Canadian Community Health Survey (CCHS) - Annual Component - 2023
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For Information onlyThis is an electronic survey example for information purposes only. This is not a working questionnaire.
Table of Contents
- Respondent availability (TR)
- The proxy respondent (PRX)
- Verification (VER2)
- Date of birth (AGE)
- Sex and gender (GDRA)
- Relationship with confirmation (RWC)
- Main activity (MAC)
- Main activity (MA)
- Main activity (EDC)
- General health (GEN)
- Life satisfaction measures (LSM)
- Pregnancy (PRS)
- Height and weight (HWT)
- COVID-19 (COVA)
- COVID-19 (COVB)
- COVID-19 (COVC)
- COVID-19 (COVD)
- COVID-19 (COVE)
- COVID-19 (COVF)
- Chronic conditions (CCC)
- Chronic conditions (CC1)
- Health utility index (HUI)
- Long-term condition (LTC)
- Activities of daily living (ADL)
- Eating habits (EAH)
- Use of protective equipment (UPE)
- Moderate physical activity (MPA)
- Other physical activities (OPA)
- Current smoking status (CSS)
- Smoking - past use (SPU)
- Electronic cigarettes and vaping (ECV)
- Alcohol use (ALC)
- Alcohol use (ALW)
- Cannabis use (CAN)
- Maternal experiences (MEX)
- Flu shots (FLU)
- Positive mental health (PMS)
- Consultations about mental health (CMH)
- Mental health (DEP)
- Social provisions (SPS)
- Regular health care provider (RHC)
- Labour market activities (LMAM)
- Labour market activities (LMA3)
- Labour market activities (LMA4)
- Labour market activities (LMA5)
- Labour market activities (LMA6)
- Labour market activities (LBF)
- Telework (LM)
- Place of birth, immigration and citizenship (IM)
- Indigenous identity (ABM)
- Population group (PG)
- Language (LAN)
- Sexual orientation (SOR)
- Home care services (HMC)
- Food security (FSC)
- Total household income (INC)
- Administrative information (ADMC)
Respondent availability (TR)
Respondent availability (TR) - Question identifier:TR_Q01
May I speak to [First name of household contact] [Last name of household contact]?
- 1: Yes, speaking to respondent
- 2: Yes, respondent available
- 3: No, respondent unable to complete this survey
- 4: No, respondent not available at this time
The proxy respondent (PRX)
The proxy respondent (PRX) - Question identifier:PRX_Q01
What is the reason [First name of household contact] is unable to complete this survey?
- 1: Respondent does not speak English or French (Language barrier)
- 2: Respondent unable to answer because of a health condition, a physical or mental disability, or problems related to aging
- 3: Respondent absent for the duration of the collection period
- 4: Other
The proxy respondent (PRX) - Question identifier:PRX_Q02
Is there someone [Minimum age of person providing proxy interview] or older who could provide us with some information on behalf of [First name of household contact]? We would like to ask this person questions about [First name of household contact]'s health status, factors that affect their health and their use of health care services.
- 1: Yes
- 2: No
The proxy respondent (PRX) - Question identifier:PRX_Q03A
What is the first name of this person?
Long Answer Length = 80
The proxy respondent (PRX) - Question identifier:PRX_Q03B
What is the last name of this person?
Long Answer Length = 80
Verification (VER2)
Verification (VER2) - Question identifier:VER2_Q05
Are you [First name of specific respondent] [Last name of specific respondent]?
- 1: Yes
- 2: No
Verification (VER2) - Question identifier:VER2_Q07C
What is your date of birth?
Year
Min = 2000; Max = 2022
Verification (VER2) - Question identifier:VER2_Q07B
What is your date of birth?
Month
- 01: January
- 02: February
- 03: March
- 04: April
- 05: May
- 06: June
- 07: July
- 08: August
- 09: September
- 10: October
- 11: November
- 12: December
Verification (VER2) - Question identifier:VER2_Q07A
What is your date of birth?
Day
Min = 1; Max = 31
Verification (VER2) - Question identifier:VER2_Q08
In which province or territory do you currently live?
- 10: Newfoundland and Labrador
- 11: Prince Edward Island
- 12: Nova Scotia
- 13: New Brunswick
- 24: Quebec
- 35: Ontario
- 46: Manitoba
- 47: Saskatchewan
- 48: Alberta
- 59: British Columbia
- 60: Yukon
- 61: Northwest Territories
- 62: Nunavut
Date of birth (AGE)
Date of birth (AGE) - Question identifier:AGE_Q01A
What is [your] date of birth?
Year
Min = 1897; Max = 2022
Date of birth (AGE) - Question identifier:AGE_Q01B
What is [your] date of birth?
Month
- 01: January
- 02: February
- 03: March
- 04: April
- 05: May
- 06: June
- 07: July
- 08: August
- 09: September
- 10: October
- 11: November
- 12: December
Date of birth (AGE) - Question identifier:AGE_Q01C
What is [your] date of birth?
Day
Min = 1; Max = 31
Sex and gender (GDRA)
Sex and gender (GDRA) - Question identifier:GDRA_R05
The following questions are about sex at birth and gender.
Sex and gender (GDRA) - Question identifier:GDRA_Q05
What was [your] sex at birth?
- 1: Male
- 2: Female
Sex and gender (GDRA) - Question identifier:GDRA_Q10
What is [your] gender?
- 1: Male
- 2: Female
- 3: Or please specify
Sex and gender (GDRA) - Question identifier:GDRA_R15
Please verify that all of the information is correct.
[Your]
Sex assigned at birth: [Male/Female/Information not provided]
Gender: [Male/Female/Other/Information not provided]
Relationship with confirmation (RWC)
Relationship with confirmation (RWC) - Question identifier:RWC_Q05
What is the relationship of the following [people/person] to you?
- 01: Husband or wife
- 02: Common-law partner
- 03: Father or mother
- 04: Son or daughter
- 05: Brother or sister
- 06: In-law
- 07: Other related
- 08: Unrelated
Relationship with confirmation (RWC) - Question identifier:RWC_Q30
Select the type of relationship.
- 1: Aunt or uncle
- 2: Cousin
- 3: Niece or nephew
- 4: Grandfather or grandmother
- 5: Grandson or granddaughter
- 6: Other relative
Main activity (MAC)
Main activity (MAC) - Question identifier:MAC_Q04
In the past 12 months, did you work at a job or business?
- 1: Yes
- 2: No
Main activity (MAC) - Question identifier:MAC_Q05
In the past 12 months, was working at a job or business your main activity?
- 1: Yes
- 2: No
Main activity (MA)
Main activity (MA) - Question identifier:MA_Q02
During the past 12 months, what was your main activity?
- 01: Looking for paid work
- 02: Going to school
- 03: Caring for your children
- 04: Household work
- 05: Retired
- 06: Maternity, paternity or parental leave
- 07: Long term illness
- 08: Volunteering or care-giving other than for your children
- 09: Other
Main activity (EDC)
Main activity (EDC) - Question identifier:EDC_Q10
Are you currently attending a school, college, CEGEP or university?
- 1: Yes
- 2: No
Main activity (EDC) - Question identifier:EDC_Q20
Are you enrolled as a full-time or part-time student?
Each educational institution classifies students as full-time or part-time depending on the type of program, and the number of courses, credits or hours of instruction.
- 1: Full-time student
- 2: Part-time student
General health (GEN)
General health (GEN) - Question identifier:GEN_R01
The following question is about health. By health, we mean not only the absence of disease or injury but also physical, mental and social well-being.
General health (GEN) - Question identifier:GEN_Q01
In general, how is your health?
- 1: Excellent
- 2: Very good
- 3: Good
- 4: Fair
- 5: Poor
General health (GEN) - Question identifier:GEN_Q05
In general, how is your mental health?
- 1: Excellent
- 2: Very good
- 3: Good
- 4: Fair
- 5: Poor
General health (GEN) - Question identifier:GEN_Q10
Thinking about the amount of stress in your life, how would you describe most of your days?
- 1: Not at all stressful
- 2: Not very stressful
- 3: A bit stressful
- 4: Quite a bit stressful
- 5: Extremely stressful
General health (GEN) - Question identifier:GEN_R15
The next question is about your main job or business in the past 12 months.
General health (GEN) - Question identifier:GEN_Q15
How would you describe most days at work?
- 1: Not at all stressful
- 2: Not very stressful
- 3: A bit stressful
- 4: Quite a bit stressful
- 5: Extremely stressful
General health (GEN) - Question identifier:GEN_Q20
How would you describe your sense of belonging to your local community?
- 1: Very strong
- 2: Somewhat strong
- 3: Somewhat weak
- 4: Very weak
Life satisfaction measures (LSM)
Life satisfaction measures (LSM) - Question identifier:LSM_Q01
Using a scale of 0 to 10, where 0 means "Very dissatisfied" and 10 means "Very satisfied", how do you feel about your life as a whole right now?
- 00: Very dissatisfied
- 01: |
- 02: |
- 03: |
- 04: |
- 05: |
- 06: |
- 07: |
- 08: |
- 09: V
- 10: Very satisfied
Pregnancy (PRS)
Pregnancy (PRS) - Question identifier:PRS_R05
To better understand your health information, it is important to know if you are pregnant.
Pregnancy (PRS) - Question identifier:PRS_Q05
Are you pregnant?
- 1: Yes
- 2: No
Height and weight (HWT)
Height and weight (HWT) - Question identifier:HWT_Q05A
How tall are you without shoes on?
Feet
Min = 0; Max = 9
Height and weight (HWT) - Question identifier:HWT_Q05B
How tall are you without shoes on?
Inches
Min = 0; Max = 99
Height and weight (HWT) - Question identifier:HWT_Q05C
How tall are you without shoes on?
Centimetres
Min = 0; Max = 999
Height and weight (HWT) - Question identifier:HWT_Q40A
How much do you weigh?
Weight
Min = 0; Max = 999
Height and weight (HWT) - Question identifier:HWT_Q40B
How much do you weigh?
Pounds or kilograms
- 1: Pounds
- 2: Kilograms
COVID-19 (COVA)
COVID-19 (COVA) - Question identifier:COVA_R005
The next questions are about your experiences during the COVID-19 pandemic.
COVID-19 (COVA) - Question identifier:COVA_Q005
Compared to before the pandemic started, how would you say your mental health is now?
- 1: Much better now
- 2: Somewhat better now
- 3: About the same
- 4: Somewhat worse now
- 5: Much worse now
COVID-19 (COVB)
COVID-19 (COVB) - Question identifier:COVB_Q010
Which of the following precautions are you taking to protect yourself or others against COVID-19?
- 01: Wash hands more frequently
- 02: Wear a mask in public places where physical distancing is difficult
- 03: Keep a 2 meter or 6 foot distance from others
- 04: Avoid crowds and large gatherings
- 05: Avoid leaving the house for non-essential reasons
- 06: Work from home
- 07: Use delivery or curb side pick-up services (e.g., groceries, prescriptions)
- 08: Self-isolate if you have symptoms
- 09: Other precaution
- 10: No precaution taken
COVID-19 (COVC)
COVID-19 (COVC) - Question identifier:COVC_Q015
In the last 3 months, have you experienced any symptoms that led you to believe that you had COVID-19, such as fever, cough, headache, sore throat, runny nose, difficulty breathing, tiredness or loss of taste or smell?
- 1: Yes
- 2: No
COVID-19 (COVC) - Question identifier:COVC_Q020
While you were experiencing these symptoms, did you follow provincial guidelines (e.g., self-isolate for a required number of days)?
- 1: Yes
- 2: No
COVID-19 (COVD)
COVID-19 (COVD) - Question identifier:COVD_Q038
Have you been vaccinated against COVID-19?
- 1: Yes, received at least one dose of a vaccine
- 2: No
COVID-19 (COVD) - Question identifier:COVD_Q030
Does the vaccine you received require one or two doses?
- 1: One dose (e.g., Johnson & Johnson)
- 2: Two doses (e.g., Moderna, Pfizer-BioNTech, AstraZeneca, Novavax, etc.)
COVID-19 (COVD) - Question identifier:COVD_Q035
How many doses of the COVID-19 vaccine have you received so far?
- 1: One dose
- 2: Two doses
- 3: Three doses
- 4: Four doses
- 5: Five doses or more
COVID-19 (COVD) - Question identifier:COVD_Q036A
When did you receive your last dose of a COVID-19 vaccine?
Month
- 01: January
- 02: February
- 03: March
- 04: April
- 05: May
- 06: June
- 07: July
- 08: August
- 09: September
- 10: October
- 11: November
- 12: December
COVID-19 (COVD) - Question identifier:COVD_Q036B
When did you receive your last dose of a COVID-19 vaccine?
Year
- 1: 2020
- 2: 2021
- 3: 2022
- 4: 2023
- 5: 2024
COVID-19 (COVE)
COVID-19 (COVE) - Question identifier:COVE_Q041
What is the main reason why you haven't been vaccinated against COVID-19?
- 1: I do not trust the effectiveness or safety of the COVID-19 vaccines
- 2: If I get COVID-19, the risk of having serious symptoms is low
- 3: The vaccine is not recommended for me (e.g., a pre-existing medical condition)
- 4: I am not at high risk of getting infected with COVID-19
- 5: I have already had COVID-19
- 6: Other reason
COVID-19 (COVE) - Question identifier:COVE_Q055
What is the main reason why you haven't received a booster dose?
- 01: The number of doses I have received is enough to protect me against COVID-19
- 02: I have already had COVID-19
- 03: I had a bad reaction to a previous dose
- 04: I have concerns about side effects associated with a booster dose
- 05: If I get COVID-19, the risk of having serious symptoms is low
- 06: I just did not get around to it
- 07: I have an appointment in the future
- 08: Other reason
COVID-19 (COVF)
COVID-19 (COVF) - Question identifier:COVF_Q060A
How likely is it that you would get a booster dose?
- 1: Very likely
- 2: Somewhat likely
- 3: Somewhat unlikely
- 4: Very unlikely
Chronic conditions (CCC)
Chronic conditions (CCC) - Question identifier:CCC_R01
The next questions are about long-term health conditions. These are conditions which are expected to last or have already lasted 6 months or more and that have been diagnosed by a health professional.
Chronic conditions (CCC) - Question identifier:CCC_Q05
Do you have diabetes?
- 1: Yes
- 2: No
Chronic conditions (CCC) - Question identifier:CCC_Q10
How old were you when this was first diagnosed?
Min = 0; Max = 999
Chronic conditions (CCC) - Question identifier:CCC_Q15
Were you pregnant when you were first diagnosed with diabetes?
- 1: Yes
- 2: No
Chronic conditions (CCC) - Question identifier:CCC_Q20
Other than during pregnancy, has a health professional ever told you that you have diabetes?
- 1: Yes
- 2: No
Chronic conditions (CCC) - Question identifier:CCC_Q25
Were you diagnosed with type 1 or type 2 diabetes?
