Canadian Community Health Survey (CCHS) Rapid Response July-September 2015 - Risk Factors for Heart Disease
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For Information onlyThis is an electronic survey example for information purposes only. This is not a working questionnaire.
Table of Contents
- Proxy interview (GR)
- Age of respondent (ANC1)
- Relationship without confirmation (RNC)
- Main activity (MAC)
- General health (GEN)
- Height and weight - self reported (HWT)
- Chronic conditions (CCC)
- Fruit and vegetable consumption (FVC)
- Smoking (SMK)
- Exposure to second hand smoke (ETS)
- Alcohol use (ALC)
- Physical activities - adults 18 years and older (PAA)
- Physical activities for youth (PAY)
- Maternal experiences (MEX)
- Flu shots (FLU)
- Primary health care (PHC)
- Contacts with health professionals - part 1 (CHP)
- Risk Factors for Heart Disease (RFH)
- Labour force (LBF)
- Socio-demographic characteristics (SDC)
- Person most knowledgeable about household situation (PMK)
- Income (INC)
- Administration information (ADM)
Proxy interview (GR)
Proxy interview (GR) - Question identifier:GR_N005
Who is providing the information for this person's component?
- 01: MEMBER1
- 02: MEMBER2
- 03: MEMBER3
- 04: MEMBER4
- 05: MEMBER5
- 06: MEMBER6
- 07: MEMBER7
- 08: MEMBER8
- 09: MEMBER9
- 10: MEMBER10
- 11: MEMBER11
- 12: MEMBER12
- 13: MEMBER13
- 14: MEMBER14
- 15: MEMBER15
- 16: MEMBER16
- 17: MEMBER17
- 18: MEMBER18
- 19: MEMBER19
- 20: MEMBER20
- 88: Not a household member
Proxy interview (GR) - Question identifier:GR_N010
Do you want to complete this component by proxy?
- 1: Yes
- 2: No
Proxy interview (GR) - Question identifier:GR_N015
Record the reason why this component is being completed by proxy. Proxy interviews are to occur only if the mental or physical health of the selected member makes it impossible to complete the interview during the collection period. If the reason for the proxy interview is neither of these choices, please press <F10> to exit the application and assign an appropriate outcome code.
- 1: Physical health condition
- 2: Mental health condition
Proxy interview (GR) - Question identifier:GR_N020
Enter the condition.
Long Answer Length = 80
Age of respondent (ANC1)
Age of respondent (ANC1) - Question identifier:ANC1_Q01
What is ^SPECRESPNAME's date of birth?
Min = 1; Max = 31
Age of respondent (ANC1) - Question identifier:ANC1_Q02
(What is ^SPECRESPNAME's date of birth?)
- 01: January
- 02: February
- 03: March
- 04: April
- 05: May
- 06: June
- 07: July
- 08: August
- 09: September
- 10: October
- 11: November
- 12: December
- 98: RF
- 99: DK
Age of respondent (ANC1) - Question identifier:ANC1_Q03
(What is ^SPECRESPNAME's date of birth?)
Min = 0; Max = 9997
Age of respondent (ANC1) - Question identifier:ANC1_Q04
So ^SPECRESPNAME's age on ^REFERENCEDATEE was ^DV_CALCULATEDAGE ^DT_YEARSMONTHSE.
Is that correct?
- 1: Yes
- 2: No, return and correct date of birth
- 3: No, collect age
Age of respondent (ANC1) - Question identifier:ANC1_Q05
What is ^SPECRESPNAME's age?
Min = 0; Max = 121
Age of respondent (ANC1) - Question identifier:ANC1_R010
Because you are less than 12 years old, you are not eligible to participate in the Canadian Community Health Survey.
Age of respondent (ANC1) - Question identifier:ANC1_R015
Because you are more than 17 years old, you are not eligible to participate in the Canadian Community Health Survey.
Age of respondent (ANC1) - Question identifier:ANC1_R020
Because you are less than 18 years old, you are not eligible to participate in the Canadian Community Health Survey.
Age of respondent (ANC1) - Question identifier:ANC1_N030
Please confirm the spelling of respondent's first name. Update first name, if necessary.
Original First Name: ^FNAME
Original Last Name: ^LNAME
Long Answer Length = 25
Age of respondent (ANC1) - Question identifier:ANC1_N035
Please confirm the spelling of respondent's last name. Update last name, if necessary.
Original First Name: ^FNAME
Original Last Name: ^LNAME
Long Answer Length = 25
Relationship without confirmation (RNC)
Relationship without confirmation (RNC) - Question identifier:RNC_Q1
What is the relationship...
of: ^SPECRESPNAME1 (^SPECRESPAGE1, ^DT_SPECRESPSEXE1)
to: ^SPECRESPNAME2 (^SPECRESPAGE2, ^DT_SPECRESPSEXE2)?
- 01: (Husband/Wife)
- 02: Common-law partner
- 03: (Father/Mother)
- 04: (Son/Daughter)
- 05: (Brother/Sister)
- 06: (Father/Mother)
- 07: Foster (Son/Daughter)
- 08: (Grandfather/Grandmother)
- 09: (Grandson/Granddaughter)
- 10: In-law
- 11: Other related
- 12: Unrelated
- 98: RF
- 99: DK
Relationship without confirmation (RNC) - Question identifier:RNC_Q2A
Is that a(n)... ?
- 1: Birth (father/mother)
- 2: Step(father/mother)
- 3: Adoptive (father/mother)
- 8: RF
- 9: DK
Relationship without confirmation (RNC) - Question identifier:RNC_Q2B
Is that a(n)... ?
- 1: Birth (son/daughter)
- 2: Step (son/daughter)
- 3: Adopted (son/daughter)
- 8: RF
- 9: DK
Relationship without confirmation (RNC) - Question identifier:RNC_Q2C
Is that a(n)... ?
- 1: Full (brother/sister)
- 2: Half (brother/sister)
- 3: Step(brother/sister)
- 4: Adopted (brother/sister)
- 5: Foster (brother/sister)
- 8: RF
- 9: DK
Relationship without confirmation (RNC) - Question identifier:RNC_Q2D
Is that a(n)... ?
- 1: (Father/Mother)-in-law
- 2: (Son/Daughter)-in-law
- 3: (Brother/Sister)-in-law
- 4: Other in-law
- 8: RF
- 9: DK
Relationship without confirmation (RNC) - Question identifier:RNC_Q2E
Is that a(n)... ?
- 1: (Uncle/Aunt)
- 2: Cousin
- 3: (Nephew/Neice)
- 4: Other relative
- 8: RF
- 9: DK
Relationship without confirmation (RNC) - Question identifier:RNC_Q2F
Is that a(n)... ?
- 1: (Boyfriend/Girlfriend)
- 2: Roommate/lodger/boarder
- 3: Other - Specify
- 8: RF
- 9: DK
Main activity (MAC)
Main activity (MAC) - Question identifier:MAC_Q005
Last week, was your main activity working at a paid job or business, looking for paid work, going to school, caring for children, household work, retired or something else?
- 01: Working at a paid job or business
- 02: Vacation (from paid work)
- 03: Looking for paid work
- 04: Going to school (including vacation from school)
- 05: Caring for children
- 06: Household work
- 07: Retired
- 08: Maternity/paternity leave
- 09: Long term illness
- 10: Volunteering
- 11: Care-giving other than for children
- 12: Other
- 98: RF
- 99: DK
Main activity (MAC) - Question identifier:MAC_Q010
Have you worked at a job or business at any time in the past 12 months?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Main activity (MAC) - Question identifier:MAC_Q015
Are you currently attending school, college, CEGEP or university?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Main activity (MAC) - Question identifier:MAC_Q020
Are you enrolled as...?
- 1: A full-time student
- 2: A part-time student
- 3: Both full-time and part-time student
- 8: RF
- 9: DK
Main activity (MAC) - Question identifier:MAC_Q025
To better understand the information you will provide on your health it is important to know if you are pregnant. Are you pregnant?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
General health (GEN)
General health (GEN) - Question identifier:GEN_R005
The next questions are about your health. By health, we mean not only the absence of disease or injury but also physical, mental and social well-being.
General health (GEN) - Question identifier:GEN_Q005
In general, would you say your health is... ?
- 1: Excellent
- 2: Very good
- 3: Good
- 4: Fair
- 5: Poor
- 8: RF
- 9: DK
General health (GEN) - Question identifier:GEN_Q010
Using a scale of 0 to 10, where 0 means "Very dissatisfied" and 10 means "Very satisfied", how do you feel about your life as a whole right now?
Min = 0; Max = 10
General health (GEN) - Question identifier:GEN_Q015
In general, would you say your mental health is...?
- 1: Excellent
- 2: Very good
- 3: Good
- 4: Fair
- 5: Poor
- 8: RF
- 9: DK
General health (GEN) - Question identifier:GEN_Q020
Thinking about the amount of stress in your life, would you say that most of your days are...?
- 1: Not at all stressful
- 2: Not very stressful
- 3: A bit stressful
- 4: Quite a bit stressful
- 5: Extremely stressful
- 8: RF
- 9: DK
General health (GEN) - Question identifier:GEN_R025
The next question is about your main job or business in the past 12 months.
General health (GEN) - Question identifier:GEN_Q025
Would you say that most days at work were...?
- 1: Not at all stressful
- 2: Not very stressful
- 3: A bit stressful
- 4: Quite a bit stressful
- 5: Extremely stressful
- 8: RF
- 9: DK
General health (GEN) - Question identifier:GEN_Q030
How would you describe your sense of belonging to your local community? Would you say it is...?
- 1: Very strong
- 2: Somewhat strong
- 3: Somewhat weak
- 4: Very weak
- 8: RF
- 9: DK
Height and weight - self reported (HWT)
Height and weight - self reported (HWT) - Question identifier:HWT_Q005
The next questions are about height and weight. How tall are you without shoes on?
- 0: Less than 1' / 12" (less than 29.2 cm.)
