[p. 1]
2004 NHIS Questionnaire -- Household Composition
Household Composition
Instrument Variable Name: NAME_FNAME
Question Text:
Question Text:
[fill: What are the names of all the persons living or staying here?
Start with the name of the person, or one of the persons, who owns or rents this home.
/What is the name of the next person living or staying here?]
*Enter 999 if no more persons.
Start with the name of the person, or one of the persons, who owns or rents this home.
/What is the name of the next person living or staying here?]
*Enter 999 if no more persons.
Universe Text: All persons
Skip Instructions:
Skip Instructions:
(999) if PCNT = 0, [goto ERR1_NAME_FNAME]
elseif POS2 or POS3 ne 0, [goto HHRESP]
else, [goto MISPERS_MCHILD]
(allow 20,R,D) if name on fake/false name list
[goto ERR2_NAME_FNAME];
else [goto NAME_MNAME]
elseif POS2 or POS3 ne 0, [goto HHRESP]
else, [goto MISPERS_MCHILD]
(allow 20,R,D) if name on fake/false name list
[goto ERR2_NAME_FNAME];
else [goto NAME_MNAME]
Instrument Variable Name: ALIAS
Question Text:
Question Text:
How shall I refer to [fill: you/this person] for the rest of the interview?
Universe Text: Persons who don't know or refused to give first or last name.
Skip Instructions:
Skip Instructions:
(allow 41) [goto USUALRES]
Instrument Variable Name: USUALRES
Question Text:
Question Text:
[fill: Do you/Does ALIAS] usually live here?
1 Yes
2 No
7 Refusesd
9 Don't know
2 No
7 Refusesd
9 Don't know
Universe Text: All non-deleted persons
Skip Instructions:
Skip Instructions:
(1) [goto NAME_FNAME]
(2,R,D) [goto ASKURE]
(2,R,D) [goto ASKURE]
[p. 2]
Instrument Variable Name: ASKURE
Question Text:
Question Text:
[fill1: Do you/Does ALIAS] have some other place where [fill2: he/she] usually lives?
1 Yes
2 No
7 Refused
9 Don't know
2 No
7 Refused
9 Don't know
Universe Text: If the usual residence is not here, or 'don't know', or 'refused'.
Skip Instructions:
Skip Instructions:
(1) [goto NOLIST]
(2, R, D) [goto NAME_FNAME]
(2, R, D) [goto NAME_FNAME]
Instrument Variable Name: NOLIST
Question Text:
Question Text:
Since [fill1: you do/ALIAS does] not usually live here and [fill2: have/has] another residence elsewhere, [fill3: you/he/she] will not be included in this interview.
*Enter (1) to continue to the next person.
*Enter (1) to continue to the next person.
1 To continue
Universe Text: Person living elsewhere
Skip Instructions:
Skip Instructions:
[goto NAME_FNAME]
Instrument Variable Name: MISPERS_MCHILD
Question Text:
Question Text:
I have listed living here ...
[fill roster]
Have I missed any babies or small children?
[fill roster]
Have I missed any babies or small children?
1 Yes
2 No
7 Refused
9 Don't know
2 No
7 Refused
9 Don't know
Universe Text: After completing household roster
Skip Instructions:
Skip Instructions:
(1) empty out '999' in NAME_FNAME
empty out MISPERS_CHILD
empty out MISPERS_MLODGE
empty out MISPERS_MAWAY
empty out MISPERS_MELSE
[goto NAME_FNAME]
(2, R, D) goto MISPERS_MLODGE
empty out MISPERS_CHILD
empty out MISPERS_MLODGE
empty out MISPERS_MAWAY
empty out MISPERS_MELSE
[goto NAME_FNAME]
(2, R, D) goto MISPERS_MLODGE
[p. 3]
Instrument Variable Name: MISPERS_MLODGE
Question Text:
Question Text:
*Read if necessary.
I have listed living here ...
[fill roster]
Have I missed any lodgers, boarders, or persons you employ who live here?
I have listed living here ...
[fill roster]
Have I missed any lodgers, boarders, or persons you employ who live here?
1 Yes
2 No
7 Refused
9 Don't know
2 No
7 Refused
9 Don't know
Universe Text: Not missing any children or R or D
Skip Instructions:
Skip Instructions:
(1) empty out '999' in NAME_FNAME
empty out MISPERS_CHILD
empty out MISPERS_MLODGE
empty out MISPERS_MAWAY
empty out MISPERS_MELSE
[goto NAME_FNAME]
(2,R,D) goto MISPERS_MAWAY
empty out MISPERS_CHILD
empty out MISPERS_MLODGE
empty out MISPERS_MAWAY
empty out MISPERS_MELSE
[goto NAME_FNAME]
(2,R,D) goto MISPERS_MAWAY
Instrument Variable Name: MISPERS_MAWAY
Question Text:
Question Text:
*Read if necessary.
I have listed living here...
[fill roster]
Have I missed anyone who USUALLY lives here, but is now away from home traveling or in a hospital?
I have listed living here...
[fill roster]
Have I missed anyone who USUALLY lives here, but is now away from home traveling or in a hospital?
1 Yes
2 No
7 Refused
9 Don't know
2 No
7 Refused
9 Don't know
Universe Text: No 'lodgers' living here or R or D
Skip Instructions:
Skip Instructions:
(1) empty out '999' in NAME_FNAME
empty out MISPERS_CHILD
empty out MISPERS_MLODGE
empty out MISPERS_MAWAY
empty out MISPERS_MELSE
[goto NAME_FNAME]
(2,R,D) goto MISPERS_MELSE
empty out MISPERS_CHILD
empty out MISPERS_MLODGE
empty out MISPERS_MAWAY
empty out MISPERS_MELSE
[goto NAME_FNAME]
(2,R,D) goto MISPERS_MELSE
[p. 4]
Instrument Variable Name: MISPERS_MELSE
Question Text:
Question Text:
*Read if necessary.
I have listed living here...
