Impacts of COVID-19 on Canadians - Living with Long-term Conditions and Disabilities
For Information onlyThis is an electronic survey example for information purposes only. This is not a working questionnaire.
Table of Contents
- Employment (EMP)
- Income (CIN)
- Expenses (EXP)
- Long-term conditions (LTC)
- Health (HL)
- Education (EDU)
- Education (ED)
- Indigenous identity (IS)
- Sociodemographic characteristics (PG)
- Demographic questions (DEM)
- Sign-up (UCE)
Employment (EMP)
Employment (EMP) - Question identifier:EMP_R05
Measures to limit the spread of COVID-19 in Canada were implemented by federal, provincial and territorial governments towards the mid-March 2020. The next questions are about your employment situation and any changes that may have resulted from the pandemic.
Employment (EMP) - Question identifier:EMP_Q05
Which of the following best describes your work situation before the COVID-19 pandemic?
- 1: Had a full-time job or business (i.e., 30 hours or more a week)
- 2: Had a part-time job or business (i.e., less than 30 hours a week)
- 3: On temporary layoff or had temporarily closed my business due to business conditions
- 4: Had a job or business, but absent for personal reasons (e.g., illness or disability, parental leave)
- 5: Had a job or business, but absent for other reasons (e.g., seasonal job or business, strike or lockout)
- 6: Did not have a job or business, but was looking for work
- 7: Did not have a job or business and was not looking for work (e.g., family responsibilities, retired, cannot work due to disability)
Employment (EMP) - Question identifier:EMP_Q10
Since the beginning of the COVID-19 pandemic in March 2020, which of the following have you experienced?
- 01: A decrease in work hours
- 02: An increase in work hours
- 03: A decrease in pay or self-employment earnings
- 04: An increase in pay or self-employment earnings (Include overtime pay.)
- 05: A temporary layoff or business closure (e.g., due to business conditions or COVID-19-related public health restrictions)
- 06: A work absence for voluntary or personal reasons related to COVID-19 (e.g., personal safety, your own or a household member's diagnosis, self-isolation after recent travel, taking care of children due to school closure)
- 07: A job loss or permanent closure of your business
- 08: Other changes in work status
- 09: None of the above
Employment (EMP) - Question identifier:EMP_Q15A
Which of the following best describes your current work situation?
- 1: Have a full-time job or business (i.e., 30 hours or more a week)
- 2: Have a part-time job or business (i.e., less than 30 hours a week)
- 3: On temporary layoff or temporarily closed my business due to business conditions
- 4: Have a job or business, but absent for personal reasons (e.g., illness or disability, parental leave)
- 5: Have a job or business, but absent for other reasons (e.g., seasonal job or business, strike or lockout)
- 6: Do not have a job or business, but looking for work
- 7: Do not have a job or business and not looking for work (e.g., family responsibilities, retired, cannot work due to disability)
Employment (EMP) - Question identifier:EMP_Q15B
Which of the following best describes your current work location?
- 1: Working from home instead of my usual workplace
- 2: Working from home, which is my usual workplace
- 3: Still working at usual workplace outside my home
Employment (EMP) - Question identifier:EMP_Q15C
Which of the following best describes your current work location?
- 1: Working from home instead of my usual workplace
- 2: Working from home, which is my usual workplace
- 3: Still working at usual workplace outside my home
Income (CIN)
Income (CIN) - Question identifier:CIN_R05
The following question is about your personal income.
Income (CIN) - Question identifier:CIN_Q05
Since the beginning of the COVID-19 pandemic in March 2020, have you personally received income from any of the following sources?
- 01: Employment or self-employment income (Include wages, salaries, commissions and tips.)
- 02: Workers' compensation
- 03: Employment Insurance or Quebec Parental Insurance Plan (Exclude short-term disability sickness benefit.)
- 04: Disability benefits
- 05: Pension plan benefits (Exclude disability benefits.)
- 06: Social assistance or welfare (Exclude disability benefits.)
- 07: CERB or Canada Emergency Response Benefit
- 08: CESB or Canada Emergency Student Benefit as a student with or without dependents
- 09: CESB or Canada Emergency Student Benefit as a student with a disability
- 10: Other sources (e.g., other government income, child tax benefit, child support, education allowances and scholarships, Northern Allowance, spousal support, honoraria)
- 11: None of the above
Income (CIN) - Question identifier:CIN_R10
The following question is about your household income.
Income (CIN) - Question identifier:CIN_Q10A
Since March 2020, how has your overall household monthly income from all sources changed?
- 1: Stayed about the same as before the COVID-19 pandemic
- 2: Increased since before the COVID-19 pandemic
- 3: Decreased since before the COVID-19 pandemic
- 4: Prefer not to say
- 9: DK
Income (CIN) - Question identifier:CIN_Q10B
By how much did your monthly income increase?
- 1: More than $1,000
- 2: $500 to $1,000
- 3: Less than $500
- 9: DK
Income (CIN) - Question identifier:CIN_Q10C
By how much did your monthly income decrease?