- 1: 1'0" to 1'11" / 12" to 23" (29.2 to 59.6 cm.)
- 2: 2'0" to 2'11" / 24" to 35" (59.7 to 90.1 cm.)
- 3: 3'0" to 3'11" / 36" to 47" (90.2 to 120.6 cm.)
- 4: 4'0" to 4'11" / 48" to 59" (120.7 to 151.0 cm.)
- 5: 5'0" to 5'11" (151.1 to 181.5 cm.)
- 6: 6'0" to 6'11" (181.6 to 212.0 cm.)
- 7: 7'0" and over (212.1 cm. and over)
- 8: RF
- 9: DK
Height and weight - self reported (HWT) - Question identifier:HWT_N010
Select the exact height.
- 00: Less than or equal to 1'0" / 12" (29.2 to 31.7 cm.)
- 01: 1'1" / 13" (31.8 to 34.2 cm.)
- 02: 1'2" / 14" (34.3 to 36.7 cm.)
- 03: 1'3" / 15" (36.8 to 39.3 cm.)
- 04: 1'4" / 16" (39.4 to 41.8 cm.)
- 05: 1'5" / 17" (41.9 to 44.4 cm.)
- 06: 1'6" / 18" (44.5 to 46.9 cm.)
- 07: 1'7" / 19" (47.0 to 49.4 cm.)
- 08: 1'8" / 20" (49.5 to 52.0 cm.)
- 09: 1'9" / 21" (52.1 to 54.5 cm.)
- 10: 1'10" / 22" (54.6 to 57.1 cm.)
- 11: 1'11" / 23" (57.2 to 59.6 cm.)
- 98: RF
- 99: DK
Height and weight - self reported (HWT) - Question identifier:HWT_N015
Select the exact height.
- 00: 2'0" / 24" (59.7 to 62.1 cm.)
- 01: 2'1" / 25" (62.2 to 64.7 cm.)
- 02: 2'2" / 26" (64.8 to 67.2 cm.)
- 03: 2'3" / 27" (67.3 to 69.8 cm.)
- 04: 2'4" / 28" (69.9 to 72.3 cm.)
- 05: 2'5" / 29" (72.4 to 74.8 cm.)
- 06: 2'6" / 30" (74.9 to 77.4 cm.)
- 07: 2'7" / 31" (77.5 to 79.9 cm.)
- 08: 2'8" / 32" (80.0 to 82.5 cm.)
- 09: 2'9" / 33" (82.6 to 85.0 cm.)
- 10: 2'10" / 34" (85.1 to 87.5 cm.)
- 11: 2'11" / 35" (87.6 to 90.1 cm.)
- 98: RF
- 99: DK
Height and weight - self reported (HWT) - Question identifier:HWT_N020
Select the exact height.
- 00: 3'0" / 36" (90.2 to 92.6 cm.)
- 01: 3'1" / 37" (92.7 to 95.2 cm.)
- 02: 3'2" / 38" (95.3 to 97.7 cm.)
- 03: 3'3" / 39" (97.8 to 100.2 cm.)
- 04: 3'4" / 40" (100.3 to 102.8 cm.)
- 05: 3'5" / 41" (102.9 to 105.3 cm.)
- 06: 3'6" / 42" (105.4 to 107.9 cm.)
- 07: 3'7" / 43" (108.0 to 110.4 cm.)
- 08: 3'8" / 44" (110.5 to 112.9 cm.)
- 09: 3'9" / 45" (113.0 to 115.5 cm.)
- 10: 3'10" / 46" (115.6 to 118.0 cm.)
- 11: 3'11" / 47" (118.1 to 120.6 cm.)
- 98: RF
- 99: DK
Height and weight - self reported (HWT) - Question identifier:HWT_N025
Select the exact height.
- 00: 4'0" / 48" (120.7 to 123.1 cm.)
- 01: 4'1" / 49" (123.2 to 125.6 cm.)
- 02: 4'2" / 50" (125.7 to 128.2 cm.)
- 03: 4'3" / 51" (128.3 to 130.7 cm.)
- 04: 4'4" / 52" (130.8 to 133.3 cm.)
- 05: 4'5" / 53" (133.4 to 135.8 cm.)
- 06: 4'6" / 54" (135.9 to 138.3 cm.)
- 07: 4'7" / 55" (138.4 to 140.9 cm.)
- 08: 4'8" / 56" (141.0 to 143.4 cm.)
- 09: 4'9" / 57" (143.5 to 146.0 cm.)
- 10: 4'10" / 58" (146.1 to 148.5 cm.)
- 11: 4'11" / 59" (148.6 to 151.0 cm.)
- 98: RF
- 99: DK
Height and weight - self reported (HWT) - Question identifier:HWT_N030
Select the exact height.
- 00: 5'0" (151.1 to 153.6 cm.)
- 01: 5'1" (153.7 to 156.1 cm.)
- 02: 5'2" (156.2 to 158.7 cm.)
- 03: 5'3" (158.8 to 161.2 cm.)
- 04: 5'4" (161.3 to 163.7 cm.)
- 05: 5'5" (163.8 to 166.3 cm.)
- 06: 5'6" (166.4 to 168.8 cm.)
- 07: 5'7" (168.9 to 171.4 cm.)
- 08: 5'8" (171.5 to 173.9 cm.)
- 09: 5'9" (174.0 to 176.4 cm.)
- 10: 5'10" (176.5 to 179.0 cm.)
- 11: 5'11" (179.1 to 181.5 cm.)
- 98: RF
- 99: DK
Height and weight - self reported (HWT) - Question identifier:HWT_N035
Select the exact height.
- 00: 6'0" (181.6 to 184.1 cm.)
- 01: 6'1" (184.2 to 186.6 cm.)
- 02: 6'2" (186.7 to 189.1 cm.)
- 03: 6'3" (189.2 to 191.7 cm.)
- 04: 6'4" (191.8 to 194.2 cm.)
- 05: 6'5" (194.3 to 196.8 cm.)
- 06: 6'6" (196.9 to 199.3 cm.)
- 07: 6'7" (199.4 to 201.8 cm.)
- 08: 6'8" (201.9 to 204.4 cm.)
- 09: 6'9" (204.5 to 206.9 cm.)
- 10: 6'10" (207.0 to 209.5 cm.)
- 11: 6'11" (209.6 to 212.0 cm.)
- 98: RF
- 99: DK
Height and weight - self reported (HWT) - Question identifier:HWT_Q040
How much do you weigh?
Min = 1; Max = 575
Height and weight - self reported (HWT) - Question identifier:HWT_N045
Was that in pounds or kilograms?
- 1: Pounds
- 2: Kilograms
Height and weight - self reported (HWT) - Question identifier:HWT_Q050
Do you consider yourself...?
- 1: Overweight
- 2: Underweight
- 3: Just about right
- 8: RF
- 9: DK
Chronic conditions (CCC)
Chronic conditions (CCC) - Question identifier:CCC_R005
The next question refers to your joints. Please do not include the back or neck.
Chronic conditions (CCC) - Question identifier:CCC_Q005
During the past 30 days, have you had any symptoms of pain, aching, or stiffness in or around a joint?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q010
Did your joint symptoms first begin more than 3 months ago?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_R015
Now I'd like to ask about certain long-term health conditions which you may have. We are interested in "long-term conditions" which are expected to last or have already lasted 6 months or more and that have been diagnosed by a health professional.
Chronic conditions (CCC) - Question identifier:CCC_Q015
Do you have asthma?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q020
Have you had any asthma symptoms or asthma attacks in the past 12 months?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q025
In the past 12 months, have you taken any medicine for asthma such as inhalers (pumps), nebulizers, pills, liquids or injections?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q030
Do you have chronic bronchitis, emphysema or chronic obstructive pulmonary disease or COPD?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q035
Have you been told by a health professional that you have sleep apnea?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q040
Do you have scoliosis?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_R045
Remember, we're interested in conditions diagnosed by a health professional and that are expected to last or have already lasted 6 months or more.
Chronic conditions (CCC) - Question identifier:CCC_Q045
Do you have fibromyalgia?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q050
Do you have arthritis, for example osteoarthritis, rheumatoid arthritis, gout or any other type, excluding fibromyalgia?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q055
Do you have back problems, excluding scoliosis, fibromyalgia and arthritis?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q060
Do you have osteoporosis?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q065
Do you have high blood pressure?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q070
In the past month, have you taken any medicine for high blood pressure?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q075
Do you have high blood cholesterol or lipids?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q080
In the past month, have you taken any medicine for high blood cholesterol or lipids?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q085
Do you have heart disease?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q090
Do you suffer from the effects of a stroke?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q095
Do you have diabetes?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q100
How old were you when this was first diagnosed?
Min = 1; Max = 121
Chronic conditions (CCC) - Question identifier:CCC_Q105
Were you pregnant when you were first diagnosed with diabetes?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q110
Other than during pregnancy, has a health professional ever told you that you have diabetes?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q115
When you were first diagnosed with diabetes, how long was it before you were started on insulin?
- 1: Less than 1 month
- 2: 1 month to less than 2 months
- 3: 2 months to less than 6 months
- 4: 6 months to less than 1 year
- 5: 1 year or more
- 6: Never
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q120
Do you currently take insulin for your diabetes?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q125
In the past month, did you take pills to control your blood sugar?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q130
Do you have cancer?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q135
Have you ever been diagnosed with cancer?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_R140
Remember, we're interested in conditions diagnosed by a health professional and that are expected to last or have already lasted 6 months or more.
Chronic conditions (CCC) - Question identifier:CCC_Q140
Do you have migraine headaches?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q145
Do you have Alzheimer's Disease or any other dementia?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q185
Do you have chronic fatigue syndrome?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q190
Do you suffer from multiple chemical sensitivities?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q195
Do you have a mood disorder such as depression, bipolar disorder, mania or dysthymia?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Chronic conditions (CCC) - Question identifier:CCC_Q200
Do you have an anxiety disorder such as a phobia, obsessive-compulsive disorder or a panic disorder?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Fruit and vegetable consumption (FVC)
Fruit and vegetable consumption (FVC) - Question identifier:FVC_R001
These next questions are about the fruits and vegetables you ate or drank during the past month. Please report your consumption either per day, per week or per month. Think about all meals and snacks, at home and away from home.
