Canadian Community Health Survey (CCHS) Rapid Response January-June 2016 - Prescriptions - Cost-related Non-adherence

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Table of Contents

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

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

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.

Administration information (ADM)

Administration information (ADM) - Question identifier:ADM_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.

Administration information (ADM) - Question identifier:ADM_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, ^DV_PASTYEAR?

  • 01: Wages and salaries
  • 02: Income from self-employment
  • 03: Dividends and interest (e.g., on bonds, savings)
  • 04: Employment insurance
  • 05: Worker's 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
  • 12: Child support
  • 13: Alimony
  • 14: Other (e.g., rental income, scholarships)
  • 15: None
  • 98: RF
  • 99: DK

Administration information (ADM) - Question identifier:ADM_Q010

Does this amount include a supplement for people with disabilities?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Administration information (ADM) - Question identifier:ADM_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: Worker's 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
  • 12: Child support
  • 13: Alimony
  • 14: Other (e.g., rental income, scholarships)
  • 15: None
  • 98: RF
  • 99: DK

Administration information (ADM) - Question identifier:ADM_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, ^DV_PASTYEAR?

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

Administration information (ADM) - Question identifier:ADM_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, ^DV_PASTYEAR... ?

  • 1: Less than $50,000 including income loss
  • 2: $50,000 and more
  • 8: RF
  • 9: DK

Administration information (ADM) - Question identifier:ADM_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

Administration information (ADM) - Question identifier:ADM_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

Administration information (ADM) - Question identifier:ADM_Q025

Thinking about your total personal income, from which of the following sources did you receive any income in the year ending December 31, ^DV_PASTYEAR?

  • 01: Wages and salaries
  • 02: Income from self-employment
  • 03: Dividends and interest (e.g., on bonds, savings)
  • 04: Employment insurance
  • 05: Worker's 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
  • 12: Child support
  • 13: Alimony
  • 14: Other (e.g., rental income, scholarships)
  • 15: None
  • 98: RF
  • 99: DK

Administration information (ADM) - Question identifier:ADM_Q030

Does this amount include a supplement for people with disabilities?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Administration information (ADM) - Question identifier:ADM_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: Worker's 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
  • 12: Child support
  • 13: Alimony
  • 14: Other (e.g., rental income, scholarships)
  • 15: None
  • 98: RF
  • 99: DK

Administration information (ADM) - Question identifier:ADM_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, ^DV_PASTYEAR?

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

Administration information (ADM) - Question identifier:ADM_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, ^DV_PASTYEAR... ?

  • 1: Less than $30,000 including income loss
  • 2: $30,000 and more
  • 8: RF
  • 9: DK

Administration information (ADM) - Question identifier:ADM_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

Administration information (ADM) - Question identifier:ADM_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) - Question identifier:ADM_Q045

Having a provincial or territorial health number will assist us in linking to this other information.

^DT_DOYOU2 have a provincial or territorial health number?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Administration information (ADM) - Question identifier:ADM_Q050

For which province or territory is ^DT_YOUR1 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_Q055

What is ^DT_YOUR1 health number?

Long Answer Length = 50

Prescriptions - Cost-related Non-adherence (PCN)

Prescriptions - Cost-related Non-adherence (PCN) - Question identifier:PCN_Q005

During the last 12 months, was there a time when ['you or ^FNAME'/'^FNAME'/'you'] did not fill or collect a prescription for ['his'/'her'/'your'] medicine, or ['he'/'she'/'you'] skipped doses of ['his'/'her'/'your'] medicine because of the cost?

  • 1: Yes
  • 2: No
  • 3: Not applicable, ['he'/'she'/'I'] had no medication prescription to fill in the last 12 months
  • 8: RF
  • 9: DK

Prescriptions - Cost-related Non-adherence (PCN) - Question identifier:PCN_Q010

["Earlier we asked you about skipping doses of medication or not filling a prescription because of the cost."/null] In the last 12 months, was there a time when ['he'/'she'/'you or ^FNAME'/'you'] reduced the dosage of ['his'/'her'/'your'] medication or delayed filling ['his'/'her'/'your'] prescription, because of the cost?

  • 1: Yes
  • 2: No
  • 3: Not applicable, ['he'/'she'/'I'] had no medication prescription to fill in the last 12 months
  • 8: RF
  • 9: DK

Prescriptions - Cost-related Non-adherence (PCN) - Question identifier:PCN_Q015

In the last 12 months, how many different medications ['has'/'have'] ['he'/'she'/'you'] received a prescription for, including on-going prescriptions?

  • 1: 0
  • 2: 1 or 2
  • 3: 3 or 4
  • 4: 5 or more
  • 8: RF
  • 9: DK

Prescriptions - Cost-related Non-adherence (PCN) - Question identifier:PCN_R020

Now some questions about the cost of ['^FNAME's'/'your'] prescriptions.

Prescriptions - Cost-related Non-adherence (PCN) - Question identifier:PCN_Q020

In the last 12 months, how much money was spent for ['his'/'her'/'your'] own medication prescribed by a healthcare professional? Please exclude any amounts reimbursed by an insurance plan.

