Canadian Community Health Survey (CCHS) - 2017
Archived Content
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For Information onlyThis is an electronic survey example for information purposes only. This is not a working questionnaire.
Table of Contents
- Proxy interview (GR)
- Age of respondent (ANC1)
- Relationship without confirmation (RNC)
- Main activity (MAC)
- General health (GEN)
- Height and weight - self reported (HWT)
- Chronic conditions (CCC)
- Washington Group - disability measure (WDM)
- Activities of daily living (ADL)
- Injuries (INJ)
- Workplace injury (INW)
- Oral health (OHT)
- Dental care (DEN)
- Changes made to improve health (CIH)
- Sleep (SLP)
- Fruit and vegetable consumption (FVC)
- Food choices (FDC)
- Canada's Food Guide use (FGU)
- Smoking (SMK)
- Smoking cessation methods (SCA)
- Tobacco products alternatives (TAL)
- Exposure to second hand smoke (ETS)
- Alcohol use (ALC)
- Alcohol use during the past week (ALW)
- Medication use (MED)
- Drug use methods (DRM)
- Drug use (DRG)
- Physical activities - adults 18 years and older (PAA)
- Physical activities for youth (PAY)
- Use of protective equipment (UPE)
- Sun safety behaviours (SSB)
- Sedentary behaviours (SBE)
- Maternal experiences (MEX)
- Smoking during maternal experience (MXS)
- Alcohol use during maternal experience (MXA)
- Driving and safety (DRV)
- Flu shots (FLU)
- Blood pressure check (BPC)
- Pap smear test (PAP)
- Mammography (MAM)
- Prostate cancer screening (PSA)
- Colorectal cancer testing (CCT)
- Diabetes care (DIA)
- Consultations about mental health (CMH)
- Satisfaction with life (SWL)
- Distress (DIS)
- Depression (DEP)
- Sources of stress (STS)
- Social provisions (SPS)
- Primary health care (PHC)
- Medical doctor attachment (MDA)
- Contacts with health professionals - extended block (CP2)
- Patient satisfaction - community-based care (PSC)
- Consultations with health professionals on smoking (SPC)
- Access to health care services (ACC)
- Home care services (HMC)
- Unmet health care needs (UCN)
- Labour force (LBF)
- Socio-demographic characteristics (SDC)
- Person most knowledgeable about household situation (PMK)
- Health insurance coverage (INS)
- Food security (FSC)
- Administration information (ADM)
- Income (INC)
Proxy interview (GR)
This module identifies the individual who will be providing information for the selected respondent and determines if the interview is to be conducted by proxy if the mental or physical health of the selected member makes it impossible to complete the interview during the collection period.
New since 2013, the interview by proxy could be conducted with a knowledgeable household member, or a non-household member in very rare circumstances.
Proxy interview (GR) - Question identifier:GR_N005
Who is providing the information for this person's component?
- 01: MEMBER1
- 02: MEMBER2
- 03: MEMBER3
- 04: MEMBER4
- 05: MEMBER5
- 06: MEMBER6
- 07: MEMBER7
- 08: MEMBER8
- 09: MEMBER9
- 10: MEMBER10
- 11: MEMBER11
- 12: MEMBER12
- 13: MEMBER13
- 14: MEMBER14
- 15: MEMBER15
- 16: MEMBER16
- 17: MEMBER17
- 18: MEMBER18
- 19: MEMBER19
- 20: MEMBER20
- 88: Not a household member
Proxy interview (GR) - Question identifier:GR_N010
Do you want to complete this component by proxy?
- 1: Yes
- 2: No
Proxy interview (GR) - Question identifier:GR_N015
Record the reason why this component is being completed by proxy. Proxy interviews are to occur only if the mental or physical health of the selected member makes it impossible to complete the interview during the collection period.
- 1: Physical health condition
- 2: Mental health condition
Proxy interview (GR) - Question identifier:GR_N020
Enter the condition.
Long Answer Length = 80
Age of respondent (ANC1)
The actual age of the respondent is very important. It influences which questions will be asked and is key to the analysis of the data.
It is particularly important to confirm the age of 11- or 12-year-olds, as 12 is the lower age limit to determine if the respondent is an out-of-scope to our survey. Similarly, because of the use of a different sampling frame for youth and adults, it is also important to confirm the age of 17- or 18-year-olds, as they are the age limits to determine if the respondent is an out-of-scope to the frame (and therefore, of the survey).
Age of respondent (ANC1) - Question identifier:ANC1_Q01
What is ^SPECRESPNAME's date of birth?
Min = 1; Max = 31
Age of respondent (ANC1) - Question identifier:ANC1_Q02
What is ^SPECRESPNAME's date of birth?
- 01: January
- 02: February
- 03: March
- 04: April
- 05: May
- 06: June
- 07: July
- 08: August
- 09: September
- 10: October
- 11: November
- 12: December
- 98: RF
- 99: DK
Age of respondent (ANC1) - Question identifier:ANC1_Q03
What is ^SPECRESPNAME's date of birth?
Min = 0; Max = 9997
Age of respondent (ANC1) - Question identifier:ANC1_Q04
So ^SPECRESPNAME's age on ^REFERENCEDATEE was ^DV_CALCULATEDAGE ^DT_YEARSMONTHSE.
Is that correct?
- 1: Yes
- 2: No, return and correct date of birth
- 3: No, collect age
Age of respondent (ANC1) - Question identifier:ANC1_Q05
What is ^SPECRESPNAME's age?
Min = 0; Max = 121
Age of respondent (ANC1) - Question identifier:ANC1_R010
Because you are less than 12 years old, you are not eligible to participate in the Canadian Community Health Survey.
Age of respondent (ANC1) - Question identifier:ANC1_R015
Because you are more than 17 years old, you are not eligible to participate in the Canadian Community Health Survey.
Age of respondent (ANC1) - Question identifier:ANC1_R020
Because you are less than 18 years old, you are not eligible to participate in the Canadian Community Health Survey.
Age of respondent (ANC1) - Question identifier:ANC1_N030
Please confirm the spelling of respondent's first name. Update first name, if necessary.
Original First Name: ^FNAME
Original Last Name: ^LNAME
Long Answer Length = 25
Age of respondent (ANC1) - Question identifier:ANC1_N035
Please confirm the spelling of respondent's last name. Update last name, if necessary.
Original First Name: ^FNAME
Original Last Name: ^LNAME
Long Answer Length = 25
Relationship without confirmation (RNC)
The Relationship without Confirmation block is used to collect the relationship of an individual to someone else in the household when any previously collected relationship is not to be confirmed. Surveys may choose the level of detail desired, i.e., which of the sub-questions to ask. For example, one survey may choose to have all six detail questions, another may choose to have only three of them, and a third may choose not to have any. The block should not be called if there is only one person in the household.
Relationship without confirmation (RNC) - Question identifier:RNC_Q1
What is the relationship...
of: ^SPECRESPNAME1 (^SPECRESPAGE1, [Male/Female])
to: ^SPECRESPNAME2 (^SPECRESPAGE2, [Male/Female])?
- 01: [Husband/Wife]
- 02: Common-law partner
- 03: [Father/Mother]
- 04: [Son/Daughter]
- 05: [Brother/Sister]
- 06: Foster [father/mother]
- 07: Foster [son/daughter]
- 08: [Grandfather/Grandmother]
- 09: [Grandson/Granddaughter]
- 10: In-law
- 11: Other related
- 12: Unrelated
- 98: RF
- 99: DK
Relationship without confirmation (RNC) - Question identifier:RNC_Q2A
Is that a(n)... ?
- 1: Birth [father/mother]
- 2: Step[father/mother]
- 3: Adoptive [father/mother]
- 8: RF
- 9: DK
Relationship without confirmation (RNC) - Question identifier:RNC_Q2B
Is that a(n)... ?
- 1: Birth [son/daughter]
- 2: Step[son/daughter]
- 3: Adopted [son/daughter]
- 8: RF
- 9: DK
Relationship without confirmation (RNC) - Question identifier:RNC_Q2C
Is that a(n)... ?
- 1: Full [brother/sister]
- 2: Half [brother/sister]
- 3: Step[brother/sister]
- 4: Adopted [brother/sister]
- 5: Foster [brother/sister]
- 8: RF
- 9: DK
Relationship without confirmation (RNC) - Question identifier:RNC_Q2D
Is that a(n)... ?
- 1: [Father/Mother]-in-law
- 2: [Son/Daughter]-in-law
- 3: [Brother/Sister]-in-law
- 4: Other in-law
- 8: RF
- 9: DK
Relationship without confirmation (RNC) - Question identifier:RNC_Q2E
Is that a(n)... ?
- 1: [Uncle/Aunt]
- 2: Cousin
- 3: [Nephew/Niece]
- 4: Other relative
- 8: RF
- 9: DK
Relationship without confirmation (RNC) - Question identifier:RNC_Q2F
Is that a(n)... ?
- 1: [Boyfriend/Girlfriend]
- 2: Roommate/lodger/boarder
- 3: Other - Specify
- 8: RF
- 9: DK
Main activity (MAC)
This module collects information about the respondent's main activity in the last week.
If their main activity is not 'caring for children' and they are 15 to 75 years of age, they are asked if they have worked any time in the past 12 months.
If their main activity is not 'going to school' or they are 14 or older, they are asked if they are currently attending school, college, CEGEP or university.
In this module, female respondents aged 15 to 55 are asked if they are pregnant.
Main activity (MAC) - Question identifier:MAC_Q005
Last week, was your main activity working at a paid job or business, looking for paid work, going to school, caring for children, household work, retired or something else?
- 01: Working at a paid job or business
- 02: Vacation (from paid work)
- 03: Looking for paid work
- 04: Going to school (including vacation from school)
- 05: Caring for children
- 06: Household work
- 07: Retired
- 08: Maternity/paternity leave
- 09: Long term illness
- 10: Volunteering
- 11: Care-giving other than for children
- 12: Other
- 98: RF
- 99: DK
Main activity (MAC) - Question identifier:MAC_Q010
Have you worked at a job or business at any time in the past 12 months?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Main activity (MAC) - Question identifier:MAC_Q015
Are you currently attending school, college, CEGEP or university?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Main activity (MAC) - Question identifier:MAC_Q020
Are you enrolled as...?
- 1: A full-time student
- 2: A part-time student
- 3: Both full-time and part-time student
- 8: RF
- 9: DK
Main activity (MAC) - Question identifier:MAC_Q025
To better understand the information you will provide on your health it is important to know if you are pregnant. Are you pregnant?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
General health (GEN)
The general health module is used to collect data on self-perceived health, satisfaction with life, self-perceived mental health, self-perceived stress at work and with life in general, and sense of belonging to local community.
Researchers are interested in these topics because they are good basic measures of health status. They can also be used to predict other aspects of the respondent's health. For example, respondents who describe their health as fair or poor are more likely to have long-term health problems, to suffer from depression and to be heavy users of the health care system.
General health (GEN) - Question identifier:GEN_R005
The next questions are about your health. By health, we mean not only the absence of disease or injury but also physical, mental and social well-being.
General health (GEN) - Question identifier:GEN_Q005
In general, would you say your health is... ?
- 1: Excellent
- 2: Very good
- 3: Good
- 4: Fair
- 5: Poor
- 8: RF
- 9: DK
General health (GEN) - Question identifier:GEN_Q010
Using a scale of 0 to 10, where 0 means "Very dissatisfied" and 10 means "Very satisfied", how do you feel about your life as a whole right now?
Min = 0; Max = 10
General health (GEN) - Question identifier:GEN_Q015
In general, would you say your mental health is...?
- 1: Excellent
- 2: Very good
- 3: Good
- 4: Fair
- 5: Poor
- 8: RF
- 9: DK
General health (GEN) - Question identifier:GEN_Q020
Thinking about the amount of stress in your life, would you say that most of your days are...?
- 1: Not at all stressful
- 2: Not very stressful
- 3: A bit stressful
- 4: Quite a bit stressful
- 5: Extremely stressful
- 8: RF
- 9: DK
General health (GEN) - Question identifier:GEN_R025
The next question is about your main job or business in the past 12 months.
General health (GEN) - Question identifier:GEN_Q025
Would you say that most days at work were...?
- 1: Not at all stressful
- 2: Not very stressful
- 3: A bit stressful
- 4: Quite a bit stressful
- 5: Extremely stressful
- 8: RF
- 9: DK
General health (GEN) - Question identifier:GEN_Q030
How would you describe your sense of belonging to your local community? Would you say it is...?
- 1: Very strong
- 2: Somewhat strong
- 3: Somewhat weak
- 4: Very weak
- 8: RF
- 9: DK
Height and weight - self reported (HWT)
In this module, respondents are asked to report their height and weight, and indicate whether they consider themselves overweight, underweight or just about right.
Answers to these questions are used in many ways, including calculating the number of people who are overweight, or obese.
Obesity, especially amongst young people, is a major health problem. It can be associated with a number of major medical problems, including high blood pressure, heart disease and diabetes.
Height and weight - self reported (HWT) - Question identifier:HWT_Q005
The next questions are about height and weight. How tall are you without shoes on?
- 0: Less than 1' / 12" (less than 29.2 cm.)
- 1: 1'0" to 1'11" / 12" to 23" (29.2 to 59.6 cm.)
- 2: 2'0" to 2'11" / 24" to 35" (59.7 to 90.1 cm.)
- 3: 3'0" to 3'11" / 36" to 47" (90.2 to 120.6 cm.)
- 4: 4'0" to 4'11" / 48" to 59" (120.7 to 151.0 cm.)
- 5: 5'0" to 5'11" (151.1 to 181.5 cm.)
- 6: 6'0" to 6'11" (181.6 to 212.0 cm.)
- 7: 7'0" and over (212.1 cm. and over)
- 8: RF
- 9: DK
Height and weight - self reported (HWT) - Question identifier:HWT_N010
Select the exact height.
- 00: Less than or equal to 1'0" / 12" (29.2 to 31.7 cm.)
- 01: 1'1" / 13" (31.8 to 34.2 cm.)
- 02: 1'2" / 14" (34.3 to 36.7 cm.)
- 03: 1'3" / 15" (36.8 to 39.3 cm.)
- 04: 1'4" / 16" (39.4 to 41.8 cm.)
- 05: 1'5" / 17" (41.9 to 44.4 cm.)
- 06: 1'6" / 18" (44.5 to 46.9 cm.)
- 07: 1'7" / 19" (47.0 to 49.4 cm.)
- 08: 1'8" / 20" (49.5 to 52.0 cm.)
- 09: 1'9" / 21" (52.1 to 54.5 cm.)
- 10: 1'10" / 22" (54.6 to 57.1 cm.)
- 11: 1'11" / 23" (57.2 to 59.6 cm.)
- 98: RF
- 99: DK
Height and weight - self reported (HWT) - Question identifier:HWT_N015
Select the exact height.
- 00: 2'0" / 24" (59.7 to 62.1 cm.)
- 01: 2'1" / 25" (62.2 to 64.7 cm.)
- 02: 2'2" / 26" (64.8 to 67.2 cm.)
- 03: 2'3" / 27" (67.3 to 69.8 cm.)
- 04: 2'4" / 28" (69.9 to 72.3 cm.)
- 05: 2'5" / 29" (72.4 to 74.8 cm.)
- 06: 2'6" / 30" (74.9 to 77.4 cm.)
- 07: 2'7" / 31" (77.5 to 79.9 cm.)
- 08: 2'8" / 32" (80.0 to 82.5 cm.)
- 09: 2'9" / 33" (82.6 to 85.0 cm.)
- 10: 2'10" / 34" (85.1 to 87.5 cm.)
- 11: 2'11" / 35" (87.6 to 90.1 cm.)
- 98: RF
- 99: DK
Height and weight - self reported (HWT) - Question identifier:HWT_N020
Select the exact height.
- 00: 3'0" / 36" (90.2 to 92.6 cm.)
- 01: 3'1" / 37" (92.7 to 95.2 cm.)
- 02: 3'2" / 38" (95.3 to 97.7 cm.)
- 03: 3'3" / 39" (97.8 to 100.2 cm.)
- 04: 3'4" / 40" (100.3 to 102.8 cm.)
- 05: 3'5" / 41" (102.9 to 105.3 cm.)
- 06: 3'6" / 42" (105.4 to 107.9 cm.)
- 07: 3'7" / 43" (108.0 to 110.4 cm.)
- 08: 3'8" / 44" (110.5 to 112.9 cm.)
- 09: 3'9" / 45" (113.0 to 115.5 cm.)
- 10: 3'10" / 46" (115.6 to 118.0 cm.)
- 11: 3'11" / 47" (118.1 to 120.6 cm.)
- 98: RF
- 99: DK
Height and weight - self reported (HWT) - Question identifier:HWT_N025
Select the exact height.
- 00: 4'0" / 48" (120.7 to 123.1 cm.)
- 01: 4'1" / 49" (123.2 to 125.6 cm.)
- 02: 4'2" / 50" (125.7 to 128.2 cm.)
- 03: 4'3" / 51" (128.3 to 130.7 cm.)
- 04: 4'4" / 52" (130.8 to 133.3 cm.)
- 05: 4'5" / 53" (133.4 to 135.8 cm.)
- 06: 4'6" / 54" (135.9 to 138.3 cm.)
- 07: 4'7" / 55" (138.4 to 140.9 cm.)
- 08: 4'8" / 56" (141.0 to 143.4 cm.)
- 09: 4'9" / 57" (143.5 to 146.0 cm.)
- 10: 4'10" / 58" (146.1 to 148.5 cm.)
- 11: 4'11" / 59" (148.6 to 151.0 cm.)
- 98: RF
- 99: DK
Height and weight - self reported (HWT) - Question identifier:HWT_N030
Select the exact height.
- 00: 5'0" (151.1 to 153.6 cm.)
- 01: 5'1" (153.7 to 156.1 cm.)
- 02: 5'2" (156.2 to 158.7 cm.)
- 03: 5'3" (158.8 to 161.2 cm.)
- 04: 5'4" (161.3 to 163.7 cm.)
- 05: 5'5" (163.8 to 166.3 cm.)
- 06: 5'6" (166.4 to 168.8 cm.)
- 07: 5'7" (168.9 to 171.4 cm.)
- 08: 5'8" (171.5 to 173.9 cm.)
- 09: 5'9" (174.0 to 176.4 cm.)
- 10: 5'10" (176.5 to 179.0 cm.)
- 11: 5'11" (179.1 to 181.5 cm.)
- 98: RF
- 99: DK
Height and weight - self reported (HWT) - Question identifier:HWT_N035
Select the exact height.
- 00: 6'0" (181.6 to 184.1 cm.)
- 01: 6'1" (184.2 to 186.6 cm.)
- 02: 6'2" (186.7 to 189.1 cm.)
- 03: 6'3" (189.2 to 191.7 cm.)
- 04: 6'4" (191.8 to 194.2 cm.)
- 05: 6'5" (194.3 to 196.8 cm.)
- 06: 6'6" (196.9 to 199.3 cm.)
- 07: 6'7" (199.4 to 201.8 cm.)
- 08: 6'8" (201.9 to 204.4 cm.)
- 09: 6'9" (204.5 to 206.9 cm.)
- 10: 6'10" (207.0 to 209.5 cm.)
- 11: 6'11" (209.6 to 212.0 cm.)
- 98: RF
- 99: DK
Height and weight - self reported (HWT) - Question identifier:HWT_Q040
How much do you weigh?
Min = 1; Max = 575
Height and weight - self reported (HWT) - Question identifier:HWT_N045
Was that in pounds or kilograms?
- 1: Pounds
- 2: Kilograms
Height and weight - self reported (HWT) - Question identifier:HWT_Q050
Do you consider yourself...?
- 1: Overweight
- 2: Underweight
- 3: Just about right
- 8: RF
- 9: DK
Chronic conditions (CCC)
The first set of questions in this module deal with pain in the joints during the past 30 days. The remaining questions deal with long-term health conditions that have lasted or are expected to last at least 6 months. Chronic conditions reported by respondents must have been diagnosed by a health professional.
Answers to these questions can be used to estimate the number of people in Canada suffering from conditions such as diabetes, heart disease, and asthma.
By combining answers from this module with information from other modules, researchers can look at the relationship between chronic conditions and other characteristics, such as use of health care services or use of medications.
Chronic conditions (CCC) - Question identifier:CCC_R015
Now I'd like to ask about certain long-term health conditions which you may have. We are interested in "long-term conditions" which are expected to last or have already lasted 6 months or more and that have been diagnosed by a health professional.
Chronic conditions (CCC) - Question identifier:CCC_Q015
Do you have asthma?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q020
Have you had any asthma symptoms or asthma attacks in the past 12 months?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q025
In the past 12 months, have you taken any medicine for asthma such as inhalers (pumps), nebulizers, pills, liquids or injections?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q030
Do you have chronic bronchitis, emphysema or chronic obstructive pulmonary disease or COPD?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q050
Do you have arthritis, for example osteoarthritis, rheumatoid arthritis, gout or any other type, excluding fibromyalgia?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q065
Do you have high blood pressure?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q070
In the past month, have you taken any medicine for high blood pressure?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q075
Do you have high blood cholesterol or lipids?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q080
In the past month, have you taken any medicine for high blood cholesterol or lipids?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q085
Do you have heart disease?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q090
Do you suffer from the effects of a stroke?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q095
Do you have diabetes?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q100
How old were you when this was first diagnosed?
Min = 1; Max = 121
Chronic conditions (CCC) - Question identifier:CCC_Q105
Were you pregnant when you were first diagnosed with diabetes?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q110
Other than during pregnancy, has a health professional ever told you that you have diabetes?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q115
When you were first diagnosed with diabetes, how long was it before you were started on insulin?
- 1: Less than 1 month
- 2: 1 month to less than 2 months
- 3: 2 months to less than 6 months
- 4: 6 months to less than 1 year
- 5: 1 year or more
- 6: Never
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q120
Do you currently take insulin for your diabetes?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q125
In the past month, did you take pills to control your blood sugar?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q130
Do you have cancer?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q135
Have you ever been diagnosed with cancer?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q145
Do you have Alzheimer's Disease or any other dementia?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q150
Do you have intestinal or stomach ulcers?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q155
Do you have a bowel disorder such as Crohn's Disease, ulcerative colitis, Irritable Bowel Syndrome or bowel incontinence?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q160
What kind of bowel disease do you have?
- 1: Crohn's Disease
- 2: Ulcerative colitis
- 3: Irritable Bowel Syndrome
- 4: Bowel incontinence
- 5: Other
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q165
Do you have urinary incontinence?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q170
As a result of allergy tests, were you ever told by a health professional that you had allergies?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q175
What did your health professional say you were allergic to?
- 01: Certain foods
- 02: Certain animals
- 03: Dust mites
- 04: Mould
- 05: Pollens or grasses
- 06: Chemicals
- 07: Certain medicine
- 08: Other
- 98: RF
- 99: DK
Chronic conditions (CCC) - Question identifier:CCC_Q180
Were you ever told by a doctor that you have hay fever or nasal allergy?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q195
Do you have a mood disorder such as depression, bipolar disorder, mania or dysthymia?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q200
Do you have an anxiety disorder such as a phobia, obsessive-compulsive disorder or a panic disorder?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Washington Group - disability measure (WDM)
Disability indicates an impairment limiting activities of daily living. This module is adapted from the "Washington Group - Extended Question Set on Functioning" (WG WS-F) questionnaire and provides a description of an individual's overall functional health based on, vision, hearing, mobility (walking or climbing steps), cognition (memory and concentration), self-care) and communication. This module is designed to produce comparable data on disability cross-nationally. The module is appropriate for use to describe and monitor the majority of persons with limitations in basic activity functioning. The results from these questions are used to identify which limitations occur most.
Washington Group - disability measure (WDM) - Question identifier:WDM_R001
The next set of questions asks about your ability to do different activities.
Washington Group - disability measure (WDM) - Question identifier:WDM_Q005
Do you have difficulty seeing, even if wearing glasses? Would you say...?
- 1: No difficulty
- 2: Some difficulty
- 3: A lot of difficulty
- 4: Cannot do at all / Unable to do
- 8: RF
- 9: DK
Washington Group - disability measure (WDM) - Question identifier:WDM_Q010
Do you have difficulty hearing, even if using a hearing aid? Would you say...?
- 1: No difficulty
- 2: Some difficulty
- 3: A lot of difficulty
- 4: Cannot do at all / Unable to do
- 8: RF
- 9: DK
Washington Group - disability measure (WDM) - Question identifier:WDM_Q015
Do you have difficulty walking or climbing steps?
- 1: No difficulty
- 2: Some difficulty
- 3: A lot of difficulty
- 4: Cannot do at all / Unable to do
- 8: RF
- 9: DK
Washington Group - disability measure (WDM) - Question identifier:WDM_Q020
Do you have difficulty remembering or concentrating?
- 1: No difficulty
- 2: Some difficulty
- 3: A lot of difficulty
- 4: Cannot do at all / Unable to do
- 8: RF
- 9: DK
Washington Group - disability measure (WDM) - Question identifier:WDM_Q025
Do you have difficulty with self-care, such as washing all over or dressing? Would you say...?
- 1: No difficulty
- 2: Some difficulty
- 3: A lot of difficulty
- 4: Cannot do at all / Unable to do
- 8: RF
- 9: DK
Washington Group - disability measure (WDM) - Question identifier:WDM_Q030
Using your usual language, do you have difficulty communicating, for example understanding or being understood?
- 1: No difficulty
- 2: Some difficulty
- 3: A lot of difficulty
- 4: Cannot do at all / Unable to do
- 8: RF
- 9: DK
Activities of daily living (ADL)
This module looks at the impact of a physical or mental condition or health problem on common activities of daily living such as preparing meals, running errands, and doing housework.
It is very important to ask all questions of everyone in order to compare those with activity limitations and those without.
Activities of daily living (ADL) - Question identifier:ADL_R001
The next few questions are about common daily activities. These questions may not apply to you, but we need to ask the same questions of everyone.