Fruit and vegetable consumption (FVC) - Question identifier:FVC_Q005
In the last month, how many times per day, per week or per month did you drink 100% PURE fruit juices, such as pure orange juice, apple juice or pure juice blends? Do not include fruit-flavored drinks with added sugar or fruit punch.
Min = 0; Max = 300
Fruit and vegetable consumption (FVC) - Question identifier:FVC_N005A
Select the reporting period that corresponds to FVC_Q005.
- 1: Per day
- 2: Per week
- 3: Per month
Fruit and vegetable consumption (FVC) - Question identifier:FVC_Q010
In the last month, not counting juice, how many times did you eat fruit? Please remember to include frozen, dried or canned fruit.
Min = 0; Max = 300
Fruit and vegetable consumption (FVC) - Question identifier:FVC_N010A
Select the reporting period that corresponds to FVC_Q010.
- 1: Per day
- 2: Per week
- 3: Per month
Fruit and vegetable consumption (FVC) - Question identifier:FVC_Q015
In the last month, how many times did you eat dark green vegetables such as broccoli, green beans, peas and green peppers or dark leafy greens including romaine or spinach? Please remember to include (frozen or canned vegetables and) vegetables that were cooked in soups or mixed in salad.
Min = 0; Max = 300
Fruit and vegetable consumption (FVC) - Question identifier:FVC_N015A
Select the reporting period that corresponds to FVC_Q015.
- 1: Per day
- 2: Per week
- 3: Per month
Fruit and vegetable consumption (FVC) - Question identifier:FVC_Q020
In the last month, how many times did you eat orange-colored vegetables such as carrots, orange bell pepper, sweet potatoes, pumpkin or squash? (Please remember to include frozen or canned vegetables and vegetables that were cooked in soups or mixed in salad).
Min = 0; Max = 300
Fruit and vegetable consumption (FVC) - Question identifier:FVC_N020A
Select the reporting period that corresponds to FVC_Q020.
- 1: Per day
- 2: Per week
- 3: Per month
Fruit and vegetable consumption (FVC) - Question identifier:FVC_Q025
In the last month, how many times per day, per week or per month did you eat potatoes that are not deep fried?
Min = 0; Max = 300
Fruit and vegetable consumption (FVC) - Question identifier:FVC_N025A
Select the reporting period that corresponds to FVC_Q025.
- 1: Per day
- 2: Per week
- 3: Per month
Fruit and vegetable consumption (FVC) - Question identifier:FVC_Q030
Excluding the green and orange vegetables as well as the potatoes you have already reported, in the last month, how many times did you eat OTHER vegetables? Examples include cucumber, celery, corn, cabbage and vegetable juice.
Min = 0; Max = 300
Fruit and vegetable consumption (FVC) - Question identifier:FVC_N030A
Select the reporting period that corresponds to FVC_Q030.
- 1: Per day
- 2: Per week
- 3: Per month
Smoking (SMK)
Smoking (SMK) - Question identifier:SMK_R001
The next questions are about cigarette smoking.
Smoking (SMK) - Question identifier:SMK_Q005
At the present time, do you smoke cigarettes every day, occasionally or not at all?
- 1: Daily
- 2: Occasionally
- 3: Not at all
- 8: RF
- 9: DK
Smoking (SMK) - Question identifier:SMK_Q010
In the past 30 days, did you smoke any cigarettes?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Smoking (SMK) - Question identifier:SMK_Q015
During the past 30 days, did you smoke every day?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Smoking (SMK) - Question identifier:SMK_Q020
Have you smoked more than 100 cigarettes (about 4 packs) in your life?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Smoking (SMK) - Question identifier:SMK_Q025
Have you ever smoked a whole cigarette?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Smoking (SMK) - Question identifier:SMK_Q030
Have you ever smoked cigarettes daily?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Smoking (SMK) - Question identifier:SMK_Q035
At what age did you smoke your first whole cigarette?
Min = 5; Max = 121
Smoking (SMK) - Question identifier:SMK_Q040
At what age did you begin to smoke cigarettes daily?
Min = 5; Max = 121
Smoking (SMK) - Question identifier:SMK_Q045
How many cigarettes do you smoke each day now?
Min = 1; Max = 99
Smoking (SMK) - Question identifier:SMK_Q050
On the days that you do smoke, how many cigarettes do you usually smoke?
Min = 1; Max = 99
Smoking (SMK) - Question identifier:SMK_Q055
In the past month, on how many days have you smoked one or more cigarettes?
Min = 0; Max = 31
Smoking (SMK) - Question identifier:SMK_Q060
When did you stop smoking? Was it...?
- 1: Less than one year ago
- 2: 1 year to less than 2 years ago
- 3: 2 years to less than 3 years ago
- 4: 3 or more years ago
- 8: RF
- 9: DK
Smoking (SMK) - Question identifier:SMK_Q065
In what month did you stop?
- 01: January
- 02: February
- 03: March
- 04: April
- 05: May
- 06: June
- 07: July
- 08: August
- 09: September
- 10: October
- 11: November
- 12: December
- 98: RF
- 99: DK
Smoking (SMK) - Question identifier:SMK_Q070
How many years ago was it?
Min = 3; Max = 121
Smoking (SMK) - Question identifier:SMK_Q075
When you smoked every day, how many cigarettes did you usually smoke each day?
Min = 1; Max = 99
Smoking (SMK) - Question identifier:SMK_Q080
When did you stop smoking daily? Was it...?
- 1: Less than one year ago
- 2: 1 year to less than 2 years ago
- 3: 2 years to less than 3 years ago
- 4: 3 or more years ago
- 8: RF
- 9: DK
Smoking (SMK) - Question identifier:SMK_Q085
In what month did you stop?
- 01: January
- 02: February
- 03: March
- 04: April
- 05: May
- 06: June
- 07: July
- 08: August
- 09: September
- 10: October
- 11: November
- 12: December
- 98: RF
- 99: DK
Smoking (SMK) - Question identifier:SMK_Q090
How many years ago was it?
Min = 3; Max = 121
Smoking (SMK) - Question identifier:SMK_Q095
Was that when you completely quit smoking?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Smoking (SMK) - Question identifier:SMK_Q100
When did you stop smoking completely? Was it...?
- 1: Less than one year ago
- 2: 1 year to less than 2 years ago
- 3: 2 years to less than 3 years ago
- 4: 3 or more years ago
- 8: RF
- 9: DK
Smoking (SMK) - Question identifier:SMK_Q105
In what month did you stop?
- 01: January
- 02: February
- 03: March
- 04: April
- 05: May
- 06: June
- 07: July
- 08: August
- 09: September
- 10: October
- 11: November
- 12: December
- 98: RF
- 99: DK
Smoking (SMK) - Question identifier:SMK_Q110
How many years ago was it?
Min = 3; Max = 121
Exposure to second hand smoke (ETS)
Exposure to second hand smoke (ETS) - Question identifier:ETS_R001
The next questions are about exposure to second-hand smoke.
Exposure to second hand smoke (ETS) - Question identifier:ETS_Q005
Including both household members and regular visitors, does anyone smoke inside your home, every day or almost every day?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Exposure to second hand smoke (ETS) - Question identifier:ETS_Q010
How many people smoke inside your home every day or almost every day?
Min = 1; Max = 15
Exposure to second hand smoke (ETS) - Question identifier:ETS_Q015
Is smoking allowed inside your home?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Exposure to second hand smoke (ETS) - Question identifier:ETS_Q020
Is smoking inside your home restricted in any way?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Exposure to second hand smoke (ETS) - Question identifier:ETS_Q025
How is smoking restricted inside your home?
- 1: Allowed in certain rooms only
- 2: Restricted in the presence of young children
- 3: Allowed only if windows are open or with another type of ventilation
- 4: Other restriction(s)
- 8: RF
- 9: DK
Exposure to second hand smoke (ETS) - Question identifier:ETS_Q030
In the past month, were you exposed to second-hand smoke, every day or almost every day, at your workplace or at school?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Exposure to second hand smoke (ETS) - Question identifier:ETS_Q035
In the past month, were you exposed to second-hand smoke, every day or almost every day, in a car or other private vehicle?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Exposure to second hand smoke (ETS) - Question identifier:ETS_Q040
In the past month, were you exposed to second-hand smoke, every day or almost every day, in public places (such as bars, restaurants, shopping malls, arenas, bingo halls, bowling alleys)?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Alcohol use (ALC)
Alcohol use (ALC) - Question identifier:ALC_R001
Now, some questions about your alcohol consumption.
A 'drink' refers to:
- a bottle or small can of beer, cider or cooler with 5% alcohol content, or a small draft;
- a glass of wine with 12% alcohol content;
- a glass or cocktail containing 1½ oz. of a spirit with 40% alcohol content.
Alcohol use (ALC) - Question identifier:ALC_Q005
Have you ever had a drink in your lifetime?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Alcohol use (ALC) - Question identifier:ALC_Q010
During the past 12 months, that is, from [CURRENTDATE-1] to yesterday, have you had a drink of beer, wine, liquor or any other alcoholic beverage?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Alcohol use (ALC) - Question identifier:ALC_Q015
During the past 12 months, how often did you drink alcoholic beverages?
- 1: Less than once a month
- 2: Once a month
- 3: 2 to 3 times a month
- 4: Once a week
- 5: 2 to 3 times a week
- 6: 4 to 6 times a week
- 7: Every day
- 8: RF
- 9: DK
Alcohol use (ALC) - Question identifier:ALC_Q020
How often in the past 12 months have you had [5/4] or more drinks on one occasion?