- 1: More than $1,000
- 2: $500 to $1,000
- 3: Less than $500
- 9: DK
Expenses (EXP)
Expenses (EXP) - Question identifier:EXP_Q05A
How much of an impact did the COVID-19 pandemic have on your ability to meet each of the following financial obligations or essential needs?
Rent or mortgage payments
- 1: Major impact
- 2: Moderate impact
- 3: Minor impact
- 4: No impact
- 5: Too soon to tell
Expenses (EXP) - Question identifier:EXP_Q05B
How much of an impact did the COVID-19 pandemic have on your ability to meet each of the following financial obligations or essential needs?
Basic utilities
- 1: Major impact
- 2: Moderate impact
- 3: Minor impact
- 4: No impact
- 5: Too soon to tell
Expenses (EXP) - Question identifier:EXP_Q05C
How much of an impact did the COVID-19 pandemic have on your ability to meet each of the following financial obligations or essential needs?
Phone or Internet service
- 1: Major impact
- 2: Moderate impact
- 3: Minor impact
- 4: No impact
- 5: Too soon to tell
Expenses (EXP) - Question identifier:EXP_Q05D
How much of an impact did the COVID-19 pandemic have on your ability to meet each of the following financial obligations or essential needs?
Food and groceries
- 1: Major impact
- 2: Moderate impact
- 3: Minor impact
- 4: No impact
- 5: Too soon to tell
Expenses (EXP) - Question identifier:EXP_Q05E
How much of an impact did the COVID-19 pandemic have on your ability to meet each of the following financial obligations or essential needs?
Transportation
- 1: Major impact
- 2: Moderate impact
- 3: Minor impact
- 4: No impact
- 5: Too soon to tell
Expenses (EXP) - Question identifier:EXP_Q05F
How much of an impact did the COVID-19 pandemic have on your ability to meet each of the following financial obligations or essential needs?
Prescription medication
- 1: Major impact
- 2: Moderate impact
- 3: Minor impact
- 4: No impact
- 5: Too soon to tell
Expenses (EXP) - Question identifier:EXP_Q05G
How much of an impact did the COVID-19 pandemic have on your ability to meet each of the following financial obligations or essential needs?
Personal care products
- 1: Major impact
- 2: Moderate impact
- 3: Minor impact
- 4: No impact
- 5: Too soon to tell
Expenses (EXP) - Question identifier:EXP_Q05H
How much of an impact did the COVID-19 pandemic have on your ability to meet each of the following financial obligations or essential needs?
Personal protective equipment
- 1: Major impact
- 2: Moderate impact
- 3: Minor impact
- 4: No impact
- 5: Too soon to tell
Long-term conditions (LTC)
Long-term conditions (LTC) - Question identifier:LTC_R05
The following questions are about any long-term conditions you may have.
Long-term conditions (LTC) - Question identifier:LTC_Q05
Do you have any of the following difficulties?
- 1: Difficulty seeing even when wearing glasses or contact lenses
- 2: Difficulty hearing even when using a hearing aid or cochlear implant
- 3: Difficulty walking, using stairs, using your hands or fingers or doing other physical activities
- 4: Difficulty learning, remembering or concentrating
- 5: Emotional, psychological or mental health conditions (e.g., anxiety, depression, bipolar disorder, substance abuse, anorexia)
- 6: Other health problem or long-term condition that has lasted or is expected to last for six or more months
- 7: I do not have any difficulty or long-term condition that has lasted or is expected to last for six or more months
Long-term conditions (LTC) - Question identifier:LTC_Q10
Do you identify as a person with a disability?
- 1: Yes
- 2: No
Health (HL)
Health (HL) - Question identifier:HL_R05
The following questions are about your health.
Health (HL) - Question identifier:HL_Q05
In general, how would you describe your health since the start of the COVID-19 pandemic?
- 1: Excellent
- 2: Very good
- 3: Good
- 4: Fair
- 5: Poor
Health (HL) - Question identifier:HL_Q10
In general, how would you describe your mental health since the start of the COVID-19 pandemic?
- 1: Excellent
- 2: Very good
- 3: Good
- 4: Fair
- 5: Poor
Health (HL) - Question identifier:HL_Q15
Compared to before the COVID-19 pandemic, how would you say your health is now?
- 1: Much better now
- 2: Somewhat better now
- 3: About the same
- 4: Somewhat worse now
- 5: Much worse now
Health (HL) - Question identifier:HL_Q20
Compared to before the COVID-19 pandemic, how would you say your mental health is now?
- 1: Much better now
- 2: Somewhat better now
- 3: About the same
- 4: Somewhat worse now
- 5: Much worse now
Health (HL) - Question identifier:HL_Q25
Did you need any of the following therapies or services for a long-term condition, but did not receive it due to the COVID-19 pandemic?
