Canadian Community Health Survey (CCHS) - Annual Component - 2023

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

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Table of Contents

Respondent availability (TR)

In this module, we ask if the respondent is available.

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)

This module asks why the respondent is unable to complete the survey.

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 of [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)

This module confirms the identity of the respondent before proceeding with the child portion of the survey.

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)

Harmonized content

This module is used to collect the respondent's date of birth, which is used to calculate the age of the household member and is necessary for determining question flows.

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)

Harmonized content

The Sex and gender block is used to collect the gender and sex at birth of the respondent.

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)

The Relationship with Confirmation block is used to determine the relationship of each household member to the selected respondent. This is used in the analysis and interpretation of changes in family and household characteristics and composition. For households of 1 person, the RWC module is not required.

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

Relationship with confirmation (RWC) - Question identifier:RWC_Q30

Select the type of relationship.

  • 1: Aunt or uncle
  • 2: Cousin
  • 3: Niece or nephew
  • 4: Grandfather or grandmother
  • 5: Grandson or granddaughter
  • 6: Other relative

Main activity (MAC)

The Main activity block is used to determine whether the main activity of the respondent for the past 12 months was working at a job or business.

Main activity (MAC) - Question identifier:MAC_Q04

In the past 12 months, did you work at a job or business?

Regardless of the number of hours.

  • 1: Yes
  • 2: No

Main activity (MAC) - Question identifier:MAC_Q05

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

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

  • 1: Yes
  • 2: No

Main activity (MA)

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 (EDC)

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)

The general health module is used to collect data on self-perceived health, satisfaction with life, self-perceived mental health, self-perceived stress at work and with life in general, and sense of belonging to local community.

Researchers are interested in these topics because they are good basic measures of health status. They can also be used to predict other aspects of the respondent's health. For example, respondents who describe their health as fair or poor are more likely to have long-term health problems, to suffer from depression and to be heavy users of the health care system.

General health (GEN) - Question identifier:GEN_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)

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 about your life as a whole right now?

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

Pregnancy (PRS)

In this module, female respondents aged 15 to 55 are asked if they are pregnant. This information is required for other modules, like Height and weight.

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)

In this module, respondents are asked to report their height and weight. Answers to these questions are used in many ways, including calculating the number of people who are overweight, or obese.

Obesity, especially amongst young people, is a major health problem. It can be associated with a number of major medical problems, including high blood pressure, heart disease and diabetes.

Height and weight (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

COVID-19 (COVA)

This module collects information about experiences during the COVID-19 pandemic.

Respondents are asked about their mental health during the pandemic compared to their mental health before the pandemic.This is a submodule taken from COV2 and implemented in 2023.

COVID-19 (COVA) - Question identifier:COVA_R005

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

COVID-19 (COVA) - Question identifier:COVA_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 (COVB)

This module collects information about experiences during the COVID-19 pandemic.

Respondents are asked about the precautions they have been taking to protect themselves or others from COVID-19.This is a submodule taken from COV2 and implemented in 2023.

COVID-19 (COVB) - Question identifier:COVB_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 (COVC)

This module collects information about experiences during the COVID-19 pandemic.

Respondents are asked if they have experienced symptoms of COVID-19 and whether they followed provincial guidelines. This is a submodule taken from COV2 and implemented in 2023.

COVID-19 (COVC) - Question identifier:COVC_Q015

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

  • 1: Yes
  • 2: No

COVID-19 (COVC) - Question identifier:COVC_Q020

While you were experiencing these symptoms, did you follow provincial guidelines (e.g., self-isolate for a required number of days)?

  • 1: Yes
  • 2: No

COVID-19 (COVD)

This module collects information about experiences during the COVID-19 pandemic.

Respondents are asked about their COVID-19 vaccination status.This is a submodule taken from COV2 and implemented in 2023.

COVID-19 (COVD) - Question identifier:COVD_Q038

Have you been vaccinated against COVID-19?

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

COVID-19 (COVD) - Question identifier:COVD_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 booster dose.

  • 1: One dose (e.g., Johnson & Johnson)
  • 2: Two doses (e.g., Moderna, Pfizer-BioNTech, AstraZeneca, Novavax, etc.)

COVID-19 (COVD) - Question identifier:COVD_Q035

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

Do not include getting infected with COVID-19 as a dose.

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

COVID-19 (COVD) - Question identifier:COVD_Q036A

When did you receive your last dose of a COVID-19 vaccine?

Month

Do not include getting infected with COVID-19 as a dose.

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

COVID-19 (COVD) - Question identifier:COVD_Q036B

When did you receive your last dose of a COVID-19 vaccine?

Year

Do not include getting infected with COVID-19 as a dose.

  • 1: 2020
  • 2: 2021
  • 3: 2022
  • 4: 2023
  • 5: 2024

COVID-19 (COVE)

This module collects information about experiences during the COVID-19 pandemic.

Respondents are asked about the reasons for their vaccination status.This is a submodule taken from COV2 and implemented in 2023.

COVID-19 (COVE) - Question identifier:COVE_Q041

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

  • 1: I do not trust the effectiveness or safety of the COVID-19 vaccines
  • 2: If I get COVID-19, the risk of having serious symptoms is low
  • 3: The vaccine is not recommended for me (e.g., a pre-existing medical condition)
  • 4: I am not at high risk of getting infected with COVID-19
  • 5: I have already had COVID-19
  • 6: Other reason

COVID-19 (COVE) - Question identifier:COVE_Q055

What is the main reason why you haven't received a booster dose?

A COVID-19 booster dose is a dose of a COVID-19 vaccine given some time after the primary series to increase protection.

  • 01: The number of doses I have received is enough to protect me against COVID-19
  • 02: I have already had COVID-19
  • 03: I had a bad reaction to a previous dose
  • 04: I have concerns about side effects associated with a booster dose
  • 05: If I get COVID-19, the risk of having serious symptoms is low
  • 06: I just did not get around to it
  • 07: I have an appointment in the future
  • 08: Other reason

COVID-19 (COVF)

This module collects information about experiences during the COVID-19 pandemic.

Respondents are asked about the likelihood of receiving a booster dose.This is a submodule taken from COV2 and implemented in 2023.

COVID-19 (COVF) - Question identifier:COVF_Q060A

How likely is it that you would get a booster dose?

A COVID-19 booster dose is a dose of a COVID-19 vaccine given some time after the primary series to increase protection.

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

Chronic conditions (CCC)

The questions in this module deal with long-term health conditions that have lasted or are expected to last at least 6 months. Chronic conditions reported by respondents must have been diagnosed by a health professional.

Answers to these questions can be used to estimate the number of people in Canada suffering from conditions such as diabetes, heart disease, etc.

By combining answers from this module with information from other modules, researchers can look at the relationship between chronic conditions and other characteristics, such as use of health care services or use of medications.

Chronic conditions (CCC) - Question identifier:CCC_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)

The questions in this module deal with long-term health conditions that have lasted or are expected to last at least 6 months. Chronic conditions reported by respondents must have been diagnosed by a health professional.

Answers to these questions can be used to estimate the number of people in Canada suffering from conditions such as an anxiety disorder, post-traumatic stress disorder, and dementia.

By combining answers from this module with information from other modules, researchers can look at the relationship between chronic conditions and other characteristics, such as use of health care services or use of medications.

Chronic conditions (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

Health utility index (HUI)

The health utility index provides a description of an individual's overall functional health, based on eight attributes: vision, hearing, speech, mobility (ability to get around), dexterity (use of hands and fingers), emotion (feelings), cognition (memory and thinking) and pain. The version of the index used in CCHS is adapted from the HUI Mark 3 (HUI3). The index is designed to produce both an overall health utility score and eight individual attribute scores. Analysts can use either a single-attribute utility scale or look at the complete health state (levels on all eight attributes) on the overall utility scale to produce a measure of an individual's perceived health related quality of life (HRQL).

The index is appropriate for use to describe and monitor the health of general populations, and has been extensively validated for use in cross-sectional and longitudinal population health studies.

The 8 single-attribute utility scores measure functional capacity within a single attribute, and range from 1.00 (normal) to 0.00 (most disabled). In combination, these scores are used to produce a multi-attribute utility index producing a score ranging from 1.00 (perfect health), through 0.00 (health status equal to death) to -0.36 (health status worse than death).

Health utility index (HUI) - Question identifier:HUI_R001

The next set of questions asks about your day-to-day health.

You may feel that some of these questions do not apply to you, but it is important that we ask the same questions of everyone.

Health utility index (HUI) - Question identifier:HUI_Q005

Are you usually able to see well enough to read ordinary newsprint without glasses or contact lenses?

  • 1: Yes
  • 2: No

Health utility index (HUI) - Question identifier:HUI_Q005A

Are you able to see well enough to recognize a friend on the other side of the street without glasses or contact lenses?

  • 1: Yes
  • 2: No

Health utility index (HUI) - Question identifier:HUI_Q005B

Are you usually able to see well enough to recognize a friend on the other side of the street with glasses or contact lenses?