- 1: Type 1 - Insulin dependent diabetes
- 2: Type 2 - Non-Insulin dependent diabetes
- 3: Both types
Chronic conditions (CCC) - Question identifier:CCC_Q30
When you were first diagnosed with diabetes, how long was it before you were started on insulin?
- 1: Less than 1 month
- 2: 1 month to less than 2 months
- 3: 2 months to less than 6 months
- 4: 6 months to less than 1 year
- 5: 1 year or more
- 6: Never
Chronic conditions (CCC) - Question identifier:CCC_Q35
Do you currently take insulin for your diabetes?
- 1: Yes
- 2: No
Chronic conditions (CCC) - Question identifier:CCC_Q40
In the past month, did you take pills to control your blood sugar?
- 1: Yes
- 2: No
Chronic conditions (CCC) - Question identifier:CCC_Q45
Have you ever been diagnosed with cancer?
- 1: Yes
- 2: No
Chronic conditions (CCC) - Question identifier:CCC_Q50
How old were you when this was first diagnosed?
Min = 0; Max = 999
Chronic conditions (CCC) - Question identifier:CCC_Q55
Have you received treatment for cancer in the past 12 months?
- 1: Yes
- 2: No
Chronic conditions (CCC) - Question identifier:CCC_Q60
What type of cancer were you diagnosed with?
- 01: Breast
- 02: Prostate
- 03: Colorectal
- 04: Skin - Melanoma
- 05: Skin - Non-melanoma
- 06: Ovarian
- 07: Cervical
- 08: Uterine
- 09: Lung
- 10: Other - specify
Chronic conditions (CCC) - Question identifier:CCC_Q65
Do you have heart disease?
- 1: Yes
- 2: No
Chronic conditions (CCC) - Question identifier:CCC_Q70
How old were you when this was first diagnosed?
Min = 0; Max = 999
Chronic conditions (CCC) - Question identifier:CCC_Q75
[Have you] ever been told by a health professional that you have had a heart attack?
- 1: Yes
- 2: No
Chronic conditions (CCC) - Question identifier:CCC_Q80
Do you have high blood pressure?
- 1: Yes
- 2: No
Chronic conditions (CCC) - Question identifier:CCC_Q85
In the past month, have you taken any medicine for high blood pressure?
- 1: Yes
- 2: No
Chronic conditions (CCC) - Question identifier:CCC_Q90
[Have you] ever been told by a health professional that your blood cholesterol was high?
- 1: Yes
- 2: No
Chronic conditions (CCC) - Question identifier:CCC_Q95
Do you suffer from the effects of a stroke?
- 1: Yes
- 2: No
Chronic conditions (CCC) - Question identifier:CCC_Q100
Do you have osteoporosis?
- 1: Yes
- 2: No
Chronic conditions (CCC) - Question identifier:CCC_R105
We are interested in conditions diagnosed by a health professional and that are expected to last or have already lasted 6 months or more.
Chronic conditions (CCC) - Question identifier:CCC_Q105
Do you have fibromyalgia?
- 1: Yes
- 2: No
Chronic conditions (CCC) - Question identifier:CCC_Q110
How old were you when the first symptoms appeared?
Min = 0; Max = 999
Chronic conditions (CCC) - Question identifier:CCC_Q115
How old were you when this was first diagnosed?
Min = 0; Max = 999
Chronic conditions (CCC) - Question identifier:CCC_Q120
Do you have arthritis?
- 1: Yes
- 2: No
Chronic conditions (CCC) - Question identifier:CCC_Q125
Do you have back problems?
- 1: Yes
- 2: No
Chronic conditions (CCC) - Question identifier:CCC_Q130
Was this diagnosed by a health professional?
- 1: Yes
- 2: No
Chronic conditions (CCC) - Question identifier:CCC_Q135
Do you have a mood disorder?
- 1: Yes
- 2: No
Chronic conditions (CC1)
Chronic conditions (CC1) - Question identifier:CC1_R140
We are interested in conditions diagnosed by a health professional and that are expected to last or have already lasted 6 months or more.
Chronic conditions (CC1) - Question identifier:CC1_Q140
Do you have an anxiety disorder?
- 1: Yes
- 2: No
Chronic conditions (CC1) - Question identifier:CC1_Q145
Do you have post-traumatic stress disorder (PTSD)?
- 1: Yes
- 2: No
Chronic conditions (CC1) - Question identifier:CC1_Q150
Do you have Alzheimer's disease or any other dementia?
- 1: Yes
- 2: No
Chronic conditions (CC1) - Question identifier:CC1_Q155
Do you have chronic fatigue syndrome (CFS)?
- 1: Yes
- 2: No
Chronic conditions (CC1) - Question identifier:CC1_Q160
How old were you when the first symptoms appeared?
Age in years
Min = 0; Max = 999
Chronic conditions (CC1) - Question identifier:CC1_Q165
How old were you when this was first diagnosed?
Age in years
Min = 0; Max = 999
Chronic conditions (CC1) - Question identifier:CC1_Q170
Do you have multiple chemical sensitivities (MCS)?
- 1: Yes
- 2: No
Chronic conditions (CC1) - Question identifier:CC1_Q175
How old were you when the first symptoms appeared?
Age in years
Min = 0; Max = 999
Chronic conditions (CC1) - Question identifier:CC1_Q180
How old were you when this was first diagnosed?
Age in years
Min = 0; Max = 999
Health utility index (HUI)
Health utility index (HUI) - Question identifier:HUI_R001
The next set of questions asks about your day-to-day health.
You may feel that some of these questions do not apply to you, but it is important that we ask the same questions of everyone.
Health utility index (HUI) - Question identifier:HUI_Q005
Are you usually able to see well enough to read ordinary newsprint without glasses or contact lenses?
- 1: Yes
- 2: No
Health utility index (HUI) - Question identifier:HUI_Q005A
Are you able to see well enough to recognize a friend on the other side of the street without glasses or contact lenses?
- 1: Yes
- 2: No
Health utility index (HUI) - Question identifier:HUI_Q005B
Are you usually able to see well enough to recognize a friend on the other side of the street with glasses or contact lenses?
- 1: Yes
- 2: No
Health utility index (HUI) - Question identifier:HUI_Q010
Are you usually able to see well enough to read ordinary newsprint with glasses or contact lenses?
- 1: Yes
- 2: No
Health utility index (HUI) - Question identifier:HUI_Q010A
Are you able to see well enough to recognize a friend on the other side of the street without glasses or contact lenses?
- 1: Yes
- 2: No
Health utility index (HUI) - Question identifier:HUI_Q010B
Are you usually able to see well enough to recognize a friend on the other side of the street with glasses or contact lenses?
- 1: Yes
- 2: No
Health utility index (HUI) - Question identifier:HUI_Q015
Are you able to see at all?
- 1: Yes
- 2: No
Health utility index (HUI) - Question identifier:HUI_Q015A
Are you able to see well enough to recognize a friend on the other side of the street without glasses or contact lenses?
- 1: Yes
- 2: No
Health utility index (HUI) - Question identifier:HUI_Q015B
Are you usually able to see well enough to recognize a friend on the other side of the street with glasses or contact lenses?
- 1: Yes
- 2: No
Health utility index (HUI) - Question identifier:HUI_Q030
Are you usually able to hear what is said in a group conversation with at least three other people without a hearing aid?
- 1: Yes
- 2: No
Health utility index (HUI) - Question identifier:HUI_Q035
Are you usually able to hear what is said in a group conversation with at least three other people with a hearing aid?
- 1: Yes
- 2: No
Health utility index (HUI) - Question identifier:HUI_Q035A
Are you usually able to hear what is said in a conversation with one other person in a quiet room without a hearing aid?
- 1: Yes
- 2: No
Health utility index (HUI) - Question identifier:HUI_Q035B
Are you usually able to hear what is said in a conversation with one other person in a quiet room with a hearing aid?
- 1: Yes
- 2: No
Health utility index (HUI) - Question identifier:HUI_Q040
Are you able to hear at all?
- 1: Yes
- 2: No
Health utility index (HUI) - Question identifier:HUI_Q040A
Are you usually able to hear what is said in a conversation with one other person in a quiet room without a hearing aid?
- 1: Yes
- 2: No
Health utility index (HUI) - Question identifier:HUI_Q040B
Are you usually able to hear what is said in a conversation with one other person in a quiet room with a hearing aid?
- 1: Yes
- 2: No
Health utility index (HUI) - Question identifier:HUI_Q055
Are you usually able to be understood completely when speaking with strangers in your own language?
- 1: Yes
- 2: No
Health utility index (HUI) - Question identifier:HUI_Q060
Are you able to be understood partially when speaking with strangers?
- 1: Yes
- 2: No
Health utility index (HUI) - Question identifier:HUI_Q065
Are you able to be understood completely when speaking with those who know you well?
- 1: Yes
- 2: No
Health utility index (HUI) - Question identifier:HUI_Q070
Are you able to be understood partially when speaking with those who know you well?
- 1: Yes
- 2: No
Health utility index (HUI) - Question identifier:HUI_Q075
Are you usually able to walk around the neighbourhood without difficulty and without mechanical support such as braces, a cane or crutches?
- 1: Yes
- 2: No
Health utility index (HUI) - Question identifier:HUI_Q080
Are you able to walk at all?
- 1: Yes
- 2: No
Health utility index (HUI) - Question identifier:HUI_Q085
Do you require mechanical support such as braces, a cane or crutches to be able to walk around the neighbourhood?
- 1: Yes
- 2: No
Health utility index (HUI) - Question identifier:HUI_Q090
Do you require the help of another person to be able to walk?
- 1: Yes
- 2: No
Health utility index (HUI) - Question identifier:HUI_Q095
Do you require a wheelchair to get around?
- 1: Yes
- 2: No
Health utility index (HUI) - Question identifier:HUI_Q100
How often do you use a wheelchair?
- 1: Always
- 2: Often
- 3: Sometimes
- 4: Never
Health utility index (HUI) - Question identifier:HUI_Q105
Do you need the help of another person to get around in the wheelchair?
- 1: Yes
- 2: No
Health utility index (HUI) - Question identifier:HUI_Q110
Are you usually able to grasp and handle small objects such as a pencil or scissors?
- 1: Yes
- 2: No
Health utility index (HUI) - Question identifier:HUI_Q115
Do you require the help of another person because of limitations in the use of your hands or fingers?
- 1: Yes
- 2: No
Health utility index (HUI) - Question identifier:HUI_Q120
How many tasks do you require the help of another person with?
- 1: Some tasks
- 2: Most tasks
- 3: Almost all tasks
- 4: All tasks
Health utility index (HUI) - Question identifier:HUI_Q125
Do you require special equipment, for example, devices to assist in dressing, because of limitations in the use of your hands or fingers?
- 1: Yes
- 2: No
Health utility index (HUI) - Question identifier:HUI_Q130
How would you describe yourself as being usually?
- 1: Happy and interested in life
- 2: Somewhat happy
- 3: Somewhat unhappy
- 4: Unhappy with little interest in life
- 5: So unhappy, that life is not worthwhile
Health utility index (HUI) - Question identifier:HUI_Q135
How would you describe your usual ability to remember things?
- 1: Able to remember most things
- 2: Somewhat forgetful
- 3: Very forgetful
- 4: Unable to remember anything at all
Health utility index (HUI) - Question identifier:HUI_Q140
How would you describe your usual ability to think and solve day-to-day problems?
- 1: Able to think clearly and solve problems
- 2: Having a little difficulty
- 3: Having some difficulty
- 4: Having a great deal of difficulty
- 5: Unable to think or solve problems
Health utility index (HUI) - Question identifier:HUI_R145
The next set of questions asks about the level of pain or discomfort you usually experience. They are not about illnesses like colds that affect people for short periods of time.
Health utility index (HUI) - Question identifier:HUI_Q145
Are you usually free of pain or discomfort?
- 1: Yes
- 2: No
Health utility index (HUI) - Question identifier:HUI_Q150
How would you describe the usual intensity of your pain or discomfort?
- 1: Mild
- 2: Moderate
- 3: Severe
Health utility index (HUI) - Question identifier:HUI_Q155
How many activities does your pain or discomfort prevent?
- 1: None
- 2: A few
- 3: Some
- 4: Most
Long-term condition (LTC)
Long-term condition (LTC) - Question identifier:LTC_Q10
Do you identify as a person with a disability?
- 1: Yes
- 2: No
Activities of daily living (ADL)
Activities of daily living (ADL) - Question identifier:ADL_R01
These questions may not apply to you, but we need to ask the same questions of everyone.
Activities of daily living (ADL) - Question identifier:ADL_Q05
Because of any health problem, physical or mental condition, do you have any difficulty with the following common daily activities?
Preparing meals
- 1: No difficulty
- 2: Some difficulty, but no help required
- 3: Some difficulty and help from others is required
- 4: Cannot do at all
Activities of daily living (ADL) - Question identifier:ADL_Q10
Because of any health problem, physical or mental condition, do you have any difficulty with the following common daily activities?
Running errands
- 1: No difficulty
- 2: Some difficulty, but no help required
- 3: Some difficulty and help from others is required
- 4: Cannot do at all
Activities of daily living (ADL) - Question identifier:ADL_Q15
Because of any health problem, physical or mental condition, do you have any difficulty with the following common daily activities?
Everyday housework
- 1: No difficulty
- 2: Some difficulty, but no help required
- 3: Some difficulty and help from others is required
- 4: Cannot do at all
Activities of daily living (ADL) - Question identifier:ADL_Q20
Because of any health problem, physical or mental condition, do you have any difficulty with the following common daily activities?
Personal care
- 1: No difficulty
- 2: Some difficulty, but no help required
- 3: Some difficulty and help from others is required
- 4: Cannot do at all
Activities of daily living (ADL) - Question identifier:ADL_Q25
Because of any health problem, physical or mental condition, do you have any difficulty with the following common daily activities?
Moving inside the house
- 1: No difficulty
- 2: Some difficulty, but no help required
- 3: Some difficulty and help from others is required
- 4: Cannot do at all
Activities of daily living (ADL) - Question identifier:ADL_Q30
Because of any health problem, physical or mental condition, do you have any difficulty with the following common daily activities?
Personal finances
- 1: No difficulty
- 2: Some difficulty, but no help required
- 3: Some difficulty and help from others is required
- 4: Cannot do at all
Eating habits (EAH)
Eating habits (EAH) - Question identifier:EAH_R01
The next questions are about some of your eating and drinking habits.
Eating habits (EAH) - Question identifier:EAH_Q05A
In the past 30 days, how many times did you eat food from a restaurant?
Min = 0; Max = 999
Eating habits (EAH) - Question identifier:EAH_Q05B
In the past 30 days, how many times did you eat food from a restaurant?