- 01: Physiotherapy, massage therapy or chiropractic treatments
- 02: Speech therapy
- 03: Occupational therapy
- 04: Counselling services from a psychologist, psychiatrist, psychotherapist or social worker
- 05: Professional nursing care at home (e.g., injections, catheter or colostomy care, wound care or tube feeding)
- 06: Support group services, drop-in centre or addiction services, telephone information or support lines
- 07: Regular medical testing for issues unrelated to COVID-19 (e.g., blood work, X-ray, CT scan, MRI, colonoscopy, biopsy)
- 08: Regular medical or dental treatments or appointments for issues unrelated to COVID-19
- 09: Surgery
- 10: Other therapies or services
- 11: I did not need any of the above therapies or services OR I received the therapies or services that I required
Health (HL) - Question identifier:HL_Q30
Did you require testing or medical attention for COVID-19, but were unable to receive it because of a long-term condition?
- 1: Yes
- 2: No
Education (EDU)
Education (EDU) - Question identifier:EDU_R01
The following questions are about your education.
Education (EDU) - Question identifier:EDU_Q01
At the beginning of March 2020, were you enrolled in a postsecondary program?
- 1: Yes
- 2: No
Education (ED)
Education (ED) - Question identifier:ED_Q05
What is the highest certificate, diploma or degree that you have completed?
- 1: Less than high school diploma or its equivalent
- 2: High school diploma or a high school equivalency certificate
- 3: Trades certificate or diploma
- 4: College, CEGEP or other non-university certificate or diploma (other than trades certificates or diplomas)
- 5: University certificate or diploma below the bachelor's level
- 6: Bachelor's degree (e.g., B.A., B.A. (Hons), B.Sc., B.Ed., LL.B.)
- 7: University certificate, diploma or degree above the bachelor's level
Indigenous identity (IS)
Indigenous identity (IS) - Question identifier:IS_Q01
Are you First Nations, Métis or Inuk (Inuit)?
- 1: No
- 2: Yes, First Nations
- 3: Yes, Métis
- 4: Yes, Inuk (Inuit)
Sociodemographic characteristics (PG)
Sociodemographic characteristics (PG) - Question identifier:PG_Q05
The following question collects information in accordance with the Employment Equity Act and its Regulations and Guidelines to support programs that promote equal opportunity for everyone to share in the social, cultural, and economic life of Canada.
- 01: White
- 02: South Asian (e.g., East Indian, Pakistani, Sri Lankan)
- 03: Chinese
- 04: Black
- 05: Filipino
- 06: Arab
- 07: Latin American
- 08: Southeast Asian (e.g., Vietnamese, Cambodian, Laotian, Thai)
- 09: West Asian (e.g., Iranian, Afghan)
- 10: Korean
- 11: Japanese
- 12: Other
Demographic questions (DEM)
Demographic questions (DEM) - Question identifier:DEM_Q05
What is your age?
Min = 0; Max = 999
Demographic questions (DEM) - Question identifier:DEM_Q10
What is your gender?
- 1: Male
- 2: Female
- 3: Or please specify
Demographic questions (DEM) - Question identifier:DEM_Q11
Including yourself, how many people live in your household?
- 01: 1
- 02: 2
- 03: 3
- 04: 4
- 05: 5
- 06: 6
- 07: 7
- 08: 8
- 09: 9
- 10: 10
- 11: 11
- 12: 12
- 13: 13
- 14: 14
- 15: 15
- 16: 16
- 17: 17
- 18: 18
- 19: 19
- 20: 20 or more
Demographic questions (DEM) - Question identifier:DEM_Q12
Including yourself, how many of these people are less than 18 years of age?
- 00: 0
- 01: 1
- 02: 2
- 03: 3
- 04: 4
- 05: 5
- 06: 6
- 07: 7
- 08: 8
- 09: 9
- 10: 10
- 11: 11
- 12: 12
- 13: 13
- 14: 14
- 15: 15
- 16: 16
- 17: 17
- 18: 18
- 19: 19
- 20: 20 or more
Demographic questions (DEM) - Question identifier:DEM_Q15
To determine which geographic region you live in, please provide your postal code.
Long Answer Length = 6
Sign-up (UCE)
Sign-up (UCE) - Question identifier:UCE_R05
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Statistics Canada is planning a series of surveys about important social topics. These surveys will be sent out every month or two and will ask about a wide variety of issues such as COVID-19, fake news, digital technologies, health, education and justice.
By participating in this survey series, you will be able to share your opinions and thoughts on these issues and compare your ideas with those of other Canadians.
Sign-up (UCE) - Question identifier:UCE_Q01
Would you like to sign-up for future surveys?
- 1: Yes
- 2: No
Sign-up (UCE) - Question identifier:UCE_Q05B
Please provide the following information so we can email or text you to participate in this survey series.
Email address
Long Answer Length = 80
Sign-up (UCE) - Question identifier:UCE_Q05C
Please provide the following information so we can email or text you to participate in this survey series.
Cellular number
Long Answer Length = 10
Sign-up (UCE) - Question identifier:UCE_R09
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