[fill roster]
Have I missed anyone else staying here?
I have listed living here...
[fill roster]
Have I missed anyone else staying here?
1 Yes
2 No
7 Refused
9 Don't know
2 No
7 Refused
9 Don't know
Universe Text: Nobody is away from home or R or D
Skip Instructions:
Skip Instructions:
(1) empty out '999' in NAME_FNAME
empty out MISPERS_CHILD
empty out MISPERS_MLODGE
empty out MISPERS_MAWAY
empty out MISPERS_MELSE
[goto NAME_FNAME]
(2,R,D) if PCNT = 0, goto EXIT
elseif PCNT = 1
store Yes (1) in LIVEAT, goto OTHLIV
else goto LIVEAT
empty out MISPERS_CHILD
empty out MISPERS_MLODGE
empty out MISPERS_MAWAY
empty out MISPERS_MELSE
[goto NAME_FNAME]
(2,R,D) if PCNT = 0, goto EXIT
elseif PCNT = 1
store Yes (1) in LIVEAT, goto OTHLIV
else goto LIVEAT
Instrument Variable Name: LIVEAT
Question Text:
Question Text:
Do all the persons I have listed live AND eat together?
*Read names if necessary. [fill roster]
*Read names if necessary. [fill roster]
1 Yes
2 No
7 Refused
9 Don't know
2 No
7 Refused
9 Don't know
Universe Text: Person count is greater than one
Skip Instructions:
Skip Instructions:
(1,R,D) [goto OTHLIV]
(2) [goto XACCESS]
(2) [goto XACCESS]
[p. 5]
Instrument Variable Name: XACCESS
Question Text:
Question Text:
Do the people who do not live and eat here have direct access from the outside or through a common hallway to a separate living quarters?
1 Yes
2 No
7 Refused
9 Don't know
2 No
7 Refused
9 Don't know
Universe Text: Nobody is away from home or R or D
Skip Instructions:
Skip Instructions:
(1) [goto TABX]
(2,R,D) [goto OTHLIV]
(2,R,D) [goto OTHLIV]
Instrument Variable Name: OTHLIV
Question Text:
Question Text:
Do members of any other household on the property live and eat with members of this household?
1 Yes
2 No
7 Refused
9 Don't know
2 No
7 Refused
9 Don't know
Universe Text: All
Skip Instructions:
Skip Instructions:
(1) [goto ERR_OTHLIV]
(2,R D) if PCNT = 1, [goto SEX]
else [goto HHRESP]
(2,R D) if PCNT = 1, [goto SEX]
else [goto HHRESP]
Instrument Variable Name: SEX
Question Text:
Question Text:
*Ask if not apparent.
*If don't know or refused enter your best guess.
[Are you/Is ALIAS] male or female?
*If don't know or refused enter your best guess.
[Are you/Is ALIAS] male or female?
1 Male
2 Female
2 Female
Universe Text: All nondeleted persons in parent cases or all nondeleted persons being added in spawn cases.
Skip Instructions:
Skip Instructions:
(1,2) [goto AGEDOB_1]
[p. 6]
Instrument Variable Name: AGEDOB_1
Question Text:
Question Text:
1 of 5
What is [fill: your/ALIAS's] age?
*Enter number for age.
What is [fill: your/ALIAS's] age?
*Enter number for age.
01-120 Age in years
Universe Text: All nondeleted persons in parent cases or all nondeleted persons being added in spawn cases.
Skip Instructions:
Skip Instructions:
(001-120) [goto AGEDOB_2]
(R,D) [goto AGEDOB_3]
(R,D) [goto AGEDOB_3]
Instrument Variable Name: AGEDOB_2
Question Text:
Question Text:
2 of 5
*Enter number for age time period.
*Enter number for age time period.
1 Days
2 Weeks
3 Months
4 Years
2 Weeks
3 Months
4 Years
Universe Text: Valid age - number entered
Skip Instructions:
Skip Instructions:
(1-4) [goto AGEDOB_3]
[p. 7]
Instrument Variable Name: AGEDOB_3
Question Text:
Question Text:
3 of 5
And what is [fill: your/ALIAS's] date of birth?
Please give month, day, and year for the date of birth.
*Enter month of birth.
And what is [fill: your/ALIAS's] date of birth?
Please give month, day, and year for the date of birth.
*Enter month 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
97 Refused
99 Don't know
02 February
03 March
04 April
05 May
06 June
07 July
08 August
09 September
10 October
11 November
12 December
97 Refused
99 Don't know
Universe Text: All nondeleted persons in parent cases or all nondeleted persons being added in spawn cases.
Skip Instructions:
Skip Instructions:
(1-12,R,D) [goto AGEDOB_4]
Instrument Variable Name: AGEDOB_4
Question Text:
Question Text:
2 of 5
4 of 5
*Enter day of birth
4 of 5
*Enter day of birth
01-31 Day of the month
Universe Text: All nondeleted persons in parent cases or all nondeleted persons being added in spawn cases.
Skip Instructions:
Skip Instructions:
(1-31,R,D)
Only allow valid days for month entered.
If days not valid, [goto ERR_AGEDOB_4]
ELSE [goto AGEDOB_5]
Only allow valid days for month entered.
If days not valid, [goto ERR_AGEDOB_4]
ELSE [goto AGEDOB_5]
[p. 8]
Instrument Variable Name: AGEDOB_5
Question Text:
Question Text:
5 of 5
*Enter year of birth.
*Enter year of birth.
1880-2030 Year of birth
9997 Refused
9997 Refused
Universe Text: All nondeleted persons in parent cases or all nondeleted persons being added in spawn cases.
Skip Instructions:
Skip Instructions:
(1880 - 2030, R,D) [goto AGECAL]
Instrument Variable Name: DOBVER
Question Text:
Question Text:
There is a difference between the age the computer calculated from [fill: your/ALIAS's] date-of-birth and the age that you gave me.