Activities of daily living (ADL) - Question identifier:ADL_Q005
Because of any physical condition, mental condition or health problem, do you have any difficulty:
with preparing meals?
- 1: No, you have no difficulty
- 2: Yes, you have difficulty, but do not require help of others
- 3: Yes, you have difficulty, but can do it with the help of others
- 4: [You] cannot do it at all
- 8: RF
- 9: DK
Activities of daily living (ADL) - Question identifier:ADL_Q010
Because of any physical condition, mental condition or health problem, do you have any difficulty:
with running errands such as shopping for groceries?
- 1: No, you have no difficulty
- 2: Yes, you have difficulty, but do not require help of others
- 3: Yes, you have difficulty, but can do it with the help of others
- 4: [You] cannot do it at all
- 8: RF
- 9: DK
Activities of daily living (ADL) - Question identifier:ADL_Q015
Because of any physical condition, mental condition or health problem, do you have any difficulty:
with doing everyday housework?
- 1: No, you have no difficulty
- 2: Yes, you have difficulty, but do not require help of others
- 3: Yes, you have difficulty, but can do it with the help of others
- 4: [You] cannot do it at all
- 8: RF
- 9: DK
Activities of daily living (ADL) - Question identifier:ADL_Q020
Because of any physical condition, mental condition or health problem, do you have any difficulty:
with personal care such as bathing, dressing, eating or taking medication?
- 1: No, you have no difficulty
- 2: Yes, you have difficulty, but do not require help of others
- 3: Yes, you have difficulty, but can do it with the help of others
- 4: [You] cannot do it at all
- 8: RF
- 9: DK
Activities of daily living (ADL) - Question identifier:ADL_Q025
Because of any physical condition, mental condition or health problem, do you have any difficulty:
with moving about inside the house?
- 1: No, you have no difficulty
- 2: Yes, you have difficulty, but do not require help of others
- 3: Yes, you have difficulty, but can do it with the help of others
- 4: [You] cannot do it at all
- 8: RF
- 9: DK
Activities of daily living (ADL) - Question identifier:ADL_Q030
Because of any physical condition, mental condition or health problem, do you have any difficulty:
with looking after your personal finances such as making bank transactions or paying bills?
- 1: No, you have no difficulty
- 2: Yes, you have difficulty, but do not require help of others
- 3: Yes, you have difficulty, but can do it with the help of others
- 4: [You] cannot do it at all
- 8: RF
- 9: DK
Injuries (INJ)
This module begins with a series of questions on repetitive strain injuries. These are injuries caused by overuse or by repeating the same movement over a long period of time.
The rest of the module deals with the causes, the nature, frequency, and treatment of all other types of injuries, such as broken bones, cuts, burns or poisonings. This part of the module deals with injuries that are serious enough to limit normal activities, and all questions refer to the most serious injury suffered in the past 12 months.
To put effective injury prevention in place, health planners need to know which types and causes of injuries are most common and which groups of people are most likely to be injured.
Module INJ must be selected for INW to be asked.
Injuries (INJ) - Question identifier:INJ_R001
Now, questions on repetitive strain injuries. By this we mean injuries to muscles, tendons or nerves caused by overuse or repeating the same movement over an extended period. For example, carpal tunnel syndrome, tennis elbow or tendonitis.
Injuries (INJ) - Question identifier:INJ_Q005
In the past 12 months, did you have any injuries due to repetitive strain?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Injuries (INJ) - Question identifier:INJ_Q010
Were these injuries serious enough to limit your normal activities?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Injuries (INJ) - Question identifier:INJ_Q015
Thinking about the most serious repetitive strain injury, what part of the body was affected?
- 01: Head
- 02: Neck
- 03: Shoulder, upper arm
- 04: Elbow, lower arm
- 05: Wrist
- 06: Hand
- 07: Hip
- 08: Thigh
- 09: Knee, lower leg
- 10: Ankle, foot
- 11: Upper back or upper spine (excluding neck)
- 12: Lower back or lower spine
- 13: Chest (excluding back and spine)
- 14: Abdomen or pelvis (excluding back and spine)
- 98: RF
- 99: DK
Injuries (INJ) - Question identifier:INJ_Q020
What type of activity caused this repetitive strain injury?
- 01: Walking
- 02: Sports or physical exercise (including school activities and running)
- 03: Leisure or hobby (include volunteering)
- 04: Household chores, outdoor yard maintenance, home renovations or other unpaid work
- 05: Computer use or typing
- 06: Driving a motor vehicle
- 07: Lifting or carrying an object or person
- 08: Other
- 98: RF
- 99: DK
Injuries (INJ) - Question identifier:INJ_Q025
Was the activity something you did while working at your job or business (excluding travel to or from work)?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Injuries (INJ) - Question identifier:INJ_R030
For the next questions, think about other injuries which occurred in the past 12 months, and were serious enough to limit your normal activities at least 24 hours after the injury occurred. For example, a broken bone, a bad cut, a burn or a sprain.
Injuries (INJ) - Question identifier:INJ_Q030
[Not counting repetitive strain injuries or food poisoning,] in the past 12 months, that is, from [CURRENTDATE - 1] to yesterday, were you injured?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Injuries (INJ) - Question identifier:INJ_Q035
How many times were you injured?
Min = 1; Max = 30
Injuries (INJ) - Question identifier:INJ_Q040
[Thinking about the most serious injury, in which] month did it happen?
- 01: January
- 02: February
- 03: March
- 04: April
- 05: May
- 06: June
- 07: July
- 08: August
- 09: September
- 10: October
- 11: November
- 12: December
- 98: RF
- 99: DK
Injuries (INJ) - Question identifier:INJ_Q045
Was that this year or last year?
- 1: This year
- 2: Last year
- 8: RF
- 9: DK
Injuries (INJ) - Question identifier:INJ_Q050
What type of injury did you have? For example, a broken bone or burn.
- 01: Multiple serious injuries (excluding multiple minor injuries)
- 02: Broken or fractured bones
- 03: Burn, scald, chemical burn
- 04: Dislocation
- 05: Sprain or strain (including torn ligaments and muscles)
- 06: Cut, puncture, animal or human bite (open wound)
- 07: Scrape(s), bruise(s), blister(s) (including multiple minor injuries)
- 08: Concussion or other brain injury
- 09: Poisoning (excluding food poisoning, poison ivy, other contact dermatitis, and allergies)
- 10: Injury to internal organs
- 11: Other - Specify
- 98: RF
- 99: DK
Injuries (INJ) - Question identifier:INJ_Q055
What part of the body was injured?
- 01: Multiple sites
- 02: Eyes (excluding fracture of facial bones around the eye)
- 03: Head (including facial bones)
- 04: Neck
- 05: Shoulder, upper arm
- 06: Elbow, lower arm
- 07: Wrist
- 08: Hand
- 09: Hip
- 10: Thigh
- 11: Knee, lower leg
- 12: Ankle, foot
- 13: Upper back or upper spine (excluding neck)
- 14: Lower back or lower spine
- 15: Chest (excluding back and spine)
- 16: Abdomen or pelvis (excluding back and spine)
- 17: Other
- 98: RF
- 99: DK
Injuries (INJ) - Question identifier:INJ_Q060
Where were you when you were injured? For example, someone's house, an office building, construction site.
- 01: In a home or its surrounding area (including respondent's home or other homes)
- 02: Residential institution (e.g., nursing home, long term care)
- 03: School, college, university (exclude sports areas)
- 04: Sports or athletics area of school, college, university
- 05: Other sports or athletics area (exclude school sports areas)
- 06: Other institution (e.g., church, hospital, theatre, civic building)
- 07: Street, highway, sidewalk
- 08: Commercial area (e.g., store, restaurant, office building, transport terminal)
- 09: Industrial or construction area
- 10: Farm (exclude farmhouse and its surrounding area)
- 11: Countryside, forest, lake, ocean, mountains, prairie, etc.
- 12: Other
- 98: RF
- 99: DK
Injuries (INJ) - Question identifier:INJ_Q065
What were you doing when you were injured?
- 01: Organized sports involving coaching and competitions
- 02: Leisure sports or physical exercise, including school activities and running
- 03: Non-sport leisure or hobby (including volunteering)
- 04: Working at a job or business (excluding travel to and from work)
- 05: Household chores, outdoor yard maintenance, home renovations or other unpaid work
- 06: Sleeping, eating, personal care
- 07: Going up and down stairs
- 08: Driver or passenger in/on road motor vehicle (including motorcycles and trucks)
- 09: Driver or passenger in/on off-road motor vehicle (including boat, ATV, snowmobile)
- 10: Walking
- 11: Other - Specify
- 98: RF
- 99: DK
Injuries (INJ) - Question identifier:INJ_Q070
Was the injury the result of a fall?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Injuries (INJ) - Question identifier:INJ_Q075
How did you fall?
- 01: While skating, skiing or snowboarding
- 02: While engaged in other sport or physical exercise (including school activities and running)
- 03: Going up or down stairs / steps (icy or not)
- 04: Slip, trip or stumble, or loss of balance while walking on ice or snow
- 05: Slip, trip or stumble, or loss of balance while walking on any other surface
- 06: From furniture or while rising from furniture (e.g., bed, chair)
- 07: From elevated position (e.g., ladder, tree, scaffolding)
- 08: Due to health problems (e.g., faint, weakness, dizziness, hip/knee gave out, seizure)
- 09: Other - Specify
- 98: RF
- 99: DK
Injuries (INJ) - Question identifier:INJ_Q080
What caused the injury? For example, wrong movement, accidental contact with an object, transportation accident.
- 01: Transportation accident
- 02: Accidentally bumped, pushed, bitten, etc. by a person or animal
- 03: Accidentally struck or crushed by object(s)
- 04: Accidental contact with sharp object, tool or machine
- 05: Smoke, fire, flames
- 06: Accidental contact with hot object, liquid or gas
- 07: Extreme weather or natural disaster
- 08: Overexertion or strenuous movement
- 09: Physical assault
- 10: Intentional self-inflicted injury
- 11: Other - Specify
- 98: RF
- 99: DK
Injuries (INJ) - Question identifier:INJ_Q085
At what time of day did your injury occur?
- 1: Morning (06:00-11:59)
- 2: Afternoon (12:00-17:59)
- 3: Evening (18:00-23:59)
- 4: Night (00:00-05:59)
- 8: RF
- 9: DK
Injuries (INJ) - Question identifier:INJ_Q090
Did you receive any medical attention for the injury from a health professional in the 48 hours following the injury?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Injuries (INJ) - Question identifier:INJ_Q095
Where did you initially go to receive treatment within the first 48 hours following the injury?
- 01: Doctor's office
- 02: Hospital emergency room
- 03: Hospital outpatient clinic (e.g., day surgery)
- 04: Other clinic (e.g., walk-in, appointment, sports)
- 05: Physiotherapist or massage therapist's office
- 06: Community health centre / CLSC
- 07: Chiropractor's office
- 08: Where the injury happened/on-site (workplace, school, sports field, hotel, ski hill)
- 09: Other
- 98: RF
- 99: DK
Injuries (INJ) - Question identifier:INJ_Q100
Were you admitted to a hospital overnight because of this injury?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Injuries (INJ) - Question identifier:INJ_Q105
At the present time, are you getting follow-up care from a health professional because of this injury?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Injuries (INJ) - Question identifier:INJ_Q110
In the past 12 months [, excluding injuries previously mentioned, did] have any other injuries that were treated by a health professional, but did not limit your normal activities?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Injuries (INJ) - Question identifier:INJ_Q115
How many injuries?
Min = 1; Max = 30
Workplace injury (INW)
This module deals with injuries that occurred at a job other than the current main job. It determines the industry, occupation and the most important duties of the job when the injury occurred.
This information will further the study of workplace injuries as a whole, including those that take place outside of the main job, as we already get the main job information from the module LBF.
Module INJ must be selected for INW to be asked.
Workplace injury (INW) - Question identifier:INW_R001
You mentioned earlier that you were working at a job or business when you were injured.
Workplace injury (INW) - Question identifier:INW_Q005
Did this injury occur in your current main job?
- 1: Yes
- 2: No
- 3: Was not at a job or business when injured
- 8: RF
- 9: DK
Workplace injury (INW) - Question identifier:INW_Q010
What kind of business, industry or service were you working in when you were injured? (For example: cardboard box manufacturing, road maintenance, retail shoe store, secondary school, dairy farm, municipal government)
Long Answer Length = 50
Workplace injury (INW) - Question identifier:INW_Q015
What kind of work were you doing? (For example: babysitting in own home, factory worker, forestry technician)
Long Answer Length = 50
Workplace injury (INW) - Question identifier:INW_Q020
What were your most important activities or duties? (For example: caring for children, stamp press machine operator, forest examiner)
Long Answer Length = 50
Oral health (OHT)
This module asks the respondent to describe the health of their mouth and teeth (or dentures), and rate their satisfaction with their appearance. Respondent's also identify any discomfort they have with eating and how often they experience pain in their mouth, if they avoid eating particular foods, and how often they've experienced any other persistent or on-going pain in their mouth.
The health of a person's teeth and mouth is related to many other aspects of their health. For example, poor teeth and poor nutrition are related to each other.
Data from this module could be used to identify groups with the greatest need for improved dental health services.
Oral health (OHT) - Question identifier:OHT_R001
Now, some questions about the health of your mouth, including your teeth or dentures, tongue, gums, lips and jaw joints.
Oral health (OHT) - Question identifier:OHT_Q005
In general, would you say the health of your mouth is...?
- 1: Excellent
- 2: Very good
- 3: Good
- 4: Fair
- 5: Poor
- 8: RF
- 9: DK
Oral health (OHT) - Question identifier:OHT_Q010
How satisfied are you with the appearance of your teeth and/or dentures?
- 1: Very satisfied
- 2: Satisfied
- 3: Neither satisfied nor dissatisfied
- 4: Dissatisfied
- 5: Very dissatisfied
- 8: RF
- 9: DK
Oral health (OHT) - Question identifier:OHT_Q015
In the past 12 months, how often have you found it uncomfortable to eat any food because of problems with your mouth?
- 1: Often
- 2: Sometimes
- 3: Rarely
- 4: Never
- 8: RF
- 9: DK
Oral health (OHT) - Question identifier:OHT_Q020
In the past 12 months, how often have you avoided eating particular foods because of problems with your mouth?
- 1: Often
- 2: Sometimes
- 3: Rarely
- 4: Never
- 8: RF
- 9: DK
Oral health (OHT) - Question identifier:OHT_Q025
Remember, by mouth we mean teeth, dentures, tongue, gums, lips and jaw joints.
In the past 12 months, how often have you had any other persistent or on-going pain anywhere in your mouth?
- 1: Often
- 2: Sometimes
- 3: Rarely
- 4: Never
- 8: RF
- 9: DK
Oral health (OHT) - Question identifier:OHT_Q030
Do you have at least one of your own teeth?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Oral health (OHT) - Question identifier:OHT_Q035
Do you wear dentures, dental prosthesis or false teeth?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Oral health (OHT) - Question identifier:OHT_Q040
In the past 12 months, how often have you had bleeding gums, including while brushing or flossing your teeth?
- 1: Often
- 2: Sometimes
- 3: Rarely
- 4: Never
- 8: RF
- 9: DK
Oral health (OHT) - Question identifier:OHT_Q045
In the past 12 months, how often have you had persistent dry mouth?
- 1: Often
- 2: Sometimes
- 3: Rarely
- 4: Never
- 8: RF
- 9: DK
Oral health (OHT) - Question identifier:OHT_Q050
In the past 12 months, how often have you had persistent bad breath?
- 1: Often
- 2: Sometimes
- 3: Rarely
- 4: Never
- 8: RF
- 9: DK
Dental care (DEN)
This module asks respondents about the personal care of their teeth or dentures and the frequency of this care, including brushing or cleaning and flossing, how often they see a dental professional, and if the cost is a deterrent to seeing a dental professional.
Healthy teeth and gums are an important part of good overall health.
Answers to these questions can identify which groups are less likely to see a dentist and shed light on reasons for not seeking dental care.
Dental care (DEN) - Question identifier:DEN_R001
The next questions are about dental care.
Dental care (DEN) - Question identifier:DEN_Q005
Do you have at least one of your own teeth?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Dental care (DEN) - Question identifier:DEN_Q010
How often do you usually brush your teeth?
Min = 0; Max = 500
Dental care (DEN) - Question identifier:DEN_N010A
Select the reporting period.
- 1: By day
- 2: By week
- 3: By month
- 4: By year
Dental care (DEN) - Question identifier:DEN_Q015
How often do you usually floss your teeth?
Min = 0; Max = 500
Dental care (DEN) - Question identifier:DEN_N015A
Select the reporting period.
- 1: By day
- 2: By week
- 3: By month
- 4: By year
Dental care (DEN) - Question identifier:DEN_Q020
Do you wear dentures, dental prosthesis or false teeth?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Dental care (DEN) - Question identifier:DEN_Q025
How often do you usually clean your dentures or dental prosthesis?
Min = 0; Max = 500
Dental care (DEN) - Question identifier:DEN_N025A
Select the reporting period.
- 1: By day
- 2: By week
- 3: By month
- 4: By year
Dental care (DEN) - Question identifier:DEN_Q030
How often do you usually see a dental professional, such as a dentist, a dental hygienist or a denturologist?
- 1: More than once a year for check-ups or treatment
- 2: About once a year (for check-ups or treatment)
- 3: Less than once a year (for check-ups or treatment)
- 4: Only for emergency care
- 5: Never
- 8: RF
- 9: DK
Dental care (DEN) - Question identifier:DEN_Q035
When was the last time you saw a dental professional?
- 1: Less than 1 year to 1 year ago
- 2: More than 1 year to 2 years ago
- 3: More than 2 years to 3 years ago
- 4: More than 3 years to 4 years ago
- 5: More than 4 years to 5 years ago
- 6: More than 5 years ago
- 7: Never
- 8: RF
- 9: DK
Dental care (DEN) - Question identifier:DEN_Q040
In the past 12 months, have you avoided going to a dental professional because of the cost of dental care?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Dental care (DEN) - Question identifier:DEN_Q045
Do you have insurance or a government program that covers all or part of your dental expenses?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Dental care (DEN) - Question identifier:DEN_Q050
Is it...?
- 1: An employer-sponsored plan
- 2: A provincial or territorial government program for children or seniors
- 3: A private plan
- 4: A government program for social service (welfare) clients
- 5: A government program for First Nations and Inuit
- 6: Other
- 8: RF
- 9: DK
Changes made to improve health (CIH)
Respondents are asked a number of questions related to changes in behaviour that they have made in the past year (and intentions for the future) to improve their health, including losing weight, stopping smoking and increasing exercise.
The module also asks about things that have stopped the respondent from making a change, including lack of time and lack of will power.
The results from this module are very valuable in designing programs to promote healthy living. For example, local health region planners might find that a large number of people want to do more exercise but find that lack of time is stopping them from doing so. Programs might be put in place to remind people of ways to include exercise in their everyday activities.
Changes made to improve health (CIH) - Question identifier:CIH_Q005
Now, some questions about changes made to improve health.
In the past 12 months, did you do anything to improve your health? (For example, lost weight, quit smoking, increased exercise.)
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Changes made to improve health (CIH) - Question identifier:CIH_Q010
What is the single most important change you have made?
- 01: Increased exercise, sports / physical activity
- 02: Lost weight
- 03: Changed diet / improved eating habits
- 04: Quit smoking / reduced amount smoked
- 05: Drank less alcohol
- 06: Reduced stress level
- 07: Received medical treatment
- 08: Took vitamins
- 09: Other
- 98: RF
- 99: DK
Changes made to improve health (CIH) - Question identifier:CIH_Q015
Do you think there is [anything else/anything] you should do to improve your physical health?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Changes made to improve health (CIH) - Question identifier:CIH_Q020
What is the most important thing?
- 01: Start / Increase exercise, sports / physical activity
- 02: Lose weight
- 03: Change diet / improve eating habits
- 04: Quit smoking / reduce amount smoked
- 05: Drink less alcohol
- 06: Reduce stress level
- 07: Receive medical treatment
- 08: Take vitamins
- 09: Other
- 98: RF
- 99: DK
Changes made to improve health (CIH) - Question identifier:CIH_Q025
Is there anything stopping you from making this improvement?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Changes made to improve health (CIH) - Question identifier:CIH_Q030
What is that?
- 01: Lack of will power / self-discipline
- 02: Family responsibilities
- 03: Work schedule
- 04: Addiction to drugs / alcohol
- 05: Disability / health condition
- 06: Too stressed
- 07: Too costly / financial constraints
- 08: Not available in area
- 09: Transportation problems
- 10: Weather problems
- 11: Other
- 98: RF
- 99: DK
Changes made to improve health (CIH) - Question identifier:CIH_Q035
Is there anything you intend to do to improve your physical health in the next year?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Changes made to improve health (CIH) - Question identifier:CIH_Q040
What is that?
- 01: Start / Increase exercise, sports / physical activity
- 02: Lose weight
- 03: Change diet / improve eating habits
- 04: Quit smoking / reduce amount smoked
- 05: Drink less alcohol
- 06: Reduce stress level
- 07: Receive medical treatment
- 08: Take vitamins
- 09: Other
- 98: RF
- 99: DK
Sleep (SLP)
In this module, respondents are asked a number of questions related to sleep, including number of hours usually spent sleeping, difficulty in going to sleep or staying asleep, how often sleep is refreshing, and difficulty in staying awake.
These questions will be used to examine the links between sleep and other factors, such as poor health and stress.
Sleep (SLP) - Question identifier:SLP_R001
Now a few questions about sleep.
Sleep (SLP) - Question identifier:SLP_Q005
How long do you usually spend sleeping each night?
- 01: Under 2 hours
- 02: 2 hours to less than 3 hours
- 03: 3 hours to less than 4 hours
- 04: 4 hours to less than 5 hours
- 05: 5 hours to less than 6 hours
- 06: 6 hours to less than 7 hours
- 07: 7 hours to less than 8 hours
- 08: 8 hours to less than 9 hours
- 09: 9 hours to less than 10 hours
- 10: 10 hours to less than 11 hours
- 11: 11 hours to less than 12 hours
- 12: 12 hours or more
- 98: RF
- 99: DK
Sleep (SLP) - Question identifier:SLP_Q010
How often do you have trouble going to sleep or staying asleep?
- 1: Never
- 2: Rarely
- 3: Sometimes
- 4: Most of the time
- 5: All of the time
- 8: RF
- 9: DK
Sleep (SLP) - Question identifier:SLP_Q015
How often do you find your sleep refreshing?
- 1: Never
- 2: Rarely
- 3: Sometimes
- 4: Most of the time
- 5: All of the time
- 8: RF
- 9: DK
Sleep (SLP) - Question identifier:SLP_Q020
How often do you find it difficult to stay awake when you want to?
- 1: Never
- 2: Rarely
- 3: Sometimes
- 4: Most of the time
- 5: All of the time
- 8: RF
- 9: DK
Fruit and vegetable consumption (FVC)
The health benefits of vegetable and fruit consumption are popular topics in nutrition promotion programs and research. Among the research findings, there is thought to be a link between increased consumption of vegetables and fruit and a reduction in the risk of many cancers.
Fruit and vegetable consumption (FVC) - Question identifier:FVC_R001
These next questions are about the fruits and vegetables you ate or drank during the last month. Think about all meals and snacks, at home and away from home.
Fruit and vegetable consumption (FVC) - Question identifier:FVC_Q004
In the last month, did you drink 100% PURE fruit juices, such as pure orange juice, apple juice or pure juice blends? Exclude fruit-flavored drinks with added sugar or fruit punch.
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Fruit and vegetable consumption (FVC) - Question identifier:FVC_Q005
How many times? You can report per day, per week or per month.
Min = 1; Max = 300
Fruit and vegetable consumption (FVC) - Question identifier:FVC_N005A
Select the reporting period that corresponds to FVC_Q005.
- 1: Per day
- 2: Per week
- 3: Per month
Fruit and vegetable consumption (FVC) - Question identifier:FVC_Q009
In the last month, not counting juice, did you eat fruit? Please remember to include frozen, dried or canned fruit.
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Fruit and vegetable consumption (FVC) - Question identifier:FVC_Q010
How many times? (You can report per day, per week or per month.)
Min = 1; Max = 300
Fruit and vegetable consumption (FVC) - Question identifier:FVC_N010A
Select the reporting period that corresponds to FVC_Q010.
- 1: Per day
- 2: Per week
- 3: Per month
Fruit and vegetable consumption (FVC) - Question identifier:FVC_Q014
In the last month, did you eat dark green vegetables such as broccoli, green beans, peas and green peppers or dark leafy greens including romaine or spinach? Please remember to include (frozen or canned vegetables and) vegetables that were cooked in soups or mixed in salad.
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Fruit and vegetable consumption (FVC) - Question identifier:FVC_Q015
How many times? (You can report per day, per week or per month.)
Min = 1; Max = 300
Fruit and vegetable consumption (FVC) - Question identifier:FVC_N015A
Select the reporting period that corresponds to FVC_Q015.
- 1: Per day
- 2: Per week
- 3: Per month
Fruit and vegetable consumption (FVC) - Question identifier:FVC_Q019
In the last month, did you eat orange-coloured vegetables such as carrots, orange bell pepper, sweet potatoes, pumpkin or squash? (Please remember to include frozen or canned vegetables and vegetables that were cooked in soups or mixed in salad).
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Fruit and vegetable consumption (FVC) - Question identifier:FVC_Q020
How many times? (You can report per day, per week or per month.)
Min = 1; Max = 300
Fruit and vegetable consumption (FVC) - Question identifier:FVC_N020A
Select the reporting period that corresponds to FVC_Q020.
- 1: Per day
- 2: Per week
- 3: Per month
Fruit and vegetable consumption (FVC) - Question identifier:FVC_Q024
In the last month, did you eat potatoes that are not deep fried?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Fruit and vegetable consumption (FVC) - Question identifier:FVC_Q025
How many times? (You can report per day, per week or per month.)
Min = 1; Max = 300
Fruit and vegetable consumption (FVC) - Question identifier:FVC_N025A
Select the reporting period that corresponds to FVC_Q025.