  • 1: 0
  • 2: 1 to 200 dollars
  • 3: 201 to 500 dollars
  • 4: 501 to 1000 dollars
  • 5: More than 1000 dollars
  • 8: RF
  • 9: DK

Prescriptions - Cost-related Non-adherence (PCN) - Question identifier:PCN_Q025

In the past 12 months, how often did ['he'/'she'/'you or ^FNAME'/'you'] delay or not have ['his'/'her'/'your'] prescription filled, or not take the medication as prescribed because of the cost?

  • 1: Rarely
  • 2: Sometimes
  • 3: Often
  • 4: Always
  • 8: RF
  • 9: DK

Prescriptions - Cost-related Non-adherence (PCN) - Question identifier:PCN_R030

The next few questions concern all of ['^FNAME's'/'your'] prescriptions for medication that ['he'/'she'/'you or he'/'you or she'/'you'] could not afford in the last 12 months.

Prescriptions - Cost-related Non-adherence (PCN) - Question identifier:PCN_Q030

What health conditions were these prescriptions meant to treat?

  • 01: Heart disease, high cholesterol, or high blood pressure
  • 02: Asthma or COPD (chronic obstructive pulmonary disease)
  • 03: Depression, anxiety, or other mental health condition
  • 04: Diabetes
  • 05: Gut problems (e.g. peptic ulcer, heartburn, bowel disease)
  • 06: Arthritis or other chronic pain
  • 07: An infection(e.g. bacterial, fungal, or viral)
  • 08: A type of cancer
  • 09: Other condition
  • 98: RF
  • 99: DK

Prescriptions - Cost-related Non-adherence (PCN) - Question identifier:PCN_Q035

Do you think that being unable to afford ['his'/'her'/'your'] prescriptions made ['^FNAME's'/'your'] health worse?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Prescriptions - Cost-related Non-adherence (PCN) - Question identifier:PCN_Q040

Did being unable to afford ['his'/'her'/'your'] prescriptions result in ['him'/'her'/'you'] having to do any of the following:

  • 1: Go to the emergency department?
  • 2: Be admitted to hospital?
  • 3: Go to the doctor, which ['he'/'she'/'you'] would not have had to do otherwise?
  • 4: None of the above
  • 8: RF
  • 9: DK

Prescriptions - Cost-related Non-adherence (PCN) - Question identifier:PCN_R050

The next few questions concern the last time ['you or ^FNAME'/'^FNAME'/'you'] couldn't afford to pay for ['his'/'her'/'your'] prescription in the last 12 months.

Prescriptions - Cost-related Non-adherence (PCN) - Question identifier:PCN_Q050

Approximately how much was this prescription going to cost ['him'/'her'/'you or him"/'you or her'/'you']? Please exclude any amounts that were reimbursed by an insurance plan.

  • 1: 1 to 25 dollars
  • 2: 26 to 50 dollars
  • 3: 51 to 200 dollars
  • 4: 201 to1000 dollars
  • 5: 1001 dollars or more
  • 8: RF
  • 9: DK

Prescriptions - Cost-related Non-adherence (PCN) - Question identifier:PCN_Q055

Did the healthcare professional, who gave this prescription to ['him'/'her'/'you'], ask if ['he'/'she'/'you or he'/'you or she'/'you'] could afford to pay for it?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK

Prescriptions - Cost-related Non-adherence (PCN) - Question identifier:PCN_Q060

Did this person help to come up with strategies to lower the cost, such as suggesting cheaper alternative medications, or providing free samples?

  • 1: Yes
  • 2: No
  • 3: Not applicable, no alternative or free sample exists for what respondent cannot afford.
  • 8: RF
  • 9: DK

Prescriptions - Cost-related Non-adherence (PCN) - Question identifier:PCN_Q065

Did the pharmacist, who filled this prescription, ask if ['he'/'she'/'you or he'/'you or she'/'you'] could afford to pay for it?

  • 1: Yes
  • 2: No
  • 3: ['He'/'She'/'He or I'/'She or I'/'I'] didn't try to fill the prescription
  • 8: RF
  • 9: DK

Prescriptions - Cost-related Non-adherence (PCN) - Question identifier:PCN_Q070

Did this person help to come up with strategies to lower the cost, such as suggesting cheaper alternative medications or providing a drug discount card?

  • 1: Yes
  • 2: No
  • 3: Not applicable, no alternative or discount card exists for what respondent cannot afford
  • 8: RF
  • 9: DK

Prescriptions - Cost-related Non-adherence (PCN) - Question identifier:PCN_Q075

In the last 12 months, ['has'/'have'] ['^FNAME'/'you'] ['or anyone else in the household'/'Null'] ever spent less on any of the following in order to pay for ['his'/'her'/'your'] prescription medications?

  • 01: Food
  • 02: Housing
  • 03: Heat for your dwelling
  • 04: Car, public transit, or other transportation costs
  • 05: Leisure or vacation
  • 06: Other healthcare expenses for ['himself'/'herself'/'yourself'] ['or anyone else in the household'/'Null']
  • 07: Other expenses not already mentioned
  • 08: No - Have not spent less on anything
  • 98: RF
  • 99: DK

Prescriptions - Cost-related Non-adherence (PCN) - Question identifier:PCN_Q080

In the last 12 months, ['has'/'have'] ['^FNAME'/'you'] ['or anyone else in the household'/'Null'] ever had to borrow money in order to pay for ['his'/'her'/'your'] prescriptions?

  • 1: Yes
  • 2: No
  • 8: RF
  • 9: DK
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