I recorded [fill: your/ALIAS's] date-of-birth as [AGEDOB_3] [AGEDOB_4], [AGEDOB _5]. Is that [fill: your/ALIAS's] correct date-of-birth?
I recorded [fill: your/ALIAS's] date-of-birth as [AGEDOB_3] [AGEDOB_4], [AGEDOB _5]. Is that [fill: your/ALIAS's] correct date-of-birth?
1 Yes
2 No
7 Refused
9 Don't know
2 No
7 Refused
9 Don't know
Universe Text: Age reported is not equal to age calculated from date of birth.
Skip Instructions:
Skip Instructions:
(1,R,D) [goto INTWKCK1]
(2) [goto AGEDOB_3]
(2) [goto AGEDOB_3]
Instrument Variable Name: AGEPIC
Question Text:
Question Text:
[fill1: Are you/Would you say ALIAS is] [fill2: less than 1 year old/AGE3 years old?]
1 AGE=AGE3 (or less than 1 years old)
2 AGE=AGE4
3 Neither is correct
7 Refused
9 Don't know
2 AGE=AGE4
3 Neither is correct
7 Refused
9 Don't know
Universe Text: Able to narrow age to two options
Skip Instructions:
Skip Instructions:
(1,2) [goto INTWKCK1]
(3,R,D) if AGEDOB_1 = R, [goto AGEGES2]
elseif AGEDOB_1 = D, [goto AGEGES1_NUM]
(3,R,D) if AGEDOB_1 = R, [goto AGEGES2]
elseif AGEDOB_1 = D, [goto AGEGES1_NUM]
[p. 9]
Instrument Variable Name: AGEGES1_NUM
Question Text:
Question Text:
1 of 2
What is your best guess of [fill: your/ALIAS's] age?
*If the respondent gives a range of ages, enter "C" to continue to the screen that will compute an age.
*If the respondent does not know the age, enter your best estimate of the person's age.
What is your best guess of [fill: your/ALIAS's] age?
*If the respondent gives a range of ages, enter "C" to continue to the screen that will compute an age.
*If the respondent does not know the age, enter your best estimate of the person's age.
000-120 Age (number)
997 Refused
999 Don't know
C Compute from range
997 Refused
999 Don't know
C Compute from range
Universe Text: Age unknown and unable to narrow age down to two age choices and respondent did not refuse AGEDOB_1
Skip Instructions:
Skip Instructions:
(0-120) [goto AGEGES1_TP]
elseif outside range, [goto ERR_AGEGES1_NUM]
(C) [goto AGERNG_N1]
(R,D) [goto AGEGES2]
elseif outside range, [goto ERR_AGEGES1_NUM]
(C) [goto AGERNG_N1]
(R,D) [goto AGEGES2]
Instrument Variable Name: AGEGES1_TP
Question Text:
Question Text:
2 of 2
*Enter time period for age guess.
*Enter time period for age guess.
3 Month(s)
4 Year(s)
4 Year(s)
Universe Text: Valid age number
Skip Instructions:
Skip Instructions:
(3, 4) If AGEDOB_5 = D, [goto YEARPIC]
else [goto INTWKCK1]
else [goto INTWKCK1]
Instrument Variable Name: AGEGES2
Question Text:
Question Text:
Certain sections of this interview depend on knowing if a person is 18 years old or older.
Could you please tell me if [fill: you are/ALIAS is] at least 18 years old?
Could you please tell me if [fill: you are/ALIAS is] at least 18 years old?
1 Less than 18
2 18 or older
7 Refused
9 Don't know
2 18 or older
7 Refused
9 Don't know
Universe Text: (Age unknown and unable to narrow to two age choices and respondent refused or didn't know age at AGEDOB_1) or (Refused to or did not guess age)
Skip Instructions:
Skip Instructions:
(1) [goto LESS18]
(2,R,D) [goto GREAT18]
(2,R,D) [goto GREAT18]
[p. 10]
Instrument Variable Name: LESS18
Question Text:
Question Text:
*Enter your best estimate of [ALIAS's] age.
*Enter age "0" to 17
*Enter "0" if less than 1 year old.
*Enter age "0" to 17
*Enter "0" if less than 1 year old.
000 Less than one year old
001 lt 17 1 to 17 years of age
001 lt 17 1 to 17 years of age
Universe Text: Person estimated less than eighteen years of age
Skip Instructions:
Skip Instructions:
(0-17) [goto AGEDOB_1, to collect information about next person in roster]
else, [goto INTWKCK1]
else, [goto INTWKCK1]
Instrument Variable Name: GREAT18
Question Text:
Question Text:
*Enter your best estimate of [ALIAS's] age.
*Enter age 18 or greater.
*Enter age 18 or greater.
018-120 Age in years
Universe Text: Person estimated age (18 or older)
Skip Instructions:
Skip Instructions:
(18-120) [goto AGEDOB_1, to collect information about next person in roster]
else, [goto INTWKCK1]
else, [goto INTWKCK1]
Instrument Variable Name: AGERNG_N1
Question Text:
Question Text:
1 of 4
*Enter lower age of the range in months or years.
*Enter lower age of the range in months or years.
000-120 Age in years
Universe Text: Computing age when not given the year the subject was born or the subject's age.
Skip Instructions:
Skip Instructions:
(0-120) [goto AGERNG _T1]
Instrument Variable Name: AGERNG_T1
Question Text:
Question Text:
2 of 4
*Enter lower age time period.
*Enter lower age time period.
3 Month(s)
4 Year(s)
4 Year(s)
Universe Text: First age number has been entered for range.
Skip Instructions:
Skip Instructions:
goto AGERNG_N2
[p. 11]
Instrument Variable Name: AGERNG_N2
Question Text:
Question Text:
3 of 4
*Enter higher age of the range in months or years.
*Enter higher age of the range in months or years.
000-120 Age in years
Universe Text: First age number and time period has been entered for range.