Per month, per week or per day
- 1: Per month
- 2: Per week
- 3: Per day
Eating habits (EAH) - Question identifier:EAH_Q10A
In the past 30 days, how many times did you drink the following beverages?
100% pure fruit juice
Min = 0; Max = 999
Eating habits (EAH) - Question identifier:EAH_Q10B
In the past 30 days, how many times did you drink the following beverages?
Per month, per week or per day
- 1: Per month
- 2: Per week
- 3: Per day
Eating habits (EAH) - Question identifier:EAH_Q15A
In the past 30 days, how many times did you drink the following beverages?
Fruit flavoured drinks or sports drinks
Min = 0; Max = 999
Eating habits (EAH) - Question identifier:EAH_Q15B
In the past 30 days, how many times did you drink the following beverages?
Per month, per week or per day
- 1: Per month
- 2: Per week
- 3: Per day
Eating habits (EAH) - Question identifier:EAH_Q20A
In the past 30 days, how many times did you drink the following beverages?
Regular soft drinks
Min = 0; Max = 999
Eating habits (EAH) - Question identifier:EAH_Q20B
In the past 30 days, how many times did you drink the following beverages?
Per month, per week or per day
- 1: Per month
- 2: Per week
- 3: Per day
Eating habits (EAH) - Question identifier:EAH_Q25A
In the past 30 days, how many times did you drink the following beverages?
Sweetened coffee drinks or iced tea
Min = 0; Max = 999
Eating habits (EAH) - Question identifier:EAH_Q25B
In the past 30 days, how many times did you drink the following beverages?
Per month, per week or per day
- 1: Per month
- 2: Per week
- 3: Per day
Eating habits (EAH) - Question identifier:EAH_Q30A
In the past 30 days, how many times did you drink the following beverages?
Energy drinks
Min = 0; Max = 999
Eating habits (EAH) - Question identifier:EAH_Q30B
In the past 30 days, how many times did you drink the following beverages?
Per month, per week or per day
- 1: Per month
- 2: Per week
- 3: Per day
Eating habits (EAH) - Question identifier:EAH_Q35A
In the past 30 days, how many times did you drink the following beverages?
Chocolate milk
Min = 0; Max = 999
Eating habits (EAH) - Question identifier:EAH_Q35B
In the past 30 days, how many times did you drink the following beverages?
Per month, per week or per day
- 1: Per month
- 2: Per week
- 3: Per day
Eating habits (EAH) - Question identifier:EAH_Q40A
In the past 30 days, how many times did you eat the following fruits and vegetables?
Fruits
Min = 0; Max = 999
Eating habits (EAH) - Question identifier:EAH_Q40B
In the past 30 days, how many times did you eat the following fruits and vegetables?
Per month, per week or per day
- 1: Per month
- 2: Per week
- 3: Per day
Eating habits (EAH) - Question identifier:EAH_Q45A
In the past 30 days, how many times did you eat the following fruits and vegetables?
Dark green vegetables
Min = 0; Max = 999
Eating habits (EAH) - Question identifier:EAH_Q45B
In the past 30 days, how many times did you eat the following fruits and vegetables?
Per month, per week or per day
- 1: Per month
- 2: Per week
- 3: Per day
Eating habits (EAH) - Question identifier:EAH_Q50A
In the past 30 days, how many times did you eat the following fruits and vegetables?
Orange-coloured vegetables
Min = 0; Max = 999
Eating habits (EAH) - Question identifier:EAH_Q50B
In the past 30 days, how many times did you eat the following fruits and vegetables?
Per month, per week or per day
- 1: Per month
- 2: Per week
- 3: Per day
Eating habits (EAH) - Question identifier:EAH_Q55A
In the past 30 days, how many times did you eat the following fruits and vegetables?
Starchy vegetables
Min = 0; Max = 999
Eating habits (EAH) - Question identifier:EAH_Q55B
In the past 30 days, how many times did you eat the following fruits and vegetables?
Per month, per week or per day
- 1: Per month
- 2: Per week
- 3: Per day
Eating habits (EAH) - Question identifier:EAH_Q60A
In the past 30 days, how many times did you eat the following fruits and vegetables?
Other vegetables
Min = 0; Max = 999
Eating habits (EAH) - Question identifier:EAH_Q60B
In the past 30 days, how many times did you eat the following fruits and vegetables?
Per month, per week or per day
- 1: Per month
- 2: Per week
- 3: Per day
Use of protective equipment (UPE)
Use of protective equipment (UPE) - Question identifier:UPE_Q05
In the past 12 months, have you participated in any of these activities?
- 1: Bicycling
- 2: In-line skating or rollerblading
- 3: Downhill skiing
- 4: Snowboarding
- 5: Skateboarding
- 6: Playing ice hockey
Use of protective equipment (UPE) - Question identifier:UPE_Q10
When riding a bicycle, how often do you wear a helmet?
- 1: Always
- 2: Most of the time
- 3: Rarely
- 4: Never
Use of protective equipment (UPE) - Question identifier:UPE_Q20
When in-line skating or rollerblading, how often do you wear the following equipment?
A helmet
- 1: Always
- 2: Most of the time
- 3: Rarely
- 4: Never
Use of protective equipment (UPE) - Question identifier:UPE_Q25
When in-line skating or rollerblading, how often do you wear the following equipment?
Wrist guards or wrist protectors
- 1: Always
- 2: Most of the time
- 3: Rarely
- 4: Never
Use of protective equipment (UPE) - Question identifier:UPE_Q30
When in-line skating or rollerblading, how often do you wear the following equipment?
Elbow pads
- 1: Always
- 2: Most of the time
- 3: Rarely
- 4: Never
Use of protective equipment (UPE) - Question identifier:UPE_Q35
When in-line skating or rollerblading, how often do you wear the following equipment?
Knee pads
- 1: Always
- 2: Most of the time
- 3: Rarely
- 4: Never
Use of protective equipment (UPE) - Question identifier:UPE_Q45
When downhill skiing, how often do you wear a helmet?
- 1: Always
- 2: Most of the time
- 3: Rarely
- 4: Never
Use of protective equipment (UPE) - Question identifier:UPE_Q50
When snowboarding, how often do you wear the following equipment?
A helmet
- 1: Always
- 2: Most of the time
- 3: Rarely
- 4: Never
Use of protective equipment (UPE) - Question identifier:UPE_Q55
When snowboarding, how often do you wear the following equipment?
Wrist guards or wrist protectors
- 1: Always
- 2: Most of the time
- 3: Rarely
- 4: Never
Use of protective equipment (UPE) - Question identifier:UPE_Q65
When skateboarding, how often do you wear the following equipment?
A helmet
- 1: Always
- 2: Most of the time
- 3: Rarely
- 4: Never
Use of protective equipment (UPE) - Question identifier:UPE_Q70
When skateboarding, how often do you wear the following equipment?
Wrist guards or wrist protectors
- 1: Always
- 2: Most of the time
- 3: Rarely
- 4: Never
Use of protective equipment (UPE) - Question identifier:UPE_Q75
When skateboarding, how often do you wear the following equipment?
Elbow pads
- 1: Always
- 2: Most of the time
- 3: Rarely
- 4: Never
Use of protective equipment (UPE) - Question identifier:UPE_Q85
When playing ice hockey, how often do you wear a mouth guard?
- 1: Always
- 2: Most of the time
- 3: Rarely
- 4: Never
Moderate physical activity (MPA)
Moderate physical activity (MPA) - Question identifier:MPA_R01
Thinking again of the past 7 days, we would like to record your physical activities.
We will be asking about common sources of physical activity including: gym at school, recess or free time at school, organized sports and lessons, walking or playing for leisure, [walking or cycling for transportation, and physical activity while at work, volunteering, or at home/walking or cycling for transportation].
To make it easier, we will ask about weekdays and weekend days separately. If recall is too difficult, give your best estimate.
Moderate physical activity (MPA) - Question identifier:MPA_R05
In the past 7 days, how much time did you spend doing the following activities that made you sweat or breathe harder?
Moderate physical activity (MPA) - Question identifier:MPA_Q05A
Doing physical activity that made you sweat or breathe harder during school hours as part of physical education classes or at lunch hour or recess.
On a typical weekday
Hours per day
- 01: 1
- 02: 2
- 03: 3
- 04: 4
- 05: 5
- 06: 6
- 07: 7
- 08: 8
Moderate physical activity (MPA) - Question identifier:MPA_Q05B
Doing physical activity that made you sweat or breathe harder during school hours as part of physical education classes or at lunch hour or recess.
On a typical weekday
Minutes per day
- 00: 0
- 05: 5
- 10: 10
- 15: 15
- 20: 20
- 25: 25
- 30: 30
- 35: 35
- 40: 40
- 45: 45
- 50: 50
- 55: 55
Moderate physical activity (MPA) - Question identifier:MPA_Q15A
Doing physical activity that made you sweat or breathe harder while participating in clubs, lessons, leagues, or team sports.
On a typical weekday
Hours per day
- 01: 1
- 02: 2
- 03: 3
- 04: 4
- 05: 5
- 06: 6
- 07: 7
- 08: 8
Moderate physical activity (MPA) - Question identifier:MPA_Q15B
Doing physical activity that made you sweat or breathe harder while participating in clubs, lessons, leagues, or team sports.
On a typical weekday
Minutes per day
- 00: 0
- 05: 5
- 10: 10
- 15: 15
- 20: 20
- 25: 25
- 30: 30
- 35: 35
- 40: 40
- 45: 45
- 50: 50
- 55: 55
Moderate physical activity (MPA) - Question identifier:MPA_Q15C
Doing physical activity that made you sweat or breathe harder while participating in clubs, lessons, leagues, or team sports.
On a typical weekend day
Hours per day
- 01: 1
- 02: 2
- 03: 3
- 04: 4
- 05: 5
- 06: 6
- 07: 7
- 08: 8
Moderate physical activity (MPA) - Question identifier:MPA_Q15D
Doing physical activity that made you sweat or breathe harder while participating in clubs, lessons, leagues, or team sports.
On a typical weekend day
Minutes per day
- 00: 0
- 05: 5
- 10: 10
- 15: 15
- 20: 20
- 25: 25
- 30: 30
- 35: 35
- 40: 40
- 45: 45
- 50: 50
- 55: 55
Moderate physical activity (MPA) - Question identifier:MPA_Q20A
Doing physical activity that made you sweat or breathe harder for fitness, fun or recreation with friends, family or alone.
On a typical weekday
Hours per day
- 01: 1
- 02: 2
- 03: 3
- 04: 4
- 05: 5
- 06: 6
- 07: 7
- 08: 8
Moderate physical activity (MPA) - Question identifier:MPA_Q20B
Doing physical activity that made you sweat or breathe harder for fitness, fun or recreation with friends, family or alone.
On a typical weekday
Minutes per day
- 00: 0
- 05: 5
- 10: 10
- 15: 15
- 20: 20
- 25: 25
- 30: 30
- 35: 35
- 40: 40
- 45: 45
- 50: 50
- 55: 55
Moderate physical activity (MPA) - Question identifier:MPA_Q20C
Doing physical activity that made you sweat or breathe harder for fitness, fun or recreation with friends, family or alone.
On a typical weekend day
Hours per day
- 01: 1
- 02: 2
- 03: 3
- 04: 4
- 05: 5
- 06: 6
- 07: 7
- 08: 8
Moderate physical activity (MPA) - Question identifier:MPA_Q20D
Doing physical activity that made you sweat or breathe harder for fitness, fun or recreation with friends, family or alone.
On a typical weekend day
Minutes per day
- 00: 0
- 05: 5
- 10: 10
- 15: 15
- 20: 20
- 25: 25
- 30: 30
- 35: 35
- 40: 40
- 45: 45
- 50: 50
- 55: 55
Moderate physical activity (MPA) - Question identifier:MPA_Q25
In the past 7 days, did you use active ways like walking or cycling to get to places such as [school, stores, visiting friends or work/school, stores, or visiting friends]?
- 1: Yes
- 2: No
Moderate physical activity (MPA) - Question identifier:MPA_Q25A
In the past 7 days, how much time did you spend using the following active ways to get to places?
Walking
On a typical weekday
Hours per day
- 01: 1
- 02: 2
- 03: 3
- 04: 4
- 05: 5
- 06: 6
- 07: 7
- 08: 8
Moderate physical activity (MPA) - Question identifier:MPA_Q25B
In the past 7 days, how much time did you spend using the following active ways to get to places?
Walking
On a typical weekday
Minutes per day
- 00: 0
- 05: 5
- 10: 10
- 15: 15
- 20: 20
- 25: 25
- 30: 30
- 35: 35
- 40: 40
- 45: 45
- 50: 50
- 55: 55
Moderate physical activity (MPA) - Question identifier:MPA_Q25C
In the past 7 days, how much time did you spend using the following active ways to get to places?
Walking
On a typical weekend day
Hours per day
- 01: 1
- 02: 2
- 03: 3
- 04: 4
- 05: 5
- 06: 6
- 07: 7
- 08: 8
Moderate physical activity (MPA) - Question identifier:MPA_Q25D
In the past 7 days, how much time did you spend using the following active ways to get to places?
Walking
On a typical weekend day
Minutes per day
- 00: 0
- 05: 5
- 10: 10
- 15: 15
- 20: 20
- 25: 25
- 30: 30
- 35: 35
- 40: 40
- 45: 45
- 50: 50
- 55: 55
Moderate physical activity (MPA) - Question identifier:MPA_Q30A
In the past 7 days, how much time did you spend using the following active ways to get to places?
Cycling
On a typical weekday
Hours per day
- 01: 1
- 02: 2
- 03: 3
- 04: 4
- 05: 5
- 06: 6
- 07: 7
- 08: 8
Moderate physical activity (MPA) - Question identifier:MPA_Q30B
In the past 7 days, how much time did you spend using the following active ways to get to places?
Cycling
On a typical weekday
Minutes per day
- 00: 0
- 05: 5
- 10: 10
- 15: 15
- 20: 20
- 25: 25
- 30: 30
- 35: 35
- 40: 40
- 45: 45
- 50: 50
- 55: 55
Moderate physical activity (MPA) - Question identifier:MPA_Q30C
In the past 7 days, how much time did you spend using the following active ways to get to places?
Cycling
On a typical weekend day
Hours per day
- 01: 1
- 02: 2
- 03: 3
- 04: 4
- 05: 5
- 06: 6
- 07: 7
- 08: 8
Moderate physical activity (MPA) - Question identifier:MPA_Q30D
In the past 7 days, how much time did you spend using the following active ways to get to places?
Cycling
On a typical weekend day
Minutes per day
- 00: 0
- 05: 5
- 10: 10
- 15: 15
- 20: 20
- 25: 25
- 30: 30
- 35: 35
- 40: 40
- 45: 45
- 50: 50
- 55: 55
Moderate physical activity (MPA) - Question identifier:MPA_R32
Thinking again of the past 7 days, we wish to record your physical activities. We will be asking you about common sources of physical activity while on the job, during sports, fitness or recreational activities, walking or cycling for transportation, and physical activity while volunteering, at home or at work.