  • 1: Yes
  • 2: No

Health utility index (HUI) - Question identifier:HUI_Q010

Are you usually able to see well enough to read ordinary newsprint with glasses or contact lenses?

  • 1: Yes
  • 2: No

Health utility index (HUI) - Question identifier:HUI_Q010A

Are you able to see well enough to recognize a friend on the other side of the street without glasses or contact lenses?

  • 1: Yes
  • 2: No

Health utility index (HUI) - Question identifier:HUI_Q010B

Are you usually able to see well enough to recognize a friend on the other side of the street with glasses or contact lenses?

  • 1: Yes
  • 2: No

Health utility index (HUI) - Question identifier:HUI_Q015

Are you able to see at all?

  • 1: Yes
  • 2: No

Health utility index (HUI) - Question identifier:HUI_Q015A

Are you able to see well enough to recognize a friend on the other side of the street without glasses or contact lenses?

  • 1: Yes
  • 2: No

Health utility index (HUI) - Question identifier:HUI_Q015B

Are you usually able to see well enough to recognize a friend on the other side of the street with glasses or contact lenses?

  • 1: Yes
  • 2: No

Health utility index (HUI) - Question identifier:HUI_Q030

Are you usually able to hear what is said in a group conversation with at least three other people without a hearing aid?

  • 1: Yes
  • 2: No

Health utility index (HUI) - Question identifier:HUI_Q035

Are you usually able to hear what is said in a group conversation with at least three other people with a hearing aid?

  • 1: Yes
  • 2: No

Health utility index (HUI) - Question identifier:HUI_Q035A

Are you usually able to hear what is said in a conversation with one other person in a quiet room without a hearing aid?

  • 1: Yes
  • 2: No

Health utility index (HUI) - Question identifier:HUI_Q035B

Are you usually able to hear what is said in a conversation with one other person in a quiet room with a hearing aid?

  • 1: Yes
  • 2: No

Health utility index (HUI) - Question identifier:HUI_Q040

Are you able to hear at all?

  • 1: Yes
  • 2: No

Health utility index (HUI) - Question identifier:HUI_Q040A

Are you usually able to hear what is said in a conversation with one other person in a quiet room without a hearing aid?

  • 1: Yes
  • 2: No

Health utility index (HUI) - Question identifier:HUI_Q040B

Are you usually able to hear what is said in a conversation with one other person in a quiet room with a hearing aid?

  • 1: Yes
  • 2: No

Health utility index (HUI) - Question identifier:HUI_Q055

Are you usually able to be understood completely when speaking with strangers in your own language?

  • 1: Yes
  • 2: No

Health utility index (HUI) - Question identifier:HUI_Q060

Are you able to be understood partially when speaking with strangers?

  • 1: Yes
  • 2: No

Health utility index (HUI) - Question identifier:HUI_Q065

Are you able to be understood completely when speaking with those who know you well?

  • 1: Yes
  • 2: No

Health utility index (HUI) - Question identifier:HUI_Q070

Are you able to be understood partially when speaking with those who know you well?

  • 1: Yes
  • 2: No

Health utility index (HUI) - Question identifier:HUI_Q075

Are you usually able to walk around the neighbourhood without difficulty and without mechanical support such as braces, a cane or crutches?

  • 1: Yes
  • 2: No

Health utility index (HUI) - Question identifier:HUI_Q080

Are you able to walk at all?

  • 1: Yes
  • 2: No

Health utility index (HUI) - Question identifier:HUI_Q085

Do you require mechanical support such as braces, a cane or crutches to be able to walk around the neighbourhood?

  • 1: Yes
  • 2: No

Health utility index (HUI) - Question identifier:HUI_Q090

Do you require the help of another person to be able to walk?

  • 1: Yes
  • 2: No

Health utility index (HUI) - Question identifier:HUI_Q095

Do you require a wheelchair to get around?

  • 1: Yes
  • 2: No

Health utility index (HUI) - Question identifier:HUI_Q100

How often do you use a wheelchair?

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

Health utility index (HUI) - Question identifier:HUI_Q105

Do you need the help of another person to get around in the wheelchair?

  • 1: Yes
  • 2: No

Health utility index (HUI) - Question identifier:HUI_Q110

Are you usually able to grasp and handle small objects such as a pencil or scissors?

  • 1: Yes
  • 2: No

Health utility index (HUI) - Question identifier:HUI_Q115

Do you require the help of another person because of limitations in the use of your hands or fingers?

  • 1: Yes
  • 2: No

Health utility index (HUI) - Question identifier:HUI_Q120

How many tasks do you require the help of another person with?

  • 1: Some tasks
  • 2: Most tasks
  • 3: Almost all tasks
  • 4: All tasks

Health utility index (HUI) - Question identifier:HUI_Q125

Do you require special equipment, for example, devices to assist in dressing, because of limitations in the use of your hands or fingers?

  • 1: Yes
  • 2: No

Health utility index (HUI) - Question identifier:HUI_Q130

How would you describe yourself as being usually?

  • 1: Happy and interested in life
  • 2: Somewhat happy
  • 3: Somewhat unhappy
  • 4: Unhappy with little interest in life
  • 5: So unhappy, that life is not worthwhile

Health utility index (HUI) - Question identifier:HUI_Q135

How would you describe your usual ability to remember things?

  • 1: Able to remember most things
  • 2: Somewhat forgetful
  • 3: Very forgetful
  • 4: Unable to remember anything at all

Health utility index (HUI) - Question identifier:HUI_Q140

How would you describe your usual ability to think and solve day-to-day problems?

  • 1: Able to think clearly and solve problems
  • 2: Having a little difficulty
  • 3: Having some difficulty
  • 4: Having a great deal of difficulty
  • 5: Unable to think or solve problems

Health utility index (HUI) - Question identifier:HUI_R145

The next set of questions asks about the level of pain or discomfort you usually experience. They are not about illnesses like colds that affect people for short periods of time.

Health utility index (HUI) - Question identifier:HUI_Q145

Are you usually free of pain or discomfort?

  • 1: Yes
  • 2: No

Health utility index (HUI) - Question identifier:HUI_Q150

How would you describe the usual intensity of your pain or discomfort?

  • 1: Mild
  • 2: Moderate
  • 3: Severe

Health utility index (HUI) - Question identifier:HUI_Q155

How many activities does your pain or discomfort prevent?

  • 1: None
  • 2: A few
  • 3: Some
  • 4: Most

Long-term condition (LTC)

This module asks the respondent if they identify as a person with a disability.

The question is from the Canadian Social Survey - Well-being and used in the Census.

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

Do you identify as a person with a disability?

  • 1: Yes
  • 2: No

Activities of daily living (ADL)

This module looks at the impact of a physical or mental condition or health problem on common activities of daily living such as preparing meals, running errands, and doing housework.

It is very important to ask all questions of everyone in order to compare those with activity limitations and those without.

Activities of daily living (ADL) - Question identifier:ADL_R01

These questions may not apply to you, but we need to ask the same questions of everyone.

Activities of daily living (ADL) - Question identifier:ADL_Q05

Because of any health problem, physical or mental condition, do you have any difficulty with the following common daily activities?

Preparing meals

  • 1: No difficulty
  • 2: Some difficulty, but no help required
  • 3: Some difficulty and help from others is required
  • 4: Cannot do at all

Activities of daily living (ADL) - Question identifier:ADL_Q10

Because of any health problem, physical or mental condition, do you have any difficulty with the following common daily activities?

Running errands

e.g., shopping for groceries

  • 1: No difficulty
  • 2: Some difficulty, but no help required
  • 3: Some difficulty and help from others is required
  • 4: Cannot do at all

Activities of daily living (ADL) - Question identifier:ADL_Q15

Because of any health problem, physical or mental condition, do you have any difficulty with the following common daily activities?

Everyday housework

  • 1: No difficulty
  • 2: Some difficulty, but no help required
  • 3: Some difficulty and help from others is required
  • 4: Cannot do at all

Activities of daily living (ADL) - Question identifier:ADL_Q20

Because of any health problem, physical or mental condition, do you have any difficulty with the following common daily activities?

Personal care

e.g., bathing, dressing, eating or taking medication

  • 1: No difficulty
  • 2: Some difficulty, but no help required
  • 3: Some difficulty and help from others is required
  • 4: Cannot do at all

Activities of daily living (ADL) - Question identifier:ADL_Q25

Because of any health problem, physical or mental condition, do you have any difficulty with the following common daily activities?

Moving inside the house

  • 1: No difficulty
  • 2: Some difficulty, but no help required
  • 3: Some difficulty and help from others is required
  • 4: Cannot do at all

Activities of daily living (ADL) - Question identifier:ADL_Q30

Because of any health problem, physical or mental condition, do you have any difficulty with the following common daily activities?