Skip Instructions:
Skip Instructions:
(0-120) [goto AGERNG _T2]
Instrument Variable Name: AGERNG_T2
Question Text:
Question Text:
4 of 4
*Enter higher age time period.
*Enter higher age time period.
3 Month(s)
4 Year(s)
4 Year(s)
Universe Text: Second age number has been entered for range.
Skip Instructions:
Skip Instructions:
If LOWER gt HIGHER, [goto ERR_AGERNG_T2]
(3,4) if AGEDOB_5 = Don't know, [goto YEARPIC]
else, [goto INTWKCK1]
(3,4) if AGEDOB_5 = Don't know, [goto YEARPIC]
else, [goto INTWKCK1]
Instrument Variable Name: YEARPIC
Question Text:
Question Text:
Would you say that [fill: you were/ALIAS was] born in:
1 Low guess for year born
2 High guess for year born
3 Neither is correct
7 Refused
9 Don't know
2 High guess for year born
3 Neither is correct
7 Refused
9 Don't know
Universe Text: Person's age is known and birth year answered with 'don't know'
Skip Instructions:
Skip Instructions:
(1,2,3,R,D) [goto AGEDOB_1, to collect information about next person in roster]
else, [goto INTWKCK1]
else, [goto INTWKCK1]
[p. 12]
Instrument Variable Name: INTWKCK
Question Text:
Question Text:
Was [ALIAS] born on or after [STARTDATE]?
1 Yes
2 No
2 No
Universe Text: Child's age = 0 and date of birth not known
Skip Instructions:
Skip Instructions:
(1) [goto ERR_INTWKCK]
then, [goto AGEDOB_1 to collect information about next person in roster]
else, [goto NATOR]
(2) [goto AGEDOB_1 to collect information about next person in roster]
else, [goto NATOR]
then, [goto AGEDOB_1 to collect information about next person in roster]
else, [goto NATOR]
(2) [goto AGEDOB_1 to collect information about next person in roster]
else, [goto NATOR]
Instrument Variable Name: NATOR
Question Text:
Question Text:
(book) H1. [fill1: Do you/Does ALIAS] consider [fill2: yourself/himself/herself] to be Hispanic or Latino?
*Read if necessary.
Puerto Rican
Cuban/Cuban American
Dominican (Republic)
Mexican
Mexican American
Central or South American
Other Latin American
Other Hispanic/Latino
Where did [your/ALIAS's] ancestors come from?
Card H1
*Read if necessary.
Puerto Rican
Cuban/Cuban American
Dominican (Republic)
Mexican
Mexican American
Central or South American
Other Latin American
Other Hispanic/Latino
Where did [your/ALIAS's] ancestors come from?
You may choose more than one.
1. Puerto Rican
2. Cuban/Cuban American
3. Dominican (Republic)
4. Mexican
5. Mexican American
6. Central or South American
7. Other Latin American
8. Other Hispanic/Latino
2. Cuban/Cuban American
3. Dominican (Republic)
4. Mexican
5. Mexican American
6. Central or South American
7. Other Latin American
8. Other Hispanic/Latino
1 Yes
2 No
7 Refused
9 Don't know
2 No
7 Refused
9 Don't know
Universe Text: All nondeleted persons in parent cases or all nondeleted persons being added in spawn cases.
Skip Instructions:
Skip Instructions:
(1) [goto HISPAN]
(2,R,D) [goto NATOR for next person in roster]
else [goto RACE]
(2,R,D) [goto NATOR for next person in roster]
else [goto RACE]
[p. 13]
Instrument Variable Name: HISPAN
Question Text:
Question Text:
(book) H1
Please give me the number of the group that represents [fill: your/ ALIAS's] Hispanic origin or ancestry.
You may choose up to five (5), if applicable.
*If a nonhispanic group is named, backup to previous screen and change the answer from "yes" to "no".
Enter all that apply, separate with commas.
Please give me the number of the group that represents [fill: your/ ALIAS's] Hispanic origin or ancestry.
You may choose up to five (5), if applicable.
*If a nonhispanic group is named, backup to previous screen and change the answer from "yes" to "no".
Enter all that apply, separate with commas.
01 Puerto Rican
02 Cuban/Cuban American
03 Dominican (Republic)
04 Mexican
05 Mexican American
06 Central or South American
07 Other Latin American
08 Other Hispanic/Latino/Spanish
97 Refused
99 Don't know
Card H1
02 Cuban/Cuban American
03 Dominican (Republic)
04 Mexican
05 Mexican American
06 Central or South American
07 Other Latin American
08 Other Hispanic/Latino/Spanish
97 Refused
99 Don't know
You may choose more than one.
1. Puerto Rican
2. Cuban/Cuban American
3. Dominican (Republic)
4. Mexican
5. Mexican American
6. Central or South American
7. Other Latin American
8. Other Hispanic/Latino
2. Cuban/Cuban American
3. Dominican (Republic)
4. Mexican
5. Mexican American
6. Central or South American
7. Other Latin American
8. Other Hispanic/Latino
Universe Text: National origin was answered yes to being Hispanic or Latino
Skip Instructions:
Skip Instructions:
(1-6) [goto NATOR (for the next person)] else [goto RACE]
(7) [goto HIS_SP2]
(8) [goto HIS_SP3]
(7) [goto HIS_SP2]
(8) [goto HIS_SP3]
Instrument Variable Name: HIS_SP2
Question Text:
Question Text:
*Probe for the country.
*If any of the following are mentioned, backup to previous screen and correct the entry.
Puerto Rican
Cuban/Cuban American
Dominican (Republic)
Mexican
Mexican American
Central or South American (REFER TO HELP SCREEN)
*(F1) For a list of Central or South American countries.
*Specify the other Latin American.
*If any of the following are mentioned, backup to previous screen and correct the entry.
Puerto Rican
Cuban/Cuban American
Dominican (Republic)
Mexican
Mexican American
Central or South American (REFER TO HELP SCREEN)
*(F1) For a list of Central or South American countries.
*Specify the other Latin American.