To make it easier, we will ask about weekdays and weekend days separately. If you work shifts, please adjust answers to typical workdays and days off. If recall is too difficult, give your best estimate.
Moderate physical activity (MPA) - Question identifier:MPA_R35
In the past 7 days, how much time did you spend doing the following activities that made you sweat or breathe harder?
Moderate physical activity (MPA) - Question identifier:MPA_Q35A
Active work as part of your job that made you sweat or breathe harder.
On a typical weekday
Hours per day
- 01: 1
- 02: 2
- 03: 3
- 04: 4
- 05: 5
- 06: 6
- 07: 7
- 08: 8
- 09: 9
- 10: 10
- 11: 11
- 12: 12
- 13: 13
- 14: 14
- 15: 15
- 16: 16
- 17: 17
- 18: 18
- 19: 19
- 20: 20
Moderate physical activity (MPA) - Question identifier:MPA_Q35B
Active work as part of your job that made you sweat or breathe harder.
On a typical weekday
Minutes per day
- 00: 0
- 05: 5
- 10: 10
- 15: 15
- 20: 20
- 25: 25
- 30: 30
- 35: 35
- 40: 40
- 45: 45
- 50: 50
- 55: 55
Moderate physical activity (MPA) - Question identifier:MPA_Q35C
Active work as part of your job that made you sweat or breathe harder.
On a typical weekend day
Hours per day
- 01: 1
- 02: 2
- 03: 3
- 04: 4
- 05: 5
- 06: 6
- 07: 7
- 08: 8
- 09: 9
- 10: 10
- 11: 11
- 12: 12
- 13: 13
- 14: 14
- 15: 15
- 16: 16
- 17: 17
- 18: 18
- 19: 19
- 20: 20
Moderate physical activity (MPA) - Question identifier:MPA_Q35D
Active work as part of your job that made you sweat or breathe harder.
On a typical weekend day
Minutes per day
- 00: 0
- 05: 5
- 10: 10
- 15: 15
- 20: 20
- 25: 25
- 30: 30
- 35: 35
- 40: 40
- 45: 45
- 50: 50
- 55: 55
Moderate physical activity (MPA) - Question identifier:MPA_Q40A
Sports, fitness or recreational physical activities that made you sweat or breathe harder.
On a typical weekday
Hours per day
- 01: 1
- 02: 2
- 03: 3
- 04: 4
- 05: 5
- 06: 6
- 07: 7
- 08: 8
- 09: 9
- 10: 10
- 11: 11
- 12: 12
- 13: 13
- 14: 14
- 15: 15
- 16: 16
- 17: 17
- 18: 18
- 19: 19
- 20: 20
Moderate physical activity (MPA) - Question identifier:MPA_Q40B
Sports, fitness or recreational physical activities that made you sweat or breathe harder.
On a typical weekday
Minutes per day
- 00: 0
- 05: 5
- 10: 10
- 15: 15
- 20: 20
- 25: 25
- 30: 30
- 35: 35
- 40: 40
- 45: 45
- 50: 50
- 55: 55
Moderate physical activity (MPA) - Question identifier:MPA_Q40C
Sports, fitness or recreational physical activities that made you sweat or breathe harder.
On a typical weekend day
Hours per day
- 01: 1
- 02: 2
- 03: 3
- 04: 4
- 05: 5
- 06: 6
- 07: 7
- 08: 8
- 09: 9
- 10: 10
- 11: 11
- 12: 12
- 13: 13
- 14: 14
- 15: 15
- 16: 16
- 17: 17
- 18: 18
- 19: 19
- 20: 20
Moderate physical activity (MPA) - Question identifier:MPA_Q40D
Sports, fitness or recreational physical activities that made you sweat or breathe harder.
On a typical weekend day
Minutes per day
- 00: 0
- 05: 5
- 10: 10
- 15: 15
- 20: 20
- 25: 25
- 30: 30
- 35: 35
- 40: 40
- 45: 45
- 50: 50
- 55: 55
Moderate physical activity (MPA) - Question identifier:MPA_Q45
In the past 7 days, did you use active ways like walking or cycling to get to places such as school, stores, visiting friends or work?
- 1: Yes
- 2: No
Moderate physical activity (MPA) - Question identifier:MPA_Q45A
In the past 7 days, how much time did you spend using the following active ways to get to places?
Walking
On a typical weekday
Hours per day
- 01: 1
- 02: 2
- 03: 3
- 04: 4
- 05: 5
- 06: 6
- 07: 7
- 08: 8
- 09: 9
- 10: 10
- 11: 11
- 12: 12
Moderate physical activity (MPA) - Question identifier:MPA_Q45B
In the past 7 days, how much time did you spend using the following active ways to get to places?
Walking
On a typical weekday
Minutes per day
- 00: 0
- 05: 5
- 10: 10
- 15: 15
- 20: 20
- 25: 25
- 30: 30
- 35: 35
- 40: 40
- 45: 45
- 50: 50
- 55: 55
Moderate physical activity (MPA) - Question identifier:MPA_Q45C
In the past 7 days, how much time did you spend using the following active ways to get to places?
Walking
On a typical weekend day
Hours per day
- 01: 1
- 02: 2
- 03: 3
- 04: 4
- 05: 5
- 06: 6
- 07: 7
- 08: 8
- 09: 9
- 10: 10
- 11: 11
- 12: 12
Moderate physical activity (MPA) - Question identifier:MPA_Q45D
In the past 7 days, how much time did you spend using the following active ways to get to places?
Walking
On a typical weekend day
Minutes per day
- 00: 0
- 05: 5
- 10: 10
- 15: 15
- 20: 20
- 25: 25
- 30: 30
- 35: 35
- 40: 40
- 45: 45
- 50: 50
- 55: 55
Moderate physical activity (MPA) - Question identifier:MPA_Q50A
In the past 7 days, how much time did you spend using the following active ways to get to places?
Cycling
On a typical weekday
Hours per day
- 01: 1
- 02: 2
- 03: 3
- 04: 4
- 05: 5
- 06: 6
- 07: 7
- 08: 8
- 09: 9
- 10: 10
- 11: 11
- 12: 12
Moderate physical activity (MPA) - Question identifier:MPA_Q50B
In the past 7 days, how much time did you spend using the following active ways to get to places?
Cycling
On a typical weekday
Minutes per day
- 00: 0
- 05: 5
- 10: 10
- 15: 15
- 20: 20
- 25: 25
- 30: 30
- 35: 35
- 40: 40
- 45: 45
- 50: 50
- 55: 55
Moderate physical activity (MPA) - Question identifier:MPA_Q50C
In the past 7 days, how much time did you spend using the following active ways to get to places?
Cycling
On a typical weekend day
Hours per day
- 01: 1
- 02: 2
- 03: 3
- 04: 4
- 05: 5
- 06: 6
- 07: 7
- 08: 8
- 09: 9
- 10: 10
- 11: 11
- 12: 12
Moderate physical activity (MPA) - Question identifier:MPA_Q50D
In the past 7 days, how much time did you spend using the following active ways to get to places?
Cycling
On a typical weekend day
Minutes per day
- 00: 0
- 05: 5
- 10: 10
- 15: 15
- 20: 20
- 25: 25
- 30: 30
- 35: 35
- 40: 40
- 45: 45
- 50: 50
- 55: 55
Moderate physical activity (MPA) - Question identifier:MPA_Q55A
In the past 7 days, how much time did you spend doing other physical activities that made you sweat or breathe harder while [at work.] doing household chores, or while volunteering?
On a typical weekday
Hours per day
- 01: 1
- 02: 2
- 03: 3
- 04: 4
- 05: 5
- 06: 6
- 07: 7
- 08: 8
- 09: 9
- 10: 10
- 11: 11
- 12: 12
Moderate physical activity (MPA) - Question identifier:MPA_Q55B
In the past 7 days, how much time did you spend doing other physical activities that made you sweat or breathe harder while [at work.] doing household chores, or while volunteering?
On a typical weekday
Minutes per day
- 00: 0
- 05: 5
- 10: 10
- 15: 15
- 20: 20
- 25: 25
- 30: 30
- 35: 35
- 40: 40
- 45: 45
- 50: 50
- 55: 55
Moderate physical activity (MPA) - Question identifier:MPA_Q55C
In the past 7 days, how much time did you spend doing other physical activities that made you sweat or breathe harder while [at work.] doing household chores, or while volunteering?
On a typical weekend day
Hours per day
- 01: 1
- 02: 2
- 03: 3
- 04: 4
- 05: 5
- 06: 6
- 07: 7
- 08: 8
- 09: 9
- 10: 10
- 11: 11
- 12: 12
Moderate physical activity (MPA) - Question identifier:MPA_Q55D
In the past 7 days, how much time did you spend doing other physical activities that made you sweat or breathe harder while [at work.] doing household chores, or while volunteering?
On a typical weekend day
Minutes per day
- 00: 0
- 05: 5
- 10: 10
- 15: 15
- 20: 20
- 25: 25
- 30: 30
- 35: 35
- 40: 40
- 45: 45
- 50: 50
- 55: 55
Other physical activities (OPA)
Other physical activities (OPA) - Question identifier:OPA_R02
Now we will ask some questions to gather more details about the physical activities that you do. These activities may include those which have already been reported.
Other physical activities (OPA) - Question identifier:OPA_Q05A
In the past 7 days, how much time did you spend outdoors?
On a typical weekday
Hours per day
- 01: 1
- 02: 2
- 03: 3
- 04: 4
- 05: 5
- 06: 6
- 07: 7
- 08: 8
- 09: 9
- 10: 10
- 11: 11
- 12: 12
- 13: 13
- 14: 14
- 15: 15
- 16: 16
- 17: 17
- 18: 18
- 19: 19
- 20: 20
- 21: 21
- 22: 22
- 23: 23
- 24: 24
Other physical activities (OPA) - Question identifier:OPA_Q05B
In the past 7 days, how much time did you spend outdoors?
On a typical weekday
Minutes per day
- 00: 0
- 05: 5
- 10: 10
- 15: 15
- 20: 20
- 25: 25
- 30: 30
- 35: 35
- 40: 40
- 45: 45
- 50: 50
- 55: 55
Other physical activities (OPA) - Question identifier:OPA_Q05C
In the past 7 days, how much time did you spend outdoors?
On a typical weekend day
Hours per day
- 01: 1
- 02: 2
- 03: 3
- 04: 4
- 05: 5
- 06: 6
- 07: 7
- 08: 8
- 09: 9
- 10: 10
- 11: 11
- 12: 12
- 13: 13
- 14: 14
- 15: 15
- 16: 16
- 17: 17
- 18: 18
- 19: 19
- 20: 20
- 21: 21
- 22: 22
- 23: 23
- 24: 24
Other physical activities (OPA) - Question identifier:OPA_Q05D
In the past 7 days, how much time did you spend outdoors?
On a typical weekend day
Minutes per day
- 00: 0
- 05: 5
- 10: 10
- 15: 15
- 20: 20
- 25: 25
- 30: 30
- 35: 35
- 40: 40
- 45: 45
- 50: 50
- 55: 55
Other physical activities (OPA) - Question identifier:OPA_R10
Now we will ask some questions to gather more details about the physical activities that you do. These activities may include those which have already been reported.
Other physical activities (OPA) - Question identifier:OPA_Q10
In the past 7 days, how many days did you engage in strength-building exercise?
- 1: 1
- 2: 2
- 3: 3
- 4: 4
- 5: 5
- 6: 6
- 7: 7
Other physical activities (OPA) - Question identifier:OPA_Q15
In the past 7 days, how many days did you engage in flexibility exercises?
- 1: 1
- 2: 2
- 3: 3
- 4: 4
- 5: 5
- 6: 6
- 7: 7
Other physical activities (OPA) - Question identifier:OPA_Q20
In the past 7 days, how many days did you engage in any vigorous-intensity exercise?
- 1: 1
- 2: 2
- 3: 3
- 4: 4
- 5: 5
- 6: 6
- 7: 7
Current smoking status (CSS)
Current smoking status (CSS) - Question identifier:CSS_R01
The next questions are about cigarette smoking.
Include cigarettes that are self-made. Exclude e-cigarettes or vapes.
Current smoking status (CSS) - Question identifier:CSS_Q05
Have you ever smoked a whole cigarette?
- 1: Yes
- 2: No
Current smoking status (CSS) - Question identifier:CSS_Q10
How old were you when you smoked your first whole cigarette?
Min = 0; Max = 999
Current smoking status (CSS) - Question identifier:CSS_Q15
Have you smoked more than 100 cigarettes (about 4 packs) in your life?
- 1: Yes
- 2: No
Current smoking status (CSS) - Question identifier:CSS_Q20
In the past 30 days, how often did you smoke cigarettes?
- 1: Every day
- 2: Less than once a day, but at least once a week
- 3: Less than once a week, but at least once in the past month
- 4: Not at all
Current smoking status (CSS) - Question identifier:CSS_Q25
How many cigarettes do you usually smoke each day?
Min = 0; Max = 999
Current smoking status (CSS) - Question identifier:CSS_Q35
In the past 30 days, how many days have you smoked one or more cigarettes?
Min = 0; Max = 99
Current smoking status (CSS) - Question identifier:CSS_Q30
On the days that you do smoke, how many cigarettes do you usually smoke?
Min = 0; Max = 999
Current smoking status (CSS) - Question identifier:CSS_Q41
In the past 12 months, did you stop smoking for at least 24 hours because you were trying to cut back or quit?
- 1: Yes
- 2: No
Smoking - past use (SPU)
Smoking - past use (SPU) - Question identifier:SPU_Q05
Have you ever smoked cigarettes daily?
- 1: Yes
- 2: No
Smoking - past use (SPU) - Question identifier:SPU_Q10
When did you stop smoking?
- 1: Less than one year ago
- 2: 1 year to less than 2 years ago
- 3: 2 years to less than 3 years ago
- 4: 3 or more years ago
Smoking - past use (SPU) - Question identifier:SPU_Q15
At what age did you begin to smoke cigarettes daily?
Min = 0; Max = 999
Smoking - past use (SPU) - Question identifier:SPU_Q20
When you smoked every day, how many cigarettes did you usually smoke each day?
Min = 0; Max = 999
Smoking - past use (SPU) - Question identifier:SPU_Q25
When did you stop smoking daily?
- 1: Less than one year ago
- 2: 1 year to less than 2 years ago
- 3: 2 years to less than 3 years ago
- 4: 3 or more years ago
Smoking - past use (SPU) - Question identifier:SPU_Q30
Was that when you completely quit smoking?
- 1: Yes
- 2: No
Smoking - past use (SPU) - Question identifier:SPU_Q35
When did you stop completely?