Personal finances

e.g., making transactions or paying bills

  • 1: No difficulty
  • 2: Some difficulty, but no help required
  • 3: Some difficulty and help from others is required
  • 4: Cannot do at all

Eating habits (EAH)

The Eating habits module is about some of the eating and drinking habits of the respondent, including the consumption of certain fruits and vegetables.

The health benefits of vegetable and fruit consumption are popular topics in nutrition promotion programs and research. Among research findings, there appears to be a link between an increased consumption of vegetables and fruits and a reduction in the risk of many types of cancer.

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

Use of protective equipment (UPE)

Injuries suffered while participating in leisure activities are a major burden to both the people injured and to the health care system.

This module asks about the use of helmets, wrist protectors, elbow pads and mouth guards to protect against injuries while bicycling, in-line skating, skiing, snowboarding, skateboarding and playing hockey.

Results from this module are very useful to health region planners attempting to design programs to promote the use of protective equipment.

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

Moderate physical activity (MPA)

Answers to this module are used to determine how active respondents, have been in the past seven days.

Respondents are asked how much time they spent doing physical activities that caused them to sweat or breathe harder on weekdays and weekend days.

Higher levels of activity are widely thought to be associated with better health.

Moderate physical activity (MPA) - Question identifier:MPA_R01

Thinking again of the past 7 days, we would like to record your physical activities.

We will be asking about common sources of physical activity including: gym at school, recess or free time at school, organized sports and lessons, walking or playing for leisure, [walking or cycling for transportation, and physical activity while at work, volunteering, or at home/walking or cycling for transportation].

To make it easier, we will ask about weekdays and weekend days separately. If recall is too difficult, give your best estimate.

Moderate physical activity (MPA) - Question identifier:MPA_R05

In the past 7 days, how much time did you spend doing the following activities that made you sweat or breathe harder?

Moderate physical activity (MPA) - Question identifier:MPA_Q05A

Doing physical activity that made you sweat or breathe harder during school hours as part of physical education classes or at lunch hour or recess.
On a typical weekday

Hours per day

  • 01: 1
  • 02: 2
  • 03: 3
  • 04: 4
  • 05: 5
  • 06: 6
  • 07: 7
  • 08: 8

Moderate physical activity (MPA) - Question identifier:MPA_Q05B

Doing physical activity that made you sweat or breathe harder during school hours as part of physical education classes or at lunch hour or recess.
On a typical weekday

Minutes per day

  • 00: 0
  • 05: 5
  • 10: 10
  • 15: 15
  • 20: 20
  • 25: 25
  • 30: 30
  • 35: 35
  • 40: 40
  • 45: 45
  • 50: 50
  • 55: 55

Moderate physical activity (MPA) - Question identifier:MPA_Q15A

Doing physical activity that made you sweat or breathe harder while participating in clubs, lessons, leagues, or team sports.
On a typical weekday

Hours per day

  • 01: 1
  • 02: 2
  • 03: 3
  • 04: 4
  • 05: 5
  • 06: 6
  • 07: 7
  • 08: 8

Moderate physical activity (MPA) - Question identifier:MPA_Q15B

Doing physical activity that made you sweat or breathe harder while participating in clubs, lessons, leagues, or team sports.
On a typical weekday

Minutes per day

  • 00: 0
  • 05: 5
  • 10: 10
  • 15: 15
  • 20: 20
  • 25: 25
  • 30: 30
  • 35: 35
  • 40: 40
  • 45: 45
  • 50: 50
  • 55: 55

Moderate physical activity (MPA) - Question identifier:MPA_Q15C

Doing physical activity that made you sweat or breathe harder while participating in clubs, lessons, leagues, or team sports.
On a typical weekend day

Hours per day

  • 01: 1
  • 02: 2
  • 03: 3
  • 04: 4
  • 05: 5
  • 06: 6
  • 07: 7
  • 08: 8

Moderate physical activity (MPA) - Question identifier:MPA_Q15D

Doing physical activity that made you sweat or breathe harder while participating in clubs, lessons, leagues, or team sports.
On a typical weekend day

Minutes per day

  • 00: 0
  • 05: 5
  • 10: 10
  • 15: 15
  • 20: 20
  • 25: 25
  • 30: 30
  • 35: 35
  • 40: 40
  • 45: 45
  • 50: 50
  • 55: 55

Moderate physical activity (MPA) - Question identifier:MPA_Q20A

Doing physical activity that made you sweat or breathe harder for fitness, fun or recreation with friends, family or alone.
On a typical weekday

Hours per day

  • 01: 1
  • 02: 2
  • 03: 3
  • 04: 4
  • 05: 5
  • 06: 6
  • 07: 7
  • 08: 8

Moderate physical activity (MPA) - Question identifier:MPA_Q20B

Doing physical activity that made you sweat or breathe harder for fitness, fun or recreation with friends, family or alone.
On a typical weekday

Minutes per day

  • 00: 0
  • 05: 5
  • 10: 10
  • 15: 15
  • 20: 20
  • 25: 25
  • 30: 30
  • 35: 35
  • 40: 40
  • 45: 45
  • 50: 50
  • 55: 55

Moderate physical activity (MPA) - Question identifier:MPA_Q20C

Doing physical activity that made you sweat or breathe harder for fitness, fun or recreation with friends, family or alone.
On a typical weekend day

Hours per day

  • 01: 1
  • 02: 2
  • 03: 3
  • 04: 4
  • 05: 5
  • 06: 6
  • 07: 7
  • 08: 8

Moderate physical activity (MPA) - Question identifier:MPA_Q20D

Doing physical activity that made you sweat or breathe harder for fitness, fun or recreation with friends, family or alone.
On a typical weekend day

Minutes per day

  • 00: 0
  • 05: 5
  • 10: 10
  • 15: 15
  • 20: 20
  • 25: 25
  • 30: 30
  • 35: 35
  • 40: 40
  • 45: 45
  • 50: 50
  • 55: 55

Moderate physical activity (MPA) - Question identifier:MPA_Q25

In the past 7 days, did you use active ways like walking or cycling to get to places such as [school, stores, visiting friends or work/school, stores, or visiting friends]?

Exclude walking or cycling for fitness, fun or recreation.

  • 1: Yes
  • 2: No

Moderate physical activity (MPA) - Question identifier:MPA_Q25A

In the past 7 days, how much time did you spend using the following active ways to get to places?
Walking

On a typical weekday

Hours per day

  • 01: 1
  • 02: 2
  • 03: 3
  • 04: 4
  • 05: 5
  • 06: 6
  • 07: 7
  • 08: 8

Moderate physical activity (MPA) - Question identifier:MPA_Q25B

In the past 7 days, how much time did you spend using the following active ways to get to places?
Walking

On a typical weekday

Minutes per day

  • 00: 0
  • 05: 5
  • 10: 10
  • 15: 15
  • 20: 20
  • 25: 25
  • 30: 30
  • 35: 35
  • 40: 40
  • 45: 45
  • 50: 50
  • 55: 55

Moderate physical activity (MPA) - Question identifier:MPA_Q25C

In the past 7 days, how much time did you spend using the following active ways to get to places?
Walking

On a typical weekend day

Hours per day

  • 01: 1
  • 02: 2
  • 03: 3
  • 04: 4
  • 05: 5
  • 06: 6
  • 07: 7
  • 08: 8

Moderate physical activity (MPA) - Question identifier:MPA_Q25D

In the past 7 days, how much time did you spend using the following active ways to get to places?
Walking

On a typical weekend day

Minutes per day

  • 00: 0
  • 05: 5
  • 10: 10
  • 15: 15
  • 20: 20
  • 25: 25
  • 30: 30
  • 35: 35
  • 40: 40
  • 45: 45
  • 50: 50
  • 55: 55

Moderate physical activity (MPA) - Question identifier:MPA_Q30A

In the past 7 days, how much time did you spend using the following active ways to get to places?
Cycling

On a typical weekday

Hours per day

  • 01: 1
  • 02: 2
  • 03: 3
  • 04: 4
  • 05: 5
  • 06: 6
  • 07: 7
  • 08: 8

Moderate physical activity (MPA) - Question identifier:MPA_Q30B

In the past 7 days, how much time did you spend using the following active ways to get to places?
Cycling

On a typical weekday

Minutes per day

  • 00: 0
  • 05: 5
  • 10: 10
  • 15: 15
  • 20: 20
  • 25: 25
  • 30: 30
  • 35: 35
  • 40: 40
  • 45: 45
  • 50: 50
  • 55: 55

Moderate physical activity (MPA) - Question identifier:MPA_Q30C

In the past 7 days, how much time did you spend using the following active ways to get to places?
Cycling

On a typical weekend day

Hours per day

  • 01: 1
  • 02: 2
  • 03: 3
  • 04: 4
  • 05: 5
  • 06: 6
  • 07: 7
  • 08: 8

Moderate physical activity (MPA) - Question identifier:MPA_Q30D

In the past 7 days, how much time did you spend using the following active ways to get to places?
Cycling

On a typical weekend day

Minutes per day

  • 00: 0
  • 05: 5
  • 10: 10
  • 15: 15
  • 20: 20
  • 25: 25
  • 30: 30
  • 35: 35
  • 40: 40
  • 45: 45
  • 50: 50
  • 55: 55

Moderate physical activity (MPA) - Question identifier:MPA_R32

Thinking again of the past 7 days, we wish to record your physical activities. We will be asking you about common sources of physical activity while on the job, during sports, fitness or recreational activities, walking or cycling for transportation, and physical activity while volunteering, at home or at work.