Universe Text: HISPAN answered from selection 7 for Hispanic origin.
Skip Instructions:
Skip Instructions:
(allow 30) [goto NATOR (for the next person)]
else [goto RACE]
else [goto RACE]
[p. 14]
Instrument Variable Name: HIS_SP3
Question Text:
Question Text:
*Probe for the country.
*If any of the following are mentioned, backup to previous screen and correct the entry.
Puerto Rican
Cuban/Cuban American
Dominican (Republic)
Mexican
Mexican American
Central or South American (REFER TO HELP SCREEN)
*(F1) For a list of Central or South American countries.
*Specify the other Hispanic/Latino.
*If any of the following are mentioned, backup to previous screen and correct the entry.
Puerto Rican
Cuban/Cuban American
Dominican (Republic)
Mexican
Mexican American
Central or South American (REFER TO HELP SCREEN)
*(F1) For a list of Central or South American countries.
*Specify the other Hispanic/Latino.
Universe Text: HISPAN answer from selection 8 (other Hispanic/Latino) origi
Skip Instructions:
Skip Instructions:
(allow 30) [goto NATOR (for the next person)]
else [goto RACE]
else [goto RACE]
[p. 15]
Instrument Variable Name: RACE
Question Text:
Question Text:
(Book) H2
What race or races [fill1: Do you/Does ALIAS] consider [fill2: yourself/himself/herself] to be? Please select 1 or more of these categories.
*Enter all that apply, separate with commas.
What race or races [fill1: Do you/Does ALIAS] consider [fill2: yourself/himself/herself] to be? Please select 1 or more of these categories.
*Enter all that apply, separate with commas.
01 White
02 Black/African American
03 Indian (American)
04 Alaska Native
05 Native Hawaiin
06 Guamanian
07 Samoan
08 Other Pacific Islander
09 Asian Indian
10 Chinese
11 Filipino
12 Japanese
13 Korean
14 Vietnamese
15 Other Asian
16 Some other race
97 Refused
99 Don't know
Card H2
02 Black/African American
03 Indian (American)
04 Alaska Native
05 Native Hawaiin
06 Guamanian
07 Samoan
08 Other Pacific Islander
09 Asian Indian
10 Chinese
11 Filipino
12 Japanese
13 Korean
14 Vietnamese
15 Other Asian
16 Some other race
97 Refused
99 Don't know
You may choose more than one.
1. White
2. Black/African American
3. Indian (American)
4. Alaska Native
5. Native Hawaiian
6. Guamanian
7. Samoan
8. Other Pacific Islander
9. Asian Indian
10. Chinese
11. Filipino
12. Japanese
13. Korean
14. Vietnamese
15. Other Asian
2. Black/African American
3. Indian (American)
4. Alaska Native
5. Native Hawaiian
6. Guamanian
7. Samoan
8. Other Pacific Islander
9. Asian Indian
10. Chinese
11. Filipino
12. Japanese
13. Korean
14. Vietnamese
15. Other Asian
Universe Text: All nondeleted persons in parent cases or all nondeleted persons being added in spawn cases.
Skip Instructions:
Skip Instructions:
(1-7, 9-14) If more than one selected, [goto MLTRAC, then goto RACE for next person in roster]
else [goto NOWAF_A]
(8) [goto RAC_SP1]
(15) [goto RAC_SP2]
(16) [goto RAC_SP3]
(R,D) [goto RACE, for the next person in roster]
else [goto NOWAF_A]
else [goto NOWAF_A]
(8) [goto RAC_SP1]
(15) [goto RAC_SP2]
(16) [goto RAC_SP3]
(R,D) [goto RACE, for the next person in roster]
else [goto NOWAF_A]
[p. 16]
Instrument Variable Name: RAC_SP1
Question Text:
Question Text:
*Specify the other pacific islander.
REM *If any of the following are mentioned, go back to RACE screen to correct.
*If the respondent's answer could not be found, clear entry, type 'ZZ'.
White
Black/African American
Indian (American)
Alaska Native
Native Hawaiian
Guamanian
Samoan
Asian Indian
Chinese
Filipino
Japanese
Korean
Vietnamese
*If the respondent's answer could not be found, type 'ZZ' to enable you to type an entry.
REM *If any of the following are mentioned, go back to RACE screen to correct.
*If the respondent's answer could not be found, clear entry, type 'ZZ'.
White
Black/African American
Indian (American)
Alaska Native
Native Hawaiian
Guamanian
Samoan
Asian Indian
Chinese
Filipino
Japanese
Korean
Vietnamese
*If the respondent's answer could not be found, type 'ZZ' to enable you to type an entry.
Universe Text: RACE= 8 (other Pacific Islander)
Skip Instructions:
Skip Instructions:
(allow 30) If more than one selected, [goto MLTRAC]
If 'ZZ' entered [goto RAC_SP1A]
then [goto RACE for next person on the roster]
else [goto NOWAF_A]
If 'ZZ' entered [goto RAC_SP1A]
then [goto RACE for next person on the roster]
else [goto NOWAF_A]
HHC.212_00.000
Instrument Variable Name: RAC_SP2
Question Text:
Question Text:
*Specify the other Asian.
*If any of the following are mentioned, backup to previous item and correct the entry.
White
Black/African American
Indian (American)
Alaska Native
Native Hawaiian
uamanian
Samoan
Asian Indian
Chinese
Filipino
Japanese
Korean
Vietnamese
*If the respondent's answer could not be found, type 'ZZ' to enable you to type an entry.
*If any of the following are mentioned, backup to previous item and correct the entry.
White
Black/African American
Indian (American)
Alaska Native
Native Hawaiian
uamanian
Samoan
Asian Indian
Chinese
Filipino
Japanese
Korean
Vietnamese
*If the respondent's answer could not be found, type 'ZZ' to enable you to type an entry.