- 1: Per day
- 2: Per week
- 3: Per month
Fruit and vegetable consumption (FVC) - Question identifier:FVC_Q029
[Excluding the green and orange vegetables as well as the potatoes you have already reported, in/In] the last month, did you eat OTHER vegetables? Examples include cucumber, celery, corn, cabbage and vegetable juice.
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Fruit and vegetable consumption (FVC) - Question identifier:FVC_Q030
How many times? (You can report per day, per week or per month.)
Min = 1; Max = 300
Fruit and vegetable consumption (FVC) - Question identifier:FVC_N030A
Select the reporting period that corresponds to FVC_Q030.
- 1: Per day
- 2: Per week
- 3: Per month
Food choices (FDC)
This module examines a range of reasons that people might have for choosing or avoiding certain foods. Reasons include concern about body weight or heart disease and concern about the fat or salt content of food.
Information from this module can be used to develop programs to encourage healthy eating. This can improve overall health and may, in the long run, help reduce the cost of the health care system.
Food choices (FDC) - Question identifier:FDC_R001
Now, some questions about the foods you eat.
Food choices (FDC) - Question identifier:FDC_Q005
Do you choose certain foods or avoid others:
because you are concerned about your body weight?
- 1: Yes (or sometimes)
- 2: No
- 8: RF
- 9: DK
Food choices (FDC) - Question identifier:FDC_Q010
Do you choose certain foods or avoid others:
because you are concerned about heart disease?
- 1: Yes (or sometimes)
- 2: No
- 8: RF
- 9: DK
Food choices (FDC) - Question identifier:FDC_Q015
Do you choose certain foods or avoid others:
because you are concerned about cancer?
- 1: Yes (or sometimes)
- 2: No
- 8: RF
- 9: DK
Food choices (FDC) - Question identifier:FDC_Q020
Do you choose certain foods or avoid others:
because you are concerned about osteoporosis (brittle bones)?
- 1: Yes (or sometimes)
- 2: No
- 8: RF
- 9: DK
Food choices (FDC) - Question identifier:FDC_Q025
Do you choose certain foods because of:
the lower fat content?
- 1: Yes (or sometimes)
- 2: No
- 8: RF
- 9: DK
Food choices (FDC) - Question identifier:FDC_Q030
Do you choose certain foods because of:
the fibre content?
- 1: Yes (or sometimes)
- 2: No
- 8: RF
- 9: DK
Food choices (FDC) - Question identifier:FDC_Q035
Do you choose certain foods because of:
the calcium content?
- 1: Yes (or sometimes)
- 2: No
- 8: RF
- 9: DK
Food choices (FDC) - Question identifier:FDC_Q040
Do you avoid certain foods because of:
the fat content?
- 1: Yes (or sometimes)
- 2: No
- 8: RF
- 9: DK
Food choices (FDC) - Question identifier:FDC_Q045
Do you avoid certain foods because of:
the type of fat they contain?
- 1: Yes (or sometimes)
- 2: No
- 8: RF
- 9: DK
Food choices (FDC) - Question identifier:FDC_Q050
Do you avoid certain foods because of:
the salt content?
- 1: Yes (or sometimes)
- 2: No
- 8: RF
- 9: DK
Food choices (FDC) - Question identifier:FDC_Q055
Do you avoid certain foods because of:
the cholesterol content?
- 1: Yes (or sometimes)
- 2: No
- 8: RF
- 9: DK
Food choices (FDC) - Question identifier:FDC_Q060
Do you avoid certain foods because of:
the calorie content?
- 1: Yes (or sometimes)
- 2: No
- 8: RF
- 9: DK
Canada's Food Guide use (FGU)
This module collects information on the population's knowledge and use of the Canada Food Guide.
Specifically, this module asks if the respondent is aware of the Canada Food Guide, and whether the information in the guide was ever used.
This information can be used to better understand the link between the use of Canada's Food Guide and eating habits and health behaviours.
Canada's Food Guide use (FGU) - Question identifier:FGU_Q005
Have you ever seen or heard of Canada's Food Guide?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Canada's Food Guide use (FGU) - Question identifier:FGU_Q010
Have you ever used information from Canada's Food Guide?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Canada's Food Guide use (FGU) - Question identifier:FGU_Q015
What did you use the information for?
- 1: To choose foods for you or household members
- 2: To determine how much you or household members need to eat every day
- 3: To plan meals or to help with grocery shopping
- 4: To assess how well you or household members are eating
- 5: Other
- 6: None of the above
- 8: RF
- 9: DK
Smoking (SMK)
Cigarette smoking is a major cause of heart disease and lung disease. The economic cost of illnesses and deaths caused by smoking is a major concern to health care planners and administrators.
The number of people who smoke varies significantly between health regions, between men and women and among age groups.
This module includes a series of questions about current and past smoking habits.
The results of this module can be used to develop smoking prevention and cessation programs for the groups that need them most.
Smoking (SMK) - Question identifier:SMK_R001
The next questions are about cigarette smoking.
Smoking (SMK) - Question identifier:SMK_Q005
At the present time, do you smoke cigarettes every day, occasionally or not at all?
- 1: Daily
- 2: Occasionally
- 3: Not at all
- 8: RF
- 9: DK
Smoking (SMK) - Question identifier:SMK_Q010
In the past 30 days, did you smoke any cigarettes?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Smoking (SMK) - Question identifier:SMK_Q015
During the past 30 days, did you smoke every day?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Smoking (SMK) - Question identifier:SMK_Q020
Have you smoked more than 100 cigarettes (about 4 packs) in your life?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Smoking (SMK) - Question identifier:SMK_Q025
Have you ever smoked a whole cigarette?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Smoking (SMK) - Question identifier:SMK_Q030
Have you ever smoked cigarettes daily?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Smoking (SMK) - Question identifier:SMK_Q035
At what age did you smoke your first whole cigarette?
Min = 5; Max = 121
Smoking (SMK) - Question identifier:SMK_Q040
At what age did you begin to smoke cigarettes daily?
Min = 5; Max = 121
Smoking (SMK) - Question identifier:SMK_Q045
How many cigarettes do you smoke each day now?
Min = 1; Max = 99
Smoking (SMK) - Question identifier:SMK_Q050
On the days that you do smoke, how many cigarettes do you usually smoke?
Min = 1; Max = 99
Smoking (SMK) - Question identifier:SMK_Q055
In the past month, on how many days have you smoked one or more cigarettes?
Min = 0; Max = 31
Smoking (SMK) - Question identifier:SMK_Q060
When did you stop smoking? Was it...?
- 1: Less than one year ago
- 2: 1 year to less than 2 years ago
- 3: 2 years to less than 3 years ago
- 4: 3 or more years ago
- 8: RF
- 9: DK
Smoking (SMK) - Question identifier:SMK_Q065
In what month did you stop?
- 01: January
- 02: February
- 03: March
- 04: April
- 05: May
- 06: June
- 07: July
- 08: August
- 09: September
- 10: October
- 11: November
- 12: December
- 98: RF
- 99: DK
Smoking (SMK) - Question identifier:SMK_Q070
How many years ago was it?
Min = 3; Max = 121
Smoking (SMK) - Question identifier:SMK_Q075
When you smoked every day, how many cigarettes did you usually smoke each day?
Min = 1; Max = 99
Smoking (SMK) - Question identifier:SMK_Q080
When did you stop smoking daily? Was it...?
- 1: Less than one year ago
- 2: 1 year to less than 2 years ago
- 3: 2 years to less than 3 years ago
- 4: 3 or more years ago
- 8: RF
- 9: DK
Smoking (SMK) - Question identifier:SMK_Q085
In what month did you stop?
- 01: January
- 02: February
- 03: March
- 04: April
- 05: May
- 06: June
- 07: July
- 08: August
- 09: September
- 10: October
- 11: November
- 12: December
- 98: RF
- 99: DK
Smoking (SMK) - Question identifier:SMK_Q090
How many years ago was it?
Min = 3; Max = 121
Smoking (SMK) - Question identifier:SMK_Q095
Was that when you completely quit smoking?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Smoking (SMK) - Question identifier:SMK_Q100
When did you stop smoking completely? Was it...?
- 1: Less than one year ago
- 2: 1 year to less than 2 years ago
- 3: 2 years to less than 3 years ago
- 4: 3 or more years ago
- 8: RF
- 9: DK
Smoking (SMK) - Question identifier:SMK_Q105
In what month did you stop?
- 01: January
- 02: February
- 03: March
- 04: April
- 05: May
- 06: June
- 07: July
- 08: August
- 09: September
- 10: October
- 11: November
- 12: December
- 98: RF
- 99: DK
Smoking (SMK) - Question identifier:SMK_Q110
How many years ago was it?
Min = 3; Max = 121
Smoking cessation methods (SCA)
In this module, people who smoke and people who have stopped smoking within the past year are asked about their use of various aids to reduce or quit smoking, and their usefulness. These methods include nicotine patches, nicotine gum or candy and medications such as Zyban.
Information about the use of smoking cessation aids is useful in understanding the effectiveness of these different methods in reducing or stopping smoking. This can be used to design effective programs that encourage people to stop smoking.
Smoking cessation methods (SCA) - Question identifier:SCA_Q005
In the past 12 months, did you try a nicotine patch to reduce or quit smoking?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Smoking cessation methods (SCA) - Question identifier:SCA_Q010
How useful was that in helping you reduce or quit smoking?
- 1: Very useful
- 2: Somewhat useful
- 3: Not very useful
- 4: Not useful at all
- 8: RF
- 9: DK
Smoking cessation methods (SCA) - Question identifier:SCA_Q015
In the past 12 months, did you use nicotine gum such as 'Nicorette' to reduce or quit smoking?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Smoking cessation methods (SCA) - Question identifier:SCA_Q020
How useful was that in helping you reduce or quit smoking?
- 1: Very useful
- 2: Somewhat useful
- 3: Not very useful
- 4: Not useful at all
- 8: RF
- 9: DK
Smoking cessation methods (SCA) - Question identifier:SCA_Q025
In the past 12 months, did you try medication such as Zyban, Wellbutrin or Champix to reduce or quit smoking?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Smoking cessation methods (SCA) - Question identifier:SCA_Q030
How useful was that in helping you reduce or quit smoking?
- 1: Very useful
- 2: Somewhat useful
- 3: Not very useful
- 4: Not useful at all
- 8: RF
- 9: DK
Smoking cessation methods (SCA) - Question identifier:SCA_Q035
In the past 12 months, did you stop smoking for at least 24 hours because you were trying to reduce or quit?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Smoking cessation methods (SCA) - Question identifier:SCA_Q040
In the past 12 months, did you try any of the following to reduce or quit smoking:
a nicotine patch?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Smoking cessation methods (SCA) - Question identifier:SCA_Q045
In the past 12 months, did you try any of the following to reduce or quit smoking:
nicotine gum such as Nicorette?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Smoking cessation methods (SCA) - Question identifier:SCA_Q050
In the past 12 months, did you try any of the following to reduce or quit smoking:
medication such as Zyban, Wellbutrin or Champix?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Tobacco products alternatives (TAL)
This module deals with the use of cigars, cigarillos, electronic cigarettes, pipes, snuff, chewing tobacco, pinch, and water pipes, all of which are not included in the Smoking module.
These alternatives to cigarettes have different implications for health.
The module will be used to understand which groups are most likely to use these products.
Tobacco products alternatives (TAL) - Question identifier:TAL_R001
Now, I would like to ask you a few questions about tobacco products, other than cigarettes.
Tobacco products alternatives (TAL) - Question identifier:TAL_Q005
In the past 30 days, did you smoke any little cigars or cigarillos?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Tobacco products alternatives (TAL) - Question identifier:TAL_Q010
Were these (little cigars or cigarillos) plain, flavoured or both?
- 1: Plain
- 2: Flavoured
- 3: Both
- 8: RF
- 9: DK
Tobacco products alternatives (TAL) - Question identifier:TAL_Q015
In the past 30 days, did you smoke any cigars other than little cigars or cigarillos?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Tobacco products alternatives (TAL) - Question identifier:TAL_Q020
In the past 30 days, did you use an electronic cigarette, also known as an 'e-cigarette'?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Tobacco products alternatives (TAL) - Question identifier:TAL_Q025
In the past 30 days, did you smoke a pipe?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Tobacco products alternatives (TAL) - Question identifier:TAL_Q030
In the past 30 days, did you use any chewing tobacco, pinch or snuff?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Tobacco products alternatives (TAL) - Question identifier:TAL_Q035
In the past 30 days, did you smoke a tobacco water-pipe, also known as a hookah, shisha, nargeelay, hubble-bubble or gouza to smoke tobacco?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Exposure to second hand smoke (ETS)
Exposure to second-hand smoke is known to have a variety of negative effects on health, including lung disease and childhood asthma.
This module includes questions about the number of people who smoke regularly inside the home (including household members and regular visitors), and questions about smoking restrictions in the home. These questions are asked of all respondents.
Respondents who do not smoke are asked how often they have been exposed to second-hand smoke in vehicles, the workplace, school and in public places in the past month.
Exposure to second hand smoke (ETS) - Question identifier:ETS_R001
The next questions are about exposure to second-hand smoke.
Exposure to second hand smoke (ETS) - Question identifier:ETS_Q005
Including both household members and regular visitors, does anyone smoke inside your home, every day or almost every day?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Exposure to second hand smoke (ETS) - Question identifier:ETS_Q010
How many people smoke inside your home every day or almost every day?
Min = 1; Max = 15
Exposure to second hand smoke (ETS) - Question identifier:ETS_Q015
Is smoking allowed inside your home?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Exposure to second hand smoke (ETS) - Question identifier:ETS_Q020
Is smoking inside your home restricted in any way?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Exposure to second hand smoke (ETS) - Question identifier:ETS_Q025
How is smoking restricted inside your home?
- 1: Allowed in certain rooms only
- 2: Restricted in the presence of young children
- 3: Allowed only if windows are open or with another type of ventilation
- 4: Other restriction(s)
- 8: RF
- 9: DK
Exposure to second hand smoke (ETS) - Question identifier:ETS_Q030
In the past month, were you exposed to second-hand smoke, every day or almost every day, at your workplace or at school?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Exposure to second hand smoke (ETS) - Question identifier:ETS_Q035
In the past month, were you exposed to second-hand smoke, every day or almost every day, in a car or other private vehicle?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Exposure to second hand smoke (ETS) - Question identifier:ETS_Q040
In the past month, were you exposed to second-hand smoke, every day or almost every day, in public places (such as bars, restaurants, shopping malls, arenas, bingo halls, bowling alleys)?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Alcohol use (ALC)
Consumption of alcohol has a number of implications for health. Excessive drinking is related to a number of diseases and social and mental health problems. Drinking is also a leading cause of accidents and injuries.
This module includes questions about how often and how much alcohol the respondent has drunk in the past 12 months, and if they have ever had a drink in their life.
This module will help researchers and health planners to understand patterns of alcohol consumption. For example, which groups are more likely to binge drink, i.e., drink 4 (or 5 in the case of males) or more drinks on one occasion.
Alcohol use (ALC) - Question identifier:ALC_R001
Now, some questions about your alcohol consumption.
A 'drink' refers to:
- a bottle or small can of beer, cider or cooler with 5% alcohol content, or a small draft;
- a glass of wine with 12% alcohol content;
- a glass or cocktail containing 1½ oz. of a spirit with 40% alcohol content.
Alcohol use (ALC) - Question identifier:ALC_Q005
Have you ever had a drink in your lifetime?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Alcohol use (ALC) - Question identifier:ALC_Q010
During the past 12 months, that is, from [CURRENTDATE-1] to yesterday, have you had a drink of beer, wine, liquor or any other alcoholic beverage?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Alcohol use (ALC) - Question identifier:ALC_Q015
During the past 12 months, how often did you drink alcoholic beverages?
- 1: Less than once a month
- 2: Once a month
- 3: 2 to 3 times a month
- 4: Once a week
- 5: 2 to 3 times a week
- 6: 4 to 6 times a week
- 7: Every day
- 8: RF
- 9: DK
Alcohol use (ALC) - Question identifier:ALC_Q020
How often in the past 12 months have you had [5/4] or more drinks on one occasion?
- 1: Never
- 2: Less than once a month
- 3: Once a month
- 4: 2 to 3 times a month
- 5: Once a week
- 6: More than once a week
- 8: RF
- 9: DK
Alcohol use during the past week (ALW)
This module asks those who had a drink in the past 12 months about their drinking consumption on each day of the past week.
This module will be used to see how the population abides by the Low Risk Drinking Guidelines.
Alcohol use during the past week (ALW) - Question identifier:ALW_Q005
Thinking back over the past week, that is, from last ^DV_DAYLASTWEEKE to yesterday, did you have a drink of beer, wine, liquor or any other alcoholic beverage?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Alcohol use during the past week (ALW) - Question identifier:ALW_Q010
Starting with yesterday, that is [DAY1_TEXT], how many drinks did you have?
Min = 0; Max = 99
Alcohol use during the past week (ALW) - Question identifier:ALW_Q015
How many drinks did you have:
on [DAY2_TEXT]?
Min = 0; Max = 99
Alcohol use during the past week (ALW) - Question identifier:ALW_Q020
How many drinks did you have:
on [DAY3_TEXT]?
Min = 0; Max = 99
Alcohol use during the past week (ALW) - Question identifier:ALW_Q025
How many drinks did you have:
on [DAY4_TEXT]?
Min = 0; Max = 99
Alcohol use during the past week (ALW) - Question identifier:ALW_Q030
How many drinks did you have:
on [DAY5_TEXT]?
Min = 0; Max = 99
Alcohol use during the past week (ALW) - Question identifier:ALW_Q035
How many drinks did you have:
on [DAY6_TEXT]?
Min = 0; Max = 99
Alcohol use during the past week (ALW) - Question identifier:ALW_Q040
How many drinks did you have:
on [DAY7_TEXT]?
Min = 0; Max = 99
Medication use (MED)
This module deals with the use of prescription and non-prescription medications in the past 12 months, including different pain relievers, stimulants and sedatives.
The results of this module will be used to create a picture of which medications are taken by various groups. Researchers will use the results to examine the relationship between health problems, use of medications, and use of other health care services.
Medication use (MED) - Question identifier:MED_R001
The next series of questions are about various medications.
The first series of questions are about your use of various pain relievers. By pain relievers, we mean products that contain opioids such as codeine or morphine, or related drugs. Most of these products require a prescription, although some codeine products are available without a prescription, for example, Tylenol #1 or 222s.
We are not interested in pain relievers such as Aspirin, Advil, regular Tylenol, Celebrex, etc.
Medication use (MED) - Question identifier:MED_Q005
During the past 12 months, have you used any codeine products like Tylenol #3, Tylenol #1, 292s or 222s?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Medication use (MED) - Question identifier:MED_Q010
During the past 12 months, have you used any oxycodone products such as Percocet or Percodan?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Medication use (MED) - Question identifier:MED_Q015
During the past 12 months, have you used any other opioid products such as hydromorphone, Dilaudid, Hydromorph Contin, morphine, MS Contin, or Demerol?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Medication use (MED) - Question identifier:MED_Q020
During the past 12 months, how often did you use any such pain relievers? Would you say...?
- 01: Once or twice
- 02: 3 to 11 times a year
- 03: About once a month
- 04: 2 or 3 times a month
- 05: About once or twice a week
- 06: 3 or 4 times a week
- 07: Daily or almost daily
- 08: As needed, or following surgery
- 98: RF
- 99: DK
Medication use (MED) - Question identifier:MED_Q025
Thinking about all the pain relievers you have used during the past 12 months, were they prescribed for you?
- 1: No, none were prescribed
- 2: Yes, they all were prescribed
- 3: Some were prescribed and others were not
- 8: RF
- 9: DK
Medication use (MED) - Question identifier:MED_Q030
Sometimes people do not take their pills as directed by a physician or pharmacist. Thinking about all the pain relievers you have used during the past 12 months, did you ever take more pills, or take them more often than you were supposed to?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Medication use (MED) - Question identifier:MED_Q035
During the past 12 months, did you ever use pain relievers only for the experience, the feeling they caused or to get high?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Medication use (MED) - Question identifier:MED_Q040
During the past 12 months, did you ever use pain relievers for reasons other than pain relief, for example, to feel better (improve mood), to cope with stress or problems, or any other reason?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Medication use (MED) - Question identifier:MED_Q045
During the past 12 months, did you ever tamper with a pain reliever product before taking it, [for example, by crushing tablets to swallow, snort or inject, not counting for ease of swallowing or to take a lower dose]?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Medication use (MED) - Question identifier:MED_R050
The next few questions are about your use of various stimulants.
By stimulants, we mean products prescribed by a doctor to help people who have attention or concentration problems (such as ADHD). Examples of stimulants include Ritalin, Concerta, Adderall, Dexedrine or others.
Medication use (MED) - Question identifier:MED_Q050
During the past 12 months, have you used any stimulants?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Medication use (MED) - Question identifier:MED_Q055
During the past 12 months, how often did you use any stimulants? Would you say...?
- 01: Once or twice
- 02: 3 to 11 times a year
- 03: About once a month
- 04: 2 or 3 times a month
- 05: About once or twice a week
- 06: 3 or 4 times a week
- 07: Daily or almost daily
- 08: As needed, or following surgery
- 98: RF
- 99: DK
Medication use (MED) - Question identifier:MED_Q060
Thinking about all the stimulants you used during the past 12 months, were they prescribed for you?
- 1: No, none were prescribed
- 2: Yes, they all were prescribed
- 3: Some were prescribed and others were not
- 8: RF
- 9: DK
Medication use (MED) - Question identifier:MED_Q065
Sometimes people do not take their pills as directed by a physician or pharmacist. Thinking about all the stimulants you have used during the past 12 months, did you ever take more pills or take them more often than you were supposed to?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Medication use (MED) - Question identifier:MED_Q070
During the past 12 months, did you ever use stimulants only for the experience, the feeling they caused or to get high?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Medication use (MED) - Question identifier:MED_Q075
During the past 12 months, did you ever use stimulants for reasons other than why they were prescribed, for example, to study, to stay alert, to decrease your appetite or for any other reason?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Medication use (MED) - Question identifier:MED_R080
The next few questions are about your use of various sedatives or anti-anxiety medications.
By sedatives, we mean products that can be obtained from a doctor such as diazepam, Valium, lorazepam, Ativan, alprazolam, Xanax, clonazepam, Rivotril or others.
Sedatives are sometimes prescribed to help people sleep, calm down, or to relax their muscles.
Medication use (MED) - Question identifier:MED_Q080
During the past 12 months, have you used any sedatives?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Medication use (MED) - Question identifier:MED_Q085
During the past 12 months, how often did you use any sedatives? Would you say...?
- 01: Once or twice
- 02: 3 to 11 times a year
- 03: About once a month
- 04: 2 or 3 times a month
- 05: About once or twice a week
- 06: 3 or 4 times a week
- 07: Daily or almost daily
- 08: As needed, or following surgery
- 98: RF
- 99: DK
Medication use (MED) - Question identifier:MED_Q090
Thinking about all the sedatives you have used during the past 12 months, were they prescribed for you?
- 1: No, none were prescribed
- 2: Yes, they all were prescribed
- 3: Some were prescribed and others were not
- 8: RF
- 9: DK
Medication use (MED) - Question identifier:MED_Q095
Sometimes people do not take their pills as directed by a physician or pharmacist. Thinking about all the sedatives you have used during the past 12 months, did you ever take more pills or take them more often than you were supposed to?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Medication use (MED) - Question identifier:MED_Q100
During the past 12 months, did you ever use sedatives only for the experience, the feeling they caused or to get high?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Drug use methods (DRM)
For those respondents who have used illicit drugs, this module deals with the various methods that are used when taking illicit drugs. Methods for illicit drug use can include injection, smoking, inhalation, or oral use.
This module will be used to study risky drug method behaviours.
Drug use methods (DRM) - Question identifier:DRM_R001
The next questions are about various methods that are used when people use illicit drugs.
Drug use methods (DRM) - Question identifier:DRM_Q005
Have you ever smoked illicit drugs?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Drug use methods (DRM) - Question identifier:DRM_Q010
Was this in the past 12 months?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Drug use methods (DRM) - Question identifier:DRM_Q015
Have you ever taken illicit drugs orally?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Drug use methods (DRM) - Question identifier:DRM_Q020
Was this in the past 12 months?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Drug use methods (DRM) - Question identifier:DRM_Q025
Have you ever snorted or sniffed illicit drugs?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Drug use methods (DRM) - Question identifier:DRM_Q030
Was this in the past 12 months?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Drug use methods (DRM) - Question identifier:DRM_Q035
Have you ever used a needle to inject or be injected with a drug not prescribed by a doctor?
- 1: Yes, just once
- 2: Yes, more than once
- 3: No
- 8: RF
- 9: DK
Drug use methods (DRM) - Question identifier:DRM_Q040
Have you ever used a needle to inject or be injected with a drug not prescribed by a doctor?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Drug use methods (DRM) - Question identifier:DRM_Q045
Was this in the past 12 months?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Drug use (DRG)
This module asks about the use of a number of drugs used and whether they were used in the past 12 months, including marijuana (for both medical and illicit purposes), cocaine, amphetamines, ecstasy, hallucinogens, solvents and non-prescription needle injections.
The answers to these questions will be used to identify which groups could benefit from treatment programs.
Drug use (DRG) - Question identifier:DRG_R005
I am now going to ask questions on your use of various drugs.
Drug use (DRG) - Question identifier:DRG_Q005
Have you ever used or tried marijuana or hashish?
- 1: Yes, just once
- 2: Yes, more than once
- 3: No
- 8: RF
- 9: DK
Drug use (DRG) - Question identifier:DRG_Q010
Was this in the past 12 months?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Drug use (DRG) - Question identifier:DRG_Q015
How often did you use marijuana or hashish in the past 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: Every day
- 8: RF
- 9: DK
Drug use (DRG) - Question identifier:DRG_Q020
Have you ever used or tried cocaine in any form, including crack, freebase, powder or snow?