- 1: Less than one year ago
- 2: 1 year to less than 2 years ago
- 3: 2 years to less than 3 years ago
- 4: 3 or more years ago
Smoking - past use (SPU) - Question identifier:SPU_Q40
During the past 12 months, did you do any of the following to help you quit smoking?
- 01: Use nicotine replacement products (e.g., nicotine patch, nicotine gum, nicotine inhaler, nicotine nasal spray, nicotine lozenge, nicotine mouth spray)
- 02: Use smoking cessation medications (e.g., Zyban®, Wellbutrin® or Champix®)
- 03: Use an internet-based program or an app
- 04: Use a vaping device or e-cigarette
- 05: Make a deal with a friend or your family
- 06: Reduce the number of cigarettes
- 07: Try to quit smoking on your own
- 08: Other
Smoking - past use (SPU) - Question identifier:SPU_Q45
During the past 12 months, did you do any of the following to help you when you quit smoking completely?
- 01: Use nicotine replacement products (e.g., nicotine patch, nicotine gum, nicotine inhaler, nicotine nasal spray, nicotine lozenge, nicotine mouth spray)
- 02: Use smoking cessation medications (e.g., Zyban®, Wellbutrin® or Champix®)
- 03: Use an internet-based program or an app
- 04: Use a vaping device or e-cigarette
- 05: Make a deal with a friend or your family
- 06: Reduce the number of cigarettes
- 07: Try to quit smoking on your own
- 08: Other
Electronic cigarettes and vaping (ECV)
Electronic cigarettes and vaping (ECV) - Question identifier:ECV_R05
Now questions about electronic cigarettes (e-cigarettes) or vaping devices.
Electronic cigarettes and vaping (ECV) - Question identifier:ECV_Q05
Have you ever tried an e-cigarette or vaping device, also known as a vape?
- 1: Yes
- 2: No
Electronic cigarettes and vaping (ECV) - Question identifier:ECV_Q10
At what age did you first use an e-cigarette or vaping device?
Min = 0; Max = 999
Electronic cigarettes and vaping (ECV) - Question identifier:ECV_Q15
In the past 30 days, how often did you use an e-cigarette or vaping device?
- 1: Every day
- 2: At least once a week
- 3: At least once in the past month
- 4: Not at all
Electronic cigarettes and vaping (ECV) - Question identifier:ECV_Q21
The last time you used an e-cigarette or vaping device, also known as a vape, what did it contain?
- 1: An e-cigarette or a vaping device with nicotine
- 2: An e-cigarette or a vaping device without nicotine (e.g., just flavouring)
- 3: An e-cigarette or a vaping device but you did not know what it contained
Electronic cigarettes and vaping (ECV) - Question identifier:ECV_Q25A
During the past 30 days, on how many days did you vape an e-cigarette or a vaping device with nicotine?
Min = 0; Max = 30
Electronic cigarettes and vaping (ECV) - Question identifier:ECV_Q25B
During the past 30 days, on how many days did you vape an e-cigarette or a vaping device without nicotine?
Min = 0; Max = 30
Electronic cigarettes and vaping (ECV) - Question identifier:ECV_Q25C
During the past 30 days, on how many days did you vape an e-cigarette or a vaping device but you did not know what it contained?
Min = 0; Max = 30
Electronic cigarettes and vaping (ECV) - Question identifier:ECV_Q30
Which did you try first, an e-cigarette or vaping device or a cigarette?
- 1: E-cigarette or vaping device
- 2: Cigarette
Alcohol use (ALC)
Alcohol use (ALC) - Question identifier:ALC_R01
Now some questions about alcohol consumption.
Alcohol use (ALC) - Question identifier:ALC_Q05
Have you ever had a drink in your lifetime?
- 1: Yes
- 2: No
Alcohol use (ALC) - Question identifier:ALC_Q10
In the past 12 months, have you had a drink of beer, wine, liquor or any other alcoholic beverage?
- 1: Yes
- 2: No
Alcohol use (ALC) - Question identifier:ALC_Q15
In the past 12 months, how often did you drink alcoholic beverages?
- 1: Less than once a month
- 2: Once a month
- 3: 2 to 3 times a month
- 4: Once a week
- 5: 2 to 3 times a week
- 6: 4 to 5 times a week
- 7: Daily or almost daily
Alcohol use (ALC) - Question identifier:ALC_Q20
How often in the past 12 months have you had [4/5] or more drinks on one occasion?
- 1: Never
- 2: Less than once a month
- 3: Once a month
- 4: 2 to 3 times a month
- 5: Once a week
- 6: More than once a week
Alcohol use (ALW)
Alcohol use (ALW) - Question identifier:ALW_Q05
In the past 7 days, that is from [7 days ago] to yesterday, did you have a drink of beer, wine, liquor or any other alcoholic beverage?
- 1: Yes
- 2: No
Alcohol use (ALW) - Question identifier:ALW_Q10
In the past 7 days, that is from [7 days ago] to yesterday, how many drinks did you have each day?
a. [Yesterday]
- 00: 0
- 01: 1
- 02: 2
- 03: 3
- 04: 4
- 05: 5
- 06: 6
- 07: 7
- 08: 8
- 09: 9
- 10: 10
- 11: 11
- 12: 12
- 13: 13
- 14: 14
- 15: 15
- 16: 16
- 17: 17
- 18: 18
- 19: 19
- 20: 20
- 21: 21
- 22: 22
- 23: 23
- 24: 24
- 25: 25
- 26: 26
- 27: 27
- 28: 28
- 29: 29
- 30: 30
- 31: 31
- 32: 32
- 33: 33
- 34: 34
- 35: 35
- 36: 36
- 37: 37
- 38: 38
- 39: 39
- 40: 40
- 41: 41
- 42: 42
- 43: 43
- 44: 44
- 45: 45
- 46: 46
- 47: 47
- 48: 48
- 49: 49
- 50: 50 or more
Alcohol use (ALW) - Question identifier:ALW_Q15
In the past 7 days, that is from [7 days ago] to yesterday, how many drinks did you have each day?
b. [2 days ago]
- 00: 0
- 01: 1
- 02: 2
- 03: 3
- 04: 4
- 05: 5
- 06: 6
- 07: 7
- 08: 8
- 09: 9
- 10: 10
- 11: 11
- 12: 12
- 13: 13
- 14: 14
- 15: 15
- 16: 16
- 17: 17
- 18: 18
- 19: 19
- 20: 20
- 21: 21
- 22: 22
- 23: 23
- 24: 24
- 25: 25
- 26: 26
- 27: 27
- 28: 28
- 29: 29
- 30: 30
- 31: 31
- 32: 32
- 33: 33
- 34: 34
- 35: 35
- 36: 36
- 37: 37
- 38: 38
- 39: 39
- 40: 40
- 41: 41
- 42: 42
- 43: 43
- 44: 44
- 45: 45
- 46: 46
- 47: 47
- 48: 48
- 49: 49
- 50: 50 or more
Alcohol use (ALW) - Question identifier:ALW_Q20
In the past 7 days, that is from [7 days ago] to yesterday, how many drinks did you have each day?
c. [3 days ago]
- 00: 0
- 01: 1
- 02: 2
- 03: 3
- 04: 4
- 05: 5
- 06: 6
- 07: 7
- 08: 8
- 09: 9
- 10: 10
- 11: 11
- 12: 12
- 13: 13
- 14: 14
- 15: 15
- 16: 16
- 17: 17
- 18: 18
- 19: 19
- 20: 20
- 21: 21
- 22: 22
- 23: 23
- 24: 24
- 25: 25
- 26: 26
- 27: 27
- 28: 28
- 29: 29
- 30: 30
- 31: 31
- 32: 32
- 33: 33
- 34: 34
- 35: 35
- 36: 36
- 37: 37
- 38: 38
- 39: 39
- 40: 40
- 41: 41
- 42: 42
- 43: 43
- 44: 44
- 45: 45
- 46: 46
- 47: 47
- 48: 48
- 49: 49
- 50: 50 or more
Alcohol use (ALW) - Question identifier:ALW_Q25
In the past 7 days, that is from [7 days ago] to yesterday, how many drinks did you have each day?
d. [4 days ago]
- 00: 0
- 01: 1
- 02: 2
- 03: 3
- 04: 4
- 05: 5
- 06: 6
- 07: 7
- 08: 8
- 09: 9
- 10: 10
- 11: 11
- 12: 12
- 13: 13
- 14: 14
- 15: 15
- 16: 16
- 17: 17
- 18: 18
- 19: 19
- 20: 20
- 21: 21
- 22: 22
- 23: 23
- 24: 24
- 25: 25
- 26: 26
- 27: 27
- 28: 28
- 29: 29
- 30: 30
- 31: 31
- 32: 32
- 33: 33
- 34: 34
- 35: 35
- 36: 36
- 37: 37
- 38: 38
- 39: 39
- 40: 40
- 41: 41
- 42: 42
- 43: 43
- 44: 44
- 45: 45
- 46: 46
- 47: 47
- 48: 48
- 49: 49
- 50: 50 or more
Alcohol use (ALW) - Question identifier:ALW_Q30
In the past 7 days, that is from [7 days ago] to yesterday, how many drinks did you have each day?
e. [5 days ago]
- 00: 0
- 01: 1
- 02: 2
- 03: 3
- 04: 4
- 05: 5
- 06: 6
- 07: 7
- 08: 8
- 09: 9
- 10: 10
- 11: 11
- 12: 12
- 13: 13
- 14: 14
- 15: 15
- 16: 16
- 17: 17
- 18: 18
- 19: 19
- 20: 20
- 21: 21
- 22: 22
- 23: 23
- 24: 24
- 25: 25
- 26: 26
- 27: 27
- 28: 28
- 29: 29
- 30: 30
- 31: 31
- 32: 32
- 33: 33
- 34: 34
- 35: 35
- 36: 36
- 37: 37
- 38: 38
- 39: 39
- 40: 40
- 41: 41
- 42: 42
- 43: 43
- 44: 44
- 45: 45
- 46: 46
- 47: 47
- 48: 48
- 49: 49
- 50: 50 or more
Alcohol use (ALW) - Question identifier:ALW_Q35
In the past 7 days, that is from [7 days ago] to yesterday, how many drinks did you have each day?
f. [6 days ago]
- 00: 0
- 01: 1
- 02: 2
- 03: 3
- 04: 4
- 05: 5
- 06: 6
- 07: 7
- 08: 8
- 09: 9
- 10: 10
- 11: 11
- 12: 12
- 13: 13
- 14: 14
- 15: 15
- 16: 16
- 17: 17
- 18: 18
- 19: 19
- 20: 20
- 21: 21
- 22: 22
- 23: 23
- 24: 24
- 25: 25
- 26: 26
- 27: 27
- 28: 28
- 29: 29
- 30: 30
- 31: 31
- 32: 32
- 33: 33
- 34: 34
- 35: 35
- 36: 36
- 37: 37
- 38: 38
- 39: 39
- 40: 40
- 41: 41
- 42: 42
- 43: 43
- 44: 44
- 45: 45
- 46: 46
- 47: 47
- 48: 48
- 49: 49
- 50: 50 or more
Alcohol use (ALW) - Question identifier:ALW_Q40
In the past 7 days, that is from [7 days ago] to yesterday, how many drinks did you have each day?
g. [7 days ago]
- 00: 0
- 01: 1
- 02: 2
- 03: 3
- 04: 4
- 05: 5
- 06: 6
- 07: 7
- 08: 8
- 09: 9
- 10: 10
- 11: 11
- 12: 12
- 13: 13
- 14: 14
- 15: 15
- 16: 16
- 17: 17
- 18: 18
- 19: 19
- 20: 20
- 21: 21
- 22: 22
- 23: 23
- 24: 24
- 25: 25
- 26: 26
- 27: 27
- 28: 28
- 29: 29
- 30: 30
- 31: 31
- 32: 32
- 33: 33
- 34: 34
- 35: 35
- 36: 36
- 37: 37
- 38: 38
- 39: 39
- 40: 40
- 41: 41
- 42: 42
- 43: 43
- 44: 44
- 45: 45
- 46: 46
- 47: 47
- 48: 48
- 49: 49
- 50: 50 or more
Cannabis use (CAN)
Cannabis use (CAN) - Question identifier:CAN_R01
The next few questions are about the use of cannabis for medical and non-medical purposes. The term "cannabis" refers to marijuana, hashish, hash oil or any other product of the cannabis plant.
Cannabis use (CAN) - Question identifier:CAN_Q05
Have you ever used or tried cannabis?
- 1: Yes
- 2: No
Cannabis use (CAN) - Question identifier:CAN_Q05A
Have you used or tried cannabis just once or more than once?
- 1: Just once
- 2: More than once
Cannabis use (CAN) - Question identifier:CAN_Q05B
At what age did you first try cannabis?
Min = 0; Max = 999
Cannabis use (CAN) - Question identifier:CAN_Q05C
Have you used cannabis in the past 12 months?
- 1: Yes
- 2: No
Cannabis use (CAN) - Question identifier:CAN_Q10
How often did you use cannabis in the past 12 months?
- 1: Less than once a month
- 2: 1 to 3 times a month
- 3: Once a week
- 4: More than once a week
- 5: Daily or almost daily
Cannabis use (CAN) - Question identifier:CAN_Q15
In the past 12 months, which of the following methods did you use to consume cannabis?
- 1: Smoked (e.g., joint, pipe, bong)
- 2: Vaporized
- 3: Swallowed (e.g., in food, beverages, capsules)
- 4: Absorbed (e.g., placed under the tongue, applied to skin)
- 5: Other
Cannabis use (CAN) - Question identifier:CAN_Q15B
Which cannabis preparation did you vaporize?
- 1: Dried flower or leaf
- 2: Cannabis liquid
- 3: Cannabis solid
Cannabis use (CAN) - Question identifier:CAN_Q20
In the past 12 months, which of the following methods did you use most often to consume cannabis?
- 1: Smoked
- 2: Vaporized
- 3: Swallowed
- 4: Absorbed
- 5: Other method
Cannabis use (CAN) - Question identifier:CAN_Q25
In the past 12 months, which of the following cannabis products have you used?
- 01: Dried flower or leaf
- 02: Hashish (e.g., hash, hash oil)
- 03: Cannabis oil for oral use (e.g., capsules, spray, tincture)
- 04: Cannabis vape pens or cartridges
- 05: Cannabis concentrates (e.g., shatter, budder, butane honey oil)
- 06: Cannabis edible food products (e.g., baked goods, candy, other foods)
- 07: Cannabis beverages (e.g., cola, tea, coffee)
- 08: Topicals (e.g., lotion, ointment, creams applied to skin)
- 09: Other (e.g., seeds)
Cannabis use (CAN) - Question identifier:CAN_Q30
In the past 12 months, for which of the following purposes have you used cannabis?
