ_Q05CA

How many times in the past 12 months?

Min = 0; Max = 99

Injuries (INJ) - Question identifier:INJ_Q10

What were you doing when your head injury or concussion occured?

If you had more than one head injury or concussion in the past 12 months, report for the most serious.

• 1: Riding a bike
• 2: Sports or physical activity (Exclude riding a bike)
• 3: Household chores, outdoor yard maintenance or unpaid work
• 4: Riding or driving a motor vehicle (Include off-road vehicles)
• 5: Working at a paid job or business (Exclude when driving is your job)
• 6: Other

Injuries (INJ) - Question identifier:INJ_Q15

Was your head injury or concussion the result of a fall?

• 1: Yes
• 2: No

Injuries (INJ) - Question identifier:INJ_Q15A

How did you fall?

• 1: While doing physical activity
• 2: Going up or down stairs
• 3: Slipped or stumbled while walking
• 4: Getting into or out of furniture (e.g., bed, chair)
• 5: From an elevated position (e.g., ladder, tree, scaffolding)
• 6: Due to health problems (e.g., fainting, weakness, dizziness)
• 7: Other

Injuries (INJ) - Question identifier:INJ_Q20

In the 48 hours following your head injury or concussion, did you consult a health care professional?

• 1: Yes
• 2: No

Injuries (INJ) - Question identifier:INJ_Q20A

Where did you go to consult this health professional?

• 1: Doctor's office or clinic (e.g., walk-in, hospital outpatient, sports)
• 2: Hospital emergency room
• 3: Chiropractor or physiotherapist's office
• 4: Other

Injuries (INJ) - Question identifier:INJ_Q25

Were you admitted to a hospital overnight because of this injury?

• 1: Yes
• 2: No

Injuries (INJ) - Question identifier:INJ_Q30

What were you doing when your broken or fractured bone occured?

If you had more than one broken or fractured bone in the past 12 months, report the most serious.

• 1: Riding a bike
• 2: Sports or physical activity (Exclude riding a bike)
• 3: Household chores, outdoor yard maintenance or unpaid work
• 4: Riding or driving a motor vehicle (Include off-road vehicles)
• 5: Working at a paid job or business (Exclude when driving is your job)
• 6: Other

Injuries (INJ) - Question identifier:INJ_Q35

Which part of the body was injured?

• 01: Multiple body parts
• 02: Head or neck
• 03: Shoulder or upper arm
• 04: Elbow or lower arm
• 05: Wrist or hand
• 06: Hip or thigh
• 07: Knee or lower leg
• 08: Ankle or foot
• 09: Back or spine
• 10: Chest
• 11: Abdomen or pelvis
• 12: Other

Injuries (INJ) - Question identifier:INJ_Q40

Was your broken or fractured bone the result of a fall?

• 1: Yes
• 2: No

Injuries (INJ) - Question identifier:INJ_Q40A

How did you fall?

• 1: While doing physical activity
• 2: Going up or down stairs
• 3: Slipped or stumbled while walking
• 4: Getting into or out of furniture (e.g., bed, chair)
• 5: From an elevated position (e.g., ladder, tree, scaffolding)
• 6: Due to health problems (e.g., fainting, weakness, dizziness)
• 7: Other

Injuries (INJ) - Question identifier:INJ_Q45

In the 48 hours following your broken or fractured bone, did you consult a health care professional?

• 1: Yes
• 2: No

Injuries (INJ) - Question identifier:INJ_Q45A

Where did you go to consult this health professional?

• 1: Doctor's office or clinic (e.g., walk-in, hospital outpatient, sports)
• 2: Hospital emergency room
• 3: Other

Injuries (INJ) - Question identifier:INJ_Q50

Were you admitted to a hospital overnight because of this injury?

• 1: Yes
• 2: No

Injuries (INJ) - Question identifier:INJ_Q55

What were you doing when your serious cut or puncture occured?

If you had more than one serious cut or puncture in the past 12 months, report for the most serious.

• 1: Riding a bike
• 2: Sports or physical activity (Exclude riding a bike)
• 3: Household chores, outdoor yard maintenance or unpaid work
• 4: Riding or driving a motor vehicle (Include off-road vehicles)
• 5: Working at a paid job or business (Exclude when driving is your job)
• 6: Other

Injuries (INJ) - Question identifier:INJ_Q60

Which part of the body was injured?

• 01: Multiple body parts
• 02: Head or neck
• 03: Shoulder or upper arm
• 04: Elbow or lower arm
• 05: Wrist or hand
• 06: Hip or thigh
• 07: Knee or lower leg
• 08: Ankle or foot
• 09: Back or spine
• 10: Chest
• 11: Abdomen or pelvis
• 12: Other

Injuries (INJ) - Question identifier:INJ_Q65

Was your serious cut or puncture the result of a fall?

• 1: Yes
• 2: No

Injuries (INJ) - Question identifier:INJ_Q70

In the 48 hours following your serious cut or puncture, did you consult a health care professional?

• 1: Yes
• 2: No

Injuries (INJ) - Question identifier:INJ_Q70A

Where did you go to consult this health professional?

• 1: Doctor's office or clinic (e.g., walk-in, hospital outpatient, sports)
• 2: Hospital emergency room
• 3: Other

Injuries (INJ) - Question identifier:INJ_Q75

Were you admitted to a hospital overnight because of this injury?

• 1: Yes
• 2: No

Oral health (OHM) - Question identifier:OHM_R01

Now some questions about the health of your mouth.
Include teeth or dentures, tongue, gums, lips and jaw joints.

Oral health (OHM) - Question identifier:OHM_Q05

In general, how would you rate the health of your mouth?

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

Oral health (OHM) - Question identifier:OHM_Q10

Do you have at least one of your own teeth?

• 1: Yes
• 2: No

Oral health (OHM) - Question identifier:OHM_Q15

In the past 12 months, how often have you had any persistent or on-going mouth pain?

Include pain in teeth, gums, tongue, jaw, jaw joints.

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

Oral health (OHM3) - Question identifier:OHM3_R01

Now a few questions about your regular dental care habits.

Oral health (OHM3) - Question identifier:OHM3_Q05

How often do you usually see a dental professional?

• 1: More than once a year for check-ups or treatments
• 2: About once a year for check-ups or treatments
• 3: Less than once a year for check-ups or treatments
• 4: Only for emergency care
• 5: Never

Oral health (OHM3) - Question identifier:OHM3_Q10

When was the last time you saw a dental professional?

• 1: Less than a year ago
• 2: 1 year to less than 2 years ago
• 3: 2 years to less than 3 years ago
• 4: 3 years to less than 4 years ago
• 5: 4 years to less than 5 years ago
• 6: 5 or more years ago

Oral health (OHM3) - Question identifier:OHM3_R15

Now a few questions about the cost of your dental care.
[It is important that we get this information from each individual that we interview, even those in the same family./]

Oral health (OHM3) - Question identifier:OHM3_Q15

In the past 12 months, have you avoided going to a dental professional for your dental care due to the cost?

• 1: Yes
• 2: No

Oral health (OHM3) - Question identifier:OHM3_Q18

In the past 12 months, have you avoided having any of your recommended dental treatment because of the cost?

• 1: Yes
• 2: No

Oral health (OHM3) - Question identifier:OHM3_Q20

What types of dental treatment did you avoid due to cost?

Select all that apply.

• 1: Check-ups and cleanings
• 2: Fillings
• 3: Root canal treatment
• 4: Tooth extraction
• 5: Tooth replacement or tooth reconstruction (e.g., dentures, crowns, bridgework, implants)

Oral health (OHM3) - Question identifier:OHM3_Q45

Are all or part of your dental expenses covered by any insurance plan or government program?

• 1: Yes
• 2: No
• 3: Don't know

Oral health (OHM3) - Question identifier:OHM3_Q50

What type of insurance plan or program?

Select all that apply.

• 1: A plan through an employer (Include plans that are partially paid or sponsored by an employer.)
• 2: A private plan (Include personally purchased plans.)
• 3: A government paid plan (e.g., Children or seniors dental program, RAMQ, First Nations and Inuit program)
• 4: A plan through college or university
• 5: Don't know

Eating habits (EAH) - Question identifier:EAH_R01

The next questions are about some of your eating and drinking habits.

Eating habits (EAH) - Question identifier:EAH_Q05A

In the past 30 days, how many times did you eat food from a restaurant?

Min = 0; Max = 999

Include fast-food, take-out, sit-down restaurants or prepared food from grocery stores.

Frequency can be reported per month, per week or per day.

Eating habits (EAH) - Question identifier:EAH_Q05B

In the past 30 days, how many times did you eat food from a restaurant?

Per month, per week or per day

Include fast-food, take-out, sit-down restaurants or prepared food from grocery stores.

Frequency can be reported per month, per week or per day.