- 1: Yes, just once
- 2: Yes, more than once
- 3: No
- 8: RF
- 9: DK
Drug use (DRG) - Question identifier:DRG_Q025
Was this in the past 12 months?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Drug use (DRG) - Question identifier:DRG_Q030
Have you ever used or tried amphetamines, speed, methamphetamines or crystal meth?
- 1: Yes, just once
- 2: Yes, more than once
- 3: No
- 8: RF
- 9: DK
Drug use (DRG) - Question identifier:DRG_Q035
Was this in the past 12 months?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Drug use (DRG) - Question identifier:DRG_Q040
Have you ever used or tried ecstasy, also known as MDMA, E, Xtc, Adam or X?
- 1: Yes, just once
- 2: Yes, more than once
- 3: No
- 8: RF
- 9: DK
Drug use (DRG) - Question identifier:DRG_Q045
Was this in the past 12 months?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Drug use (DRG) - Question identifier:DRG_Q050
Have you ever used or tried hallucinogens such as PCP, LSD, acid, magic mushrooms, mescaline or angel dust?
- 1: Yes, just once
- 2: Yes, more than once
- 3: No
- 8: RF
- 9: DK
Drug use (DRG) - Question identifier:DRG_Q055
Was this in the past 12 months?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Drug use (DRG) - Question identifier:DRG_Q060
Have you ever sniffed glue, gasoline or other solvents to get high?
- 1: Yes, just once
- 2: Yes, more than once
- 3: No
- 8: RF
- 9: DK
Drug use (DRG) - Question identifier:DRG_Q065
Was this in the past 12 months?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Drug use (DRG) - Question identifier:DRG_Q070
Have you ever used a needle to inject or be injected with a drug not prescribed by a doctor?
- 1: Yes, just once
- 2: Yes, more than once
- 3: No
- 8: RF
- 9: DK
Drug use (DRG) - Question identifier:DRG_Q075
Was this in the past 12 months?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Drug use (DRG) - Question identifier:DRG_Q080
Which of the following drugs have you injected using a needle?
- 1: Cocaine
- 2: Heroin or opium
- 3: Methamphetamine
- 4: Steroids
- 5: Other
- 6: I have never injected a drug using a needle
- 8: RF
- 9: DK
Physical activities - adults 18 years and older (PAA)
Answers to this module are used to determine how active respondents, 18 years of age and older, have been in the last seven days.
Respondents are asked if they have spent a minimum of 10 minutes of physical activity, and on which days of the week, doing various activities, such as walking or cycling to get to places, sports or recreational activities that caused sweating or heavy breathing. They are also asked how much time in total was spent doing vigorous activities.
Higher levels of activity are widely thought to be associated with better health.
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_R001
The following questions are about various types of physical activities done in the last 7 days. I want you to only think of activities you did for a minimum of 10 continuous minutes.
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_Q005
In the last 7 days, that is from last ^DT_DAYLASTWEEKE to yesterday, did you use active ways like walking or cycling to get to places such as work, school, the bus stop, the shopping centre or to visit friends?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_Q010
In the last 7 days, on which days did you do these activities?
- 1: Monday
- 2: Tuesday
- 3: Wednesday
- 4: Thursday
- 5: Friday
- 6: Saturday
- 7: Sunday
- 8: RF
- 9: DK
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_Q015
How much time in total, in the last 7 days, did you spend doing these activities? Please only include activities that lasted a minimum of 10 continuous minutes.
Min = 0; Max = 168
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_N020
Enter number of minutes.
Min = 0; Max = 9995
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_Q030
[Not including activities you just reported, in] the last 7 days, did you do sports, fitness or recreational physical activities, organized or non-organized, that lasted a minimum of 10 continuous minutes?
Examples are walking, home or gym exercise, swimming, cycling, running, skiing, dancing and all team sports.
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_Q035
Did any of these recreational physical activities make you sweat at least a little and breathe harder?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_Q040
In the last 7 days, on which days did you do these recreational activities that made you sweat at least a little and breathe harder?
- 1: Monday
- 2: Tuesday
- 3: Wednesday
- 4: Thursday
- 5: Friday
- 6: Saturday
- 7: Sunday
- 8: RF
- 9: DK
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_Q045
In the last 7 days, how much time in total did you spend doing these activities that made you sweat at least a little and breathe harder?
Min = 0; Max = 168
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_N050
Enter number of minutes.
Min = 0; Max = 9995
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_Q060
In the last 7 days, did you do any other physical activities while at work, in or around your home or while volunteering?
Examples are carrying heavy loads, shoveling, and household chores such as vacuuming or washing windows. Please remember to only include activities that lasted a minimum of 10 continuous minutes.
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_Q065
Did any of these other physical activities make you sweat at least a little and breathe harder?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_Q070
In the last 7 days, on which days did you do these other activities that made you sweat at least a little and breathe harder?
- 1: Monday
- 2: Tuesday
- 3: Wednesday
- 4: Thursday
- 5: Friday
- 6: Saturday
- 7: Sunday
- 8: RF
- 9: DK
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_Q075
In the last 7 days, how much time in total did you spend doing these activities that made you sweat at least a little and breathe harder?
Min = 0; Max = 168
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_N080
Enter number of minutes.
Min = 0; Max = 9995
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_Q095
You have reported a total of ^DV_PAATOTAL minutes of physical activity. Of these activities, were there any of vigorous intensity, meaning they caused you to be out of breath?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_Q100
In the last 7 days, how much time in total did you spend doing vigorous activities that caused you to be out of breath?
Min = 0; Max = 168
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_N105
Enter number of minutes.
Min = 0; Max = 9995
Physical activities for youth (PAY)
Answers to this module are used to determine how active respondents, aged 12 to 17, have been in the last seven days.
Respondents are asked on which days of the week they have been active, and for how long, doing various activities such as walking or cycling (to get to school, work, the shopping centre or to visit friends), or participating in sports or recreational activities or other activities that caused sweating or heavy breathing. They are also asked how much time in total was spent doing vigorous activities.
Higher levels of activity are widely thought to be associated with better health.
Physical activities for youth (PAY) - Question identifier:PAY_R001
The following questions are about various types of physical activities that you have done each day in the past week.
Physical activities for youth (PAY) - Question identifier:PAY_Q005
During the last 7 days, that is from last ^DT_DAYLASTWEEKE to yesterday, did you...?
- 1: Attend school
- 2: Attend a day camp
- 3: Attend paid or unpaid work
- 4: None of the above
- 8: RF
- 9: DK
Physical activities for youth (PAY) - Question identifier:PAY_Q010
In the last 7 days, did you use active ways like walking or cycling to get to places such as [school, the bus stop, the shopping centre, work] or to visit friends?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Physical activities for youth (PAY) - Question identifier:PAY_Q015
How much time did you spend using active ways to get to places...
...yesterday?
...on ^DT_DAY2DAYSAGOE?
...on ^DT_DAY3DAYSAGOE?
...on ^DT_DAY4DAYSAGOE?
...on ^DT_DAY5DAYSAGOE?
...on ^DT_DAY6DAYSAGOE?
...on ^DT_DAYLASTWEEKE?
Min = 0; Max = 10080
Physical activities for youth (PAY) - Question identifier:PAY_Q025
In the last 7 days, did you do sports, fitness or recreational physical activities while at [school or day camp, including during physical education classes, during your breaks and any other time you played indoors or outdoors]?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Physical activities for youth (PAY) - Question identifier:PAY_Q030
Did any of these activities make you sweat at least a little and breathe harder?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Physical activities for youth (PAY) - Question identifier:PAY_Q035
How much time did you spend doing these activities at [school or day camp] that made you sweat at least a little and breathe harder...
...yesterday?
...on ^DT_DAY2DAYSAGOE?
...on ^DT_DAY3DAYSAGOE?
...on ^DT_DAY4DAYSAGOE?
...on ^DT_DAY5DAYSAGOE?
...on ^DT_DAY6DAYSAGOE?
...on ^DT_DAYLASTWEEKE?
Min = 0; Max = 10080
Physical activities for youth (PAY) - Question identifier:PAY_Q045
In the last 7 days, did you do physical activities in your leisure time including exercising, playing an organized or non-organized sport or playing with your friends?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Physical activities for youth (PAY) - Question identifier:PAY_Q050
Did any of these leisure-time activities make you sweat at least a little and breathe harder?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Physical activities for youth (PAY) - Question identifier:PAY_Q055
How much time did you spend doing these leisure-time activities that made you sweat at least a little and breathe harder...
...yesterday?
...on ^DT_DAY2DAYSAGOE?
...on ^DT_DAY3DAYSAGOE?
...on ^DT_DAY4DAYSAGOE?
...on ^DT_DAY5DAYSAGOE?
...on ^DT_DAY6DAYSAGOE?
...on ^DT_DAYLASTWEEKE?
Min = 0; Max = 10080
Physical activities for youth (PAY) - Question identifier:PAY_Q065
In the last 7 days, did you do any other physical [activities that you have not already reported], for example, while you [were doing paid or unpaid work or] helping your family with chores?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Physical activities for youth (PAY) - Question identifier:PAY_Q070
Did any of these other physical activities make you sweat at least a little and breathe harder?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Physical activities for youth (PAY) - Question identifier:PAY_Q075
How much time did you spend doing these other physical activities that made you sweat at least a little and breathe harder...
...yesterday?
...on ^DT_DAY2DAYSAGOE?
...on ^DT_DAY3DAYSAGOE?
...on ^DT_DAY4DAYSAGOE?
...on ^DT_DAY5DAYSAGOE?
...on ^DT_DAY6DAYSAGOE?
...on ^DT_DAYLASTWEEKE?
Min = 0; Max = 10080
Physical activities for youth (PAY) - Question identifier:PAY_Q090
You have reported a total of [DV_PAYTRAVEL + DV_PAYSCHOOL + DV_PAYREC + DV_PAYOTHER] minutes of physical activity. Of these activities, were there any of vigorous intensity, meaning they caused you to be out of breath?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Physical activities for youth (PAY) - Question identifier:PAY_Q095
In the last 7 days, on which days did you do these vigorous activities that caused you to be out of breath?
- 1: Yesterday
- 2: ^DT_DAY2DAYSAGOE
- 3: ^DT_DAY3DAYSAGOE
- 4: ^DT_DAY4DAYSAGOE
- 5: ^DT_DAY5DAYSAGOE
- 6: ^DT_DAY6DAYSAGOE
- 7: ^DT_DAYLASTWEEKE
- 8: RF
- 9: DK
Physical activities for youth (PAY) - Question identifier:PAY_Q100
In the last 7 days, how much time in total did you spend doing vigorous activities that caused you to be out of breath?
Min = 0; Max = 168
Physical activities for youth (PAY) - Question identifier:PAY_N105
Enter number of minutes.
Min = 0; Max = 9995
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_R005
Now a few questions about precautions you take while participating in some physical activities.
Use of protective equipment (UPE) - Question identifier:UPE_Q005
In the past 12 months, have you done any bicycling?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Use of protective equipment (UPE) - Question identifier:UPE_Q010
When riding a bicycle, how often do you wear a helmet?
- 1: Always
- 2: Most of the time
- 3: Rarely
- 4: Never
- 8: RF
- 9: DK
Use of protective equipment (UPE) - Question identifier:UPE_Q015
In the past 12 months, have you done any in-line skating or rollerblading?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Use of protective equipment (UPE) - Question identifier:UPE_Q020
When in-line skating or rollerblading, how often do you wear a helmet?
- 1: Always
- 2: Most of the time
- 3: Rarely
- 4: Never
- 8: RF
- 9: DK
Use of protective equipment (UPE) - Question identifier:UPE_Q025
How often do you wear wrist guards or wrist protectors?
- 1: Always
- 2: Most of the time
- 3: Rarely
- 4: Never
- 8: RF
- 9: DK
Use of protective equipment (UPE) - Question identifier:UPE_Q030
How often do you wear elbow pads?
- 1: Always
- 2: Most of the time
- 3: Rarely
- 4: Never
- 8: RF
- 9: DK
Use of protective equipment (UPE) - Question identifier:UPE_Q035
How often do you wear knee pads?
- 1: Always
- 2: Most of the time
- 3: Rarely
- 4: Never
- 8: RF
- 9: DK
Use of protective equipment (UPE) - Question identifier:UPE_Q040
In the past 12 months, did you do...?
- 1: Downhill skiing only
- 2: Snowboarding only
- 3: Both
- 4: Neither
- 8: RF
- 9: DK
Use of protective equipment (UPE) - Question identifier:UPE_Q045
When downhill skiing, how often do you wear a helmet?
- 1: Always
- 2: Most of the time
- 3: Rarely
- 4: Never
- 8: RF
- 9: DK
Use of protective equipment (UPE) - Question identifier:UPE_Q050
When snowboarding, how often do you wear a helmet?
- 1: Always
- 2: Most of the time
- 3: Rarely
- 4: Never
- 8: RF
- 9: DK
Use of protective equipment (UPE) - Question identifier:UPE_Q055
When snowboarding, how often do you wear wrist guards or wrist protectors?
- 1: Always
- 2: Most of the time
- 3: Rarely
- 4: Never
- 8: RF
- 9: DK
Use of protective equipment (UPE) - Question identifier:UPE_Q060
In the past 12 months, have you done any skateboarding?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Use of protective equipment (UPE) - Question identifier:UPE_Q065
How often do you wear a helmet?
- 1: Always
- 2: Most of the time
- 3: Rarely
- 4: Never
- 8: RF
- 9: DK
Use of protective equipment (UPE) - Question identifier:UPE_Q070
How often do you wear wrist guards or wrist protectors?
- 1: Always
- 2: Most of the time
- 3: Rarely
- 4: Never
- 8: RF
- 9: DK
Use of protective equipment (UPE) - Question identifier:UPE_Q075
How often do you wear elbow pads?
- 1: Always
- 2: Most of the time
- 3: Rarely
- 4: Never
- 8: RF
- 9: DK
Use of protective equipment (UPE) - Question identifier:UPE_Q080
In the past 12 months, have you played any ice hockey?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Use of protective equipment (UPE) - Question identifier:UPE_Q085
When playing ice hockey, how often do you wear a mouth guard?
- 1: Always
- 2: Most of the time
- 3: Rarely
- 4: Never
- 8: RF
- 9: DK
Sun safety behaviours (SSB)
This module asks about sunburning in the past 12 months, typical exposure to sunshine during the summer months, and the steps that people can take to reduce the risk of exposure to the sun, such as wearing a hat, seeking shade, and applying sunscreen. It also asks about the use of tanning beds and the reason for doing so.
Results of this module can be used to measure the effectiveness of public health programs which warn about the dangers of sun exposure.
Sun safety behaviours (SSB) - Question identifier:SSB_R001
The next questions are about exposure to the sun and various sun behaviours.
Sun safety behaviours (SSB) - Question identifier:SSB_Q005
In the past 12 months, has any part of your body been sunburnt?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Sun safety behaviours (SSB) - Question identifier:SSB_R010
For the next questions, think about a typical weekend, or day off from work or school during the summer months.
Sun safety behaviours (SSB) - Question identifier:SSB_Q010
About how much time each day do you spend in the sun between 10 am and 4 pm?
- 1: None
- 2: Less than 30 minutes
- 3: 30 to 59 minutes
- 4: 1 hour to less than 2 hours
- 5: 2 hours to less than 3 hours
- 6: 3 hours to less than 4 hours
- 7: 4 hours to 6 hours
- 8: RF
- 9: DK
Sun safety behaviours (SSB) - Question identifier:SSB_Q015
In the summer months, on a typical weekend or day off, when you are in the sun for periods of 30 minutes or more, how often do you:
seek shade?
- 1: Always
- 2: Often
- 3: Sometimes
- 4: Rarely
- 5: Never
- 8: RF
- 9: DK
Sun safety behaviours (SSB) - Question identifier:SSB_Q020
In the summer months, on a typical weekend or day off, when you are in the sun for 30 minutes or more, how often do you:
wear a hat that shades your face, ears and neck?
- 1: Always
- 2: Often
- 3: Sometimes
- 4: Rarely
- 5: Never
- 8: RF
- 9: DK
Sun safety behaviours (SSB) - Question identifier:SSB_Q025
In the summer months, on a typical weekend or day off, when you are in the sun for 30 minutes or more, how often do you:
wear long pants or a long skirt?
- 1: Always
- 2: Often
- 3: Sometimes
- 4: Rarely
- 5: Never
- 8: RF
- 9: DK
Sun safety behaviours (SSB) - Question identifier:SSB_Q030
In the summer months, on a typical weekend or day off, when you are in the sun for 30 minutes or more, how often do you:
wear sunglasses?
- 1: Always
- 2: Often
- 3: Sometimes
- 4: Rarely
- 5: Never
- 8: RF
- 9: DK
Sun safety behaviours (SSB) - Question identifier:SSB_Q035
In the summer months, on a typical weekend or day off, when you are in the sun for 30 minutes or more, how often do you:
use sunscreen on your face?
- 1: Always
- 2: Often
- 3: Sometimes
- 4: Rarely
- 5: Never
- 8: RF
- 9: DK
Sun safety behaviours (SSB) - Question identifier:SSB_Q040
What Sun Protection Factor (SPF) do you usually use on your face?
- 1: Less than 15
- 2: 15 to 29
- 3: 30 to 44
- 4: 45 or higher
- 8: RF
- 9: DK
Sun safety behaviours (SSB) - Question identifier:SSB_Q045
In the summer months, on a typical weekend or day off, when you are in the sun for 30 minutes or more, how often do you:
use sunscreen on your body?
- 1: Always
- 2: Often
- 3: Sometimes
- 4: Rarely
- 5: Never
- 8: RF
- 9: DK
Sun safety behaviours (SSB) - Question identifier:SSB_Q050
What Sun Protection Factor (SPF) do you usually use on your body?
- 1: Less than 15
- 2: 15 to 29
- 3: 30 to 44
- 4: 45 or higher
- 8: RF
- 9: DK
Sun safety behaviours (SSB) - Question identifier:SSB_Q055
In the past 12 months, have you used a tanning bed or booth with tanning lamps?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Sun safety behaviours (SSB) - Question identifier:SSB_Q060
How often?
Min = 1; Max = 365
Sun safety behaviours (SSB) - Question identifier:SSB_N060A
Select the reporting period.
- 1: Per day
- 2: Per week
- 3: Per month
- 4: Per year
- 8: RF
- 9: DK
Sun safety behaviours (SSB) - Question identifier:SSB_Q065
What is the main reason that you use tanning beds or booths with lamps?
- 1: It is a safe way of getting a tan
- 2: To get a good base tan that will provide protection prior to sun exposure
- 3: To look good / obtain a healthy glow
- 4: To boost vitamin D intake
- 5: To treat a skin condition or for other medical reasons
- 6: Other
- 8: RF
- 9: DK
Sedentary behaviours (SBE)
Sedentary behaviour refers to time spent seated with little or no physical activity. In this module, respondents are asked how many hours of their free time, in the last seven days, they spent watching television or a screen on any electronic device while sitting or lying down. The answers to these questions are important in understanding overall health because too much sedentary time can be associated with lack of physical exercise, poor nutrition and other health problems.
Sedentary behaviours (SBE) - Question identifier:SBE_R001
The next questions are about the time you spent sitting in the last 7 days.
Sedentary behaviours (SBE) - Question identifier:SBE_Q005
On a school or work day, how much of your free time did you spend watching television or a screen on any electronic device while sitting or lying down?
- 1: 2 hours or less per day
- 2: More than 2 hours but less than 4 hours
- 3: 4 hours to less than 6 hours
- 4: 6 hours to less than 8 hours
- 5: 8 hours or more per day
- 6: Was not at work or school
- 8: RF
- 9: DK
Sedentary behaviours (SBE) - Question identifier:SBE_Q010
On a day that was not a school or workday, how much of your free time did you spend watching television or a screen on any electronic device while sitting or lying down?
- 1: 2 hours or less per day
- 2: More than 2 hours but less than 4 hours
- 3: 4 hours to less than 6 hours
- 4: 6 hours to less than 8 hours
- 5: 8 hours or more per day
- 8: RF
- 9: DK
Maternal experiences (MEX)
Increasingly, health promotion programs are targeted at very young children. Researchers believe that children who have a good start in life become healthier teenagers and adults.
The focus of the next 3 modules is the behaviour of new mothers (aged 15 to 55) of babies under 6 years old.
The questions in the first module cover topics such as folic acid and iron supplements, weight gain, breastfeeding, sleeping arrangements for the child, and the child's diet.
The results of this module can be used to identify which groups of women could benefit from educational programs that promote healthier babies.
Maternal experiences (MEX) - Question identifier:MEX_R001
The next questions are specific to women's health.
Maternal experiences (MEX) - Question identifier:MEX_Q005
Are you taking a vitamin supplement containing folic acid?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q010
Have you given birth in the past 5 years?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q015
What is the name of your last born child?
Long Answer Length = 50
Maternal experiences (MEX) - Question identifier:MEX_Q020
What is [your last child]'s date of birth?
Min = 1; Max = 31
Maternal experiences (MEX) - Question identifier:MEX_Q025
What is [your last child]'s date of birth?
- 01: January
- 02: February
- 03: March
- 04: April
- 05: May
- 06: June
- 07: July
- 08: August
- 09: September
- 10: October
- 11: November
- 12: December
- 98: RF
- 99: DK
Maternal experiences (MEX) - Question identifier:MEX_Q030
What is [your last child]'s date of birth?
Min = 2010; Max = 2099
Maternal experiences (MEX) - Question identifier:MEX_R040
The next questions are about your maternal experiences related to [your last child].
Maternal experiences (MEX) - Question identifier:MEX_Q040
In the three months before you got pregnant with [your last child], did you take a folic acid supplement or a multivitamin containing folic acid?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q045
Did you take it every day or almost every day?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q050
During the first three months of your pregnancy (with [your last child]), did you take a folic acid supplement or a multivitamin containing folic acid?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q055
Did you take it every day or almost every day?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q060
Before your pregnancy (with [your last child]), were you aware that taking folic acid before becoming pregnant can help prevent some birth defects?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q065
During your pregnancy (with [your last child]), did you take a vitamin supplement containing iron?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q070
Just before your pregnancy (with [your last child]), how much did you weigh?
Min = 1; Max = 700
Maternal experiences (MEX) - Question identifier:MEX_N075
Was that in pounds or kilograms?
- 1: Pounds
- 2: Kilograms
Maternal experiences (MEX) - Question identifier:MEX_Q080
How much weight did you gain during that pregnancy?
Min = -50; Max = 199
Maternal experiences (MEX) - Question identifier:MEX_N085
Was that in pounds or kilograms?
- 1: Pounds
- 2: Kilograms
Maternal experiences (MEX) - Question identifier:MEX_Q090
[How often does [your last child]/When [your last child] was less than one year old, how often did he/she] sleep in the same bed with you or anyone else?
- 1: Every day or almost every day
- 2: Once or twice a week
- 3: A few times a month
- 4: Less than once a month
- 5: Never
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q095
What is the main reason [your last child] [is/was] sleeping in the same bed with you or someone else?
- 1: To breastfeed
- 2: So the baby would sleep / So I could get some sleep
- 3: Did not have room for a crib
- 4: Could not afford a crib
- 5: Believe that bedsharing was best for my child
- 6: Child was sick
- 7: Other
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q100
Was [your last child] breastfed or given breast milk even for a short time?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q105
What is the main reason that you did not breastfeed or give breast milk?
- 1: Bottle feeding is easier
- 2: Formula is as good as breast milk
- 3: Breastfeeding is unappealing
- 4: Medical condition - mother
- 5: Other - Specify
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q110
Are you still breastfeeding or giving breast milk to [your last child]?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q115
How long did you breastfeed or give breast milk to [your last child]?
Min = 1; Max = 365
Maternal experiences (MEX) - Question identifier:MEX_N115A
Was this time in days, weeks, months or years?
If respondent reports less than 1 year but with a fraction, round the amount up. For example, 3 and ½ months would become 4 months.
If the respondent reports more than a year, with half values, report in months. For example, 2 ½ years = 30 months.
- 1: Days
- 2: Weeks
- 3: Months
- 4: Years
Maternal experiences (MEX) - Question identifier:MEX_Q120
What is the main reason that you stopped breastfeeding or giving breast milk?
- 01: Not enough breast milk
- 02: Baby was ready for solid foods
- 03: Inconvenience / fatigue due to breastfeeding
- 04: Difficulty with breastfeeding (e.g., sore nipples, engorged breasts, mastitis)
- 05: Medical condition - mother
- 06: Medical condition - baby
- 07: Planned to stop at this time
- 08: Child weaned him / herself (e.g., baby refusing breast, lack of interest)
- 09: Returned to work / school
- 10: Other - Specify
- 98: RF
- 99: DK
Maternal experiences (MEX) - Question identifier:MEX_Q125
[Are you giving [your last child] a vitamin D supplement?/When [your last child] was less than a year old, did you give him/her a vitamin D supplement?/When [your last child] was less than one year old and fed breast milk, did you give him/her a vitamin D supplement?/When [your last child] was fed breast milk, did you give him/her a vitamin D supplement?]
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q130
[Now that [your last child] is more than a year old, are you still giving him/her a vitamin D supplement?/When [your last child] was older than one and fed breast milk, did you continue to give him/her a vitamin D supplement?]
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q140
Overall, how often [do/did] you give [your last child] a supplement containing vitamin D?
- 1: Every day
- 2: Almost every day
- 3: Once or twice a week
- 4: Less than once a week
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q150
[While you were still breastfeeding, had/Have] liquids such as milk, formula, water, juice, tea or herbal mixture been introduced to [your last child]'s feeds?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q155
How old was your last child when other liquids were first added to the feeds?
Min = 1; Max = 365
Maternal experiences (MEX) - Question identifier:MEX_N160
Was this time in days, weeks, months or years?
If respondent reports less than 1 year but with a fraction, round the amount up. For example, 3 and ½ months would become 4 months.
If the respondent reports more than a year, with half values, report in months. For example, 2 ½ years = 30 months.