- 1: Non-medical purposes only
- 2: Medical purposes only (Either with or without a medical document)
- 3: Both medical and non-medical purposes
Cannabis use (CAN) - Question identifier:CAN_Q35
In the past 12 months, when you used cannabis for medical purposes, which symptoms were you using it for?
- 01: Pain
- 02: Nausea or vomiting
- 03: Lack of appetite or weight loss
- 04: Headaches or migraines
- 05: Muscle spasms or seizures
- 06: Anxiety or depression
- 07: Symptoms of PTSD
- 08: Problems sleeping
- 09: Opioid withdrawal symptoms
- 10: Other
Cannabis use (CAN) - Question identifier:CAN_Q40
Do you have a medical document from a healthcare professional to use cannabis for medical purposes?
- 1: Yes
- 2: No
Cannabis use (CAN) - Question identifier:CAN_Q45
In the past 30 days, on how many days did you use cannabis?
- 1: Never
- 2: 1 day
- 3: 2 or 3 days
- 4: 1 or 2 days per week
- 5: 3 or 4 days per week
- 6: 5 or 6 days per week
- 7: Daily
Cannabis use (CAN) - Question identifier:CAN_Q50
At what age did you begin to use cannabis daily or almost daily?
Min = 0; Max = 999
Maternal experiences (MEX)
Maternal experiences (MEX) - Question identifier:MEX_R01
The next questions are specific to women's health.
Maternal experiences (MEX) - Question identifier:MEX_Q05
Are you taking a vitamin supplement containing folic acid?
- 1: Yes
- 2: No
Maternal experiences (MEX) - Question identifier:MEX_Q10
Have you given birth in the past 5 years?
- 1: Yes
- 2: No
Maternal experiences (MEX) - Question identifier:MEX_Q12
Was your last pregnancy a single birth or multiple births?
- 1: Single birth
- 2: Multiple births
Maternal experiences (MEX) - Question identifier:MEX_Q15
What is the first name of your last born child?
Long Answer Length = 30
Maternal experiences (MEX) - Question identifier:MEX_Q20
What is [your last child]'s date of birth?
Day
Min = 1; Max = 31
Maternal experiences (MEX) - Question identifier:MEX_Q25
What is [your last child]'s date of birth?
Month
- 01: January
- 02: February
- 03: March
- 04: April
- 05: May
- 06: June
- 07: July
- 08: August
- 09: September
- 10: October
- 11: November
- 12: December
Maternal experiences (MEX) - Question identifier:MEX_Q30
What is [your last child]'s date of birth?
Year
- 01: 2023
- 02: 2022
- 03: 2021
- 04: 2020
- 05: 2019
- 06: 2018
- 07: 2017
- 08: 2016
Maternal experiences (MEX) - Question identifier:MEX_Q40
During your pregnancy with [your last child], did you take folic acid supplements during the following time frames?
During the three months before you got pregnant
- 1: Yes
- 2: No
- 3: Don't know
Maternal experiences (MEX) - Question identifier:MEX_Q50
During your pregnancy with [your last child], did you take folic acid supplements during the following time frames?
During the first three months of your pregnancy
- 1: Yes
- 2: No
- 3: Don't know
Maternal experiences (MEX) - Question identifier:MEX_Q65
During your pregnancy with [your last child], did you take a vitamin supplement containing iron?
- 1: Yes
- 2: No
- 3: Don't know
Maternal experiences (MEX) - Question identifier:MEX_Q70
Just before your pregnancy with [your last child], how much did you weigh?
Weight
Min = 0; Max = 999
Maternal experiences (MEX) - Question identifier:MEX_Q75
Just before your pregnancy with [your last child], how much did you weigh?
Pounds or kilograms
- 1: Pounds
- 2: Kilograms
Maternal experiences (MEX) - Question identifier:MEX_Q80
How much weight did you gain during that pregnancy?
Weight
Min = -999; Max = 999
Maternal experiences (MEX) - Question identifier:MEX_Q85
How much weight did you gain during that pregnancy?
Pounds or kilograms
- 1: Pounds
- 2: Kilograms
Maternal experiences (MEX) - Question identifier:MEX_Q90
[How often does [your last child]/When [your last child] was less than one year old, how often did they] sleep in the same bed with you or anyone else?
- 1: Every day or almost every day
- 2: Occasionally
- 3: Never
Maternal experiences (MEX) - Question identifier:MEX_Q100
Was [your last child] breastfed or given breast milk even for a short time?
- 1: Yes
- 2: No
Maternal experiences (MEX) - Question identifier:MEX_Q105
What is the main reason that you did not breastfeed or give breast milk?
- 1: Did not want to breastfeed
- 2: No support or information to breastfeed
- 3: Medical condition
- 4: Other
Maternal experiences (MEX) - Question identifier:MEX_Q110
Are you still breastfeeding or giving breast milk to [your last child]?
- 1: Yes
- 2: No
Maternal experiences (MEX) - Question identifier:MEX_Q115A
How old was [your last child] when you stopped breastfeeding or giving breast milk?
Age
Min = 0; Max = 99
Maternal experiences (MEX) - Question identifier:MEX_Q115B
How old was [your last child] when you stopped breastfeeding or giving breast milk?
Time period
- 1: Days
- 2: Weeks
- 3: Months
- 4: Years
Maternal experiences (MEX) - Question identifier:MEX_Q120
What is the main reason that you stopped breastfeeding or giving breast milk?
- 1: Not enough breast milk
- 2: Child weaned themselves
- 3: Planned to stop at this time
- 4: Difficulty with breastfeeding
- 5: Medical condition
- 6: Other
Maternal experiences (MEX) - Question identifier:MEX_Q125
[Are you giving [your last child] a vitamin D supplement?/When [your last child] was less than a year old, did you give them a vitamin D supplement?/When [your last child] was less than one year old and fed breast milk, did you give them a vitamin D supplement?/When [your last child] was fed breast milk, did you give them a vitamin D supplement?]
- 1: Every day or almost every day
- 2: Occasionally
- 3: Never
Maternal experiences (MEX) - Question identifier:MEX_Q150
[Have/While you were still breastfeeding, had] liquids been introduced to [your last child]'s diet?
- 1: Yes
- 2: No
Maternal experiences (MEX) - Question identifier:MEX_Q155
How old was [your last child] when liquids were first introduced?
Age
Min = 0; Max = 99
Maternal experiences (MEX) - Question identifier:MEX_Q160
How old was [your last child] when liquids were first introduced?
Time period
- 1: Days
- 2: Weeks
- 3: Months
- 4: Years
Maternal experiences (MEX) - Question identifier:MEX_Q170
Have solid foods been introduced to the baby's diet?
- 1: Yes
- 2: No
Maternal experiences (MEX) - Question identifier:MEX_Q175
How old was [your last child] when solids were first added?
Age
Min = 0; Max = 99
Maternal experiences (MEX) - Question identifier:MEX_Q180
How old was [your last child] when solids were first added?
Time period
- 1: Days
- 2: Weeks
- 3: Months
- 4: Years
Maternal experiences (MEX) - Question identifier:MEX_Q190
What was the first solid food added to [your last child]'s diet?
- 1: Infant cereals
- 2: Fruits or vegetables
- 3: Meat and meat alternatives
- 4: Other
Maternal experiences (MEX) - Question identifier:MEX_Q195
What is the main reason [other liquids/solid foods/other liquids and solid foods] were first added to [your last child]'s diet?
- 1: Not enough breast milk
- 2: Baby was ready
- 3: Difficulty with breastfeeding
- 4: Medical conditions
- 5: Advice from health professional or family
- 6: Returned to work or school
- 7: Other
Flu shots (FLU)
Flu shots (FLU) - Question identifier:FLU_R01
Now a few questions about the flu vaccine.
Flu shots (FLU) - Question identifier:FLU_Q05
In the past 12 months, have you had a seasonal flu vaccine?
- 1: Yes
- 2: No
Flu shots (FLU) - Question identifier:FLU_Q10
In which month did you have your last seasonal flu vaccine?
- 01: January
- 02: February
- 03: March
- 04: April
- 05: May
- 06: June
- 07: July
- 08: August
- 09: September
- 10: October
- 11: November
- 12: December
Flu shots (FLU) - Question identifier:FLU_Q15
Was that this year or last year?
- 1: This year
- 2: Last year
Flu shots (FLU) - Question identifier:FLU_Q20
What are the reasons that you did not have a seasonal flu vaccine in the past 12 months?
- 1: Did not think it was necessary
- 2: Concern about discomfort or side effects
- 3: Flu is not that severe
- 4: Flu vaccine does not work that well
- 5: Previously had a bad reaction to the flu vaccine or other vaccine
- 6: Other
Positive mental health (PMS)
Positive mental health (PMS) - Question identifier:PMS_Q05
The following questions are about how you have been feeling during the past 2 weeks.
I've been feeling optimistic about the future.
- 1: None of the time
- 2: Rarely
- 3: Some of the time
- 4: Often
- 5: All of the time
Positive mental health (PMS) - Question identifier:PMS_Q10
The following questions are about how you have been feeling during the past 2 weeks.
I've been feeling useful.
- 1: None of the time
- 2: Rarely
- 3: Some of the time
- 4: Often
- 5: All of the time
Positive mental health (PMS) - Question identifier:PMS_Q15
The following questions are about how you have been feeling during the past 2 weeks.
I've been feeling relaxed.
- 1: None of the time
- 2: Rarely
- 3: Some of the time
- 4: Often
- 5: All of the time
Positive mental health (PMS) - Question identifier:PMS_Q20
The following questions are about how you have been feeling during the past 2 weeks.
I've been feeling interested in other people.
- 1: None of the time
- 2: Rarely
- 3: Some of the time
- 4: Often
- 5: All of the time
Positive mental health (PMS) - Question identifier:PMS_Q25
The following questions are about how you have been feeling during the past 2 weeks.
I've had energy to spare.
- 1: None of the time
- 2: Rarely
- 3: Some of the time
- 4: Often
- 5: All of the time
Positive mental health (PMS) - Question identifier:PMS_Q30
The following questions are about how you have been feeling during the past 2 weeks.
I've been dealing with problems well.
- 1: None of the time
- 2: Rarely
- 3: Some of the time
- 4: Often
- 5: All of the time
Positive mental health (PMS) - Question identifier:PMS_Q35
The following questions are about how you have been feeling during the past 2 weeks.
I've been thinking clearly.
- 1: None of the time
- 2: Rarely
- 3: Some of the time
- 4: Often
- 5: All of the time
Positive mental health (PMS) - Question identifier:PMS_Q40
The following questions are about how you have been feeling during the past 2 weeks.
I've been feeling good about myself.
- 1: None of the time
- 2: Rarely
- 3: Some of the time
- 4: Often
- 5: All of the time
Positive mental health (PMS) - Question identifier:PMS_Q45
The following questions are about how you have been feeling during the past 2 weeks.
I've been feeling close to other people.
- 1: None of the time
- 2: Rarely
- 3: Some of the time
- 4: Often
- 5: All of the time
Positive mental health (PMS) - Question identifier:PMS_Q50
The following questions are about how you have been feeling during the past 2 weeks.
I've been feeling confident.
- 1: None of the time
- 2: Rarely
- 3: Some of the time
- 4: Often
- 5: All of the time
Positive mental health (PMS) - Question identifier:PMS_Q55
The following questions are about how you have been feeling during the past 2 weeks.
I've been able to make up my own mind about things.
- 1: None of the time
- 2: Rarely
- 3: Some of the time
- 4: Often
- 5: All of the time
Positive mental health (PMS) - Question identifier:PMS_Q60
The following questions are about how you have been feeling during the past 2 weeks.
I've been feeling loved.
- 1: None of the time
- 2: Rarely
- 3: Some of the time
- 4: Often
- 5: All of the time
Positive mental health (PMS) - Question identifier:PMS_Q65
The following questions are about how you have been feeling during the past 2 weeks.
I've been interested in new things.
- 1: None of the time
- 2: Rarely
- 3: Some of the time
- 4: Often
- 5: All of the time
Positive mental health (PMS) - Question identifier:PMS_Q70
The following questions are about how you have been feeling during the past 2 weeks.
I've been feeling cheerful.
- 1: None of the time
- 2: Rarely
- 3: Some of the time
- 4: Often
- 5: All of the time
Consultations about mental health (CMH)
Consultations about mental health (CMH) - Question identifier:CMH_R01
The following questions are about mental and emotional well-being.
Consultations about mental health (CMH) - Question identifier:CMH_Q05
In the past 12 months, have you seen or talked to a health professional about your emotional or mental health?
- 1: Yes
- 2: No
Consultations about mental health (CMH) - Question identifier:CMH_Q15A
How many times in the past 12 months did you see or talk to the following health professionals about your emotional or mental health?
Family doctor or general practitioner
Min = 0; Max = 999
Consultations about mental health (CMH) - Question identifier:CMH_Q15B
How many times in the past 12 months did you see or talk to the following health professionals about your emotional or mental health?
Psychiatrist
Min = 0; Max = 999
Consultations about mental health (CMH) - Question identifier:CMH_Q15C
How many times in the past 12 months did you see or talk to the following health professionals about your emotional or mental health?
Psychologist
Min = 0; Max = 999
Consultations about mental health (CMH) - Question identifier:CMH_Q15D
How many times in the past 12 months did you see or talk to the following health professionals about your emotional or mental health?
Nurse
Min = 0; Max = 999
Consultations about mental health (CMH) - Question identifier:CMH_Q15E
How many times in the past 12 months did you see or talk to the following health professionals about your emotional or mental health?
Social worker or counsellor
Min = 0; Max = 999
Consultations about mental health (CMH) - Question identifier:CMH_Q15F
How many times in the past 12 months did you see or talk to the following health professionals about your emotional or mental health?
Other
Min = 0; Max = 999
Mental health (DEP)
Mental health (DEP) - Question identifier:DEP_R001
The following questions deal with problems you may have had during the last two weeks.
Mental health (DEP) - Question identifier:DEP_Q005
Over the last 2 weeks, how often have you been bothered by any of the following problems?
Had little interest or pleasure in doing things
- 1: Not at all
- 2: Several days
- 3: More than half the days
- 4: Nearly every day
Mental health (DEP) - Question identifier:DEP_Q010
Over the last 2 weeks, how often have you been bothered by any of the following problems?
Felt down, depressed, or hopeless
- 1: Not at all
- 2: Several days
- 3: More than half the days
- 4: Nearly every day
Mental health (DEP) - Question identifier:DEP_Q015
Over the last 2 weeks, how often have you been bothered by any of the following problems?
Had trouble falling or staying asleep, or sleeping too much
- 1: Not at all
- 2: Several days
- 3: More than half the days
- 4: Nearly every day
Mental health (DEP) - Question identifier:DEP_Q020
Over the last 2 weeks, how often have you been bothered by any of the following problems?