• 1: Per month
• 2: Per week
• 3: Per day

Eating habits (EAH) - Question identifier:EAH_Q10A

In the past 30 days, how many times did you drink the following beverages?

100% pure fruit juice

Min = 0; Max = 999

Frequency can be reported per month, per week or per day.

Eating habits (EAH) - Question identifier:EAH_Q10B

In the past 30 days, how many times did you drink the following beverages?

Per month, per week or per day

Frequency can be reported per month, per week or per day.

• 1: Per month
• 2: Per week
• 3: Per day

Eating habits (EAH) - Question identifier:EAH_Q15A

In the past 30 days, how many times did you drink the following beverages?

Fruit flavoured drinks or sports drinks

Min = 0; Max = 999

e.g., FruitéTM, fruit punch, GatoradeTM

Frequency can be reported per month, per week or per day.

Eating habits (EAH) - Question identifier:EAH_Q15B

In the past 30 days, how many times did you drink the following beverages?

Per month, per week or per day

Frequency can be reported per month, per week or per day.

• 1: Per month
• 2: Per week
• 3: Per day

Eating habits (EAH) - Question identifier:EAH_Q20A

In the past 30 days, how many times did you drink the following beverages?

Regular soft drinks

Min = 0; Max = 999

Exclude diet soft drinks.

Frequency can be reported per month, per week or per day.

Eating habits (EAH) - Question identifier:EAH_Q20B

In the past 30 days, how many times did you drink the following beverages?

Per month, per week or per day

Frequency can be reported per month, per week or per day.

• 1: Per month
• 2: Per week
• 3: Per day

Eating habits (EAH) - Question identifier:EAH_Q25A

In the past 30 days, how many times did you drink the following beverages?

Sweetened coffee drinks or iced tea

Min = 0; Max = 999

e.g., StarbucksTM Macchiato, Tim Hortons Iced CappTM, NesteaTM

Frequency can be reported per month, per week or per day.

Eating habits (EAH) - Question identifier:EAH_Q25B

In the past 30 days, how many times did you drink the following beverages?

Per month, per week or per day

Frequency can be reported per month, per week or per day.

• 1: Per month
• 2: Per week
• 3: Per day

Eating habits (EAH) - Question identifier:EAH_Q30A

In the past 30 days, how many times did you drink the following beverages?

Energy drinks

Min = 0; Max = 999

e.g., Red BullTM, MonsterTM

Frequency can be reported per month, per week or per day.

Eating habits (EAH) - Question identifier:EAH_Q30B

In the past 30 days, how many times did you drink the following beverages?

Per month, per week or per day

Frequency can be reported per month, per week or per day.

• 1: Per month
• 2: Per week
• 3: Per day

Eating habits (EAH) - Question identifier:EAH_Q35A

In the past 30 days, how many times did you drink the following beverages?

Chocolate milk

Min = 0; Max = 999

Frequency can be reported per month, per week or per day.

Eating habits (EAH) - Question identifier:EAH_Q35B

In the past 30 days, how many times did you drink the following beverages?

Per month, per week or per day

Frequency can be reported per month, per week or per day.

• 1: Per month
• 2: Per week
• 3: Per day

Eating habits (EAH) - Question identifier:EAH_Q40A

In the past 30 days, how many times did you eat the following fruits and vegetables?

Fruits

Min = 0; Max = 999

Frequency can be reported per month, per week or per day.

Include fresh, frozen, canned or dried.
Exclude fruit juices.

Eating habits (EAH) - Question identifier:EAH_Q40B

In the past 30 days, how many times did you eat the following fruits and vegetables?

Per month, per week or per day

Include fresh, frozen, canned or dried.

Frequency can be reported per month, per week or per day.

• 1: Per month
• 2: Per week
• 3: Per day

Eating habits (EAH) - Question identifier:EAH_Q45A

In the past 30 days, how many times did you eat the following fruits and vegetables?

Dark green vegetables

Min = 0; Max = 999

e.g., broccoli, green beans, dark lettuce, spinach

Include fresh, frozen, canned or dried.

Frequency can be reported per month, per week or per day.

Eating habits (EAH) - Question identifier:EAH_Q45B

In the past 30 days, how many times did you eat the following fruits and vegetables?

Per month, per week or per day

Include fresh, frozen, canned or dried.

Frequency can be reported per month, per week or per day.

• 1: Per month
• 2: Per week
• 3: Per day

Eating habits (EAH) - Question identifier:EAH_Q50A

In the past 30 days, how many times did you eat the following fruits and vegetables?

Orange-coloured vegetables

Min = 0; Max = 999

e.g., carrots, orange bell peppers, sweet potatoes

Include fresh, frozen, canned or dried.

Frequency can be reported per month, per week or per day.

Eating habits (EAH) - Question identifier:EAH_Q50B

In the past 30 days, how many times did you eat the following fruits and vegetables?

Per month, per week or per day

Include fresh, frozen, canned or dried.

Frequency can be reported per month, per week or per day.

• 1: Per month
• 2: Per week
• 3: Per day

Eating habits (EAH) - Question identifier:EAH_Q55A

In the past 30 days, how many times did you eat the following fruits and vegetables?

Starchy vegetables

Min = 0; Max = 999

e.g., white potatoes, corn

Exclude deep fried potatoes.
Include fresh, frozen, canned or dried.

Frequency can be reported per month, per week or per day.

Eating habits (EAH) - Question identifier:EAH_Q55B

In the past 30 days, how many times did you eat the following fruits and vegetables?

Per month, per week or per day

Include fresh, frozen, canned or dried.

Frequency can be reported per month, per week or per day.

• 1: Per month
• 2: Per week
• 3: Per day

Eating habits (EAH) - Question identifier:EAH_Q60A

In the past 30 days, how many times did you eat the following fruits and vegetables?

Other vegetables

Min = 0; Max = 999

e.g., cucumber, celery, cabbage, tomatoes, cauliflower

Include fresh, frozen, canned or dried.

Frequency can be reported per month, per week or per day.

Eating habits (EAH) - Question identifier:EAH_Q60B

In the past 30 days, how many times did you eat the following fruits and vegetables?

Per month, per week or per day

Include fresh, frozen, canned or dried.

Frequency can be reported per month, per week or per day.

• 1: Per month
• 2: Per week
• 3: Per day

Physical activities (PAA) - Question identifier:PAA_R01

The following questions are about physical activities.

Physical activities (PAA) - Question identifier:PAA_Q05

In the past 7 days, did you use active ways like walking or cycling to get to places?

Include work, school, bus stops, shopping centres or visiting friends.

• 1: Yes
• 2: No

Physical activities (PAA) - Question identifier:PAA_Q10

In the past 7 days, on which days did you use active ways to get to places?

Select all that apply.

• 1: Monday
• 2: Tuesday
• 3: Wednesday
• 4: Thursday
• 5: Friday
• 6: Saturday
• 7: Sunday

Physical activities (PAA) - Question identifier:PAA_Q15A

In the past 7 days, how much time in total did you spend using active ways to get to places?
Hours

Min = 0; Max = 100

Physical activities (PAA) - Question identifier:PAA_Q15B

In the past 7 days, how much time in total did you spend using active ways to get to places?
Minutes

• 01: 0
• 02: 5
• 03: 10
• 04: 15
• 05: 20
• 06: 25
• 07: 30
• 08: 35
• 09: 40
• 10: 45
• 11: 50
• 12: 55

Physical activities (PAA) - Question identifier:PAA_Q30

In the past 7 days, did you do sports, fitness or recreational physical activities?

Include organized or non-organized activities. e.g., walking, home or gym exercise, cycling, running, skiing, team sports.

Exclude activities already reported.

• 1: Yes
• 2: No

Physical activities (PAA) - Question identifier:PAA_Q35

Did any of these physical activities make you sweat at least a little and breathe harder?

• 1: Yes
• 2: No

Physical activities (PAA) - Question identifier:PAA_Q40

In the past 7 days, on which days did you do the activities that made you sweat at least a little and breathe harder?

Select all that apply.

• 1: Monday
• 2: Tuesday
• 3: Wednesday
• 4: Thursday
• 5: Friday
• 6: Saturday
• 7: Sunday

Physical activities (PAA) - Question identifier:PAA_Q45A

How much time in total, did you spend doing these activities?
Hours

Min = 0; Max = 100

Physical activities (PAA) - Question identifier:PAA_Q45B

How much time in total, did you spend doing these activities?
Minutes

• 01: 0
• 02: 5
• 03: 10
• 04: 15
• 05: 20
• 06: 25
• 07: 30
• 08: 35
• 09: 40
• 10: 45
• 11: 50
• 12: 55

Physical activities (PAA) - Question identifier:PAA_Q60

In the past 7 days, did you do any other physical activities while at work, in or around your home or while volunteering?

e.g., carrying heavy loads, shoveling, vacuuming.