Universe Text: RACE = other Asian listed
Skip Instructions:
Skip Instructions:
(allow 30) If more than one selected [goto MLTRAC]
then [goto RACE] for next person on the roster
else [goto NOWAF_A]
then [goto RACE] for next person on the roster
else [goto NOWAF_A]
HHC.214_00.000
Instrument Variable Name: RAC_SP3
Question Text:
Question Text:
*Specify the other race.
*If any of the following are mentioned, backup to previous item and correct the entry.
White
Black/African American
Indian (American)
Alaska Native
Native Hawaiian
Guamanian
Samoan
Asian Indian
Chinese
Filipino
Japanese
Korean
Vietnamese
*If the respondent's answer could not be found, type 'ZZ' to enable you to type an entry.
*If any of the following are mentioned, backup to previous item and correct the entry.
White
Black/African American
Indian (American)
Alaska Native
Native Hawaiian
Guamanian
Samoan
Asian Indian
Chinese
Filipino
Japanese
Korean
Vietnamese
*If the respondent's answer could not be found, type 'ZZ' to enable you to type an entry.
Universe Text: RACE answered some other race.
Skip Instructions:
Skip Instructions:
(30 chars long) If more than one selected [goto MLTRAC] then [goto RACE] for next person on the roster
Else [goto NOWAF_A ]
Else [goto NOWAF_A ]
HHC.220_00.000
Instrument Variable Name: MLTRAC
Question Text:
Question Text:
Which one of these groups, that is [Read Groups] would you say BEST represents [fill: your/ALIAS's] race?
01 White
02 Black/African American
03 Indian (American)
04 Alaska Native
05 Native Hawaiian
06 Guamanian
07 Samoan
08 Other Pacific Islander
09 Asian Indian
10 Chinese
11 Filipino
12 Japanese
13 Korean
14 Vietnamese
15 Other Asian
16 Other Race
97 Refused
99 Don't know
02 Black/African American
03 Indian (American)
04 Alaska Native
05 Native Hawaiian
06 Guamanian
07 Samoan
08 Other Pacific Islander
09 Asian Indian
10 Chinese
11 Filipino
12 Japanese
13 Korean
14 Vietnamese
15 Other Asian
16 Other Race
97 Refused
99 Don't know
Universe Text: More than on race entered
Skip Instructions:
Skip Instructions:
(1-16,R,D) [goto NOWAF_A]
else, [goto ERR_MLTRAC]
else, [goto ERR_MLTRAC]
[p. 18]
Instrument Variable Name: NOWAF_A
Question Text:
Question Text:
[fill: Is anyone in the household/Are you/Is ALIAS] now on full-time active duty with the Armed Forces?
[display eligible persons]
[display eligible persons]
1 Yes
2 No
7 Refused
9 Don't know
2 No
7 Refused
9 Don't know
Universe Text: If household contains 1 or more persons 18-64 years old
Skip Instructions:
Skip Instructions:
If no person eq (18-64) years of age [goto EXIT]
( 2,R,D) if POS2 or POS3 ne 0, [goto ADC]
else [goto HHREF_A]
if NOWAF_A eq (1) and ADULTCNT eq (1) [goto EXIT]
else [goto NOWAF2_B]
( 2,R,D) if POS2 or POS3 ne 0, [goto ADC]
else [goto HHREF_A]
if NOWAF_A eq (1) and ADULTCNT eq (1) [goto EXIT]
else [goto NOWAF2_B]
Instrument Variable Name: NOWAF2_B
Question Text:
Question Text:
Who is this? (Anyone else)
*Enter line numbers as appropriate.
*Enter all that apply, separate with commas.
*Enter line numbers as appropriate.
*Enter all that apply, separate with commas.
1 Armed Forces
2 Not Armed Forces
7 Refused
2 Not Armed Forces
7 Refused
Universe Text: At least 1 person in the AF and more than 1 person eligible to be in the AF
Skip Instructions:
Skip Instructions:
(1-25) if all PX have HHSTAT = D or HHSTAT3 = A [goto EXIT]
elseif POS2 and POS3 ne 0 [goto ADC]
else [goto HHREF_A]
Invalid person # selected [goto ERR_NOWAF2_B]
elseif POS2 and POS3 ne 0 [goto ADC]
else [goto HHREF_A]
Invalid person # selected [goto ERR_NOWAF2_B]
Instrument Variable Name: EXIT
Question Text:
Question Text:
Not every household in our survey is asked all questions. I have all the information about your household that I need at this time. Thank you for your assistance.
*Enter (1) to proceed.
*Enter (1) to proceed.
1 Proceed
Universe Text: All persons are in the Armed Forces or everybody is either deleted or in the AF or All non-Armed Forces persons are not Black or Hispanic and not marked for an interview
Skip Instructions:
Skip Instructions:
(1) [goto VISITCNT]
[p. 19]
Instrument Variable Name: HHREF_A
Question Text:
Question Text:
*[fill: You have/ALIAS has] has been selected as the household reference person. Is this household member an appropriate choice? Preferably a civilian adult?
[Display all non-deleted household members ge 14 years of age]
*Press shift F1 to see full roster information.
[Display all non-deleted household members ge 14 years of age]
*Press shift F1 to see full roster information.
1 Yes
2 No
2 No
Universe Text: If more than one non-deleted person in the HH
Skip Instructions:
Skip Instructions:
(1) [goto RPREL]
(2) [goto HHREF_B]
(2) [goto HHREF_B]
[p. 20]
Instrument Variable Name: RPREL
Question Text:
Question Text:
(book) H3.