- 1: Days
- 2: Weeks
- 3: Months
- 4: Years
Maternal experiences (MEX) - Question identifier:MEX_Q170
Have solid foods such as cereals, mashed up or pureed meat, vegetables or fruits been introduced to the baby's feeds?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q175
How old was [your last child] when solid foods (such as cereals, mashed up or pureed meat, vegetables or fruits) were first added to their feeds?
Min = 1; Max = 365
Maternal experiences (MEX) - Question identifier:MEX_N180
Was this time in days, weeks, months or years?
If respondent reports less than 1 year but with a fraction, round the amount up. For example, 3 and ½ months would become 4 months.
If the respondent reports more than a year, with half values, report in months. For example, 2 ½ years = 30 months.
- 1: Days
- 2: Weeks
- 3: Months
- 4: Years
Maternal experiences (MEX) - Question identifier:MEX_Q190
What was the first solid food added to ^BABYSNAME's feeds?
- 1: Infant cereals
- 2: Meat, fish or poultry
- 3: Meat alternatives (includes eggs, tofu, legumes, peas or lentils)
- 4: Fruits or vegetables
- 5: Other
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q195
What is the main reason [other liquids/solid foods/other liquids and solid foods] were first added to [your last child]'s feeds?
- 01: Not enough breast milk
- 02: [Baby was ready for solid foods]
- 03: Inconvenience / fatigue due to breastfeeding
- 04: Difficulty with breastfeeding (e.g., sore nipples, engorged breasts, mastitis)
- 05: Medical condition - mother
- 06: Medical condition - baby
- 07: Advice from health professional / family
- 08: Returned to work / school
- 09: Formula equally healthy for baby
- 10: Other - Specify
- 98: RF
- 99: DK
Smoking during maternal experience (MXS)
This module explores whether women smoked cigarettes before or during their pregnancy, and whether they were exposed on a regular basis to second-hand smoke during the pregnancy.
The results of this module can be used to identify which groups of women could benefit from educational programs that promote healthier babies.
Smoking during maternal experience (MXS) - Question identifier:MXS_Q005
In the three months before your pregnancy with ^DT_BABYSNAME, or before you realized you were pregnant, did you smoke cigarettes?
- 1: Everyday
- 2: Almost everyday
- 3: About 2 or 3 times a week
- 4: About once a week
- 5: Once or twice
- 6: Never
- 8: RF
- 9: DK
Smoking during maternal experience (MXS) - Question identifier:MXS_Q010
Once you found out you were pregnant (with ^DT_BABYSNAME), did you smoke?
- 1: Everyday
- 2: Almost everyday
- 3: About 2 or 3 times a week
- 4: About once a week
- 5: Once or twice
- 6: Never
- 8: RF
- 9: DK
Smoking during maternal experience (MXS) - Question identifier:MXS_Q015
During the last 3 months of your pregnancy (with ^DT_BABYSNAME), did you smoke?
- 1: Everyday
- 2: Almost everyday
- 3: About 2 or 3 times a week
- 4: About once a week
- 5: Once or twice
- 6: Never
- 8: RF
- 9: DK
Smoking during maternal experience (MXS) - Question identifier:MXS_Q020
Did anyone regularly smoke in your presence during your pregnancy with ^DT_BABYSNAME?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Alcohol use during maternal experience (MXA)
This module explores whether women drank alcohol before or during their pregnancy or while they were breastfeeding.
The results of this module can be used to identify which groups of women could benefit from educational programs that promote healthier babies.
Alcohol use during maternal experience (MXA) - Question identifier:MXA_Q005
In the three months before your pregnancy with ^DT_BABYSNAME, or before you realized you were pregnant, did you drink any alcohol?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Alcohol use during maternal experience (MXA) - Question identifier:MXA_Q010
How often did you drink?
- 1: Less than once per month
- 2: Once per month
- 3: 2 to 3 times per month
- 4: Once a week
- 5: 2 to 3 times per week
- 6: 4 to 6 times per week
- 7: Everyday
- 8: RF
- 9: DK
Alcohol use during maternal experience (MXA) - Question identifier:MXA_Q015
Once you found out you were pregnant with ^DT_BABYSNAME, did you drink any alcohol?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Alcohol use during maternal experience (MXA) - Question identifier:MXA_Q020
How often did you drink?
- 1: Less than once per month
- 2: Once per month
- 3: 2 to 3 times per month
- 4: Once a week
- 5: 2 to 3 times per week
- 6: 4 to 6 times per week
- 7: Everyday
- 8: RF
- 9: DK
Alcohol use during maternal experience (MXA) - Question identifier:MXA_Q025
During the last 3 months of your pregnancy (with ^DT_BABYSNAME), did you drink any alcohol?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Alcohol use during maternal experience (MXA) - Question identifier:MXA_Q030
How often did you drink?
- 1: Less than once per month
- 2: Once per month
- 3: 2 to 3 times per month
- 4: Once a week
- 5: 2 to 3 times per week
- 6: 4 to 6 times per week
- 7: Everyday
- 8: RF
- 9: DK
Alcohol use during maternal experience (MXA) - Question identifier:MXA_Q035
While you were breastfeeding (^DT_BABYSNAME), did you drink any alcohol?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Alcohol use during maternal experience (MXA) - Question identifier:MXA_Q040
How often did you drink?
- 1: Less than once per month
- 2: Once per month
- 3: 2 to 3 times per month
- 4: Once a week
- 5: 2 to 3 times per week
- 6: 4 to 6 times per week
- 7: Everyday
- 8: RF
- 9: DK
Driving and safety (DRV)
Understanding the safety behaviours of drivers and passengers is an essential part of reducing deaths and injuries caused by road accidents and collisions.
In this module, respondents who have driven in the past 12 months are asked about a number of topics, including their use of cell phones (with and without a hands-free device) while driving in a motor vehicle other than a motorcycle.
There are also other questions, such as tiredness while driving, the frequency of driving while under the influence of an illicit substance and the frequency of driving, or being a passenger in a vehicle, after the driver has been drinking. These questions relate to any vehicle.
The module also includes questions about helmet use for passengers or drivers of an ATV or snowmobile. There are also questions about the frequency of driving ATVs or snowmobiles while under the influence of an illicit substance, and the frequency of driving, or being a passenger, after the driver has been drinking.
Driving and safety (DRV) - Question identifier:DRV_R001
The next questions are about the use of a motor vehicle.
Driving and safety (DRV) - Question identifier:DRV_Q005
In the past 12 months, excluding motorcycles and off-road vehicles, have you driven a motor vehicle such as a car, truck or a van?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Driving and safety (DRV) - Question identifier:DRV_Q010
In the past 12 months, how often did you use a hands-free device such as Bluetooth when talking on the cell phone while driving a motor vehicle?
- 1: Often
- 2: Sometimes
- 3: Rarely
- 4: Never
- 5: Does not possess or have access to a cell phone
- 8: RF
- 9: DK
Driving and safety (DRV) - Question identifier:DRV_Q015
In the past 12 months, excluding hands-free use, how often did you talk on a cell phone while driving a motor vehicle?
- 1: Often
- 2: Sometimes
- 3: Rarely
- 4: Never
- 5: Does not possess or have access to a cell phone
- 8: RF
- 9: DK
Driving and safety (DRV) - Question identifier:DRV_Q020
In the past 12 months, how often did you text on a cell phone while driving a motor vehicle?
- 1: Often
- 2: Sometimes
- 3: Rarely
- 4: Never
- 5: Does not possess or have access to a cell phone
- 8: RF
- 9: DK
Driving and safety (DRV) - Question identifier:DRV_Q025
In the past 12 months, how often did you use a cell phone for any other reason while driving a motor vehicle, for example, to send or receive emails, use social media, look at maps, etc.?
- 1: Often
- 2: Sometimes
- 3: Rarely
- 4: Never
- 5: Does not possess or have access to a cell phone
- 8: RF
- 9: DK
Driving and safety (DRV) - Question identifier:DRV_Q030
In the past 12 months, have you driven a motorcycle?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Driving and safety (DRV) - Question identifier:DRV_Q035
In the past 12 months, how often did you [drive any vehicle] when you were feeling tired?
- 1: Often
- 2: Sometimes
- 3: Rarely
- 4: Never
- 8: RF
- 9: DK
Driving and safety (DRV) - Question identifier:DRV_R040
The next few questions are about substance use while driving. Please be assured that anything you say will remain confidential.
Driving and safety (DRV) - Question identifier:DRV_Q040
In the past 12 months, have you driven a motor vehicle after having 2 or more drinks in the hour before you drove?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Driving and safety (DRV) - Question identifier:DRV_Q045
How many times (in the past 12 months)?
Min = 1; Max = 95
Driving and safety (DRV) - Question identifier:DRV_Q050
In the past 12 months, have you driven a motor vehicle under the influence of an illicit substance such as marijuana or hashish?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Driving and safety (DRV) - Question identifier:DRV_Q055
How many times (in the past 12 months)?
Min = 1; Max = 95
Driving and safety (DRV) - Question identifier:DRV_R060
Now some questions about driving leisure vehicles and being a passenger in different vehicles.
Driving and safety (DRV) - Question identifier:DRV_Q060
In the past 12 months, have you been a passenger with a driver who had 2 or more drinks in the hour before driving?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Driving and safety (DRV) - Question identifier:DRV_Q065
How many times (in the past 12 months)?
Min = 1; Max = 95
Driving and safety (DRV) - Question identifier:DRV_Q070
In the past 12 months, have you been the driver of, or a passenger on, an ATV (all-terrain vehicle) or a snowmobile?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Driving and safety (DRV) - Question identifier:DRV_Q075
How often do you wear a helmet when on an ATV or a snowmobile?
- 1: Always
- 2: Most of the time
- 3: Rarely
- 4: Never
- 8: RF
- 9: DK
Driving and safety (DRV) - Question identifier:DRV_Q080
In the past 12 months, have you driven an ATV or snowmobile after having 2 or more drinks in the hour before you drove?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Driving and safety (DRV) - Question identifier:DRV_Q085
How many times (in the past 12 months)?
Min = 1; Max = 95
Driving and safety (DRV) - Question identifier:DRV_Q090
In the past 12 months, have you driven an ATV or snowmobile under the influence of an illicit substance such as marijuana or hashish?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Driving and safety (DRV) - Question identifier:DRV_Q095
How many times (in the past 12 months)?
Min = 1; Max = 95
Driving and safety (DRV) - Question identifier:DRV_Q100
In the past 12 months, have you been a passenger on an ATV or snowmobile with a driver who had 2 or more drinks in the hour before driving?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Driving and safety (DRV) - Question identifier:DRV_Q105
How many times (in the past 12 months)?
Min = 1; Max = 95
Flu shots (FLU)
Respondents are asked when they last had a flu shot, excluding the H1N1 shot. Respondents who have not had a shot in the past year are asked the reasons why they did not receive one.
Influenza is a serious illness for certain groups, including the elderly. For all groups, the flu is a major cause of days lost from work, school and other activities.
Results of this module will be used to identify groups of people who are less likely to have a flu shot. This information may be useful in planning and designing new programs to promote immunization.
Flu shots (FLU) - Question identifier:FLU_R001
Now a few questions about your use of various health care services.
Flu shots (FLU) - Question identifier:FLU_Q005
Have you ever had a seasonal flu shot, excluding the H1N1 flu shot?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Flu shots (FLU) - Question identifier:FLU_Q010
When did you have your last seasonal flu shot?
- 1: Less than 1 year ago
- 2: 1 year to less than 2 years ago
- 3: 2 years ago or more
- 8: RF
- 9: DK
Flu shots (FLU) - Question identifier:FLU_Q015
In which month did you have your last seasonal flu shot?
- 01: January
- 02: February
- 03: March
- 04: April
- 05: May
- 06: June
- 07: July
- 08: August
- 09: September
- 10: October
- 11: November
- 12: December
- 98: RF
- 99: DK
Flu shots (FLU) - Question identifier:FLU_Q020
Was that this year or last year?
- 1: This year
- 2: Last year
- 8: RF
- 9: DK
Flu shots (FLU) - Question identifier:FLU_Q025
What are the reasons that you have not had a seasonal flu shot in the past year?
- 01: Lack of time
- 02: Respondent - did not think it was necessary
- 03: Doctor - did not think it was necessary
- 04: Not available - at time required
- 05: Did not know where to go / uninformed
- 06: Feelings of fear or discomfort
- 07: Bad reaction to previous flu shot
- 08: Bad reaction to previous vaccine other than flu shot
- 09: Unsure of / does not believe in benefits of vaccine
- 10: Does not want vaccine for fear of what it contains
- 11: Other
- 98: RF
- 99: DK
Blood pressure check (BPC)
Heart disease is one of the leading causes of death in Canada. Regular blood pressure checks are an effective way of diagnosing hypertension, which is very strongly related to heart disease.
In this module, respondents are asked if they have had their blood pressure checked in the past 2 years and, if so, when, and if not, why not. As well, females aged 15 to 55 are asked if they were pregnant the last time their blood pressure was measured.
By looking at reasons why certain groups do not have their blood pressure checked as recommended, health region planners and others can develop promotional campaigns to remind people of the benefits.
Blood pressure check (BPC) - Question identifier:BPC_R001
Now, a few questions about blood pressure measurement.
Blood pressure check (BPC) - Question identifier:BPC_Q005
Have you ever had your blood pressure measured by a health professional?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Blood pressure check (BPC) - Question identifier:BPC_Q010
When was the last time you had your blood pressure measured (by a health professional)?
- 1: Less than 1 year to 1 year ago
- 2: More than 1 year to 2 years ago
- 3: More than 2 years to 3 years ago
- 4: More than 3 years to 5 years ago
- 5: More than 5 years ago
- 8: RF
- 9: DK
Blood pressure check (BPC) - Question identifier:BPC_Q015
What are the reasons that you have not had your blood pressure measured (by a health professional) in the past 2 years?
- 1: Lack of time
- 2: Respondent did not think it was necessary
- 3: Doctor did not think it was necessary
- 4: Feelings of fear or discomfort
- 5: Don't have a doctor
- 6: Other
- 8: RF
- 9: DK
Blood pressure check (BPC) - Question identifier:BPC_Q020
Were you pregnant the last time your blood pressure was measured (by a health professional)?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Pap smear test (PAP)
Cervical cancer is a leading type of cancer among Canadian women. Regular PAP smear tests are an effective way of detecting this cancer early enough for treatment to be effective.
In this module, female respondents aged 18 to 70 are asked if they have had a PAP smear test in the past 3 years and, if not, why not.
Pap smear test (PAP) - Question identifier:PAP_Q005
Have you ever had a PAP smear test?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Pap smear test (PAP) - Question identifier:PAP_Q010
When was the last time?
- 1: Less than 1 year to 1 year ago
- 2: More than 1 year to 2 years ago
- 3: More than 2 years to 3 years ago
- 4: More than 3 years to 5 years ago
- 5: More than 5 years ago
- 8: RF
- 9: DK
Pap smear test (PAP) - Question identifier:PAP_Q015
What are the reasons that you have not had a PAP smear test in the past 3 years?
- 1: Lack of time
- 2: Respondent did not think it was necessary
- 3: Doctor did not think it was necessary/ he never brought it up
- 4: Feelings of fear or discomfort
- 5: Don't have a doctor
- 6: [Had a complete hysterectomy]
- 7: Other
- 8: RF
- 9: DK
Pap smear test (PAP) - Question identifier:PAP_Q020
How often do you usually have this test?
- 1: It was the first time
- 2: More than once a year
- 3: Between once a year to less than every 3 years
- 4: Every 3 years
- 5: Less often than every 3 years
- 6: No fixed frequency
- 8: RF
- 9: DK
Mammography (MAM)
Mammography, or an x-ray of the breast, is an important tool for detecting breast cancer.
In this module, female respondents aged 40 to 74 are asked if they have ever had a mammography exam and, if so, when, and if not in the past 3 years, why not.
Mammography (MAM) - Question identifier:MAM_Q005
Have you ever had a mammogram, that is, a breast x-ray?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Mammography (MAM) - Question identifier:MAM_Q010
When was the last time?
- 1: Less than 1 year to 1 year ago
- 2: More than 1 year to 2 years ago
- 3: More than 2 years to 3 years ago
- 4: More than 3 years to 5 years ago
- 5: More than 5 years ago
- 8: RF
- 9: DK
Mammography (MAM) - Question identifier:MAM_Q015
What were the reasons for having this mammogram?
- 01: Family history of breast cancer
- 02: Part of regular check-up / routine screening
- 03: Age
- 04: Previously detected lump
- 05: Follow-up of breast cancer treatment
- 06: On hormone replacement therapy
- 07: Breast problem
- 08: Other
- 98: RF
- 99: DK
Mammography (MAM) - Question identifier:MAM_Q020
What are the reasons you have not had a [mammogram in the past 3 years/mammogram]?
- 1: Lack of time
- 2: Respondent did not think it was necessary
- 3: Doctor did not think it was necessary/ he never brought it up
- 4: Feelings of fear or discomfort
- 5: Don't have a doctor
- 6: Had a bilateral mastectomy (both breasts were removed)
- 7: Other
- 8: RF
- 9: DK
Mammography (MAM) - Question identifier:MAM_Q025
How often do you usually have this test?
- 1: It was the first time
- 2: More than once a year
- 3: Between once a year to less than every 3 years
- 4: Every 3 years
- 5: Less often than every 3 years
- 6: No fixed frequency
- 8: RF
- 9: DK
Prostate cancer screening (PSA)
This module includes questions about two common methods of screening for prostate cancer:
1. A PSA blood test involves taking a small sample of blood and testing the level of a specific chemical, prostate specific antigen. A high level indicates that the patient may have a higher than normal risk of prostate cancer and further tests are usually ordered.
2. A digital rectal exam involves a doctor inserting a gloved finger into the rectum to feel whether the prostate gland is enlarged.
Results from this module can be used to plan prostate cancer screening programs and to identify which groups of men might benefit the most from campaigns to raise awareness of the importance of early prostate cancer detection.
The questions are asked to male respondents aged 35 and older.
Prostate cancer screening (PSA) - Question identifier:PSA_R001
Now, a few questions related to prostate exams.
Prostate cancer screening (PSA) - Question identifier:PSA_Q005
Have you ever had a prostate specific antigen test for prostate cancer, that is, a PSA blood test?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Prostate cancer screening (PSA) - Question identifier:PSA_Q010
When was the last time?
- 1: Less than 1 year to 1 year ago
- 2: More than 1 year to 2 years ago
- 3: More than 2 years to 3 years ago
- 4: More than 3 years to 5 years ago
- 5: More than 5 years ago
- 8: RF
- 9: DK
Prostate cancer screening (PSA) - Question identifier:PSA_Q015
Why did you have it?
- 1: Family history of prostate cancer
- 2: Part of regular check-up / routine screening
- 3: Age
- 4: Race
- 5: Follow-up of problem
- 6: Follow-up of prostate cancer treatment
- 7: Other
- 8: RF
- 9: DK
Prostate cancer screening (PSA) - Question identifier:PSA_Q020
A Digital Rectal Exam is an exam in which a gloved finger is inserted into the rectum in order to feel the prostate gland.
Have you ever had this exam?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Prostate cancer screening (PSA) - Question identifier:PSA_Q025
When was the last time?
- 1: Less than 1 year to 1 year ago
- 2: More than 1 year to 2 years ago
- 3: More than 2 years to 3 years ago
- 4: More than 3 years to 5 years ago
- 5: More than 5 years ago
- 8: RF
- 9: DK
Colorectal cancer testing (CCT)
Colorectal cancer is one of the most common and serious types of cancer in Canada. In this module, respondents aged 40 to 74 are asked about three common methods of screening for colorectal cancer:
1. A fecal test, also called FOBT or FIT, which checks for blood in the stool.
2. A colonoscopy, which involves inserting a tube into the rectum to examine the entire colon in order to detect signs of cancer or other health problems.
3. A sigmoidoscopy, which is similar to the colonoscopy, but only examines the first section of the colon and requires less preparation. Results from this module can be used to plan colorectal cancer screening programs and to identify which groups might benefit the most from campaigns to raise awareness of the importance of early detection of colorectal cancer.
Colorectal cancer testing (CCT) - Question identifier:CCT_R001
Now a few questions about colorectal tests.
Colorectal cancer testing (CCT) - Question identifier:CCT_Q005
A fecal test is a test to check for blood in the stool, in which a stick is used to smear a small stool sample on a special card.
Have you ever had this test?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Colorectal cancer testing (CCT) - Question identifier:CCT_Q010
When was the last time?
- 1: 6 months ago or less
- 2: More than 6 months to 1 year ago
- 3: More than 1 year to 2 years ago
- 4: More than 2 years to 5 years ago
- 5: More than 5 years ago
- 8: RF
- 9: DK
Colorectal cancer testing (CCT) - Question identifier:CCT_Q015
What are the reasons you did not have a fecal test in the past 2 years?
- 01: Lack of time
- 02: No access to test (distance, clinic hours or cost)
- 03: Respondent did not think it was necessary
- 04: Doctor did not think it was necessary/ he never brought it up
- 05: Feelings of fear or discomfort
- 06: Don't have a doctor
- 07: Had a colonoscopy or sigmoidoscopy instead
- 08: Did not know it existed/it was a possibility
- 09: Other
- 98: RF
- 99: DK
Colorectal cancer testing (CCT) - Question identifier:CCT_Q020
How often do you usually have this test?
- 1: It was the first time
- 2: More than once a year
- 3: Every year
- 4: Every 2 years
- 5: Less than once every 2 years
- 6: No fixed frequency
- 8: RF
- 9: DK
Colorectal cancer testing (CCT) - Question identifier:CCT_R025
A sigmoidoscopy and a colonoscopy are two tests in which a tube is inserted into the rectum in order to detect signs of cancer or other health problems.
A colonoscopy examines the entire colon, while a sigmoidoscopy only examines the first section of the colon. The sigmoidoscopy requires less preparation.
Colorectal cancer testing (CCT) - Question identifier:CCT_Q025
Have you ever had either one of these tests?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Colorectal cancer testing (CCT) - Question identifier:CCT_Q030
What are the reasons you have not had these tests?
- 01: Lack of time
- 02: No access to test (distance, clinic hours or cost)
- 03: Respondent did not think it was necessary
- 04: Doctor did not think it was necessary/ he never brought it up
- 05: Feelings of fear or discomfort
- 06: Don't have a doctor
- 07: Had a fecal test instead
- 08: Did not know it existed/it was a possibility
- 09: Other
- 98: RF
- 99: DK
Colorectal cancer testing (CCT) - Question identifier:CCT_Q035
Which of these tests have you had, a colonoscopy, a sigmoidoscopy or both?
- 1: Colonoscopy
- 2: Sigmoidoscopy
- 3: Both
- 8: RF
- 9: DK
Colorectal cancer testing (CCT) - Question identifier:CCT_Q040
When was the last time you had a sigmoidoscopy?
- 1: 1 year ago or less
- 2: More than 1 year to 2 years ago
- 3: More than 2 years to 5 years ago
- 4: More than 5 years to 10 years ago
- 5: More than 10 years ago
- 8: RF
- 9: DK
Colorectal cancer testing (CCT) - Question identifier:CCT_Q045
What are the reasons you have not had this test in the past 10 years?
- 01: Lack of time
- 02: No access to test (distance, clinic hours or cost)
- 03: Respondent did not think it was necessary
- 04: Doctor did not think it was necessary/ he never brought it up
- 05: Feelings of fear or discomfort
- 06: Don't have a doctor
- 07: Had a different colorectal test instead
- 08: Did not know it existed/it was a possibility
- 09: Other
- 98: RF
- 99: DK
Colorectal cancer testing (CCT) - Question identifier:CCT_Q050
How often do you usually have this test?
- 1: It was the first time
- 2: More than once every 5 years
- 3: Every 5 years
- 4: Less than once every 5 years
- 5: No fixed frequency
- 8: RF
- 9: DK
Colorectal cancer testing (CCT) - Question identifier:CCT_Q055
When was the last time you had a colonoscopy?
- 1: 1 year ago or less
- 2: More than 1 year to 2 years ago
- 3: More than 2 years to 5 years ago
- 4: More than 5 years to 10 years ago
- 5: More than 10 years ago
- 8: RF
- 9: DK
Colorectal cancer testing (CCT) - Question identifier:CCT_Q065
What are the reasons you have not had this test in the past 10 years?
- 01: Lack of time
- 02: No access to test (distance, clinic hours or cost)
- 03: Respondent did not think it was necessary
- 04: Doctor did not think it was necessary/ he never brought it up
- 05: Feelings of fear or discomfort
- 06: Don't have a doctor
- 07: Had a different colorectal test instead
- 08: Did not know it existed/it was a possibility
- 09: Other
- 98: RF
- 99: DK
Colorectal cancer testing (CCT) - Question identifier:CCT_Q070
How often do you usually have this test?
- 1: It was the first time
- 2: More than once every 10 years
- 3: Every 10 years
- 4: Less than once every 10 years
- 5: No fixed frequency
- 8: RF
- 9: DK
Colorectal cancer testing (CCT) - Question identifier:CCT_Q075
Was the colonoscopy or sigmoidoscopy a follow-up of the results of a fecal test?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Colorectal cancer testing (CCT) - Question identifier:CCT_Q080
Were you prescribed [a colonoscopy/a sigmoidoscopy/one of these tests] because of a family history, an inflammatory bowel disease, a colorectal cancer follow-up or other symptoms?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Diabetes care (DIA)
In this module, respondents who have diabetes (non gestational) are asked about various aspects of the care of their diabetes.
They are asked about:
· tests or examinations done by health professionals, such as a haemoglobin "A-one-C" test, a check of the feet, a urine test, an eye examination and nutrition therapy
· tests or examinations done by themselves or other nonprofessionals, such as a glucose check and a check of the feet
· medications they may be taking.
Diabetes is a growing health problem in Canada. Answers to these questions can be used to study the care that people in Canada are getting to help manage their diabetes.