• 1: Yes
• 2: No

Physical activities (PAA) - Question identifier:PAA_Q65

Did any of these other physical activities make you sweat at least a little and breathe harder?

• 1: Yes
• 2: No

Physical activities (PAA) - Question identifier:PAA_Q70

In the past 7 days, on which days did you do these other activities that made you sweat at least a little and breathe harder?

Select all that apply.

• 1: Monday
• 2: Tuesday
• 3: Wednesday
• 4: Thursday
• 5: Friday
• 6: Saturday
• 7: Sunday

Physical activities (PAA) - Question identifier:PAA_Q75A

How much time in total, did you spend doing these activities?
Hours

Min = 0; Max = 100

Physical activities (PAA) - Question identifier:PAA_Q75B

How much time in total, did you spend doing these activities?
Minutes

• 01: 0
• 02: 5
• 03: 10
• 04: 15
• 05: 20
• 06: 25
• 07: 30
• 08: 35
• 09: 40
• 10: 45
• 11: 50
• 12: 55

Physical activities (PAA) - Question identifier:PAA_Q95

You have reported a total of [total hours of active transportation + total hours of recreational physical activities + total hours of other physical activity] hours 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

Physical activities (PAA) - Question identifier:PAA_Q100A

In the past 7 days, how much time in total did you spend doing these vigorous activities?
Hours

Min = 0; Max = 100

Physical activities (PAA) - Question identifier:PAA_Q100B

In the past 7 days, how much time in total did you spend doing these vigorous activities?
Minutes

• 01: 0
• 02: 5
• 03: 10
• 04: 15
• 05: 20
• 06: 25
• 07: 30
• 08: 35
• 09: 40
• 10: 45
• 11: 50
• 12: 55

Physical activities (PAY) - Question identifier:PAY_R01

The following questions are about physical activities.

Physical activities (PAY) - Question identifier:PAY_Q05

In the past 7 days, did you do any of the following?

Select all that apply.

• 1: Attend school
• 2: Attend a day camp
• 3: Work, paid or unpaid
• 4: None of the above

Physical activities (PAY) - Question identifier:PAY_Q10

In the past 7 days, that is from [7 days ago] to [yesterday], did you use active ways like walking or cycling to get to places such as [school, the bus stop, the shopping centre, work/school, the bus stop, the shopping centre/the bus stop, the shopping centre, work/the bus stop, the shopping centre] or to visit friends?

Exclude walking, cycling or other activities done purely for leisure.

• 1: Yes
• 2: No

Physical activities (PAY) - Question identifier:PAY_Q15A

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 (PAY) - Question identifier:PAY_Q15B

Enter number of minutes.

• 01: 0
• 02: 5
• 03: 10
• 04: 15
• 05: 20
• 06: 25
• 07: 30
• 08: 35
• 09: 40
• 10: 45
• 11: 50
• 12: 55

Physical activities (PAY) - Question identifier:PAY_Q20

In the past 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/school, 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

Physical activities (PAY) - Question identifier:PAY_Q25

Did any of these activities make you sweat at least a little and breathe harder?

• 1: Yes
• 2: No

Physical activities (PAY) - Question identifier:PAY_Q30A

How much time per day did you spend doing these activities at [school or day camp/school/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 (PAY) - Question identifier:PAY_Q30B

Enter number of minutes.

• 01: 0
• 02: 5
• 03: 10
• 04: 15
• 05: 20
• 06: 25
• 07: 30
• 08: 35
• 09: 40
• 10: 45
• 11: 50
• 12: 55

Physical activities (PAY) - Question identifier:PAY_Q35

In the past 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?

Exclude physical activities already reported.

• 1: Yes
• 2: No

Physical activities (PAY) - Question identifier:PAY_Q40

Did any of these make you sweat at least a little and breathe harder?

• 1: Yes
• 2: No

Physical activities (PAY) - Question identifier:PAY_Q45A

How much time per day did you spend doing these 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 (PAY) - Question identifier:PAY_Q45B

Enter number of minutes.

• 01: 0
• 02: 5
• 03: 10
• 04: 15
• 05: 20
• 06: 25
• 07: 30
• 08: 35
• 09: 40
• 10: 45
• 11: 50
• 12: 55

Physical activities (PAY) - Question identifier:PAY_Q50

In the past 7 days, did you do any other physical activities?

e.g., while you [were doing paid or unpaid work or/were] helping your family with chores.

Exclude physical activities already reported.

• 1: Yes
• 2: No

Physical activities (PAY) - Question identifier:PAY_Q55

Did any of these other physical activities make you sweat at least a little and breathe harder?

• 1: Yes
• 2: No

Physical activities (PAY) - Question identifier:PAY_Q60A

How much time per day 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 (PAY) - Question identifier:PAY_Q60B

Enter number of minutes.

• 01: 0
• 02: 5
• 03: 10
• 04: 15
• 05: 20
• 06: 25
• 07: 30
• 08: 35
• 09: 40
• 10: 45
• 11: 50
• 12: 55

Physical activities (PAY) - Question identifier:PAY_Q65

You have reported a total of [total hours of active transportation + total hours of recreational physical activities + total hours of other physical activity] hours 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

Physical activities (PAY) - Question identifier:PAY_Q70

In the past 7 days, on which days did you do these vigorous activities?

Select all that apply.

• 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]

Physical activities (PAY) - Question identifier:PAY_Q75A

How much time in total did you spend doing these vigorous activities?
Hours

Min = 0; Max = 100

Physical activities (PAY) - Question identifier:PAY_Q75B

How much time in total did you spend doing these vigorous activities?
Minutes

• 01: 0
• 02: 5
• 03: 10
• 04: 15
• 05: 20
• 06: 25
• 07: 30
• 08: 35
• 09: 40
• 10: 45
• 11: 50
• 12: 55

Use of protective equipment (UPE) - Question identifier:UPE_Q05

In the past 12 months, have you participated in any of these activities?

Select all that apply.

• 1: Bicycling
• 2: In-line skating or rollerblading
• 3: Downhill skiing
• 4: Snowboarding
• 5: Skateboarding
• 6: Playing ice hockey

Use of protective equipment (UPE) - Question identifier:UPE_Q10

When riding a bicycle, how often do you wear a helmet?

• 1: Always
• 2: Most of the time
• 3: Rarely
• 4: Never

Use of protective equipment (UPE) - Question identifier:UPE_Q20

When in-line skating or rollerblading, how often do you wear the following equipment?
A helmet

• 1: Always
• 2: Most of the time
• 3: Rarely
• 4: Never

Use of protective equipment (UPE) - Question identifier:UPE_Q25

When in-line skating or rollerblading, how often do you wear the following equipment?
Wrist guards or wrist protectors

• 1: Always
• 2: Most of the time
• 3: Rarely
• 4: Never

Use of protective equipment (UPE) - Question identifier:UPE_Q30

When in-line skating or rollerblading, how often do you wear the following equipment?
Elbow pads

• 1: Always
• 2: Most of the time
• 3: Rarely
• 4: Never

Use of protective equipment (UPE) - Question identifier:UPE_Q35

When in-line skating or rollerblading, how often do you wear the following equipment?
Knee pads

• 1: Always
• 2: Most of the time
• 3: Rarely
• 4: Never

Use of protective equipment (UPE) - Question identifier:UPE_Q45

When downhill skiing, how often do you wear a helmet?

• 1: Always
• 2: Most of the time
• 3: Rarely
• 4: Never

Use of protective equipment (UPE) - Question identifier:UPE_Q50

When snowboarding, how often do you wear the following equipment?
A helmet

• 1: Always
• 2: Most of the time
• 3: Rarely
• 4: Never

Use of protective equipment (UPE) - Question identifier:UPE_Q55

When snowboarding, how often do you wear the following equipment?
Wrist guards or wrist protectors

• 1: Always
• 2: Most of the time
• 3: Rarely
• 4: Never

Use of protective equipment (UPE) - Question identifier:UPE_Q65

When skateboarding, how often do you wear the following equipment?
A helmet

• 1: Always
• 2: Most of the time
• 3: Rarely
• 4: Never

Use of protective equipment (UPE) - Question identifier:UPE_Q70

When skateboarding, how often do you wear the following equipment?
Wrist guards or wrist protectors

• 1: Always
• 2: Most of the time
• 3: Rarely
• 4: Never

Use of protective equipment (UPE) - Question identifier:UPE_Q75

When skateboarding, how often do you wear the following equipment?
Elbow pads

• 1: Always
• 2: Most of the time
• 3: Rarely
• 4: Never

Use of protective equipment (UPE) - Question identifier:UPE_Q85

When playing ice hockey, how often do you wear a mouth guard?

• 1: Always
• 2: Most of the time
• 3: Rarely
• 4: Never

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?