What is [fill1: your/ALIAS's] relationship to [fill2: Reference Person's name/you]
What is [fill1: your/ALIAS's] relationship to [fill2: Reference Person's name/you]
01 Household reference person
02 Spouse (husband/wife)
03 Unmarried Partner
04 Child (biological/adoptive/in-law/step/foster)
05 Child of partner
06 Grandchild
07 Parent (biological/adoptive/in-law/step/foster)
08 Brother/sister (biological/adoptive/in-law/step/foster)
09 Grandparent (Grandmother/Grandfather)
10 Aunt/Uncle
11 Niece/Nephew
12 Other relative
13 Housemate/roommate
14 Roomer/Boarder
15 Other nonrelative
16 Legal guardian
17 Ward
97 Refused
99 Don't know
Card H302 Spouse (husband/wife)
03 Unmarried Partner
04 Child (biological/adoptive/in-law/step/foster)
05 Child of partner
06 Grandchild
07 Parent (biological/adoptive/in-law/step/foster)
08 Brother/sister (biological/adoptive/in-law/step/foster)
09 Grandparent (Grandmother/Grandfather)
10 Aunt/Uncle
11 Niece/Nephew
12 Other relative
13 Housemate/roommate
14 Roomer/Boarder
15 Other nonrelative
16 Legal guardian
17 Ward
97 Refused
99 Don't know
2. Spouse (husband/wife)
3. Unmarried Partner
4. Child (biological/adoptive/in-law/step/foster)
5. Child of Partner
6. Grandchild
7. Parent (biological/adoptive/in-law/step/foster)
8. Brother/Sister (biological/adoptive/in-law/step/foster)
9. Grandparent (Grandmother/Grandfather)
10. Aunt/Uncle
11. Niece/Nephew
12. Other relative
13. Housemate/Roommate
14. Roomer/Boarder
15. Other nonrelative
16. Legal Guardian
17. Ward
3. Unmarried Partner
4. Child (biological/adoptive/in-law/step/foster)
5. Child of Partner
6. Grandchild
7. Parent (biological/adoptive/in-law/step/foster)
8. Brother/Sister (biological/adoptive/in-law/step/foster)
9. Grandparent (Grandmother/Grandfather)
10. Aunt/Uncle
11. Niece/Nephew
12. Other relative
13. Housemate/Roommate
14. Roomer/Boarder
15. Other nonrelative
16. Legal Guardian
17. Ward
Universe Text: All where RPREL NE Reference Person
Skip Instructions:
Skip Instructions:
Loop through all non-deleted PX
(2, 3) if selected for more than one PX [goto ERR4_RPREL]
elseif AGE lt 14 [goto ERR1_RPREL]
(4) [goto DEGREE1]
(5) if loop is completed and no PX has RPREL = 3 [goto ERR5_RPREL] endif
(6) if AGEDIFF lt 25 [goto ERR2_RPREL] endif
(7) [goto DEGREE2]
(8) [goto DEGREE3]
(9) if AGEDIFF lt 25 [goto ERR3_RPREL] endif
(10-17,R,D) end loop
if UNRELTAL gt 1 [GOTO FAMNUM]
else [goto HHCHANGE]
(2, 3) if selected for more than one PX [goto ERR4_RPREL]
elseif AGE lt 14 [goto ERR1_RPREL]
(4) [goto DEGREE1]
(5) if loop is completed and no PX has RPREL = 3 [goto ERR5_RPREL] endif
(6) if AGEDIFF lt 25 [goto ERR2_RPREL] endif
(7) [goto DEGREE2]
(8) [goto DEGREE3]
(9) if AGEDIFF lt 25 [goto ERR3_RPREL] endif
(10-17,R,D) end loop
if UNRELTAL gt 1 [GOTO FAMNUM]
else [goto HHCHANGE]
[p. 21]
Instrument Variable Name: DEGREE1
Question Text:
Question Text:
[fill1: Are you/Is ALIAS] [fill2: Reference Person's name's/your] biological (natural), adoptive, step, or foster [fill3: son/daughter] or [fill4: son/daughter]-in-law?
1 Biological (natural) {son/daughter]
2 Adoptive {son/daughter}
3 Step {son/daughter]
4 Foster {son/daughter}
5 {son/daughter]-in-law
7 Refused Refused
9 Don't know
2 Adoptive {son/daughter}
3 Step {son/daughter]
4 Foster {son/daughter}
5 {son/daughter]-in-law
7 Refused Refused
9 Don't know
Universe Text: RPREL=(4) child
Skip Instructions:
Skip Instructions:
(1) if AGEDIFF lt 12 [goto ERR1_DEGREE1]
else [goto RPREL]
(2-5,R,D) [goto RPREL]
else [goto RPREL]
(2-5,R,D) [goto RPREL]
Instrument Variable Name: DEGREE2
Question Text:
Question Text:
[fill1: Are you/Is ALIAS] [fill2: Reference Person's name's/your] biological (natural), adoptive, step, or foster [fill3: mother/father] or [fill4: mother/father]-in-law?
1 Biological (natural) {mother/father]
2 Adoptive {mother/father}
3 Step {mother/father]
4 Foster {mother/father}
5 {mother/father]-in-law
7 Refused
9 Don't know
2 Adoptive {mother/father}
3 Step {mother/father]
4 Foster {mother/father}
5 {mother/father]-in-law
7 Refused
9 Don't know
Universe Text: RPREL=(7) parent
Skip Instructions:
Skip Instructions:
(1) if AGEDIFF lt 12 [goto ERR_DEGREE2]
elseif additional PX's remain [goto RPREL]
elseif UNRELTAL gt 1 [goto FAMNUM]
else [goto HHCHANGE]
(2-5,R,D) if additional PX's remain [goto RPREL]
elseif UNRELTAL gt 1 [goto FAMNUM]
else [goto HHCHANGE]
elseif additional PX's remain [goto RPREL]
elseif UNRELTAL gt 1 [goto FAMNUM]
else [goto HHCHANGE]
(2-5,R,D) if additional PX's remain [goto RPREL]
elseif UNRELTAL gt 1 [goto FAMNUM]
else [goto HHCHANGE]
[p. 22]
Instrument Variable Name: DEGREE3
Question Text:
Question Text:
[fill1: Are you/Is ALIAS] [fill2: Reference Person's name's/your] full, half, adoptive, step, or foster [fill3: brother/sister] or [fill4: brother/sister]-in-law?