To make it easier, we will ask about weekdays and weekend days separately. If you work shifts, please adjust answers to typical workdays and days off. If recall is too difficult, give your best estimate.

Moderate physical activity (MPA) - Question identifier:MPA_R35

In the past 7 days, how much time did you spend doing the following activities that made you sweat or breathe harder?

Moderate physical activity (MPA) - Question identifier:MPA_Q35A

Active work as part of your job that made you sweat or breathe harder.
On a typical weekday

Hours per day

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

Moderate physical activity (MPA) - Question identifier:MPA_Q35B

Active work as part of your job that made you sweat or breathe harder.
On a typical weekday

Minutes per day

  • 00: 0
  • 05: 5
  • 10: 10
  • 15: 15
  • 20: 20
  • 25: 25
  • 30: 30
  • 35: 35
  • 40: 40
  • 45: 45
  • 50: 50
  • 55: 55

Moderate physical activity (MPA) - Question identifier:MPA_Q35C

Active work as part of your job that made you sweat or breathe harder.
On a typical weekend day

Hours per day

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

Moderate physical activity (MPA) - Question identifier:MPA_Q35D

Active work as part of your job that made you sweat or breathe harder.
On a typical weekend day

Minutes per day

  • 00: 0
  • 05: 5
  • 10: 10
  • 15: 15
  • 20: 20
  • 25: 25
  • 30: 30
  • 35: 35
  • 40: 40
  • 45: 45
  • 50: 50
  • 55: 55

Moderate physical activity (MPA) - Question identifier:MPA_Q40A

Sports, fitness or recreational physical activities that made you sweat or breathe harder.
On a typical weekday

Hours per day

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

Moderate physical activity (MPA) - Question identifier:MPA_Q40B

Sports, fitness or recreational physical activities that made you sweat or breathe harder.
On a typical weekday

Minutes per day

  • 00: 0
  • 05: 5
  • 10: 10
  • 15: 15
  • 20: 20
  • 25: 25
  • 30: 30
  • 35: 35
  • 40: 40
  • 45: 45
  • 50: 50
  • 55: 55

Moderate physical activity (MPA) - Question identifier:MPA_Q40C

Sports, fitness or recreational physical activities that made you sweat or breathe harder.
On a typical weekend day

Hours per day

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

Moderate physical activity (MPA) - Question identifier:MPA_Q40D

Sports, fitness or recreational physical activities that made you sweat or breathe harder.
On a typical weekend day

Minutes per day

  • 00: 0
  • 05: 5
  • 10: 10
  • 15: 15
  • 20: 20
  • 25: 25
  • 30: 30
  • 35: 35
  • 40: 40
  • 45: 45
  • 50: 50
  • 55: 55

Moderate physical activity (MPA) - Question identifier:MPA_Q45

In the past 7 days, did you use active ways like walking or cycling to get to places such as school, stores, visiting friends or work?

Exclude walking or cycling for fitness, fun or recreation.

  • 1: Yes
  • 2: No

Moderate physical activity (MPA) - Question identifier:MPA_Q45A

In the past 7 days, how much time did you spend using the following active ways to get to places?
Walking

On a typical weekday

Hours per day

  • 01: 1
  • 02: 2
  • 03: 3
  • 04: 4
  • 05: 5
  • 06: 6
  • 07: 7
  • 08: 8
  • 09: 9
  • 10: 10
  • 11: 11
  • 12: 12

Moderate physical activity (MPA) - Question identifier:MPA_Q45B

In the past 7 days, how much time did you spend using the following active ways to get to places?
Walking

On a typical weekday

Minutes per day

  • 00: 0
  • 05: 5
  • 10: 10
  • 15: 15
  • 20: 20
  • 25: 25
  • 30: 30
  • 35: 35
  • 40: 40
  • 45: 45
  • 50: 50
  • 55: 55

Moderate physical activity (MPA) - Question identifier:MPA_Q45C

In the past 7 days, how much time did you spend using the following active ways to get to places?
Walking

On a typical weekend day

Hours per day

  • 01: 1
  • 02: 2
  • 03: 3
  • 04: 4
  • 05: 5
  • 06: 6
  • 07: 7
  • 08: 8
  • 09: 9
  • 10: 10
  • 11: 11
  • 12: 12

Moderate physical activity (MPA) - Question identifier:MPA_Q45D

In the past 7 days, how much time did you spend using the following active ways to get to places?
Walking

On a typical weekend day

Minutes per day

  • 00: 0
  • 05: 5
  • 10: 10
  • 15: 15
  • 20: 20
  • 25: 25
  • 30: 30
  • 35: 35
  • 40: 40
  • 45: 45
  • 50: 50
  • 55: 55

Moderate physical activity (MPA) - Question identifier:MPA_Q50A

In the past 7 days, how much time did you spend using the following active ways to get to places?
Cycling

On a typical weekday

Hours per day

  • 01: 1
  • 02: 2
  • 03: 3
  • 04: 4
  • 05: 5
  • 06: 6
  • 07: 7
  • 08: 8
  • 09: 9
  • 10: 10
  • 11: 11
  • 12: 12

Moderate physical activity (MPA) - Question identifier:MPA_Q50B

In the past 7 days, how much time did you spend using the following active ways to get to places?
Cycling

On a typical weekday

Minutes per day

  • 00: 0
  • 05: 5
  • 10: 10
  • 15: 15
  • 20: 20
  • 25: 25
  • 30: 30
  • 35: 35
  • 40: 40
  • 45: 45
  • 50: 50
  • 55: 55

Moderate physical activity (MPA) - Question identifier:MPA_Q50C

In the past 7 days, how much time did you spend using the following active ways to get to places?
Cycling

On a typical weekend day

Hours per day

  • 01: 1
  • 02: 2
  • 03: 3
  • 04: 4
  • 05: 5
  • 06: 6
  • 07: 7
  • 08: 8
  • 09: 9
  • 10: 10
  • 11: 11
  • 12: 12

Moderate physical activity (MPA) - Question identifier:MPA_Q50D

In the past 7 days, how much time did you spend using the following active ways to get to places?
Cycling

On a typical weekend day

Minutes per day

  • 00: 0
  • 05: 5
  • 10: 10
  • 15: 15
  • 20: 20
  • 25: 25
  • 30: 30
  • 35: 35
  • 40: 40
  • 45: 45
  • 50: 50
  • 55: 55

Moderate physical activity (MPA) - Question identifier:MPA_Q55A

In the past 7 days, how much time did you spend doing other physical activities that made you sweat or breathe harder while [at work.] doing household chores, or while volunteering?
On a typical weekday

Hours per day

  • 01: 1
  • 02: 2
  • 03: 3
  • 04: 4
  • 05: 5
  • 06: 6
  • 07: 7
  • 08: 8
  • 09: 9
  • 10: 10
  • 11: 11
  • 12: 12

Moderate physical activity (MPA) - Question identifier:MPA_Q55B

In the past 7 days, how much time did you spend doing other physical activities that made you sweat or breathe harder while [at work.] doing household chores, or while volunteering?
On a typical weekday

Minutes per day

  • 00: 0
  • 05: 5
  • 10: 10
  • 15: 15
  • 20: 20
  • 25: 25
  • 30: 30
  • 35: 35
  • 40: 40
  • 45: 45
  • 50: 50
  • 55: 55

Moderate physical activity (MPA) - Question identifier:MPA_Q55C

In the past 7 days, how much time did you spend doing other physical activities that made you sweat or breathe harder while [at work.] doing household chores, or while volunteering?
On a typical weekend day

Hours per day

  • 01: 1
  • 02: 2
  • 03: 3
  • 04: 4
  • 05: 5
  • 06: 6
  • 07: 7
  • 08: 8
  • 09: 9
  • 10: 10
  • 11: 11
  • 12: 12

Moderate physical activity (MPA) - Question identifier:MPA_Q55D

In the past 7 days, how much time did you spend doing other physical activities that made you sweat or breathe harder while [at work.] doing household chores, or while volunteering?
On a typical weekend day

Minutes per day

  • 00: 0
  • 05: 5
  • 10: 10
  • 15: 15
  • 20: 20
  • 25: 25
  • 30: 30
  • 35: 35
  • 40: 40
  • 45: 45
  • 50: 50
  • 55: 55

Other physical activities (OPA)

Answers to this module are used to determine how active respondents, have been in the last seven days.

Respondents are asked how much time they spend doing other physical activities.

Higher levels of activity are widely thought to be associated with better health.

Other physical activities (OPA) - Question identifier:OPA_R02

Now we will ask some questions to gather more details about the physical activities that you do. These activities may include those which have already been reported.