Include mobile devices, computers, tablets, video game consoles or TV.

• 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

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?

Include mobile devices, computers, tablets, video game consoles or TV.

• 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

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?

Exclude time spent resting.

• 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

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

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

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

Current smoking status (CSS) - Question identifier:CSS_R01

The next questions are about cigarette smoking.

Include cigarettes that are self-made. Exclude e-cigarettes.

Current smoking status (CSS) - Question identifier:CSS_Q05

Have you ever smoked a whole cigarette?

• 1: Yes
• 2: No

Current smoking status (CSS) - Question identifier:CSS_Q10

How old were you when you smoked your first whole cigarette?

Min = 0; Max = 999

Current smoking status (CSS) - Question identifier:CSS_Q15

Have you smoked more than 100 cigarettes (about 4 packs) in your life?

• 1: Yes
• 2: No

Current smoking status (CSS) - Question identifier:CSS_Q20

In the past 30 days, how often did you smoke cigarettes?

• 1: Every day
• 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

Current smoking status (CSS) - Question identifier:CSS_Q25

How many cigarettes do you usually smoke each day?

Min = 0; Max = 999

Current smoking status (CSS) - Question identifier:CSS_Q35

In the past 30 days, how many days have you smoked one or more cigarettes?

Min = 0; Max = 99

Current smoking status (CSS) - Question identifier:CSS_Q30

On the days that you do smoke, how many cigarettes do you usually smoke?

Min = 0; Max = 999

Current smoking status (CSS) - Question identifier:CSS_Q40

In the past 12 months, have you made a serious attempt to stop smoking cigarettes, even if you stopped for less than a day?

• 1: Yes
• 2: No

Smoking - past use (SPU) - Question identifier:SPU_Q05

Have you ever smoked cigarettes daily?

• 1: Yes
• 2: No

Smoking - past use (SPU) - Question identifier:SPU_Q10A

When did you stop smoking?
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

Smoking - past use (SPU) - Question identifier:SPU_Q10B

When did you stop smoking?
Year

Min = 0; Max = 9999

Example: YYYY

Smoking - past use (SPU) - Question identifier:SPU_Q15

At what age did you begin to smoke cigarettes daily?

Min = 0; Max = 999

Smoking - past use (SPU) - Question identifier:SPU_Q20

When you smoked every day, how many cigarettes did you usually smoke each day?

Min = 0; Max = 999

Smoking - past use (SPU) - Question identifier:SPU_Q25A

When did you stop smoking daily?
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

Smoking - past use (SPU) - Question identifier:SPU_Q25B

When did you stop smoking daily?
Year

Min = 0; Max = 9999

Example: YYYY

Smoking - past use (SPU) - Question identifier:SPU_Q30

Was that when you completely quit smoking?

• 1: Yes
• 2: No

Smoking - past use (SPU) - Question identifier:SPU_Q35A

When did you stop completely?
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

Smoking - past use (SPU) - Question identifier:SPU_Q35B

When did you stop completely?
Year

Min = 0; Max = 9999

Example: YYYY

Electronic cigarettes and vaping (ECV) - Question identifier:ECV_R05

Now questions about electronic cigarettes (e-cigarettes) or vaping devices.

Electronic cigarettes and vaping (ECV) - Question identifier:ECV_Q05

Have you ever tried an e-cigarette or vaping device?

Include vaping e-liquid with nicotine and without nicotine i.e., just flavouring

Exclude vaping cannabis.

• 1: Yes
• 2: No

Electronic cigarettes and vaping (ECV) - Question identifier:ECV_Q10

At what age did you first use an e-cigarette or vaping device?

Min = 0; Max = 999

Electronic cigarettes and vaping (ECV) - Question identifier:ECV_Q15

In the past 30 days, how often did you use an e-cigarette or vaping device?

• 1: Every day
• 2: Almost every day
• 3: At least once a week
• 4: At least once in the past month
• 5: Never

Electronic cigarettes and vaping (ECV) - Question identifier:ECV_Q20

The last time you used an e-cigarette, did it contain nicotine?

• 1: Yes
• 2: No

Electronic cigarettes and vaping 2 (ECV2) - Question identifier:ECV2_Q05A

During the past 30 days, on how many days did you vape the following products?
An e-liquid with nicotine

Min = 0; Max = 30

Electronic cigarettes and vaping 2 (ECV2) - Question identifier:ECV2_Q05B

During the past 30 days, on how many days did you vape the following products?
An e-liquid without nicotine

Min = 0; Max = 30

e.g., just flavouring

Electronic cigarettes and vaping 2 (ECV2) - Question identifier:ECV2_Q05C

During the past 30 days, on how many days did you vape the following products?
An e-liquid but you did not know what it contained

Min = 0; Max = 30

Electronic cigarettes and vaping 2 (ECV2) - Question identifier:ECV2_Q10

During the past 12 months, did you try to quit smoking cigarettes by switching to a vaping device or an e-cigarette?

• 1: Yes
• 2: No

Electronic cigarettes and vaping 2 (ECV2) - Question identifier:ECV2_Q15

Which did you try first, an e-cigarette or vaping device or a cigarette?

• 1: E-cigarette or vaping device
• 2: Cigarette

Alcohol use (ALC) - Question identifier:ALC_R01

Now some questions about alcohol consumption.

Alcohol use (ALC) - Question identifier:ALC_Q05

Have you ever had a drink in your lifetime?

[A "drink" refers to:
- a small bottle, draft or can of beer, cider or cooler
- a glass of wine
- a cocktail or glass containing 1.5 ounces of liquor./]

• 1: Yes
• 2: No

Alcohol use (ALC) - Question identifier:ALC_Q10

In the past 12 months, have you had a drink of beer, wine, liquor or any other alcoholic beverage?

• 1: Yes
• 2: No

Alcohol use (ALC) - Question identifier:ALC_Q15

In 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 5 times a week
• 7: Daily or almost daily

Alcohol use (ALC) - Question identifier:ALC_Q20

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

Medication use — pain relievers (PRM) - Question identifier:PRM_R01

The next series of questions are about various pain relievers.

By pain relievers, we mean products that contain opioids such as codeine, morphine or related drugs. Most of these products require a prescription, although some do not.

Medication use — pain relievers (PRM) - Question identifier:PRM_Q10

In the past 12 months, have you taken any codeine products?

Include prescribed or non-prescribed drugs such as 292™ or Tylenol® 1, 2, 3 and 4.

Exclude Regular Tylenol® or Extra Strength Tylenol®, Aspirin™, Advil®, Motrin® or their generic equivalents.

• 1: Yes
• 2: No

Medication use — pain relievers (PRM) - Question identifier:PRM_Q15

In the past 12 months, have you taken any oxycodone products?

Include Percocet®, Percodan®, OxyContin® and OxyNEO®.

• 1: Yes
• 2: No

Medication use — pain relievers (PRM) - Question identifier:PRM_Q20

In the past 12 months, have you taken any fentanyl products?

• 1: Yes
• 2: No

Medication use — pain relievers (PRM) - Question identifier:PRM_Q25

In the past 12 months, have you taken any other opioid products?

Include hydromorphone, Dilaudid®, Hydromorph Contin®, morphine, MS Contin® or Demerol®.

• 1: Yes
• 2: No

Medication use — pain relievers (PRM) - Question identifier:PRM_Q30

In the past 12 months, how often did you take any such pain relievers?

If more than one pain reliever was prescribed in the last 12 months, report the most recent.

• 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

Medication use — pain relievers (PRM) - Question identifier:PRM_Q35

Thinking about all the pain relievers you have taken in 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

Medication use — pain relievers (PRM) - Question identifier:PRM_Q40A

In the past 12 months, did you take a higher dose of pain relievers than what was recommended?

• 1: Yes
• 2: No

Medication use — pain relievers (PRM) - Question identifier:PRM_Q40B

In the past 12 months, did you take pain relievers more often than what was recommended?

• 1: Yes
• 2: No

Medication use — pain relievers (PRM) - Question identifier:PRM_Q50

In the past 12 months, did you ever take or use pain relievers for reasons other than pain relief?

e.g., to feel better, improve mood, cope with stress or problems

• 1: Yes
• 2: No

Medication use — pain relievers (PRM) - Question identifier:PRM_Q55

In the past 12 months, did you ever tamper with a pain reliever product before taking it?

e.g., by crushing tablets to swallow, snort or inject

Exclude for ease of swallowing or to take a lower dose.

• 1: Yes
• 2: No

Cannabis use (CAN) - Question identifier:CAN_R01

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_Q05

Have you ever used or tried cannabis?

• 1: Yes
• 2: No

Cannabis use (CAN) - Question identifier:CAN_Q05A

Have you used or tried cannabis just once or more than once?