Diabetes care (DIA) - Question identifier:DIA_R001
You reported earlier that you have diabetes. The following questions are about diabetes care.
Diabetes care (DIA) - Question identifier:DIA_Q005
In the past 12 months, has a health care professional tested you for haemoglobin "A-one-C"? (An "A-one-C" haemoglobin test measures the average level of blood sugar over a 3-month period.)
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Diabetes care (DIA) - Question identifier:DIA_Q010
How many times? (In the past 12 months, has a health care professional tested you for haemoglobin "A-one-C"?)
Min = 1; Max = 99
Diabetes care (DIA) - Question identifier:DIA_Q015
In the past 12 months, has a health care professional checked your feet for any sores or irritations?
- 1: Yes
- 2: No
- 3: No feet
- 8: RF
- 9: DK
Diabetes care (DIA) - Question identifier:DIA_Q020
How many times? (In the past 12 months, has a health care professional checked your feet for any sores or irritations?)
Min = 1; Max = 99
Diabetes care (DIA) - Question identifier:DIA_Q025
In the past 12 months, has a health care professional tested your urine for protein (i.e., Microalbumin)?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Diabetes care (DIA) - Question identifier:DIA_Q030
Have you ever had an eye exam where the pupils of your eyes were dilated? (This procedure would have made you temporarily sensitive to light.)
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Diabetes care (DIA) - Question identifier:DIA_Q035
When was the last time?
- 1: Less than 1 year ago
- 2: 1 year to less than 2 years ago
- 3: 2 or more years ago
- 8: RF
- 9: DK
Diabetes care (DIA) - Question identifier:DIA_Q040
In the past 12 months, has a dietitian provided you with nutrition therapy adapted for people with diabetes? Please exclude advice received by a nurse.
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Diabetes care (DIA) - Question identifier:DIA_R045
Now, some questions about diabetes care not provided by a health care professional.
Diabetes care (DIA) - Question identifier:DIA_Q045
How often do you usually have your blood checked for glucose or sugar by yourself or by a family member or friend?
Min = 0; Max = 365
Diabetes care (DIA) - Question identifier:DIA_N045A
Select the reporting period.
- 1: Per day
- 2: Per week
- 3: Per month
- 4: Per year
Diabetes care (DIA) - Question identifier:DIA_Q050
How often do you usually have your feet checked for any sores or irritations by yourself or by a family member or friend?
Min = 0; Max = 365
Diabetes care (DIA) - Question identifier:DIA_N050A
Select the reporting period.
- 1: Per day
- 2: Per week
- 3: Per month
- 4: Per year
Diabetes care (DIA) - Question identifier:DIA_R055
Now, a few questions about medication.
Diabetes care (DIA) - Question identifier:DIA_Q055
In the past month, have you taken any medicine for high blood pressure?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Diabetes care (DIA) - Question identifier:DIA_Q060
In the past month, have you taken any medicine for high blood cholesterol or lipids?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Consultations about mental health (CMH)
This module deals with the number of times in the past 12 months that the respondents have consulted with mental health professionals to discuss their emotional or mental health, and which professionals they saw or talked to.
The results will help planners to understand how existing mental health services are being used and to target new services to the groups that need them the most.
Consultations about mental health (CMH) - Question identifier:CMH_R001
Now I would like to ask you some questions about mental and emotional well-being.
Consultations about mental health (CMH) - Question identifier:CMH_Q005
In the past 12 months, that is, from [CURRENTDATE - 1] to yesterday, have you seen or talked to a health professional about your emotional or mental health?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Consultations about mental health (CMH) - Question identifier:CMH_Q010
How many times (in the past 12 months)?
Min = 1; Max = 366
Consultations about mental health (CMH) - Question identifier:CMH_Q015
Whom did you see or talk to?
- 1: Family doctor or general practitioner
- 2: Psychiatrist
- 3: Psychologist
- 4: Nurse
- 5: Social worker or counsellor
- 6: Other - Specify
- 8: RF
- 9: DK
Satisfaction with life (SWL)
This module includes questions about the respondent's level of satisfaction with various aspects of their life, including their job, their experiences, their financial situation, themselves, their relationships, their housing and their neighbourhood.
Researchers are interested in the connection between satisfaction with life and overall physical and mental health and well-being.
Satisfaction with life (SWL) - Question identifier:SWL_R001
Now, I'd like to ask about your satisfaction with various aspects of your life. For each question, please tell me whether you are very satisfied, satisfied, neither satisfied nor dissatisfied, dissatisfied or very dissatisfied.
Satisfaction with life (SWL) - Question identifier:SWL_Q005
How satisfied are you with your job or main activity?
- 1: Very satisfied
- 2: Satisfied
- 3: Neither satisfied nor dissatisfied
- 4: Dissatisfied
- 5: Very dissatisfied
- 8: RF
- 9: DK
Satisfaction with life (SWL) - Question identifier:SWL_Q010
How satisfied are you with your leisure activities?
- 1: Very satisfied
- 2: Satisfied
- 3: Neither satisfied nor dissatisfied
- 4: Dissatisfied
- 5: Very dissatisfied
- 8: RF
- 9: DK
Satisfaction with life (SWL) - Question identifier:SWL_Q015
How satisfied are you with your financial situation?
- 1: Very satisfied
- 2: Satisfied
- 3: Neither satisfied nor dissatisfied
- 4: Dissatisfied
- 5: Very dissatisfied
- 8: RF
- 9: DK
Satisfaction with life (SWL) - Question identifier:SWL_Q020
How satisfied are you with yourself?
- 1: Very satisfied
- 2: Satisfied
- 3: Neither satisfied nor dissatisfied
- 4: Dissatisfied
- 5: Very dissatisfied
- 8: RF
- 9: DK
Satisfaction with life (SWL) - Question identifier:SWL_Q025
How satisfied are you with the way your body looks?
- 1: Very satisfied
- 2: Satisfied
- 3: Neither satisfied nor dissatisfied
- 4: Dissatisfied
- 5: Very dissatisfied
- 8: RF
- 9: DK
Satisfaction with life (SWL) - Question identifier:SWL_Q030
How satisfied are you with your relationships with family members?
- 1: Very satisfied
- 2: Satisfied
- 3: Neither satisfied nor dissatisfied
- 4: Dissatisfied
- 5: Very dissatisfied
- 8: RF
- 9: DK
Satisfaction with life (SWL) - Question identifier:SWL_Q035
How satisfied are you with your relationships with friends?
- 1: Very satisfied
- 2: Satisfied
- 3: Neither satisfied nor dissatisfied
- 4: Dissatisfied
- 5: Very dissatisfied
- 8: RF
- 9: DK
Satisfaction with life (SWL) - Question identifier:SWL_Q040
How satisfied are you with your housing?
- 1: Very satisfied
- 2: Satisfied
- 3: Neither satisfied nor dissatisfied
- 4: Dissatisfied
- 5: Very dissatisfied
- 8: RF
- 9: DK
Satisfaction with life (SWL) - Question identifier:SWL_Q045
How satisfied are you with your neighbourhood?
- 1: Very satisfied
- 2: Satisfied
- 3: Neither satisfied nor dissatisfied
- 4: Dissatisfied
- 5: Very dissatisfied
- 8: RF
- 9: DK
Distress (DIS)
The items and scoring used to derive the distress score are based on the work of Kessler and Mroczek (2002). The index is based on a subset of items from the Composite International Diagnostic Interview (CIDI). The CIDI is a structure diagnostic instrument that was designed to produce diagnoses according to the definition and criteria of both DSM-III-R and the Diagnostic criteria for Research of the ICD-10.
This module explores how often the respondent has experienced a range of feelings in the past month, including tiredness, nervousness, hopelessness, worthlessness, feeling restless or fidgety, feeling sad or depressed, and feeling that everything is an effort.
Respondents are also asked to compare their feelings of distress from their usual feelings, and to rate how much their feelings of distress interfered with their lives in the past month.
The answers to all the questions are combined to create an overall measure of the respondent's level of distress.
Distress is an important part of overall mental well-being. Feelings of distress can interfere with many aspects of life, including physical and emotional health.
Distress (DIS) - Question identifier:DIS_R001
The following questions deal with feelings you may have had during the past month.
Distress (DIS) - Question identifier:DIS_Q005
During the past month, that is, from [CURRENTDATE-1] to yesterday, about how often did you feel:
tired out for no good reason?
- 1: All of the time
- 2: Most of the time
- 3: Some of the time
- 4: A little of the time
- 5: None of the time
- 8: RF
- 9: DK
Distress (DIS) - Question identifier:DIS_Q010
During the past month, that is, from [CURRENTDATE-1] to yesterday, about how often did you feel:
nervous?
- 1: All of the time
- 2: Most of the time
- 3: Some of the time
- 4: A little of the time
- 5: None of the time
- 8: RF
- 9: DK
Distress (DIS) - Question identifier:DIS_Q015
During the past month, that is, from [CURRENTDATE-1] to yesterday, about how often did you feel:
so nervous that nothing could calm you down?
- 1: All of the time
- 2: Most of the time
- 3: Some of the time
- 4: A little of the time
- 5: None of the time
- 8: RF
- 9: DK
Distress (DIS) - Question identifier:DIS_Q020
During the past month, that is, from [CURRENTDATE-1] to yesterday, about how often did you feel:
hopeless?
- 1: All of the time
- 2: Most of the time
- 3: Some of the time
- 4: A little of the time
- 5: None of the time
- 8: RF
- 9: DK
Distress (DIS) - Question identifier:DIS_Q025
During the past month, that is, from [CURRENTDATE-1] to yesterday, about how often did you feel:
restless or fidgety?
- 1: All of the time
- 2: Most of the time
- 3: Some of the time
- 4: A little of the time
- 5: None of the time
- 8: RF
- 9: DK
Distress (DIS) - Question identifier:DIS_Q030
During the past month, that is, from [CURRENTDATE-1] to yesterday, about how often did you feel:
so restless you could not sit still?
- 1: All of the time
- 2: Most of the time
- 3: Some of the time
- 4: A little of the time
- 5: None of the time
- 8: RF
- 9: DK
Distress (DIS) - Question identifier:DIS_Q035
During the past month, that is, from [CURRENTDATE-1] to yesterday, about how often did you feel:
sad or depressed?
- 1: All of the time
- 2: Most of the time
- 3: Some of the time
- 4: A little of the time
- 5: None of the time
- 8: RF
- 9: DK
Distress (DIS) - Question identifier:DIS_Q040
During the past month, that is, from [CURRENTDATE-1] to yesterday, about how often did you feel:
so depressed that nothing could cheer you up?
- 1: All of the time
- 2: Most of the time
- 3: Some of the time
- 4: A little of the time
- 5: None of the time
- 8: RF
- 9: DK
Distress (DIS) - Question identifier:DIS_Q045
During the past month, that is, from [CURRENTDATE-1] to yesterday, about how often did you feel:
that everything was an effort?
- 1: All of the time
- 2: Most of the time
- 3: Some of the time
- 4: A little of the time
- 5: None of the time
- 8: RF
- 9: DK
Distress (DIS) - Question identifier:DIS_Q050
During the past month, that is, from [CURRENTDATE-1] to yesterday, about how often did you feel:
worthless?
- 1: All of the time
- 2: Most of the time
- 3: Some of the time
- 4: A little of the time
- 5: None of the time
- 8: RF
- 9: DK
Distress (DIS) - Question identifier:DIS_Q055
We just talked about feelings that occurred to different degrees during the past month. Putting them all together, did these feelings occur more often in the past month than is usual for you, less often than usual or about the same as usual?
- 1: More often
- 2: Less often
- 3: About the same
- 4: Never have had any
- 8: RF
- 9: DK
Distress (DIS) - Question identifier:DIS_Q060
Is that a lot more, somewhat more or only a little more often than usual?
- 1: A lot
- 2: Somewhat
- 3: A little
- 8: RF
- 9: DK
Distress (DIS) - Question identifier:DIS_Q065
Is that a lot less, somewhat less or only a little less often than usual?
- 1: A lot
- 2: Somewhat
- 3: A little
- 8: RF
- 9: DK
Distress (DIS) - Question identifier:DIS_Q070
During the past month, how much did these feelings usually interfere with your life or activities?
- 1: A lot
- 2: Some
- 3: A little
- 4: Not at all
- 8: RF
- 9: DK
Depression (DEP)
Many people feel depressed at one time or another, to varying degrees. However, long-lasting depression is a serious mental and physical health concern.
This module consists of a series of detailed questions about depression. The answers will be combined to determine how likely it is that the respondent is depressed.
This module gathers information on the length, timing and consequences of depressive episodes.
Depression (DEP) - Question identifier:DEP_R001
The following questions deal with problems you may have had during the last two weeks.
Depression (DEP) - Question identifier:DEP_Q005
Over the last two weeks, how often have you:
had little interest or pleasure in doing things?
- 1: Not at all
- 2: Several days
- 3: More than half the days
- 4: Nearly every day
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q010
Over the last two weeks, how often have you:
felt down, depressed, or hopeless?
- 1: Not at all
- 2: Several days
- 3: More than half the days
- 4: Nearly every day
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q015
Over the last two weeks, how often have you:
had trouble falling or staying asleep, or sleeping too much?
- 1: Not at all
- 2: Several days
- 3: More than half the days
- 4: Nearly every day
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q020
Over the last two weeks, how often have you:
felt tired or had little energy?
- 1: Not at all
- 2: Several days
- 3: More than half the days
- 4: Nearly every day
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q025
Over the last two weeks, how often have you:
had poor appetite or overate?
- 1: Not at all
- 2: Several days
- 3: More than half the days
- 4: Nearly every day
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q030
Over the last two weeks, how often have you:
felt bad about yourself, or that you are a failure or have let yourself or your family down?
- 1: Not at all
- 2: Several days
- 3: More than half the days
- 4: Nearly every day
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q035
Over the last two weeks, how often have you:
had trouble concentrating on things, such as reading the newspaper or watching television?
- 1: Not at all
- 2: Several days
- 3: More than half the days
- 4: Nearly every day
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q040
Over the last two weeks, how often have you:
been moving or speaking so slowly that other people could have noticed? Or the opposite, being so fidgety or restless that you have been moving around a lot more than usual?
- 1: Not at all
- 2: Several days
- 3: More than half the days
- 4: Nearly every day
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q045
Over the last two weeks, how often have you:
had thoughts that you would be better off dead, or of hurting yourself?
- 1: Not at all
- 2: Several days
- 3: More than half the days
- 4: Nearly every day
- 8: RF
- 9: DK
Depression (DEP) - Question identifier:DEP_Q050
How difficult have these problems made it for you to do your work, take care of things at home, or get along with other people?
- 1: Not difficult at all
- 2: Somewhat difficult
- 3: Very difficult
- 4: Extremely difficult
- 8: RF
- 9: DK
Sources of stress (STS)
The relationship between stress and health is complicated. For example, stress may be the cause of certain health problems and the effect of others.
Health planners will be able to use the results of this module to identify the most common sources of stress and develop programs that promote healthy ways of dealing with stress.
This module covers a range of issues related to stress, including the ability to deal with unexpected and difficult problems, the ability to deal with everyday demands, and the main source of day-to-day stress.
Sources of stress (STS) - Question identifier:STS_R001
Now a few questions about the stress in your life.
Sources of stress (STS) - Question identifier:STS_Q005
In general, how would you rate your ability to handle unexpected and difficult problems, for example, a family or personal crisis? Would you say your ability is...?
- 1: Excellent
- 2: Good
- 3: Fair
- 4: Poor
- 8: RF
- 9: DK
Sources of stress (STS) - Question identifier:STS_Q010
In general, how would you rate your ability to handle the day-to-day demands in your life, for example, handling work, family and volunteer responsibilities? Would you say your ability is...?
- 1: Excellent
- 2: Good
- 3: Fair
- 4: Poor
- 8: RF
- 9: DK
Sources of stress (STS) - Question identifier:STS_Q015
Thinking about stress in your day-to-day life, what would you say is the most important thing contributing to feelings of stress you may have?
- 01: Work
- 02: Financial concerns
- 03: Family
- 04: School work
- 05: Time pressures / not enough time
- 06: Health
- 07: Other - Specify
- 08: None
- 98: RF
- 99: DK
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 attachment, social integration, reassurance of worth, reliable alliance, and guidance.
Social provisions (SPS) - Question identifier:SPS_R001
The next questions are about your current relationships with friends, family members, co-workers, community members, and so on. Please indicate to what extent each statement describes your current relationships with other people.
Social provisions (SPS) - Question identifier:SPS_Q005
There are people I can depend on to help me if I really need it.
- 1: Strongly agree
- 2: Agree
- 3: Disagree
- 4: Strongly disagree
- 8: RF
- 9: DK
Social provisions (SPS) - Question identifier:SPS_Q010
There are people who enjoy the same social activities I do.
- 1: Strongly agree
- 2: Agree
- 3: Disagree
- 4: Strongly disagree
- 8: RF
- 9: DK
Social provisions (SPS) - Question identifier:SPS_Q015
I have close relationships that provide me with a sense of emotional security and wellbeing.
- 1: Strongly agree
- 2: Agree
- 3: Disagree
- 4: Strongly disagree
- 8: RF
- 9: DK
Social provisions (SPS) - Question identifier:SPS_Q020
There is someone I could talk to about important decisions in my life.
- 1: Strongly agree
- 2: Agree
- 3: Disagree
- 4: Strongly disagree
- 8: RF
- 9: DK
Social provisions (SPS) - Question identifier:SPS_Q025
I have relationships where my competence and skill are recognized.
- 1: Strongly agree
- 2: Agree
- 3: Disagree
- 4: Strongly disagree
- 8: RF
- 9: DK
Social provisions (SPS) - Question identifier:SPS_Q030
There is a trustworthy person I could turn to for advice if I were having problems.
- 1: Strongly agree
- 2: Agree
- 3: Disagree
- 4: Strongly disagree
- 8: RF
- 9: DK
Social provisions (SPS) - Question identifier:SPS_Q035
I feel part of a group of people who share my attitudes and beliefs.
- 1: Strongly agree
- 2: Agree
- 3: Disagree
- 4: Strongly disagree
- 8: RF
- 9: DK
Social provisions (SPS) - Question identifier:SPS_Q040
I feel a strong emotional bond with at least one other person.
- 1: Strongly agree
- 2: Agree
- 3: Disagree
- 4: Strongly disagree
- 8: RF
- 9: DK
Social provisions (SPS) - Question identifier:SPS_Q045
There are people who admire my talents and abilities.
- 1: Strongly agree
- 2: Agree
- 3: Disagree
- 4: Strongly disagree
- 8: RF
- 9: DK
Social provisions (SPS) - Question identifier:SPS_Q050
There are people I can count on in an emergency.
- 1: Strongly agree
- 2: Agree
- 3: Disagree
- 4: Strongly disagree
- 8: RF
- 9: DK
Primary health care (PHC)
Primary health care is often the first point of entry into the Canadian health care system. It incorporates diagnosis, treatment and management of health problems.
This module covers a number of topics related to the use of primary health care, including whether the respondent has a usual place to go for immediate care for minor health problems, whether the respondent has a regular health care provider, language spoken during appointments, and the types of health care professionals that are involved in the care of the respondent.
This module has a number of uses for governments, health care planners and researchers. For example, results could be used to compare how different groups-such as men and women, young and old, urban and rural-use health services. It will also track the change over time as to where Canadians go to and whom they chose to see when they need care.
Primary health care (PHC) - Question identifier:PHC_R001
Now I'd like to ask about your primary health care. It is often the first point of entry to the Canadian health system. It incorporates diagnosis, treatment and management of health problems.
Primary health care (PHC) - Question identifier:PHC_Q005
Is there a place that you usually go to when you need immediate care for a minor health problem?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Primary health care (PHC) - Question identifier:PHC_Q010
What kind of place is it?
- 1: A doctor's office
- 2: A hospital outpatient clinic
- 3: A community health centre [or CLSC]
- 4: A walk-in clinic
- 5: A hospital emergency room
- 6: Some other place
- 8: RF
- 9: DK
Primary health care (PHC) - Question identifier:PHC_Q015
Is this...?
- 1: An office with one doctor working in a solo practice
- 2: An office with several health care professionals working together as a team, that may include a dietician, nurse, social worker or psychologist
- 3: An office with several doctors working independently of each other, who may share one or more nurses
- 4: Other
- 8: RF
- 9: DK
Primary health care (PHC) - Question identifier:PHC_Q020
Do you have a regular health care provider? By this, we mean one health professional that you regularly see or talk to when you need care or advice for your health.
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Primary health care (PHC) - Question identifier:PHC_Q025
What are the reasons why you do not have a regular health care provider?
- 1: Do not need one in particular, but you have a usual place of care
- 2: No one available in the area
- 3: No one in the area is taking new patients
- 4: [You] have not tried to find one
- 5: Had one who left or retired
- 6: Other
- 8: RF
- 9: DK
Primary health care (PHC) - Question identifier:PHC_Q030
Is that regular health care provider a...?
- 1: Family doctor or general practitioner
- 2: Medical specialist such as a cardiologist or a pediatrician
- 3: Nurse practitioner
- 4: Other
- 8: RF
- 9: DK
Primary health care (PHC) - Question identifier:PHC_Q035
When you need immediate care for a minor health problem, how long do you usually have to wait before you can have an appointment with this [family physician/specialist/nurse practitioner/regular health care provider, or another care provider from the same office?]
- 1: On the same day
- 2: The next day
- 3: In 2 to 3 days
- 4: In 4 to 6 days
- 5: In 1 to 2 weeks
- 6: Between 2 weeks and one month
- 7: One month or more
- 8: RF
- 9: DK
Primary health care (PHC) - Question identifier:PHC_Q040
Do you usually speak in English, in French or in another language with this [family physician/specialist/nurse practitioner/regular health care provider]?
- 1: English
- 2: French
- 3: English and French
- 4: English and another language
- 5: French and another language
- 6: Another language
- 8: RF
- 9: DK
Primary health care (PHC) - Question identifier:PHC_Q045
Is there one or more nurses working with your [family physician/specialist/nurse practitioner/regular health care provider] who are regularly involved in your health care?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Primary health care (PHC) - Question identifier:PHC_Q050
Other than doctors and nurses, are there other health professionals like nutritionists working in the same office where you get your regular health care?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Primary health care (PHC) - Question identifier:PHC_Q055
Other than from your [family physician/specialist/nurse practitioner/regular health care provider], who do you receive regular health care from?
- 01: Another family doctor or general practitioner
- 02: Specialist doctor
- 03: Nurse / Nurse practitioner
- 04: Chiropractor
- 05: Registered dietician
- 06: Pharmacist
- 07: Physiotherapist
- 08: Psychologist / Mental Health Professional
- 09: Social Worker
- 10: Other
- 11: None
- 98: RF
- 99: DK
Primary health care (PHC) - Question identifier:PHC_Q060
In general, how would you rate the level of coordination between your [family physician/specialist/nurse practitioner/regular health care provider] and other health professionals who provide you with regular care? Would you say the coordination is...?
- 1: Excellent
- 2: Very good
- 3: Good
- 4: Fair
- 5: Poor
- 6: Not applicable
- 8: RF
- 9: DK
Medical doctor attachment (MDA)
This module provides information on the level of attachment of Canadians to their doctor. If they have a family doctor or general practitioner (GP), it asks about the length of time they have had their doctor. If they don't have a doctor, it asks if they are looking for one.
If they have a 'usual place of care' where there is more than one doctor, it asks about the number of doctors they can see, and how often they are taken care of by the same doctor.
The data collected will enable researchers to get a sense of whether Canadians are followed-up by a regular doctor.
Medical doctor attachment (MDA) - Question identifier:MDA_Q005
How long have you had your family doctor or general practitioner for?
- 1: Less than 6 months
- 2: 6 months to less than 1 year
- 3: 1 year to less than 2 years
- 4: 2 years or more
- 8: RF
- 9: DK
Medical doctor attachment (MDA) - Question identifier:MDA_Q010
Are you currently looking for a family doctor or general practitioner?
- 1: Yes
- 2: No
- 3: Not applicable; [I already have one]
- 8: RF
- 9: DK
Medical doctor attachment (MDA) - Question identifier:MDA_Q015
Earlier you said that you have a usual place to go when you need care for a minor health problem. In this place, is there more than one medical doctor who you can see?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Medical doctor attachment (MDA) - Question identifier:MDA_Q020
When you go to that usual place, how often are you taken care of by the same medical doctor?
- 1: Always
- 2: Often
- 3: Sometimes
- 4: Rarely
- 5: Never
- 6: Not applicable
- 8: RF
- 9: DK
Contacts with health professionals - extended block (CP2)
The objective of this module is to gather information on the place and frequency of contact with various health professionals during the past 12 months for physical, emotional or mental health.
Questions pertain to the following health professionals:
chiropractor, physiotherapist, psychologist, social worker/counsellor, audiologist/speech or occupational therapist, dietician/nutritionist, and pharmacist.
Contacts with health professionals - extended block (CP2) - Question identifier:CP2_Q005
[Not counting when you were an overnight patient, in the past 12 months/In the past 12 months], have you seen or talked to any of the following health professionals about your physical, emotional or mental health:
a chiropractor?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Contacts with health professionals - extended block (CP2) - Question identifier:CP2_Q010
How many times (in the past 12 months)?
Min = 1; Max = 366
Contacts with health professionals - extended block (CP2) - Question identifier:CP2_Q015
[Not counting when you were an overnight patient, in the past 12 months/In the past 12 months], have you seen or talked to
a physiotherapist?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Contacts with health professionals - extended block (CP2) - Question identifier:CP2_Q020
How many times (in the past 12 months)?
Min = 1; Max = 366
Contacts with health professionals - extended block (CP2) - Question identifier:CP2_Q025
[Not counting when you were an overnight patient, in the past 12 months/In the past 12 months], have you seen or talked to
a psychologist (about your physical, emotional or mental health)?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Contacts with health professionals - extended block (CP2) - Question identifier:CP2_Q030
How many times (in the past 12 months)?