Other physical activities (OPA) - Question identifier:OPA_Q05A

In the past 7 days, how much time did you spend outdoors?
On a typical weekday

Hours per day

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

Other physical activities (OPA) - Question identifier:OPA_Q05B

In the past 7 days, how much time did you spend outdoors?
On a typical weekday

Minutes per day

  • 00: 0
  • 05: 5
  • 10: 10
  • 15: 15
  • 20: 20
  • 25: 25
  • 30: 30
  • 35: 35
  • 40: 40
  • 45: 45
  • 50: 50
  • 55: 55

Other physical activities (OPA) - Question identifier:OPA_Q05C

In the past 7 days, how much time did you spend outdoors?
On a typical weekend day

Hours per day

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

Other physical activities (OPA) - Question identifier:OPA_Q05D

In the past 7 days, how much time did you spend outdoors?
On a typical weekend day

Minutes per day

  • 00: 0
  • 05: 5
  • 10: 10
  • 15: 15
  • 20: 20
  • 25: 25
  • 30: 30
  • 35: 35
  • 40: 40
  • 45: 45
  • 50: 50
  • 55: 55

Other physical activities (OPA) - Question identifier:OPA_R10

Now we will ask some questions to gather more details about the physical activities that you do. These activities may include those which have already been reported.

Other physical activities (OPA) - Question identifier:OPA_Q10

In the past 7 days, how many days did you engage in strength-building exercise?

e.g., [tree climbing, swinging on playground equipment.] weight or resistance training, push-ups, sit-ups, chores that require lifting and carrying

  • 1: 1
  • 2: 2
  • 3: 3
  • 4: 4
  • 5: 5
  • 6: 6
  • 7: 7

Other physical activities (OPA) - Question identifier:OPA_Q15

In the past 7 days, how many days did you engage in flexibility exercises?

e.g., yoga, stretching exercises

  • 1: 1
  • 2: 2
  • 3: 3
  • 4: 4
  • 5: 5
  • 6: 6
  • 7: 7

Other physical activities (OPA) - Question identifier:OPA_Q20

In the past 7 days, how many days did you engage in any vigorous-intensity exercise?

e.g., exercise where one is out of breath and breathing heavily

  • 1: 1
  • 2: 2
  • 3: 3
  • 4: 4
  • 5: 5
  • 6: 6
  • 7: 7

Current smoking status (CSS)

Cigarette smoking is a major cause of heart disease and lung disease. The economic cost of illnesses and deaths caused by smoking is a major concern to health care planners and administrators.

The number of people who smoke varies significantly between health regions, between men and women and among age groups.

This module includes a series of questions about current and past smoking habits.

The results of this module can be used to develop smoking prevention and cessation programs for the groups that need them most.

Current smoking status (CSS) - Question identifier:CSS_R01

The next questions are about cigarette smoking.

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

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_Q41

In the past 12 months, did you stop smoking for at least 24 hours because you were trying to cut back or quit?

  • 1: Yes
  • 2: No

Smoking - past use (SPU)

Cigarette smoking is a major cause of heart disease and lung disease. The economic cost of illnesses and deaths caused by smoking is a major concern to health care planners and administrators.

The number of people who smoke varies significantly between health regions, between men and women and among age groups.

This module includes a series of questions about past smoking habits and smoking cessation.

The results of this module can be used to develop smoking prevention and cessation programs for the groups that need them most.

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_Q10

When did you stop smoking?

  • 1: Less than one year ago
  • 2: 1 year to less than 2 years ago
  • 3: 2 years to less than 3 years ago
  • 4: 3 or more years ago

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_Q25

When did you stop smoking daily?

  • 1: Less than one year ago
  • 2: 1 year to less than 2 years ago
  • 3: 2 years to less than 3 years ago
  • 4: 3 or more years ago

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_Q35

When did you stop completely?

  • 1: Less than one year ago
  • 2: 1 year to less than 2 years ago
  • 3: 2 years to less than 3 years ago
  • 4: 3 or more years ago

Smoking - past use (SPU) - Question identifier:SPU_Q40

During the past 12 months, did you do any of the following to help you quit smoking?

Select all that apply.

  • 01: Use nicotine replacement products (e.g., nicotine patch, nicotine gum, nicotine inhaler, nicotine nasal spray, nicotine lozenge, nicotine mouth spray)
  • 02: Use smoking cessation medications (e.g., Zyban®, Wellbutrin® or Champix®)
  • 03: Use an internet-based program or an app
  • 04: Use a vaping device or e-cigarette
  • 05: Make a deal with a friend or your family
  • 06: Reduce the number of cigarettes
  • 07: Try to quit smoking on your own
  • 08: Other

Smoking - past use (SPU) - Question identifier:SPU_Q45

During the past 12 months, did you do any of the following to help you when you quit smoking completely?

Select all that apply.

  • 01: Use nicotine replacement products (e.g., nicotine patch, nicotine gum, nicotine inhaler, nicotine nasal spray, nicotine lozenge, nicotine mouth spray)
  • 02: Use smoking cessation medications (e.g., Zyban®, Wellbutrin® or Champix®)
  • 03: Use an internet-based program or an app
  • 04: Use a vaping device or e-cigarette
  • 05: Make a deal with a friend or your family
  • 06: Reduce the number of cigarettes
  • 07: Try to quit smoking on your own
  • 08: Other

Electronic cigarettes and vaping (ECV)

This module includes a series of questions on electronic cigarettes and vaping devices, excluding vaping cannabis. Respondents are asked if they have ever tried an e-cigarette or vaping device, and, if so, at what age they first tried it, and how often in the past 30 days and if it contained nicotine.

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, also known as a vape?

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: At least once a week
  • 3: At least once in the past month
  • 4: Not at all

Electronic cigarettes and vaping (ECV) - Question identifier:ECV_Q21

The last time you used an e-cigarette or vaping device, also known as a vape, what did it contain?

  • 1: An e-cigarette or a vaping device with nicotine
  • 2: An e-cigarette or a vaping device without nicotine (e.g., just flavouring)
  • 3: An e-cigarette or a vaping device but you did not know what it contained

Electronic cigarettes and vaping (ECV) - Question identifier:ECV_Q25A

During the past 30 days, on how many days did you vape an e-cigarette or a vaping device with nicotine?

Min = 0; Max = 30

Electronic cigarettes and vaping (ECV) - Question identifier:ECV_Q25B

During the past 30 days, on how many days did you vape an e-cigarette or a vaping device without nicotine?

Min = 0; Max = 30

Electronic cigarettes and vaping (ECV) - Question identifier:ECV_Q25C

During the past 30 days, on how many days did you vape an e-cigarette or a vaping device but you did not know what it contained?

Min = 0; Max = 30

Electronic cigarettes and vaping (ECV) - Question identifier:ECV_Q30

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)

Consumption of alcohol has a number of implications for health. Excessive drinking is related to a number of diseases and social and mental health problems. Drinking is also a leading cause of accidents and injuries.

This module includes questions about how often and how much alcohol the respondent has drunk in the past 12 months, and if they have ever had a drink in their life.

This module will help researchers and health planners to understand patterns of alcohol consumption. For example, which groups are more likely to binge drink, i.e., drink 4 (or 5 in the case of males) or more drinks on one occasion.

Alcohol use (ALC) - Question identifier:ALC_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

Alcohol use (ALW)

This module asks those who had a drink in the past 12 months about their drinking consumption on each day of the past week.

This module will be used to see how the population abides by the Low Risk Drinking Guidelines.

Alcohol use (ALW) - Question identifier:ALW_Q05

In the past 7 days, that is from [7 days ago] to yesterday, did you have a drink of beer, wine, liquor or any other alcoholic beverage?