• 1: Just once
• 2: More than once

Cannabis use (CAN) - Question identifier:CAN_Q05B

At what age did you first try cannabis?

Min = 0; Max = 999

Cannabis use (CAN) - Question identifier:CAN_Q05C

Have you used cannabis in the past 12 months?

• 1: Yes
• 2: No

Cannabis use (CAN) - Question identifier:CAN_Q10

How often did you use cannabis in the past 12 months?

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

Cannabis use (CAN) - Question identifier:CAN_Q15

In the past 12 months, which of the following methods did you use to consume cannabis?

Select all that apply.

• 1: Smoked (e.g., joint, pipe, bong)
• 2: Vaporized
• 3: Swallowed (e.g., in food, beverages, capsules)
• 4: Absorbed (e.g., placed under the tongue, applied to skin)
• 5: Other

Cannabis use (CAN) - Question identifier:CAN_Q15B

Which cannabis preparation did you vaporize?

Select all that apply.

• 1: Dried flower or leaf
• 2: Cannabis liquid
• 3: Cannabis solid

Cannabis use (CAN) - Question identifier:CAN_Q20

In the past 12 months, which of the following methods did you use most often to consume cannabis?

• 1: Smoked
• 2: Vaporized
• 3: Swallowed
• 4: Absorbed
• 5: Other method

Cannabis use (CAN) - Question identifier:CAN_Q25

In the past 12 months, which of the following cannabis products have you used?

Select all that apply.

• 01: Dried flower or leaf
• 02: Hashish (e.g., hash, hash oil)
• 03: Cannabis oil for oral use (e.g., capsules, spray, tincture)
• 04: Cannabis vape pens or cartridges
• 05: Cannabis concentrates (e.g., shatter, budder, butane honey oil)
• 06: Cannabis edible food products (e.g., baked goods, candy, other foods)
• 07: Cannabis beverages (e.g., cola, tea, coffee)
• 08: Topicals (e.g., lotion, ointment, creams applied to skin)
• 09: Other (e.g., seeds)

Cannabis use (CAN) - Question identifier:CAN_Q30

In the past 12 months, for which of the following purposes have you used cannabis?

• 1: Non-medical purposes only
• 2: Medical purposes only (Either with or without a medical document)
• 3: Both medical and non-medical purposes

Cannabis use (CAN) - Question identifier:CAN_Q35

In the past 12 months, when you used cannabis for medical purposes, which symptoms were you using it for?

Select all that apply.

• 01: Pain
• 02: Nausea or vomiting
• 03: Lack of appetite or weight loss
• 04: Headaches or migraines
• 05: Muscle spasms or seizures
• 06: Anxiety or depression
• 07: Symptoms of PTSD
• 08: Problems sleeping
• 09: Opioid withdrawal symptoms
• 10: Other

Cannabis use (CAN) - Question identifier:CAN_Q40

Do you have a medical document from a healthcare professional to use cannabis for medical purposes?

• 1: Yes
• 2: No

Cannabis use (CAN) - Question identifier:CAN_Q45

In the past 30 days, on how many days did you use cannabis?

• 1: Never
• 2: 1 day
• 3: 2 or 3 days
• 4: 1 or 2 days per week
• 5: 3 or 4 days per week
• 6: 5 or 6 days per week
• 7: Daily

Cannabis use (CAN) - Question identifier:CAN_Q50

At what age did you begin to use cannabis daily or almost daily?

Min = 0; Max = 999

Maternal experiences (MEX) - Question identifier:MEX_R01

The next questions are specific to women's health.

Maternal experiences (MEX) - Question identifier:MEX_Q05

Are you taking a vitamin supplement containing folic acid?

Include prenatal vitamins.

• 1: Yes
• 2: No

Maternal experiences (MEX) - Question identifier:MEX_Q10

Have you given birth in the past 5 years?

Exclude stillbirths.

• 1: Yes
• 2: No

Maternal experiences (MEX) - Question identifier:MEX_Q12

Was your last pregnancy a single birth or multiple births?

• 1: Single birth
• 2: Multiple births

Maternal experiences (MEX) - Question identifier:MEX_Q15

What is the first name of your last born child?

Long Answer Length = 30

[Refer to the last baby born during this multiple birth./]

Maternal experiences (MEX) - Question identifier:MEX_Q20

What is [your last child]'s date of birth?
Day

Min = 1; Max = 31

Maternal experiences (MEX) - Question identifier:MEX_Q25

What is [your last child]'s date of birth?
Month

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

Maternal experiences (MEX) - Question identifier:MEX_Q30

What is [your last child]'s date of birth?
Year

• 01: 2023
• 02: 2022
• 03: 2021
• 04: 2020
• 05: 2019
• 06: 2018
• 07: 2017
• 08: 2016

Maternal experiences (MEX) - Question identifier:MEX_Q40

During your pregnancy with [your last child], did you take folic acid supplements during the following time frames?

During the three months before you got pregnant

Include prenatal vitamins and multivitamins containing folic acid.

• 1: Yes
• 2: No
• 3: Don't know

Maternal experiences (MEX) - Question identifier:MEX_Q50

During your pregnancy with [your last child], did you take folic acid supplements during the following time frames?

During the first three months of your pregnancy

Include prenatal vitamins and multivitamins containing folic acid.

• 1: Yes
• 2: No
• 3: Don't know

Maternal experiences (MEX) - Question identifier:MEX_Q65

During your pregnancy with [your last child], did you take a vitamin supplement containing iron?

Include prenatal vitamins.

• 1: Yes
• 2: No
• 3: Don't know

Maternal experiences (MEX) - Question identifier:MEX_Q70

Just before your pregnancy with [your last child], how much did you weigh?
Weight

Min = 0; Max = 999

Maternal experiences (MEX) - Question identifier:MEX_Q75

Just before your pregnancy with [your last child], how much did you weigh?
Pounds or kilograms

• 1: Pounds
• 2: Kilograms

Maternal experiences (MEX) - Question identifier:MEX_Q80

How much weight did you gain during that pregnancy?
Weight

Min = -999; Max = 999

If you lost weight, enter a negative value.

Maternal experiences (MEX) - Question identifier:MEX_Q85

How much weight did you gain during that pregnancy?
Pounds or kilograms

If you lost weight, enter a negative value.

• 1: Pounds
• 2: Kilograms

Maternal experiences (MEX) - Question identifier:MEX_Q90

[How often does [your last child]/When [your last child] was less than one year old, how often did they] sleep in the same bed with you or anyone else?

• 1: Every day or almost every day
• 2: Occasionally
• 3: Never

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

Maternal experiences (MEX) - Question identifier:MEX_Q105

What is the main reason that you did not breastfeed or give breast milk?

• 1: Did not want to breastfeed
• 2: No support or information to breastfeed
• 3: Medical condition
• 4: Other

Maternal experiences (MEX) - Question identifier:MEX_Q110

Are you still breastfeeding or giving breast milk to [your last child]?

• 1: Yes
• 2: No

Maternal experiences (MEX) - Question identifier:MEX_Q115A

How old was [your last child] when you stopped breastfeeding or giving breast milk?
Age

Min = 0; Max = 99

You can report the age in days, weeks, months or years.

Maternal experiences (MEX) - Question identifier:MEX_Q115B

How old was [your last child] when you stopped breastfeeding or giving breast milk?
Time period

You can report the age 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?

• 1: Not enough breast milk
• 2: Child weaned themselves
• 3: Planned to stop at this time
• 4: Difficulty with breastfeeding
• 5: Medical condition
• 6: Other

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, did you give them a vitamin D supplement?/When [your last child] was less than one year old and fed breast milk, did you give them a vitamin D supplement?/When [your last child] was fed breast milk, did you give them a vitamin D supplement?]

• 1: Every day or almost every day
• 2: Occasionally
• 3: Never

Maternal experiences (MEX) - Question identifier:MEX_Q150

[Have/While you were still breastfeeding, had] liquids been introduced to [your last child]'s diet?

e.g., milk, formula, water or juice

• 1: Yes
• 2: No

Maternal experiences (MEX) - Question identifier:MEX_Q155

How old was [your last child] when liquids were first introduced?
Age

Min = 0; Max = 99

You can report the age in days, weeks, months or years.

Maternal experiences (MEX) - Question identifier:MEX_Q160

How old was [your last child] when liquids were first introduced?
Time period

You can report the age in days, weeks, months or years.

• 1: Days
• 2: Weeks
• 3: Months
• 4: Years

Maternal experiences (MEX) - Question identifier:MEX_Q170

Have solid foods been introduced to the baby's diet?

e.g. cereals, pureed meat, vegetables or fruits

• 1: Yes
• 2: No

Maternal experiences (MEX) - Question identifier:MEX_Q175

How old was [your last child] when solids were first added?
Age

Min = 0; Max = 99

You can report the age in days, weeks, months or years.