1 Full {brother/sister}
2 Half {brother/sister}
3 Adopted {brother/sister}
4 Step {brother/sister]
5 Foster {brother/sister}
6 {brother/sister]-in-law
7 Refused
9 Don't know
2 Half {brother/sister}
3 Adopted {brother/sister}
4 Step {brother/sister]
5 Foster {brother/sister}
6 {brother/sister]-in-law
7 Refused
9 Don't know
Universe Text: All siblings
Skip Instructions:
Skip Instructions:
(1-6,R,D) [goto RPREL]
Instrument Variable Name: HHRESP
Question Text:
Question Text:
*Ask if necessary
With whom am I speaking?
*Enter the line number of the respondent. If more than one, enter the number of the one you consider to be the main respondent.
With whom am I speaking?
*Enter the line number of the respondent. If more than one, enter the number of the one you consider to be the main respondent.
Universe Text: All households with more than one nondeleted person in parent cases or more than one nondeleted person in spawn cases and no household/family demographic respondent identified yet.
Skip Instructions:
Skip Instructions:
(1-25)
If deleted PX [goto ERR1_HHRESP]
elseif out of bound [goto ERR2_HHRESP]
elseif ADC = 1 [goto HHREF_A]
else [goto SEX]
If deleted PX [goto ERR1_HHRESP]
elseif out of bound [goto ERR2_HHRESP]
elseif ADC = 1 [goto HHREF_A]
else [goto SEX]
[p. 1]
2004 NHIS Questionnaire -- Recontact
Recontact
Instrument Variable Name: TELCEL
Question Text:
Question Text:
Does anyone in your family have a working cellular telephone?
1 Yes
2 No
7 Refused
9 Don't know
2 No
7 Refused
9 Don't know
Universe Text: All responding families
Skip Instructions:
Skip Instructions:
(1) [goto WRKCEL]
(2, R,D) if TELENUM = N orTELECHG = R,D [goto RNOSERV]
else if TELECHK = 1,R,D or TELECHG ne R,D,empty [goto TELDIRC]
(2, R,D) if TELENUM = N orTELECHG = R,D [goto RNOSERV]
else if TELECHK = 1,R,D or TELECHG ne R,D,empty [goto TELDIRC]
Instrument Variable Name: WRKCEL
Question Text:
Question Text:
How many working cellular telephones do people in your family have?
01-10 1-10
97 Refused
99 Don't know
97 Refused
99 Don't know
Universe Text: Responding families with a working cellular telephone
Skip Instructions:
Skip Instructions:
(1-10,R,D) if TELECHG = R,D or TELENUM = N [goto CURWRK]
else if TELECHK = 1,R,D or TELECHG ne R,D,empty [goto VCELNUM]
else if TELECHK = 1,R,D or TELECHG ne R,D,empty [goto VCELNUM]
Instrument Variable Name: VCELNUM
Question Text:
Question Text:
Is [fill1: Telephone number given previously] the telephone number for [fill2: the cellular phone/one of the cellular phones]?
1 Yes
2 No
7 Refused
9 Don't know
2 No
7 Refused
9 Don't know
Universe Text: Families who report number of cellular phones or who refuse or don't know number of cellular phones, and have given a valid phone number
Skip Instructions:
Skip Instructions:
(1,R,D) [goto CURWRK]
(2) [goto TELDIRC]
(2) [goto TELDIRC]
[p. 2]
Instrument Variable Name: CURWRK
Question Text:
Question Text:
Is there at least one telephone INSIDE your home that is currently working and is not a cellular telephone?
1 Yes
2 No
7 Refused
9 Don't know
2 No
7 Refused
9 Don't know
Universe Text: Families who report their home phone number as (one of) their cellular phone number, or who refuse or don't know this information
Skip Instructions:
Skip Instructions:
(1) if TELECHK = 1,R,D or TELECHG ne R,D,empty [goto TELHOME]
elseif TELENUM = N or TELECHG = R,D [goto RNOSERV]
(2, Refused, Don't know) goto RNOSERV
elseif TELENUM = N or TELECHG = R,D [goto RNOSERV]
(2, Refused, Don't know) goto RNOSERV
Instrument Variable Name: TELHOME
Question Text:
Question Text:
What is the telephone number for your home telephone?
*Read if necessary.
Home telephone refers to the phone that is not your cellular phone.
*Read if necessary.
Home telephone refers to the phone that is not your cellular phone.
2000000000-9999999996 Telephone number
9999999997 Refused
9999999999 Don't know
9999999997 Refused
9999999999 Don't know
Universe Text: Families with at least one cellular phone and have a working telephone that is not a cellular phone
Skip Instructions:
Skip Instructions:
(2000000000 - 9999999999) [goto TELDIRC]
(R,D) [goto RNOSERV]
(0 - 1999999999) [goto ERR_TELHOME]
(R,D) [goto RNOSERV]
(0 - 1999999999) [goto ERR_TELHOME]
Instrument Variable Name: TELDIRC
Question Text:
Question Text:
[fill: Is the number just mentioned listed in the telephone directory?/Is this phone number listed in the telephone directory?]
1 Yes
2 No
7 Refused
9 Don't know
2 No
7 Refused
9 Don't know
Universe Text: Families with no cellular phone but who have a home phone or who have a cellular phone, but its number was not the phone number given previously as the home phone number or who have a valid phone number for a home phone that is currently working and is not a cellular phone
Skip Instructions:
Skip Instructions:
(1) [goto TELST]
(2,R,D) [goto RNOSERV]
(2,R,D) [goto RNOSERV]
[p. 3]
Instrument Variable Name: RNOSERV
Question Text:
Question Text:
Not including cellular telephones, has your family been without telephone service for more than one week during the past 12 months?
1 Yes
2 No
7 Refused
9 Don't know
2 No
7 Refused
9 Don't know
Universe Text: All responding familes
Skip Instructions:
Skip Instructions:
(1,2,R,D) goto MOVE
hh