Min = 1; Max = 366
Contacts with health professionals - extended block (CP2) - Question identifier:CP2_Q035
[Not counting when you were an overnight patient, in the past 12 months/In the past 12 months], have you seen or talked to:
a social worker or counsellor?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Contacts with health professionals - extended block (CP2) - Question identifier:CP2_Q040
How many times (in the past 12 months)?
Min = 1; Max = 366
Contacts with health professionals - extended block (CP2) - Question identifier:CP2_Q045
[Not counting when you were an overnight patient, in the past 12 months/In the past 12 months], have you seen or talked to
an audiologist, a speech or occupational therapist?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Contacts with health professionals - extended block (CP2) - Question identifier:CP2_Q050
How many times (in the past 12 months)?
Min = 1; Max = 200
Contacts with health professionals - extended block (CP2) - Question identifier:CP2_Q055
[Not counting when you were an overnight patient, in the past 12 months/In the past 12 months], have you seen or talked to
a dietician or nutritionist?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Contacts with health professionals - extended block (CP2) - Question identifier:CP2_Q060
How many times (in the past 12 months)?
Min = 1; Max = 366
Contacts with health professionals - extended block (CP2) - Question identifier:CP2_Q065
[Not counting when you were an overnight patient, in the past 12 months/In the past 12 months], have you consulted with or sought advice from a pharmacist?
Include both face to face and telephone contacts.
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Contacts with health professionals - extended block (CP2) - Question identifier:CP2_Q070
How many times (in the past 12 months)?
Min = 1; Max = 366
Patient satisfaction - community-based care (PSC)
This module assesses whether respondents received any community-based health care services in the past 12 months (outside of a hospital or doctor's office), and includes their rating of the quality and satisfaction with the care received.
Examples of community-based health care services are: home nursing care, home-based counselling or therapy, personal care and community walk-in clinics.
Patient satisfaction - community-based care (PSC) - Question identifier:PSC_R001
The next questions are about community-based health care which include other health care services received outside of a hospital or doctor's office.
Examples are: home nursing care, home-based counselling or therapy, personal care and community health clinics.
Patient satisfaction - community-based care (PSC) - Question identifier:PSC_Q005
In the past 12 months, have you received any community-based care?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Patient satisfaction - community-based care (PSC) - Question identifier:PSC_Q010
Overall, how would you rate the quality of the community-based care you received? Would you say it was...?
- 1: Excellent
- 2: Good
- 3: Fair
- 4: Poor
- 8: RF
- 9: DK
Patient satisfaction - community-based care (PSC) - Question identifier:PSC_Q015
Using a scale of 0 to 5, where 0 means "Very dissatisfied" and 5 means "Very satisfied", overall, how satisfied were you with the way community-based care was provided?
- 0: Very dissatisfied
- 1: |
- 2: |
- 3: |
- 4: V
- 5: Very satisfied
- 8: RF
- 9: DK
Patient satisfaction - community-based care (PSC) - Question identifier:PSC_Q020
In the past 12 months, have you received any home nursing care?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Patient satisfaction - community-based care (PSC) - Question identifier:PSC_Q025
Overall, how would you rate the quality of the home nursing care you received? Would you say it was...?
- 1: Excellent
- 2: Good
- 3: Fair
- 4: Poor
- 8: RF
- 9: DK
Patient satisfaction - community-based care (PSC) - Question identifier:PSC_Q030
Using a scale of 0 to 5, where 0 means "Very dissatisfied" and 5 means "Very satisfied", overall, how satisfied were you with the way the home nursing care was provided?
- 0: Very dissatisfied
- 1: |
- 2: |
- 3: |
- 4: V
- 5: Very satisfied
- 8: RF
- 9: DK
Patient satisfaction - community-based care (PSC) - Question identifier:PSC_Q035
In the past 12 months, have you received any home-based counselling or therapy?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Patient satisfaction - community-based care (PSC) - Question identifier:PSC_Q040
Overall, how would you rate the quality of the home-based counselling or therapy you received? Would you say it was...?
- 1: Excellent
- 2: Good
- 3: Fair
- 4: Poor
- 8: RF
- 9: DK
Patient satisfaction - community-based care (PSC) - Question identifier:PSC_Q045
Using a scale of 0 to 5, where 0 means "Very dissatisfied" and 5 means "Very satisfied", overall, how satisfied were you with the way the home-based counselling or therapy was provided?
- 0: Very dissatisfied
- 1: |
- 2: |
- 3: |
- 4: V
- 5: Very satisfied
- 8: RF
- 9: DK
Patient satisfaction - community-based care (PSC) - Question identifier:PSC_Q050
In the past 12 months, have you received any personal care services?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Patient satisfaction - community-based care (PSC) - Question identifier:PSC_Q055
Overall, how would you rate the quality of the personal care service you received? Would you say it was...?
- 1: Excellent
- 2: Good
- 3: Fair
- 4: Poor
- 8: RF
- 9: DK
Patient satisfaction - community-based care (PSC) - Question identifier:PSC_Q060
Using a scale of 0 to 5, where 0 means "Very dissatisfied" and 5 means "Very satisfied", overall, how satisfied were you with the way the personal care service was provided?
- 0: Very dissatisfied
- 1: |
- 2: |
- 3: |
- 4: V
- 5: Very satisfied
- 8: RF
- 9: DK
Patient satisfaction - community-based care (PSC) - Question identifier:PSC_Q065
In the past 12 months, have you received any services from a community walk-in clinic?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Patient satisfaction - community-based care (PSC) - Question identifier:PSC_Q070
Overall, how would you rate the quality of the service you received at the community walk-in clinic? Would you say it was...?
- 1: Excellent
- 2: Good
- 3: Fair
- 4: Poor
- 8: RF
- 9: DK
Patient satisfaction - community-based care (PSC) - Question identifier:PSC_Q075
Using a scale of 0 to 5, where 0 means "Very dissatisfied" and 5 means "Very satisfied", overall, how satisfied were you with the way the community walk-in clinic service was provided?
- 0: Very dissatisfied
- 1: |
- 2: |
- 3: |
- 4: V
- 5: Very satisfied
- 8: RF
- 9: DK
Consultations with health professionals on smoking (SPC)
In this module, respondents who smoke are asked whether their regular health care provider or dentist knows that they smoke, or has advised them to stop or reduce smoking. Questions about the type of help, if any, provided by the regular health care provider, dentist and pharmacist are also asked.
The results of this module will be used to understand what role regular health care providers, dentists and pharmacists can play in helping people reduce smoking.
Consultations with health professionals on smoking (SPC) - Question identifier:SPC_Q005
Does your [regular health care provider] know that you [smoke/smoked] cigarettes?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Consultations with health professionals on smoking (SPC) - Question identifier:SPC_Q010
In the past 12 months, did your [regular health care provider] advise you to reduce or quit smoking?
- 1: Yes
- 2: No
- 3: Did not see or talk to him or her
- 8: RF
- 9: DK
Consultations with health professionals on smoking (SPC) - Question identifier:SPC_Q015
In the past 12 months, did your [regular health care provider] give you any specific help or information to reduce or quit smoking?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Consultations with health professionals on smoking (SPC) - Question identifier:SPC_Q020
What type of help did the [regular health care provider] give?
- 01: Referral to a one-on-one cessation program
- 02: Referral to a group cessation program
- 03: Recommended use of nicotine patch or nicotine gum
- 04: Recommended Zyban or other medication
- 05: Provided self-help information (e.g., pamphlet, referral to website)
- 06: Referral to a 1-800 telephone quit line or other smoker help lines
- 07: Family physician offered counselling
- 08: Other
- 98: RF
- 99: DK
Consultations with health professionals on smoking (SPC) - Question identifier:SPC_Q025
Does your dental professional know that you [smoke/smoked] cigarettes?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Consultations with health professionals on smoking (SPC) - Question identifier:SPC_Q030
In the past 12 months, did your dental professional advise you to reduce or quit smoking?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Consultations with health professionals on smoking (SPC) - Question identifier:SPC_Q035
In the past 12 months, did your dental professional give you any specific help or information to reduce or quit smoking?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Consultations with health professionals on smoking (SPC) - Question identifier:SPC_Q040
What type of help did the dental professional give?
- 01: Referral to a one-on-one cessation program
- 02: Referral to a group cessation program
- 03: Recommended use of nicotine patch or nicotine gum
- 04: Recommended Zyban or other medication
- 05: Provided self-help information (e.g., pamphlet, referral to website)
- 06: Referral to a 1-800 telephone quit line or other smoker help lines
- 07: Dentist offered counselling
- 08: Other
- 98: RF
- 99: DK
Consultations with health professionals on smoking (SPC) - Question identifier:SPC_Q045
In the past 12 months, have you asked a pharmacist for advice to help you to reduce or quit smoking?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Consultations with health professionals on smoking (SPC) - Question identifier:SPC_Q050
What type of help did the pharmacist give?
- 1: Referral to a one-on-one cessation program
- 2: Referral to a group cessation program
- 3: Recommended use of nicotine patch or nicotine gum
- 4: Recommended Zyban or other medication
- 5: Provided self-help information (e.g., pamphlet, referral to website)
- 6: Referral to a 1-800 telephone quit line or other smoker help lines
- 7: Other
- 8: RF
- 9: DK
Access to health care services (ACC)
This module deals with respondents' experiences and perceptions regarding access to various types of health care services. It is asked only of those respondents aged 15 or over. These include:
· health care received from a medical specialist
· non-emergency surgical procedures
· diagnostic tests such as MRIs, CAT scans and angiographies
· obtaining health information or advice
· health care services for routine or on-going medical or dental care
· immediate care for a minor health problem
Respondents are asked if they experienced any difficulties obtaining the health service(s) that they required.
This module will be used to compare different groups of Canadians according to how they use health care services (including the time of day and day of the week) and what barriers they faced when trying to access health care services.
Module ACC must be selected for WTM to be asked ACC
Access to health care services (ACC) - Question identifier:ACC_R001
The next questions are about the use of various health care services.
I will start by asking about your experiences getting health care from a medical specialist such as a cardiologist, endocrinologist, allergist, [urologist/gynaecologist] or psychiatrist (excluding an optometrist).
Access to health care services (ACC) - Question identifier:ACC_Q005
In the past 12 months, did you require a visit to a medical specialist for a diagnosis or a consultation?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Access to health care services (ACC) - Question identifier:ACC_Q010
In the past 12 months, did you ever experience any difficulties getting the specialist care you needed for a diagnosis or consultation?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Access to health care services (ACC) - Question identifier:ACC_Q015
What types of difficulties did you experience?
- 01: Difficulty getting a referral
- 02: Difficulty getting an appointment
- 03: Waited too long between booking appointment and visit
- 04: Waited too long to see the specialist (i.e. in-office waiting)
- 05: Service not available at time required
- 06: Service not available in the area
- 07: Transportation problems
- 08: Language problem
- 09: Cost
- 10: General deterioration of health
- 11: Appointment cancelled or deferred by specialist
- 12: Unable to leave the house because of a health problem
- 13: Other
- 98: RF
- 99: DK
Access to health care services (ACC) - Question identifier:ACC_R020
The following questions are about any surgery, not provided in an emergency, that you may have required, such as cardiac surgery, joint surgery - knee or hip[, caesarean sections/,] and cataract surgery, excluding laser eye surgery.
Access to health care services (ACC) - Question identifier:ACC_Q020
In the past 12 months, did you require any non-emergency surgery?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Access to health care services (ACC) - Question identifier:ACC_Q025
In the past 12 months, did you ever experience any difficulties getting the surgery you needed?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Access to health care services (ACC) - Question identifier:ACC_Q030
What types of difficulties did you experience?
- 01: Difficulty getting an appointment
- 02: Difficulty getting a diagnosis including obtaining a diagnostic test
- 03: Waited too long for a hospital bed to become available
- 04: Waited too long for surgery
- 05: Service not available at time required
- 06: Service not available in the area
- 07: Transportation problems
- 08: Language problem
- 09: Cost
- 10: General deterioration of health
- 11: Appointment cancelled or deferred by surgeon or hospital
- 12: Unable to leave the house because of a health problem
- 13: Other
- 98: RF
- 99: DK
Access to health care services (ACC) - Question identifier:ACC_R035
Now, some questions about MRIs, CAT Scans and angiographies provided in a non-emergency situation.
Access to health care services (ACC) - Question identifier:ACC_Q035
In the past 12 months, did you require one of these tests?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Access to health care services (ACC) - Question identifier:ACC_Q040
In the past 12 months, did you ever experience any difficulties getting the tests you needed?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Access to health care services (ACC) - Question identifier:ACC_Q045
What types of difficulties did you experience?
- 01: Difficulty getting a referral
- 02: Difficulty getting an appointment
- 03: Waited too long to get an appointment
- 04: Waited too long to get test (i.e. in-office waiting)
- 05: Service not available at time required
- 06: Service not available in the area
- 07: Transportation problems
- 08: Language problem
- 09: Cost
- 10: General deterioration of health
- 11: Did not know where to go (i.e. information problems)
- 12: Unable to leave the house because of a health problem
- 13: Other
- 98: RF
- 99: DK
Access to health care services (ACC) - Question identifier:ACC_R050A
Now, I'd like you to think about yourself and family members living in your dwelling.
The next questions are about your experiences getting health information or advice when you needed it for yourself or a family member living in your dwelling.
Access to health care services (ACC) - Question identifier:ACC_R050B
The next questions are about your experiences getting health information or advice when you needed it.
Access to health care services (ACC) - Question identifier:ACC_Q050
In the past 12 months, have you required health information or advice for yourself or a family member?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Access to health care services (ACC) - Question identifier:ACC_Q055
Whom did you contact when you needed health information or advice advice [for yourself or a family member]?
- 01: A doctor's office
- 02: A community health centre [or CLSC]
- 03: A walk-in clinic
- 04: A telephone health line (for example, HealthLinks, Telehealth Ontario, Health-Line, TeleCare, Info-Santé)
- 05: Internet (for example, AboutKidsHealth)
- 06: An emergency department or emergency room
- 07: A hospital outpatient clinic
- 08: Other - Specify
- 98: RF
- 99: DK
Access to health care services (ACC) - Question identifier:ACC_Q060
In the past 12 months, did you ever experience any difficulties getting the health information or advice [for yourself or a family member]?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Access to health care services (ACC) - Question identifier:ACC_Q065
Did you experience difficulties during "regular" office hours (that is, 9:00 am to 5:00 pm, Monday to Friday)?
- 1: Yes
- 2: No
- 3: Not required at this time
- 8: RF
- 9: DK
Access to health care services (ACC) - Question identifier:ACC_Q070
What types of difficulties did you experience?
- 01: Difficulty contacting a physician or nurse
- 02: Did not have a phone number
- 03: Could not get through (i.e. no answer)
- 04: Waited too long to speak to someone
- 05: Did not get adequate info or advice
- 06: Language problem
- 07: Did not know where to go / call / uninformed
- 08: Unable to leave the house because of a health problem
- 09: Other
- 98: RF
- 99: DK
Access to health care services (ACC) - Question identifier:ACC_Q075
Did you experience difficulties getting health information or advice during evenings and weekends (that is, 5:00 pm to 9:00 pm Monday to Friday, or 9:00 am to 5:00 pm, Saturdays and Sundays)?
- 1: Yes
- 2: No
- 3: Not required at this time
- 8: RF
- 9: DK
Access to health care services (ACC) - Question identifier:ACC_Q080
What types of difficulties did you experience?
- 01: Difficulty contacting a physician or nurse
- 02: Did not have a phone number
- 03: Could not get through (i.e. no answer)
- 04: Waited too long to speak to someone
- 05: Did not get adequate info or advice
- 06: Language problem
- 07: Did not know where to go / call / uninformed
- 08: Unable to leave the house because of a health problem
- 09: Other
- 98: RF
- 99: DK
Access to health care services (ACC) - Question identifier:ACC_Q085
Did you experience difficulties getting health information or advice during the middle of the night?
- 1: Yes
- 2: No
- 3: Not required at this time
- 8: RF
- 9: DK
Access to health care services (ACC) - Question identifier:ACC_Q090
What types of difficulties did you experience?
- 01: Difficulty contacting a physician or nurse
- 02: Did not have a phone number
- 03: Could not get through (i.e. no answer)
- 04: Waited too long to speak to someone
- 05: Did not get adequate info or advice
- 06: Language problem
- 07: Did not know where to go / call / uninformed
- 08: Unable to leave the house because of a health problem
- 09: Other
- 98: RF
- 99: DK
Access to health care services (ACC) - Question identifier:ACC_R095A
Now, some questions about your experiences when you needed health care services for routine or on-going care such as a medical or dental exam or follow-up for yourself or a family member living in your dwelling.
Access to health care services (ACC) - Question identifier:ACC_R095B
Now, some questions about your experiences when you needed health care services for routine or on-going care such as a medical or dental exam or follow-up.
Access to health care services (ACC) - Question identifier:ACC_Q095
Do you have a regular health care provider?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Access to health care services (ACC) - Question identifier:ACC_Q100
In the past 12 months, did you require any routine or on-going care for yourself or a family member?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Access to health care services (ACC) - Question identifier:ACC_Q105
In the past 12 months, did you ever experience any difficulties getting the routine or on-going care [you or a family member] needed?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Access to health care services (ACC) - Question identifier:ACC_Q110
Did you experience difficulties getting such care during "regular" office hours (that is, 9:00 am to 5:00 pm, Monday to Friday)?
- 1: Yes
- 2: No
- 3: Not required at this time
- 8: RF
- 9: DK
Access to health care services (ACC) - Question identifier:ACC_Q115
What types of difficulties did you experience?
- 01: Difficulty contacting a health care provider
- 02: Difficulty getting an appointment
- 03: Do not have a regular health care provider
- 04: Waited too long to get an appointment
- 05: Waited too long to see the health care provider (i.e. in-office waiting)
- 06: Service not available at time required
- 07: Service not available in the area
- 08: Transportation problems
- 09: Language problem
- 10: Cost
- 11: Did not know where to go (i.e. information problems)
- 12: Unable to leave the house because of a health problem
- 13: Other
- 98: RF
- 99: DK
Access to health care services (ACC) - Question identifier:ACC_Q120
Did you experience difficulties getting such care during evenings and weekends (that is, 5:00 pm to 9:00 pm, Monday to Friday, or 9:00 am to 5:00 pm, Saturdays and Sundays)?
- 1: Yes
- 2: No
- 3: Not required at this time
- 8: RF
- 9: DK
Access to health care services (ACC) - Question identifier:ACC_Q125
What types of difficulties did you experience?
- 01: Difficulty contacting a health care provider
- 02: Difficulty getting an appointment
- 03: Do not have a regular health care provider
- 04: Waited too long to get an appointment
- 05: Waited too long to see the health care provider (i.e. in-office waiting)
- 06: Service not available at time required
- 07: Service not available in the area
- 08: Transportation problems
- 09: Language problem
- 10: Cost
- 11: Did not know where to go (i.e. information problems)
- 12: Unable to leave the house because of a health problem
- 13: Other
- 98: RF
- 99: DK
Access to health care services (ACC) - Question identifier:ACC_R130
The next questions are about situations when [you or a family member] have needed immediate care for a minor health problem such as fever, headache, a sprained ankle, vomiting or an unexplained rash.
Access to health care services (ACC) - Question identifier:ACC_Q130
In the past 12 months, did [you or a family member] require immediate health care services for a minor health problem?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Access to health care services (ACC) - Question identifier:ACC_Q135
In the past 12 months, did you ever experience any difficulties getting the immediate care needed for a minor health problem [for yourself or a family member]?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Access to health care services (ACC) - Question identifier:ACC_Q140
Did you experience difficulties getting such care during "regular" office hours (that is, 9:00 am to 5:00 pm, Monday to Friday)?
- 1: Yes
- 2: No
- 3: Not required at this time
- 8: RF
- 9: DK
Access to health care services (ACC) - Question identifier:ACC_Q145
What types of difficulties did you experience?
- 01: Difficulty contacting a health care provider
- 02: Difficulty getting an appointment
- 03: Do not have a regular health care provider
- 04: Waited too long to get an appointment
- 05: Waited too long to see the health care provider (i.e. in-office waiting)
- 06: Service not available at time required
- 07: Service not available in the area
- 08: Transportation problems
- 09: Language problem
- 10: Cost
- 11: Did not know where to go (i.e. information problems)
- 12: Unable to leave the house because of a health problem
- 13: Other
- 98: RF
- 99: DK
Access to health care services (ACC) - Question identifier:ACC_Q150
Did you experience difficulties getting such care during evenings and weekends (that is, 5:00 pm to 9:00 pm, Monday to Friday, or 9:00 am to 5:00 pm, Saturdays and Sundays)?
- 1: Yes
- 2: No
- 3: Not required at this time
- 8: RF
- 9: DK
Access to health care services (ACC) - Question identifier:ACC_Q155
What types of difficulties did you experience?
- 01: Difficulty contacting a health care provider
- 02: Difficulty getting an appointment
- 03: Do not have a regular health care provider
- 04: Waited too long to get an appointment
- 05: Waited too long to see the health care provider (i.e. in-office waiting)
- 06: Service not available at time required
- 07: Service not available in the area
- 08: Transportation problems
- 09: Language problem
- 10: Cost
- 11: Did not know where to go (i.e. information problems)
- 12: Unable to leave the house because of a health problem
- 13: Other
- 98: RF
- 99: DK
Access to health care services (ACC) - Question identifier:ACC_Q160
Did you experience difficulties getting such care during the middle of the night?
- 1: Yes
- 2: No
- 3: Not required at this time
- 8: RF
- 9: DK
Access to health care services (ACC) - Question identifier:ACC_Q165
What types of difficulties did you experience?
- 01: Difficulty contacting a health care provider
- 02: Difficulty getting an appointment
- 03: Do not have a regular health care provider
- 04: Waited too long to get an appointment
- 05: Waited too long to see the health care provider (i.e. in-office waiting)
- 06: Service not available at time required
- 07: Service not available in the area
- 08: Transportation problems
- 09: Language problem
- 10: Cost
- 11: Did not know where to go (i.e. information problems)
- 12: Unable to leave the house because of a health problem
- 13: Other
- 98: RF
- 99: DK
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, 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 your household] may have received because of a health condition or a limitation in daily activities. These include services provided in your own home such as nursing care, meal preparation, someone to help with bathing or housework, etc. Do not include the help from family, friends or neighbours.
Home care services (HMC) - Question identifier:HMC_Q005
In the past 12 months, what type of home care services have [you or anyone in your household] received?
- 1: Nursing care (e.g., dressing changes, preparing
medications, V.O.N. visits) - 2: Other health care services (e.g., physiotherapy,
occupational or speech therapy, nutrition counselling) - 3: Medical equipment or supplies (e.g., wheelchair, pads for incontinence, help with using a ventilator or oxygen equipment)
- 4: Personal or home support (such as bathing, housekeeping, meal preparation)
- 5: Other services (such as transportation, meals-on-wheels)
- 6: No one in the household received any home care services
- 8: RF
- 9: DK
Home care services (HMC) - Question identifier:HMC_Q010
Were [the nursing care/the other health care/the medical equipment or supplies/the personal or home support/the other] services provided for yourself or someone else living in your household?
- 1: Home care provided to selected respondent only
- 2: Home care provided to other household member only
- 3: Home care provided to selected respondent and other household member
- 8: RF
- 9: DK
Home care services (HMC) - Question identifier:HMC_R015
For the next two questions please only report for the home care services provided for you.
Home care services (HMC) - Question identifier:HMC_Q015
How long [have you/have other household members] been receiving [the nursing care/the other health care/the medical equipment or supplies/the personal or home support/the other] services?
- 1: Less than 1 month
- 2: 1 month to less than 3 months
- 3: 3 months to less than 6 months
- 4: 6 months to less than 1 year
- 5: 1 year to 3 years
- 6: More than 3 years
- 8: RF
- 9: DK
Home care services (HMC) - Question identifier:HMC_Q020
In a typical month over the past 12 months, how much [have you/have other household members] paid for [the nursing care/the other health care/the medical equipment or supplies/the personal or home support/the other] services?
- 01: $0
- 02: $1 to less than $50
- 03: $50 to less than $100
- 04: $100 to less than $200
- 05: $200 to less than $300
- 06: $300 to less than $400
- 07: $400 to less than $1000
- 08: $1000 and more
- 98: RF
- 99: DK
Home care services (HMC) - Question identifier:HMC_Q025
Who paid for these services?
- 1: Out of your / their own pocket
- 2: Family or friend living in the same household
- 3: Someone living outside the household (e.g., family, friends, volunteer organization)
- 4: Insurance
- 5: Government
- 6: Other
- 8: RF
- 9: DK
Home care services (HMC) - Question identifier:HMC_Q030
Overall, how satisfied [were you/were the other household members] with the home care services received?
[were you/were the other household members]...?
- 1: Very satisfied
- 2: Somewhat satisfied
- 3: Neither satisfied nor dissatisfied
- 4: Somewhat dissatisfied
- 5: Very dissatisfied
- 8: RF
- 9: DK
Home care services (HMC) - Question identifier:HMC_Q035
What are the reasons why [you were/the other household members were] not satisfied?
- 1: Poor quality (i.e. concerns about provider competence, reliability of services, etc.)
- 2: Services did not address perceived needs
- 3: Services provided were insufficient
- 4: Long wait times to receive services
- 5: Other reason
- 8: RF
- 9: DK
Home care services (HMC) - Question identifier:HMC_Q040
During the past 12 months, was there ever a time when [you or anyone in your household] felt that home care services were needed but were not received?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Home care services (HMC) - Question identifier:HMC_Q045
Were these (home care) services needed for yourself or someone else living in your household?
- 1: Selected Respondent only
- 2: Other household member only
- 3: Selected respondent and other household member
- 8: RF
- 9: DK
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?