Maternal experiences (MEX) - Question identifier:MEX_Q180

How old was [your last child] when solids were first added?
Time period

You can report the age 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 diet?

• 1: Infant cereals
• 2: Fruits or vegetables
• 3: Meat and meat alternatives
• 4: Other

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 diet?

• 1: Not enough breast milk
• 2: Baby was ready
• 3: Difficulty with breastfeeding
• 4: Medical conditions
• 5: Advice from health professional or family
• 6: Returned to work or school
• 7: Other

Smoking during maternal experience (MXS) - Question identifier:MXS_Q05

In the 3 months before your pregnancy with [your last child] or before you realized you were pregnant, did you smoke cigarettes?

• 1: Yes
• 2: No

Smoking during maternal experience (MXS) - Question identifier:MXS_Q10

How often did you smoke?

• 1: Everyday
• 2: Almost everyday
• 3: A few times a week
• 4: Rarely

Smoking during maternal experience (MXS) - Question identifier:MXS_Q15

Once you found out you were pregnant with [your last child], did you smoke?

• 1: Yes
• 2: No

Smoking during maternal experience (MXS) - Question identifier:MXS_Q20

How often did you smoke?

• 1: Everyday
• 2: Almost everyday
• 3: A few times a week
• 4: Rarely

Smoking during maternal experience (MXS) - Question identifier:MXS_Q35

Did anyone regularly smoke in your presence during your pregnancy with [your last child]?

• 1: Yes
• 2: No

Maternal experiences (MXA) - Question identifier:MXA_Q05

In the 3 months before your pregnancy with [your last child], or before you realized you were pregnant, did you drink alcohol?

• 1: Yes
• 2: No

Maternal experiences (MXA) - Question identifier:MXA_Q10

How often did you drink?

• 1: A few times a month or less
• 2: Once or twice a week
• 3: Many times a week
• 4: Everyday

Maternal experiences (MXA) - Question identifier:MXA_Q12

On the days you did drink, how many drinks did you usually have?

• 1: One drink
• 2: Two drinks
• 3: Three drinks
• 4: More than three

Maternal experiences (MXA) - Question identifier:MXA_Q15

Once you found out you were pregnant with [your last child], did you drink alcohol?

• 1: Yes
• 2: No

Maternal experiences (MXA) - Question identifier:MXA_Q20

How often did you drink?

• 1: A few times a month or less
• 2: Once or twice a week
• 3: Many times a week
• 4: Everyday

Maternal experiences (MXA) - Question identifier:MXA_Q22

On the days you did drink, how many drinks did you usually have?

• 1: One drink
• 2: Two drinks
• 3: Three drinks
• 4: More than three

Maternal experiences (MXA) - Question identifier:MXA_Q35

[While you were breastfeeding [your last child] did you drink alcohol/Since you gave birth to [your last child], did you drink alcohol]?

• 1: Yes
• 2: No

Maternal experiences (MXA) - Question identifier:MXA_Q40

[How often did you drink/How often do you drink]?

• 1: A few times a month or less
• 2: Once or twice a week
• 3: Many times a week
• 4: Everyday

Maternal experiences (MXA) - Question identifier:MXA_Q42

[On the days you did drink, how many drinks did you usually have/On the days you drink, how may drinks do you usually have]?

• 1: One drink
• 2: Two drinks
• 3: Three drinks
• 4: More than three

Flu shots (FLU) - Question identifier:FLU_R01

Now a few questions about the flu vaccine.

Flu shots (FLU) - Question identifier:FLU_Q05

In the past 12 months, have you had a seasonal flu vaccine?

Seasonal flu vaccine can be administered either by a needle, called a flu shot, or by a nasal spray called FluMist®

• 1: Yes
• 2: No

Flu shots (FLU) - Question identifier:FLU_Q10

In which month did you have your last seasonal flu vaccine?

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

Flu shots (FLU) - Question identifier:FLU_Q15

Was that this year or last year?

• 1: This year
• 2: Last year

Flu shots (FLU) - Question identifier:FLU_Q20

What are the reasons that you did not have a seasonal flu vaccine in the past 12 months?
Select all that apply.

• 1: Did not think it was necessary
• 2: Concern about discomfort or side effects
• 3: Flu is not that severe
• 4: Flu vaccine does not work that well
• 5: Previously had a bad reaction to the flu vaccine or other vaccine
• 6: Other

Regular health care provider (RHC) - Question identifier:RHC_Q05

Which of the following health care providers do you regularly consult with?

If you have more than one, report for the health care provider you consult with the most.

• 1: Family doctor or general practitioner
• 2: Medical specialist (e.g., cardiologist, pediatrician, oncologist)
• 3: Nurse practitioner
• 4: Other (e.g., chiropractor, psychologist)
• 5: Don't have a regular health care provider

Labour market activities (LMAM) - Question identifier:LMAM_R01

Many of the following questions concern your activities last week.

Last week is from [7 days ago] to [yesterday].

Labour market activities (LMAM) - Question identifier:LMAM_Q01

Last week, did you work at a job or business?

Select ''Yes'' if you worked at least one hour:
• for pay (wages, salary, etc.)
• in self-employment.
Select ''No'' if you:
• were away from work for the entire week for a reason such as vacation, illness, work schedule or layoff
• did not have a job or business but were able to work.
Select ''Permanently unable to work'' if you:
• did not have a job or business because of a physical or mental health condition that prevents you from working.

• 1: Yes
• 2: No
• 3: Permanently unable to work

Labour market activities (LMAM) - Question identifier:LMAM_Q02

Last week, did you have a job or business from which you were absent?

Select ''Yes'' if you:
• were away from work for the entire week for a reason such as vacation, illness, parental leave or work schedule
• were self-employed with a business, but no work was available.
Select ''No'' if you:
• did not have a job or business
• had a casual job, but no work was available.

• 1: Yes
• 2: No

Labour market activities (LMAM) - Question identifier:LMAM_Q03

What was the main reason you were absent from work last week?

• 01: Vacation
• 02: Own illness or disability
• 03: Caring for own children
• 04: Caring for elder relative (60 years of age or older)
• 05: Maternity or parental leave
• 06: Other personal or family responsibilities
• 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., 10 days on, 10 days off, employees only)
• 12: Self-employed, no work available (Self-employed only)
• 13: Seasonal business (Excluding employees)
• 14: Other

Labour market activities (LMA3) - Question identifier:LMA3_Q01

Were you an employee or self-employed?

Select ''Employee'' if you worked:
• for pay (wages, salary, tips or commissions).
Select ''Self-employed'' if you worked:
• for your own business, farm or professional practice
• as an independent contractor, painter, babysitter, etc.

• 1: Employee
• 2: Self-employed
• 3: Working in a family business without pay

Labour market activities (LMA4) - Question identifier:LMA4_Q01

What was the full name of your business?

Long Answer Length = 50

Enter the full name of the business. If there is no business name, enter the respondent's full name.

Specify the full name of your business

Labour market activities (LMA4) - Question identifier:LMA4_Q02

For whom did you work?

Long Answer Length = 50

Enter the full name of the company, business, government department or agency, or person.

Specify who you worked for

Labour market activities (LMA4) - Question identifier:LMA4_Q03

What kind of business, industry or service was this?

Long Answer Length = 80

Examples: new home construction, primary school, municipal police, wheat farm, retail shoe store, food wholesale, car parts factory, federal government

Specify the kind of business, industry or service

Labour market activities (LMA5) - Question identifier:LMA5_R01

The following questions refer to the work or occupation in which you spent most of your time.

Labour market activities (LMA5) - Question identifier:LMA5_Q01

What kind of work were you doing?

Long Answer Length = 50

Examples: legal secretary, plumber, fishing guide, wood furniture assembler, secondary school teacher, computer programmer

Specify the kind of work you were doing

Labour market activities (LMA5) - Question identifier:LMA5_Q02

What were your most important activities or duties?

Long Answer Length = 50

Examples: prepared legal documents, installed residential plumbing, guided fishing parties, made wood furniture products, taught mathematics, developed software

Specify your most important activities or duties

Labour market activities (LMA6) - Question identifier:LMA6_Q01

[Excluding overtime, on average, how many paid hours do you usually work per week?/On average, how many hours do you usually work per week?]

Min = 0; Max = 999.9

If necessary, enter a decimal value e.g., 32.5.

Labour market activities (LBF) - Question identifier:LBF_Q11

Did you have more than one job or business last week?

• 1: Yes
• 2: No

Labour market activities (LBF) - Question identifier:LBF_Q12

On average, how many hours do you usually work per week at your other job(s)?

Min = 0; Max = 999.9

If necessary, enter a decimal value e.g., 32.5.

Telework (LM) - Question identifier:LM_Q025

In the past 30 days, in which of these locations did you work the most hours?