Felt tired or having little energy
- 1: Not at all
- 2: Several days
- 3: More than half the days
- 4: Nearly every day
Mental health (DEP) - Question identifier:DEP_Q025
Over the last 2 weeks, how often have you been bothered by any of the following problems?
Had poor appetite or overate
- 1: Not at all
- 2: Several days
- 3: More than half the days
- 4: Nearly every day
Mental health (DEP) - Question identifier:DEP_Q030
Over the last 2 weeks, how often have you been bothered by any of the following problems?
Felt bad about yourself or that you are a failure or have let yourself or your family down
- 1: Not at all
- 2: Several days
- 3: More than half the days
- 4: Nearly every day
Mental health (DEP) - Question identifier:DEP_Q035
Over the last 2 weeks, how often have you been bothered by any of the following problems?
Had trouble concentrating on things, such as reading the newspaper or watching television
- 1: Not at all
- 2: Several days
- 3: More than half the days
- 4: Nearly every day
Mental health (DEP) - Question identifier:DEP_Q040
Over the last 2 weeks, how often have you been bothered by any of the following problems?
Been moving or speaking so slowly that other people could have noticed? Or the opposite, being so fidgety or restless that you have been moving around a lot more than usual
- 1: Not at all
- 2: Several days
- 3: More than half the days
- 4: Nearly every day
Mental health (DEP) - Question identifier:DEP_Q045
Over the last 2 weeks, how often have you been bothered by any of the following problems?
Had thoughts that you would be better off dead or of hurting yourself in some way
- 1: Not at all
- 2: Several days
- 3: More than half the days
- 4: Nearly every day
Mental health (DEP) - Question identifier:DEP_Q050
How difficult have these problems made it for you to do your work, take care of things at home, or get along with other people?
- 1: Not difficult at all
- 2: Somewhat difficult
- 3: Very difficult
- 4: Extremely difficult
Social provisions (SPS)
Social provisions (SPS) - Question identifier:SPS_R001
The next questions are about your current relationships with friends, family members, co-workers, community members, and so on.
Social provisions (SPS) - Question identifier:SPS_Q015
Please indicate to what extent each statement describes your current relationships with other people.
I have close relationships that provide me with a sense of emotional security and wellbeing.
- 1: Strongly agree
- 2: Agree
- 3: Disagree
- 4: Strongly disagree
Social provisions (SPS) - Question identifier:SPS_Q020
Please indicate to what extent each statement describes your current relationships with other people.
There is someone I could talk to about important decisions in my life.
- 1: Strongly agree
- 2: Agree
- 3: Disagree
- 4: Strongly disagree
Social provisions (SPS) - Question identifier:SPS_Q025
Please indicate to what extent each statement describes your current relationships with other people.
I have relationships where my competence and skill are recognized.
- 1: Strongly agree
- 2: Agree
- 3: Disagree
- 4: Strongly disagree
Social provisions (SPS) - Question identifier:SPS_Q035
Please indicate to what extent each statement describes your current relationships with other people.
I feel part of a group of people who share my attitudes and beliefs.
- 1: Strongly agree
- 2: Agree
- 3: Disagree
- 4: Strongly disagree
Social provisions (SPS) - Question identifier:SPS_Q050
Please indicate to what extent each statement describes your current relationships with other people.
There are people I can count on in an emergency.
- 1: Strongly agree
- 2: Agree
- 3: Disagree
- 4: Strongly disagree
Regular health care provider (RHC)
Regular health care provider (RHC) - Question identifier:RHC_Q05
Which of the following health care providers do you regularly consult with?
- 1: Family doctor or general practitioner
- 2: Medical specialist (e.g., cardiologist, pediatrician, oncologist)
- 3: Nurse practitioner
- 4: Other (e.g., chiropractor, psychologist)
- 5: Don't have a regular health care provider
Labour market activities (LMAM)
Labour market activities (LMAM) - Question identifier:LMAM_R01
Many of the following questions concern your activities last week.
Last week is from [7 days ago] to [yesterday].
Labour market activities (LMAM) - Question identifier:LMAM_Q01
Last week, did you work at a job or business?
- 1: Yes
- 2: No
- 3: Permanently unable to work
Labour market activities (LMAM) - Question identifier:LMAM_Q02
Last week, did you have a job or business from which you were absent?
- 1: Yes
- 2: No
Labour market activities (LMAM) - Question identifier:LMAM_Q03
What was the main reason you were absent from work last week?
- 01: Vacation
- 02: Own illness or disability
- 03: Caring for own children
- 04: Caring for elder relative (60 years of age or older)
- 05: Maternity or parental leave
- 06: Other personal or family responsibilities
- 07: Labour dispute (strike or lockout) (Employees only)
- 08: Temporary layoff due to business conditions (Employees only)
- 09: Seasonal layoff (Employees only)
- 10: Casual job, no work available (Employees only)
- 11: Work schedule (e.g., 10 days on, 10 days off, employees only)
- 12: Self-employed, no work available (Self-employed only)
- 13: Seasonal business (Excluding employees)
- 14: Other
Labour market activities (LMA3)
Labour market activities (LMA3) - Question identifier:LMA3_Q01
Were you an employee or self-employed?
- 1: Employee
- 2: Self-employed
- 3: Working in a family business without pay
Labour market activities (LMA4)
Labour market activities (LMA4) - Question identifier:LMA4_Q01
What was the full name of your business?
Long Answer Length = 50
Labour market activities (LMA4) - Question identifier:LMA4_Q02
For whom did you work?
Long Answer Length = 50
Labour market activities (LMA4) - Question identifier:LMA4_Q03
What kind of business, industry or service was this?
Long Answer Length = 80
Labour market activities (LMA5)
Labour market activities (LMA5) - Question identifier:LMA5_R01
The following questions refer to the work or occupation in which you spent most of your time.
Labour market activities (LMA5) - Question identifier:LMA5_Q01
What kind of work were you doing?
Long Answer Length = 50
Labour market activities (LMA5) - Question identifier:LMA5_Q02
What were your most important activities or duties?
Long Answer Length = 50
Labour market activities (LMA6)
Labour market activities (LMA6) - Question identifier:LMA6_Q01
[Excluding overtime, on average, how many paid hours do you usually work per week?/On average, how many hours do you usually work per week?]
Min = 0; Max = 999.9
Labour market activities (LBF)
Labour market activities (LBF) - Question identifier:LBF_Q11
Did you have more than one job or business last week?
- 1: Yes
- 2: No
Labour market activities (LBF) - Question identifier:LBF_Q12
On average, how many hours do you usually work per week at your other job(s)?
Min = 0; Max = 999.9
Telework (LM)
Telework (LM) - Question identifier:LM_Q01
At the present time, in which of the following locations do you usually work as part of your main job or business?
- 1: At a fixed location outside the home
- 2: Outside the home with no fixed location (e.g., driving, door-to-door sales)
- 3: At home (Include farms and all work done at the same address as your home, but on a different part of the property)
Telework (LM) - Question identifier:LM_Q02
Last week, what proportion of your work hours did you work at home as part of your main job or business?
- 1: All your hours at home
- 2: More than half, but not all your hours at home
- 3: One quarter to half at home
- 4: Less than a quarter at home
- 5: No hours at home
Place of birth, immigration and citizenship (IM)
Place of birth, immigration and citizenship (IM) - Question identifier:IM_Q01A
Where were you born?
- 1: Born in Canada
- 2: Born outside Canada
Place of birth, immigration and citizenship (IM) - Question identifier:IM_Q01AA
Specify the province or territory
- 10: Newfoundland and Labrador
- 11: Prince Edward Island
- 12: Nova Scotia
- 13: New Brunswick
- 24: Quebec
- 35: Ontario
- 46: Manitoba
- 47: Saskatchewan
- 48: Alberta
- 59: British Columbia
- 60: Yukon
- 61: Northwest Territories
- 62: Nunavut
Place of birth, immigration and citizenship (IM) - Question identifier:IM_Q01AB
Select the country
- 1: Search
- 2: Other - Specify
Place of birth, immigration and citizenship (IM) - Question identifier:IM_Q02
In what year did you first come to Canada to live?
Min = 0; Max = 9999
Place of birth, immigration and citizenship (IM) - Question identifier:IM_Q03
Are you now, or have you ever been a landed immigrant?
- 1: Yes
- 2: No
Place of birth, immigration and citizenship (IM) - Question identifier:IM_Q04
In what year did you first become a landed immigrant?
Min = 0; Max = 9999
Place of birth, immigration and citizenship (IM) - Question identifier:IM_Q05
Of what country are you a citizen?
Are you a citizen of:
- 1: Canada
- 2: Another country
Place of birth, immigration and citizenship (IM) - Question identifier:IM_Q05AA
Is it:
- 1: By birth
- 2: By naturalization (i.e., the process by which an immigrant is granted citizenship of Canada, under the Citizenship Act.)
Place of birth, immigration and citizenship (IM) - Question identifier:IM_Q05AB
Select the country
- 1: Search
- 2: Other - Specify
Indigenous identity (ABM)
Indigenous identity (ABM) - Question identifier:ABM_Q01
Are you First Nations, Métis or Inuk (Inuit)?
- 1: No, not First Nations, Métis or Inuk (Inuit)
- 2: Yes, First Nations (North American Indian)
- 3: Yes, Métis
- 4: Yes, Inuk (Inuit)
Population group (PG)
Population group (PG) - Question identifier:PG_R05
The following question collects information in accordance with the Employment Equity Act and its Regulations and Guidelines to support programs that promote equal opportunity for everyone to share in the social, cultural, and economic life of Canada.
Population group (PG) - Question identifier:PG_Q05
Are you?
- 01: White
- 02: South Asian (e.g., East Indian, Pakistani, Sri Lankan)
- 03: Chinese
- 04: Black
- 05: Filipino
- 06: Arab
- 07: Latin American
- 08: Southeast Asian (e.g. Vietnamese, Cambodian, Laotian, Thai)
- 09: West Asian (e.g., Iranian, Afghan)
- 10: Korean
- 11: Japanese
- 12: Other specify:
Language (LAN)
Language (LAN) - Question identifier:LAN_Q01
Can you speak English or French well enough to conduct a conversation?
- 1: English only
- 2: French only
- 3: Both English and French
- 4: Neither English nor French
Language (LAN) - Question identifier:LAN_Q02
What language do you speak most often at home?
- 1: English
- 2: French
- 3: Other
Language (LAN) - Question identifier:LAN_Q04
What is the language that you first learned at home in childhood and still understand?
- 1: English
- 2: French
- 3: Other
Sexual orientation (SOR)
Sexual orientation (SOR) - Question identifier:SOR_Q01
What is your sexual orientation?
- 1: Heterosexual
- 2: Lesbian or gay
- 3: Bisexual
- 4: Or please specify
Home care services (HMC)
Home care services (HMC) - Question identifier:HMC_R005
Now some questions on home care services that you or anyone in the household may have received because of a health condition or a limitation in daily activities.
Home care services (HMC) - Question identifier:HMC_Q005
In the past 12 months, what type of home care services have been received?
- 1: Nursing care (e.g., dressing changes, preparing medications, V.O.N. visits)
- 2: Other health care services (e.g., physiotherapy, occupational or speech therapy, nutrition counselling)
- 3: Medical equipment or supplies (e.g., wheelchair, pads for incontinence, help with using a ventilator or oxygen equipment)
- 4: Personal or home support (e.g., bathing, housekeeping, meal preparation)
- 5: Palliative or end-of-life care
- 6: Other services (e.g., transportation, meals-on-wheels)
- 7: No one in the household received any home care services
Home care services (HMC) - Question identifier:HMC_Q010A
Who received these home care services?
Nursing care
- 1: You
- 2: Another member of the household
- 3: You and another member of the household
Home care services (HMC) - Question identifier:HMC_Q010B
Who received these home care services?
Other health care services
- 1: You
- 2: Another member of the household
- 3: You and another member of the household
Home care services (HMC) - Question identifier:HMC_Q010C
Who received these home care services?
Medical equipment or supplies
- 1: You
- 2: Another member of the household
- 3: You and another member of the household
Home care services (HMC) - Question identifier:HMC_Q010D
Who received these home care services?
Personal or home support
- 1: You
- 2: Another member of the household
- 3: You and another member of the household
Home care services (HMC) - Question identifier:HMC_Q010E
Who received these home care services?
Palliative or end-of-life care
- 1: You
- 2: Another member of the household
- 3: You and another member of the household
Home care services (HMC) - Question identifier:HMC_Q010F
Who received these home care services?
Other services
- 1: You
- 2: Another member of the household
- 3: You and another member of the household
Home care services (HMC) - Question identifier:HMC_Q015A
How long were home care services received?
Nursing care
- 1: Less than 1 month
- 2: 1 month to less than 3 months
- 3: 3 months to less than 6 months
- 4: 6 months to less than 1 year
- 5: 1 year to 3 years
- 6: More than 3 years
Home care services (HMC) - Question identifier:HMC_Q015B
How long were home care services received?
Other health care services
- 1: Less than 1 month
- 2: 1 month to less than 3 months
- 3: 3 months to less than 6 months
- 4: 6 months to less than 1 year
- 5: 1 year to 3 years
- 6: More than 3 years
Home care services (HMC) - Question identifier:HMC_Q015C
How long were home care services received?
Medical equipment or supplies
- 1: Less than 1 month
- 2: 1 month to less than 3 months
- 3: 3 months to less than 6 months
- 4: 6 months to less than 1 year
- 5: 1 year to 3 years
- 6: More than 3 years
Home care services (HMC) - Question identifier:HMC_Q015D
How long were home care services received?
Personal or home support
- 1: Less than 1 month
- 2: 1 month to less than 3 months
- 3: 3 months to less than 6 months
- 4: 6 months to less than 1 year
- 5: 1 year to 3 years
- 6: More than 3 years
Home care services (HMC) - Question identifier:HMC_Q015E
How long were home care services received?
Palliative or end-of-life care
- 1: Less than 1 month
- 2: 1 month to less than 3 months
- 3: 3 months to less than 6 months
- 4: 6 months to less than 1 year
- 5: 1 year to 3 years
- 6: More than 3 years
Home care services (HMC) - Question identifier:HMC_Q015F
How long were home care services received?
Other services
- 1: Less than 1 month
- 2: 1 month to less than 3 months
- 3: 3 months to less than 6 months
- 4: 6 months to less than 1 year
- 5: 1 year to 3 years
- 6: More than 3 years
Home care services (HMC) - Question identifier:HMC_Q020A
In a typical month over the past 12 months, how much was paid for home care services?
Nursing care
- 01: $0
- 02: $1 to less than $50
- 03: $50 to less than $100
- 04: $100 to less than $200
- 05: $200 to less than $300
- 06: $300 to less than $400
- 07: $400 to less than $1,000
- 08: $1,000 and more
Home care services (HMC) - Question identifier:HMC_Q020B
In a typical month over the past 12 months, how much was paid for home care services?