  • 1: Yes
  • 2: No

Alcohol use (ALW) - Question identifier:ALW_Q10

In the past 7 days, that is from [7 days ago] to yesterday, how many drinks did you have each day?
a. [Yesterday]

Number of drinks per day

  • 00: 0
  • 01: 1
  • 02: 2
  • 03: 3
  • 04: 4
  • 05: 5
  • 06: 6
  • 07: 7
  • 08: 8
  • 09: 9
  • 10: 10
  • 11: 11
  • 12: 12
  • 13: 13
  • 14: 14
  • 15: 15
  • 16: 16
  • 17: 17
  • 18: 18
  • 19: 19
  • 20: 20
  • 21: 21
  • 22: 22
  • 23: 23
  • 24: 24
  • 25: 25
  • 26: 26
  • 27: 27
  • 28: 28
  • 29: 29
  • 30: 30
  • 31: 31
  • 32: 32
  • 33: 33
  • 34: 34
  • 35: 35
  • 36: 36
  • 37: 37
  • 38: 38
  • 39: 39
  • 40: 40
  • 41: 41
  • 42: 42
  • 43: 43
  • 44: 44
  • 45: 45
  • 46: 46
  • 47: 47
  • 48: 48
  • 49: 49
  • 50: 50 or more

Alcohol use (ALW) - Question identifier:ALW_Q15

In the past 7 days, that is from [7 days ago] to yesterday, how many drinks did you have each day?
b. [2 days ago]

  • 00: 0
  • 01: 1
  • 02: 2
  • 03: 3
  • 04: 4
  • 05: 5
  • 06: 6
  • 07: 7
  • 08: 8
  • 09: 9
  • 10: 10
  • 11: 11
  • 12: 12
  • 13: 13
  • 14: 14
  • 15: 15
  • 16: 16
  • 17: 17
  • 18: 18
  • 19: 19
  • 20: 20
  • 21: 21
  • 22: 22
  • 23: 23
  • 24: 24
  • 25: 25
  • 26: 26
  • 27: 27
  • 28: 28
  • 29: 29
  • 30: 30
  • 31: 31
  • 32: 32
  • 33: 33
  • 34: 34
  • 35: 35
  • 36: 36
  • 37: 37
  • 38: 38
  • 39: 39
  • 40: 40
  • 41: 41
  • 42: 42
  • 43: 43
  • 44: 44
  • 45: 45
  • 46: 46
  • 47: 47
  • 48: 48
  • 49: 49
  • 50: 50 or more

Alcohol use (ALW) - Question identifier:ALW_Q20

In the past 7 days, that is from [7 days ago] to yesterday, how many drinks did you have each day?
c. [3 days ago]

  • 00: 0
  • 01: 1
  • 02: 2
  • 03: 3
  • 04: 4
  • 05: 5
  • 06: 6
  • 07: 7
  • 08: 8
  • 09: 9
  • 10: 10
  • 11: 11
  • 12: 12
  • 13: 13
  • 14: 14
  • 15: 15
  • 16: 16
  • 17: 17
  • 18: 18
  • 19: 19
  • 20: 20
  • 21: 21
  • 22: 22
  • 23: 23
  • 24: 24
  • 25: 25
  • 26: 26
  • 27: 27
  • 28: 28
  • 29: 29
  • 30: 30
  • 31: 31
  • 32: 32
  • 33: 33
  • 34: 34
  • 35: 35
  • 36: 36
  • 37: 37
  • 38: 38
  • 39: 39
  • 40: 40
  • 41: 41
  • 42: 42
  • 43: 43
  • 44: 44
  • 45: 45
  • 46: 46
  • 47: 47
  • 48: 48
  • 49: 49
  • 50: 50 or more

Alcohol use (ALW) - Question identifier:ALW_Q25

In the past 7 days, that is from [7 days ago] to yesterday, how many drinks did you have each day?
d. [4 days ago]

  • 00: 0
  • 01: 1
  • 02: 2
  • 03: 3
  • 04: 4
  • 05: 5
  • 06: 6
  • 07: 7
  • 08: 8
  • 09: 9
  • 10: 10
  • 11: 11
  • 12: 12
  • 13: 13
  • 14: 14
  • 15: 15
  • 16: 16
  • 17: 17
  • 18: 18
  • 19: 19
  • 20: 20
  • 21: 21
  • 22: 22
  • 23: 23
  • 24: 24
  • 25: 25
  • 26: 26
  • 27: 27
  • 28: 28
  • 29: 29
  • 30: 30
  • 31: 31
  • 32: 32
  • 33: 33
  • 34: 34
  • 35: 35
  • 36: 36
  • 37: 37
  • 38: 38
  • 39: 39
  • 40: 40
  • 41: 41
  • 42: 42
  • 43: 43
  • 44: 44
  • 45: 45
  • 46: 46
  • 47: 47
  • 48: 48
  • 49: 49
  • 50: 50 or more

Alcohol use (ALW) - Question identifier:ALW_Q30

In the past 7 days, that is from [7 days ago] to yesterday, how many drinks did you have each day?
e. [5 days ago]

  • 00: 0
  • 01: 1
  • 02: 2
  • 03: 3
  • 04: 4
  • 05: 5
  • 06: 6
  • 07: 7
  • 08: 8
  • 09: 9
  • 10: 10
  • 11: 11
  • 12: 12
  • 13: 13
  • 14: 14
  • 15: 15
  • 16: 16
  • 17: 17
  • 18: 18
  • 19: 19
  • 20: 20
  • 21: 21
  • 22: 22
  • 23: 23
  • 24: 24
  • 25: 25
  • 26: 26
  • 27: 27
  • 28: 28
  • 29: 29
  • 30: 30
  • 31: 31
  • 32: 32
  • 33: 33
  • 34: 34
  • 35: 35
  • 36: 36
  • 37: 37
  • 38: 38
  • 39: 39
  • 40: 40
  • 41: 41
  • 42: 42
  • 43: 43
  • 44: 44
  • 45: 45
  • 46: 46
  • 47: 47
  • 48: 48
  • 49: 49
  • 50: 50 or more

Alcohol use (ALW) - Question identifier:ALW_Q35

In the past 7 days, that is from [7 days ago] to yesterday, how many drinks did you have each day?
f. [6 days ago]

  • 00: 0
  • 01: 1
  • 02: 2
  • 03: 3
  • 04: 4
  • 05: 5
  • 06: 6
  • 07: 7
  • 08: 8
  • 09: 9
  • 10: 10
  • 11: 11
  • 12: 12
  • 13: 13
  • 14: 14
  • 15: 15
  • 16: 16
  • 17: 17
  • 18: 18
  • 19: 19
  • 20: 20
  • 21: 21
  • 22: 22
  • 23: 23
  • 24: 24
  • 25: 25
  • 26: 26
  • 27: 27
  • 28: 28
  • 29: 29
  • 30: 30
  • 31: 31
  • 32: 32
  • 33: 33
  • 34: 34
  • 35: 35
  • 36: 36
  • 37: 37
  • 38: 38
  • 39: 39
  • 40: 40
  • 41: 41
  • 42: 42
  • 43: 43
  • 44: 44
  • 45: 45
  • 46: 46
  • 47: 47
  • 48: 48
  • 49: 49
  • 50: 50 or more

Alcohol use (ALW) - Question identifier:ALW_Q40

In the past 7 days, that is from [7 days ago] to yesterday, how many drinks did you have each day?
g. [7 days ago]

  • 00: 0
  • 01: 1
  • 02: 2
  • 03: 3
  • 04: 4
  • 05: 5
  • 06: 6
  • 07: 7
  • 08: 8
  • 09: 9
  • 10: 10
  • 11: 11
  • 12: 12
  • 13: 13
  • 14: 14
  • 15: 15
  • 16: 16
  • 17: 17
  • 18: 18
  • 19: 19
  • 20: 20
  • 21: 21
  • 22: 22
  • 23: 23
  • 24: 24
  • 25: 25
  • 26: 26
  • 27: 27
  • 28: 28
  • 29: 29
  • 30: 30
  • 31: 31
  • 32: 32
  • 33: 33
  • 34: 34
  • 35: 35
  • 36: 36
  • 37: 37
  • 38: 38
  • 39: 39
  • 40: 40
  • 41: 41
  • 42: 42
  • 43: 43
  • 44: 44
  • 45: 45
  • 46: 46
  • 47: 47
  • 48: 48
  • 49: 49
  • 50: 50 or more

Cannabis use (CAN)

In 2018, the Canadian government legalized the use of non-medical cannabis, allowing Canadians to legally purchase and consume cannabis for recreational purposes.

The purpose of this module is to collect information about the use of cannabis in Canada. Respondents are asked if they have ever tried cannabis and the age of first use; the frequency of cannabis use in the past twelve months, in the past 30 days, and daily consumption. This module asks respondents about medical versus recreational marijuana use.

This information will be used to gain a better understanding of the scope of cannabis use in Canada, and the impact of cannabis use on the health and well-being of Canadians.

Cannabis use (CAN) - Question identifier:CAN_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)

Increasingly, health promotion programs are targeted at very young children. Researchers believe that children who have a good start in life become healthier teenagers and adults.

The focus of the next 3 modules is the behaviour of new mothers (aged 15 to 55) of babies under 6 years old.

The questions in the first module cover topics such as folic acid and iron supplements, weight gain, breastfeeding, sleeping arrangements for the child and the child's diet.

The results of this module can be used to identify which groups of women could benefit from educational programs that promote healthier babies.

Maternal experiences (MEX) - Question identifier:MEX_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

Flu shots (FLU)

Respondents are asked about receiving a flu shot within the last 12 months. Respondents who have not had a shot in the past year are asked the reasons why they have not received one.

Influenza is a serious illness for certain groups, including the elderly. For all groups, the flu is a major cause of days absent from work, school, and other activities.

Results from this module will be used to identify groups of people who are less likely to get a flu shot. This information may be useful in planning and designing new programs to promote immunization.

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

Positive mental health (PMS)

Answers to this module are used to determine the positive mental health of the respondent. Higher levels of positive mental health are widely thought to be associated with better overall health.