"At home" could be any place where you live temporarily or permanently, from which you telework.

• 1: At a fixed location outside the home (e.g., office building, factory)
• 2: Outside the home with no fixed location (e.g., driving, making sales calls)
• 3: At home (e.g., main residence, cottage)
• 4: Absent from work

Place of birth, immigration and citizenship (IM) - Question identifier:IM_Q01A

Where were you born?

Specify place of birth according to present boundaries.

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

Place of birth, immigration and citizenship (IM) - Question identifier:IM_Q01AA

Specify the province or territory

• 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

Place of birth, immigration and citizenship (IM) - Question identifier:IM_Q01AB

Select the country

To search for a country, type the first few letters to narrow down the choices.
Note: If the country is not listed, select "Other".

• 1: Search
• 2: Other - Specify

Place of birth, immigration and citizenship (IM) - Question identifier:IM_Q02

In what year did you first come to Canada to live?

Min = 0; Max = 9999

If exact year is not known, enter best estimate.

Place of birth, immigration and citizenship (IM) - Question identifier:IM_Q03

Are you now, or have you ever been a landed immigrant?

A 'landed immigrant' (permanent resident) is a person who has been granted the right to live in Canada permanently by immigration authorities.

• 1: Yes
• 2: No

Place of birth, immigration and citizenship (IM) - Question identifier:IM_Q04

In what year did you first become a landed immigrant?

Min = 0; Max = 9999

If exact year is not known, enter best estimate.

Place of birth, immigration and citizenship (IM) - Question identifier:IM_Q05

Of what country are you a citizen?

Are you a citizen of:

Select all that apply.

• 1: Canada
• 2: Another country

Place of birth, immigration and citizenship (IM) - Question identifier:IM_Q05AA

Is it:

• 1: By birth
• 2: By naturalization (i.e., the process by which an immigrant is granted citizenship of Canada, under the Citizenship Act.)

Place of birth, immigration and citizenship (IM) - Question identifier:IM_Q05AB

Select the country

To search for a country, type the first few letters to narrow down the choices.
Note: If the country is not listed, select "Other".

• 1: Search
• 2: Other - Specify

Indigenous identity (ABM) - Question identifier:ABM_Q01

Are you First Nations, Métis or Inuk (Inuit)?

First Nations (North American Indian) includes Status and Non-Status Indians.
If "Yes", select the responses that best describes this person now.

Select all that apply.

• 1: No, not First Nations, Métis or Inuk (Inuit)
• 2: Yes, First Nations (North American Indian)
• 3: Yes, Métis
• 4: Yes, Inuk (Inuit)

Population group (PG) - Question identifier:PG_R05

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

Population group (PG) - Question identifier:PG_Q05

Are you?

Select all that apply.

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

Language (LAN) - Question identifier:LAN_Q01

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

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

Language (LAN) - Question identifier:LAN_Q02

What language do you speak most often at home?

Select all that apply.

• 1: English
• 2: French
• 3: Other

Language (LAN) - Question identifier:LAN_Q04

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

If you no longer understand the first language learned, indicate the second language learned.

Select all that apply.

• 1: English
• 2: French
• 3: Other

Sexual orientation (SOR) - Question identifier:SOR_Q01

What is your sexual orientation?

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

Home care services (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.

Home care services (HMC) - Question identifier:HMC_Q005

In the past 12 months, what type of home care services have been received?

Include services provided at home such as nursing care, meal preparation, someone to help with bathing or housework, etc.

Exclude post-partum care, help from family, friends or neighbours.

Select all that apply.

• 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 (e.g., bathing, housekeeping, meal preparation)
• 5: Palliative or end-of-life care
• 6: Other services (e.g., transportation, meals-on-wheels)
• 7: No one in the household received any home care services

Home care services (HMC) - Question identifier:HMC_Q010A

Who received these home care services?
Nursing care

e.g., dressing changes, preparing medications, V.O.N. visits

• 1: You
• 2: Another member of the household
• 3: You and another member of the household

Home care services (HMC) - Question identifier:HMC_Q010B

Who received these home care services?
Other health care services

e.g., physiotherapy, occupational or speech therapy, nutrition counselling

• 1: You
• 2: Another member of the household
• 3: You and another member of the household

Home care services (HMC) - Question identifier:HMC_Q010C

Who received these home care services?
Medical equipment or supplies

e.g., wheelchair, pads for incontinence, help with using a ventilator or oxygen equipment

• 1: You
• 2: Another member of the household
• 3: You and another member of the household

Home care services (HMC) - Question identifier:HMC_Q010D

Who received these home care services?
Personal or home support

e.g., bathing, housekeeping, meal preparation

• 1: You
• 2: Another member of the household
• 3: You and another member of the household

Home care services (HMC) - Question identifier:HMC_Q010E

Who received these home care services?
Palliative or end-of-life care

• 1: You
• 2: Another member of the household
• 3: You and another member of the household

Home care services (HMC) - Question identifier:HMC_Q010F

Who received these home care services?
Other services

e.g., transportation, meals-on-wheels

• 1: You
• 2: Another member of the household
• 3: You and another member of the household

Home care services (HMC) - Question identifier:HMC_Q015A

How long were home care services received?
Nursing care

e.g., dressing changes, preparing medications, V.O.N. visits

• 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

Home care services (HMC) - Question identifier:HMC_Q015B

How long were home care services received?
Other health care services

e.g., physiotherapy, occupational or speech therapy, nutrition counselling

• 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

Home care services (HMC) - Question identifier:HMC_Q015C

How long were home care services received?
Medical equipment or supplies

e.g., wheelchair, pads for incontinence, help with using a ventilator or oxygen equipment

• 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

Home care services (HMC) - Question identifier:HMC_Q015D

How long were home care services received?
Personal or home support

e.g., bathing, housekeeping, meal preparation

• 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

Home care services (HMC) - Question identifier:HMC_Q015E

How long were home care services received?
Palliative or end-of-life care

• 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

Home care services (HMC) - Question identifier:HMC_Q015F

How long were home care services received?
Other services

e.g., transportation, meals-on-wheels

• 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

Home care services (HMC) - Question identifier:HMC_Q020A

In a typical month over the past 12 months, how much was paid for home care services?
Nursing care

e.g., dressing changes, preparing medications, V.O.N. visits

• 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 $1,000
• 08: $1,000 and more

Home care services (HMC) - Question identifier:HMC_Q020B

In a typical month over the past 12 months, how much was paid for home care services?
Other health care services

e.g., physiotherapy, occupational or speech therapy, nutrition counselling

• 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 $1,000
• 08: $1,000 and more

Home care services (HMC) - Question identifier:HMC_Q020C

In a typical month over the past 12 months, how much was paid for home care services?
Medical equipment or supplies

e.g., wheelchair, pads for incontinence, help with using a ventilator or oxygen equipment

• 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 $1,000
• 08: $1,000 and more

Home care services (HMC) - Question identifier:HMC_Q020D

In a typical month over the past 12 months, how much was paid for home care services?
Personal or home support

e.g., bathing, housekeeping, meal preparation

• 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 $1,000
• 08: $1,000 and more

Home care services (HMC) - Question identifier:HMC_Q020E

In a typical month over the past 12 months, how much was paid for home care services?
Palliative or end-of-life care

• 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 $1,000
• 08: $1,000 and more

Home care services (HMC) - Question identifier:HMC_Q020F

In a typical month over the past 12 months, how much was paid for home care services?
Other services

e.g., transportation, meals-on-wheels

• 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 $1,000
• 08: $1,000 and more

Home care services (HMC) - Question identifier:HMC_Q025

Who paid for these services?

Select all that apply.

• 1: Out of your 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

Home care services (HMC) - Question identifier:HMC_Q030

Overall, what was the level of satisfaction for the home care services received?

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

Home care services (HMC) - Question identifier:HMC_Q035

What are the reasons for the dissatisfaction?

Select all that apply.

• 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

Home care services (HMC) - Question identifier:HMC_Q037

Thinking of the home care services received in the past 12 months, how helpful were they in allowing the person or persons receiving these services 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)

Home care services (HMC) - Question identifier:HMC_Q038

Why weren't the home care services helpful in allowing the person or persons receiving these services to stay at home?

Select all that apply.

• 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 (e.g., coverage, frequency, etc.)
• 4: Long wait times to receive services
• 5: Cost of services was too high
• 6: Other reason

Home care services (HMC) - Question identifier:HMC_Q040

During the past 12 months, was there ever a time when you or anyone in the household felt that home care services were needed but were not received?

• 1: Yes
• 2: No

Home care services (HMC) - Question identifier:HMC_Q045

Were these home care services needed for yourself or someone else living in the household?

• 1: You only
• 2: Other household member
• 3: You and other household member

Home care services (HMC) - Question identifier:HMC_R050

For the following questions, please only report for the home care services you personally needed.