Other health care services
- 01: $0
- 02: $1 to less than $50
- 03: $50 to less than $100
- 04: $100 to less than $200
- 05: $200 to less than $300
- 06: $300 to less than $400
- 07: $400 to less than $1,000
- 08: $1,000 and more
Home care services (HMC) - Question identifier:HMC_Q020C
In a typical month over the past 12 months, how much was paid for home care services?
Medical equipment or supplies
- 01: $0
- 02: $1 to less than $50
- 03: $50 to less than $100
- 04: $100 to less than $200
- 05: $200 to less than $300
- 06: $300 to less than $400
- 07: $400 to less than $1,000
- 08: $1,000 and more
Home care services (HMC) - Question identifier:HMC_Q020D
In a typical month over the past 12 months, how much was paid for home care services?
Personal or home support
- 01: $0
- 02: $1 to less than $50
- 03: $50 to less than $100
- 04: $100 to less than $200
- 05: $200 to less than $300
- 06: $300 to less than $400
- 07: $400 to less than $1,000
- 08: $1,000 and more
Home care services (HMC) - Question identifier:HMC_Q020E
In a typical month over the past 12 months, how much was paid for home care services?
Palliative or end-of-life care
- 01: $0
- 02: $1 to less than $50
- 03: $50 to less than $100
- 04: $100 to less than $200
- 05: $200 to less than $300
- 06: $300 to less than $400
- 07: $400 to less than $1,000
- 08: $1,000 and more
Home care services (HMC) - Question identifier:HMC_Q020F
In a typical month over the past 12 months, how much was paid for home care services?
Other services
- 01: $0
- 02: $1 to less than $50
- 03: $50 to less than $100
- 04: $100 to less than $200
- 05: $200 to less than $300
- 06: $300 to less than $400
- 07: $400 to less than $1,000
- 08: $1,000 and more
Home care services (HMC) - Question identifier:HMC_Q025
Who paid for these services?
- 1: Out of your own pocket
- 2: Family or friend living in the same household
- 3: Someone living outside the household (e.g., family, friends, volunteer organization)
- 4: Insurance
- 5: Government
- 6: Other
Home care services (HMC) - Question identifier:HMC_Q030
Overall, what was the level of satisfaction for the home care services received?
- 1: Very satisfied
- 2: Somewhat satisfied
- 3: Neither satisfied nor dissatisfied
- 4: Somewhat dissatisfied
- 5: Very dissatisfied
Home care services (HMC) - Question identifier:HMC_Q035
What are the reasons for the dissatisfaction?
- 1: Poor quality (i.e., concerns about provider competence, reliability of services, etc.)
- 2: Services did not address perceived needs
- 3: Services provided were insufficient
- 4: Long wait times to receive services
- 5: Other reason
Home care services (HMC) - Question identifier:HMC_Q037
Thinking of the home care services received in the past 12 months, how helpful were they in allowing the person or persons receiving these services to stay at home?
- 1: Very helpful
- 2: Somewhat helpful
- 3: Not helpful
- 4: Reason for homecare was unrelated to staying at home (e.g., wound care)
Home care services (HMC) - Question identifier:HMC_Q038
Why weren't the home care services helpful in allowing the person or persons receiving these services to stay at home?
- 1: Poor quality (i.e., concerns about provider competence, reliability of services, etc.)
- 2: Services did not address perceived needs
- 3: Services provided were insufficient (e.g., coverage, frequency, etc.)
- 4: Long wait times to receive services
- 5: Cost of services was too high
- 6: Other reason
Home care services (HMC) - Question identifier:HMC_Q040
During the past 12 months, was there ever a time when you or anyone in the household felt that home care services were needed but were not received?
- 1: Yes
- 2: No
Home care services (HMC) - Question identifier:HMC_Q045
Were these home care services needed for yourself or someone else living in the household?
- 1: You only
- 2: Other household member
- 3: You and other household member
Home care services (HMC) - Question identifier:HMC_R050
For the following questions, please only report for the home care services you personally needed.
Home care services (HMC) - Question identifier:HMC_Q050
Thinking of the most recent time, what type of home care was needed?
- 1: Nursing care (e.g., dressing changes, preparing medications, V.O.N. visits)
- 2: Other health care services (e.g., physiotherapy, occupational or speech therapy, nutrition counselling)
- 3: Medical equipment or supplies (e.g., wheelchair, pads for incontinence, help with using a ventilator or oxygen equipment)
- 4: Personal or home support (e.g., bathing, housekeeping, meal preparation)
- 5: Palliative or end-of-life care
- 6: Other services (e.g., transportation, meals-on-wheels)
Home care services (HMC) - Question identifier:HMC_Q055
Again, thinking of the most recent time, why didn't you or another member of the household get these services?
- 01: Not available in the area
- 02: Not available at time required (e.g., inconvenient hours)
- 03: Waiting time too long
- 04: Cost
- 05: Didn't get around to it or didn't bother
- 06: Didn't know where to go or call
- 07: Language barrier
- 08: Decided not to seek services
- 09: Doctor did not think it was necessary
- 10: Not eligible for home care
- 11: Still waiting for home care
- 12: Other
Home care services (HMC) - Question identifier:HMC_Q060
Where did you or another member of the household try to get these home care services?
- 1: A government Home Care Program (e.g., CLSC in Quebec, CCAC in Ontario, Extra-Mural Program in New Brunswick)
- 2: A private agency
- 3: A family member, friend or neighbour
- 4: A volunteer organization
- 5: Nowhere - did not try to get service
- 6: Other
Food security (FSC)
Food security (FSC) - Question identifier:FSC_R10
The following statements may describe the food situation for your household in the past 12 months. Please indicate if the statement was often true, sometimes true or never true for [you/you and other household members] in the past 12 months.
Food security (FSC) - Question identifier:FSC_Q10
[You/You and other household members] worried that food would run out before you got money to buy more
- 1: Often true
- 2: Sometimes true
- 3: Never true
Food security (FSC) - Question identifier:FSC_Q15
The food that [you/you and other household members] bought just didn't last and there wasn't any money to get more
- 1: Often true
- 2: Sometimes true
- 3: Never true
Food security (FSC) - Question identifier:FSC_Q20
[You/You and other household members] couldn't afford to eat balanced meals
- 1: Often true
- 2: Sometimes true
- 3: Never true
Food security (FSC) - Question identifier:FSC_Q25
[You/You or other adults in your household] relied on only a few kinds of low-cost food to feed [your child/the children] because you were running out of money to buy food
- 1: Often true
- 2: Sometimes true
- 3: Never true
Food security (FSC) - Question identifier:FSC_Q30
[You/You or other adults in your household] couldn't feed [your child/the children] a balanced meal because you couldn't afford it
- 1: Often true
- 2: Sometimes true
- 3: Never true
Food security (FSC) - Question identifier:FSC_Q35
[Your child was/The children were] not eating enough because [you/you or other adults in your household] just couldn't afford enough food?
- 1: Often true
- 2: Sometimes true
- 3: Never true
Food security (FSC) - Question identifier:FSC_R40
[The following few questions are about the food situation in the past 12 months for you or any other adults in your household.]
Food security (FSC) - Question identifier:FSC_Q40
In the past 12 months, since last [January/ February/ March/ April/ May/ June/ July/ August/ September/ October/ November/ December], did [you/you or other adults in your household] ever cut the size of your meals or skip meals because there wasn't enough money for food?
- 1: Yes
- 2: No
Food security (FSC) - Question identifier:FSC_Q45
How often did this happen?
- 1: Almost every month
- 2: Some months but not every month
- 3: Only 1 or 2 months
Food security (FSC) - Question identifier:FSC_Q50
In the past 12 months, did you personally ever eat less than you felt you should because there wasn't enough money to buy food?
- 1: Yes
- 2: No
Food security (FSC) - Question identifier:FSC_Q55
In the past 12 months, were you personally ever hungry but didn't eat because you couldn't afford enough food?
- 1: Yes
- 2: No
Food security (FSC) - Question identifier:FSC_Q60
In the past 12 months, did you personally ever lose weight because you didn't have enough money for food?
- 1: Yes
- 2: No
Food security (FSC) - Question identifier:FSC_Q65
In the past 12 months, did [you/you or other adults in your household] ever not eat for a whole day because there wasn't enough money for food?
- 1: Yes
- 2: No
Food security (FSC) - Question identifier:FSC_Q70
How often did this happen?
- 1: Almost every month
- 2: Some months but not every month
- 3: Only 1 or 2 months
Food security (FSC) - Question identifier:FSC_R75
Now, a few questions on the food experiences for children in your household.
Food security (FSC) - Question identifier:FSC_Q75
In the past 12 months, did [you/you or other adults in your household] ever cut the size of [your child's/any of the children's] meals because there wasn't enough money for food?
- 1: Yes
- 2: No
Food security (FSC) - Question identifier:FSC_Q80
In the past 12 months, did [your child/any of the children] ever skip meals because there wasn't enough money for food?
- 1: Yes
- 2: No
Food security (FSC) - Question identifier:FSC_Q85
How often did this happen?
- 1: Almost every month
- 2: Some months but not every month
- 3: Only 1 or 2 months
Food security (FSC) - Question identifier:FSC_Q90
In the past 12 months, [was your child/were any of the children] ever hungry but you couldn't afford more food?
- 1: Yes
- 2: No
Food security (FSC) - Question identifier:FSC_Q95
In the past 12 months, did [your child/any of the children] ever not eat for a whole day because there wasn't enough money for food?
- 1: Yes
- 2: No
Total household income (INC)
Total household income (INC) - Question identifier:INC_R01A
Although many health expenses are covered by health insurance, there is still an important relationship between health and income. Please be assured that, like all other information you have provided, these answers will be kept strictly confidential.
Total household income (INC) - Question identifier:INC_R01B
Now a question about total household income.
Total household income (INC) - Question identifier:INC_Q01
What is your best estimate of total household income received by all household members, from all sources, before taxes and deductions, during the year ending December 31, [Past year]?
Min = -99999999; Max = 99999999
Total household income (INC) - Question identifier:INC_Q02
Which of the following categories best represents your total household income for the year ending December 31, [past year]?
- 1: Less than $50,000
- 2: $50,000 and more
Total household income (INC) - Question identifier:INC_Q03
What was your total household income?
- 1: Less than $5,000
- 2: $5,000 to less than $10,000
- 3: $10,000 to less than $15,000
- 4: $15,000 to less than $20,000
- 5: $20,000 to less than $30,000
- 6: $30,000 to less than $40,000
- 7: $40,000 to less than $50,000
Total household income (INC) - Question identifier:INC_Q04
What was your total household income?
- 1: $50,000 to less than $60,000
- 2: $60,000 to less than $70,000
- 3: $70,000 to less than $80,000
- 4: $80,000 to less than $90,000
- 5: $90,000 to less than $100,000
- 6: $100,000 to less than $150,000
- 7: $150,000 and over
Administrative information (ADMC)
Administrative information (ADMC) - Question identifier:ADMC_R10
To enhance the data from this survey and to minimize the reporting burden for respondents, Statistics Canada will combine [your responses] with information from the tax data of all members of your household. [Statistics Canada, the provincial ministry of health and the Institut de la statistique du Québec/Statistics Canada and the territorial ministry of health/Statistics Canada and the provincial ministry of health] may also add information from other surveys or administrative sources.
Administrative information (ADMC) - Question identifier:ADMC_Q10
Having a provincial or territorial health number will assist us in linking to this other information. [Do you] have [Newfoundland and Labrador/ Prince Edward Island/ Nova Scotia/ New Brunswick/ Quebec/ Ontario/ Manitoba/ Saskatchewan/ Alberta/ British Columbia/ Yukon/ the Northwest Territories/ Nunavut] health number?
- 1: Yes
- 2: No
Administrative information (ADMC) - Question identifier:ADMC_Q10A
For which province or territory is your health number?
Province or territory
- 10: Newfoundland and Labrador
- 11: Prince Edward Island
- 12: Nova Scotia
- 13: New Brunswick
- 24: Quebec
- 35: Ontario
- 46: Manitoba
- 47: Saskatchewan
- 48: Alberta
- 59: British Columbia
- 60: Yukon
- 61: Northwest Territories
- 62: Nunavut
- 88: Does not have a Canadian health number
Administrative information (ADMC) - Question identifier:ADMC_Q15
What is your health number?
Long Answer Length = 12
Administrative information (ADMC) - Question identifier:ADMC_R25A
To avoid duplication of surveys, Statistics Canada has signed agreements to share the data from this survey with provincial and territorial ministries of health, Health Canada and the Public Health Agency of Canada. Provincial ministries of health may make the data available to local health authorities.
Data shared with your ministry of health may also include identifiers such as name, address, telephone number and health card number. Health Canada, the Public Health Agency of Canada, and local health authorities, would receive only survey responses and the postal code.
Administrative information (ADMC) - Question identifier:ADMC_R25B
To avoid duplication of surveys, Statistics Canada has signed agreements to share the data from this survey with provincial and territorial ministries of health, the Institut de la statistique du Québec, Health Canada and the Public Health Agency of Canada. The Institut de la statistique du Québec and provincial ministries of health may make this data available to local health authorities.
Data shared with your ministry of health or the Institut de la statistique du Québec may also include identifiers such as name, address, telephone number and health card number. Health Canada, the Public Health Agency of Canada, and local health authorities, would receive only survey responses and the postal code.
Administrative information (ADMC) - Question identifier:ADMC_R25C
Statistics Canada has also entered into an agreement to share information from the interviews conducted as part of this survey with Veterans Affairs Canada and the Department of National Defence.
Veterans Affairs Canada and the Department of National Defence intend to link the information collected during this interview to your administrative records.
Administrative information (ADMC) - Question identifier:ADMC_Q35
These organizations have agreed to keep the data confidential and use it only for statistical purposes.
Do you agree to share the data you provided?
- 1: Yes
- 2: No
Administrative information (ADMC) - Question identifier:ADMC_Q37
To reduce the number of questions in this questionnaire, Statistics Canada will use information from your tax forms submitted to the Canada Revenue Agency. With your consent Statistics Canada will share this information from your tax forms with [provincial and territorial ministries of health, the Institut de la statistique du Québec, [Veterans Affairs Canada, the Department of National Defence,] Health Canada and the Public Health Agency of Canada/provincial and territorial ministries of health, Health Canada and the Public Health Agency of Canada]. These organizations have agreed to keep the information confidential and to use it only for statistical and research purposes.
Do you give Statistics Canada permission to share your tax information with [provincial and territorial ministries of health, the Institut de la statistique du Québec, [Veterans Affairs Canada, the Department of National Defence,] Health Canada and the Public Health Agency of Canada/provincial and territorial ministries of health, Health Canada and the Public Health Agency of Canada]?
- 1: Yes
- 2: No
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