The questions in this module will determine the past two weeks frequency during which respondents report having positive feelings about themselves, their lives and their experiences.

Positive mental health (PMS) - Question identifier:PMS_Q05

The following questions are about how you have been feeling during the past 2 weeks.

I've been feeling optimistic about the future.

  • 1: None of the time
  • 2: Rarely
  • 3: Some of the time
  • 4: Often
  • 5: All of the time

Positive mental health (PMS) - Question identifier:PMS_Q10

The following questions are about how you have been feeling during the past 2 weeks.

I've been feeling useful.

  • 1: None of the time
  • 2: Rarely
  • 3: Some of the time
  • 4: Often
  • 5: All of the time

Positive mental health (PMS) - Question identifier:PMS_Q15

The following questions are about how you have been feeling during the past 2 weeks.

I've been feeling relaxed.

  • 1: None of the time
  • 2: Rarely
  • 3: Some of the time
  • 4: Often
  • 5: All of the time

Positive mental health (PMS) - Question identifier:PMS_Q20

The following questions are about how you have been feeling during the past 2 weeks.

I've been feeling interested in other people.

  • 1: None of the time
  • 2: Rarely
  • 3: Some of the time
  • 4: Often
  • 5: All of the time

Positive mental health (PMS) - Question identifier:PMS_Q25

The following questions are about how you have been feeling during the past 2 weeks.

I've had energy to spare.

  • 1: None of the time
  • 2: Rarely
  • 3: Some of the time
  • 4: Often
  • 5: All of the time

Positive mental health (PMS) - Question identifier:PMS_Q30

The following questions are about how you have been feeling during the past 2 weeks.

I've been dealing with problems well.

  • 1: None of the time
  • 2: Rarely
  • 3: Some of the time
  • 4: Often
  • 5: All of the time

Positive mental health (PMS) - Question identifier:PMS_Q35

The following questions are about how you have been feeling during the past 2 weeks.

I've been thinking clearly.

  • 1: None of the time
  • 2: Rarely
  • 3: Some of the time
  • 4: Often
  • 5: All of the time

Positive mental health (PMS) - Question identifier:PMS_Q40

The following questions are about how you have been feeling during the past 2 weeks.

I've been feeling good about myself.

  • 1: None of the time
  • 2: Rarely
  • 3: Some of the time
  • 4: Often
  • 5: All of the time

Positive mental health (PMS) - Question identifier:PMS_Q45

The following questions are about how you have been feeling during the past 2 weeks.

I've been feeling close to other people.

  • 1: None of the time
  • 2: Rarely
  • 3: Some of the time
  • 4: Often
  • 5: All of the time

Positive mental health (PMS) - Question identifier:PMS_Q50

The following questions are about how you have been feeling during the past 2 weeks.

I've been feeling confident.

  • 1: None of the time
  • 2: Rarely
  • 3: Some of the time
  • 4: Often
  • 5: All of the time

Positive mental health (PMS) - Question identifier:PMS_Q55

The following questions are about how you have been feeling during the past 2 weeks.

I've been able to make up my own mind about things.

  • 1: None of the time
  • 2: Rarely
  • 3: Some of the time
  • 4: Often
  • 5: All of the time

Positive mental health (PMS) - Question identifier:PMS_Q60

The following questions are about how you have been feeling during the past 2 weeks.

I've been feeling loved.

  • 1: None of the time
  • 2: Rarely
  • 3: Some of the time
  • 4: Often
  • 5: All of the time

Positive mental health (PMS) - Question identifier:PMS_Q65

The following questions are about how you have been feeling during the past 2 weeks.

I've been interested in new things.

  • 1: None of the time
  • 2: Rarely
  • 3: Some of the time
  • 4: Often
  • 5: All of the time

Positive mental health (PMS) - Question identifier:PMS_Q70

The following questions are about how you have been feeling during the past 2 weeks.

I've been feeling cheerful.

  • 1: None of the time
  • 2: Rarely
  • 3: Some of the time
  • 4: Often
  • 5: All of the time

Consultations about mental health (CMH)

This module deals with the number of times respondents have consulted with mental health professionals to discuss their emotional or mental health, and which professionals they saw or talked to in the past 12 months.

The results will help planners understand how existing mental health services are being used and to target new services to the groups that need them the most.

Consultations about mental health (CMH) - Question identifier:CMH_R01

The following questions are about mental and emotional well-being.

Consultations about mental health (CMH) - Question identifier:CMH_Q05

In the past 12 months, have you seen or talked to a health professional about your emotional or mental health?

Include both face to face and telephone contacts.

  • 1: Yes
  • 2: No

Consultations about mental health (CMH) - Question identifier:CMH_Q15A

How many times in the past 12 months did you see or talk to the following health professionals about your emotional or mental health?

Family doctor or general practitioner

Min = 0; Max = 999

Consultations about mental health (CMH) - Question identifier:CMH_Q15B

How many times in the past 12 months did you see or talk to the following health professionals about your emotional or mental health?

Psychiatrist

Min = 0; Max = 999

Consultations about mental health (CMH) - Question identifier:CMH_Q15C

How many times in the past 12 months did you see or talk to the following health professionals about your emotional or mental health?

Psychologist

Min = 0; Max = 999

Consultations about mental health (CMH) - Question identifier:CMH_Q15D

How many times in the past 12 months did you see or talk to the following health professionals about your emotional or mental health?

Nurse

Min = 0; Max = 999

Consultations about mental health (CMH) - Question identifier:CMH_Q15E

How many times in the past 12 months did you see or talk to the following health professionals about your emotional or mental health?

Social worker or counsellor

Min = 0; Max = 999

Consultations about mental health (CMH) - Question identifier:CMH_Q15F

How many times in the past 12 months did you see or talk to the following health professionals about your emotional or mental health?

Other

Min = 0; Max = 999

Mental health (DEP)

Many people feel depressed at one time or another, to varying degrees. However, long-lasting depression is a serious mental and physical health concern.

This module consists of a series of detailed questions about depression. The answers will be combined to determine how likely it is that the respondent is depressed.

This module gathers information on the length, timing and consequences of depressive episodes.

Mental health (DEP) - Question identifier:DEP_R001

The following questions deal with problems you may have had during the last two weeks.

Mental health (DEP) - Question identifier:DEP_Q005

Over the last 2 weeks, how often have you been bothered by any of the following problems?

Had little interest or pleasure in doing things

Note: Press the help button (?) for additional information, including a list of mental health resources you may wish to access should you need any support or are in crisis

  • 1: Not at all
  • 2: Several days
  • 3: More than half the days
  • 4: Nearly every day

Mental health (DEP) - Question identifier:DEP_Q010

Over the last 2 weeks, how often have you been bothered by any of the following problems?

Felt down, depressed, or hopeless

Note: Press the help button (?) for additional information, including a list of mental health resources you may wish to access should you need any support or are in crisis

  • 1: Not at all
  • 2: Several days
  • 3: More than half the days
  • 4: Nearly every day

Mental health (DEP) - Question identifier:DEP_Q015

Over the last 2 weeks, how often have you been bothered by any of the following problems?

Had trouble falling or staying asleep, or sleeping too much

Note: Press the help button (?) for additional information, including a list of mental health resources you may wish to access should you need any support or are in crisis

  • 1: Not at all
  • 2: Several days
  • 3: More than half the days
  • 4: Nearly every day

Mental health (DEP) - Question identifier:DEP_Q020

Over the last 2 weeks, how often have you been bothered by any of the following problems?

Felt tired or having little energy

Note: Press the help button (?) for additional information, including a list of mental health resources you may wish to access should you need any support or are in crisis

  • 1: Not at all
  • 2: Several days
  • 3: More than half the days
  • 4: Nearly every day

Mental health (DEP) - Question identifier:DEP_Q025

Over the last 2 weeks, how often have you been bothered by any of the following problems?

Had poor appetite or overate

Note: Press the help button (?) for additional information, including a list of mental health resources you may wish to access should you need any support or are in crisis

  • 1: Not at all
  • 2: Several days
  • 3: More than half the days
  • 4: Nearly every day

Mental health (DEP) - Question identifier:DEP_Q030

Over the last 2 weeks, how often have you been bothered by any of the following problems?

Felt bad about yourself — or that you are a failure or have let yourself or your family down

Note: Press the help button (?) for additional information, including a list of mental health resources you may wish to access should you need any support or are in crisis

  • 1: Not at all
  • 2: Several days
  • 3: More than half the days
  • 4: Nearly every day

Mental health (DEP) - Question identifier:DEP_Q035

Over the last 2 weeks, how often have you been bothered by any of the following problems?

Had trouble concentrating on things, such as reading the newspaper or watching television

Note: Press the help button (?) for additional information, including a list of mental health resources you may wish to access should you need any support or are in crisis

  • 1: Not at all
  • 2: Several days
  • 3: More than half the days
  • 4: Nearly every day

Mental health (DEP) - Question identifier:DEP_Q040

Over the last 2 weeks, how often have you been bothered by any of the following problems?