Home care services (HMC) - Question identifier:HMC_Q050

Thinking of the most recent time, what type of home care was needed?

Select all that apply.

• 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 (e.g., bathing, housekeeping, meal preparation)
• 5: Palliative or end-of-life care
• 6: Other services (e.g., transportation, meals-on-wheels)

Home care services (HMC) - Question identifier:HMC_Q055

Again, thinking of the most recent time, why didn't you or another member of the household get these services?

Select all that apply.

• 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 or didn't bother
• 06: Didn't know where to go or 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

Home care services (HMC) - Question identifier:HMC_Q060

Where did you or another member of the household try to get these home care services?

Select all that apply.

• 1: A government Home Care Program (e.g., CLSC in Quebec, CCAC in Ontario, Extra-Mural 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

Insurance coverage (INL) - Question identifier:INL_Q05

[Do you] have insurance that covers all or part of the cost of [your] long term care, including home care?

Include coverage from [your] own plan or someone else's.

e.g., private, government or employer-paid plans.

• 1: Yes
• 2: No
• 3: Don't know

Insurance coverage (INP) - Question identifier:INP_Q05

[Do you] have insurance that covers all or part of the cost of [your] prescription medications?

Include coverage from [your] own plan or someone else's.
e.g., private, government or employer-paid plans.

• 1: Yes
• 2: No
• 3: Don't know

Prescription cost (PCN) - Question identifier:PCN_Q05

In the past 12 months, did [you] have any prescriptions for medication?

• 1: Yes
• 2: No

Prescription cost (PCN) - Question identifier:PCN_Q10

In the past 12 months, did [you] do any of the following because of the cost of [your] prescriptions?

[]

Select all that apply. If none apply, click on "Next" to continue.

• 1: Not fill a prescription
• 2: Not collect a prescription
• 3: Skip doses of [your] medicine
• 4: Reduce the dosage of [your] medication
• 5: Delay filling a prescription

Food security (FSC) - Question identifier:FSC_R10

The following statements may describe the food situation for your household in the past 12 months. Please indicate if the statement was often true, sometimes true or never true for [you/you and other household members] in the past 12 months.

Food security (FSC) - Question identifier:FSC_Q10

[You/You and other household members] worried that food would run out before you got money to buy more

• 1: Often true
• 2: Sometimes true
• 3: Never true

Food security (FSC) - Question identifier:FSC_Q15

The food that [you/you and other household members] bought just didn't last and there wasn't any money to get more

• 1: Often true
• 2: Sometimes true
• 3: Never true

Food security (FSC) - Question identifier:FSC_Q20

[You/You and other household members] couldn't afford to eat balanced meals

• 1: Often true
• 2: Sometimes true
• 3: Never true

Food security (FSC) - Question identifier:FSC_Q25

[You/You or other adults in your household] relied on only a few kinds of low-cost food to feed [your child/the children] because you were running out of money to buy food

• 1: Often true
• 2: Sometimes true
• 3: Never true

Food security (FSC) - Question identifier:FSC_Q30

[You/You or other adults in your household] couldn't feed [your child/the children] a balanced meal because you couldn't afford it

• 1: Often true
• 2: Sometimes true
• 3: Never true

Food security (FSC) - Question identifier:FSC_Q35

[Your child was/The children were] not eating enough because [you/you or other adults in your household] just couldn't afford enough food?

• 1: Often true
• 2: Sometimes true
• 3: Never true

Food security (FSC) - Question identifier:FSC_R40

[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_Q40

In the past 12 months, since last [January/February/March/April/May/June/July/August/September/October/November/December], did [you/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

Food security (FSC) - Question identifier:FSC_Q45

How often did this happen?

• 1: Almost every month
• 2: Some months but not every month
• 3: Only 1 or 2 months

Food security (FSC) - Question identifier:FSC_Q50

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

Food security (FSC) - Question identifier:FSC_Q55

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

Food security (FSC) - Question identifier:FSC_Q60

In the past 12 months, did you personally ever lose weight because you didn't have enough money for food?

• 1: Yes
• 2: No

Food security (FSC) - Question identifier:FSC_Q65

In the past 12 months, did [you/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

Food security (FSC) - Question identifier:FSC_Q70

How often did this happen?

• 1: Almost every month
• 2: Some months but not every month
• 3: Only 1 or 2 months

Food security (FSC) - Question identifier:FSC_R75

Now, a few questions on the food experiences for children in your household.

Food security (FSC) - Question identifier:FSC_Q75

In the past 12 months, did [you/you or other adults in your household] ever cut the size of [your child's/any of the children's] meals because there wasn't enough money for food?

• 1: Yes
• 2: No

Food security (FSC) - Question identifier:FSC_Q80

In the past 12 months, did [your child/any of the children] ever skip meals because there wasn't enough money for food?

• 1: Yes
• 2: No

Food security (FSC) - Question identifier:FSC_Q85

How often did this happen?

• 1: Almost every month
• 2: Some months but not every month
• 3: Only 1 or 2 months

Food security (FSC) - Question identifier:FSC_Q90

In the past 12 months, [was your child/were any of the children] ever hungry but you couldn't afford more food?

• 1: Yes
• 2: No

Food security (FSC) - Question identifier:FSC_Q95

In the past 12 months, did [your child/any of the children] ever not eat for a whole day because there wasn't enough money for food?

• 1: Yes
• 2: No

Total household income (INC) - Question identifier:INC_R01A

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.

Total household income (INC) - Question identifier:INC_R01B

Now a question about total household income.

Total household income (INC) - Question identifier:INC_Q01

What is your best estimate of total household income received by all household members, from all sources, before taxes and deductions, during the year ending December 31, [Past year]?

Min = -99999999; Max = 99999999

Income can come from various sources such as from work, investments, pensions or government. Examples include Employment Insurance, Social Assistance, COVID-19 benefits, Child Tax Benefit and other income such as child support, spousal support (alimony) and rental income.

Capital gains should not be included in the household income.

Total household income (INC) - Question identifier:INC_Q02

Which of the following categories best represents your total household income for the year ending December 31, [Past year]?

Include income loss.

• 1: Less than $50,000
• 2: $50,000 and more

Total household income (INC) - Question identifier:INC_Q03

What was your total household income?

• 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

Total household income (INC) - Question identifier:INC_Q04

What was your total household income?

• 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

Administrative information (ADMC) - Question identifier:ADMC_R10

To enhance the data from this survey and to minimize the reporting burden for respondents, Statistics Canada will combine [your responses] with information from the tax data of all members of your household. [Statistics Canada, the provincial ministry of health and the Institut de la statistique du Québec/Statistics Canada and the territorial ministry of health/Statistics Canada and the provincial ministry of health] may also add information from other surveys or administrative sources.

Administrative information (ADMC) - Question identifier:ADMC_Q10

Having a provincial or territorial health number will assist us in linking to this other information. [Do you] have [a Newfoundland and Labrador/a Prince Edward Island/a Nova Scotia/a New Brunswick/a Quebec/an Ontario/a Manitoba/a Saskatchewan/an Alberta/a British Columbia/a Yukon/a the Northwest Territories/a Nunavut] health number?

• 1: Yes
• 2: No

Administrative information (ADMC) - Question identifier:ADMC_Q10A

For which province or territory is your health number?

Province or territory

• 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

Administrative information (ADMC) - Question identifier:ADMC_Q15

What is your health number?

Long Answer Length = 12

Administrative information (ADMC) - Question identifier:ADMC_R25A

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 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 survey responses and the postal code.

Administrative information (ADMC) - Question identifier:ADMC_R25B

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 or the Institut de la statistique du Québec may also include 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 survey responses and the postal code.

Administrative information (ADMC) - Question identifier:ADMC_R25C

Statistics Canada has also entered into an agreement to share information from the interviews conducted as part of this survey with Veterans Affairs Canada and the Department of National Defence.

Veterans Affairs Canada and the Department of National Defence intend to link the information collected during this interview to your administrative records.

Administrative information (ADMC) - Question identifier:ADMC_Q35

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

Administrative information (ADMC) - Question identifier:ADMC_Q37

To reduce the number of questions in this questionnaire, Statistics Canada will use information from your tax forms submitted to the Canada Revenue Agency. With your consent Statistics Canada will share this information from your tax forms with [provincial and territorial ministries of health, the Institut de la statistique du Québec, [Veterans Affairs Canada, the Department of National Defence,/] Health Canada and the Public Health Agency of Canada/provincial and territorial ministries of health, 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 with [provincial and territorial ministries of health, the Institut de la statistique du Québec, [Veterans Affairs Canada, the Department of National Defence,/] Health Canada and the Public Health Agency of Canada/provincial and territorial ministries of health, Health Canada and the Public Health Agency of Canada]?

• 1: Yes
• 2: No