- 1: Never
- 2: Less than once a month
- 3: Once a month
- 4: 2 to 3 times a month
- 5: Once a week
- 6: More than once a week
- 8: RF
- 9: DK
Physical activities - adults 18 years and older (PAA)
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_R001
The following questions are about various types of physical activities done in the last 7 days. I want you to only think of activities you did for a minimum of 10 continuous minutes.
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_Q005
In the last 7 days, that is from last ^DT_DAYLASTWEEKE to yesterday, did you use active ways like walking or cycling to get to places such as work, school, the bus stop, the shopping centre or to visit friends?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_Q010
In the last 7 days, on which days did you do these activities?
- 1: Monday
- 2: Tuesday
- 3: Wednesday
- 4: Thursday
- 5: Friday
- 6: Saturday
- 7: Sunday
- 8: RF
- 9: DK
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_Q015
How much time in total, in the last 7 days, did you spend doing these activities? Please only include activities that lasted a minimum of 10 continuous minutes.
Min = 0; Max = 168
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_N020
Enter number of minutes.
Min = 0; Max = 9995
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_Q030
[Not including activities you just reported, in] the last 7 days, did you do sports, fitness or recreational physical activities, organized or non-organized, that lasted a minimum of 10 continuous minutes?
Examples are walking, home or gym exercise, swimming, cycling, running, skiing, dancing and all team sports.
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_Q035
Did any of these recreational physical activities make you sweat at least a little and breathe harder?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_Q040
In the last 7 days, on which days did you do these recreational activities that made you sweat at least a little and breathe harder?
- 1: Monday
- 2: Tuesday
- 3: Wednesday
- 4: Thursday
- 5: Friday
- 6: Saturday
- 7: Sunday
- 8: RF
- 9: DK
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_Q045
(In the last 7 days), how much time in total did you spend doing these activities that made you sweat at least a little and breathe harder?
Min = 0; Max = 168
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_N050
Enter number of minutes.
Min = 0; Max = 9995
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_Q060
In the last 7 days, did you do any other physical activities while at work, in or around your home or while volunteering?
Examples are carrying heavy loads, shoveling, and household chores such as vacuuming or washing windows. Please remember to only include activities that lasted a minimum of 10 continuous minutes.
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_Q065
Did any of these other physical activities make you sweat at least a little and breathe harder?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_Q070
In the last 7 days, on which days did you do these other activities that made you sweat at least a little and breathe harder?
- 1: Monday
- 2: Tuesday
- 3: Wednesday
- 4: Thursday
- 5: Friday
- 6: Saturday
- 7: Sunday
- 8: RF
- 9: DK
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_Q075
(In the last 7 days), how much time in total did you spend doing these activities that made you sweat at least a little and breathe harder?
Min = 0; Max = 168
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_N080
Enter number of minutes.
Min = 0; Max = 9995
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_Q095
You have reported a total of ^DV_PAATOTAL minutes of physical activity. Of these activities, were there any of vigorous intensity, meaning they caused you to be out of breath?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_Q100
In the last 7 days, how much time in total did you spend doing vigorous activities that caused you to be out of breath?
Min = 0; Max = 168
Physical activities - adults 18 years and older (PAA) - Question identifier:PAA_N105
Enter number of minutes.
Min = 0; Max = 9995
Physical activities for youth (PAY)
Physical activities for youth (PAY) - Question identifier:PAY_R001
The following questions are about various types of physical activities that you have done each day in the past week.
Physical activities for youth (PAY) - Question identifier:PAY_Q005
During the last 7 days, that is from last ^DT_DAYLASTWEEKE to yesterday, did you...?
- 1: Attend school
- 2: Attend a day camp
- 3: Attend paid or unpaid work
- 4: None of the above
- 8: RF
- 9: DK
Physical activities for youth (PAY) - Question identifier:PAY_Q010
In the last 7 days, did you use active ways like walking or cycling to get to places such as [school, the bus stop, the shopping centre, work] or to visit friends?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Physical activities for youth (PAY) - Question identifier:PAY_Q015
How much time did you spend using active ways to get to places...
...yesterday?
...on ^DT_DAY2DAYSAGOE?
...on ^DT_DAY3DAYSAGOE?
...on ^DT_DAY4DAYSAGOE?
...on ^DT_DAY5DAYSAGOE?
...on ^DT_DAY6DAYSAGOE?
...on ^DT_DAYLASTWEEKE?
Min = 0; Max = 10080
Physical activities for youth (PAY) - Question identifier:PAY_Q025
In the last 7 days, did you do sports, fitness or recreational physical activities while at [school or day camp, including during physical education classes, during your breaks and any other time you played indoors or outdoors]?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Physical activities for youth (PAY) - Question identifier:PAY_Q030
Did any of these activities make you sweat at least a little and breathe harder?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Physical activities for youth (PAY) - Question identifier:PAY_Q035
How much time did you spend doing these activities at [school or day camp] that made you sweat at least a little and breathe harder...
...yesterday?
...on ^DT_DAY2DAYSAGOE?
...on ^DT_DAY3DAYSAGOE?
...on ^DT_DAY4DAYSAGOE?
...on ^DT_DAY5DAYSAGOE?
...on ^DT_DAY6DAYSAGOE?
...on ^DT_DAYLASTWEEKE?
Min = 0; Max = 10080
Physical activities for youth (PAY) - Question identifier:PAY_Q045
In the last 7 days, did you do physical activities in your leisure time including exercising, playing an organized or non-organized sport or playing with your friends?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Physical activities for youth (PAY) - Question identifier:PAY_Q050
Did any of these leisure-time activities make you sweat at least a little and breathe harder?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Physical activities for youth (PAY) - Question identifier:PAY_Q055
How much time did you spend doing these leisure-time activities that made you sweat at least a little and breathe harder...
...yesterday?
...on ^DT_DAY2DAYSAGOE?
...on ^DT_DAY3DAYSAGOE?
...on ^DT_DAY4DAYSAGOE?
...on ^DT_DAY5DAYSAGOE?
...on ^DT_DAY6DAYSAGOE?
...on ^DT_DAYLASTWEEKE?
Min = 0; Max = 10080
Physical activities for youth (PAY) - Question identifier:PAY_Q065
In the last 7 days, did you do any other physical [activities that you have not already reported], for example, while you [were doing paid or unpaid work or] helping your family with chores?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Physical activities for youth (PAY) - Question identifier:PAY_Q070
Did any of these other physical activities make you sweat at least a little and breathe harder?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Physical activities for youth (PAY) - Question identifier:PAY_Q075
How much time did you spend doing these other physical activities that made you sweat at least a little and breathe harder...
...yesterday?
...on ^DT_DAY2DAYSAGOE?
...on ^DT_DAY3DAYSAGOE?
...on ^DT_DAY4DAYSAGOE?
...on ^DT_DAY5DAYSAGOE?
...on ^DT_DAY6DAYSAGOE?
...on ^DT_DAYLASTWEEKE?
Min = 0; Max = 10080
Physical activities for youth (PAY) - Question identifier:PAY_Q090
You have reported a total of [DV_PAYTRAVEL + DV_PAYSCHOOL + DV_PAYREC + DV_PAYOTHER] minutes of physical activity. Of these activities, were there any of vigorous intensity, meaning they caused you to be out of breath?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Physical activities for youth (PAY) - Question identifier:PAY_Q095
In the last 7 days, on which days did you do these vigorous activities that caused you to be out of breath?
- 1: Yesterday
- 2: ^DT_DAY2DAYSAGOE
- 3: ^DT_DAY3DAYSAGOE
- 4: ^DT_DAY4DAYSAGOE
- 5: ^DT_DAY5DAYSAGOE
- 6: ^DT_DAY6DAYSAGOE
- 7: ^DT_DAYLASTWEEKE
- 8: RF
- 9: DK
Physical activities for youth (PAY) - Question identifier:PAY_Q100
(In the last 7 days), how much time in total did you spend doing vigorous activities that caused you to be out of breath?
Min = 0; Max = 168
Physical activities for youth (PAY) - Question identifier:PAY_N105
Enter number of minutes.
Min = 0; Max = 9995
Maternal experiences (MEX)
Maternal experiences (MEX) - Question identifier:MEX_R001
The next questions are specific to women's health.
Maternal experiences (MEX) - Question identifier:MEX_Q005
Are you taking a vitamin supplement containing folic acid?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q010
Have you given birth in the past 5 years?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q015
What is the name of your last born child?
Long Answer Length = 50
Maternal experiences (MEX) - Question identifier:MEX_Q020
What is [your last child]'s date of birth?
Min = 1; Max = 31
Maternal experiences (MEX) - Question identifier:MEX_Q025
(What is [your last child]'s date of birth?)
- 01: January
- 02: February
- 03: March
- 04: April
- 05: May
- 06: June
- 07: July
- 08: August
- 09: September
- 10: October
- 11: November
- 12: December
- 98: RF
- 99: DK
Maternal experiences (MEX) - Question identifier:MEX_Q030
(What is [your last child]'s date of birth?)
Min = 2010; Max = 2099
Maternal experiences (MEX) - Question identifier:MEX_R040
The next questions are about your maternal experiences related to [your last child].
Maternal experiences (MEX) - Question identifier:MEX_Q040
In the three months before you got pregnant with [your last child], did you take a folic acid supplement or a multivitamin containing folic acid?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q045
Did you take it every day or almost every day?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q050
During the first three months of your pregnancy (with [your last child]), did you take a folic acid supplement or a multivitamin containing folic acid?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q055
Did you take it every day or almost every day?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q060
Before your pregnancy (with [your last child]), were you aware that taking folic acid before becoming pregnant can help prevent some birth defects?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q065
During your pregnancy (with [your last child]), did you take a vitamin supplement containing iron?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q070
Just before your pregnancy (with [your last child]), how much did you weigh?
Min = 1; Max = 700
Maternal experiences (MEX) - Question identifier:MEX_N075
Was that in pounds or kilograms?
