IPUMS NHIS

NATIONAL HEALTH INTERVIEW SURVEY

rm
[p. 110]

RESIDENTIAL MOBILITY PAGE

RM1

1 [] H box, 17+ (1)
2 [] SP, 17+ (1)
3 [] Other (NP)

Complete 1a and b from household composition items, if not clear, ask:

1 a. Is -- related to any persons now living in this household?

1 [] Y
2 [] N (2)

b. Is -- now living with --'s:

(1) Brother or sister?
(3) Father or mother?
(5) (Husband/wife)?
(7) Son or daughter?

Mark all that apply
1 [] Sibling
3 [] Parent
5 [] Spouse
7 [] Child
0 [] None of the above

2. How long has -- lived at this address? Enter number, then mark box
If "3" years, ask:
Was it less than 3 years or more than 3 years?

Number ____
1 [] Days
2 [] Weeks
3 [] Months
4 [] Years

RM2

1 [] 3+ years in 2 (RM3)
2 [] Less than 3 years in 2

3. Including the time -- moved here, how many times has -- moved in the past 3 years, that is, since (12-month date), 1976?

Number ____

4 a. What was --'s address, including county (12-month date), 1976?
Enter only county and State

County ____
State ____

b. About how many miles is that address from here?

[] Initial DK - probe
Miles ____

c. How many people was -- living with at that time, not counting --?

00 [] Live alone (5)
Number ____

d. Were any of these people related to --?

1 [] Y
2 [] N (5)

e. Was -- living with --'s:

(1) Brother or sister?
(3) Father or mother?
(5) (Husband/wife)?
(7) Son or daughter?

Mark all that apply
1 [] Sibling
3 [] Parent
5 [] Spouse
7 [] Child
0 [] None of the above

5 a. What is the (other) reason -- moved here? Was it because -- changed jobs, because -- retired, because of --'s health, or was it for some other reason?

1 [] Job-self
2 [] Retire-self
3 [] Health-self
4 [] Job-other person
5 [] Retired-other person
6 [] Health-other person
8 [] Other - Specify ____

b. Any other reason?

[] Y (Reask 5a and b)
[] N

Mark box or ask:
c. What is the main reason -- moved?

[] Only one reason
____

RM3
Q's 1-5
For persons 17 years or over, show who responded for (or was present during the asking of) Questions 1-5.
If persons responded for self, show whether entirely or partly.

1 [] Responded for self-entirely
2 [] Responded for self-partly
Person ____ was respondent

[p. 111]

[MK Note: Page 111 contains a response sheet for questions asked on page 110. The response sheet has five columns to enter responses in; only one is represented here since each column contains the same information.]

RM1

1 [] H box, 17+ (1)
2 [] SP, 17+ (1)
3 [] Other (NP)

1a.

1 Y
2 N (2)

b.

1 [] Sibling
3 [] Parent
5 [] Spouse
7 [] Child
0 [] None of the above

2. How long has -- lived at this address? Enter number, then mark box