- 1: Nursing care (e.g., dressing changes, preparing
medications, V.O.N. visits) - 2: Other health care services (e.g., physiotherapy,
occupational or speech therapy, nutrition counselling) - 3: Medical equipment or supplies (e.g., wheelchair, pads for incontinence, help with using a ventilator or oxygen equipment)
- 4: Personal or home support (such as bathing, housekeeping, meal preparation)
- 5: Other services (such as transportation, meals-on-wheels)
- 8: RF
- 9: DK
Home care services (HMC) - Question identifier:HMC_Q055
Again, thinking of the most recent time, why didn't [you/they] get these services?
- 01: Not available in the area
- 02: Not available at time required (e.g., inconvenient hours)
- 03: Waiting time too long
- 04: Cost
- 05: Didn't get around to it / didn't bother
- 06: Didn't know where to go / call
- 07: Language barrier
- 08: Decided not to seek services
- 09: Doctor did not think it was necessary
- 10: Not eligible for home care
- 11: Still waiting for home care
- 12: Other
- 98: RF
- 99: DK
Home care services (HMC) - Question identifier:HMC_Q060
Where did [you/they] try to get these home care services?
- 1: A government Home Care Program (e.g., CLSC in Quebec, CCAC in Ontario, 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
- 8: RF
- 9: DK
Unmet health care needs (UCN)
The purpose of this module is to identify respondents who needed health care (other than home care services) in the last 12 months but did not receive it. Questions are asked about the type of care they needed, whether they actively tried to obtain the health care, where they went to get care, and why they didn't receive it.
Data will be used to assess the extent of unmet health care needs, identify geographic areas where improvements could be made and determine why these needs are not fulfilled.
Unmet health care needs (UCN) - Question identifier:UCN_Q005
During the past 12 months, was there ever a time when you felt that you needed health care, other than homecare services, but you did not receive it?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Unmet health care needs (UCN) - Question identifier:UCN_Q010
Thinking of the most recent time you felt this way, why didn't you get care?
- 01: Care not available in the area
- 02: Care not available at time required (e.g., doctor busy, away from office or no longer at that practice, inconvenient hours)
- 03: Do not have a regular health care provider
- 04: Waiting time too long
- 05: Appointment was cancelled
- 06: Felt would receive inadequate care
- 07: Cost
- 08: Decided not to seek care
- 09: Doctor didn't think it was necessary
- 10: Transportation issue
- 11: Other
- 98: RF
- 99: DK
Unmet health care needs (UCN) - Question identifier:UCN_Q015
Again, thinking of the most recent time, what was the type of care that was needed?
- 01: Treatment of a chronic physical health condition diagnosed by a health professional
- 02: Treatment of a chronic mental health condition diagnosed by a health professional
- 03: Treatment of an acute infectious disease (e.g., cold, flu and stomach flu)
- 04: Treatment of an acute physical condition (non-infectious)
- 05: Treatment of an acute mental health condition (e.g., acute stress reaction)
- 06: A regular check-up (including pre-natal care)
- 07: Care of an injury
- 08: Dental care
- 09: Medication / Prescription refill
- 10: Other
- 98: RF
- 99: DK
Unmet health care needs (UCN) - Question identifier:UCN_Q020
Did you actively try to obtain the health care that was needed?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Unmet health care needs (UCN) - Question identifier:UCN_Q025
Where did you try to get the service you were seeking?
- 1: A doctor's office
- 2: A hospital outpatient clinic
- 3: A community health centre [or CLSC]
- 4: A walk-in clinic
- 5: An emergency department or emergency room
- 6: Other
- 8: RF
- 9: DK
Labour force (LBF)
There are many relationships between work and health. For example, unemployment can cause various stress-related illnesses while some occupations are more likely to cause repetitive strain injuries.
This module includes questions about the respondent's current labour force activities during the past week, including job status and absenteeism, job classification (employee or self-employed), industry, occupation and main activities, number of jobs, and usual hours worked per week.
The concepts and definitions are, for the most part, the same as those used in the Labour Force Survey.
The module is asked of respondents aged between 15 and 75. Not all questions will be asked of all respondents - pay attention to the skip patterns.
Labour force (LBF) - Question identifier:LBF_Q005A
Many of the following questions concern [your] activities last week. By last week, I mean the week beginning on ^REFBEGE, and ending ^REFENDE.
Last week, did you work at a job or business? (regardless of the number of hours)
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Labour force (LBF) - Question identifier:LBF_Q005B
Last week, did you have a job or business from which you were absent?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Labour force (LBF) - Question identifier:LBF_Q005C
What was the main reason you were absent from work last week?
- 01: Own illness or disability
- 02: Caring for own children
- 03: Caring for elder relative (60 years of age or older)
- 04: Maternity or parental leave
- 05: Other personal or family responsibilities
- 06: Vacation
- 07: Labour dispute (strike or lockout) (Employees only)
- 08: Temporary layoff due to business conditions (Employees only)
- 09: Seasonal layoff (Employees only)
- 10: Casual job, no work available (Employees only)
- 11: Work schedule (e.g., shift work) (Employees only)
- 12: Self-employed, no work available (Self-employed only)
- 13: Seasonal business (Excluding employees)
- 14: Other - Specify
- 98: RF
- 99: DK
Labour force (LBF) - Question identifier:LBF_R010
The next questions are about your current job or business.
Labour force (LBF) - Question identifier:LBF_Q010
Were you an employee or self-employed?
- 1: Employee
- 2: Self-employed
- 3: Working in a family business without pay
- 8: RF
- 9: DK
Labour force (LBF) - Question identifier:LBF_Q015A
What was the name of your business?
Long Answer Length = 50
Labour force (LBF) - Question identifier:LBF_Q015B
For whom did you work?
Long Answer Length = 50
Labour force (LBF) - Question identifier:LBF_Q015C
What kind of business, industry or service was this?
Long Answer Length = 50
Labour force (LBF) - Question identifier:LBF_Q020A
What was your work or occupation?
Long Answer Length = 50
Labour force (LBF) - Question identifier:LBF_Q020B
In this work, what were your main activities?
Long Answer Length = 50
Labour force (LBF) - Question identifier:LBF_Q025
On average, how many hours do you usually work per week?
Min = 0.0; Max = 168.0
Labour force (LBF) - Question identifier:LBF_Q030
Did you have more than one job or business last week?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Labour force (LBF) - Question identifier:LBF_Q035
On average, how many hours do you usually work per week at your other job(s)?
Min = 1; Max = 168
Socio-demographic characteristics (SDC)
Very important knowledge of understanding the health of Canadians is obtained by comparing the health of different groups. For example, do recent immigrants to Canada use health care services more or less than people born in Canada? Are people from European ethnic groups more likely to have certain chronic conditions than other groups?
In this module, important social and demographic information is collected, including immigrant status, country/province of birth, ethnic origin, aboriginal status, racial/cultural group, language, dwelling type and sexual orientation.
Socio-demographic characteristics (SDC) - Question identifier:SDC_R001
Now, some general background questions which will help us compare the health of people in Canada.
Socio-demographic characteristics (SDC) - Question identifier:SDC_Q005
In what country were you born?
- 1: Search
- 3: Other - Specify
- 8: RF
- 9: DK
Socio-demographic characteristics (SDC) - Question identifier:SDC_Q006
In which province or territory were you born?
- 10: Newfoundland and Labrador
- 11: Prince Edward Island
- 12: Nova Scotia
- 13: New Brunswick
- 24: Quebec
- 35: Ontario
- 46: Manitoba
- 47: Saskatchewan
- 48: Alberta
- 59: British Columbia
- 60: Yukon
- 61: Northwest Territories
- 62: Nunavut
- 98: RF
- 99: DK
Socio-demographic characteristics (SDC) - Question identifier:SDC_Q007
Are you now, or have you ever been a landed immigrant in Canada?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Socio-demographic characteristics (SDC) - Question identifier:SDC_Q008
In what year did you first become a landed immigrant in Canada?
Min = 1870; Max = 2100
Socio-demographic characteristics (SDC) - Question identifier:SDC_Q010
To which ethnic or cultural groups did your ancestors belong? (For example: French, Scottish, Chinese, East Indian)
- 01: Canadian
- 02: French
- 03: English
- 04: German
- 05: Scottish
- 06: Irish
- 07: Italian
- 08: Ukrainian
- 09: Dutch (Netherlands)
- 10: Chinese
- 11: Jewish
- 12: Polish
- 13: Portuguese
- 14: South Asian (e.g., East Indian, Pakistani, Sri Lankan)
- 15: Norwegian
- 16: Welsh
- 17: Swedish
- 18: First Nations (North American Indian)
- 19: Métis
- 20: Inuit
- 21: Other - Specify
- 98: RF
- 99: DK
Socio-demographic characteristics (SDC) - Question identifier:SDC_Q015
Are you an Aboriginal person, that is, First Nations, Métis or Inuk (Inuit)? First Nations includes Status and Non-Status Indians.
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Socio-demographic characteristics (SDC) - Question identifier:SDC_Q016
Are you First Nations, Métis or Inuk (Inuit)?
- 1: First Nations (North American Indian)
- 2: Métis
- 3: Inuk (Inuit)
- 8: RF
- 9: DK
Socio-demographic characteristics (SDC) - Question identifier:SDC_Q020
You may belong to one or more racial or cultural groups on the following list. Are you... ?
- 01: White
- 02: South Asian (e.g., East Indian, Pakistani, Sri Lankan)
- 03: Chinese
- 04: Black
- 05: Filipino
- 06: Latin American
- 07: Arab
- 08: Southeast Asian (e.g., Vietnamese, Cambodian,
Malaysian, Laotian) - 09: West Asian (e.g., Iranian, Afghan)
- 10: Korean
- 11: Japanese
- 12: Other - Specify
- 98: RF
- 99: DK
Socio-demographic characteristics (SDC) - Question identifier:SDC_Q025
Of English or French, which language(s) do you speak well enough to conduct a conversation? Is it... ?
- 1: English only
- 2: French only
- 3: Both English and French
- 4: Neither English nor French
- 8: RF
- 9: DK
Socio-demographic characteristics (SDC) - Question identifier:SDC_Q026
What language do you speak most often at home?
Long Answer Length = 80
Socio-demographic characteristics (SDC) - Question identifier:SDC_Q027
What is the language that you first learned at home in childhood and still understand?
Long Answer Length = 80
Socio-demographic characteristics (SDC) - Question identifier:SDC_R030
Now a question about the dwelling in which you live.
Socio-demographic characteristics (SDC) - Question identifier:SDC_Q030
Is this dwelling...?
- 1: Owned by you or a member of this household, even if it is still being paid for
- 2: Rented, even if no cash rent is paid
- 8: RF
- 9: DK
Socio-demographic characteristics (SDC) - Question identifier:SDC_R035
Now, one additional background question which will help us compare the health of people in Canada.
Socio-demographic characteristics (SDC) - Question identifier:SDC_Q035
Do you consider yourself to be...?
- 1: Heterosexual (sexual relations with people of the opposite sex)
- 2: Homosexual, that is lesbian or gay (sexual relations with people of your own sex)
- 3: Bisexual (sexual relations with people of both sexes)
- 8: RF
- 9: DK
Person most knowledgeable about household situation (PMK)
The purpose of this module is to identify someone who may be more knowledgeable and better prepared than the 12-17 year-old selected respondent to answer household level questions such as income, insurance and food security questions.
Person most knowledgeable about household situation (PMK) - Question identifier:PMK_R010
For the last few questions, I would like to speak with someone who would be best able to answer questions about the entire household such as household income and food purchases.
Person most knowledgeable about household situation (PMK) - Question identifier:PMK_Q010
Who would this person be?
- 01: MEMBER1
- 02: MEMBER2
- 03: MEMBER3
- 04: MEMBER4
- 05: MEMBER5
- 06: MEMBER6
- 07: MEMBER7
- 08: MEMBER8
- 09: MEMBER9
- 10: MEMBER10
- 11: MEMBER11
- 12: MEMBER12
- 13: MEMBER13
- 14: MEMBER14
- 15: MEMBER15
- 16: MEMBER16
- 17: MEMBER17
- 18: MEMBER18
- 19: MEMBER19
- 20: MEMBER20
Person most knowledgeable about household situation (PMK) - Question identifier:PMK_Q015
Is [MEMBER#] available?
- 1: Yes
- 2: No
- 3: Person most knowledgeable about household refuses to participate.
Person most knowledgeable about household situation (PMK) - Question identifier:PMK_R025
This completes your portion of the interview. On behalf of Statistics Canada, I would like to thank you very much for your time.
Person most knowledgeable about household situation (PMK) - Question identifier:PMK_R030
This completes your portion of the interview. On behalf of Statistics Canada, I would like to thank you very much for your time. I would now like to try and find the best time to speak with [MEMBER#].
Person most knowledgeable about household situation (PMK) - Question identifier:PMK_R035
This completes your portion of the interview. On behalf of Statistics Canada, I would like to thank you very much for your time. I would now like to speak with ^MEMBERNAME.
Person most knowledgeable about household situation (PMK) - Question identifier:PMK_R040
Hello, My name is... I've just completed the main portion of the interview with <Respondent's name>. At this point I need to finish the interview with a few general questions on your household's situation. <Respondent's name> said you would be the best person to answer these types of questions.
Health insurance coverage (INS)
In this module, respondents are asked whether they have insurance to cover all or part of the cost of prescription medications, home care or long-term care.
Respondents should include any private, government, association or employer-paid insurance plans.
The results of this module will be used to get an overall picture of which groups have various types of insurance. Researchers will be able to study this in combination with levels of health and use of health care services.
Health insurance coverage (INS) - Question identifier:INS_R001
Now, turning to [your] health insurance coverage. Please include any private, government or employer-paid plans.
Health insurance coverage (INS) - Question identifier:INS_Q005
[Do you] have insurance that covers all or part of the cost of [your] prescription medications?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Health insurance coverage (INS) - Question identifier:INS_Q010
Is it...?
- 1: A government-sponsored plan
- 2: An employer-sponsored benefit plan
- 3: A plan sponsored through an association such as a union, trade association or student organization
- 4: Other, such as your own private plan purchased from an insurance company
- 8: RF
- 9: DK
Health insurance coverage (INS) - Question identifier:INS_Q015
[Do you] have insurance that covers all or part of [your] long-term care costs, including home care?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Health insurance coverage (INS) - Question identifier:INS_Q020
Is it...?
- 1: A government-sponsored plan
- 2: An employer-sponsored benefit plan
- 3: A plan sponsored through an association such as a union, trade association or student organization
- 4: Other, such as your own private plan purchased from an insurance company
- 8: RF
- 9: DK
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_R010
The following questions are about the food situation for your household in the past 12 months. I'm going to read you several statements that may be used to describe the food situation for a household. Please tell me if the statement was often true, sometimes true, or never true for [you and other household members] in the past 12 months.
Food security (FSC) - Question identifier:FSC_Q010
The first statement is: [You and other household members] worried that food would run out before you got money to buy more. Was that often true, sometimes true, or never true in the past 12 months?
- 1: Often true
- 2: Sometimes true
- 3: Never true
- 8: RF
- 9: DK
Food security (FSC) - Question identifier:FSC_Q015
The food that [you and other household members] bought just didn't last, and there wasn't any money to get more. Was that often true, sometimes true, or never true in the past 12 months?
- 1: Often true
- 2: Sometimes true
- 3: Never true
- 8: RF
- 9: DK
Food security (FSC) - Question identifier:FSC_Q020
[You and other household members] couldn't afford to eat balanced meals. In the past 12 months was that often true, sometimes true, or never true?
- 1: Often true
- 2: Sometimes true
- 3: Never true
- 8: RF
- 9: DK
Food security (FSC) - Question identifier:FSC_R025
Now, I'm going to read a few statements that may describe the food situation for households with children.
Food security (FSC) - Question identifier:FSC_Q025
[You or other adults in your household] relied on only a few kinds of low-cost food to feed [the children] because you were running out of money to buy food. Was that often true, sometimes true, or never true in the past 12 months?
- 1: Often true
- 2: Sometimes true
- 3: Never true
- 8: RF
- 9: DK
Food security (FSC) - Question identifier:FSC_Q030
[You or other adults in your household] couldn't feed [the children] a balanced meal, because you couldn't afford it. Was that often true, sometimes true, or never true in the past 12 months?
- 1: Often true
- 2: Sometimes true
- 3: Never true
- 8: RF
- 9: DK
Food security (FSC) - Question identifier:FSC_Q035
[The children were] not eating enough because [you or other adults in your household] just couldn't afford enough food. Was that often, sometimes, or never true in the past 12 months?
- 1: Often true
- 2: Sometimes true
- 3: Never true
- 8: RF
- 9: DK
Food security (FSC) - Question identifier:FSC_R040
The following few questions are about the food situation in the past 12 months for you or any other adults in your household.
Food security (FSC) - Question identifier:FSC_Q040
In the past 12 months, since last ^CURRENTMONTH, did [you or other adults in your household] ever cut the size of your meals or skip meals because there wasn't enough money for food?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Food security (FSC) - Question identifier:FSC_Q045
How often did this happen? Was it...?
- 1: Almost every month
- 2: Some months but not every month
- 3: Only 1 or 2 months
- 8: RF
- 9: DK
Food security (FSC) - Question identifier:FSC_Q050
In the past 12 months, did you (personally) ever eat less than you felt you should because there wasn't enough money to buy food?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Food security (FSC) - Question identifier:FSC_Q055
In the past 12 months, were you (personally) ever hungry but didn't eat because you couldn't afford enough food?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Food security (FSC) - Question identifier:FSC_Q060
In the past 12 months, did you (personally) ever lose weight because you didn't have enough money for food?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Food security (FSC) - Question identifier:FSC_Q065
In the past 12 months, did [you or other adults in your household] ever not eat for a whole day because there wasn't enough money for food?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Food security (FSC) - Question identifier:FSC_Q070
How often did this happen? Was it...?
- 1: Almost every month
- 2: Some months but not every month
- 3: Only 1 or 2 months
- 8: RF
- 9: DK
Food security (FSC) - Question identifier:FSC_R075
Now, a few questions on the food experiences for children in your household.
Food security (FSC) - Question identifier:FSC_Q075
In the past 12 months, did [you or other adults in your household] ever cut the size of [any of the children's] meals because there wasn't enough money for food?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Food security (FSC) - Question identifier:FSC_Q080
In the past 12 months, did [any of the children] ever skip meals because there wasn't enough money for food?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Food security (FSC) - Question identifier:FSC_Q085
How often did this happen? Was it...?
- 1: Almost every month
- 2: Some months but not every month
- 3: Only 1 or 2 months
- 8: RF
- 9: DK
Food security (FSC) - Question identifier:FSC_Q090
In the past 12 months, [were any of the children] ever hungry but you just couldn't afford more food?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Food security (FSC) - Question identifier:FSC_Q095
In the past 12 months, did [any of the children] ever not eat for a whole day because there wasn't enough money for food?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Administration information (ADM)
In this module, respondents are informed that their information may be used for data linkage. Respondents are asked to provide their provincial or territorial health number.
Respondents are also asked to give their permission to share their reported data and their tax data with health partners.
Administration information (ADM) - Question identifier:ADM_Q005
[To minimize the number of questions asked/To enhance the information you have provided], Statistics Canada will combine [your responses] with information from [the tax data of all members of the household/your tax data]. [Statistics Canada, your [territorial/provincial] ministry of health and the "Institut de la Statistique du Québec"/Statistics Canada and your [territorial/provincial] ministry of health] may also combine [your responses] with information from other survey or administrative sources. This may include information on past and continuing use of health services such as visits to hospitals, clinics and doctors' offices.
- 1: Continue (Go to ADM_D010A)
- 2: Respondent does not want his or her responses combined with other sources
- 3: Other [e.g., respondent hung up, interview suspended or interrupted]
Administration information (ADM) - Question identifier:ADM_Q010
Having a provincial or territorial health number will assist us in linking to this other information.
[Do you] have [a Newfoundland and Labrador/a Prince Edward Island/a Nova Scotia/a New Brunswick/a Quebec/an Ontario/a Manitoba/a Saskatchewan/an Alberta/a British Columbia/a Yukon/a Northwest Territories/a Nunavut] health number?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Administration information (ADM) - Question identifier:ADM_Q015
For which province or territory is [your] health number?
- 10: Newfoundland and Labrador
- 11: Prince Edward Island
- 12: Nova Scotia
- 13: New Brunswick
- 24: Quebec
- 35: Ontario
- 46: Manitoba
- 47: Saskatchewan
- 48: Alberta
- 59: British Columbia
- 60: Yukon
- 61: Northwest Territories
- 62: Nunavut
- 88: Does not have a Canadian health number
- 98: RF
- 99: DK
Administration information (ADM) - Question identifier:ADM_Q24
What is your health number?
Long Answer Length = 12
Administration information (ADM) - Question identifier:ADM_R025
To avoid duplication of surveys, Statistics Canada has signed agreements with provincial and territorial ministries of health, Health Canada and the Public Health Agency of Canada to share the information that you provided on this survey.
Provincial ministries of health may make this information available to local health authorities, but no identifiable information such as [names, addresses, telephone numbers and health numbers will be provided/names, addresses and telephone numbers will be provided].
Administration information (ADM) - Question identifier:ADM_R030
To avoid duplication of surveys, Statistics Canada has signed agreements with provincial and territorial ministries of health, the "Institut de la Statistique du Québec", Health Canada and the Public Health Agency of Canada to share the information that you provided on this survey.
The "Institut de la Statistique du Québec" and provincial ministries of health may make this information available to local health authorities, but no identifiable information such as [names, addresses, telephone numbers and health numbers will be provided/names, addresses and telephone numbers will be provided].
Administration information (ADM) - Question identifier:ADM_Q035
These organizations have agreed to keep your information confidential and use it only for statistical purposes.
Do you agree to share the information provided?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Administration information (ADM) - Question identifier:ADM_Q037
To reduce the number of questions in this questionnaire, Statistics Canada will use information from your tax forms submitted to the Canada Revenue Agency. With your consent Statistics Canada will disclose this information from your forms to [provincial and territorial ministries of health, the "Institut de la Statistique du Québec", 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 disclose your tax information to [provincial and territorial ministries of health, the "Institut de la Statistique du Québec", Health Canada and the Public Health Agency of Canada/provincial and territorial ministries of health, Health Canada and the Public Health Agency of Canada]?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Income (INC)
In this module, respondents are asked to provide the amount of their household income, all sources of income, and their main sources of household income, for the last calendar year. The respondent is also asked if the total household income includes a supplement for people with disabilities, for certain types of income.
Although income is a sensitive topic, this information is very important for studying the link between income and health.
Although many health care costs in Canada are covered by insurance, income still plays an important role in people's health. People living in households with lower incomes are more likely to have poorer health. People living in households with varying income levels also tend to use the health care system differently.
Income (INC) - Question identifier:INC_R001
Although many health expenses are covered by health insurance, there is still an important relationship between health and income. Please be assured that, like all other information you have provided, these answers will be kept strictly confidential.
Income (INC) - Question identifier:INC_Q005
Thinking about the total income for all household members, from which of the following sources did your household receive any income in the year ending December 31, [CURRENTYEAR [minus] 1]?
- 01: Wages and salaries
- 02: Income from self-employment
- 03: Dividends and interest (e.g., on bonds, savings)
- 04: Employment insurance
- 05: Workers' compensation
- 06: Benefits from Canada or Quebec Pension Plan
- 07: Job-related retirement pensions, superannuation and annuities
- 08: RRSP/RRIF (Registered Retirement Savings Plan/Registered Retirement Income Fund)
- 09: Old Age Security and Guaranteed Income Supplement
- 10: Provincial or municipal social assistance or welfare
- 11: Child Tax Benefit or family allowances
- 12: Child support
- 13: Alimony
- 14: Other (e.g., rental income, scholarships)
- 15: None
- 98: RF
- 99: DK
Income (INC) - Question identifier:INC_Q010
Does this amount include a supplement for people with disabilities?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Income (INC) - Question identifier:INC_Q015
What was the main source of household income?
- 01: Wages and salaries
- 02: Income from self-employment
- 03: Dividends and interest (e.g., on bonds, savings)
- 04: Employment insurance
- 05: Workers' compensation
- 06: Benefits from Canada or Quebec Pension Plan
- 07: Job-related retirement pensions, superannuation and annuities
- 08: RRSP/RRIF (Registered Retirement Savings Plan/Registered Retirement Income Fund)
- 09: Old Age Security and Guaranteed Income Supplement
- 10: Provincial or municipal social assistance or welfare
- 11: Child Tax Benefit or family allowances
- 12: Child support
- 13: Alimony
- 14: Other (e.g., rental income, scholarships)
- 15: None
- 98: RF
- 99: DK
Income (INC) - Question identifier:INC_Q25
Now a question about your total household income.
What is your best estimate of your total household income received by all household members, from all sources, before taxes and deductions, during the year ending December 31,[CURRENTYEAR [minus] 1] ]?
Income can come from various sources such as from work, investments, pensions or government. Examples include Employment Insurance, Social Assistance, Child Tax Benefit and other income such as child support, spousal support (alimony) and rental income.
Min = -9000000; Max = 90000000
Income (INC) - Question identifier:INC_Q30
Can you estimate in which of the following groups your household income falls? Was the total household income during the year ending December 31, [CURRENTYEAR [minus] 1]... ?
- 1: Less than $50,000, including income loss
- 2: $50,000 and more
- 8: RF
- 9: DK
Income (INC) - Question identifier:INC_Q35
Please stop me when I have read the category which applies to your household.
Was it... ?
- 1: Less than $5,000
- 2: $5,000 to less than $10,000
- 3: $10,000 to less than $15,000
- 4: $15,000 to less than $20,000
- 5: $20,000 to less than $30,000
- 6: $30,000 to less than $40,000
- 7: $40,000 to less than $50,000
- 8: RF
- 9: DK
Income (INC) - Question identifier:INC_Q40
Please stop me when I have read the category which applies to your household.
Was it... ?
- 1: $50,000 to less than $60,000
- 2: $60,000 to less than $70,000
- 3: $70,000 to less than $80,000
- 4: $80,000 to less than $90,000
- 5: $90,000 to less than $100,000
- 6: $100,000 to less than $150,000
- 7: $150,000 and over
- 8: RF
- 9: DK
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