- 1: Pounds
- 2: Kilograms
Maternal experiences (MEX) - Question identifier:MEX_Q080
How much weight did you gain during that pregnancy?
Min = -50; Max = 199
Maternal experiences (MEX) - Question identifier:MEX_N085
Was that in pounds or kilograms?
- 1: Pounds
- 2: Kilograms
Maternal experiences (MEX) - Question identifier:MEX_Q090
[How often does [your last child]/When [your last child] was less than one year old, how often did he/she] sleep in the same bed with you or anyone else?
- 1: Every day or almost every day
- 2: Once or twice a week
- 3: A few times a month
- 4: Less than once a month
- 5: Never
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q095
What is the main reason that [your last child] [is/was] sleeping in the same bed with you or someone else?
- 1: To breastfeed
- 2: So the baby would sleep / So I could get some sleep
- 3: Did not have room for a crib
- 4: Could not afford a crib
- 5: Believe that bedsharing was best for my child
- 6: Child was sick
- 7: Other
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q100
Was [your last child] breastfed or given breast milk even for a short time?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q105
What is the main reason that you did not breastfeed or give breast milk?
- 1: Bottle feeding is easier
- 2: Formula is as good as breast milk
- 3: Breastfeeding is unappealing
- 4: Medical condition - mother
- 5: Other - Specify
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q110
Are you still breastfeeding or giving breast milk to [your last child]?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q115
How long did you breastfeed or give breast milk to [your last child]?
Min = 1; Max = 365
Maternal experiences (MEX) - Question identifier:MEX_N115A
Was this time in days, weeks, months or years?
If respondent reports less than 1 year but with a fraction, round the amount up. For example, 3 and ½ months would become 4 months.
If the respondent reports more than a year, with half values, report in months. For example, 2 ½ years = 30 months.
- 1: Days
- 2: Weeks
- 3: Months
- 4: Years
Maternal experiences (MEX) - Question identifier:MEX_Q120
What is the main reason that you stopped breastfeeding or giving breast milk?
- 01: Not enough breast milk
- 02: Baby was ready for solid foods
- 03: Inconvenience / fatigue due to breastfeeding
- 04: Difficulty with breastfeeding (e.g., sore nipples, engorged breasts, mastitis)
- 05: Medical condition - mother
- 06: Medical condition - baby
- 07: Planned to stop at this time
- 08: Child weaned him / herself (e.g., baby refusing breast, lack of interest)
- 09: Returned to work / school
- 10: Other - Specify
- 98: RF
- 99: DK
Maternal experiences (MEX) - Question identifier:MEX_Q125
[Are you giving [your last child] a vitamin D supplement?/When [your last child] was less than a year old, did you give him/her a vitamin D supplement?/When [your last child] was less than one year old and fed breast milk, did you give him/her a vitamin D supplement?/When [your last child] was fed breast milk, did you give him/her a vitamin D supplement?]
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q130
[Now that [your last child] is more than a year old, are you still giving him/her a vitamin D supplement?/When [your last child] was older than one and fed breast milk, did you continue to give him/her a vitamin D supplement?]
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q140
Overall, how often [do/did] you give [your last child] a supplement containing vitamin D?
- 1: Every day
- 2: Almost every day
- 3: Once or twice a week
- 4: Less than once a week
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q150
[While you were still breastfeeding, had/Have] liquids such as milk, formula, water, juice, tea or herbal mixture been introduced to [your last child]'s feeds?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q155
How old was [your last child] when other liquids were first added to the feeds?
Min = 1; Max = 365
Maternal experiences (MEX) - Question identifier:MEX_N160
Was this time in days, weeks, months or years?
If respondent reports less than 1 year but with a fraction, round the amount up. For example, 3 and ½ months would become 4 months.
If the respondent reports more than a year, with half values, report in months. For example, 2 ½ years = 30 months.
- 1: Days
- 2: Weeks
- 3: Months
- 4: Years
Maternal experiences (MEX) - Question identifier:MEX_Q170
Have solid foods such as cereals, mashed up or pureed meat, vegetables or fruits been introduced to the baby's feeds?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q175
How old was [your last child] when solid foods (such as cereals, mashed up or pureed meat, vegetables or fruits) were first added to their feeds?
Min = 1; Max = 365
Maternal experiences (MEX) - Question identifier:MEX_N180
Was this time in days, weeks, months or years?
If respondent reports less than 1 year but with a fraction, round the amount up. For example, 3 and ½ months would become 4 months.
If the respondent reports more than a year, with half values, report in months. For example, 2 ½ years = 30 months.
- 1: Days
- 2: Weeks
- 3: Months
- 4: Years
Maternal experiences (MEX) - Question identifier:MEX_Q190
What was the first solid food added to ^BABYSNAME's feeds?
- 1: Infant cereals
- 2: Meat, fish or poultry
- 3: Meat alternatives (includes eggs, tofu, legumes, peas or lentils)
- 4: Fruits or vegetables
- 5: Other
- 8: RF
- 9: DK
Maternal experiences (MEX) - Question identifier:MEX_Q195
What is the main reason [other liquids/solid foods/other liquids and solid foods] were first added to [your last child]'s feeds?
- 01: Not enough breast milk
- 02: [Baby was ready for solid foods/null]
- 03: Inconvenience / fatigue due to breastfeeding
- 04: Difficulty with breastfeeding (e.g., sore nipples, engorged breasts, mastitis)
- 05: Medical condition - mother
- 06: Medical condition - baby
- 07: Advice from health professional / family
- 08: Returned to work / school
- 09: Formula equally healthy for baby
- 10: Other - Specify
- 98: RF
- 99: DK
Flu shots (FLU)
Flu shots (FLU) - Question identifier:FLU_R001
Now a few questions about your use of various health care services.
Flu shots (FLU) - Question identifier:FLU_Q005
Have you ever had a seasonal flu shot, excluding the H1N1 flu shot?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Flu shots (FLU) - Question identifier:FLU_Q010
When did you have your last seasonal flu shot?
- 1: Less than 1 year ago
- 2: 1 year to less than 2 years ago
- 3: 2 years ago or more
- 8: RF
- 9: DK
Flu shots (FLU) - Question identifier:FLU_Q015
In which month did you have your last seasonal flu shot?
- 01: January
- 02: February
- 03: March
- 04: April
- 05: May
- 06: June
- 07: July
- 08: August
- 09: September
- 10: October
- 11: November
- 12: December
- 98: RF
- 99: DK
Flu shots (FLU) - Question identifier:FLU_Q020
Was that this year or last year?
- 1: This year
- 2: Last year
- 8: RF
- 9: DK
Flu shots (FLU) - Question identifier:FLU_Q025
What are the reasons that you have not had a seasonal flu shot in the past year?
- 01: Lack of time
- 02: Respondent - did not think it was necessary
- 03: Doctor - did not think it was necessary
- 04: Not available - at time required
- 05: Did not know where to go / uninformed
- 06: Feelings of fear or discomfort
- 07: Bad reaction to previous flu shot
- 08: Bad reaction to previous vaccine other than flu shot
- 09: Unsure of / does not believe in benefits of vaccine
- 10: Does not want vaccine for fear of what it contains
- 11: Other
- 98: RF
- 99: DK
Primary health care (PHC)
Primary health care (PHC) - Question identifier:PHC_R001
Now I'd like to ask about your primary health care. It is often the first point of entry to the Canadian health system. It incorporates diagnosis, treatment and management of health problems.
Primary health care (PHC) - Question identifier:PHC_Q005
Is there a place that you usually [go] to when you [need] immediate care for a minor health problem?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Primary health care (PHC) - Question identifier:PHC_Q010
What kind of place is it?
- 1: A doctor's office
- 2: A hospital outpatient clinic
- 3: A community health centre [or CLSC]
- 4: A walk-in clinic
- 5: A hospital emergency room
- 6: Some other place
- 8: RF
- 9: DK
Primary health care (PHC) - Question identifier:PHC_Q015
Is this...?
- 1: An office with one doctor working in a solo practice
- 2: An office with several health care professionals working together as a team, that may include a dietician, nurse, social worker or psychologist
- 3: An office with several doctors working independently of each other, who may share one or more nurses
- 4: Other
- 8: RF
- 9: DK
Primary health care (PHC) - Question identifier:PHC_Q020
Do you have a regular health care provider? By this, we mean one health professional that you regularly see or talk to when you need care or advice for your health.
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Primary health care (PHC) - Question identifier:PHC_Q025
What are the reasons why you do not have a regular health care provider?
- 1: Do not need one in particular, but you have a usual place of care
- 2: No one available in the area
- 3: No one in the area is taking new patients
- 4: [You] have not tried to find one
- 5: Had one who left or retired
- 6: Other
- 8: RF
- 9: DK
Primary health care (PHC) - Question identifier:PHC_Q030
Is that regular health care provider a...?
- 1: Family doctor or general practitioner
- 2: Medical specialist such as a cardiologist or a pediatrician
- 3: Nurse practitioner
- 4: Other
- 8: RF
- 9: DK
Primary health care (PHC) - Question identifier:PHC_Q035
When you [need] immediate care for a minor health problem, how long do you usually have to wait before you can have an appointment with this [family physician/specialist/nurse practitioner/regular health care provider][, or another care provider from the same office?]
- 1: On the same day
- 2: The next day
- 3: In 2 to 3 days
- 4: In 4 to 6 days
- 5: In 1 to 2 weeks
- 6: Between 2 weeks and one month
- 7: One month or more
- 8: RF
- 9: DK
Primary health care (PHC) - Question identifier:PHC_Q040
Do you usually speak in English, in French or in another language with this [family physician/specialist/nurse practitioner/regular health care provider]?
- 1: English
- 2: French
- 3: English and French
- 4: English and another language
- 5: French and another language
- 6: Another language
- 8: RF
- 9: DK
Primary health care (PHC) - Question identifier:PHC_Q045
Is there one or more nurses working with your [family physician/specialist/nurse practitioner/regular health care provider] who are regularly involved in your health care?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Primary health care (PHC) - Question identifier:PHC_Q050
Other than doctors and nurses, are there other health professionals like nutritionists working in the same office where you get your regular health care?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Primary health care (PHC) - Question identifier:PHC_Q055
Other than from your [family physician/specialist/nurse practitioner/regular health care provider], who do you receive regular health care from?