Been moving or speaking so slowly that other people could have noticed? Or the opposite, being so fidgety or restless that you have been moving around a lot more than usual

Note: Press the help button (?) for additional information, including a list of mental health resources you may wish to access should you need any support or are in crisis

  • 1: Not at all
  • 2: Several days
  • 3: More than half the days
  • 4: Nearly every day

Mental health (DEP) - Question identifier:DEP_Q045

Over the last 2 weeks, how often have you been bothered by any of the following problems?

Had thoughts that you would be better off dead or of hurting yourself in some way

Note: Press the help button (?) for additional information, including a list of mental health resources you may wish to access should you need any support or are in crisis

  • 1: Not at all
  • 2: Several days
  • 3: More than half the days
  • 4: Nearly every day

Mental health (DEP) - Question identifier:DEP_Q050

How difficult have these problems made it for you to do your work, take care of things at home, or get along with other people?

  • 1: Not difficult at all
  • 2: Somewhat difficult
  • 3: Very difficult
  • 4: Extremely difficult

Social provisions (SPS)

The relationships an individual has with friends, family, co-workers and others can have a strong impact on their own mental and physical health.

This module consists of a series of questions about the respondent's level of emotional security and well-being; guidance; reassurance of worth; social integration; and reliable alliance.

Social provisions (SPS) - Question identifier:SPS_R001

The next questions are about your current relationships with friends, family members, co-workers, community members, and so on.

Social provisions (SPS) - Question identifier:SPS_Q015

Please indicate to what extent each statement describes your current relationships with other people.

I have close relationships that provide me with a sense of emotional security and wellbeing.

  • 1: Strongly agree
  • 2: Agree
  • 3: Disagree
  • 4: Strongly disagree

Social provisions (SPS) - Question identifier:SPS_Q020

Please indicate to what extent each statement describes your current relationships with other people.

There is someone I could talk to about important decisions in my life.

  • 1: Strongly agree
  • 2: Agree
  • 3: Disagree
  • 4: Strongly disagree

Social provisions (SPS) - Question identifier:SPS_Q025

Please indicate to what extent each statement describes your current relationships with other people.

I have relationships where my competence and skill are recognized.

  • 1: Strongly agree
  • 2: Agree
  • 3: Disagree
  • 4: Strongly disagree

Social provisions (SPS) - Question identifier:SPS_Q035

Please indicate to what extent each statement describes your current relationships with other people.

I feel part of a group of people who share my attitudes and beliefs.

  • 1: Strongly agree
  • 2: Agree
  • 3: Disagree
  • 4: Strongly disagree

Social provisions (SPS) - Question identifier:SPS_Q050

Please indicate to what extent each statement describes your current relationships with other people.

There are people I can count on in an emergency.

  • 1: Strongly agree
  • 2: Agree
  • 3: Disagree
  • 4: Strongly disagree

Regular health care provider (RHC)

Respondents are asked whether or not they have a regular health care provider.

Many Canadians do not have access to a regular health care provider. This module has a number of uses for governments, health care planners, and researchers. For example, results could be used to identify groups or regions that have an increased need for health care resource allocation.

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)

This is the minimum content block for the Labour Market Activities Harmonized Content.
It contains the questions required to establish whether a respondent is employed or not.

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)

This is a block within the extended content for the Labour Market Activities Harmonized Content.
It contains the question required to identify the class of worker for a respondent who is employed.

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)

This is a block within the extended content for the Labour Market Activities Harmonized Content
It contains the questions required to identify the industry for a respondent who is employed.

The questions in this module are used to derive LBFCSIC (NAICS) and LBFCSOC (NOC)

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)

This is a block within the extended content for the Labour Market Activities Harmonized Content.
It contains the questions required to identify the occupation for a respondent who is employed.

The questions in this module are used to derive LBFCSIC (NAICS) and LBFCSOC (NOC)

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)

This is a block within the extended content for the Labour Market Activities Harmonized Content. It contains the question required to identify the number of usual hours worked for a respondent who is employed.

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)

There are many relationships between work and health. This module includes questions on whether or not a respondent held more than one job or business over the last week, and the average number of hours worked at the second job per week, if applicable.

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)

This module is used to gather information on telework, a more prevalent reality during the COVID-19 pandemic and to assess hybrid work arrangements in the post-pandemic environment.

This module was added to the questionnaire in June 2021 and was changed in 2023 to match the Labour Force Survey's WFH module.

Telework (LM) - Question identifier:LM_Q01

At the present time, in which of the following locations do you usually work as part of your main job or business?

Select all that apply.

  • 1: At a fixed location outside the home
  • 2: Outside the home with no fixed location (e.g., driving, door-to-door sales)
  • 3: At home (Include farms and all work done at the same address as your home, but on a different part of the property)

Telework (LM) - Question identifier:LM_Q02

Last week, what proportion of your work hours did you work at home as part of your main job or business?

Include farms and all work done at the same address as your home, but on a different part of the property

  • 1: All your hours at home
  • 2: More than half, but not all your hours at home
  • 3: One quarter to half at home
  • 4: Less than a quarter at home
  • 5: No hours at home

Place of birth, immigration and citizenship (IM)

Harmonized content

This module collects data on the Place of birth, Landed immigrant status and Year of immigration in Canada.

Very important knowledge of understanding the health of Canadians is obtained by comparing the health of different groups. For example, do recent immigrants to Canada use health care services more or less than people born in Canada? Are people from European ethnic groups more likely to have certain chronic conditions than other groups?

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)

Harmonized content.

Comparing the health of different groups provides very important information for understanding the health of Canadians.

In this module, important social and demographic information is collected regarding aboriginal status.

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)

Harmonized content

Surveys with a preceding Aboriginal question block will skip the Population Group question if the respondent answered "Yes" to being an Aboriginal person.

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)

Harmonized content

This module is about knowledge of the Official Languages, English and French. Respondents are asked the language most often spoken at home and their Mother tongue.

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)

Harmonized content

Comparing the health of different groups provides very important information for understanding the health of Canadians.

In this module, respondent sexual orientation is collected as it is important social and demographic information.

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)

This module asks respondents aged 18 and over if they received any home care services, such as nursing care, meal preparation, help with bathing or housework and palliative care, either for themselves or for someone else in their household.

Respondents are also asked about the length of services, cost and payment, level of satisfaction with care, unmet care needs, reasons for not getting the services, and where they tried to obtain services.

Home care is considered to be an important part of health care reform. Both the health care system and the patient may benefit if some types of care are provided in the home instead of in a hospital or institution.

This module can be used to identify which groups are receiving home care and which are not. The health status of these groups and how they use other health services can be compared. This can help researchers understand whether home care is working as planned.

Home care services (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

If more than one household member is receiving a service, choose the longest period of time for which the service was provided.

  • 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.

If more than one household member is receiving a service, choose the longest period of time for which the service was provided.

  • 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.

If more than one household member is receiving a service, choose the longest period of time for which the service was provided.

  • 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.

If more than one household member is receiving a service, choose the longest period of time for which the service was provided.

  • 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

If more than one household member is receiving a service, choose the longest period of time for which the service was provided.

  • 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.

If more than one household member is receiving a service, choose the longest period of time for which the service was provided.

  • 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.

If more than one household member is receiving a service, choose the highest cost paid for the service.

  • 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.

If more than one household member is receiving a service, choose the highest cost paid for the service.

  • 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.

If more than one household member is receiving a service, choose the highest cost paid for the service.

  • 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.

If more than one household member is receiving a service, choose the highest cost paid for the service.

  • 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

If more than one household member is receiving a service, choose the highest cost paid for the service.

  • 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.
If more than one household member is receiving a service, choose the highest cost paid for the service.

  • 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

Food security (FSC)

This module asks respondents if anyone in the household has experienced any issues associated with food security in the previous 12 months, (the ability to afford the purchase of sufficient nutritious food), with specific questions about the actions and needs of the adults who are responsible for children.

Even in households that appear to have high incomes, budget constraints may make it difficult to purchase nutritious foods. Food security questions will be asked of all respondents regardless of income.

Note: This module should be answered by a knowledgeable member of the household. Persons 18 and older are considered adults. Youths aged 16 and 17 living with a relative are considered children, all others are considered adults.

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)

In this module, respondents are asked to provide their total household income.

Although income is a sensitive topic, this information is very important for studying the link between income and health.

Although many health care costs in Canada are covered by insurance, income still plays an important role in people's health. People living in households with lower incomes are more likely to have poorer health. People living in households with varying income levels also tend to use the health care system differently.

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

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)

In this module, respondents are informed that their information may be used for data linkage. Respondents are asked to provide their provincial or territorial health number.

Respondents are also asked to give their permission to share their reported data and their tax data with health partners.

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 [Newfoundland and Labrador/ Prince Edward Island/ Nova Scotia/ New Brunswick/ Quebec/ Ontario/ Manitoba/ Saskatchewan/ Alberta/ British Columbia/ Yukon/ the Northwest Territories/ 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 you 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
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