- 01: Another family doctor or general practitioner
- 02: Specialist doctor
- 03: Nurse / Nurse practitioner
- 04: Chiropractor
- 05: Registered dietician
- 06: Pharmacist
- 07: Physiotherapist
- 08: Psychologist / Mental Health Professional
- 09: Social Worker
- 10: Other
- 11: None
- 98: RF
- 99: DK
Primary health care (PHC) - Question identifier:PHC_Q060
In general, how would you rate the level of coordination between your [family physician/specialist/nurse practitioner/regular health care provider] and other health professionals who provide you with regular care? Would you say the coordination is...?
- 1: Excellent
- 2: Very good
- 3: Good
- 4: Fair
- 5: Poor
- 6: Not applicable
- 8: RF
- 9: DK
Contacts with health professionals - part 1 (CHP)
Contacts with health professionals - part 1 (CHP) - Question identifier:CHP_R001
Now I'd like to ask about your contacts with various health professionals and use of various health care services during the past 12 months, that is, from ^DV_DATEONEYEARAGO to yesterday.
Contacts with health professionals - part 1 (CHP) - Question identifier:CHP_Q010
In the past 12 months, how many times have you personally used a hospital emergency room?
Min = 0; Max = 900
Contacts with health professionals - part 1 (CHP) - Question identifier:CHP_Q015
The last time you went, what were the reasons you went to the emergency room instead of any other health care service (like a doctor's office)?
- 01: It was clearly an emergency
- 02: [You] didn't know if your health condition was an emergency
- 03: It was not an emergency but you felt you would see a health professional or get the test you needed done faster
- 04: [You] were told to go to the emergency department for follow-up or appointment
- 05: [Your] primary health care provider was not available at the time you needed it (after hours of clinic, doctor away)
- 06: [You] do not have a primary health care provider
- 07: [You] use the emergency department for all your health concerns
- 08: Other
- 98: RF
- 99: DK
Contacts with health professionals - part 1 (CHP) - Question identifier:CHP_Q020
The last time you went to the emergency room, was it for a condition that you thought could have been treated by your primary care provider if he/she had been available?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Contacts with health professionals - part 1 (CHP) - Question identifier:CHP_Q025
[In/Excluding the time you spent in an emergency department, in] the past 12 months, have you been a patient overnight in a hospital?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Contacts with health professionals - part 1 (CHP) - Question identifier:CHP_Q030
For how many nights in the past 12 months?
Min = 1; Max = 366
Contacts with health professionals - part 1 (CHP) - Question identifier:CHP_Q035
The last time you were an overnight patient in a hospital, what were the reasons for this hospitalisation?
- 1: Post-surgery
- 2: Was too sick to go home/ admitted from ER
- 3: Waiting for care in nursing home
- 4: Waiting for home care
- 5: Postpartum care
- 6: Other
- 8: RF
- 9: DK
Contacts with health professionals - part 1 (CHP) - Question identifier:CHP_Q040
[Not counting when you were an overnight patient, in the past 12 months], have you seen or talked to any of the following health professionals about your physical, emotional or mental health:
a family doctor[, pediatrician] or general practitioner?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Contacts with health professionals - part 1 (CHP) - Question identifier:CHP_Q045
How many times (in the past 12 months)?
Min = 1; Max = 366
Contacts with health professionals - part 1 (CHP) - Question identifier:CHP_Q050
([Not counting when you were an overnight patient, in the past 12 months], have you seen or talked to:)
an eye specialist, such as an ophthalmologist or optometrist?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Contacts with health professionals - part 1 (CHP) - Question identifier:CHP_Q055
How many times (in the past 12 months)?
Min = 1; Max = 75
Contacts with health professionals - part 1 (CHP) - Question identifier:CHP_Q060
[Not counting when you were an overnight patient, in the past 12 months], have you seen or talked to:
any other medical doctor or specialist such as a surgeon, allergist, orthopaedist, [urologist/gynaecologist] or psychiatrist (about your physical, emotional or mental health)?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Contacts with health professionals - part 1 (CHP) - Question identifier:CHP_Q065
How many times (in the past 12 months)?
Min = 1; Max = 300
Contacts with health professionals - part 1 (CHP) - Question identifier:CHP_Q070
[Not counting when you were an overnight patient, in the past 12 months], have you seen or talked to:
a nurse for care or advice about your physical, emotional or mental health?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Contacts with health professionals - part 1 (CHP) - Question identifier:CHP_Q075
How many times (in the past 12 months)?
Min = 1; Max = 366
Contacts with health professionals - part 1 (CHP) - Question identifier:CHP_Q080
([Not counting when you were an overnight patient, in the past 12 months], have you seen or talked to:)
a dental professional, such as a dentist, a dental hygienist or a denturologist?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Contacts with health professionals - part 1 (CHP) - Question identifier:CHP_Q085
How many times (in the past 12 months)?
Min = 1; Max = 99
Risk Factors for Heart Disease (RFH)
Risk Factors for Heart Disease (RFH) - Question identifier:RFH_R005
The following questions are about some of your lifestyle habits.
Risk Factors for Heart Disease (RFH) - Question identifier:RFH_Q005
In the past week, how many times did you eat salty foods or snacks, such as prepared soups, lunch meat and potato chips?
- 1: More than once a day
- 2: Once a day
- 3: Less than once a day
- 4: Not in the past week
- 8: RF
- 9: DK
Risk Factors for Heart Disease (RFH) - Question identifier:RFH_Q010
In the past week, how many times did you eat meat or poultry, such as beef, pork, chicken or lamb? Please exclude fish.
- 1: More than once a day
- 2: Once a day
- 3: Less than once a day
- 4: Not in the past week
- 8: RF
- 9: DK
Risk Factors for Heart Disease (RFH) - Question identifier:RFH_Q015
In the past week, how many times did you eat deep-fried foods or snacks, such as French fries, chicken nuggets or onion rings?
- 1: 5 times or more (a week)
- 2: 3-4 times
- 3: Once or twice
- 4: Not in the past week
- 8: RF
- 9: DK
Risk Factors for Heart Disease (RFH) - Question identifier:RFH_R020
Now some questions that relate to heart health.
Risk Factors for Heart Disease (RFH) - Question identifier:RFH_Q020
Do you take aspirin or other ASA (acetylsalicylic acid) medication, every day or every second day, for heart disease and stroke prevention?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Risk Factors for Heart Disease (RFH) - Question identifier:RFH_Q025
When was the last time you had your blood pressure measured by a health professional?
- 1: Less than 1 year to 1 year ago
- 2: More than 1 year to 2 years ago
- 3: More than 2 years to 3 years ago
- 4: More than 3 years to 5 years ago
- 5: More than 5 years ago
- 6: Never had blood pressure measured
- 8: RF
- 9: DK
Risk Factors for Heart Disease (RFH) - Question identifier:RFH_Q030
When was the last time you had a blood test to measure your cholesterol levels?
- 1: Less than 1 year to 1 year ago
- 2: More than 1 year to 2 years ago
- 3: More than 2 years to 3 years ago
- 4: More than 3 years to 5 years ago
- 5: More than 5 years ago
- 6: Never had blood cholesterol measured
- 8: RF
- 9: DK
Risk Factors for Heart Disease (RFH) - Question identifier:RFH_Q035
When was the last time you had a blood test for high blood sugar or diabetes?
- 1: Less than 1 year to 1 year ago
- 2: More than 1 year to 2 years ago
- 3: More than 2 years to 3 years ago
- 4: More than 3 years to 5 years ago
- 5: More than 5 years ago
- 6: Never had a blood test for high blood sugar or diabetes
- 8: RF
- 9: DK
Risk Factors for Heart Disease (RFH) - Question identifier:RFH_Q040
In the past 12 months, were any of the following lifestyle changes recommended by a health professional? You may specify more than one.
- 01: Increase exercise
- 02: Lose weight
- 03: Reduce salt (intake)
- 04: Eat more fruits and vegetables
- 05: Reduce fatty food (intake)
- 06: Reduce sugar (intake)
- 07: Reduce smoking
- 08: Reduce alcohol
- 09: Reduce stress
- 10: Other
- 11: None
- 98: RF
- 99: DK
Risk Factors for Heart Disease (RFH) - Question identifier:RFH_Q045
Have you had any of the following heart tests in the past 5 years? You may specify more than one.
- 1: Electrocardiogram (ECG) (i.e. electrical recording of the heart's activity)
- 2: Stress Test (i.e. running on a treadmill under the supervision of a doctor or having pictures of the heart taken after a nuclear medicine injection)
- 3: Echocardiogram (i.e. ultrasound of the heart)
- 4: None
- 8: RF
- 9: DK
Risk Factors for Heart Disease (RFH) - Question identifier:RFH_Q050
^HEARTDIS. Which of the following conditions have you had? You may specify more than one.
- 01: Atrial fibrillation (i.e. an irregular heart rhythm that causes poor blood flow to the body)
- 02: Heart attack (myocardial infarction)
- 03: Angina (i.e. chest pain due to heart disease)
- 04: Heart failure (also known as congestive heart failure)
- 05: Aortic stenosis (i.e. a narrowing of the heart's aortic valve)
- 06: Peripheral vascular disease (i.e. poor circulation in limbs)
- 07: Other
- 08: None
- 98: RF
- 99: DK
Risk Factors for Heart Disease (RFH) - Question identifier:RFH_Q055
Have you ever had an angioplasty with stent?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Risk Factors for Heart Disease (RFH) - Question identifier:RFH_Q060
Have you ever had cardiac bypass surgery?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Risk Factors for Heart Disease (RFH) - Question identifier:RFH_Q065
Did your biological mother have a heart attack before the age of 65?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Risk Factors for Heart Disease (RFH) - Question identifier:RFH_Q070
Did your biological father have a heart attack before the age of 55?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Labour force (LBF)
Labour force (LBF) - Question identifier:LBF_Q005A
Many of the following questions concern [your] activities last week. By last week, I mean the week beginning on ^REFBEGE, and ending ^REFENDE.
Last week, did you work at a job or business? (regardless of the number of hours)
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Labour force (LBF) - Question identifier:LBF_Q005B
Last week, did you have a job or business from which you were absent?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Labour force (LBF) - Question identifier:LBF_Q005C
What was the main reason you were absent from work last week?
- 01: Own illness or disability
- 02: Caring for own children
- 03: Caring for elder relative (60 years of age or older)
- 04: Maternity or parental leave
- 05: Other personal or family responsibilities
- 06: Vacation
- 07: Labour dispute (strike or lockout) (Employees only)
- 08: Temporary layoff due to business conditions (Employees only)
- 09: Seasonal layoff (Employees only)
- 10: Casual job, no work available (Employees only)
- 11: Work schedule (e.g., shift work) (Employees only)
- 12: Self-employed, no work available (Self-employed only)
- 13: Seasonal business (Excluding employees)
- 14: Other - Specify
- 98: RF
- 99: DK
Labour force (LBF) - Question identifier:LBF_R010
The next questions are about your current job or business.
Labour force (LBF) - Question identifier:LBF_Q010
Were you an employee or self-employed?
- 1: Employee
- 2: Self-employed
- 3: Working in a family business without pay
- 8: RF
- 9: DK
Labour force (LBF) - Question identifier:LBF_Q015A
What was the name of your business?
Long Answer Length = 50
Labour force (LBF) - Question identifier:LBF_Q015B
For whom did you work?
Long Answer Length = 50
Labour force (LBF) - Question identifier:LBF_Q015C
What kind of business, industry or service was this?
Long Answer Length = 50
Labour force (LBF) - Question identifier:LBF_Q020A
What was your work or occupation?
Long Answer Length = 50
Labour force (LBF) - Question identifier:LBF_Q020B
In this work, what were your main activities?
Long Answer Length = 50
Labour force (LBF) - Question identifier:LBF_Q025
On average, how many hours do you usually work per week?
Min = 0.0; Max = 168.0
Labour force (LBF) - Question identifier:LBF_Q030
Did you have more than one job or business last week?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Labour force (LBF) - Question identifier:LBF_Q035
On average, how many hours do you usually work per week at your other job(s)?
Min = 1; Max = 168
Socio-demographic characteristics (SDC)
Socio-demographic characteristics (SDC) - Question identifier:SDC_R001
Now, some general background questions which will help us compare the health of people in Canada.
Socio-demographic characteristics (SDC) - Question identifier:SDC_Q005
In what country were you born?
- 1: Search
- 3: Other - Specify
- 8: RF
- 9: DK
Socio-demographic characteristics (SDC) - Question identifier:SDC_Q006
In which province or territory were you born?
- 10: Newfoundland and Labrador
- 11: Prince Edward Island
- 12: Nova Scotia
- 13: New Brunswick
- 24: Quebec
- 35: Ontario
- 46: Manitoba
- 47: Saskatchewan
- 48: Alberta
- 59: British Columbia
- 60: Yukon
- 61: Northwest Territories
- 62: Nunavut
- 98: RF
- 99: DK
Socio-demographic characteristics (SDC) - Question identifier:SDC_Q007
Are you now, or have you ever been a landed immigrant in Canada?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Socio-demographic characteristics (SDC) - Question identifier:SDC_Q008
In what year did you first become a landed immigrant in Canada?
Min = 1870; Max = 2100
Socio-demographic characteristics (SDC) - Question identifier:SDC_Q010
To which ethnic or cultural groups did your ancestors belong? (For example: French, Scottish, Chinese, East Indian)
- 01: Canadian
- 02: French
- 03: English
- 04: German
- 05: Scottish
- 06: Irish
- 07: Italian
- 08: Ukrainian
- 09: Dutch (Netherlands)
- 10: Chinese
- 11: Jewish
- 12: Polish
- 13: Portuguese
- 14: South Asian (e.g., East Indian, Pakistani, Sri Lankan)
- 15: Norwegian
- 16: Welsh
- 17: Swedish
- 18: First Nations (North American Indian)
- 19: Métis
- 20: Inuit
- 21: Other - Specify
- 98: RF
- 99: DK
Socio-demographic characteristics (SDC) - Question identifier:SDC_Q015
Are you an Aboriginal person, that is, First Nations, Métis or Inuk (Inuit)? First Nations includes Status and Non-Status Indians.
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Socio-demographic characteristics (SDC) - Question identifier:SDC_Q016
Are you First Nations, Métis or Inuk (Inuit)?
- 1: First Nations (North American Indian)
- 2: Métis
- 3: Inuk (Inuit)
- 8: RF
- 9: DK
Socio-demographic characteristics (SDC) - Question identifier:SDC_Q020
You may belong to one or more racial or cultural groups on the following list. Are you... ?
- 01: White
- 02: South Asian (e.g., East Indian, Pakistani, Sri Lankan)
- 03: Chinese
- 04: Black
- 05: Filipino
- 06: Latin American
- 07: Arab
- 08: Southeast Asian (e.g., Vietnamese, Cambodian,
Malaysian, Laotian) - 09: West Asian (e.g., Iranian, Afghan)
- 10: Korean
- 11: Japanese
- 12: Other - Specify
- 98: RF
- 99: DK
Socio-demographic characteristics (SDC) - Question identifier:SDC_Q025
Of English or French, which language(s) do you speak well enough to conduct a conversation? Is it... ?
- 1: English only
- 2: French only
- 3: Both English and French
- 4: Neither English nor French
- 8: RF
- 9: DK
Socio-demographic characteristics (SDC) - Question identifier:SDC_Q026
What language do you speak most often at home?
Long Answer Length = 80
Socio-demographic characteristics (SDC) - Question identifier:SDC_Q027
What is the language that you first learned at home in childhood and still understand?
Long Answer Length = 80
Socio-demographic characteristics (SDC) - Question identifier:SDC_R030
Now a question about the dwelling in which you live.
Socio-demographic characteristics (SDC) - Question identifier:SDC_Q030
Is this dwelling...?
- 1: Owned by you or a member of this household, even if it is still being paid for
- 2: Rented, even if no cash rent is paid
- 8: RF
- 9: DK
Socio-demographic characteristics (SDC) - Question identifier:SDC_R035
Now, one additional background question which will help us compare the health of people in Canada.
Socio-demographic characteristics (SDC) - Question identifier:SDC_Q035
Do you consider yourself to be...?
- 1: Heterosexual (sexual relations with people of the opposite sex)
- 2: Homosexual, that is lesbian or gay (sexual relations with people of your own sex)
- 3: Bisexual (sexual relations with people of both sexes)
- 8: RF
- 9: DK
Person most knowledgeable about household situation (PMK)
Person most knowledgeable about household situation (PMK) - Question identifier:PMK_R005A
To avoid duplication of surveys, Statistics Canada has signed agreements with provincial and territorial ministries of health, Health Canada and the Public Health Agency of Canada to share the information that you provided on this survey.
Provincial ministries of health may make this information available to local health authorities, but no identifiable information such as names, addresses or telephone numbers will be provided.
Person most knowledgeable about household situation (PMK) - Question identifier:PMK_R005B
To avoid duplication of surveys, Statistics Canada has signed agreements with provincial and territorial ministries of health, Health Canada and the Public Health Agency of Canada to share the information that you provided on this survey.
Territorial ministries of health may make this information available to local health authorities, but no identifiable information such as names, addresses, telephone numbers or health numbers will be provided.
Person most knowledgeable about household situation (PMK) - Question identifier:PMK_R005C
To avoid duplication of surveys, Statistics Canada has signed agreements with provincial and territorial ministries of health, the " Institut de la Statistique du Québec ", Health Canada and the Public Health Agency of Canada to share the information that you provided on this survey.
The " Institut de la Statistique du Québec " and provincial ministries of health may make this information available to local health authorities, but no identifiable information such as names, addresses or telephone numbers will be provided.
Person most knowledgeable about household situation (PMK) - Question identifier:PMK_Q005
These organizations have agreed to keep your information confidential and use it only for statistical purposes.
Do you agree to share the information provided?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Person most knowledgeable about household situation (PMK) - Question identifier:PMK_R010
For the last few questions, I would like to speak with someone who would be best able to answer questions about the entire household such as household income and food purchases.
Person most knowledgeable about household situation (PMK) - Question identifier:PMK_Q010
Who would this person be?
- 01: MEMBER1
- 02: MEMBER2
- 03: MEMBER3
- 04: MEMBER4
- 05: MEMBER5
- 06: MEMBER6
- 07: MEMBER7
- 08: MEMBER8
- 09: MEMBER9
- 10: MEMBER10
- 11: MEMBER11
- 12: MEMBER12
- 13: MEMBER13
- 14: MEMBER14
- 15: MEMBER15
- 16: MEMBER16
- 17: MEMBER17
- 18: MEMBER18
- 19: MEMBER19
- 20: MEMBER20
Person most knowledgeable about household situation (PMK) - Question identifier:PMK_Q015
Is [MEMBER#] available?
- 1: Yes
- 2: No
- 3: Person most knowledgeable about household refuses to participate.
Person most knowledgeable about household situation (PMK) - Question identifier:PMK_R025
This completes your portion of the interview. On behalf of Statistics Canada, I would like to thank you very much for your time.
Person most knowledgeable about household situation (PMK) - Question identifier:PMK_R030
This completes your portion of the interview. On behalf of Statistics Canada, I would like to thank you very much for your time. I would now like to try and find the best time to speak with [MEMBER#].
Person most knowledgeable about household situation (PMK) - Question identifier:PMK_R035
This completes your portion of the interview. On behalf of Statistics Canada, I would like to thank you very much for your time. I would now like to speak with ^MEMBERNAME.
Person most knowledgeable about household situation (PMK) - Question identifier:PMK_R040
Hello, My name is... I've just completed the main portion of the interview with <Respondent's name>. At this point I need to finish the interview with a few general questions on your household's situation. <Respondent's name> said you would be the best person to answer these types of questions.
Income (INC)
Income (INC) - Question identifier:INC_R001
Although many health expenses are covered by health insurance, there is still an important relationship between health and income. Please be assured that, like all other information you have provided, these answers will be kept strictly confidential.
Income (INC) - Question identifier:INC_Q005
Thinking about the total income for all household members, from which of the following sources did your household receive any income in the year ending December 31, [CURRENTYEAR [minus] 1]?
- 01: Wages and salaries
- 02: Income from self-employment
- 03: Dividends and interest (e.g., on bonds, savings)
- 04: Employment insurance
- 05: Workers' compensation
- 06: Benefits from Canada or Quebec Pension Plan
- 07: Job-related retirement pensions, superannuation and annuities
- 08: RRSP/RRIF (Registered Retirement Savings Plan/Registered Retirement Income Fund)
- 09: Old Age Security and Guaranteed Income Supplement
- 10: Provincial or municipal social assistance or welfare
- 11: Child Tax Benefit or family allowances
- 12: Child support
- 13: Alimony
- 14: Other (e.g., rental income, scholarships)
- 15: None
- 98: RF
- 99: DK
Income (INC) - Question identifier:INC_Q010
Does this amount include a supplement for people with disabilities?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Income (INC) - Question identifier:INC_Q015
What was the main source of household income?
- 01: Wages and salaries
- 02: Income from self-employment
- 03: Dividends and interest (e.g., on bonds, savings)
- 04: Employment insurance
- 05: Workers' compensation
- 06: Benefits from Canada or Quebec Pension Plan
- 07: Job-related retirement pensions, superannuation and annuities
- 08: RRSP/RRIF (Registered Retirement Savings Plan/Registered Retirement Income Fund)
- 09: Old Age Security and Guaranteed Income Supplement
- 10: Provincial or municipal social assistance or welfare
- 11: Child Tax Benefit or family allowances
- 12: Child support
- 13: Alimony
- 14: Other (e.g., rental income, scholarships)
- 15: None
- 98: RF
- 99: DK
Income (INC) - Question identifier:INC_Q020A
Now a question about your total household income.
What is your best estimate of your total household income received by all household members, from all sources, before taxes and deductions, during the year ending December 31, [CURRENTYEAR [minus] 1]?
Income can come from various sources such as from work, investments, pensions or government. Examples include Employment Insurance, Social Assistance, Child Tax Benefit and other income such as child support, spousal support (alimony) and rental income.
Min = -9000000; Max = 90000000
Income (INC) - Question identifier:INC_Q020B
Can you estimate in which of the following groups your household income falls? Was the total household income during the year ending December 31, [CURRENTYEAR [minus] 1]... ?
- 1: Less than $50,000 including income loss
- 2: $50,000 and more
- 8: RF
- 9: DK
Income (INC) - Question identifier:INC_Q020C
Please stop me when I have read the category which applies to your household.
Was it... ?
- 1: Less than $5,000
- 2: $5,000 to less than $10,000
- 3: $10,000 to less than $15,000
- 4: $15,000 to less than $20,000
- 5: $20,000 to less than $30,000
- 6: $30,000 to less than $40,000
- 7: $40,000 to less than $50,000
- 8: RF
- 9: DK
Income (INC) - Question identifier:INC_Q020D
Please stop me when I have read the category which applies to your household.
Was it... ?
- 1: $50,000 to less than $60,000
- 2: $60,000 to less than $70,000
- 3: $70,000 to less than $80,000
- 4: $80,000 to less than $90,000
- 5: $90,000 to less than $100,000
- 6: $100,000 to less than $150,000
- 7: $150,000 and over
- 8: RF
- 9: DK
Income (INC) - Question identifier:INC_Q025
Thinking about your total personal income, from which of the following sources did you receive any income in the year ending December 31, [CURRENTYEAR [minus] 1]?
- 01: Wages and salaries
- 02: Income from self-employment
- 03: Dividends and interest (e.g., on bonds, savings)
- 04: Employment insurance
- 05: Workers' compensation
- 06: Benefits from Canada or Quebec Pension Plan
- 07: Job-related retirement pensions, superannuation and annuities
- 08: RRSP/RRIF (Registered Retirement Savings Plan/Registered Retirement Income Fund)
- 09: Old Age Security and Guaranteed Income Supplement
- 10: Provincial or municipal social assistance or welfare
- 11: Child Tax Benefit or family allowances
- 12: Child support
- 13: Alimony
- 14: Other (e.g., rental income, scholarships)
- 15: None
- 98: RF
- 99: DK
Income (INC) - Question identifier:INC_Q030
Does this amount include a supplement for people with disabilities?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Income (INC) - Question identifier:INC_Q035
What was the main source of your personal income?
- 01: Wages and salaries
- 02: Income from self-employment
- 03: Dividends and interest (e.g., on bonds, savings)
- 04: Employment insurance
- 05: Workers' compensation
- 06: Benefits from Canada or Quebec Pension Plan
- 07: Job-related retirement pensions, superannuation and annuities
- 08: RRSP/RRIF (Registered Retirement Savings Plan/Registered Retirement Income Fund)
- 09: Old Age Security and Guaranteed Income Supplement
- 10: Provincial or municipal social assistance or welfare
- 11: Child Tax Benefit or family allowances
- 12: Child support
- 13: Alimony
- 14: Other (e.g., rental income, scholarships)
- 15: None
- 98: RF
- 99: DK
Income (INC) - Question identifier:INC_Q040A
Now a question about your total personal income.
What is your best estimate of your total personal income, before taxes and deductions, from all sources during the year ending December 31, [CURRENTYEAR [minus] 1]?
Income can come from various sources such as from work, investments, pensions or government. Examples include Employment Insurance, Social Assistance, Child Tax Benefit and other income such as child support, spousal support (alimony) and rental income.
Min = -9000000; Max = 90000000
Income (INC) - Question identifier:INC_Q040B
Can you estimate in which of the following groups your personal income falls? Was your total personal income during the year ending December 31, [CURRENTYEAR [minus] 1]... ?
- 1: Less than $30,000, including income loss
- 2: $30,000 and more
- 8: RF
- 9: DK
Income (INC) - Question identifier:INC_Q040C
Please stop me when I have read the category which applies to you.
Was it... ?
- 1: Less than $5,000
- 2: $5,000 to less than $10,000
- 3: $10,000 to less than $15,000
- 4: $15,000 to less than $20,000
- 5: $20,000 to less than $25,000
- 6: $25,000 to less than $30,000
- 8: RF
- 9: DK
Income (INC) - Question identifier:INC_Q040D
Please stop me when I have read the category which applies to you.
Was it... ?
- 01: $30,000 to less than $40,000
- 02: $40,000 to less than $50,000
- 03: $50,000 to less than $60,000
- 04: $60,000 to less than $70,000
- 05: $70,000 to less than $80,000
- 06: $80,000 to less than $90,000
- 07: $90,000 to less than $100,000
- 08: $100,000 and over
- 98: RF
- 99: DK
Administration information (ADM)
Administration information (ADM) - Question identifier:ADM_Q005
[Statistics Canada, your [territorial/provincial] ministry of health and the "Institut de la Statistique du Québec"] may combine [your] responses with information from other survey or administrative sources. This may include information on past and continuing use of health services such as visits to hospitals, clinics and doctor's offices.
- 1: Continue (Go to ADM_D010A)
- 2: Respondent does not want his or her responses combined with other sources
- 3: Other [e.g., respondent hung up, interview suspended or interrupted]
Administration information (ADM) - Question identifier:ADM_Q010
Having a provincial or territorial health number will assist us in linking to this other information.
[Do you] have [a Newfoundland and Labrador/a Prince Edward Island/a Nova Scotia/a New Brunswick/a Quebec/an Ontario/a Manitoba/a Saskatchewan/an Alberta/a British Columbia/a Yukon/a Northwest Territories/a Nunavut] health number?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
Administration information (ADM) - Question identifier:ADM_Q015
For which province or territory is [your] health number?
- 10: Newfoundland and Labrador
- 11: Prince Edward Island
- 12: Nova Scotia
- 13: New Brunswick
- 24: Quebec
- 35: Ontario
- 46: Manitoba
- 47: Saskatchewan
- 48: Alberta
- 59: British Columbia
- 60: Yukon
- 61: Northwest Territories
- 62: Nunavut
- 88: Does not have a Canadian health number
- 98: RF
- 99: DK
Administration information (ADM) - Question identifier:ADM_Q025
What is [your] health number?
Long Answer Length = 50
Administration information (ADM) - Question identifier:ADM_R025
To avoid duplication of surveys, Statistics Canada has signed agreements with provincial and territorial ministries of health, Health Canada and the Public Health Agency of Canada to share the information that you provided on this survey.
Provincial ministries of health may make this information available to local health authorities, but no identifiable information such as [names, addresses, telephone numbers and health numbers will be provided].
Administration information (ADM) - Question identifier:ADM_R030
To avoid duplication of surveys, Statistics Canada has signed agreements with provincial and territorial ministries of health, the " Institut de la Statistique du Québec ", Health Canada and the Public Health Agency of Canada to share the information that you provided on this survey.
The " Institut de la Statistique du Québec " and provincial ministries of health may make this information available to local health authorities, but no identifiable information such as [names, addresses, telephone numbers and health numbers will be provided].
Administration information (ADM) - Question identifier:ADM_Q035
These organizations have agreed to keep your information confidential and use it only for statistical purposes.
Do you agree to share the information provided?
- 1: Yes
- 2: No
- 8: RF
- 9: DK
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